Läkartidningen
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The review included randomized controlled trials on patients with chronic obstructive pulmonary disease (COPD) receiving domiciliary long-term oxygen therapy (LTOT). The authors identified six articles concerning four randomized controlled trials but could not perform any meta-analysis due to the heterogenous patient populations and treatments. From these trials they conclude that LTOT improves survival in patients with severe hypoxemia (arterial PaO2 less than 8 kPa) but has no effect in patients desaturating only at night or in patients with moderate hypoxemia. ⋯ A more recently published trial supports the conclusion that domiciliary nocturnal oxygen therapy has no impact on survival in nocturnal desaturation without severe daytime hypoxemia. There is also new evidence that the type of oxygen equipment might have a decisive impact on the quality of life in mobile patients receiving LTOT--improved quality of life with liquid oxygen and poorer quality of life with concentrator and conventional (heavy) gas cylinder. The importance of optimum equipment selection for each patient has been overlooked but merits further investigation.
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The case method is a student-activating method, used together with problem based learning (PBL) and traditional teaching methods in the curriculum for undergraduate medical education at the Faculty of Medicine in Lund/Malmö, Sweden. The case method provides training in the solving of clinical problems and is thus especially useful at the clinical level of medical education, and in an integrated and problem based curriculum. The case method consumes less teaching resources than PBL, and might thus be useful in a situation with increasing numbers of medical students.