Ugeskrift for laeger
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An elaborated research methodology elucidating the scientific quality of health-related quality of life questionnaires has been developed. With the availability of a methodology that can investigate important aspects of the validity and reliability of questionnaires, the central question is no longer whether questionnaire based studies are valid, but to what extent their validity in specific applications has been sufficiently researched. Newer statistical methods will facilitate a shift towards interactive, individualized questionnaires.
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The article reviews methods, experiences, and results of quality of life research in cancer, and presents recommendations. The research has comprised descriptive studies, end-points in clinical trials, prognostic studies, and clinical applications of quality of life questionnaires. There is a need for additional quality of life studies in relation to all cancer sites and treatments but such studies should be undertaken only when the necessary resources are available, as only well-conducted studies are of value.
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Pediatric health-related quality of life (HRQoL) assessment has increased during the last decade. However, the use of HRQoL measures in paediatric clinics and in paediatric clinical trials is still limited. ⋯ Routine implementation of HRQoL measures in paediatric clinics might improve patient-physician communication, patient and parent satisfaction as well as clinical outcome. Both generic and disease-specific instruments should be used, and paediatric HRQoL norms need to be established in Denmark.
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Ugeskrift for laeger · Feb 2008
Review[Hemodynamic monitoring with the lithium dilution cardiac output system].
The lithium dilution cardiac output (LiDCO) system measures cardiac output beat-to-beat with high precision. The system is based on an arterial pulse power analysis which is calibrated every eight hours with a small non-pharmacological dose of lithium. The system is minimally invasive; it requires only a peripheral arterial catheter and a venous access. Dynamic parameters for early goal-directed therapy are also provided.
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Regional nerve blocking techniques offer a suitable alternative to local infiltration anaesthesia for facial soft tissue-surgery. Moreover, they present several advantages over general anaesthesia, including smoother recovery, fewer side effects, residual analgesia into the postoperative period, earlier discharge from the recovery room and reduced costs. The branches of the trigeminal nerve and the sensory nerves originating from the upper cervical plexus can be targeted at several anatomical locations. We summarize current knowledge on facial nerve block techniques and recommend ten nerve blocks providing efficient anaesthesia for the entire head and upper-neck region.