[Palliative cancer care is an important part of urology. A study of the last year of life of patients who died because of urologic cancer].

A total of 330 in-patient episodes at the urology ward, with a mean duration of 9.8 days, were registered in a study of 100 patients who died from urological cancer. Twelve patients spent more than two months of their last year of life at the urology ward.

[Meager support for herbal therapy of rheumatoid arthritis].

The Cochrane collaboration has recently published a systematic review of placebo controlled randomized trials of herbal therapies for rheumatoid arthritis. An extensive search including all languages screened 2500 hits, identified 47 trials and accepted 11 as meeting set quality criteria. Modest efficacy of gamma linolenic acid containing products was supported by 7 trials, 4 trials dealt with 4 different products, and no conclusions could be derived from these.

[Both neurogenic and vascular causes of primary headache].

The cerebral circulation is innervated by sympathetic, parasympathetic and sensory nerves which store a number of neurotransmitters. The significance of these for primary headache has been evaluated. A clear association between head pain and the release of calcitonin gene-related peptide (CGRP) was demonstrated.

[Adults with congenital heart defects--a growing patient group].

The number of grown ups with congenital heart disease (GUCH) increases due to the success story of pediatric cardiology and heart surgery. However, late complications such as arrhythmia, endocarditis and heart failure are common, as are patients requiring reoperation/catheter intervention. In some categories of congenital heart disease, pregnancy may pose a substantial threat.

[A case report: young man survived penetrating knife stabs to the heart and lung].

In Sweden, penetrating injuries to the lung and especially to the heart are fortunately rare. We hereby present a case-report on a young man who was stabbed in the right lung and heart. The paramedics arrived at the scene one minute after the alarm and instituted mechanical ventilation and fluid infusion.

[High time to test hypothermia in the treatment of stroke].

There is a revived clinical interest in hypothermia as a neuroprotective intervention in brain ischemia. This originates from the experimental finding that hypothermia of only 3 degrees C-4 degrees C below normal body temperature completely abolishes neuronal damage from an ischemic insult that is lethal in normothermia. The idea that hypothermia protects cells from ischemic damage mainly by lowering metabolic rate is challenged.

[Rh-prophylaxis or not? Obstetric departments should make decisions if there are medical reasons which justify the treatment].

In order to find out whether or not the incidence rate of RhD-immunization has increased in pregnant women who were not given antenatal prophylaxis a survey was carried out comprising 620 women. It was evident that the number of new immunizations had decreased, both in absolute numbers and in relation to the number of births during the years 1991-1998. Hence prophylactic anti-D seems not to be indicated, neither for this group of women nor for women who have had a spontaneous abortion.

[Artificial respiration at home seen in a 5-year perspective. Established treatment, but remarkable differences among the counties].

The Swedish prevalence of home mechanical ventilation is 8.2 per 100.000 with 10% annual increase.

[Interleukin-18 and new drugs. Protective effect against tumor growth and infections].

IL-18, originally identified as interferon-gamma inducing factor (IGIF), is related to the IL-1 family in terms of its structure as well as its processing, receptor, signal transduction pathway and pro-inflammatory properties. IL-18 is also functionally related to IL-12, as it induces the production of Th1 cytokines and participates in cell-mediated immune cytotoxicity. A summary is made of recent advances in the understanding of IL-18 structure, processing, receptor expression and immunoregulatory functions.

[Digital imaging system are rapidly introduced in Swedish departments of radiography. This calls for new strategic planning].

Diagnostic radiology in Sweden is changing rapidly to digital (filmless) technique. The advantages are more rapid delivery of radiologic service, better working conditions and less negative effects on the environment. Teleradiology is also facilitated.

[Homocysteine and methylmalonic acid as markers of cobalamin/folate status. The association to neuropsychiatric symptoms in the elderly is explored].

Cobalamin/folate deficiency in elderly subjects may lead to psychiatric symptoms. Most studies concerning the relation between mental disorders in the elderly and deficiencies of cobalamin and folate have used methods that determine the blood concentrations of these vitamins, which might not reflect vitamin status in the tissues. Two new markers, plasma homocysteine and serum methylmalonic acid, have attracted growing interest since they are considered to reflect the functional status of cobalamins and folates in the tissues.

[Prevention of perinatal asphyxia. Can more be done by fetal monitoring?].

Intrapartum death has become a rare event since the introduction of electronic fetal monitoring (EFM). Randomized studies of EFM versus intermittent auscultation show that EFM reduces the risk of low Apgar score at birth and of neonatal seizures, although it may be possible to ensure low perinatal mortality even with intermittent auscultation alone. The rate of operative deliveries may increase with EFM, at least if scalp blood sampling is not used.

[Scandinavian guidelines for management of head injuries. Evidence-based management of minimal, mild and moderate head injuries].

The Scandinavian Neurotrauma Committee (SNC) was created by the Scandinavian Neurosurgical Society in order to develop evidence-based guidelines for improved care of neurotrauma patients. A MEDLINE search identified 475 papers dealing with the management of minimal, mild and moderate head injuries. Forty-two studies presenting Class II evidence on the initial management of such injuries were reviewed, and management guidelines were developed.