[Management of patients with gastroesophageal reflux disease can be optimized].

Gastroesophageal reflux disease (GERD) often requires lifelong treatment to return to and maintain a normal quality of life. Proton pump inhibitors (PPIs) offer effective medical treatment and can be used for a long time with good safety margins. The diagnostic criteria for GERD must be strictly based on current guidelines and the need for maintained treatment must be regularly evaluated.

[The healthcare system needs to be more active in spreading information online].

A covid-19 infection during pregnancy means an increased risk for the pregnant woman to end up in the ICU or to have a premature birth and may involve a placental infection that adversely affects the baby. Vaccination against Covid-19 among pregnant women is generally safe. The Swedish healthcare system must become better at getting its message across and adapting information to today's needs.

[Ambulance assignments for epilepsy seizures were more common in socioeconomically weaker areas].

Internationally, the prevalence and incidence of epilepsy increases with lower socioeconomic position. We analyzed GPS coordinates of ambulance assignments for seizures in Västra Götalandsregionen, a health care region in western Sweden with 1.7 million inhabitants, and correlated the number of assignments to socioeconomic data.

[Mental fatigue - possible explanations, diagnostic methods and possible treatments].

Mental fatigue or brain fatigue is a pathological and disabling symptom with diminished mental energy. It can be a long-lasting consequence after trauma or disease affecting the brain. The person can do most things in the moment and can be perceived as completely healthy, but the mental energy is insufficient over time and affects the ability to work and participate in social activities.

[Treatment and diagnosis of overuse injury in the Achilles tendon].

Achilles tendinopathy is a common overuse injury, especially among runners. It should be divided into midportion Achilles tendinopathy and insertional Achilles tendinopathy, as the treatments are different. Achilles tendinopathy is a clinical diagnosis, which includes a combination of pain, swelling and stiffness.

[The combination of nerve and tendon transfers offers good possibilities for hand function in patients with cervical spinal cord injury].

Regaining upper extremity function is a prioritized matter for patients with tetraplegia after a cervical spinal cord injury (cSCI). The purpose of this article is to describe the current evidence and treatment strategies for upper extremity reconstruction after cSCI at the Centre for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, Sweden. The specialized unit works in a multidisciplinary setting to optimize the care of the patient population.

[The number of patients diagnosed with ADHD and the number of prescriptions for ADHD are increasing].

The core symptoms of ADHD (Attention Deficit Hyperactivity Disorder) are inattention, hyperactivity and impulsivity.  The multimodal treatment of ADHD consists of a combination of pharmacological treatment, psychoeducation, psychotherapy and occupational therapy interventions. The treatment needs to be individualized with clear and measurable goals.

An approach for determining allowable between reagent lot variation.

Clinicians trust medical laboratories to provide reliable results on which they rely for clinical decisions. Laboratories fulfil their responsibility for accurate and consistent results by utilizing an arsenal of approaches, ranging from validation and verification experiments to daily quality control procedures. All these procedures verify, on different moments, that the results of a certain examination procedure have analytical performance characteristics (APC) that meet analytical performance specifications (APS) set for a particular intended use.

[Cervical myelopathy due to nitrous oxide inhalation].

A 19 year old male presented to his GP with bilateral numbness and stiffness of hands and lower limbs, as well as muscle weakness and poor balance. The patient admitted recreational use of nitrous oxide (laughing gas) some days earlier. He was hospitalised and underwent a series of plasmapheresis treatments due to an initial suspicion of inflammatory myelitis.

[Paroxysmal sympathetic hyperactivity].

Paroxysmal sympathetic hyperactivity (PSH) is a condition mainly described in patients after traumatic brain injury and it is also known under the terms "autonomic storm" and "dysautonomia". It affects between 8-10% of patients after traumatic brain injury and can also affect patients after other neurological diseases, such as anoxic brain injury, stroke, tumors or infections. PSH manifests with six main symptoms: tachycardia, tachypnea, hypertension, hyperthermia, hyperhidrosis and increased muscle tonus.

The impact of implementing a person-centred pain management intervention on resistance to change and organizational culture.

Background: Resistance to change and organizational culture are essential factors to consider in change management in health care settings. Implementation of structural change remains a challenge. There is a lack of studies providing information on the impact of implementation processes on the organization.

