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OBJECTIVES: Orofacial pain in patients taking part in a multimodal rehabilitation programme (MMRP) due to chronic bodily pain is common but it is not known whether such a rehabilitation programme can also have an effect on the presence of orofacial pain. The first aim of this study was to evaluate the effect of an MMRP on orofacial pain frequency. The second aim was to evaluate differences in the effect on quality of life and on psychosocial factors related to chronic pain. METHODS: MMRP was evaluated through validated questionnaires from the Swedish Quality Registry for Pain Rehabilitation (SQRP). Fifty-nine patients participating in MMRP filled out the two screening questions for orofacial pain in addition to the SQRP questionnaires before and after participation in MMRP during the period August 2016 to March 2018. RESULTS: Pain intensity decreased significantly after the MMRP (p=0.005). Fifty patients (69.4 %) reported orofacial pain before MMRP and no significant decrease after the programme (p=0.228). Among individuals with orofacial pain, the self-reported level of depression decreased after participation in the programme (p=0.004). CONCLUSIONS: Even though orofacial pain is common among patients with chronic bodily pain, participation in a multimodal pain programme was not enough to reduce frequent orofacial pain. This finding implies that specific orofacial pain management including information about jaw physiology could be a justified component of patient assessment prior to a multimodal rehabilitation programme for chronic bodily pain.

Objective To assess the effect of adding an oral glucose tolerance test (OGTT) to fasting plasma glucose (FPG) in terms of detection of type 2 diabetes (T2D) and impaired glucose tolerance (IGT). Design Retrospective analysis of serial cross-sectional screening study. Setting Population-based health examinations within primary care in Vasterbotten County, Sweden. Participants Individuals aged 40- 50 and 60 years with participation from 1985 to 2017. Those with previously diagnosed diabetes and FPG >= 7 mmol/L were excluded. Primary and secondary outcome measures Prevalence of hyperglycaemia on the OGTT (IGT and T2D defined as 2-hour postload capillary plasma glucose of 8.9-12.1 mmol/L and >= 12.2 mmol/L, respectively). Analyses were further stratified by age, sex and risk factor burden to identify groups at high or low risk of IGT and T2D on testing. The numbers needed to screen (NNS) to prevent one case of T2D through detection and treatment of IGT was estimated, combining prevalence numbers with average progression rates and intervention effects from previous meta-analyses. Results The prevalence of IGT ranged from 0.9% (95% CI 0.7% to 1.1%) to 29.6% (95% CI 27.4% to 31.7%), and the prevalence of T2D ranged from 0.06% (95% CI 0.02% to 0.11%) to 7.0% (95% CI 5.9% to 8.3%), depending strongly on age, sex and risk factor burden. The estimated NNS to prevent one case of T2D through detection and lifestyle treatment of IGT ranged from 1332 among 40-year-old men without risk factors, to 39 among 60-year-old women with all risk factors combined. Conclusions The prevalence of hyperglycaemia on OGTT is highly dependent on age, sex and risk factor burden; OGTT should be applied selectively to high-risk groups to avoid unnecessary testing in the general population.

Objectives Pain referral on palpation has been suggested to be a clinical sign of central sensitization potentially associated with widespread pain conditions. Our aim was to evaluate if myofascial pain with referral is a better predictor for widespread pain when compared to no pain or local myofascial pain. Materials and methods Individuals at the Public Dental services in Vasterbotten, Sweden, were randomly invited based on their answers to three screening questions for temporomandibular disorders (TMD). In total, 300 individuals (202 women, 20-69 yrs) were recruited, and examined according to the Diagnostic Criteria for TMD (DC/TMD) after completion of a body pain drawing. Widespread pain was considered present when seven or more pain sites were reported on the widespread pain index. A binary logistic regression model, adjusted for the effect of age and gender were used to evaluate the association between myofascial orofacial pain and widespread pain. Results Widespread pain was reported by 31.3% of the study sample. There was a 57.3% overlap with myofascial pain. Widespread pain was associated to myofascial orofacial pain with and myofascial orofacial pain (OR 4.83 95% CI 2.62-9.05 and OR 11.62 95% CI 5.18-27.88, respectively). Conclusion These findings reinforce the existing knowledge on the overlap between painful TMD and other chronic pain conditions.

