[Premature ovarian insufficiency - patients are underdiagnosed and undertreated].

Women presenting with amenorrhea and elevated serum levels of FSH before the age of 40 may suffer from premature ovarian insufficiency (POI). POI can be caused by ovarian damage through surgery, irradiation and chemotherapy. Autoimmune disease and genetic causes are also possible causes for development of POI.

[The core of the Apple Heart Study].

Recently, the Apple Heart Study was reported. Individuals in the United States already using an Apple Watch were recruited digitally to a mass screening study on heart rhythm. The mean age of the participants was slightly above 40 years and the yield of significant arrhythmias was low.

Chronic kidney disease of non-traditional origin in Mesoamerica: a disease primarily driven by occupational heat stress.

The death toll of the epidemic of chronic kidney disease of nontraditional origin (CKDnt) in Mesoamerica runs into the tens of thousands, affecting mostly young men. There is no consensus on the etiology. Anecdotal evidence from the 1990s pointed to work in sugarcane; pesticides and heat stress were suspected.

[New recommendations for antiepileptic drug therapy: the last piece in the review of epilepsy care].

Antiepileptic drug (AED) therapy is symptomatic. New AED:s have not decreased the proportion of epilepsy patients resistant to pharmacological treatment. Lamotrigine, levetiracetam and carbamazepine are first-line options for focal seizures.

[During the first years in Sweden migrants utilize less psychiatric care than Swedish born do].

This paper focus on migrants' utilization of psychiatric care, defined here as a contact in primary care due to psychiatric problems, psychiatric in- and outpatient secondary care, voluntary and compulsory use of psychiatric emergency services and compulsory unit admissions. The utilization of psychiatric care among migrants is lower than for the Swedish-born population during the ten first years in Sweden, except compulsory care. The utilization of psychiatric care increases over time among migrants, but the pattern differs by region of origin.

[Evening dosing of antihypertensive drugs - future studies should be awaited before changing clinical practice].

Night-time blood pressure is an independent prognostic marker for cardiovascular disease. Evening dosing of antihypertensive agents can reduce night-time blood pressure and restore night-time blood pressure dipping pattern. In the Hygia Chronotherapy Trial, evening dosing of antihypertensive agents was compared to morning dosing, with dramatic effects on cardiovascular events and total mortality.

[Treatment of orthopedic implant-associated infections].

The Swedish National Guidelines for Bone and Joint Infections were revised during 2018. The work was carried out on behalf of the Swedish Society for Infectious Diseases. The study group consists of senior consultants in infectious diseases, supported by specialists in orthopedic surgery, clinical microbiology and allergology when needed.

[Physical activity measured with accelerometers].

The development of accelerometers has revolutionized measurement of physical activity, and they are used to a large extent in research and have started to be implemented into clinical settings. However, achievement of reliable outcomes requires good methodological knowledge and skills by the user. Otherwise, significant measurement errors may occur, interfering with assessment of the physical activity level in the population, group differences, associations with health parameters or effect of treatments.

[Need for improvements in neonatal care].

The medical and nursing care of preterm infants has improved over the last decades, including the involvement of parents in the daily care. Previously parents could only visit a few scheduled hours per day but today most neonatal units in Sweden strive to let the parents be the primary caregivers, with the right to stay at the unit during the entire hospitalization period. Despite this development, there is still need for a number of improvements, not only in the neonatal care but also during the complicated pregnancy.

[Analytical investigation of a suspected case of drug-facilitated crime].

Sometimes it is suspected that people have been involuntary exposed to drugs, usually by spiked drinks. A young woman was transported to an emergency department by ambulance. Her clinical symptoms (decreased consciousness, mydriasis, confusion, hallucinations and urine retention) indicated anticholinergic syndrome that was effectively treated with the antidote physostigmine.

[Treatment of eating disorders with concurrent ADHD symptoms: knowledge, knowledge gaps and clinical implications].

Emerging evidence supports a prevalence overlap between ADHD and bulimia nervosa/binge eating disorder. A high degree of ADHD symptoms may have a negative impact on recovery in eating disorders with loss of control over the eating, bingeing and purging. Screening/diagnostic evaluation of ADHD in all persons with loss of control over the eating/bingeing/purging eating disorders is required.

[Improved and harmonised laboratory analysis of paracetamol provides safer assessment of poisoning cases].

Toxicological analysis is an important part of the acute treatment of various intoxications. Rapid laboratory responses are important for the patient to be assessed and treated correctly, and also to exclude poisoning and thus avoid unjustified and costly overtreatment. In Sweden, paracetamol (acetaminophen) is one of the most common pharmaceuticals in drug poisoning.

[Tracheal injury is a rare but potentially critical complication to intubation].

Tracheal rupture is a rare but potentially lethal injury. There are several causes; traumatic, neck surgery, tracheal dilatation and association to intubation. We describe a case of tracheal injury where the patient developed subcutaneous emphysema while coughing in the recovery room.

[Not Available].

Since 2012, the National Diabetes Council at Swedish Association of Local Authorities and Regions (SALAR) has been active to improve health care for persons with diabetes. The Council has produced a number of national care programmes, e.g.

[The neutrophil's multifaceted traps - the Dr Jekyll and Mr Hyde of the immune system].

Neutrophil extracellular traps (NETs) were first described over a decade ago as part of our innate immune system. Through the extracellular release of web-like structures composed of DNA and histones coated with antimicrobial peptides, the neutrophil was shown to entrap and disarm invading microorganisms. Recent data now propose a central role of NETs in a variety of non-infectious conditions - such as autoimmunity, thrombosis, and cancer - revealing that NETs may not only be beneficial, but also harmful if uncontrolled.

[Residential multimodal job focused rehabilitation for teachers increases return to work].

Stress induced exhaustion disorder is the disease that caused most sickleavedays in Sweden during the last 10 years. Teachers have the highest percentage of sick leave, and is the group where the number on sick leave increases most. No previous studies have achieved a statistically significant increased return to work after any specific treatment for exhaustion disorder.

[Endocrine tumours in Stockholm - increasing general incidence].

In recent years, a significantly increased incidence of endocrine tumours has been observed worldwide, not least papillary thyroid cancer - with improved diagnostics and various biological factors being two possible causes of the upsurge. In this material from the Karolinska University Hospital, to date the largest tertiary endocrine surgery unit in the Nordic region, we see a near five-fold increase in the number of diagnosed thyroid cases and a distinct rise in the incidence of tumour cases in the thyroid, parathyroid and adrenal glands. The increase can only partly be explained by an accommodation of patients to tertiary units and should therefore be considered as a true increase in incidence across the Swedish population.