Ugeskrift for laeger
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The use of methadone may be difficult and its use in the treatment of chronic non-malignant pain is only sparsely described in literature, whereas several works have shown the advantage of methadone in the treatment of cancer pain. The aim of this analysis is to assess the advantages and disadvantages of methadone in the treatment of chronic pain and to evaluate the method used in The Pain Centre of the Funen Region when initiating treatment. ⋯ Opioid treated chronic pain patients with insufficient pain relief may benefit from conversion to methadone, as 59% in our analysis achieved better pain relief, while the rotation was generally opioid-saving at the same time. The method used was safe and acceptable to the patients. The analyses did not result in any fundamental changes to the procedure.
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Ugeskrift for laeger · Apr 2007
[The influence of genetic variations on the effect of selective serotonin reuptake inhibitors].
The outcome of psychopharmacological treatment may depend on genetic polymorphisms of various neurotransmitter systems. We summarize studies of associations between genetic variations with relation to the serotonin system and response to selective serotonin reuptake inhibitors. The results are still preliminary but suggest that treatment response to antidepressant drugs is influenced by genetic factors. They also indicate that the genetic component is polygenic and highly complex and might manifest itself in interaction with other biological and environmental factors.
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Cognitive-behaviour therapy (CBT), interpersonal psychotherapy, and probably also behavioural activation therapy have been found to be effective in the treatment of mild to moderate depression (scores on Hamilton Depression Scale < or = about 25) with outcomes comparable to antidepressant medication. There is evidence that CBT has some durable effects after discontinuation of treatment. Newer evidence suggests that for chronic or complicated cases of unipolar depression combined treatment with psychotherapy and medication achieves somewhat better results than monotherapy. In bipolar disorder psychotherapy with a psycho-educative focus might reduce relapse when combined with mood-stabilizing medication.
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Ugeskrift for laeger · Apr 2007
Comparative Study[Health economic consequences of the choice of follicle stimulating hormone alternatives in IVF treatment].
There is a choice between two types of hormones for stimulation of the follicles in IVF treatment - recombinant FSH and the urine-derived menotrophin. A literature review by NICE (2004) in the United Kingdom documented that the two types of hormones were equally effective and safe, which is why it was recommended to use the cheaper urine-derived hormone. Based on the EISG study (European and Israeli Study Group), the aim was to analyse the health economic consequences of the choice between the two types of hormone in IVF treatment in Denmark. ⋯ The analysis shows that urine-derived menotrophin is a cost-effective alternative to recombinant FSH with a potential for considerable savings for patients as well as the public drug budget.
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Surgery is associated with oxidative stress. Oxidative stress is correlated with postoperative myocardial ischaemia. ⋯ Melatonin has not been used in adult patients with acute oxidative stress. A potential beneficial effect of melatonin in patients after surgery is possible and should be investigated in the future.