Lulea

This research aims to follow clinical practice for Ponto-implantation surgeries performed outside the main operating room out-of-OR to investigate the complication rates associated with these procedures. It is a combined retrospective and prospective observational study conducted at multiple centers, focusing on patients with hearing loss who receive bone-anchored hearing aids. The study includes patients who had the procedure from 2019 onward and those planned for surgery in the future. The study observes Ponto implantation, a surgical procedure that implants a bone-anchored hearing device to improve hearing by transmitting sound through bone conduction directly to the inner ear. The retrospective part reviews charts of past patients treated out-of-OR since 2019. The prospective part includes patients undergoing planned out-of-OR Ponto implantation who also complete three questionnaires after surgery and during follow-up, including after the sound processor is loaded. Participants contribute data through retrospective chart reviews or by completing questionnaires about their surgical and hearing experiences. The study measures intraoperative complications during surgery and assesses procedure room factors, surgical parameters, post-operative events, implant survival rates, time to sound processor loading, device usage time, and hearing rehabilitation effectiveness. Follow-up extends on average about one year after surgery to monitor outcomes and patient-reported benefits.

The trial investigates the feasibility of Health Web - Tem 1.0, a web-based group intervention designed to support healthy aging in older adults aged 65 and above. This study addresses the increasing demands on healthcare systems due to aging populations and workforce limits by focusing on person-centered, integrated care that promotes physical, mental, social, and environmental well-being. It aims to explore how older adults and healthcare professionals experience the intervention and assess adherence and outcome detection. Health Web Tem is delivered by an interprofessional team through a digital platform. The program includes an introductory session, six themed sessions each featuring a short educational video, reflection assignments, and moderated group meetings. The intervention concludes with a closing session held one month after the last theme session. This behavioral intervention supports older adults in recognizing, reflecting on, and developing strategies for healthy aging. Participants will be involved in pre- and post-intervention assessments using various questionnaires and interviews to evaluate health, occupational balance, self-efficacy, loneliness, life-space, and intervention adherence. Data are collected through surveys, individual and group interviews, and registration forms completed by both older adults and professionals. The primary outcome measure is the Swedish RAND-36 Health Survey, completed within two weeks before and after the intervention. The study combines qualitative and quantitative data to assess feasibility over the study period.

This research aims to determine if hip replacement surgery arthroplasty can reduce the need for additional operations compared to internal fixation in elderly patients with an undisplaced femoral neck fracture. Patients aged 75 years and older with this type of fracture will be included and randomly assigned to one of two treatments through the Swedish Fracture Register platform. The study focuses on combining reoperation rates and mortality into a single main outcome measure to evaluate which treatment offers better results. Participants will receive either arthroplasty, which may be hemi or total hip replacement depending on the patients condition and surgeons decision, or internal fixation using screws, pins, or a sliding hip screw device based on hospital routine. The study is a randomized controlled trial without blinding, comparing these two device-based treatments for hip fractures in elderly patients. During the study, researchers will monitor the combined rate of reoperations and mortality for 1 to 2 years after surgery. Additional outcomes include reoperation rates, short- and long-term mortality, and patient-reported physical function one year after surgery. Participants will be followed up to assess these outcomes, with care taken to track their progress and safety over the study period.

Researchers are studying knee osteoarthritis in patients from the Swedish region of Norrbotten who experienced tibial plateau fractures between 2001 and 2015. The study aims to find out how common radiographic knee osteoarthritis is after these fractures and to understand medium and long-term functional outcomes. It also looks for risk factors linked to these outcomes, including gender, age, body mass index, fracture pattern, and treatment method. Participants in this observational study undergo radiographic evaluations, clinical examinations, and assessments using the Knee injury and Osteoarthritis Outcome Score KOOS. General health and quality of life are measured with the EuroQol 5-Dimension 5-level EQ-5D-5L tool. Data from the Swedish Fracture Register and the Swedish Arthroplasty Register are used to follow long-term results and outcomes. During the study, participants will be monitored for at least five years after their injury to track the development of osteoarthritis through imaging and condition-specific scores. Researchers will assess symptoms, knee function, and health-related quality of life over time. The primary outcome is the number of participants showing radiographic osteoarthritis at five years or more. Secondary outcomes include symptom and function scores, condition-specific quality of life, and general health quality of life evaluations.

Researchers are studying complications after closing a temporary loop ileostomy in patients who had surgery for rectal cancer. The study aims to answer two main questions whether the choice of anastomotic method affects recovery after surgery, and if using a mesh to close the stoma site can reduce hernias. This is a prospective randomized trial involving multiple centers to explore these surgical techniques. Participants are randomly assigned to receive either a stapled anastomosis using a linear staple device or a hand-sewn anastomosis with a running monofilament suture. Additionally, there is an optional randomization to close the stoma site either with a lightweight mesh placed under the muscle or with a long-lasting suture. The skin and fascia are closed with running monofilament sutures, including a pursestring technique for the skin. During the study, researchers will monitor participants for postoperative bowel obstruction within 30 days and for stoma site hernias over 2 years. They will also assess other complications and hospital stay length within 30 days. Participants will undergo follow-up visits to evaluate these outcomes and ensure proper recovery. The total participation timeline includes short-term and long-term monitoring to capture relevant surgical results.

