Ugeskrift for laeger
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Ugeskrift for laeger · Oct 2000
Review[Surgical treatment of Parkinson disease and essential tremor].
Recognition of the often failing effect of levodopa treatment as Parkinson's disease (PD) progresses has led to the resumption of surgical treatment. In the 1950'ies and 1960'ies pallidotomy and thalamotomy were commonly performed to reduce parkinsonian symptoms, whilst today these permanent lesions are replaced by Deep Brain Stimulation (DBS) of implanted leads. ⋯ Bilateral stimulation of the STN is often preferred due to the reduction of rigidity, hypokinesia and tremor as well as the significant reduction of dyskinesias and off-periods. The motor functions are significantly improved and stabilized.
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Ugeskrift for laeger · Sep 2000
[Oral transmucosal fentanyl citrate (OTFC) in the treatment of breakthrough pain].
Breakthrough pain in patients receiving opioids for pain relief is traditionally treated with opioids given orally. This, however, implies a long time to clinical effect and a long duration of action resulting in difficult titration. ⋯ Clinical studies have shown that patient tolerance of OTFC is high and the analgesic effect is comparable to that of intravenous fentanyl, without the need for an i.v. line. Clinical indication will be breakthrough pain in patients receiving opioids for baseline pain medication.
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Ugeskrift for laeger · Sep 2000
Comparative Study[Fatal intoxications among drug addicts in Denmark in 1997].
The purpose of this study was to investigate fatal poisonings among drug addicts in 1997 and to compare the results to similar investigations from 1985 and 1991. ⋯ This study showed an increasing number of fatal intoxications and changes in drug abuse pattern and place of death since 1991.
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New knowledge about accidental hypothermia acquired in recent years may simplify treatment and aid the evaluation of prognosis. Evidence of death or severe collapse due to the feared afterdrop has not been published. Afterdrop is a phenomenon of conductive heat loss. ⋯ In hypothermia the most important differential diagnosis is death. Patients who are cold and could be resuscitated must be differentiated from patients, who are cold because they are dead. Experience from abroad has shown that extreme hyperkalaemia may be a useful diagnostic tool.
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Ugeskrift for laeger · Sep 2000
Case Reports[Treatment of severe, accidental hypothermia with a warm air bed].
Patients suffering from severe accidental hypothermia are by many authors recommended to be rewarmed by extra-corporal circulation. Some authors argue in favour of other approaches in treatment of severe hypothermia, as long as the patient has a sufficient circulation. One of these is rewarming using forced air warming. ⋯ The patient arrived with a core temperature of 25.9 degrees C and had sufficient circulation despite of atrial fibrillation. The patient was rewarmed to a core temperature of 36.1 degrees C over seven hours. No other arrhythmias or complications were observed.