Dengue Fever in Travelers to the Tropics, 1998 and 1999

Dengue fever (DF) has become common in western travelers to the tropics. To improve the basis for travel advice, risk factors and dengue manifestations were assessed in 107 Swedish patients for whom DF was diagnosed after return from travel in 1998 and 1999. Patient data were compared with data on a sample of all Swedish travelers to dengue-endemic countries in the same years. Only three of the patients had received pretravel advice concerning DF from their physicians. Hemorrhagic manifestations were common (21 of 74 patients) but caused no deaths. Risk factors for a DF diagnosis were travel to the Malay Peninsula (odds ratio [OR] 4.95; confidence interval [CI] 2.92 to 8.46), age 15–29 years (OR 3.03; CI 1.87 to 4.92), and travel duration >25 days (OR 8.75; CI 4.79 to 16.06). Pretravel advice should be given to all travelers to DF-endemic areas, but young persons traveling to southern and Southeast Asia for >3 weeks (who constituted 31% of the patients in our study) may be more likely to benefit by adhering to it

The 2000 Tularemia Outbreak: A Case-Control Study of Risk Factors in Disease-Endemic and Emergent Areas, Sweden

A widespread outbreak of tularemia in Sweden in 2000 was investigated in a case-control study in which 270 reported cases of tularemia were compared with 438 controls. The outbreak affected parts of Sweden where tularemia had hitherto been rare, and these “emergent” areas were compared with the disease-endemic areas. Multivariate regression analysis showed mosquito bites to be the main risk factor, with an odds ratio (OR) of 8.8. Other risk factors were owning a cat (OR 2.5) and farm work (OR 3.2). Farming was a risk factor only in the disease-endemic area. Swollen lymph nodes and wound infections were more common in the emergent area, while pneumonia was more common in the disease-endemic area. Mosquito bites appear to be important in transmission of tularemia. The association between cat ownership and disease merits further investigation

Ett omöjligt beslut? : en studie av det svenska beslutet om slutförvar av utbränt kärnbränsle

Validerat; 20101217 (root

Politisk egoism? : en studie av förbudet mot fildelning av upphovsrättsskyddat material

Validerat; 20101217 (root

Professionell mastering : Ett bra alternativ för oetablerade musiker?

Pre-mastering, populärt men något missvisande kallat mastering, är en process där slutmixen av en låt optimeras för att erbjuda en så pass njutbar lyssning som möjligt för de allra flesta som lyssnar på den aktuella musiken. I denna uppsats har jag föresatt mig att ta reda på om det är meningsfullt för oetablerade artister (demoartister) att anlita någon av de professionella masteringfirmor som finns för att utföra detta, eller om det går att göra med likvärdigt resultat på egen hand. Resultatet visar att de flesta lyssnare tycker att en professionellt mastrad slutmix låter bättre än en hemmagjord mastering. Även om de flesta skivbolagen enligt min undersökning tycker att det är en onödig investering för musiker som söker skivkontrakt så bör professionell mastering ändå anses som ett bra alternativ för oetablerade musiker

Smarta elnät i Sverige : Energibranschens förutsättningar och förväntningar

The need for a more efficient electrical grid has made the smart grid concept popular in recent years. The aims of this study are to identify the conditions in Sweden for implementing a smart grid and to analyse the opinions of stakeholders. One finding is that the large capacity of Sweden’s existing electrical grid decreases the immediate need for smart grid solutions. However, the rapid increase in wind power might push the development of a smart grid in the coming years. By employing case study methodology, five different smart grid projects in Sweden are discussed, using different theoretical frameworks, including actor network theory, discourse analysis, technological trajectories, diffusion of innovation and timing of entry. Norra Djurgardsstaden, a large construction project in Stockholm in which smart grid technology is used, is then analysed. The differing views of the parties involved in the project raise the question of whether more coordination is needed. Another project at Falbygdens Energi focuses on energy storage in batteries. This project poses the question of whether the regulation of the Swedish power market needs to be reformed to support the smart grid and to encourage new ways of collaborating and doing business. The final discussion concludes by suggesting new research questions