[The role of prehospital emergency care in Sweden has changed - patient safety has become a key issue].

Prehospital emergency care in Sweden has undergone dramatic changes in recent decades from the role of being a primary transport organization to a more differentiated approach to health care. The Swedish prehospital emergency nurse must therefore today make prehospital assessments to be able to decide whether patients should be transported to hospital with »fast-track« or sent to primary care or stay at home with advice on self-care. Therefore, »patient safety« has become a key issue and primary data indicate that there is a risk of a potential adverse event in approximately four percent of the primary assignments.

The role of co-production in Learning Health Systems.

Background: Co-production of health is defined as 'the interdependent work of users and professionals who are creating, designing, producing, delivering, assessing, and evaluating the relationships and actions that contribute to the health of individuals and populations'. It can assume many forms and include multiple stakeholders in pursuit of continuous improvement, as in Learning Health Systems (LHSs). There is increasing interest in how the LHS concept allows integration of different knowledge domains to support and achieve better health.

[Xerophthalmia in a 7-year-old autistic child].

Vitamin A deficiency and xerophthalmia is a rare finding in developed countries. We report a severe case of xerophthalmia in a 7-year-old autistic child with restricted diet. Both eyes had Bitot's spots and ulceration.

Health-Related Quality of Life After Nipple-Sparing Mastectomy: Results From the INSPIRE Registry.

Introduction: Nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) is increasingly used for both breast cancer (TNSM) and risk reduction (RRNSM). The aim of the study is to report the results of the INSPIRE registry assessing health-related quality of life (HRQoL) comparing baseline and 1-year follow-up, regarding surgical indications and chemotherapy (CT) received.

Methods: INSPIRE is a prospective database including women undergoing NSM and IBR from 18 countries.

[Syphilis, the forgotten disease].

The incidence of syphilis was decreasing during the last decades of the 20th century, partly due to the awareness and fear of hiv. However, an increase is now apparent in many countries. It is still uncommon in Sweden compared to chlamydia and gonorrhoea, and the incidence is 4.

[Colleague supervision as an educational model in a course for specialist training doctors: a possibility to educate many clinical supervisors for medical students].

Colleague supervision is an educational model where equal colleagues give each other feedback on a professional activity. We present how colleague supervision can be used in the training of clinical supervisors for medical students. In a course given to specialist training doctors since 2018, participants observe each other when supervising students in the clinic.

[Eye disease in primary care - examples from three different primary care units].

A retrospective study was performed at three primary care centers, between 1 July 2019 and 31 January 2020. During that period, 200 patients were assessed for eye/vision problems. Demographic data as well as how they were examined, diagnosed and the treatment that was given to them were registered.

Dizziness and health-related quality of life among older adults in an urban population: a cross-sectional study.

Background: Dizziness is a common complaint among older adults and may affect quality of life in a negative way. The aim of this study was to assess health-related quality of life (HRQL), sense of coherence (SOC), self-rated health (SRH) and comorbidity in relation to dizziness, among older persons from an urban population.

Methods: The study is part of the Gothenburg H70 Birth Cohort Studies (H70).

[SCORE2 - an updated model for cardiovascular risk prediction].

Cardiovascular disease is the most important cause of death and life-years lost in Sweden today. Cardiovascular risk prediction is a cornerstone in primary prevention; the use of antihypertensive and lipid-lowering therapy is guided by absolute cardiovascular risk. The Systematic COronary Risk Evaluation (SCORE) model has been the most widely applied model in Sweden for almost two decades.

[What aspects do medical students find important during medical school to develop basic prescribing skills?].

The process of acquiring prescribing skills starts in medical school, and recent research highlights that educational efforts are needed to make students sufficiently prepared for this professional task. In this study, we explored and quantified aspects that medical students find important during medical school to develop basic prescribing skills. Written text from 75 final-year students (median age: 25 years, 59% female) formed the data.

[The continuum of stroke care - a way to make it more cost effective].

A stroke is the most common cause for disability in the adult population. Rehabilitation is the tool to reduce the consequences of impairment. However, the continuum of stroke care is fragmented and rehabilitation is often lacking and unevenly distributed along the care pathway.