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Obsessive-compulsive disorder (OCD) affects approximately 1.3% of adults and is characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions) aimed at alleviating distress. Despite its impact on daily functioning, OCD remains underdiagnosed. Models suggest that OCD arises from maladaptive learning processes and/or biological factors, such as genetic predispositions and dysfunctional abnormalities in the cortico-striato-thalamo-cortical loops. First line treatment for OCD in Sweden is exposure and response prevention (ERP), a form of cognitive behavioral therapy (CBT). Selective serotonin reuptake inhibitors (SSRI) are first line pharmacological treatment. If treatment response is inadequate, low-dose antipsychotics can be added, followed by a switch to clomipramine. Deep transcranial magnetic stimulation (dTMS) and deep brain stimulation (DBS) may be considered for severe, treatment-resistant OCD.

Approximately 2, 000 patients in Sweden currently require active follow-up due to metal-on-metal (MoM) hip implants. These patients are at risk of complications such as elevated metal ion levels and adverse local tissue reactions (e g pseudotumors) (Fig 1). Identified risk factors include female sex, suboptimal implant selection, and, in resurfacing arthroplasties, the use of smaller femoral heads (.

High-quality and safe care is a core principle of healthcare. Since 2020, a Swedish national action plan has outlined four conditions for safer care, one of them is adequate knowledge and competence. In 2024, national competency goals for patient safety were introduced in Sweden, developed by the National Board of Health and Welfare in cooperation with patient safety academics. Covering 15 areas of knowledge, skills, and attitudes, they define what patient safety entails. The goals target leaders, physicians, nurses, and other professionals in healthcare. Though implementation is demanding, raising competence is essential to improve safety. Physicians play a key role for patient safety by identifying risks, preventing harm, and managing adverse events. As clinical experts and leaders, they must understand and apply patient safety principles. To strengthen this, continuous education in patient safety is needed in both undergraduate training and professional practice. The national competency goals are aiming to support this.

Appendectomy is the most common acute abdominal surgery worldwide, with an incidence of 96.5-100 cases per 100,000 people. Mortality rates are very low, ranging from 0.09% to 0.24% in countries with modern healthcare. In Sweden, no recent studies have reported mortality rates following appendectomy. The primary aim of this study was to investigate changes in 30-day mortality following appendectomy between 2017 and 2021. A secondary aim was to adjust for age and ASA classification when analyzing 30-day mortality. Data for this study was obtained from the national Swedish prioperative quality registry, SPOR. The study population included 38,572 appendectomy cases, with inclusion criteria requiring patients to be over 18 years old and have undergone surgery between 2017 and 2021. The overall mortality rate was 0.07%. with 26 deaths in 38,572 cases, with no statistically significant difference in 30-day mortality across the study period. No patient deceased on the day of surgery, and 9 patients deceased within 1 week. Early mortality did not change during the period studied. The 90-day mortality, total 47 patients, varied (p.

Sarcoidosis is a rare granulomatous inflammatory disease of unknown etiology that affects the nervous system in 5-10% of cases, which is referred to as neurosarcoidosis. The clinical symptoms depend on the localization and the extent of the lesions. Cranial nerves and leptomeninges are the most common sites affected. In rare cases, the disease can also affect the peripheral nervous system. In the updated 2018 classification, the disease is defined as »definite neurosarcoidosis« when confirmed by a biopsy from the nervous system. »Probable neurosarcoidosis« is defined by typical clinical findings and positive pathological findings in biopsy from systemic manifestations of sarcoidosis. »Possible neurosarcoidosis« is diagnosed when clinical observations suggest sarcoidosis, exclude alternative diagnoses, and there is no pathological confirmation. The clinical evaluation includes a thorough medical history, MRI of the central nervous system (CNS) with contrast, blood tests, and cerebrospinal fluid (CSF) analysis to detect signs of inflammation in the nervous system. There are no specific blood or CSF markers for the disease. High-resolution computed tomography (HRCT) of the chest and whole-body FDG-PET scans are used to search for systemic manifestations and find appropriate biopsy sites. A comprehensive differential diagnostic work-up should be part of the disease investigation. The cornerstone of the treatment is initially high doses of steroids, followed by tapering oral steroid doses, usually in combination with other immunosuppressive agents, including TNF-alpha inhibitors.

There is no clear consensus on when a certain amount of fat tissue becomes a health risk, and despite limited evidence supporting its accuracy, BMI continues to be used to define obesity at an individual level. Most anti-obesity drugs have been approved on the basis of their weight reduction effect, rather than on demonstrated health benefits". The expanding definition of obesity risks reinforcing stigma, especially as treatments are framed in moral and behavioral terms. Health care must balance medical necessity with awareness of social norms, ensuring that resources are directed to those most in need while acknowledging that not all larger bodies are unhealthy or in need of regulation.

Combined lifestyle management is the foundation of all obesity treatment. Through person-centered dialogue, patients are supported in designing an individualized plan. The plan may include guidance on energy-reduced healthy eating, increased physical activity, stress management strategies or improved sleep. Treatment can be delivered in-person or online, either individually or in groups. Regular evaluation is a key component of treatment, and an empathetic approach is essential for the treatment alliance.