Sweden eliminated measles in the 1980s through high vaccination coverage among children. Most adults born during the 1960s or earlier have immunity to measles following prior infection, while those born later mainly rely...Sweden eliminated measles in the 1980s through high vaccination coverage among children. Most adults born during the 1960s or earlier have immunity to measles following prior infection, while those born later mainly rely on vaccine-induced immunity. The latest serological study conducted in Sweden, with samples collected in 2016, showed an overall seroprevalence of 93 %. Persons born in 1982-1996, who were the first to receive two doses, had a lower seroprevalence of 83 %. This does not necessarily indicate waning protection, as cellular immunity also plays a role against disease. Furthermore, breakthrough infections remain rare. However, older vaccinated groups show higher rates of suspected breakthrough cases. Immigrants' immunity varies. Children arriving after six years of age often match Swedish-born peers, but adults from regions with weak vaccination programs (e g, former Yugoslavia, the Baltics, and Russia) may lack protection. A 2014-15 study from Skåne Region found that measles immunity among newly arrived adult migrants ranged from 44% to 97%, reflecting past infection or vaccination gaps. Continuous monitoring of immunity is crucial, as waning antibody levels and lack of natural boosting in the elimination settings could affect long-term immunity. The Public Health Agency of Sweden recommend adults to review their vaccination status, especially before travelling abroad, and some regions offer catch-up doses to adults free of charge to close immunity gaps.
Vaccine hesitancy has been described as one of the greatest threats to public health and a contributing factor to the recent global increase in measles cases. Reasons are often complex and rooted in an interplay of histo...Vaccine hesitancy has been described as one of the greatest threats to public health and a contributing factor to the recent global increase in measles cases. Reasons are often complex and rooted in an interplay of historical, sociocultural, and individual factors. Thus, strategies to address vaccine hesitancy should be tailored to the specific concerns and contexts of different target groups. Healthcare professionals play a crucial role in maintaining public trust in vaccines. It is essential that they approach individuals expressing vaccine hesitancy with empathy and respect. Research has shown that stigmatizing concerned parents-for example, by labeling them as conspiracy theorists or irresponsible-can further reduce vaccine confidence and lower acceptance of other vaccines. To support constructive dialogue, it is therefore vital that those involved in vaccine delivery are equipped with the training and resources needed to confidently engage in these sensitive conversations.
In 2024, over 475 000 measles cases were reported worldwide, primarily among children in low- and middle-income countries. While global case numbers slightly decreased in 2025, ongoing transmission in multiple regions hi...In 2024, over 475 000 measles cases were reported worldwide, primarily among children in low- and middle-income countries. While global case numbers slightly decreased in 2025, ongoing transmission in multiple regions highlights persistent risks. Measles is targeted for elimination by 2030, but progress is uneven. Vaccination coverage remains unequal, with only 76 % of children globally receiving two doses in 2024. Pandemic disruptions and conflicts have left many children unprotected. Measles mortality is highest among infants, though deaths are rare in high-coverage countries like Sweden. Most Swedish cases are unvaccinated and associated with international travel, emphasizing the need to review travellers' vaccination status and offer supplementary vaccinations. Sweden's two-dose immunization program has eliminated endemic transmission, but vigilance and high coverage are essential to prevent outbreaks and support global elimination goals.
The CREST-2 trial randomized 2,485 well-selected low-risk patients with asymptomatic ≥70% carotid stenosis to best medical treatment (BMT) alone versus revascularization. Carotid endarterectomy (CEA) plus BMT showed no b...The CREST-2 trial randomized 2,485 well-selected low-risk patients with asymptomatic ≥70% carotid stenosis to best medical treatment (BMT) alone versus revascularization. Carotid endarterectomy (CEA) plus BMT showed no benefit over BMT alone (3.7% vs 5.3% primary endpoint at 4 years, p=0.24). Carotid Artery Stenting (CAS) plus BMT significantly reduced the endpoint compared to BMT alone (2.8% vs 6.0%, p=0.02), but the difference was fragile and peri-procedural risk was exceptionally low (1.3-1.5%) due to highly selected patients and expert operators. Many high-risk features were excluded, and BMT targets were often missed in all four groups. Conclusion: optimal medical therapy remains the cornerstone and is sufficient for most patients. CAS may be considered for carefully selected, motivated patients with favorable anatomy, when performed in high-volume centers with low complication rates using modern endovascular techniques.
