Primary care patients with mild or stable chronic obstructive pulmonary disease need more support in disease management: a secondary analysis of a cluster randomized controlled trial.

Objective: Patient education based on the patient's individual needs and circumstances is known to be associated with positive changes in clinical outcomes in chronic obstructive pulmonary disease (COPD). We aimed to assess the levels of patients' subjective needs for information about COPD before and after their general practitioners had taken part in a COPD education.

Design: A secondary analysis of a cluster randomized controlled trial.

Patient outcomes following GPs' educations about COPD: a cluster randomized controlled trial.

This study aimed to compare patient outcomes following case method learning and traditional lectures as methods for continuing medical education (CME) about chronic obstructive pulmonary disease (COPD) for general practitioners (GPs) in Sweden. In a pragmatic cluster randomized controlled trial, COPD patients (n = 425; case method group n = 209, traditional lectures group n = 216) from 24 primary health care centers replied to questionnaires prior to and 18 months after a 2 × 2-h CME was given to GPs (n = 255). We measured changes in the scores of the Clinical COPD Questionnaire (CCQ), symptoms, needs for disease information, exacerbations, smoking, and use of pulmonary rehabilitation.

COPD patients need more information about self-management: a cross-sectional study in Swedish primary care.

In Sweden, patients with chronic conditions, such as chronic obstructive pulmonary disease (COPD), often receive education at specialized nurse-led clinics at primary health care centers (PHCCs). Identifying patients' needs for information about COPD is the key to individualized care. This study aimed to assess self-reported needs for information about COPD in primary care patients with either moderate (GOLD 2) or severe (GOLD 3) COPD and identify patient characteristics and exacerbation patterns associated with the findings.

Feasibility of referral to a therapist for assessment of psychiatric problems in primary care - an interview study.

Background: Depression and anxiety disorders are common in primary care. Comorbidities are frequent, and the diagnoses can be difficult. The Mini-International Neuropsychiatric Interview (MINI) can be a support in the clinical examination of patients with complex problems.

Effectiveness of traditional lectures and case methods in Swedish general practitioners' continuing medical education about COPD: a cluster randomised controlled trial.

Objectives: To study the effects of continuing medical education (CME) about chronic obstructive pulmonary disease (COPD) for general practitioners (GPs) by comparing two commonly used CME methods with each other and no CME (reference group).

Design: A pragmatic cluster randomised controlled trial with primary healthcare centres (PHCCs) as units of randomisation.

Setting, Participants And Interventions: 24 PHCCs in Stockholm County, Sweden, were randomised into two CME intervention arms: case method learning (CM) (n=12) and traditional lectures (TL) (n=12).

The Mini-International Neuropsychiatric Interview is useful and well accepted as part of the clinical assessment for depression and anxiety in primary care: a mixed-methods study.

Background: Psychiatric complaints are common among primary care patients, with depression and anxiety being the most frequent. Diagnosis of anxiety and depression can be difficult, potentially leading to over- as well as under-diagnosis. The diagnostic process can be facilitated by incorporating structured interviews as part of the assessment.

COPD management by Swedish general practitioners - baseline results of the PRIMAIR study.

Background: Chronic obstructive pulmonary disease (COPD) is a common cause of suffering and death. Evidence-based management of COPD by general practitioners (GPs) is crucial for decreasing the impact of the disease. Efficient strategies include early diagnosis, smoking cessation and multimodal treatment.

The Effect of Abaloparatide-SC on Fracture Risk Is Independent of Baseline FRAX Fracture Probability: A Post Hoc Analysis of the ACTIVE Study.

Daily subcutaneous (SC) injections of the investigational drug abaloparatide-SC (80 mcg) for 18 months significantly decrease the risk of vertebral and nonvertebral fracture compared with placebo in postmenopausal women. We examined the efficacy of abaloparatide-SC as a function of baseline fracture risk, assessed using the FRAX tool. Baseline clinical risk factors (age, body mass index [BMI], prior fracture, glucocorticoid use, rheumatoid arthritis, and smoking) were entered into country-specific FRAX models to calculate the 10-year probability of major osteoporotic fractures, with or without femoral neck bone mineral density (BMD).

Case Method in COPD education for primary care physicians: study protocol for a cluster randomised controlled trial.

Background: Chronic obstructive pulmonary disease (COPD) is a common cause of morbidity and mortality worldwide. It is often undiagnosed and insufficiently managed. Effective forms of continuing medical education (CME) for primary care physicians (PCPs) are necessary to ensure the implementation of guidelines in clinical practice and, thus, improve patients' health.

Time pressured deprioritization of COPD in primary care: a qualitative study.

Objective: To identify factors that hinder discussions regarding chronic obstructive pulmonary disease (COPD) between primary care physicians (PCPs) and their patients in Sweden.

