Ugeskrift for laeger
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Ugeskrift for laeger · Jun 2005
Randomized Controlled Trial Comparative Study Clinical Trial[Effect of the synthetic cannabinoid dronabinol on central pain in patients with multiple sclerosis--secondary publication].
Cannabinoids reduce allodynia/hyperalgesia in animal pain models, but few clinical studies evaluated the analgesic action in humans. We aimed to evaluate the effect of delta-9-tetrahydrocannabinol (dronabinol) on central pain in MS patients. ⋯ Dronabinol reduced the spontaneous pain intensity significantly compared with placebo (4.0 (2.3-6.0) vs. 5.0 (4.0-6.4), median (25th-75th percentiles), p = 0.02). Though dronabinol's analgesic effect is modest, its use should be evaluated considering the general difficulty in treating central pain.
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Ugeskrift for laeger · Jun 2005
Review[Increased consumption of fruits and vegetables reduces the risk of ischemic heart disease].
In Denmark it is recommended to eat 600 g of fruit and vegetables daily. This recommendation has to a large extent been derived from the demonstrated inverse association with the risk of certain major cancer diseases, while the focus with respect to prevention of ischemic heart disease (IHD) has been directed primarily towards a reduced intake of ''hard'' fats. This systematic review includes prospective studies which have examined the association between the intake of fruit and vegetables, as well as specific fruits and vegetables (e.g., nuts and pulses, which are considered to be fruits and vegetables in the Danish recommendations), and the risk of developing IHD. ⋯ In contrast, it is not possible to single out specific substances in fruit and vegetables as being beneficial. Based on the studies, it seems reasonable to recommend an increased intake of a mix of fruits and vegetables to reduce the risk of IHD. The maximum beneficial amount seems to be about 800 g per day.
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Ugeskrift for laeger · Jun 2005
[Rational blood component therapy in patients with life-threatening hemorrhage].
We present the results of the Joint Task Force on Rational Management of Life Threatening Haemorrhage (LTH) at Rigshospitalet, Copenhagen University Hospital. A standardised treatment algorithm for LTH due to trauma, surgery, or birth is presented. The key feature is balanced transfusion therapy with an "emergency transfusion package" (5 units of red blood cells plus 5 units of fresh-frozen plasma plus 2 units of platelets). The Blood Bank services, guides, monitors and delivers the emergency transfusion packages in accordance with the algorithm.
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Ugeskrift for laeger · Jun 2005
Case Reports[Treatment of uncontrollable, life-threatening hemorrhage].
A severely injured patient was treated for uncontrollable, life-threatening haemorrhage according to a new standardised algorithm at Rigshospitalet, Copenhagen University Hospital. Despite aggressive surgical treatment, the diffuse bleeding continued and treatment with an ''emergency transfusion package'' (5 units of red blood cells plus 5 units of fresh-frozen plasma plus 2 units of platelets) with a subsequent infusion of fibrinogen plus a single dose of 100 microg/kg recombinant factor VIIa was initiated. Haemostasis was achieved, and the patient recovered with a good clinical outcome.
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Ugeskrift for laeger · Jun 2005
[Fibrinogen substitution. Use in the treatment of bleeding due to lack of fibrinogen].
Fibrinogen is critically important in haemostasis. The concentration of fibrinogen in plasma is usually between 2 and 4 g/l (6-13 micromol/l). ⋯ Acquired fibrinogen deficiency may occur with a variety of underlying pathologies. Fibrinogen substitution may be done with fresh-frozen plasma, cryoprecipitate and virally inactivated concentrates of fibrinogen.