Smarta elnät i Sverige : Energibranschens förutsättningar och förväntningar

The need for a more efficient electrical grid has made the smart grid concept popular in recent years. The aims of this study are to identify the conditions in Sweden for implementing a smart grid and to analyse the opinions of stakeholders. One finding is that the large capacity of Sweden’s existing electrical grid decreases the immediate need for smart grid solutions. However, the rapid increase in wind power might push the development of a smart grid in the coming years. By employing case study methodology, five different smart grid projects in Sweden are discussed, using different theoretical frameworks, including actor network theory, discourse analysis, technological trajectories, diffusion of innovation and timing of entry. Norra Djurgardsstaden, a large construction project in Stockholm in which smart grid technology is used, is then analysed. The differing views of the parties involved in the project raise the question of whether more coordination is needed. Another project at Falbygdens Energi focuses on energy storage in batteries. This project poses the question of whether the regulation of the Swedish power market needs to be reformed to support the smart grid and to encourage new ways of collaborating and doing business. The final discussion concludes by suggesting new research questions

Surveillance for patients with precancerous lesions in the stomach

Ievads. Intestinālā tipa kuņģa adenokarcinomas attīstība notiek sekojoši kuņģa pirmsvēža stāvokļu attīstības kaskādei. Izsekojot pacientus ar kuņģa pirmsvēža stāvokļiem, ir iespējams savlaicīgi konstatēt agrīnas neoplastiskas izmaiņas. Darba mērķis. Analizēt kuņģa pirmsvēža stāvokļu izplatību pētījumā iekļauto pacientu grupā un izvērtēt kuņģa pirmsvēža stāvokļu dinamiskas izmaiņas GASTRO centra pacientiem. Materiāli un metodes. Retrospektīvi tika analizēti 909 pirmreizēji izmeklēto pacientu dati un 95 atkārtoti izmeklēto pacientu dati, kuriem veiktas augšējās endoskopijas ar biopsijas paraugu ņemšanu atbilstoši vadlīniju prasībām laika periodā no 2013. līdz 2018. gadam. Pacienti tika iedalīti četrās dažāda riska grupās, analizētas kuņģa gļotādas pirmsvēža stāvokļu dinamiskas izmaiņas šajās riska grupās. Rezultāti. No izmeklēto pacientu kopskaita 66,9% bija sievietes (biežākais vecums- 60-80 gadi) un 33,1%- vīrieši (biežākais vecums- 50-80 gadi). 82% gļotādas biopsiju tika veiktas atbilstoši standartprasībām. 82,2% pacientiem tika konstatēta kuņģa gļotādas atrofija (jebkuras pakāpes), 81,4%- intestinālā metaplāzija (IM) (jebkuras pakāpes), 50,7%- displāzija (viegla, smaga). Sieviešu populācijā 36% tika konstatēta mērena atrofijas pakāpe un 39% mērena IM pakāpe, bet vīriešu populācijā- 38% zema atrofijas pakāpe un 34% mērena, 33% augsta IM pakāpe. 66% GASTRO centra pacientu konstatēta OLGA I-II un 56%- OLGIM I-II stadijas. Visās vecuma grupās līdz 80 gadiem vīriešiem konstatēta lielāka displāzijas incidence, biežākā displāzijas lokalizācija visās pacientu grupās- kuņģa antrālā daļa (64%), visbiežāk skarts kuņģa mazais loks (80%). Sievietēm visbiežāk displāzija konstatēta 50- 60 gadu vecumā, vīriešiem- 40- 70 gadu vecumā. Atkārtoti izmeklēto pacientu grupā minimālais laika intervāls starp pirmreizējo un atkārtoto izmeklējumu- 3,5 gadi, maksimālais- 5 gadi, mediāna- 4,1 gads. Atkārtoti izmeklēto pacientu grupā 79% displāzija netika konstatēta ne pirmreizējā, ne atkārtotā izmeklējumā, 14% tās pakāpe mainījās no vieglas uz neesošu, taču nevienā gadījumā nemainījās uz augstāku; 61% atrofijas pakāpe mainījās uz zemāku, 23%- nemainījās, 16%- mainījās uz augstāku; 57% IM pakāpe mainījās uz zemāku, 30%- nemainījās; 13% mainījās uz augstāku. Secinājumi. Statistiski nozīmīga atšķirība atkarībā no dzimuma ir kuņģa gļotādas atrofijas un IM smaguma pakāpei, savukārt displāzijai- nav, kā arī atkarībā no vecuma- kuņģa gļotādas atrofijai un displāzijai, savukārt IM- nav. Atkārtoti izmeklēto pacientu grupā 68% gadījumu kuņģa gļotādas pirmsvēža stāvokļi dinamikā mainījās uz zemāku pakāpi: 17%- par vienu pakāpi, 27%- par divām, 16%- par trīs, 8%- par četrām. Atrofijas un IM gadījumā būtiskas dinamikas izmaiņas atkarībā no lokalizācijas netika konstatētas. 40% pacientu pēc kontroles izmeklējumiem turpina kuņģa pirmsvēža stāvokļu dinamisku novērošanu.Introduction. The development of intestinal type gastric adenocarcinoma occurs following a cascade of specific gastric precancerous lesions. By following- up the patients with gastric precancerous lesions, neoplastic changes can be detected early. Aim. To analyze the prevalence of gastric precancerous lesions and to evaluate the dynamic changes in the cascade of the gastric precancerous lesions in patients from GASTRO center. Materials and methods. In a retrospective analysis, data from 909 first- examined patients and 95 re-examined patients undergoing upper endoscopy with biopsy sampling in accordance with the guidelines for the period from 2013 to 2018 was obtained. Patients were divided into four different risk groups and analysed according to the dynamic changes of the precancerous lesions of the gastric mucosa in these risk groups. Results. 66.9% of all examined patients were women (most commonly 60-80 years old) and 33.1% - men (most commonly 50-80 years old). 82% of the mucosal biopsies were performed according to the standard requirements. Gastric mucosal atrophy (any grade) was found in 82.2% of patients, intestinal metaplasia (IM) (any grade) in 81.4%, dysplasia (mild, severe) in 50.7% of patients. In the female population moderate atrophy was detected in 36%, and moderate IM in 39% of cases, while in the male population mild atrophy was detected in 38% of the cases, moderate in 34%, and severe IM - in 33% of the cases. OLGA I-II was detected in 66% and OLGIM I-II in 56% of cases. In all age groups up to 80 years, men exhibited greater incidence of dysplasia, the most frequent localization of the dysplasia in all patient groups- gastric antrum (64%), the most commonly affected area- lesser curvature (80%). In women, dysplasia was most commonly found at the age of 50-60, in men- at the age of 40-70. In the re-examined patient group, the minimum time interval between the first and repeated examination was 3,5 years, maximum- 5 years, median- 4,1 years. In the re-examined patient group, 79% of the dysplasia was not detected either in the first-time or in the repeated examination, in 14% of cases it changed from mild to none, but in none of cases it changed to higher grade; in 61% atrophy grade changed to lower, 23% - did not change, 16% - changed to higher; 57% of the IM grade changed to lower, 30% - did not change; 13% changed to higher. Conclusion. When testing for statistically significant differences in observations comparing genders and different age groups, statistically significant differences were found for the severity of atrophy (gender, age group), IM (gender) and dysplasia (age group). In the re-examined patient group, in 68% of cases, gastric precancerous lesions changed to lower grade: 17% one grade lower, 27% -two, 16% -three, and 8% four grades lower. In the case of atrophy and IM, no significant changes after follow-up were detected based on localization. 40% of patients continue to be monitored

