Duodecim; lääketieteellinen aikakauskirja
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Self-administered nitrous oxide relieves labour pain in approximately two-thirds of women, and there is a dose-response with a maximum effect at a concentration of 70%. Nitrous oxide can be used during all stages of labour, and it has no impact on the progress of labour. Occupational exposure of health care workers to nitrous oxide has no adverse effects on their reproductive health if there is an adequate scavenging system in the delivery rooms. The greenhouse effect of the medical use of nitrous oxide is minimal and in future, its catalytic splitting to nitrogen and oxygen may overcome this adverse effect.
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Every woman in labor shall have the right to receive effective analgesia if she so wishes. Management of labor pains should strive for individuality according to the mother's wishes, even if they are changing. ⋯ Anesthesia may be given when labor is clearly under way, and can be continued even at the expulsive stage. With contemporary drug mixtures it is possible to carry on with the anesthesia throughout the delivery without significantly affecting its course.
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Fibromyalgia is a controversial pain syndrome with chronic widespread pain (occurring on both sides of the body as well as axially below and above the waist) and unexplained fatigue as the predominating features. Fibromyalgia involves lots of symptoms focusing on different organ systems. In sensory examination the most significant finding is general allodynia. The widespread chronic pain and tender points at certain locations as reported by the patient differentiate fibromyalgia patients from those suffering from other diseases of the musculoskeletal system.
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Long-term oxygen therapy extends the life span of hypoxemic patients with chronic obstructive pulmonary disease (COPD). The patients often have great expectations concerning the quality of life, but oxygen therapy does neither relieve dyspnea nor reduce the need for hospital treatments. ⋯ It is worthwhile to start in-hospital oxygen therapy by determining the oxygen flow with a device given to the patient, and the effect of the therapy on the nocturnal accumulation of carbon dioxide is checked. In the future, focus should be on other forms of therapy, such as rehabilitation.