[An increasing prevalence of epilepsy and stagnating or decreasing health care resources makes nationwide implementation challenging].

The Swedish national guidelines for epilepsy stipulate regular health care contacts in the years following diagnosis, referral for epilepsy surgery in cases of pharmacoresistant epilepsy, multidisciplinary teams, and adequate patient information particularly for women of childbearing age. The last years have seen advances in many research areas of relevance for the basic epilepsy care, and Sweden has contributed regarding pharmacotherapy, seizure-related risks, sudden unexpected death in epilepsy (SUDEP), and digital tools. An increasing prevalence of epilepsy and stagnating or decreasing health care resources makes nationwide implementation of this knowledge challenging and increases the risk of unequal access to care.

Illness-related outcomes of illicit substance use disorder in adolescents with early onset schizophrenia: a multicenter study.

Objectives: Lifetime co-occurring substance use disorders are common at the time of presentation for the treatment of primary psychosis. Our aim was to investigate the clinical characteristics of adolescents with early-onset schizophrenia/schizoaffective disorder (EOS), categorized as either with (EOS + SUD) or without SUD (non-SUD/EOS), in a multi-center sample.

Methods: Between 2016 and 2022, 255 patients were evaluated across three tertiary-care inpatient units.

[Circulatory failure after bupropion overdose].

A case of massive overdose of sustained release bupropion tablets is described. The patient presented with GCS 3, tachycardic and in vasoplegic shock. ECHO and EKG were initially normal.

[Is individualized education for a medical students desirable? A common policy on how to handle medical students requests for individual adaptations is needed].

In Sweden, freedom of conscience for health care professionals is not legally permitted. However, requests from medical students to adjust and/or skip compulsory learning activities because of their religious and moral convictions appear to get more abundant. This creates problems when learning activities are directly related to the examination objectives stated by the Higher Education Ordinance of Sweden.

[2.6 million cataract surgeries: 31 years with the Swedish National Cataract Register 1992-2022].

This review summarizes data collected by the Swedish National Cataract Register (NCR), which by the end of 2022 contained data on more than 2.6 million cataract surgeries between 1992-2022. During these 31 years, the cataract surgery rate (CSR) rose from 3 700 to 14 407.

[SK courses in lifestyle habits. Updated proposals and course organizers' experiences].

The physician has an important role in identifying unhealthy lifestyles, offering counselling and, if necessary, referring the patient to another profession or care unit. Therefore, knowledge and skills related to lifestyle habits are included in the goal description for residents in all clinical specialities.  SK courses in lifestyle habits should be based on National Guidelines for Prevention and Treatment - Support for Governance and Management (2018), issued by the Swedish National Board of Health and Welfare.

[Radical cystectomy for bladder cancer is a complex procedure].

Radical cystectomy (RC) for bladder cancer is a complex procedure with an inherent risk of complications and even postoperative mortality. Historically, RC was performed in 44 hospitals in Sweden, which gradually decreased over time, and since a formal regional centralisation of these operations in 2017, cystectomy care is currently provided by nine hospitals. In the Swedish national urinary bladder cancer register (SNRUBC), complications after RC has been registered with high coverage since 2012, with data presented in an interactive online data resource (RODRET).

[Telephone follow-up as a part of the sepsis care process].

In a pilot study of telephone follow-up as a part of the sepsis care process, no direct patient benefit could be demonstrated. A nurse with competency in infectious diseases called patients two to six weeks post-discharge after inpatient sepsis care to assess the need for further medical attention. Out of 51 eligible patients, only 21 telephone follow-ups could be realized.

[Not Available].

Reninoma - rare juxtaglomerular tumor associated with hypertension We present a case study of two female patients, aged 20-30 years, who were diagnosed with reninoma, a rare juxtaglomerular tumor associated with hypertension, high plasma renin and hypokalemia. Both patients were referred to the Department of Internal Medicine at Sahlgrenska University Hospital, but their cases were ten years apart. In both instances, the renin-secreting tumor was surgically removed, resulting in the normalization of blood pressure without the need for antihypertensive medication.

["Samurai cannulation" less time-consuming than other techniques for treating iatrogenic type A aortic dissection].

