Ugeskrift for laeger
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Ugeskrift for laeger · Dec 2001
[Measurement of quality of care and the "soft values" at a pediatric department].
Medical care must be provided in accordance with high professional standards and patients' needs and priorities. ⋯ Quality development must be implemented on a documented basis. Improvements have been implemented according to the results.
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The aim of the study was to assess the results of a well-defined rehabilitation programme after hip arthroplasty. ⋯ A clinical programme focusing on pain relief, oral nutrition, and rehabilitation may reduce the stay in hospital and improve recovery after hip arthroplasty.
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Ugeskrift for laeger · Dec 2001
[Hydroxyurea-induced leg ulcers in patients with chronic myeloproliferative disorders].
Hydroxyurea (HU) is usually a well-tolerated antineoplastic agent, which is commonly used in the treatment of myeloproliferative disorders. Dermatological abnormalities are often seen in patients receiving long-term HU therapy. Leg ulcers have been reported occasionally. ⋯ We found a surprisingly high number of cutaneous leg ulcers in patients on HU therapy for chronic myeloproliferative disorders. We believe this disabling complication should be given greater attention and recommend that it is included in the description of the side effects of the drug.
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Many patients with major depression have elevated serum cortisol, which cannot be suppressed with dexamethasone. This points to a disturbance in the hypothalamus-pituitary-adrenal (HPA) axis, which might have pathogenetic importance. Recent investigations with MRI have shown an increased frequency of generalised, as well as localised atrophy in the brains of depressed patients. ⋯ There is evidence that the increased cortisol concentration is neurotoxic and may cause atrophy, as is known from Cushing's disease. This is supported by studies of the accumulated duration of depressive episodes, and also by the fact that drugs that dampen the HPA axis have proved to have antidepressant properties in clinical controlled, double-blind studies. This points to new principles in the treatment of major depression and underlines the importance of early intervention in order to prevent cerebral atrophy, which is probably reversible at the beginning of the disease process.