Duodecim; lääketieteellinen aikakauskirja
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Attention-deficit hyperactivity disorder (ADHD) in not necessarily a phenomenon passing away with childhood, instead in some patients attention problems continue, causing disturbances until adulthood. ADHD hampers studying and getting along in working life, social relationships as well as traffic skills. ADHD is also associated with increased risk of substance abuse and criminal behavior. Several studies have shown that stimulant medication and psychosocial forms of treatment are able to reduce long-term handicaps of ADHD and associated psychiatric morbidity.
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Risks of injury in cross-country skiing, downhill skiing and snowboarding are largely due to the characteristics, speed, equipment and level of difficulty of the sport. The preventative means are also found among these factors. ⋯ The helmet is an easy and inexpensive means in reducing severe injuries (head injuries) occurring in downhill skiing and snowboarding. Helmet use should thus be encouraged.
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Noninvasive ventilation is effective in acute respiratory failure, in which drug therapy and administration of supplemental oxygen do not suffice and attempts are made to prevent the patient from ending up in invasive respirator therapy. The treatment is suited for acute respiratory failure for instance in cases of exacerbation of chronic obstructive pulmonary disease, in which a disturbance of pulmonary ventilation leads to the accumulation of carbon dioxide and to respiratory acidosis. Disadvantages associated with artificial airways are avoided, number of complications are reduced, hospitalization periods become shorter, mortality decreases and costs are saved.
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In Finland approximately 7,000 hip fractures occurred annually during 1996-2008. Risk of hip fracture can be diminished through efforts to prevent falls and osteoporosis. ⋯ Rehabilitation should be centralised in specialised rehabilitation centres for the elderly. Secondary prevention of future fractures should include management of osteoporosis and fall prevention.
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Adequate sedation is essential for successful performance of painful and uncomfortable interventional radiological, endoscopic or oncological procedures. Mild sedation is usually provided by the interventionists but an anaesthetic team is needed for deep sedation. A new alternative for intravenous sedation provided by a physician is patient controlled sedation (PCS). ⋯ The advantages of PCS are appropriate level of sedation and rapid recovery. PCS has proved to be safe and effective during the change of burn injury dressings, endoscopic and radiological procedures. In Helsinki University Central Hospital the preliminary experience in over 1000 patients in the endoscopic unit has been very encouraging.