[Swedish gallstone surgery during the covid-19 pandemic].

The covid-19 pandemic has necessitated reallocation of health care resources. This has raised concerns about the risks associated with postponing surgery for benign conditions that are given low priority. Data from the population-based Swedish National Register for Gallstone Surgery (GallRiks) show that the total number of procedures carried out during the initial months of each wave of the pandemic decreased.

Equal receipt of specialized palliative care in breast and prostate cancer: a register study.

Purpose: There are inequalities in cancer treatment. This study aimed to investigate whether receipt of specialized palliative care (SPC) is affected by typical female and male diagnoses (breast and prostate cancer), age, socioeconomic status (SES), comorbidities as measured by the Charlson Comorbidity Index (CCI), or living arrangements (home vs nursing home residence). Furthermore, we wanted to investigate if receipt of SPC affects the place of death, or correlated with emergency department visits, or hospital admissions.

[Hereditary transthyretin amyloidosis - from symptomatic to curative treatment?].

Hereditary transthyretin (ATTRv) amyloidosis is a rare but life-threatening multi-systemic disease with clustering areas in, for example, northern Sweden. Until the 1990s, only symptomatic treatments were available but liver transplantation has, in selected patients, been a good therapeutic option since. The first disease-modifying drug for ATTRv amyloidosis was approved in 2011 and since then, the development of new therapeutic drugs has been rapid and successful.

Pragmatic diagnostic and therapeutic algorithms to optimize new potassium binder use in cardiorenal disease.

Background: Pivotal randomized trials demonstrating efficacy, safety and good tolerance, of two new potassium binders (patiromer and sodium zirconium cyclosilicate) led to their recent approval. A major hurdle to the implementation of these potassium-binders is understanding how to integrate them safely and effectively into the long-term management of cardiovascular and kidney disease patients using renin angiotensin aldosterone system inhibitors (RAASi), the latter being prone to induce hyperkalaemia.

Methods: A multidisciplinary academic panel including nephrologists and cardiologists was convened to develop consensus therapeutic algorithm(s) aimed at optimizing the use of the two novel potassium binders (patiromer and sodium zirconium cyclosilicate) in stable adults who require treatment with RAASi and experience(d) hyperkalaemia in a non-emergent setting.

Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study.

Purpose: To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients.

Methods: Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020.

Diuretic response to Ringer's solution is normal shortly after awakening from general anaesthesia: a retrospective kinetic analysis.

Background: The elimination of Ringer's solution is severely depressed during general anaesthesia, but the degree to which this continues postoperatively is poorly established.

Methods: An intravenous infusion of Ringer's acetate solution 20 ml kg was administered over 60 min in 12 patients undergoing laparoscopic cholecystectomy. Population kinetic analysis was performed based on repeated measurements of blood haemoglobin concentration and urinary excretion over 240 min regardless of when the operations were finished.

Introduction of Small Stitch Small Bite technique: a retrospective long-term follow-up.

Purpose: Standardization of abdominal wall closure is suggested to improve quality and reduce the risk for late abdominal wall complications. The purpose of this study was to explore the impact of a structured introduction of guidelines for abdominal wall closure on the rates of incisional hernia and wound dehiscence.

Methods: All procedures performed via a midline incision in 2010-2011 and 2016-2017 at Capio St Göran's Hospital were identified and assessed for complications and risk factors.

[COVID-19 related mortality in Swedish patients with renal replacement therapy].

Data from the Swedish Renal Registry (SRR) show that during the period March 16, 2020 to March 15, 2021 0.4% of all renal transplant recipients and 3% of all dialysis patients died due to COVID-19 in Sweden. Of all registered deaths, 20% were attributed to COVID-19.

[Robotic-assisted pelvic and renal surgery - an overview].

Current studies indicate that robotic-assisted surgery is not inferior to laparoscopic or open surgery regarding oncologic or functional outcomes. An exception may be uterine cervix cancer, where the survival after minimal invasive surgery might not be as good as after open surgery. There is less bleeding and need for blood transfusion after robotic-assisted surgery, and postoperative complications are similar to open or laparoscopic surgery.