Thyroid nodules are prevalent and in the majority of cases benign, typically not requiring intervention unless symptomatic. A subset of these nodules consists of cysts which, depending on their size and anatomical locati...Thyroid nodules are prevalent and in the majority of cases benign, typically not requiring intervention unless symptomatic. A subset of these nodules consists of cysts which, depending on their size and anatomical location within the thyroid gland, may elicit clinical symptoms and thus necessitate treatment. Fine-needle aspiration (FNA) is generally considered the first-line approach; however, recurrence has been reported in up to 80% of cases. Surgical management, although effective, is resource-demanding and associated with potential complications including recurrent laryngeal nerve injury and postoperative hypothyroidism. Percutaneous ethanol injection (PEI) represents a minimally invasive, safe, cost-efficient, and cosmetically favorable alternative. In this Swedish cohort of 19 patients, PEI achieved a mean volume reduction rate of 76%, with the majority of patients reporting symptomatic relief following a single treatment session. These findings support the consideration of PEI as the preferred first-line therapy for recurrent symptomatic thyroid cysts after failed FNA.
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 201...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.
Hellström Vogel Å, Borgquist O, Näslund A
… +1 more, Dryver E
Lakartidningen
· 2026 Feb · PMID 41674237
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 o...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.
Milerad H, Bonander C, Nordqvist Kleppe S
… +2 more, Dillner J, Strömberg U
Lakartidningen
· 2026 Feb · PMID 41636138
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 recen...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.
Stener Mannheimer O, Mohsen Abed M, E G W Vanfleteren L
Lakartidningen
· 2026 Jan · PMID 41607365
This study evaluated the clinical implementation of bronchoscopic lung volume reduction (BLVR) with endobronchial valves (EBV) for patients with advanced emphysema and COPD at a university hospital in Sweden. Between 202...This study evaluated the clinical implementation of bronchoscopic lung volume reduction (BLVR) with endobronchial valves (EBV) for patients with advanced emphysema and COPD at a university hospital in Sweden. Between 2022 and 2025, a total of 116 patients were evaluated, of whom 32 were treated. BLVR with EBV significantly improved lung function (FEV1), exercise capacity (6-MWT), and symptom burden (CAT score), with mean improvements exceeding the minimal clinically important difference. 3 patients (11 %) experienced complications (2 with pneumothorax, 7 %; 1 with COPD exacerbation, 4%). A dedicated multidisciplinary team with expertise in COPD, bronchoscopic interventions, and thoracic radiology is essential for treatment success. This study highlights BLVR as a promising treatment option in Sweden, with a potential for broader implementation.
van der Have O, Wåhlander H, Tran-Lundmark K
… +1 more, Odermarsky M
Lakartidningen
· 2026 Jan · PMID 41582653
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 he...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.
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 pregnan...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.
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 t...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.
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...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...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.
An elderly, right-handed, male patient presented to the emergency department at a middle sized hospital with a few hours' history of mild confusion and a difficulty expressing himself verbally. Past medical history consi...An elderly, right-handed, male patient presented to the emergency department at a middle sized hospital with a few hours' history of mild confusion and a difficulty expressing himself verbally. Past medical history consisted of hypertension and cured hairy cell leukemia. CT scan of the brain showed a 5 cm infarction in the left occipital lobe, and a corresponding P2 occlusion was seen. The patient was admitted to the stroke unit. While at the stroke unit, a detailed neurologic exam by a neurologist was performed. It was revealed that the patient could not read at all, but he could write perfectly with preserved spelling and handwriting. A diagnosis of "alexia without agraphia" was made. An MRI of the brain was performed, and infarctions well corresponding with prior case reports on the diagnosis were seen.
Johansson S, Henningsson R, Tevell S
… +1 more, Tydén J
Lakartidningen
· 2026 Jan · PMID 41498451
Methemoglobinemia is a condition characterized by tissue hypoxia and normal oxygen partial pressure in the blood. The methemoglobin is created through the oxidation of the hemoglobin molecule in erythrocytes, changing Fe...Methemoglobinemia is a condition characterized by tissue hypoxia and normal oxygen partial pressure in the blood. The methemoglobin is created through the oxidation of the hemoglobin molecule in erythrocytes, changing Fe2+ to its ferric state Fe3+, causing it to lose its oxygen-carrying capacity. The condition can be drug-induced, caused by congenital enzyme deficiency or triggered through disease processes such as sepsis. In this case report, we describe an 80-year-old woman who developed severe methemoglobinemia in connection with a fatal pneumococcal sepsis.