The upper reference levels expected to be exceeded only by chance in 5% of single individual recordings at the ages of 20, 55 or 90 years, respectively, were estimated to be 12, 14 and 19 mm h-1 for men, and 18, 21 and 23 mm h-1 for women. Higher values should be controlled and, if confirmed, lead to a clinical check-up. However, about 76% of our overall material had ESR values lower than 9 mm h-1. Knowledge of each person's baseline ESR value might increase the disease-predictive ability of the test. If several measurements over years reveal a steeper rise with age than depicted in our population-based curves, it should be taken seriously, even when each reading is below the population-based reference limits.

Seafarer's mental health is vital for a well-functioning organisation. Neglecting mental health status on board could be extremely costly for both the crew affected as well as the company. The present article outlines an extensive programme implemented in the Royal Norwegian Navy for personnel deployed in international operations. The challenges involved in international operations bare similarities to onboard personnel in civilian maritime operations. The program utilised by the Royal Norwegian Navy is extensive and not immediately applicable to civilian maritime companies. However, elements of this program could be used with limited resources. Questionnaire based screening, before, during and at the end of a contract period could result in early detections of mental health problems and increased retaining of personnel. This should be done by health professionals. Early targeting of at risk personnel could prevent serious costs for the individual as well as the company.

Systematic ESR graphic recordings over time will enable a physician to determine each individual's baseline value, and hence note any continuously rising trend, which should lead to further investigations, e.g. an ultrasound kidney examination. This may provide an early clue to many otherwise non-symptomatic RCC cases. It is time for a reappraisal of the predictive value of the ESR to discover early RCC, and possibly other diseases as well.

A definite diagnosis of neuroendocrine carcinoma of the skin is seldom made on initial histological examination; the tumour is usually reported as a poorly differentiated or anaplastic carcinoma. By applying electron microscopy and immunohistochemistry, a correct diagnosis can be made. The ultrastructural examination shows dense-core membrane-bound granules, intermediate perinuclear filaments and desmosome-like junctions. Immunohistochemistry reveals positive staining for neuron-specific enolase and keratin, the latter in a characteristic paranuclear distribution. Confronted with an unusual clinical picture or indefinite histological diagnosis, tissue specimens should be secured for the above mentioned ancillary procedures.