05.09.2022: The Norwegian General Practice (GP) service is in crisis. Large numbers of general practitioners (GPs) are leaving and few are willing to take their place. More research-based knowledge is needed to improve the service. The GP service is a cost-effective cornerstone of today's health service – and that is how it should remain. But whether it will survive is anyone's guess. The service is in crisis, with high drop-out rates among GPs and a poor supply of new ones to take their place. Meanwhile, private institutions are queuing up to take over large parts of the GPs' work. GPs' ability to adapt...

25.05.2022: Use of MDMA seems to be increasing in Norway. But how dangerous is the drug really? The Journal of the Norwegian Medical Association is now publishing a study by Jamt et al. in which an increase has been observed in the number of cases with findings of 3,4-methylenedioxymethamphetamine (MDMA) in blood in post-mortems on fatalities and in arrested drug drivers, at the same time as seizures of MDMA by the police and customs have also increased (1). The article thus draws attention to an increasing incidence of MDMA in criminal cases in parallel with an apparent increasing exposure to MDMA in...

22.03.2022: The treatment of patients with suspected acute myocardial infarction generally works well. Sometimes other suspected diagnoses become so urgent that treatment must be initiated rapidly. When acute myocardial infarction is suspected, the standard treatment protocol is immediate transportation to a hospital able to offer percutaneous coronary intervention, called a PCI centre. If the patient's condition necessitates it or the time required for transportation is too long, the shortest journey to a local hospital for thrombolytic treatment is chosen (1, 2). The Journal of the Norwegian Medical...

07.02.2022: The COVID-19 pandemic poses a biopsychosocial health risk to pregnant women, women in labour and infants throughout the world. COVID-19 is affecting pregnant women, women in labour and infants to a greater extent than we thought. In addition to the risk of serious maternal illnesses, there is also an increased risk of severe pregnancy complications, such as premature birth, preeclampsia and stillbirth (1, 2). In an article in this edition of the Journal of the Norwegian Medical Association, Eberhard-Gran et al. describe how one-third of their sample of women who gave birth in Norway during the...

21.01.2022: Local authorities should make better use of their District Medical Officers' expertise. District medical officers have received much attention during the coronavirus pandemic. We have seen that when combined with local knowledge, public health expertise has ensured efficient handling of the pandemic at the local level. However, infection control is only one of several jobs assigned to district medical officers. Municipal executives have paid tribute to the efforts of infection control specialists during the pandemic, but they tend to be less familiar with the benefits that the localised public...

13.01.2022: Knowledge about the outcomes among COVID-19 patients admitted to a local hospital in the Oslo area provides key information preparing us for the next wave of coronavirus infections. In this issue of the Journal of the Norwegian Medical Association, Myrstad and colleagues present the course of illness and treatment for the 300 COVID-19 patients who were admitted to Bærum Hospital during the first three 'waves' of coronavirus infection in 2020 and 2021 (1). Bærum Hospital is a relatively large local hospital that caters to nearly 200 000 inhabitants. For a department with approx. 90 beds, eight...

13.01.2022: Electrical shock should be avoided, even though low-voltage shock is not as dangerous as previously thought. It is hard to fit your fingers, big or small, in a socket. Even a knitting needle can no longer be easily inserted after the introduction of new child-proof sockets with special barriers. It works if you use two knitting needles at the same time, but even then the earth-leakage circuit breaker will usually shut off the current so you don't notice anything. However, if the earth leakage circuit breaker does not trip, your fingers will clamp around the knitting needles in each hand and...

10.01.2022: Better planning and the restructuring of medical studies and specialist training can help in the recruitment of general practitioners to rural areas. How are healthcare personnel recruited to jobs in rural areas? We know that healthcare professionals with a rural affiliation and who have had positive experiences from general practice and rural exposure during their studies and clinical placements are more likely to settle outside the cities (1). The Norwegian Centre for Rural Medicine has participated in a seven-year international collaboration with Sweden, Iceland, Canada and Scotland on a...

05.01.2022: We need more knowledge about migrant health as well as a high level of professional reflection to prevent the stigmatisation of particularly vulnerable groups. Those of us who work with migrant health often say that migrant background is an independent health determinant (1). The association between migrant background and health differs in the various migrant groups. Consequently, the effects of specific measures to improve health services for these groups must be evaluated before implementation. For several years, researchers have been calling for systematic data on migrant background to be...

