Antidiabetic medication use during pregnancy: an international utilization study.

Objective: Diabetes in pregnancy and consequently the need for treatment with antidiabetic medication (ADM) has become increasingly prevalent. The prevalence and patterns of use of ADM in pregnancy from 2006 onward in seven different countries was assessed.

Research Design And Methods: Data sources included individually linked data from the nationwide health registers in Denmark (2006-2016), Finland (2006-2016), Iceland (2006-2012), Norway (2006-2015), Sweden (2006-2015), state-wide administrative and claims data for New South Wales, Australia (2006-2012) and two US insurance databases: Medicaid Analytic eXtract (MAX; 2006-2012, public) and IBM MarketScan (2012-2015, private).

[Early or delayed cardioversion in atrial fibrillation?].

Atrial fibrillation is one of the most common arrhythmias. As the symptoms can be abrupt in onset it is associated with a substantial burden on the medical emergency system. By routine practice patients with symptomatic atrial fibrillation of a duration less than 48 hours are commonly offered cardioversion therapy.

A distinct gut microbiota composition in patients with ankylosing spondylitis is associated with increased levels of fecal calprotectin.

Background: Ankylosing spondylitis (AS) shares many characteristics with inflammatory bowel disease (IBD). Intestinal microbiota most likely plays an important role in the development of IBDs and may also be involved in the pathogenesis of AS. We aimed to define and compare the fecal microbiota composition in patients with AS, ulcerative colitis (UC), and healthy controls (HC) and to determine relationships between fecal microbiota, fecal calprotectin, and disease-related variables in AS.

[Argon plasma coagulation effective treatment of solitary rectal ulcer syndrome].

Solitary rectal ulcer syndrome (SRUS) is a rare disorder likely to be caused by a traumatic and ischemic mucosal injury related to latent or overt rectal prolapse. Mucosal damage can vary between erythema and up to intractable ulceration. The typical symptoms of SRUS may resemble those of inflammatory bowel disease (IBD)-related proctitis or rectal malignancy with mucus- and blood-mixed defecation with urgency and sometimes transient incontinence.

How to increase the accuracy of the diagnosis of the accessory bone of the foot?

Purpose: The study was conducted to search for confident radiological signs in symptomatic cases of accessory bones. A normal accessory bone appearance on X-ray does not exclude that the accessory bone is the source of the discomfort; because of this, MRI examination can later be applied as part of the diagnosis.

Methods: We retrospectively analysed cases of 64 patients with recognized 70 symptomatic accessory bones of the foot.

Needle fasciotomy for Dupuytren's contracture- a prospective cohort study of 58 fingers with a median follow-up of 6.5 years.

Needle fasciotomy (NF) is a minimally invasive treatment option for Dupuytren contractures, but long-term results have indicated a high recurrence rate. This prospective study was initiated to monitor the introduction of NF in a context where limited fasciectomy had been the only treatment option, and to investigate the long-term results. The inclusion criterion was a palpable cord with a Metacarpophalangeal (MCP) and/or Proximal interphalangeal (PIP) contracture in one or more fingers.

Communication skills training in undergraduate nursing programs in Spain.

of the present cross sectional study were to analyze the offer of subjects with communication skills in the nursing degree in Spain and to describe the distribution of these subjects. Documentary, systematic and independent search of web pages from Spanish universities was carried out to collect the following variables: subjects with communication skills, course in which the subject is taught, type of teaching (exclusive or combined), type of subject (compulsory or optional) and number of credits on communication skills. Although an average of 3.

Lower reoperation rate with locking plates compared with conventional plates in Vancouver type C periprosthetic femoral fractures: A register study of 639 cases in Sweden.

Aim: To investigate demographics and outcomes of Vancouver type C periprosthetic femoral fractures (PPFF) treated with open reduction and internal fixation.

Methods: Patient data were obtained from medical charts of cases reported to the Swedish Hip Arthroplasty Register and/or from the National Patient Register. Vancouver type C fractures undergoing surgery between 2001 and 2011, in patients who had received their primary THR between 1979 and 2011, were included.

Vinflunine/gemcitabine versus carboplatin/gemcitabine as first-line treatment in cisplatin-ineligible patients with advanced urothelial carcinoma: A randomised phase II trial (VINGEM).

Background: The present study (VINGEM) is the first randomised trial comparing vinflunine/gemcitabine (VG) to standard carboplatin/gemcitabine (CG) in patients with advanced urothelial carcinoma (aUC) ineligible for treatment with cisplatin.

Patients And Methods: Patients with aUC, creatinine clearance 30-60 ml/min, performance status ≤1 and no prior chemotherapy for metastatic disease were randomised to the experimental arm (vinflunine 280 or 250 mg/m day 1, gemcitabine 1000 mg/m days 1 and 8, q21 days) or the control arm (carboplatin AUC 4.5 day 1, gemcitabine 1000 mg/m days 1 and 8, q21 days).

Symptomatic pelvic organ prolapse in middle-aged women: a national matched cohort study on the influence of childbirth.

Background: The relative impact of age, pregnancy, and vaginal delivery on symptomatic pelvic organ prolapse is still an unresolved issue that involves the controversial question about the protective effect of cesarean section.

Objective: The purpose of this study was to compare the age-related prevalence of symptomatic genital prolapse in nulliparous, vaginal- and cesarean-delivered women aged 40-64 years.

Study Design: This Swedish, nationwide matched cohort study involved 14,335 women.

[Is inhalation of hypertonic saline for bronchiolitis effective in infants and toddlers?].

The first studies of treatment of bronchiolitis in infants and toddlers with inhalation of hypertonic saline showed that the treatment was beneficial but later studies have challenged these results. Here, we review four systematic reviews from 2015-2017 and two more recent studies not included in the reviews. Our conclusions are that in moderately severe bronchiolitis, the benefits of treatment are small or absent and inhalations should not be routine.

