Duodecim; lääketieteellinen aikakauskirja
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Key findings and recommendations from a study comparing clinical research regulation in Finland with those in England, Canada (Ontario) and USA are presented. Data were collected with various methods, including interviewing key experts. ⋯ Research ethics committees (REC) were crucial, as well as drug authorities in research with drugs. Recommendations include reforming the medical research law, widening the dimensions of ethics judgment, restricting the REC tasks, including a central committee, and introducing quality assurance and restricting the drug control authority tasks.
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Hoarding is a mental disorder having its onset at young age and often worsening with age, manifested as a need of storing up goods to an extent that significantly hampers everyday life. In the light of conducted studies, at least 1 to 2% of the adult population suffers from hoarding. ⋯ Hoarding differs from obsessive-compulsive disorder in its course and treatment response. Treatment of hoarding disorder is based on methods applied in cognitive behavior therapy.
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The most common symptoms of cardiac sarcoidosis and giant cell myocarditis are atrioventricular block, ventricular tachycardia and cardiac insufficiency. Magnetic resonance imaging of the heart or positron emission tomography are utilized to evaluate the possibility of inflammatory heart disease. ⋯ The cause of cardiac sarcoidosis is not known, but granulomatous inflammation can be suppressed with corticosteroids. In giant cell myocarditis, more powerful immunosuppression is utilized than in sarcoidosis, but one third of the patients still require heart transplantation within one year from the diagnosis.