Purpose:The purpose of this research is to study drug use during pregnancy in Sweden and agreement between use according to antenatal medical records and dispensed drugs from a pharmacy database.Patients and methods:From the Swedish Medical Birth Register (MBR), we established a population-based cohort of 102,995 women who gave birth in 2007. Using the unique personal registration number, information on dispensed drugs from the Prescribed Drug Register (PDR) was obtained prior to, during, and after the pregnancies and compared with MBR information on drug use from standardized antenatal medical records.Results:According to the PDR, 57.6% of the 102,995 women filled a prescription with at least one drug during pregnancy and 50.9% during the lactating period (until 3 months after delivery). The most dispensed drugs during pregnancy were B-lactam antibacterials and penicillins. Agreement between drugs recorded in antenatal medical records and dispensed drugs was highest for drugs used for chronic conditions. The agreement was particularly high for thyroid therapy (85.3%), anti-intestinal inflammatory drugs (80.3%), antiepileptics (69.2%), immunosuppressants (67.4%), and insulin (63.8%). Agreement for drugs used for occasional use was generally lower, ranging between 42.5% for antihistamines and 0.8% for gynecological anti-infectives.Conclusions:A large proportion of women filled a prescription during pregnancy or the lactating period. Agreement between drug use in medical antenatal records and register information from a national pharmacy database was high for drugs used for chronic conditions but low for occasional use. For occasionally used drugs, medical record and register-based data may provide incomplete exposure information because of nonreporting or noncompliance.

SUMMARY BackgroundThe contribution of hereditary factors to the development of diverticular disease (DD) of the colon is unknown. Prevalence and location of diverticula differ in Western world compared to in Asia and several case reports describing families with DD have been published.

Level III, retrospective comparative study.

SUMMARY BackgroundColon cancer and diverticular disease are most common in the Western world and their incidences tend to increase with advancing age. The association between the diseases remains unclear.

Background:While treatment for breast cancer has been refined and overall survival has improved, there is concern that the incidence of brain metastases has increased.Methods:We identified patients in Sweden with incident breast cancer 1998–2006 in the National Cancer Register, and matched these to the National Patient Register to obtain information on hospital admissions for distant metastases. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed with Cox regression as estimates of relative risk.Results:Among 50 528 breast cancer patients, 696 (1.4%) were admitted with brain metastases during median 3.5 years of follow-up. Admissions for other metastases were found in 3470 (6.9%) patients. Compared with the period 1998–2000, patients diagnosed with breast cancer 2004–2006 were at a 44% increased risk of being admitted with brain metastases (HR 1.44, 95% CI 1.13–1.85).Conclusion:The incidence of admissions with brain metastases in breast cancer patients was increasing in the mid-2000s in Sweden. These findings support a true increase in incidence of brain metastases among breast cancer patients.

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This study makes an explorative overview on two main research topics in economics of wildlife management: determination of population sizes and policy design. The results point out a large and comprehensive research on each of these issues, in particular on the estimation of values and costs of wildlife, where this information is necessary for the determination of population size. A drawback is that most of the value and cost studies do not relate their estimates to wildlife population size, which limits their usability for efficient policy design. Most valuation studies estimate the recreational value of hunting, which can range between 13 and 545 USD/hunting day (in 2013 prices), and two thirds of the included studies have been applied to wildlife in the USA. A majority of the studies on the costs of wildlife management calculate losses from carnivore predation on livestock and ungulate damage to crops, while a few consider dispersal of diseases and the cost of traffic collisions. Unlike valuation studies, several of the cost estimates apply to wildlife in developing and emerging economies. With respect to policy design the literature, which is mainly theoretical, suggests economic incentives for conflict resolution, where those suffering from wildlife damages are compensated for their losses. However, there are some issues which remain to be addressed by economists: relating costs and benefits to wildlife populations; estimating values and costs of wildlife in developing countries; evaluating wildlife policies in practice; addressing implications of uncertainty in population size, costs, and benefits for policy design; and estimating transaction costs for implementation and enforcement of wildlife policies.