ObjectiveTo investigate potential violations of patient confidentiality or other breaches of medical ethics committed by physicians and medical students active on the social networking site Twitter.DesignPopulation-based cross-sectional observational study.SettingThe social networking site Twitter (Swedish-speaking users, n=298819).PopulationPhysicians and medical students (Swedish-speaking users, n=237) active on the social networking site Twitter between July 2007 and March 2012.Main outcome measurePostings that reflect unprofessional behaviour and ethical breaches among physicians and medical students.ResultsIn all, 237 Twitter accounts were established as held by physicians and medical students and a total of 13 780 tweets were analysed by content. In all, 276 (1.9%) tweets were labelled as ‘unprofessional’. Among these, 26 (0.2%) tweets written by 15 (6.3%) physicians and medical students included information that could violate patient privacy. No information on the personal ID number or names was disclosed, but parts of the patient documentation or otherwise specific indicatory information on patients were found. Unprofessional tweets were more common among users writing under a pseudonym and among medical students.ConclusionsIn this study of physicians and medical students on Twitter, we observed potential violations of patient privacy and other breaches of medical ethics. Our findings underline that every physician and medical student has to consider his or her presence on social networking sites. It remains to be investigated if the introduction of social networking site guidelines for medical professionals will improve awareness.

Background: There has been a concern that blood donations can increase the risk of hematological malignancies. We investigated if blood donations increase the risk of developing hematological malignancies, specifically acute lymphoblastic leukemia, acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), chronic myeloid leukemia, Hodgkin lymphoma, and myeloma, as well other non-Hodgkin lymphoma. Study Design and Methods: In total, the study included 1,021,433 Swedish blood donors, with 19.5 million person-years of follow-up. Two sets of analysis were performed. In the first cohort analysis, standardized incidence ratios (SIRs) were calculated, comparing the incidence of the different types of hematological cancers in blood donors to that of the general population. In the second analysis, a nested case-control study was conducted, investigating the association between number of donations and the risk of each type of malignancy. Results: Apart from a modestly elevated risk of CLL (SIR, 1.07; 95% confidence interval [CI], 1.01-1.15) and a modestly decreased risk of AML (SIR, 0.85; 95% CI, 0.77-0.83), the risk of hematological malignancies did not differ between blood donors and the general population. In the nested case-control study there were no convincing associations between number of prior whole blood donations and site-specific malignancy risk. Conclusions: There was no convincing evidence of an increased risk in any hematological malignancy when interpreting the results from both series of analyses.

Background There is a paucity of data on patterns of red‐cell transfusions in obstetrical care, but some studies have suggested an increase in transfusion rates during the last decade. The purpose of this study was to investigate maternal characteristics, temporal trends and hospital variations in red‐cell use in a large contemporary obstetric cohort in Sweden. Study design and methods Nationwide observational cohort study of maternal red‐cell transfusions for all deliveries in Sweden between 2003 and 2017. Results The proportion of deliveries that received red‐cell transfusions was stable during the study period, although the number of red‐cell units administered per delivery declined. Among transfused women, most received a low‐volume transfusion of 1 or 2 units. Red‐cell transfusion was more common among the nulliparous, for instrumental and caesarean deliveries, and with increased maternal age. We saw large variations in transfusion rates between hospitals in Sweden, despite adjusting for age and parity. Conclusions In comparison to other high‐resource countries we see a high proportion of deliveries with maternal red‐cell transfusions. However, we do not see an increase in red‐cell use over time.