Breast cancer is the most common tumor disease among women in Sweden. About 7000persons, having a median age of 65, are diagnosed each year with this disease. Withmammography screening, breast cancer can be detected in an early stage which improves theoverall survival (OS). 20-30 % of the breast cancer tumors are overexpressing humanepidermal growth factor receptor 2 (HER2), which is a protein that stimulates cell proliferation.Trastuzumab (Herceptin®) is a humanised monoclonal antibody that targets the HER2-proteinand prevent the signals for cell proliferation.Trastuzumab has earlier been used for treatment of metastatic breast cancer. In the year of 2007trastuzumab was approved for adjuvant treatment of patients who has been medicated withsurgery and/or radiation.The aim of this study was to investigate the effects of adjuvant treatment with trastuzumab inHER2-positive breast cancer patients.

Background:  Heart failure is a multidimensional phenomenon with high mortality. Heart failure is treated with angiotensin converting enzyme (ACE) - inhibitors or angiotensin receptor blockers (ARBs) that counteract neurohormonal stimuli that occur in heart failure, as well as providing vessel dilatation, which reduces symptoms and the need for hospitalization and increases survival. Despite this, only about 50% of heart failure patients survive 6 years after diagnosis with drug therapy, and as heart failure is increasing globally, due to improved care and treatment and increasing life expectancy of the population, there is a great need for new drugs such as LCZ696 that acts by dual inhibition of the renin - angiotensin - aldosterone system and neprilysin inhibition.Objective: The aim of this literature study was to evaluate the efficacy of current treatment and possible future treatments on mortality and morbidity in heart failure patients.Results: The examined articles show that treatment with ACE inhibitors in patients with symptomatic heart failure reduces the risk of total mortality by 16% over 3.5 years, reduces all-cause mortality or hospitalization due to heart failure with NNT (number needed to treat) = 10.4 over 3.5 years and increases median survival by 9.2 months over 12.1 years in patients with asymptomatic heart failure. Treatments with high-dose ACE inhibitors reduce mortality and hospitalization because of cardiovascular causes and hospitalizations from any cause by NNT = 30 over 3 years. Beta-blockers reduce sudden death and total mortality and cardiac death or non - fatal myocardial infarction with NNT = 38 and NNT = 23, respectively, over 12 months.

The aim of this study was to identify possible reasons for non-attendance related to mammographic screening. Using qualitative methods, sex women underwent a semi-structured interview on the following themes: social background, medical history, mammographic screening, invitation, and final decision.Social background was described using the "life-form theory". The concepts of illness, disease, and sickness were used in order to investigate medical conditions and their impact. The process of non-attendance was studied using a model by Zovko, balancing different needs affecting decisions and final action.According to their decision, and final action, women were defined as "participants", "passive non-attenders" or "active non-attenders". Most women belonged to the life-form "paid work" and had children.

This literature study describes the ways in which the spread of rabies can be prevented in India, what guidelines are set and also which methods have proved most effective. Every year rabies causes the death of around 20 000 people in India, which makes the prevalence in the country the highest in the world. The main source for human infection is bite wounds from infected dogs. People and animals can be vaccinated both prophylactic and post-exposure prophylactic (PEP), despite this the disease continues to claim high number of victims. The majority of those dying are young men and children from the poorer part of the population. Knowledge among the Indian population on rabies and its transmission routes, wound care and vaccinations is very limited.

- To be trapped in a roller-coaster That ?s how some of the patients are describing the situa- tion of living with heart failure. To be stuck in their home not knowing if they will have to seek care today and not knowing if they will have the energy to attend that birth- day party later this week.Each year 2-3% of the Swedish population are diagnosed with heart failure, which results in 30,000 new individu- als with the disorder. Cardiovascular disease is rapidly in- creasing in the world and before 2030, people with heart failure will increased by 100%. Our improved living condi- tions and better health have allowed us to grow older and made us more dependent on other types of care, care at home.Today the patients are only looking for changes in weight and if they have excessive water in their body.

Hypertrophic cardiomyopathy (HCM) is the most common heart disease in cats. Maine coon is one of the breeds where the disease is overrepresented. Studies have shown that HCM is inherited as an autosomal dominant trait in Maine Coon cats. This finding has led to cardiac screening using ultrasound in the breed. The results of the screening are used in a national breeding program constructed to reduce the spread and incidence of HCM in Maine Coon cats.

