Swedish Physicians Research Articles

Illustrated Handbook in Local Anaesthesia

Illustrated Handbook in Local Anaesthesia is the second edition of an apparently popular Swedish book that has been translated into English. It is intended for students and physicians in Sweden and abroad and is meant to complement more complete textbooks on local anesthesia. Twelve authors have contributed 43 chapters arranged in a more or less head-to-toe sequence. The color illustrations and photographs are aesthetically pleasing; however, in many cases, they are labeled too sparsely or not at all, requiring reference to other texts, rereading of the text several times, or an undue amount of time for right-left, cephalad-caudad orientation. This was an annoying drawback, especially since the main thrust of the book is the good drawings and illustrative pictures. The chapter on pharmacology of local anesthetic agents is elementary. No mention is made of the effect of local anesthetic drugs on sodium channels nor of the effect of pH on

Abortion and contraception in Sweden 1870–1970

The Swedish fecundity statistics show that birth control has been practised since 1870 at the latest, from 1910 to a growing extent, and since 1935 to a varying degree. The author has — as far as available statistics allowed — studied the different methods and their demographic effects, especially criminal abortions of former times using internal methods, and more modern criminal abortions using external means, legal abortions (since 1939), pessaries and condoms (which almost disappeared on account of the blockade during World War II), Oral contraception (from 1964) and IUDs (from 1966). The figures tell us that the Swedish people and the Swedish physicians during these last years have adopted a highly effective system of birth control by means of efficient contraceptives and — as safety valve — practically free legal abortion.

Pregnancies during oral contraceptive treatment. Swedish experiences.

At the beginning of 1969 Swedish physicians were called upon by the National Board of Health and Welfare to report all pregnancies known to have occurred in women who had used oral contraceptives. Ninety pregnancies were reported for 1968, 73 of these with the sequential type of therapy and 17 with the combined type. Calculations using Pearľs formula and based on sales figures gave pregnancy rates of 0.467 and 0.005 for sequential and combined agents respectively. The possible causes of errors in these statistics are discussed. However, it is concluded that the pregnancy risk, is much more than ten times higher with the sequential than with the combined type of therapy. The most important cause of the failures in this series seems to have been the lack of efficacy of the drugs.

On the Nature of the Eczematogenic Component of Oxidized δ3-carene

In the experience of both painters and physicians in Sweden, French turpentine has a conspicuously lesser tendency to cause dermatitis, than has Swedish turpentine. Prompted by these observations Hellerstrom (1) was able to show that the greater sensitizing power of Swedish turpentine was directly or indirectly due to the A3-carene content. French turpentine does not contain any A3-carene. Investigations by Danbolt and Burckhardt (2), Burckhardt and Schaaf (3), and by Hellerstrom (1) confirmed that stored turpentine causes more severe dermatitis than does freshly distilled turpentine. Storing in air is conducive to the formation of oxidation products; such products occur both in Swedish turpentine and French balsam turpentine that have been stored in air, and the A3-carene in Swedish turpentine is rather more rapidly oxidized than a-pinene, which is the chief constituent of French turpentine. Hellerstrom and Lunden (4) assumed that these circumstances had some significance in the causation of eczema. They subsequently (4) found that the eczematogenic component in turpentine apparently is not attached to the pure hydrocarbons, terpenes CioHie, but to products formed by their oxidiation. In a later paper (Hellerstrom, Thyresson, Blohm, Widmark (5)) a technic was presented that made possible concentration of the eczematogenically active component. This technic was based on the principle of displacement adsorption-a variant of column chro-matography-and a characteristic breaking down of the test substance into an active and an inactive part was possible in a series of different constituents of turpentine (carene, sylvestrene, a-pinene, limonene). In so doing, the eczematogenically active component was invariably concentrated at the end of the sample that traversed, by displacement with ethyl alcohol, a column filled with silica gel. For a detailed description of the experimental technic, vide Blohm (6). All experiments were performed on a microscale with samples amounting to a drop or so.

XV.:Investigations on Cutaneous Reaction in Scarlatina.

SUMMARY1. The Dick reaction taken on 1 200 children, 0–15 years, was positive in 66,8 %, negative in 24,2 % and of an uncertain character in 9 %.2. Investigations of the frequency of positive Dick reaction at different ages gave results agreeing with those hitherto published.3. Children with a history of scarlatina gave a positive Dick reaction in 11 %.4. Pseudoreactions were more often found in children with increased sensitivity to tuberculine than in those without.5. Investigations on 320 children of the variability (»Spontanschwankungen») of the Dick reaction, showed that a positive reaction gives practically no changes on retesting (occurred in only 1 % of our cases); a negative reaction on the other hand may in a certain percentage of cases (our figure was slightly less than 20 %) change to a positive one on retesting.6. It thus seems permissible to regard a positive reaction as giving definite information, while a negative one should be judged more cautiously and under certain conditions occasion a retesting.7. We have hitherto tested 16 foreign toxins derived from scarlatina streptococci and only 2 were found to compare in strength with the toxin which we ordinarily use. Ten toxins, among which were 2 derived from Dick strains, have plainly appeared considerably weaker, and 4 have shown themselves to be practically atoxic.For further information, cf. Acta Pædiatrica, Vol. VI. p. 442; Svenska Läkaresällskapets Förhandlingar (Transactions of the Society of Swedish Physicians) 1927.