20.11.2023: The Iranian authorities arrest doctors who practise their moral duty to provide medical assistance to all who need it. We cannot accept this. Imagine that as a doctor in a hospital or accident and emergency department you are faced with injured patients, but the authorities refuse to allow you to stop a bleed or treat a fracture because the patient has beliefs or a political stance that are not accepted; and that if you nevertheless manage to give the necessary medical assistance, you risk arrest and criminal prosecution. This is the reality for our colleagues in Iran (1) . The practice of...

16.11.2023: Older, frail patients with heart failure must receive comprehensive follow-up. Their health literacy and capacity for self-care must be enhanced. Heart failure is a frequent and common cause of hospital admissions (1) . Munkhaugen et al. have now published a study in the Journal of the Norwegian Medical Association in which they map drug treatment, self-care and health literacy in patients with heart failure admitted to Drammen Hospital and Vestfold Hospital Trust over a six-month period (2) . The vast majority of patients in the study were over 70 years of age, and many scored high on frailty...

27.09.2023: It is well-known that obesity is related to other health problems, but few researchers have been able to measure the relationship in monetary terms. Even fewer have examined the issue from a population perspective. In the study by Edwards et al. that appears in this issue of the Journal of the Norwegian Medical Association, the authors use data from the Nord Trøndelag Health Study (HUNT) to show that the economic costs of specialist healthcare services increase with body mass index (BMI) (1) . While the greatest costs are attributable to BMI over 35, this represents a relatively small group of...

12.09.2023: A holistic approach throughout the course of life-limiting illness – palliative care – provides a better quality of life for sick children and their families. 'One day we shall die. But all the other days we shall be alive.' (1) This quote from Per Olov Enquist is especially relevant for children and young people living with a severe illness. Extreme prematurity, neurodegenerative disease, congenital heart defects and cancer are examples of life-threatening and/or life-limiting conditions (2) . There is no systematic overview, but based on figures from other countries, around 3,500 children in...

15.08.2023: This autumn, record numbers will start their medical studies in Norway and their specialty training in Norwegian hospitals. Welcome to our wonderful world! Dear medical students. Some of you wanted to study medicine because you are fascinated by the incredible human body and how it works. You will find your studies and the process of learning from the ground up exciting from day one. For some of you, your decision to study medicine was driven by a desire to help others. The initial part of your studies might prove challenging as there will be little patient contact and a great deal of theory...

03.08.2023: Until now, Norwegian universities have relied on general practitioners to accept medical students based on an altruistic interest and goodwill, and have considered this arrangement adequate for both the students and the doctors. This era of unpaid efforts needs to end! A growing number of treatment-related tasks are being performed outside the hospital setting: by general practitioners (GPs) and in primary care inpatient facilities, health centres and nursing homes (1) . It is therefore important and appropriate that a larger portion of doctors' basic and specialist training takes place in...

14.03.2023: Allogeneic stem cell transplantation is a highly specialised treatment for patients for whom there are few or no curative treatments available. The results keep getting better. In this edition of the Journal of the Norwegian Medical Association, Vo et al. present an overview of the results from allogeneic stem cell transplantation at Oslo University Hospital in the period 2015–2021 (1) . The study shows that the number of transplants is increasing, while the risk of serious complications and death has been reduced. These results are gratifying, not least for patients with serious malignant...

06.03.2023: When the degree of risk is unknown and knowledge is deficient, public trust in the decision-makers is crucial. Trust is best created through transparent communication with those concerned. Trust influences the decisions we make when faced with the unknown, by guiding us through the maze of information (1) . According to the sociologist Anthony Giddens, it is the deficit in knowledge itself that gives rise to the need for trust (2) . To put it bluntly, if we had complete knowledge, we would not require trust to make a decision. Trust is also a heuristic: a strategy to reduce complexity and make...