[Treatment of orthopedic implant-associated infections].

The Swedish National Guidelines for Bone and Joint Infections were revised during 2018. The work was carried out on behalf of the Swedish Society for Infectious Diseases. The study group consists of senior consultants in infectious diseases, supported by specialists in orthopedic surgery, clinical microbiology and allergology when needed.

Intelligibility of Children With Speech Sound Disorders Evaluated by Listeners With Swedish as a Second Language.

Purpose This study aimed to investigate the intelligibility of children's atypical speech in relation to listeners' language background. Method Forty-eight participants listened to and transcribed isolated words repeated by children with speech sound disorders. Participants were divided into, on the one hand, a multilingual group ( = 29) that was further divided into subgroups based on age of acquisition (early, 0-3 years; intermediate, 4-12 years; and late, > 12 years) and, on the other hand, a monolingual comparison group ( = 19).

Virtual implantations to transition from porcine to bovine animal models for a total artificial heart.

Realheart total artificial heart (TAH) is a novel, pulsatile, four-chamber total artificial heart which had been successfully tested acutely in a porcine animal model. However, the bovine model is better suited for long-term testing and thus an evaluation of how the design would fit the bovine anatomy was required. Virtual implantation is a method that enables a computer simulated implantation based on anatomical 3D-models created from computer tomography images.

The proximal hamstring avulsion clinical trial (PHACT)-a randomised controlled non-inferiority trial of operative versus non-operative treatment of proximal hamstrings avulsions: study protocol.

Introduction: The treatment of proximal hamstring avulsions is controversial. While several trials have investigated the outcome for patients treated surgically, there is today no prospective trial comparing operative treatment with non-operative treatment. This protocol describes the design for the proximal hamstring avulsion clinical trial (PHACT)-the first randomised controlled trial of operative versus non-operative treatment for proximal hamstring avulsions.

[Prevent burnout in health care with mindfulness and compassion].

There is a growing body of evidence that mindfulness and compassion are effective in reducing stress in health care. Focus meditation brings back the wandering mind to our breath and body. This attention skill can be practiced as STOP-sign: 'Stop, Take a breath, Observe and Priority first' when facing an emergency.

[Do we overtreat patients? Heavily increased risk for ERCP pancreatitis after treatment for asymptomatic common bile duct stones].

Common bile duct stones (CBDS) as well as ERCP treatment may cause jaundice, pancreatitis and cholangitis. More than half of the patients with asymptomatic CBDS found on intraoperative cholangiography pass all of their stones spontaneously. The ERCP treatment of asymptomatic common bile duct stones seems to carry a fivefold increased risk for complications, especially pancreatitis.

[Diagnostic challenge in a man with intractable hiccups and vomiting: a case of neuromyelitis optica spectrum disorder (NMOSD)].

Neuromyelitis optica is an inflammatory CNS syndrome that is associated with serum aquaporin-4 immunoglobulin G antibodies (AQP4-IgG). According to the new diagnostic criteria the term NMO is replaced by the term NMOSD and for the first time criteria allow diagnosis in patients who have not experienced clinical involvement of either optic nerves or spinal cord. Area postrema, the emetic reflex center, may be a selective target of the disease.

A Unified Prostate Cancer Risk Prediction Model Combining the Stockholm3 Test and Magnetic Resonance Imaging.

Background: Risk prediction models and magnetic resonance imaging (MRI) of the prostate can reduce unnecessary biopsies and overdiagnosis of low-risk prostate cancer. However, it is unclear how these tools should be used in concert.

Objective: To develop a unified risk prediction model (S3M-MRI) that combines the Stockholm3 score (based on protein and genetic markers and clinical variables) and Prostate Imaging-Reporting and Data System v.

[Management of malaria in Sweden].

Malaria is a potentially severe infection and time to treatment can be decisive for the outcome. Febrile patients returning from travel in endemic areas should therefore be promptly investigated for malaria. This review focuses on the acute management of malaria in Sweden.

Monocytes Acquire the Ability to Prime Tissue-Resident T Cells via IL-10-Mediated TGF-β Release.

Using non-human primates (NHPs), mice, and human primary cells, we found a role for interleukin-10 (IL-10) in the upregulation of the tissue-resident memory T cell (T) marker CD103. In NHPs, intravenous, but not subcutaneous, immunization with peptide antigen and an adjuvant combining an agonistic anti-CD40 antibody plus poly(IC:LC) induced high levels of CD103 Ts in the lung, which correlated with early plasma IL-10 levels. Blocking IL-10 reduced CD103 expression on human T cells stimulated in vitro with the adjuvant combination as well as diminished CD103 on lung-resident T cells in vivo in mice.

Evaluation of the novel total artificial heart Realheart in a pilot human fitting study.

Heart failure affects >26 million patients worldwide. Current cardiac devices save lives, but patients suffer complications. Hence, improved devices are needed.

Quality of life in patients treated for anal carcinoma-a systematic literature review.

Purpose: Anal cancer is a mainly treated with chemoradiotherapy. A small number of patients undergo salvage surgery. There are few published studies investigating quality of life and functional outcome after treatment for anal cancer.

The benefits of collaboration: the Nordic Arthroplasty Register Association.

The Nordic Arthroplasty Register Association (NARA) was established in 2007 by arthroplasty register representatives from Sweden, Norway and Denmark with the overall aim to improve the quality of research and thereby enhance the possibility for quality improvement with arthroplasty surgery. Finland joined the NARA collaboration in 2010.NARA minimal hip, knee and shoulder datasets were created with variables that all countries can deliver.