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Leptospirosis is a zoonotic infection caused by slow-growing spirochetes of the genus Leptospira. The clinical picture varies from asymptomatic disease and mild flu-like symptoms to severe infection with jaundice, renal failure and pulmonary haemorrhage (Weil's disease). Brown rats are the most important reservoir for human infection, and the animals excrete the bacteria in their urine. Humans are infected either through direct contact with infected animals or indirectly through contaminated fresh water and soil via wounds, damaged skin or mucous membranes. Here we present two cases of indigenous leptospirosis in Sweden, one of whom developed Weil's disease.

We investigated how many of first-time fragility fracture patients were followed up in primary care and treated with bone-specific drugs. By combining data from multiple health data registers, we included 11,102 patients aged 60 years or older who sustained a fragility fracture in Region Stockholm between January 1, 2021, and June 30, 2022. The follow-up period extended up to 6 months after the fracture. Follow-up was defined as a visit to a primary care physician together with one of the following: 1) osteoporosis diagnosis, 2) bone-specific drug treatment or 3) dual-energy X-ray absorptiometry. Our findings revealed that less than 1 out of 5 patients were followed up in primary care after their first fragility fracture. Follow-up was more common among women, older patients, and for central fractures (hip, pelvis, lumbar spine). Moreover, just over 5% received bone-specific drugs within 6 months.

In this reflective practice paper, the author reports on his supervisorship of medical students in their small-group literature and ethics discussion seminars during the first five semesters at medical school in Linköping, Sweden. To ensure an open dialogue, it seems important to help students distinguish between genuinely complex medical ethical questions, on which reasonable people may have different opinions, and extremist viewpoints. Furthermore, the seminar discussions can help students realize the difference between law and ethics. Finally, the value of helping students verbalize their (often) intuitive ethical views is emphasized. In this context, a distinction is made between conversation and debate. A conversation, unlike a debate, is not about winning. Verbalizing their own views in a safe non-debate setting helps students understand the perspective of fellow students.

The Swedish guideline on post covid-19 and related syndromes classify six overlapping conditions. A functional perspective, as used in Denmark, distinguishes physiological reactions from diseases, aiding understanding and treatment. Functional symptoms arise from dysregulated adaptation systems reacting excessively. This dysregulation can persist, leading to various symptoms. Effective treatment focuses on stabilizing these systems through knowledge, behavioral changes and gradual exposure to discomfort. A biopsychosocial model addressing biological, psychological, and social factors is key. Denmark's structured approach has improved care, and similar competence-building efforts in Sweden could enhance treatment for post-infectious and long term functional conditions.

Climate transition has not been as prominent in healthcare as in other sectors of society. It is crucial to recognize the part and potential of healthcare in the climate transition, both as part of the problem and of the solution. Healthcare professionals globally are aware of the negative consequences of climate change for patients but have insufficient knowledge and experience to be able to act. This overview aims to provide insight into how the environmental and climate footprint footprint from clinical activity can be reduced while increasing resilience against extreme weather and other climate-related health effects that risk affecting our activities. It also highlights the unique role of healthcare professionals in the climate transition of society.

Unhealthy diets are a major contributor to obesity, type 2 diabetes, cardiovascular disease and cancer, but dietary improvements can significantly reduce disease risk and premature death. The food sector is responsible for one third of global greenhouse gas emissions and significant biodiversity loss, with animal-based foods having the highest environmental impact. Climate change threatens food production and nutritional quality, while over 2.3 billion people already face food insecurity. The 2023 Nordic Nutrition Recommendations (NNR) emphasize a shift towards plant-based diets for both health and environmental benefits. Achieving sustainable food systems requires political action, education, healthcare initiatives, and increased awareness. A dietary transition can improve public health, reduce environmental impact, and contribute to a sustainable future.

Climate change is already impacting our environment and health, with rising sea levels, extreme weather, and higher temperatures. Greenhouse gas levels are at their highest in three million years, making climate-related health risks increasingly urgent. Heatwaves, wildfires, and floods lead to mortality, trauma, and non-communicable diseases both in the short and long term. Climate change also alters the spread of infectious diseases in Sweden, increasing cases of Vibrio bacteria infections in brackish water and expanding the range of disease-carrying vectors like ticks and mosquitoes. Vulnerable populations, such as outdoor workers, children, elderly, and people with chronic illnesses, face higher risks. Addressing these challenges requires multidisciplinary research, proactive policy measures, and healthcare system adaptation. Additionally, the healthcare sector must reduce its own carbon footprint to mitigate climate change impacts.

Climate change poses significant risks to the health and well-being of pregnant women and children. These groups are uniquely vulnerable to climate change events due to their changing physiology, behavioural patterns and dependence on family and caregivers. Climate change leads to a range of impacts such as intensification of extreme heat and weather events, spread of infectious diseases as well as ambient air pollution and allergens. This leads to a variety of health risks for pregnant women and children, from pregnancy complications such as preeclampsia and preterm birth to increased risk of infant and child mortality. The impact of climate change is not equally distributed. Vulnerable pregnant women and children, especially those in disadvantaged communities or with comorbidities, are at greatest risk. Climate-related hazards worsen existing disparities, affecting food security, water resources, and vital health infrastructure. Addressing these issues requires a comprehensive approach to mitigate and adapt to climate change impacts, reduce vulnerabilities, and strengthen protective systems for pregnant women and children.