28.02.2023: A century and a half after the leprosy bacillus was discovered, far too many people are still contracting the disease. The anniversary is an opportunity to shine a new and necessary spotlight on the disease. Late in the evening of 28 February 1873, Gerhard Armauer Hansen (1841–1912) wrote in his notebook that, in a section taken from a lesion in a leprosy patient, he had seen 0.006–0.0015 mm rod-shaped bodies under the microscope (1) . Was this the pathogen he had been searching for? Armauer Hansen was convinced, but he was not at all sure that he could convince anyone else. In 1873, leprosy...

20.02.2023: New anti-hyperglycaemic drugs in patients with type 2 diabetes can prevent heart and kidney disease, but costs and adverse effects make it difficult to know where to place them in the treatment protocol. Good blood glucose control has traditionally been the primary treatment goal in type 2 diabetes, and it prevents late microvascular complications in the kidneys, eyes and nerves (1) . Prevention of cardiovascular disease requires a broader approach, including good lipid and blood pressure control. We have now learned that the choice of anti-hyperglycaemic drugs also has an impact on the risk...

20.02.2023: Our national health service is on the brink of collapse due to the way that resources are being used. We highlight three major threats and call for a rethink and for unity. In Norway, there has been broad political agreement and little debate about the value of a national health service based on quality, equality and solidarity. For 70 years, this public good has been a cornerstone in a society characterised by a sense of community and trust. But that is now starting to falter. The national health service is under threat from several quarters, and we must ensure its sustainability. The concept...

09.01.2023: Theranostics is the combination of therapeutics and diagnostics. Based on principles of nuclear medicine, theranostics is enabling steadily more possibilities within personalised cancer treatment. Theranostics is an emerging field of medicine that involves targeted therapy based on the identification and verification of a biological target. In nuclear medicine, theranostics entails diagnostic imaging using radioactively labelled tracers to identify a biological target structure, followed by internal radiation therapy using the same tracer. This ensures selective and targeted treatment of...

06.01.2023: Misuse of nitrous oxide among partying young people has remained under the radar for several years. Good old pathophysiology can explain the dangers of this misuse. The recreational drug market is creative and constantly evolving. The latest drug on the scene is nitrous oxide – both an anaesthetic that is being phased out and a domestic gas used to whip up cream quickly. It can also 'whip up' your mood and is therefore being increasingly misused. Nitrous oxide as a recreational drug is not illegal, and there is no age limit in Norway. The combination of an uncontrolled increase in use and a...

12.12.2022: Since 1952, the Cancer Registry of Norway has promoted science, spread knowledge and helped reduce the cancer burden. Based on statutory notification of cancer, the Cancer Registry of Norway first opened its doors in 1952 with a staff of three. This marked the start of a remarkable series of decades and an unbroken collaboration with the health services, NGOs and central authorities. The Registry's main focus was on the establishment and quality assurance of a database of incident cancer cases, in addition to production of statistics, overviews and reports (1) . In the post-war years...

21.11.2022: Immigrant women are at higher risk of pre-, intra- and post-natal complications. Caesarean section is a standard surgical procedure throughout the world, but the frequency varies considerably between countries and regions. Caesarean section performed without a clear medical indication can be more harmful than beneficial for the mother and child. The World Health Organization has concluded that the caesarean section rate is unnecessarily high in many middle- and high-income countries, while many low-income countries have insufficient access to the procedure (1) . A caesarean section should be...

24.10.2022: How clear really are the boundaries between cancer, precursors to cancer and harmless pigment spots? Cutaneous melanoma is the fastest growing cancer in Norway, as well as large areas of Europe and North America (1) . The increase is often attributed to increased exposure to ultraviolet radiation due to changes in sun habits. However, in 2021, Welch et al. demonstrated that, even in a hypothetical extreme scenario, increased sun exposure can only explain a small proportion of the increased incidence of melanoma in the United States (2) . There must be other contributory causes. The fact that...

11.10.2022: Giving the population better healthcare is contingent on effective regulation. This work cannot be left to the legal profession alone. Doctors are educated and trained in assessing patients' health and in making decisions about the investigation and treatment of illnesses on a medical basis. However, many young doctors find that decision-making processes in health care are often also based on a number of factors other than the purely medical. For example, questions about resources are becoming increasingly relevant. Do we have beds? Do we have staff? Can we afford it? Likewise, the legal and...