[Management of patients with gastroesophageal reflux disease can be optimized].

Gastroesophageal reflux disease (GERD) often requires lifelong treatment to return to and maintain a normal quality of life. Proton pump inhibitors (PPIs) offer effective medical treatment and can be used for a long time with good safety margins. The diagnostic criteria for GERD must be strictly based on current guidelines and the need for maintained treatment must be regularly evaluated.

Left atrial contraction strain and controlled preload alterations, a study in healthy individuals.

Background: In order to assess left atrial contractile function in disturbed circulatory conditions, it is necessary to have a clear understanding of how it behaves in a normal resting state with changes in loading conditions. However, currently the understanding of this relationship is incomplete. We hypothesize that in healthy individuals, left atrial contraction strain and its peak strain rate are increased or decreased by increasing or decreasing preload, respectively.

European Association of Urology Guidelines on Renal Cell Carcinoma: The 2022 Update.

Context: The European Association of Urology (EAU) Renal Cell Carcinoma (RCC) Guideline Panel has prepared evidence-based guidelines and recommendations for the management of RCC.

Objective: To present a summary of the 2022 RCC guideline, which is based on a standardised methodology including systematic reviews (SRs) and provides transparent and reliable evidence for the management of RCC.

Evidence Acquisition: For the 2022 update, a new literature search was carried out with a cutoff date of May 28, 2021, covering the Medline, EMBASE, and Cochrane databases.

An observational study of intensivists' expectations and effects of fluid boluses in critically ill patients.

Background: Fluid bolus therapy (FBT) is common in ICUs but whether it achieves the effects expected by intensivists remains uncertain. We aimed to describe intensivists' expectations and compare them to the actual physiological effects.

Methods: We evaluated 77 patients in two ICUs (Sweden and Australia).

Clinical Trial Protocol for ProBio: An Outcome-adaptive and Randomised Multiarm Biomarker-driven Study in Patients with Metastatic Prostate Cancer.

ProBio is an outcome-adaptive, multiarm, multiple-assignment randomised, biomarker-driven platform trial in men with metastatic castration-resistant prostate cancer. Here we describe the amended clinical protocol, focusing on expansion of the trial to include patients with de novo metastatic hormone-sensitive prostate cancer.

Mapping human papillomavirus, Epstein-Barr virus, cytomegalovirus, adenovirus, and p16 in laryngeal cancer.

Purpose: Apart from tobacco and alcohol, viral infections are proposed as risk factors for laryngeal cancer. The occurrence of oncogenic viruses including human papilloma virus (HPV) and Epstein-Barr virus (EBV), in laryngeal squamous cell carcinoma (LSCC) varies in the world. Carcinogenesis is a multi-step process, and the role of viruses in LSCC progression has not been clarified.

[Atelectasis during general anaesthesia - mechanisms and importance].

In 1985, Dr. Göran Hedenstierna pioneered in the transition of atelectases during anaesthesia from a concept to a clinical entity, using computed tomography to detect "pulmonary densities". These densities were soon to be fully recognized as atelectasis.

[Cerebral venous thrombosis after dural punture - three cases].

Cerebral venous thrombosis (CVT) is a rare form of cerebrovascular disease. There seems to be a relationship between intracranial hypotension due to dural puncture and CVT but causality is uncertain. Headache is common in the obstetric population, frequently preceded by epidural anesthesia.

Health-related quality of life in patients with long-standing ulcerative colitis in remission.

Introduction: Ulcerative colitis (UC) contributes to impaired health-related quality of life (HRQoL). Although disease activity is the most important factor, reduced HRQoL has been reported even in quiescent UC. We aimed to determine HRQoL, and identify predictors thereof, in patients with long-standing UC in remission.

[Respiratory failure can be seen in chronic inflammatory demyelinating polyneuropathy: a case report].

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired autoimmune inflammatory polyneuropathy characterized by a progressive or relapsing course. It has been reported that approximately 16% of CIDP patients may present with an acute clinical onset much like Guillain-Barré syndrome (GBS) but with a subsequent chronic progression. These patients are classified as acute-onset CIDP (A-CIDP).