Iatrogenic type A aortic dissection is a life-threatening condition associated with high morbidity and mortality. Traditionally, cannulation of the femoral artery or axillary artery has been preferred for arterial access, but in 2007 a new technique including direct cannulation of the ascending aorta was presented. The technique is known as "samurai cannulation" because of the quick incision of the aorta.

[The indicator »drugs that should be avoided in older people« from a medical perspective – an analysis with the patient in focus].

The drug-specific indicator »drugs that should be avoided in older people«, defined by the National Board of Health and Welfare of Sweden, is part of a large set of indicators of potentially inappropriate prescribing used for benchmarking in health care and in research. In this study, 149 consecutive primary care patients (75-99 years of age, 62 percent female, 0-20 drugs in the medication list) were included. Their medication lists were screened for potentially inappropriate drugs according to the indicator at issue, including long-acting benzodiazepines, drugs with anticholinergic action, tramadol, propiomazine, codeine, and glibenclamide.

[Documentation of prehospital emergency care].

The scientific documentation of prehospital emergency care in Sweden is slowly expanding. The first thesis on the value of a mobile coronary care unit was defended in 1982. Since then, at least 106 theses have been defended at 15 educational institutes in Sweden.

[New Swedish National care process for pediatric obstructive sleep disordered breathing].

Obstructive sleep disordered breathing (OSDB) is a spectrum from habitual snoring and labored breathing to obstructive sleep apnea (OSA), which is common and potentially serious in children. The process contains a new question at child care centers, directed at caretakers with children at age 18 months and 3 years, concerning habitual snoring (3 times a week or more). A primary care doctor verifies the suspicion of OSDB in case of a positive answer to one of 7 additional questions or 4 status findings (e.

Longstanding smoking associated with frontal brain lobe atrophy: a 32-year follow-up study in women.

Objective: To examine the association between midlife tobacco smoking and late-life brain atrophy and white matter lesions.

Methods: The study includes 369 women from the Prospective Population Study of Women in Gothenburg, Sweden. Cigarette smoking was reported at baseline 1968 (mean age=44 years) and at follow-up in 1974-1975 and 1980-1981.

Outcomes of complex oncoplastic breast surgery in older women. Analysis of data from the Age Gap cohort study.

Breast cancer, mastectomy, breast conserving surgery, post-mastectomy reconstruction, older women, quality of life.

[Thrombotic thrombocytopenic purpura - a rare diagnosis].

Thrombotic thrombocytopenic purpura (TTP) is a rare life-threatening thrombotic microangiopathy (TMA) characterized by a microangiopathic hemolytic anemia and severe thrombocytopenia, due to platelet consumption. Microthrombi form in small vessels, leading to organ ischemia, most commonly in the central nervous system (CNS). The pathophysiology of TTP is related to a deficiency of ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13), an enzyme that cleaves the von Willebrand multimer.

[Preventive treatment to avoid recurrence of stroke and TIA is effective].

Healthy living with physical activity, healthy eating habits, no smoking, and no alcohol overuse have an important role in primary and secondary stroke prevention. Further secondary prevention depends on type and cause of stroke or TIA. After intracerebral bleeding, ischemic stroke or TIA, preventive pharmacological therapies include antihypertensive drugs.

[TIA - immediate acute care and treatment decrease the risk of stroke substantially].

TIA is defined as an episode of neurological deficit with sudden onset, caused by focal cerebral or retinal ischemia lasting less than 24 hours. A tissue-based definition has been proposed but its application has been challenging, in part as its use requires magnetic resonance imaging. In most cases the diagnosis is solely based on history as provided by the patient.

[Conditions for performing CT and MRI scans in pregnant and lactating patients].

Many women are pregnant during several percent of their lives. Occasionally, there is a need for neuroradiological examinations during pregnancy or lactation. In our clinical work, we regularly see that female patients are being withheld relevant diagnostic scans during pregnancy, due to insufficient knowledge or an unbalanced comparison between benefits and risks.

[Spasticity-correcting surgery can have long-lasting effects].

Spasticity is a common secondary complication after injuries to the central nervous system (CNS). Spasticity may severely impair arm and hand function, and consequently, affect an individual's function, resulting in disabilities or limiting activities and participation. Today, there is conflicting evidence regarding the effectiveness of available spasticity treatments.