Läkartidningen
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A critical review of a meta-analysis published in JAMA of early clinical neurological signs to detect "good" or "bad" outcome after cardiac arrest is presented. The review focuses on weaknesses of Glasgow Coma Scale, the Glasgow-Pittsburgh Cerebral Performance Categories (CPC) and on individual differences in factors after arrest for study inclusion. It is suggested that the clinical assessments should be complemented with the assessment of neurochemical markers for brain damage.
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The aim of this study was to identify obstacles for recruiting organ donors in the ICU. All specialists in neurosurgery and half of the specialists in anaesthesiology in Sweden were surveyed. ⋯ The following obstacles were identified: A neutral approach of the physicians when requesting organ donation of the families instead of a pro-donation approach; ethical problems concerning non-therapeutic ventilation and requesting donation of grieving families; varying competence in diagnosing brain infarction; lack of resources at the ICU. Suggestions for organizational and educational improvements are given.
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Acute poisoning with GHB (Gamma-hydroxybutyrate, Gamma-hydroxybutyric acid) has been an increasing medical and social problem during the last decade in Sweden, especially on the west coast. The number of poisonings decreased in the beginning of this millennium but has again increased during the last years. At the same time the number of seizures by the police has increased similarly as well as the number of drug-related deaths. ⋯ Intoxication by GBL and butanediol has shown to be as dangerous as intoxication by GHB. Acute intoxications and abuse of these drugs is still a serious medical and social problem. A legal classification of GBL and butanediol as narcotics appears to be medically motivated.