Läkartidningen
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Polio close to eradication The WHO Global Polio Eradication Initiative has been highly successful. With a dramatic decrease in polio since it started in 1988, the number of globally reported cases reached a record low of 37 in 2016. This article describes the WHO Endgame Strategic Plan including milestones that have been reached and challenges that have to be overcome in order to reach the goal of polio eradication by 2020. ⋯ In 2016 the WHO took the first step to withdraw the oral polio vaccine (OPV) by globally shifting from trivalent to bivalent OPV. The role of the inactivated vaccine (IPV) in the final phase of eradication and in the post-eradication situation is also considered. Certification of eradication and containment of all polio virus by the end of 2020 is a key objective. Legacy planning includes mainstreaming polio functions into ongoing public health programmes.
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Assessment of neurologic prognosis after cardiac arrest. Updated recommendations from the Swedish CPR Council Expert Group European Resuscitation Council (ERC) issued updated guidelines for postresuscitation care in 2015. This paper provides updated Swedish recommendations for neurological prognostication of patients remaining unconscious after cardiac arrest (CA). ⋯ It should not be performed earlier than three days after CA and any influence from sedatives must be negligible. Bilateral absence of both corneal and pupillary reflexes and bilaterally absent Somatosensory Evoked N20 Potentials (SSEP) at 72 hours are reliable predictors of poor outcome but the ocular reflexes have limited sensitivity and SSEP has limited availability. Hence, further delay of at least 24 hours and combinations of findings from multiple methods are often needed for reliable prognostication. If firm evidence of a poor prognosis is lacking four days after CA, further expectation with repeated examinations is recommended.
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Venous thromboembolism prophylaxis in medical patients at Sahlgrenska University Hospital A hospitalized medical patient with risk factors has a 5-15 % risk of venous thromboembolism (VTE). Nonetheless thromboprophylaxis is largely underused. ⋯ Bleeding occurred in 5.8 % of those with increased bleeding risk. There is a need to improve thromboprophylaxis use to enhance patient safety and quality of care, for instance by issuing local guidelines.