Introduction: To compare data from preoperative positron emission tomography/computed tomography (PET/CT) with results of panscopy with biopsy and ultrasound with fine needle aspiration cytology (US-FNAC) on the same patients. Methods: In this retrospective (2014-2016) study, we compared PET/CT results with the results from panscopy with biopsy and US-FNAC in patients suspected of head and neck malignancy treated at the University Hospital in Umea, Sweden. Results: A 91.3% concordance was seen between results from PET/CT and panscopy with biopsy, whereas between PET/CT and US-FNAC the concordance was 89.1%. Conclusions: The present data show the usefulness of PET/CT in the diagnosis of head and neck malignancies.

Studies have shown lower treatment-related morbidity when using transoral robotic surgery (TORS) compared to conventional surgery. Patients investigated for oro- and hypopharyngeal cancer (T1, T2) were compared concerning quality of life (QoL) after tonsillectomy and TORS using validated QoL questionnaires: QLQ-C30 and QLQ-H&N35. The patients treated with TORS showed a higher pain score and thus also a higher need for painkillers, whereas they had lower values on self-assessment of anxiety/depression using the Hospital Anxiety and Depression Scale score. The pre- and postoperative information given did not meet the expectations of the patients treated with conventional surgery. The present data show advantages of the TORS technique from the patients' perspective. Even if patients treated with TORS are in need of more painkilling treatment, they cope better with the long-term effects of treatment, as judged by self-assessment of anxiety and depression.

A set of distributional assumptions regarding the demographic processes of birth, death, emigration and immigration have been assembled to form a probabilistic model framework of population dynamics. This framework was summarized as a Bayesian network and Bayesian inference techniques are exploited to infer the posterior distributions of the model parameters from observed data. The birth, death and emigration processes are modelled using a hierarchical beta-binomial model from which the inference of the posterior parameter distribution was analytically tractable. The immigration process was modelled with a Poisson type regression model where posterior distribution of the parameters has to be estimated numerically. This thesis suggests an implementation of the Metropolis-Hasting algorithm for this task. Classifi cation of incomings into subpopulations of age and gender is subsequently made using a Dirichlet-multinomial hierarchic model, for which parameter inference is analytically tractable. This model framework is used to generate forecasts of demographic data, which can be validated using the observed outcomes. A key component of the Bayesian model framework used is that is estimates the full posterior distributions of demographic data, which can take into account the full amount of uncertainty when forecasting population growths., Genom att använda en mängd av distributionella antaganden om de demografiska processerna födsel, dödsfall, utflyttning och inflyttning har vi byggt ett stokastiskt ramverk för att modellera befolkningsförändringar. Ramverket kan sammanfattas som ett Bayesianskt nätverk och för detta nätverk introduceras tekniker för att skatta parametrar i denna uppsats. Födsel, dödsfall och utflyttning modelleras av en hierarkisk beta-binomialmodell där parametrarnas posteriorifördelning kan skattas analytiskt från data. För inflyttning används en regressionsmodell av Poissontyp där parametervärdenas posteriorifördelning måste skattas numeriskt. Vi föreslår en implementation av Metropolis-Hastingsalgoritmen för detta. Klassificering av subpopulationer hos de inflyttande sker via en hierarkisk Dirichlet-multinomialmodell där parameterskattning sker analytiskt. Ramverket användes för att göra prognoser för tidigare demografisk data, vilka validerades med de faktiska utfallen. En av modellens huvudsakliga styrkor är att kunna skatta en prediktiv fördelning för demografisk data, vilket ger en mer nyanserad pronos än en enkel maximum-likelihood-skattning.