Lakartidningen | Year: 2016
Exocrine pancreatic insufficiency may result in urgency and foul smelling steatorrhea that is difficult to flush. The simplest way of diagnosis is by observing the response to therapy with high dose pancreatic enzymes. Here we describe two different cases of exocrine insufficiency in elderly patients who earlier had some form of pancreatic surgery. These cases illustrate the varying presentations of exocrine pancreatic insufficiency and how proper history taking can help to cure this debilitating condition. © 2016, (Publisher). All rights reserved.
Nilsson L.,Anestesi och operationskliniken |
Lakartidningen | Year: 2014
Fast-track is a multimodal strategy aimed at achieving an improved and accelerated postoperative recovery. The strategy combines unimodal evidence-based interventions concerning preoperative preparation, peroperative principles and postoperative care. There is substantial evidence for the benefits of following fast-track concepts in general elective surgery to enhance postoperative recovery. The main findings of this review are that there are benefits likewise within elective gynecological surgery, but studies of quality of life, patient satisfaction and health economics are needed. Studies of fast-track within non-elective surgery and gynaecological oncology surgery are lacking. Widespread information and education is needed to improve the rate of implementation of fast-track. Comprehensive involvement of the entire staff dealing with the patient in the perioperative period is crucial to ensure implementation and development of surgical care aiming for enhanced postoperative recovery. © 2014 Swedish Medical Association. All rights reserved.
Helmrot K.,Orebro University |
Lakartidningen | Year: 2016
For unknown reasons, the number of visits to Swedish A&E Departments is on the increase. This study was designed to research whether patients had been in contact with the health service prior to their visit to the Örebro University Hospital A&E Department and if so, which part of the healthcare system. Our study revealed that 80% of patients had been in contact with the healthcare service prior to their visit, that referrals by telephone constituted a large proportion of visits and that the level of medical seriousness differed between the various methods of referral. © 2016, Swedish Medical Association. All rights reserved.
Kreutz C.,Albert Ludwigs University of Freiburg |
Raue A.,Albert Ludwigs University of Freiburg |
Raue A.,Helmholtz Center Munich |
Timmer J.,Albert Ludwigs University of Freiburg |
BMC Systems Biology | Year: 2012
Background: Predicting a system's behavior based on a mathematical model is a primary task in Systems Biology. If the model parameters are estimated from experimental data, the parameter uncertainty has to be translated into confidence intervals for model predictions. For dynamic models of biochemical networks, the nonlinearity in combination with the large number of parameters hampers the calculation of prediction confidence intervals and renders classical approaches as hardly feasible.Results: In this article reliable confidence intervals are calculated based on the prediction profile likelihood. Such prediction confidence intervals of the dynamic states can be utilized for a data-based observability analysis. The method is also applicable if there are non-identifiable parameters yielding to some insufficiently specified model predictions that can be interpreted as non-observability. Moreover, a validation profile likelihood is introduced that should be applied when noisy validation experiments are to be interpreted.Conclusions: The presented methodology allows the propagation of uncertainty from experimental to model predictions. Although presented in the context of ordinary differential equations, the concept is general and also applicable to other types of models. Matlab code which can be used as a template to implement the method is provided at http://www.fdmold.uni-freiburg.de/∼ckreutz/PPL. © 2012 Kreutz et al.; licensee BioMed Central Ltd.
Lakartidningen | Year: 2013
Childhood stroke is an uncommon but serious condition with mortality of 8-20 % and residual impairments in 50-85 % of survivors. It is important to »think stroke« when a child or teenager presents acutely with new neurological deficit, seizures or lowered consciousness. Early consultation with an experienced radiologist, neurosurgeon and neurointerventionist is important in a childhood stroke case. The aetiology of stroke in children is very different from the adults' and dominated by heart diseases, acute infections, vasculitis, coagulopathies, chronic diseases and several syndromes. A broad investigation of risk factors should therefore be made. Current treatment is not yet evidence-based but consensus recommendations are available. A review of aetiologies, investigations and recommended treatments so far is presented. New Swedish guidelines are presented. With an earlier diagnosis a more active approach is possible and recommended.