Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Malaria is one of the main health problems in the world with 300-500 millions cases yearly and about one million deaths, mainly children in Sub-Saharan Africa. In the 1990s the malaria problem in Africa has increased, although we have methods to control the disease. In 1998 the new secretary general of WHO, Gro Harlem Brundtland, established the Roll Back Malaria programme, with the aim to markedly reduce malaria morbidity and mortality. ⋯ However, it depends for resources on international support and commitment from other UN bodies, the World Bank, governments in the western world, pharmaceutical industry, philanthropists and other sources. At present an optimistic view prevails, and the preliminary aim, to halve the malaria mortality by the year 2010, seems realistic even with the control methods of today. However, if research efforts result in new and better tools to combat the disease, the task will definitely be easier.
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Tidsskr. Nor. Laegeforen. · May 2000
Review Case Reports[Metformin associated lactic acidosis--case reports and literature review].
The use of metformin in the treatment of diabetes mellitus type II is increasing. The drug has several advantageous metabolic effects, and is considered safe if not used in the presence of contraindications, in particular renal failure. ⋯ Metformin associated lactic acidosis must be considered in obscure metabolic acidosis in diabetic patients. The single most important therapeutic approach appears to be immediate hemodialysis.
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Previous reports have demonstrated variable and partly insufficient skills levels in common practical procedures among interns after internship in hospital. The aim of the present study was to examine the development in interns' skills levels in practical procedures in relation to their gender, medical school, hospital and supervision. ⋯ The finding of a variable skills level before and a variable development during internship indicates that teaching in practical procedures is unstructured and inadequate. A consensus on the skills to be acquired and on what level is needed. Improvements are also needed in the quality of supervision.
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Accumulated general practice experience from numerous encounters with sexually victimized persons motivated this study of childhood sexual abuse with regard to its longterm impact on life and health. THEORY, METHODS, AND MATERIAL: Phenomenology is its theoretical frame of references, and its methodological tools are hermeneutics, 34 adult users of two Norwegian incest centres consented to being interviewed in depth about their encounters with the health care system. The audiotaped interviews were transcribed verbatim. Relevant medical records filled out 16 of the interviews. Likewise, extensive field notes from interview setting were collected. ⋯ The impact of childhood sexual abuse was shown to transgress linear time, cause-effect relationship, categorical distinction and individuality. Since these four central preconditions for a correct medical judgement were not provided, harmful, though presumably correct, medical treatment was a frequent result. Consequently, the abused persons were revictimized in medical contexts when asking for help for sickness in the wake of socially silenced sexual violation.
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Preeclampsia is characterized by hypertension and proteinuria with or without oedema. ⋯ We focus on early signs and close clinical surveillance. The diastolic blood pressure should be estimated with Korotkoffs' phase V. Patients with early onset preeclampsia should be hospitalized, as should women with hypertension and newly developed proteinuria. Antihypertensive treatment is discussed. Cases with reduced fetal growth and those with severe preeclampsia should in most cases be delivered preterm. Vaginal delivery is preferable. Labour may be induced by oxtocin, following cervical prostaglandin stimulation as indicated. In such cases cardiotocography surveillance during labour should be performed. Caesarean section may be performed in selected cases. Patients with mild preeclampsia can await spontaneous vaginal delivery at term, but delivery should be induced if they proceed past term.