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In patients with pleural fluid, thoracocentesis is indicated for diagnostic and/or therapeutic reasons. Pleural fluid analysis allows for the identification of infected effusions whereby fluid drainage improves patient outcome. Pleural fluid analysis is also indicated in the setting of suspected malignancy and unilateral effusions of unclear etiology. Drainage of large fluid collections reduces dyspnea. Use of ultrasound is mandatory when selecting the site of thoracocentesis. Real-time ultrasound confirms catheter placement in the pleural space and allows for its positioning in the posterocaudal recess. An 8F catheter is sufficiently large for drainage in most settings. The rate of complications from catheter insertion is very low, and coagulopathy is rarely a contraindication.

Taiwan is addressing rapid population aging by promoting senior health and nutrition. By 2025, over 20% of its population is aged 65 or older. For this reason, Taiwan launched Community Nutrition Promotion Centres in 2017, that are now operating in all counties. The community nutritionists guide seniors on balanced diets using adapted traditional recipes. They also offer nutrition screenings and promote physical activity. In 2023, Taiwan passed the Nutrition and Healthy Diet Promotion Act and showcased its efforts at a 2025 APEC conference. Taiwan is setting a regional example for healthy, sustainable aging.

A high coverage rate of cervical cancer screening is necessary to prevent cervical cancer. Women who have not been tested in the last 10 years are considered as long-term non-attenders from the screening program. A recent report from the Regional Cancer Centers in Sweden addressed geographic disparities in the 10-year coverage rate among 33-62-year-old women residing in Sweden in 2023, and compared the results with those in a previous report from 2020. The analytic method employed is referred to as geomapping, based on geo-coded data to 5984 neighborhoods (Statistics Sweden's Demographic Statistics Areas [DeSO]). Individual data on HPV/Pap testing in the previous 10-year period, age, and residential address (used for the geo-coding) were retrieved from the National Cervical Screening Registry. Neighborhood-level data on economic standard, proportion of non-Western immigrants, and geographic location (urban/semi-urban/rural) were assessed, based on data from Statistics Sweden, for estimation of neighborhood-level associations. The overall 10-year coverage rate decreased from 91.9% in 2020 to 91.1% in 2023. We identified 147 out of the 5984 neighborhoods as showing statistical evidence for a pronouncedly lower 10-year coverage rate than the overall average of 91.1 %. Furthermore, we found a decreasing 10-year coverage rate with lower economic standard, as well as with increasing proportion of non-Western immigrants. After adjustments for these two neighborhood-level covariates, we found that rural geographical location was associated with lower 10-year coverage rate. The results demonstrate that geomapping can provide a rational basis for targeting population-level interventions to improve screening. Specifically, it is rational to allocate extra resources, if available, towards the 147 identified neighborhoods with a pronouncedly lower 10-year coverage rate.

Survival for children on the waiting list has improved significantly over time in Sweden and the Nordic countries, despite an increase in waiting list duration over time. Approximately 40% of hearts used for pediatric heart transplantation in Sweden come from donors in other Nordic countries. Outcomes following pediatric heart transplantation in Sweden and the Nordic countries are comparable to much larger regions and registries, despite a low number of yearly transplants in the region.

The aim of this article was to report our first results of radiofrequency ablation (RFA) of benign thyroid nodules. The first radiofrequency ablation was performed in Sweden on 15 March 2024. Until February 2025 15 RFA treatments were completed. Inclusion criteria were the following: ≥18 years of age, compression symptoms, nodule >2.0 cm, solid component >30%, and benign cytology (Bethesda II) in two separate cytological assessments. RFA was performed using the »moving shot« technique and transisthmic approach. Nodule volume and symptoms were evaluated before treatment and during follow-up at 3 months, 6 months, and 12 months. The volume reduction rate was 40-71% (mean 63%) at 3-month control, 54%-85% (mean 71%) at 6-month control and 57-94% (mean 77%) 12-month control. There was no major complication. Minor complications (pain during intervention) were observed. RFA is an effective non-surgical treatment for patients with benign thyroid nodules.

A perimortem caesarean section should be performed within 4 minutes of maternal cardiac arrest. There is no defined upper time limit. The procedure is indicated from gestation week 20, or if the woman is "visibly pregnant". It should be performed at the location of the arrest. The procedure may increase the chances of maternal ROSC. This is due to increased venous return (by reducing aortocaval pressure), increased lung expansion and reduced uterine blood flow. In a county hospital, maternal cardiac arrest is a rare occurrence. Therefore, well-developed local emergency guidelines and protocols are important. We present a case where a young woman was admitted to the delivery ward due to dyspnea. She deteriorated quickly and went into cardiac arrest. A perimortem caesarean section was performed and ROSC was achieved. Both mother and child made a full recovery. Teamwork and communication were crucial in this favorable outcome.

This primary care case study describes a 90-year old woman with heart failure (HF), atrial fibrillation and other comorbidities. The use of multiple drugs prescribed in accordance with HF guidelines resulted in transient confusion, renal failure and hypotension leading to dependency in daily life and an unplanned hospitalisation. Cognitive impairment was confirmed through a pathological result on the »clock drawing test« normalizing after discontinuation or dose reduction of several drugs. Single disease guidelines have limited evidence in older adults with multimorbidity who are systematically excluded from randomized controlled trials, and serious adverse events are common. This underscores the necessity of closely monitoring side effects and deviating from guidelines when clinically appropriate. General practitioners should actively contribute to the development of treatment guidelines to better address the complexities of care for older adults with multimorbidity.

Most people with type 1 diabetes rely on continuous glucose monitoring (CGM) for glucose control. However, the EU Medical Device Regulation (MDR) does not sufficiently ensure quality control due to lack of a standard for CGM devices. Several cases have been reported where healthcare providers had to discard CGM systems after purchase due to poor performance. Moreover, the mean absolute relative difference (MARD) is inadequate for measuring accuracy. MARD can be influenced by study design, e.g. by including individuals with type 2 diabetes, using only data during stable glucose levels, or assessing only the most accurate days of sensor survival. Instead, accuracy should be based on methods reflecting real-world challenges in people intended to use the device. Diagnosis, age and gender should be considered. The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) is currently developing criteria for the evaluation of CGM systems.