23.11.2022: Neurodegenerative dementia may, in rare cases, initially manifest as isolated language impairments in the absence of other cognitive symptoms. These impairments are often somewhat imprecisely referred to as difficulties with 'word finding'. There are several variants of this form of dementia, each caused by different underlying neuropathologies. Occasionally problems with speech rather than language predominate. Patients may have exclusively language or speech-related symptoms for several years, but eventually all will progress to generalised dementia. This clinical review describes primary...

24.10.2022: Melanoma is a relatively common diagnosis, both in the primary and specialist health service. Ongoing research and new evidence base means that the recommendations for investigation and treatment are continually changing. This can lead to uncertainty among doctors who do not treat this patient group regularly. In this clinical review we give a summary of the latest recommendations, primarily aimed at general practitioners, dermatologists and doctors in local hospitals. Melanoma is one of the most common forms of cancer in Norway, and its incidence has been rising sharply since the 1960s. After...

22.08.2022: Concussion is common and usually resolves without complications. However, persistent symptoms occur in 10–15 % of patients. These post-concussion symptoms are predominantly somatic, cognitive and emotional. The condition is most common in those with previous somatic and mental health issues. The causes underlying long-term post-concussion symptoms are unclear, but a biopsychosocial explanatory model is currently regarded as the most appropriate basis for diagnosis and treatment. This clinical review article is based on key literature and our own clinical experiences with patients who have...

14.06.2022: Merkel cell carcinoma is an uncommon but aggressive tumour with a high metastatic potential. A rapidly growing, non-tender cutaneous tumour on sun-exposed areas of the body in older patients should raise suspicion of the condition. It may be necessary to combine the patient history with clinical, radiological and pathological findings in order to make the correct diagnosis. Excision with a 1–2 cm margin, direct closure and simultaneous sentinel-node biopsy should be performed without delay. Adjuvant radiation therapy of the tumour site may be relevant. After the diagnosis is made, assessment...

30.05.2022: Skin grafting involves covering an area of missing skin with healthy skin tissue harvested from another part of the body. The aim of this clinical overview is to give a short introduction to the procedure. Burns, scalds, trauma and cancer surgery can result in major defects in the skin that must be covered and reconstructed. The reconstructive ladder is a well-known principle within reconstructive surgery that arranges the various treatment strategies for skin defects in order of increasing complexity (Figure 1) (1). The idea behind this principle is to choose the most efficient treatment...

04.04.2022: Orbital fractures can occur as a result of direct trauma to the eye region or surrounding facial bones. The fractures can lead to significant functional impairment and cosmetic changes. Surgical treatment of orbital fractures aims to reconstruct the bony anatomy and restore the orbit's original volume. This clinical review article looks at the key factors regarding orbital fractures. Orbital fractures are fractures in the bones surrounding the eye socket (orbit), and the third most common type of facial fracture in adults and children (1, 2). The fractures are usually categorised by anatomical...

22.03.2022: Degenerative and traumatic meniscus injuries should be considered two completely different pathologies requiring treatment based on entirely different principles. Degenerative tears are part of the development of osteoarthritis and should generally be treated conservatively, whereas surgery should be considered for traumatic tears to help prevent the development of osteoarthritis. In this article, we summarise which patients should be referred promptly to an orthopaedic surgeon, and which should be referred to a physiotherapist. Over the last few decades, increasing access to MRI has helped to...

10.02.2022: Dry mouth constitutes a significant problem for most patients with grave illnesses and a need for palliative treatment. The main causes are pharmaceuticals, diseases and cancer treatment, which are often associated with increasing age. The condition may give rise to discomfort, pain, dysphagia, speech problems, increased caries activity, dehydration, malnutrition and loss of appetite. There are few evidence-based remedies against this condition. An apparently trivial problem like dry mouth may therefore cause deterioration of the clinical picture and a reduced quality of life. A study of a...

24.01.2022: Superior semicircular canal dehiscence syndrome is a condition with troubling ear symptoms and vertigo caused by a defect in the bone between the inner ear and the middle cranial fossa. The disease is not dangerous, and for many patients it is sufficient to provide a thorough explanation for the symptoms and advice about coping strategies, balance exercises and, if necessary, use of assisted hearing devices. Surgical treatment may be appropriate for patients with severe symptoms. Superior semicircular canal dehiscence syndrome was first described in the late 1990s (1). It was shown that a...

13.12.2021: Skin picking disorder is an under-recognised mental disorder that typically starts during adolescence and leads to considerable emotional distress and/or reduced functioning in important areas of life. Repeated picking at the skin happens despite efforts to stop. Feelings of lack of control and shame are prominent, and anxiety disorders and depression are common comorbidities. SSRIs and n-acetylcysteine may be beneficial, but cognitive behavioural therapy is probably more effective. Skin picking disorder is classified as an obsessive-compulsive and related disorder. The disorder is...

08.11.2021: We see an increasing number of patients with amiodarone-induced thyrotoxicosis. This condition can be treated pharmacologically, but treatment over several months may give rise to adverse reactions. In most cases we recommend that amiodarone therapy be continued despite newly detected thyrotoxicosis. Particularly in cases of heart failure, one should not wait too long before considering thyroidectomy. Treatment of amiodarone-induced thyrotoxicosis must be delivered with close collaboration between endocrinologist and cardiologist. Amiodarone is the most potent drug available against cardiac...

25.10.2021: Surgical procedures in the perineum can cause major soft-tissue defects that require reconstruction with plastic surgery. In this article we present plastic surgery principles for the reconstruction of wound defects and common methods used to reconstruct wound defects in the perineum. A need for reconstruction of defects in the perineum tends to arise as a result of surgery for gastrointestinal or gynaecological cancer. Techniques for reconstructing perineal defects range from simple methods, such as direct closure of wounds and local skin flaps, to more complex procedures such as pedicled or...