Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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More than six-fold variation in incidence between countries, an increasing incidence among immigrants to high incidence areas, and a general increase in the incidence of breast cancer within countries, are factors which suggest a potential for prevention. Reproductive factors such as early menarche, late age at first full term birth, nulliparity, and late age at menopause increase risk of breast cancer, but manipulation of any one of these factors does not seem to be a realistic preventive tool. ⋯ Alcohol consumption by young women, and overweight among postmenopausal women may also increase the incidence of breast cancer. Consequently, reduced alcohol intake by young women, and weight reduction among overweight women after menopause may reduce the risk of breast cancer.
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Tidsskr. Nor. Laegeforen. · May 1991
Clinical Trial Controlled Clinical Trial[Sterile water papulae for analgesia during labor].
In a group of Scandinavian women in labour, application of sterile water wheals intradermally was compared with a "dry needling" technique as a way of treating labour pain. 101 women received intradermal wheals, 50 were "dry needled" and 117 served as a control group for perinatal complications. 57.6% of the women in the wheal group experienced more than 50% relief of pain compared with 18% in the dry needling group (p less than 0.0001). Mean duration of pain relief was 79 +/- 15 min. (SD) in the wheal group and only 19 +/- 15 min. in the dry needling group. ⋯ Judged by the mean Apgar scores one and five minutes after delivery, the method did not seem to have any side effects, either on the mother or on the foetus. It was impossible to carry out the study double blind, but it still strongly indicates that application of small amounts of sterile water intradermally during labour is an efficient and safe way of reducing pain in labour.
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Tidsskr. Nor. Laegeforen. · May 1991
Case Reports[Extracorporeal membrane oxygenation. A therapeutic alternative in acute heart and/or pulmonary failure?].
Extracorporeal membrane oxygenation was introduced as a supplement ot mechanical ventilation in the treatment of two patients with severe acute respiratory failure and as heart assist in one patient with acute refractory cardiac failure after open heart surgery. The system includes a membrane oxygenator and a roller pump. The whole circuit is coated with partially degraded heparin covalently bound to the surface (Carmeda Bioactive Surface), reducing the need of systemic heparinization to a minimum. ⋯ On the eighth day he was weaned off intra-aortic balloon-pumping as well. Unfortunately, he died of septicemia, with multiple organ failure, 13 days later. The heparin-coated extracorporeal membrane oxygenation system may represent a major advancement in the treatment of critically ill patients in need of cardiopulmonary assist.
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Infectious diseases are the main cause of mortality and morbidity in developing countries. The Expanded Programme on Immunization, initiated by WHO in 1974, now reaches 60 mill. a year at a cost of less than 2 US $ per immunized child, and saves 2.2 mill. lives annually. The present vaccines, however, have significant shortcomings. ⋯ By only modest investments modern gene technology could give improved and new vaccines which would potentially save 20 mill. lives a year. Particularly promising is the recent development of multi-vaccine-vectors. However, poor prospects for profit in developing countries and patent "swapping" by commercial producers severely hamper development in the vaccine field.