13.12.2021: Norway's kidney transplant programme is of a high quality thanks to the close cooperation between Oslo University Hospital and the other Norwegian hospitals. The main challenge is the gap between the need for organs and organ availability. The first human-to-human kidney transplant was performed in 1933 in Ukraine, but it was not until 1954 that the first successful kidney transplant was carried out. The operation was performed in Boston, led by Joseph Murray (1919–2012) (1). It was just two years later that Professor Leif Efskind (1904–87) at Rikshospitalet carried out Norway's first kidney...

28.09.2021: What have adolescents' experiences been during the COVID-19 epidemic? It has become clear during the COVID-19 pandemic that infection control measures can have other consequences than solely controlling infection rates. The social and psychological effects on children and adolescents have been brought to the fore. We need knowledge about adolescents' lives and how they are affected during crises in order to be able to implement and evaluate local and national measures across sectors. Establishing an infrastructure for monitoring and evaluating such measures takes time, and must not be...

05.08.2021: The COVID-19 pandemic has turned medical education and training into lonely online studies. How can we ensure that the medical students still become fully fledged doctors? At this time, new cohorts of medical students are starting their studies here in Norway and abroad. We have put behind us a spring semester marked by the 'third wave' of the pandemic, with high infection rates, lockdown and the wait for our vaccines. Fortunately, this seems to be over, but some major questions remain: What will the autumn semester be like? Will society – and thus the universities – begin to return to a...

28.06.2021: There is a need to strengthen the evidence base for the Norwegian antibiotics guidelines. This base should preferably be grounded in clinical efficacy. Antibiotic therapy is not a static exercise. New studies are constantly being published, old truths are challenged, bad habits – and good habits – are shaken up and the resistance situation changes. The antibiotics guidelines are zealously discussed, both because antibiotics are widely used and thereby involve many patients and a large proportion of clinicians, and because inappropriate use harms both individual patients and society as a whole...

26.05.2021: The government has proposed that the use of hard drugs should remain illegal but not treated as a criminal offence. The government's proposal, Drug policy reform – from punishment to help, means that society's reaction to illicit drugs for personal use will be transferred from the justice sector to the health sector (1). Today, the use and possession of narcotics is penalised with fines and up to six months' imprisonment or a decision not to bring criminal charges followed by monitoring and drugs testing. This will change if the government gets its way. The police will continue to focus on use...

19.05.2021: Digital communication works well – for everybody, always? In this issue of the Journal of the Norwegian Medical Association, Tveter and colleagues publish experiences from the use of video consultations at the outpatient rheumatology clinic at Diakonhjemmet Hospital (1). The study shows that both therapists and patients were generally satisfied with video consultations for following up patients with rheumatic diseases. However, one-quarter of the patients felt that it was problematic not to be examined, and the therapists believe that video consultations are best suited for following up...

14.05.2021: While the general population is attempting to find a way back to their normal daily life, we must begin the discussion on how to live with SARS-CoV-2 as an endemic virus. The COVID-19 pandemic and the countermeasures adopted have been very costly in terms of suffering, death, the economy and jobs. The direct disease burden is a consequence of the number of individuals infected and the severity of their illness. Disease control measures have helped keep infection levels low in Norway, and ensured that those with severe symptoms have received good medical care (1). As a result of vaccination...

14.05.2021: More clinical intensive care studies are needed with outcome measures that are relevant to patients. Current intensive care practice has a much more solid empirical knowledge base than 20 years ago. Results from robust clinical studies have taught us that interventions based solely on insights into pathophysiology and pharmacology do not necessarily increase survival rates, and sometimes increase the risk of mortality. For patients on mechanical ventilation, this means that gentle ventilation trumps normalisation of blood gases, and that aggressive fluid resuscitation is best avoided for...

12.05.2021: Newly developed COVID-19 vaccines are being widely administered. Spontaneous reports from doctors on suspected adverse reactions have rarely been more important. Only a few days after the first international news reports of serious blood clots following vaccination with the AstraZeneca vaccine, several similar cases were reported in Norway (1, 2). Observant doctors reacted to unexpected and serious clinical pictures in recently vaccinated health workers who were otherwise in good health. The doctors reported these as possible adverse drug reactions (ADRs) via the melde.no webpage, and also...

03.05.2021: Clinical diagnosis of mild head injuries is difficult, and it is easy to resort to a CT scan for clarification. Biomarkers are set to play an important role. In 2013, the Scandinavian Neurotrauma Committee (SNC) published guidelines for the management of adults with minimal, mild and moderate head injuries (1). Here, a serum measurement of the brain injury marker S100B was included for the first time as an alternative to a CT scan for patients with a mild head injury and a low risk of developing an intracranial haematoma. Up to half of patients are in this category (2–4). Akre and Ingebrigtsen...