Researchers are comparing one-visit versus two-visit root canal treatments for infected necrotic teeth in general dental practice. The study aims to evaluate the outcomes one and four years after treatment, focusing on periapical health, root filling quality, and complication rates. A pilot study will first identify and address any protocol issues before the main multicenter trial across several clinics in Sweden begins. Patients will be randomly assigned to receive either a root canal treatment completed in one visit or in two visits spaced at least one week apart. Both treatment methods follow standard clinical practices without rigid protocols. After treatment, patients will have a phone call 5-7 days later, a control visit at one month, and clinical evaluations at one and four years including intra-oral radiographs reviewed by independent observers. During the study, participants will undergo regular assessments of post-operative pain, medication use, tooth survival, and any complications. Follow-up includes clinical exams and radiographic checks to determine treatment success based on clinical and radiographic normalcy. The study plans to recruit about 1000 patients to ensure statistically meaningful results, with monitoring continuing up to four years after treatment completion.

Researchers are evaluating a multimodal preoptimisation programme for patients with ventral hernia defects between four and eight centimeters wide. This randomized controlled trial compares this prehabilitation approach to surgery without structured preoptimisation, aiming to reduce complications three months after surgery. The study also explores molecular changes related to collagen metabolism by collecting tissue biopsies and blood samples around the time of surgery. Participants in the intervention group follow a home-based prehabilitation programme lasting at least three months before surgery. This programme targets physical inactivity, obesity, comorbidities, smoking, and alcohol use, and is designed for both rural and urban populations. The control group receives basic advice on physical activity and weight management during their preoperative consultation. During the study, researchers collect biopsies of skin, muscle, and fascia during surgery and take blood samples before and after surgery to analyze molecular effects. Participants will be monitored for complications up to three months postoperatively, with additional assessments at twelve months including pain, quality of life, aesthetic outcomes, hernia recurrence, physical activity, weight, and various laboratory tests. The total participation time covers preoperative optimization and follow-up visits extending up to one year after surgery.

Researchers are studying treatment options for adults with acute pulmonary embolism PE, a serious condition where blood clots block lung arteries. The study compares catheter-directed intervention CDI, which uses devices like mechanical thrombectomy or catheter-directed thrombolysis, to systemic thrombolysis ST with a clot-busting drug called alteplase. This observational study aims to understand how these treatments affect survival and bleeding risks within 30 days after treatment. Participants receive either catheter-directed intervention using various devices or systemic thrombolysis with intravenous alteplase. The FlowTriever device is a common CDI method used in Sweden. The study observes current clinical practices in Nordic countries, including patients who receive standard treatments or alternative reperfusion therapies depending on their condition and available resources. During the study, researchers will collect data on severe bleeding or death within 30 days, as well as other outcomes like recurrent PE, hospital and ICU stay duration, and heart function up to one year. Participants will be monitored through imaging, functional tests, questionnaires on quality of life and breathing difficulties, and blood biomarkers. The study lasts at least one year to evaluate both short- and long-term effects of the treatments.

Researchers are evaluating new ways to increase participation in cervical cancer screening among women at higher risk due to missed follow-ups or irregular attendance. This study focuses on women identified through registry data who may benefit from reminders sent via SMS, electronic letters, or physical letters. Cervical cancer screening has been highly successful in Sweden, preventing many cases, but non-participation remains a significant risk factor for developing the disease. The study sends invitations and reminders using different methods and offers self-sampling kits for HPV testing either by direct mailing or through an online ordering system. The sampling kits include instructions and a prepaid envelope for returning samples. The collected samples are analyzed for HPV types associated with cervical cancer using approved molecular tests, with the testing platform updated in 2022. Follow-up procedures vary based on risk, including direct referrals for women with positive HPV results and reassuring messages for those testing negative. Participants are monitored for their response to invitations over a 12-month period. Researchers measure participation rates, the number of positive HPV screens, and rates of precursors and cases of cervical cancer. The study is conducted nationally with annual identification of women at elevated risk, and follow-up is coordinated through regional contacts. The study began in 2019 and aims to assess whether modern communication methods can improve screening attendance and early detection.

This research aims to assess the safety and practicality of a single-stapled technique SST for colorectal anastomosis in adults undergoing planned left-sided colorectal surgeries, such as sigmoid resection, left hemicolectomy, or partial mesorectal excision, for benign or malignant conditions. It seeks to determine whether SST is linked to a lower rate of anastomotic leakage compared to the conventional double-stapled technique DST, across different surgical approaches including open, laparoscopic, and robot-assisted procedures. Participants in the prospective group will receive colorectal anastomosis using the single-stapled technique during routine clinical care, with data collected on perioperative variables and postoperative complications including leakage within 90 days. A retrospective group who underwent the double-stapled technique from 2023 to 2025 will be identified through medical records to compare outcomes. Both groups are followed to explore differences in leakage rates and postoperative complications. During the study, researchers will collect detailed information on surgical outcomes, including the rate of anastomotic leakage within 90 days, feasibility of the SST during surgery, completeness of anastomotic rings, air leak test results, surgery duration, hospital stay length, readmission rates, complications, mortality, recurrence-free survival up to three years, and stoma-free survival at one and three years. Data is collected prospectively for the SST group and retrospectively for the DST group, aiming to provide multicenter evidence to support future trials.