Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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The main risk factors for deep vein thrombosis in pregnancy and after delivery are preeclampsia, operative delivery, adiposity, prolonged bed rest, and haemostatic defects (antithrombin, protein C and protein S deficiencies), activated protein C resistance, lupus anticoagulant/antiphospholipid antibodies. Hyperhomocystinaemia is a general risk factor for deep vein thrombosis. The clinical diagnosis of deep vein thrombosis is difficult and must be confirmed by imaging techniques. ⋯ Anticoagulant treatment is prolonged for 6-12 weeks after delivery, usually with warfarin. During pregnancies associated with high risk of thrombosis, low molecular heparin prophylaxis is given during pregnancy and 6-12 weeks after delivery. Thrombosis in pregnancy must be followed by adequate investigation for an underlying thrombotic predisposition.
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Tidsskr. Nor. Laegeforen. · Oct 1998
Review[Emotional and cognitive disorders in Parkinson disease].
The majority of patients with Parkinson's disease develop psychiatric symptoms. 40% of the patients suffer from symptoms of depression, severely affecting daily functioning, motor symptoms, cognition, and quality of life for both the patients and their spouses. Antidepressants may alleviate the depressive symptoms, but treatment is complicated by complex pharmacodynamic interactions. Hallucinations, with or without delusions, occur in 15-20% of patients, and are usually caused by dopaminergic treatment. ⋯ Dementia increases with the age at onset and the duration of Parkinson's disease. Subcortical dementia is the most commonly observed syndrome, but symptoms of cortical dementia are also observed. No treatment is available, although cholinergic agents may prove useful.
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Over a period of three years, 378 patients with objectively verified venous thromboembolism were treated at Aker University Hospital. Below the age of 60, men and women had about the same incidence of venous thromboembolism, but that age the incidence was significantly higher among men than among women. Incidence increased exponentially with age, from about 1:10,000 at age 20 to about 1:1,000 at age 50. ⋯ Seven women were on oral contraception, and 22 used postmenopausal hormone substitution. An obvious temporary precipitating factor was present in 42% of the patients, while 36% had a spontaneous venous thromboembolism. Hereditary thrombophilic disorder was found in 32% of patients below the age of 60.