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[Sudden infant death and crib death in Scandinavia during the period 1970-1987].

Compared with other countries, infant mortality in the Nordic countries is low. However, the decrease in infant mortality since 1970 has been slower in Denmark and Norway than in Finland and Sweden. The post-neonatal death rate since 1970 has increased in Denmark, Norway and Sweden, but not in Finland. During the same period of time there has been a large increase in cot death in all the four countries, but the incidence has been higher in Denmark and Norway. This may explain much of the difference in today's infant mortality in the different countries. The authors think that the Nordic countries are faced with a serious epidemic situation and propose to appoint a Nordic expert group to follow the trend and find possible pathways for further investigations.

Humans↗

The procurement of kidneys for transplantation in Scandinavia.

In countries with active renal transplant programs and wide acceptance criteria for transplant patients, the number of cadaveric donors is not, and probably never will be, sufficient to meet the demand for renal allografts. In general between 15 and 20 cadaveric donors PMP per year (maximum 23.7 in Denmark in 1986) have been available in the Scandinavian countries in the 1980s. In most other countries fewer donors are available, but there are regions where higher figures have been reached. Continuous registrations of potential cadaveric donors in Sweden have shown that the number of donors could increase by 40% to 60% if relatives of all medically suitable patients had given consent to organ donation. Since a public survey has shown that factual information on cadaveric organ donation and transplantation had a positive effect on the public's attitude, more public awareness programs are needed. Donor acceptance criteria are already broadly based, particularly with respect to age, and could probably not be further broadened without risking results after transplantation. A varying proportion of renal allografts from living donors are used in the Scandinavian countries. An increased use of living donors, related and unrelated, in the countries where few currently are used might help meet demand in the future. At present the need for nonrenal organs can be met, but as the programs for liver and heart transplantations are developed to reach their predicted levels, the current number of donors will most likely prove insufficient.

Cadaver↗

[The need for vascular surgery in Scandinavia].

In 1987 400 vascular reconstructions per mill inhabitants were performed in Denmark. This is lower than in Sweden and Norway, where the activity is approximately twice as high. The number of vascular operations in USA in 1985 was approximately 2,400 per mill inhabitants. The need for vascular surgery in the European countries has been calculated to be between 1,300-1,500 operations per mill inhabitants. These numbers could be significantly influenced by the result of trials regarding the treatment of cerebrovascular insufficiency, and on the development of catheter-based methods for the treatment of atherosclerosis. Vascular surgery became a surgical specialty in Denmark in 1982. The same tendency is seen in many other European countries. However, patients with vascular diseases are a heterogeneous group, taken care of by doctors representing several medical disciplines. Hitherto, it has been difficult to get resources for angiology and vascular surgery. It is therefore a challenge to convince the health authorities that vascular surgery needs resources to take care of various vascular diseases that occur in the steadily growing elderly population. Units for vascular surgery, including a laboratory, should be established in our major hospitals. It is expected that the activity within vascular surgery will increase significantly in Denmark during the 1990s.

Health Services Needs and Demand↗

[Basic education in geriatrics is still unequally distributed in Scandinavia].

A survey is in progress of the training in geriatrics given in Europe, and the status of such training in the Nordic countries is reported here. The Nordic countries--particularly Sweden--have a fairly long tradition of basic training in geriatrics and the research possibilities are also comparatively good. But the distribution of professorships, university departments, and basic training in geriatric medicine are still uneven in the Nordic countries.

Aged↗

[Fatal poisoning in Scandinavia--narcotic addicts are a high-risk group].

This study on fatal intoxications in the Nordic countries indicates an over-representation of drug addicts in Denmark, Norway and Sweden. All cases of fatal intoxications in persons 15-34 years of age submitted to medicolegal autopsy and subsequent toxicological examination in the Nordic countries during 1984-1985 included in the study. A comparison between the Nordic countries is possible because the same definition of a drug addict and classification of drugs are used. The numbers of fatal intoxications among drug addicts per 10(5) population were 6.3 in Denmark, 2.1 in Norway, 1.3 in Sweden, 0.6 in Finland and none in Iceland. About 70 per cent of the drug addicts in Norway and Sweden died from heroin/morphine intoxication. In Denmark only 55 per cent of the drug addicts died from heroin/morphine and 36 per cent died from overdoses of the legal drugs methadone, dextropropoxyphene and ketobemidone.

Adolescent↗