Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Jan 1996
Case Reports[Guillain-Barré syndrome. Variation on the theme].
Guillain-Barré syndrome, or acute inflammatory demyelinating polyneuropathy, is a frequent cause of acute onset of flaccid paresis and areflexia. Electrophysiological studies show demyelination, sometimes with varying degrees of axonal degeneration. In some cases axonal degeneration apparently develops rapidly, without signs of primary demyelination. ⋯ We report on clinical and electrophysiological findings in three patients with variants of Guillain-Barré syndrome. These include pure demyelination, combined demyelination and axonal degeneration and possible primary axonal degeneration. Electrophysiological studies can differentiate between the variants of Guillain-Barré syndrome, and thus give indications of pathogenesis and prognosis.
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Tidsskr. Nor. Laegeforen. · Jan 1996
[Increasing use of cesarean section, even in developing countries].
At Kaziba hospital in rural Zaire, the frequency of deliveries by Caesarean section rose from 6.2% in 1971 to 12% in 1992, and the fraction of repeated sections rose from 17% to 49%. During the same period, the overall maternal mortality decreased from 0.3% to 0.12%, and deaths connected with Caesarean section from 3.2% to 0.7%, but still the risk of dying remained 13 times higher for births by Caesarean section compared with vaginal deliveries. The frequency of vacuum deliveries was halved during the period, and mean birth weight decreased by about 100 g. ⋯ Operations carried out by persons other than physicians were complicated by wound infections at a higher rate (20.8%) than those carried out by experienced doctors (11.2%). In areas with a poorly developed health system, a high rate of Caesarean section represents a hazard to maternal health. The need for knowledge about alternative methods like vaginal extraction, symphyseotomy and active management of labour is underlined.