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Especially low vitamin B12 or folate and low intake of omega-3-fatty acids, but also low vitamin D may associate with increased risk of depression. B12 and folate may also be useful in the treatment of depression. The importance of individual fatty acids is unclear. The causal relationship between depression and diet, the efficacy of vitamins or dietary supplements in the treatment of depression, or the impact of diet compared with other treatment options need to be scrutinized. An overall healthy diet rich in vitamin B12, D or folate and fish oils may have positive effect also on depression.

Background: Due to large volume of knee osteoarthritis referrals and increasing waiting times, the contents of referrals and patient's pathways were analyzed in the Jyväskylä Central Hospital., Methods: The referral contents of 171 knee osteoarthritis patients referred to the orthopedic outpatient clinic were screened, and the post-referral treatment decisions were pulled from the medical records., Outcome: Most of the referrals had information about the diagnosis (90%), pain (88%) and symptom duration (80%). The least frequently mentioned were BMI (3%) and the implementation of conservative treatment (7%). During the specialist visit following the referral, 62% of the patients ended up in operative and 38% in conservative treatment. There was no connection between the referral contents and the line of treatment chosen., Conclusions: Conservative treatment of knee osteoarthritis should be optimized prior to referral to specialist care.

Background: Subacromial impingement syndrome is a common orthopedic condition., Methods: Patients operated due to shoulder impingement (n=104) were sent a questionnaire inquiring rehabilitation procedures before and after surgery, pain and shoulder function., Results: Response rate was 68%, mean age of the patients was 53 years. Before surgery, 50% of the patients had received physiotherapy. The symptoms disappeared after surgery in the majority of the patients. However, 13% of the patients had significant shoulder pain (VAS over 30 mm) one year postoperatively and 15% had considerable functional deficit., Conclusions: To avoid unnecessary operations for shoulder impingement proper conservative treatment must be provided before surgery.

Medication and immunotherapy for allergy and guidance for the avoidance of allergens are determined on the basis of a skin-prick test. The testing must be performed in a standardized manner of good quality. Testing quality is not in accord with the present-day requirements everywhere. Interpretation of the test result requires experience and knowledge of the test's nature. Testing should be concentrated into larger units and testing services rearranged. A testing service system for doctors within the Finnish capital region and test reaction reading keys to the aid of clinicians have been developed at the Helsinki University Central Hospital.