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This case report is about the treatment of a 15-year-old girl who presented with mixed episode of bipolar affective disorder dominated by symptoms of mania. Initial treatment with lithium and multiple antipsychotic medications was not effective and was complicated by uncommon and unwanted side effects. The patient was treated with ECT combined with reduced and discontinued doses of antipsychotics, which resulted in measurable positive effects.

This review evaluates the evidence for the use of over-the-scope clips (OTSC), topical haemostatic agents (THA), and prophylactic embolisation (PE) in patients with peptic ulcer bleeding (PUB). The use of OTSC and THA may have the potential to increase the rate of endoscopic haemostasis in PUB not responding to conventional endoscopic treatment. In patients at high risk of recurrent bleeding, the performance of PE after achieving endoscopic haemostasis can reduce the risk of rebleeding and the need for surgery. Implementation of a local treatment protocol including these modalities may improve patient outcomes.

Developmental stuttering is characterized by early childhood onset with repetition of syllables, prolongations, and blockades as well as secondary behavioural abnormalities. Early therapy is important while there is no approved pharmacological approach. Studies associate developmental stuttering with dopamin surplus in the striatum causing dysfunction of cortical speech areas. Consequently, antidopaminergic agents are being investigated to improve symptoms. The evidence in adults is comprised of few studies of poor quality but might hold promise as a new treatment option, as argued in this review.

A 22-year-old woman, known to have a BMI of 12 kg/m2 and a personality disorder, developed urinary retention on a normal dose of quetiapine. She had earlier tolerated a dose of 800 mg quetiapine without complications. The daily dose was 600 mg in combination with oxazepam and zolpidem. Reduction had no effect. The patient intervened with intermittent urinary catheterization the next 19 months. Normal urinary function returned three days after the last dose of quetiapine 25 mg. This case report shows that patients with a low BMI may be more receptive of the anticholinergic effects of quetiapine.

Bilateral femoral hernia is extremely rare in children. The diagnosis is challenging, and it often requires multiple surgeries before the correct treatment can be provided. In this case report, a five-year-old boy had two surgeries on suspicion of a right-sided inguinal hernia, but no hernia was found. After the second operation, the suspicion of a hernia was still present. This led to a diagnostic laparoscopy, where a bilateral femoral hernia was found. Laparoscopic McVay procedure was performed on both sides with minor modifications, which consisted of hernia sac plication and fixation to fortify the abdominal wall.

Patients with cancer and pre-existing severe mental disorder, which include moderate to severe depression, bipolar disorder and schizophrenia, are known to have reduced life expectancy and are less likely to get recommended cancer treatment. Barriers at patient-, provider- and system level have been identified, e.g. lack of identification of psychiatric comorbidity, shortage of stabilising psychiatric symptoms and fragmentation of the healthcare system. Patient-centered, interdisciplinary and cross-sectorial healthcare interventions have shown a high potential to improve the cancer care, as argued in this review.

This case report describes a 40-year-old male patient with severe cardiac failure due to eosinophilic granulomatosis with polyangiitis (EGPA) and myocarditis. The fast diagnostic approach with cardiac MRI (CMR) and immunosuppressive treatment with glucocorticoid and cyclophosphamide near-normalized the patient's cardiac function. Myocarditis due to EGPA is rare, however life-threatening, so a systematic approach and early CMR should be considered in patients with known asthma presenting with eosinophilia and cardiac involvement.

The term placebo poses challenges in definition, language and use in research and clinical settings. Placebo extends beyond inactive substances, and modern exploration has revealed complex neurobiological, psychological, and social factors influencing placebo mechanisms. With knowledge of the placebo effect, clinicians can assess and enhance the effectiveness of the most optimal treatments. Future research should explore ethical ways of promoting placebo effects, aligning with broader goals in medical practice, as argued in this review.