Blekingesjukhuset

Yearly 16 000 osteoporosis related hip fractures occur in Sweden. They cause suffering for patients and high costs for society. Subsequent fractures can be reduced with osteoporosis diagnostics and treatment. 4 322 patients from two hospitals using Fracture Liaisson Services in Sweden were included to identify the rate of osteoporosis diagnostics and treatment during the first year after a hip fracture. Data between 2010-01-01 and 2018-12-31 were included from the Swedish National Hip Fracture Registry (Rikshöft). 99.2 % of all patients underwent FRAX risk assessment and DEXA was conducted on 17.3 % of patients. Women were more frequently examined with DEXA than men (21% vs 10.2 %). 6% received medical osteoporosis treatment after the fracture, women were treated more often than men (7% vs 4%). Conclusions: less than 10% received drug therapy after the first year after the hip fracture. Men underwent diagnostics and received treatment at a lower rate than women.

Prosody can be described as the rhythmic, dynamic, and melodic aspects of language. Swedish has a relatively complex prosodic system compared to, for example, English. A large percentage of Swedish children with language impairment show prosodic problems to some extent. In the present study, non-word repetition was used to assess the phonological and prosodic abilities in children with phonological language impairment and children with phonological-grammatical language impairment. In the study, 10 children with phonological language impairment and 14 children with phonological-grammatical language impairment from 4;3 to 6;2 years of age participated. All children heard the same recorded non-words and words. The group with phonological language impairment received higher scores in all variables, compared to the group with phonological-grammatical language impairment. The results showed significant differences between the groups regarding production of vowels correct in words and production of phonemes correct in non-words as well as production of unstressed syllables in non-words and production of correct stress in non-words. Percent correctly produced vowels in words, but not in non-words, correlated significantly with grammatical ability.

For investigation of chemical exposure in allergic individuals, spot tests are invaluable. A reagent may react with a specific compound to give a specific typical colour, and thus indicate the presence of the specific substance. Spot tests can give both false-negative and false-positive reactions. To confirm the presence of the substance and quantify it, more sophisticated methods are required. On the basis of a positive cobalt spot test result, a woman was initially diagnosed with an occupational allergic contact dermatitis caused by cobalt. To investigate cobalt release from three different metal weaves to which our patient was occupationally exposed. The cobalt gel test and atomic absorption spectroscopy (AAS) were used to investigate the metal weaves. Two types of extract based on artificial sweat and nitric acid, respectively, were investigated with AAS. No cobalt release was demonstrated with AAS. When a diagnosis of allergic contact dermatitis caused by a sensitizer based on a positive spot test result will have far-reaching consequences, such as change of work, retraining, and claim on and payment of worker's compensation, conformational analysis must be performed.

624 Background: The dual antiHER2 blockade has been shown promising results in patients with HER2-positive breast cancer. Whether this treatment strategy jeopardizes the risk for cardiac adverse events is unclear. We conducted a meta-analysis of randomized trials to investigate the risk of cardiac adverse events when a combination of anti-HER2 therapies is used. Methods: We searched Medline, the Cochrane library, as long as the electronic abstract databases of the major international congresses’ proceedings to identify randomized trials that evaluated the administration of anti-HER2 monotherapy (lapatinib or trastuzumab or pertuzumab) versus anti-HER2 combination therapy with or without chemotherapy in breast cancer. Study outcomes were the congestive heart failure (CHF) grade >/= 3 and left ventricular ejection fraction (LVEF) decline < 50% or more than 10% from baseline. We calculated pooled odds ratios (ORs) and 95% Confidence Intervals (CI) with the Peto method. Results: Six trials were considered eligible. Overall incidence results for CHF in the combined antiHER2 therapy and the antiHER2 monotherapy were 0.88 % (95% CI: 0.47% - 1.64%) and 1.49 % (95% CI: 0.98% - 2.23%). The incidence of LVEF decline was 3.1 % (95% CI: 2.2% – 4.4%) and 2.9% (95% CI: 2.1% - 4.1%) respectively. The OR of CHF was 0.58 (95% CI: 0.26-1.27, p-value= 0.17) while the OR of LVEF decline was 0.88 (95% CI: 0.53-1.48, p-value= 0.64). In subgroup analyses, there were no significant differences in CHF or LVEF decline among different treatment settings or types of antiHER2 therapy. Conclusions: This meta-analysis offers substantial randomized evidence from trials with well-defined cardiac evaluations that a dual anti-HER2 therapeutic approach does not increase the risk for cardiac toxicity.

Background and purpose MRI is the modality of choice when diagnosing spinal stenosis but it also shows that stenosis is prevalent in asymptomatic subjects over 60. The relationship between preoperative health-related quality of life, functional status, leg and back pain, and the objectively measured dural sac area in single and multilevel stenosis is unknown. We assessed this relationship in a prospective study.Patients and methods The cohort included 109 consecutive patients with central spinal stenosis operated on with decompressive laminectomy or laminotomy. Preoperatively, all patients completed the questionnaires for EQ-5D, SF-36, Oswestry disability index (ODI), estimated walking distance and leg and back pain (VAS). The cross-sectional area of the dural sac was measured at relevant disc levels in mm2, and spondylolisthesis was measured in mm. For comparison, the area of the most narrow level, the number of levels with dural sac area < 70 mm2, and spondylolisthesis were studied.Results Before surger...

Perioperativ dodlighet minskar i USA. Men centralisering ger inte hela forklaringen : [Decreasing perioperative mortality in USA. Centralization is not the whole explanation]