Setting: Primary health care centres (PHCCs) in Stockholm, Sweden.

Subjects: A total of 59 PCPs.

A preventive effect of unfractionated heparin on post-ERCP pancreatitis is suggested by positive effects on laboratory markers.

Background/aims: Heparin has anti-inflammatory properties. Serum tests after ERCP might serve as surrogate markers for inflammatory reactions. The aims were to study effects of low-dose unfractionated heparin on post-ERCP laboratory tests and on safety.

Family physicians' experiences when collaborating with district nurses in home care-based medical treatment. A grounded theory study.

Background: This article concerns Swedish family physicians' (FPs) experiences collaborating with district nurses (DNs) when the DNs provide medical treatment for home care patients. The aim was to develop a model to illuminate this process from the FPs' perspective.

Methods: Semi-structured interviews were conducted with 13 FPs concerning one of their patients with home care by a DN.

Experience with an electronic brachytherapy technique for intracavitary accelerated partial breast irradiation.

Objectives: Phase IV study evaluated the safety and device performance of an electronic brachytherapy system (Axxent Electronic Brachytherapy System) as adjuvant therapy for early-stage breast cancer.

Methods: Patients were > or =50 years of age and had completely resected invasive ductal carcinoma or ductal carcinoma in situ (<2.0 cm), with N0 M0 and negative microscopic margins of > or =1 mm.

Family physicians' effort to stay in charge of the medical treatment when patients have home care by district nurses. A grounded theory study.

Background: District nurses (DNs) provide home care for old persons with a mixture of chronic diseases, symptoms and reduced functional ability. Family physicians (FPs) have been criticised for their lack of involvement in this care. The aim of this study was to obtain increased knowledge concerning the FP's experience of providing medical treatment for patients with home care provided by DNs by developing a theoretical model that elucidates how FPs handle the problems they encounter regarding the individual patients and their conditions.

Does esomeprazole prevent post-operative nausea and vomiting?

Background: Esomeprazole is a potent proton pump inhibitor (PPI), reducing acid production as well as gastric juice volume. This study evaluated the possible beneficial effect of esomeprazole on reducing post-operative nausea and vomiting (PONV).

Methods: Patients undergoing laparoscopic or open gynaecological surgery, or laparoscopic cholecystectomy were randomized to receive three peri-operative doses double blindly of either esomeprazole 40 mg or placebo, given intravenously or orally.

Daily treatment with esomeprazole is superior to that taken on-demand for maintenance of healed erosive oesophagitis.

Background: On-demand therapy with esomeprazole is effective for long-term treatment of non-erosive gastro-oesophageal reflux disease, but it has not been evaluated in erosive gastro-oesophageal reflux disease.

Aims: To compare endoscopic and symptomatic remission over a 6-month period when patients with healed erosive gastro-oesophageal reflux disease are treated with esomeprazole 20 mg, either once daily or on-demand.

Methods: Patients with verified erosive reflux oesophagitis of Los Angeles grades A-D were enrolled.

The medical care of patients with primary care home nursing is complex and influenced by non-medical factors: a comprehensive retrospective study from a suburban area in Sweden.

Background: The reduced number of hospital beds and an ageing population have resulted in growing demands for home nursing. We know very little about the comprehensive care of these patients. The objectives were to identify the care, in addition to primary health care, of patients with primary-care home nursing to give a comprehensive view of their care and to investigate how personal, social and functional factors influence the use of specialised medical care.

Cinchona alkaloid derived ligands in catalytic asymmetric transfer hydrogenation.

A collection of chiral quinuclidine ligands, derived from the Cinchona alkaloids quinine and quinidine, has been evaluated in the catalytic asymmetric transfer hydrogenation of aromatic ketones. It was fond that [IrCl(COD)]2 complexes of the diamines QCI-Amine and QCD-Amine gave the most active catalysts, capable of reducing a range of aromatic ketones with excellent conversions and good enantioselectivities (up to 95% ee). These are the best selectivities reported for ligands based on the quinuclidine core in an asymmetric transformation, and advocate that these ligands, commercially available in both pseudo-enantiomeric forms, will find practical use in this and other catalytic processes.

Care by general practitioners and district nurses of patients receiving home nursing: a study from suburban Stockholm.

Objectives: To review the care by general practitioners (GPs), district nurses and assistant nurses of patients receiving home nursing.

Design: Retrospective data from questionnaires, records and official statistics. Statistical comparisons.

Blood transfusion and recurrence of colorectal cancer.

Because perioperative blood transfusions have been shown to have an impaired effect on survival in patients with colorectal cancer, we examined retrospectively the records of 882 patients who had undergone curative operations: 170 patients had distant metastases at the time of operation. Of the 499 patients with colonic cancer 332 (67%) had received perioperative blood transfusions. The corresponding figure for the 213 patients with rectal cancer was 190 (89%).