Ugeskrift for laeger
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Ugeskrift for laeger · Oct 2007
[Opioids for chronic pain patients. What are the consequences of following the Nordic recommendations?].
In this study the consequences of following the Nordic recommendation for treating chronic pain patients with opioids are illustrated with regard to how many patients started and how many ended opioid treatment, what was the success rate for going from short-acting to long-acting opioids and what were the consequences for the daily doses of going from short-acting to long-acting opioids. ⋯ Following the Nordic recommendations for treating chronic pain patients with opioids can help to minimise the number of opioid users. The recommendation for going from short-acting to long-acting opioids can be accomplished in daily routine and in this study there is no indication that changing from short-acting to long-acting opioids per se increases daily doses.
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Patients with a stroke are at high risk of new cardiovascular events and secondary prevention is therefore essential. Patients with ischemic stroke should receive treatment with statins targeting a total cholesterol and LDL-cholesterol below 4.5 and 2.5 mmol/l, respectively. ⋯ A diet low in salt and fat with a high content of fruit, vegetables, full-corn products and fish is recommended. There is no evidence that a low to moderate alcohol intake is harmful.
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Ugeskrift for laeger · Oct 2007
[Antithrombotic therapy in ischemic stroke and transient ischemic attack].
In acute ischemic stroke and transient ischemic attack (TIA), aspirin is recommended to all patients (except immediately following thrombolysis). Heparin and anticoagulant therapy using vitamin K antagonists should be avoided in the acute phase. Secondary preventive antithrombotic treatment includes anticoagulation in patients with cardioembolic stroke and antiplatelet agents aspirin possibly combined with dipyridamole or clopidogrel alone in patients with non-cardioembolic stroke. Other individual risks may modify this treatment regimen.
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The rupture of an intracranial aneurysm causing subarachnoid hemorrhage (SAH) has an incidence of 10 per 100,000 in Denmark. The diagnosis is confirmed on CT-scan which shows blood in the subarachnoid space. ⋯ The endovascular methods have improved so much during the last 10 years that some 90% of all aneurysms can currently be secured by using endovascular methods. Vasospasms which are often a most serious complication to SAH can be treated effectively with endovascular methods.
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Restless legs syndrome (RLS) is a common disorder affecting more than 2% of adults. RLS is characterized by sensory-motor phenomena predominantly in the legs, but other body parts may be involved. The symptoms are most pronounced during rest and present a characteristic diurnal variation with maximum symptoms in the evening and at night. ⋯ RLS is present in an idiopathic and secondary form due to medical and other neurological diseases. Iron and DOPA are involved in the pathogenesis of the disease. The current best-documented treatment is partial dopamine-agonists and gabapentin.