Ugeskrift for laeger
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Substantial progress has been made in our understanding of acute pain mechanisms, and our insight into postoperative convalescence and rehabilitation has increased dramatically. There is a lack of evidence for pre-emptive analgesia, whereas studies of antihyperalgesic drugs and multimodal analgesic regimens are promising. The use of opioids should be restricted, and it may be rational to develop procedure-specific pain treatment guidelines. There is a need for increased collaboration and integration of acute pain treatment and multimodal postoperative rehabilitation efforts.
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Chronic pain constitutes a major health care and social problem. Around 20% of adults in a number of Western countries suffer from severe to moderate chronic pain that seriously affects their quality of life. That chronic pain may be an adverse outcome of surgery has been overlooked so far, but new studies suggest that chronic pain even after minor surgery is far more frequent than previously assumed. This article presents epidemiological, clinical and pathophysiological aspects of chronic postoperative pain and offers suggestions for pain management and prophylaxis.
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Ugeskrift for laeger · May 2006
Review[Prevention of traffic deaths in accidents involving motor vehicles].
A vehicle's speed and age determine the degree of injury inflected in traffic accidents. Drivers under the influence of alcohol have an increased risk of death in traffic accidents, and males have twice the risk of traffic death as women per kilometre driven. ⋯ Traffic deaths are a result of accident and damage factors, which inflect lethal injury especially on the elderly. This can be illustrated as: number of deaths = accidents * damage in accidents.
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Based on previously published studies, this review describes the pulmonary consequences of marijuana smoking. Smoking of marijuana is significantly associated with chronic bronchitis (cough and phlegm), but it has not been firmly established whether it also leads to a reduction in lung function. Both epidemiological studies and case reports suggest that regular smokers of marijuana have a higher risk of developing malignancies in both the upper and lower airways. Smoking of marijuana contaminated with fungus spores has been reported to lead to pulmonary aspergillus infections in immunocompromised patients, and sharing of marijuana water pipes has been associated with transmission of tuberculosis.