Establishing a reference interval for plasma fibrinogen in foals Fibrinogen concentrations were analysed in EDTA preserved blood plasma samples from 34 thoroughbred foals born in 2001 and 2002 at one stud farm. The foals were between 0 and 240 days old at the time of the sampling, and there were 19 fillies and 12 stallions in the group. The foals were examined for clinical symptoms of disease and their body temperature was measured before blood was sampled from the jugular vein. From totally 156 blood samples, 31 were selected as originating from clinically healthy foals, and used to determine a reference range for thoroughbred foals. Samples originating from foals showing clinical symptoms of disease or an abnormal body temperature at the time of sampling, were classified as coming from unhealthy animals.

Introduction The genetic skin disease epidermolytic ichtyosis is caused by mutations in either keratin gene 1 or 10 and leads to blisters and hyperkeratosis of the epidermis. At cellular level the disease is seen as aggregates in the keratin filaments. Since medicines are hard to investigate and produce mainly due to lack of reproducible model systems, there is no good treatment available for this disease today. In this article we describe how an in vitro model consisting of cells from a stable cell line transfected with expression plasmids to mimic patient cells, may be a possible alternative for screening compounds for therapies. The first step was to generate an expression plasmid required to complete the in vitro model.

Hydropericardium or pericardial effusion (PE) is the accumulation of fluid in the pericardial sac and is often secondary to pericardial diseases or diseases related to the heart. It is unusual with clinically relevant pericardial diseases in cats but pericardial effusion is the most common one. Since PE causes serious symptoms and may lead to death it is important with a quick diagnosis and treatment. PE can be acute and cause cardiac tamponade, which gives severe clinical signs. Cardiac tamponade needs to be treated immediately or else the cat will die from cardiogenic chock. More common is chronic PE where the fluid accumulates during a longer period of time and the pericardial sac stretches.

The aim of the study was to describe what it's like to live with Multiple Sclerosis (MS) and experiences of social support and being received and met by health personnel. The method was a qualitative interview study of descriptive design and was analyzed using qualitative content analysis. Three women and two men (26-75 years) with MS from two municipalitiesin central Sweden participated in the study. The main results showed that the participants felt the disease limited everyday life. The majority described feelings of injustice being affectedby the illness, but they now have a new perspective on life.

This thesis, in the field of healthcare logistics, has been carried out at Hjärt- och Medicincentrum (HMC) at the University Hospital in Linköping during the fall and spring of 2012/2013. The thesis is done by two students at Linköping University at master?s level within the framework of Industrial Engineering and Management.As Sweden's county councils should not make a profit or loss, it is important that the councils are aware of how much care processes cost. Kardiologiska kliniken at HMC in Östergötland?s county council is one of the clinics that are profitable.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Coconut fat?s effect on blood lipids - A systematic overviewAuthor: Linnéa Hult and Sandra WestlingSupervisor: Fredrik BertzExaminer: Ingrid LarssonProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: 2013-04-11Background: Coconut fat has recently been praised in the media. Amongst other things,coconut oil has been said to lower cholesterol (1, 2). This despite the fact that coconut oilcontains of 92 % saturated fat, which strong scientific evidence support raises the blood lipidsand thus increases the risk of Cardiovascular disease (3).Objective: To examine the scientific evidence for how blood lipids in adults are affected byan intake of coconut fat compared to an intake of other kind of fats.Search strategy: PubMed and Scopus have been used in the literary search. Keywords usedwere "coconut fat", "coconut oil", "plasma lipids" and cholesterol [MeSH].Selection criteria: Human studies of RCT or cohort type, published since 1983.

Rheumatoid arthritis (RA) is an autoimmune disease, which affects mostly women. RA is also a chronic disease and the treatment is focused on moderating the immunological process. RA-patients experience daily pain which affect their prosperity. The aim of this literature study is to illuminate some factors that influence the well-being of patients with RA. The factors that have been studied are pain, nutrition and need of knowledge about nutrition.

Introduction: Diabetes type 1 is a common chronic disease in children and adolescents. The disease affect, not only the child, but also the parents in their everyday life. The specialist diabetic nurse has a huge responsibility in supporting the parents to feel confident in managing the child?s diabetes.Aims of the study: To investigate how parents of children with diabetes type 1 perceive the care given from the specialist diabetic nurse and what wishes they have concerning the care they receive.Design and methods: Searches for studies in electronic databases were conducted between January 2013 and march 2013. A literature review containing 16 studies was compiled.

This thesis, in the field of healthcare logistics, has been carried out at Hjärt- och Medicincentrum (HMC) at the University Hospital in Linköping during the fall and spring of 2012/2013. The thesis is done by two students at Linköping University at master?s level within the framework of Industrial Engineering and Management.As Sweden's county councils should not make a profit or loss, it is important that the councils are aware of how much care processes cost. Kardiologiska kliniken at HMC in Östergötland?s county council is one of the clinics that are profitable.