Läkartidningen
-
The number of patients handicapped by chronic pain is increasing in Sweden. Many of these patients do not receive adequate care despite guidelines issued in 1994 by the National Board of Health and Welfare recommending councils to establish multidisciplinary pain teams according to the guidelines issued by the International Association for the Study of Pain. A survey of Swedish general hospitals reveals that these recommendations have not yet been implemented. With the exception of university hospitals only one out of five hospitals has set up specialised pain care teams; in remaining hospitals the organisation of pain management leaves much to be desired.
-
In about 10 per cent of children with cerebral palsy, the most probable cause is birth asphyxia. The brain injury following birth asphyxia evolves in part over hours or days--as a secondary process. This opens a 'window of opportunity' for intervention. ⋯ Pilot trials of cooling suggest that the side-effects of cooling can be managed. Randomized controlled trials are underway. Obtaining informed consent from the parents for these trials represents a particular challenge.