Cardiovascular and cancer mortality in very elderly post-myocardial infarction patients receiving statin treatment.

OBJECTIVES: The purpose of this study was to determine whether statin treatment is effective and safe in very elderly (80 years and older) acute myocardial infarction (AMI) patients. BACKGROUND: Elderly individuals constitute an increasing percentage of patients admitted to hospitals for AMI. Despite that these patients have a higher mortality risk, the application of evidence-based medicine remains much lower than for younger patients. METHODS: We included all patients 80 years and older who were admitted with the diagnosis of AMI in the Register of Information and Knowledge About Swedish Heart Intensive Care Admissions between 1999 and 2003 (n = 21,410). Of these, complete covariate and follow-up data were available for 14,907 patients (study population A). To limit the bias related comorbidity on statin therapy, we also performed analyses excluding patients who died within 14 days of the acute event (study population B) and all patients who died within 365 days (study population C). A propensity score was used to adjust for initial differences between treatment groups. RESULTS: All-cause mortality was significantly lower in patients receiving statin treatment at discharge in study population A (relative risk: 0.55, 95% confidence interval: 0.51 to 0.59), in study population B (relative risk: 0.65; 95% confidence interval: 0.60 to 0.71), and in study population C (relative risk: 0.66; 95% confidence interval: 0.59 to 0.76). Similar observations were made for cardiovascular mortality as well as for AMI mortality. There was no increase in cancer mortality in statin-treated patients. CONCLUSIONS: Statin treatment is associated with lower cardiovascular mortality in very elderly post-infarction patients without increasing the risk of the development of cancer