Upsala journal of medical sciences
-
The pragmatic clinical trial addresses scientific questions in a setting close to routine clinical practice and sometimes using routinely collected data. From a regulatory perspective, when evaluating a new medicine before approving marketing authorization, there will never be enough patients studied in all subgroups that may potentially be at higher risk for adverse outcomes, or sufficient patients to detect rare adverse events, or sufficient follow-up time to detect late adverse events that require long exposure times to develop. It may therefore be relevant that post-marketing trials sometimes have more pragmatic characteristics, if there is a need for further efficacy and safety information. ⋯ A study feature such as having a wide and permissive inclusion of patients might therefore actually hamper the utility of the results for regulatory purposes. Randomization in a registry-based setting addresses confounding that could otherwise complicate a corresponding non-interventional design, but not any other methodological issues. Attention to methodological basics can help generate reliable study results, and is more important than labelling studies as 'pragmatic'.
-
The aims of this longitudinal study were to identify predictors for continued pornography consumption and to investigate pornography consumption in relation to psychosomatic and depressive symptoms among a group of adolescents in Sweden. ⋯ Pornography consumption may, for some individuals, be associated to mental health issues. Differences between teenage boys and girls and between adolescents with diverse ethnic backgrounds imply that counseling and discussion about pornography need to be adjusted and individualized.
-
Randomized Controlled Trial
Can Reproductive Life Plan-based counselling increase men's fertility awareness?
Many men have limited knowledge about reproductive health and fertility. The aim of the study was to evaluate if Reproductive Life Plan (RLP)-based counselling during a sexual health visit could increase men's fertility awareness. ⋯ The intervention managed to increase different aspects of men's fertility awareness. In the future, the format for preconception care for men needs further development. Including men in preconception health policy guidelines and identifying suitable actors for care provision would be important first steps.
-
The aim of this retrospective single-centre study was to evaluate whether mutations in the ENG, ACVRL1, and SMAD4 genes were associated with different phenotypes in hereditary haemorrhagic telangiectasia (HHT). ⋯ Our results showing that ENG and ACVRL1 gene mutations result in different HHT phenotypes confirm the results from other HHT centres worldwide. Cerebral complications of HHT are common, underscoring the importance of regular screening for pulmonary AVMs and early intervention against such AVMs. We have identified an HHT patient with simultaneous mutations in the ENG and ACVRL1 genes. Surprisingly, this patient has had a mild course of the disease.