Läkartidningen
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End-of-life sedation is not well defined in clinical medicine. The Swedish Society of Medicine, Delegation for Medical Ethics, arranged a Nordic expert workshop to discuss issues of terminology, indications, information and consent, follow up and teaching. It was concluded that the following issues must be part of the decision-making process: the diagnosis and prognosis must be correct, all other treatment options including psychological and existential support must have been tried, there must be consensus between the patient, the family and the staff about the situation and the proposed treatment. These discussions will be followed by clinical guidelines issued by the Society.
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Historical Article
[Doctor on the stage--a survey of physician's role in drama].
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Today almost 2 billion passengers fly commercially each year--and the number is increasing. Different investigations indicate one medical event per 33,600-50,000 passengers, corresponding to 33-22 events daily. The events seem to increase, which can be explained by an increasing number of elderly passengers over longer distances. ⋯ The decision to carry out a diversion is always made by the captain, and the cabin crew is responsible for the ill. Medical professionals can and should assist the cabin crew in their care for ill passengers on board. We also have unique possibilities to inform our patients in advance, whenever flying means an increased health risk.
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As part of an agreement between the Swedish government and the county councils on reimbursement for health care services for refugees, the National Board of Health and Welfare conducted a survey in Stockholm and Norrbotten counties during 2000. The study comprised a randomly selected group of refugees in which the total amount of health care services consumed was studied for 100 persons in Stockholm and 60 persons in Norrbotten. The outcome indicates that services provided in part exceeded those stipulated in the agreement, i.e. in offering elective health care services and in other respects is unsatisfactory i.e. not offering health assessment interviews to refugees.
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Sarcoidosis is characterised by lung accumulated activated T helper cells that are believed to be of central importance for the inflammatory reaction, which results in granuloma formation and in some patients in the development of fibrosis. It is generally considered that sarcoidosis is initiated and triggered by unknown antigen(s), resulting in disease in genetically predisposed individuals. ⋯ A remarkably strict correlation between lung accumulated T helper cells expressing a specific T cell receptor (AV2S3+) and HLA-DR17 was observed, indicating an immune attack against a specific target in the lungs. Future studies in this field may reveal how candidate antigens, identified by other techniques, play a role in the sarcoid inflammation.