Nordisk medicin
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The article consists in a review of the development of prehospital care in Finland and of emergency medical services in Helsinki. Based on 20 years' accumulated experience at a physician staffed prehospital emergency care unit in Helsinki, emergency medical services throughout the country have begun implementing the various links in the 'chain of survival' concept.
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An antinociceptive effect of calcitonin has been reported in numerous studies on both animals and humans. In the present article, we review the controlled clinical studies in which calcitonin has been used to relieve skeletal pain (cancer metastases, osteoporotic fractures) as well as extraskeletal pain (phantom limb pain, neurogenic claudication, reflex sympathetic dystrophy, migraine). ⋯ No controlled trials against conventional analgesic treatment is published. Thus, further studies are required before the place of calcitonin in pain therapy can be established.
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Knowledge of the pathophysiology and aetiology of asthma has expanded greatly during recent years, and hopes are strong that within the foreseeable future it will be possible to alleviate asthmatic symptoms even more effectively. This review covers some of this new knowledge, and presents viewpoints on the practical clinical management of asthma patients.
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In Denmark, emergency ambulances are dispatched by 41 centres manned either by trained firemen (in Copenhagen) or policemen (outside Copenhagen). In 1990, emergency ambulance calls totalled 284,000. Utilisation of emergency ambulance services increases with urbanisation. ⋯ In less populated areas, some general practitioners give advanced life-support. Although many areas are serviced by ambulances equipped with defibrillators, the majority of patients receive only basic life-support from ambulance personnel. New initiatives resulting from a recent report by a commission appointed by central authorities, and focused on prehospital treatment, are expected to improve the service by raising the level of training given to ambulance personnel.
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The specialized care provided at the trauma centre in Baltimore, Maryland, in the USA is described. By means of a sophisticated communications system, prehospital and hospital care are coordinated with a view to providing optimal care to people with various types of injuries. It is suggested how the American experience might be applied to conditions in the Nordic countries in order to improve the quality of trauma care.