Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Dec 2005
Biography Historical Article[Neurosurgery in antique medicine].
Trepanation and craniotomy are two of the oldest surgical procedures known, and extensive archaeological evidence of trepanation exists in ancient cultures. However, the first descriptions of the surgical techniques are from Greek and Roman medicine, where cranial surgery was used to treat head trauma. This article concerns neurosurgery in ancient medicine, with an emphasis on "De Medicina" by Aulus Cornelius Celsus (25 BC-50 AD) and the Corpus Hippocraticum (about 400 BC). These texts are further considered in the light of excavated surgical instruments from Pompeii.
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Tidsskr. Nor. Laegeforen. · Dec 2005
Review Comparative Study[Alternative emergency interventions in adult mental health care].
The objectives of this study were to review the literature on alternatives to traditional treatment of acute mental disorders and to describe the effects of these interventions. The main emphasis is on crisis resolution teams (CRT) because there are governmental plans to implement these in all Norwegian community mental health centres. ⋯ The identified alternative interventions were: emergency residential/domestic care, emergency day centres, and crisis resolution teams (or assertive/out-reach/mobile crisis teams). Studies of acute day hospitals showed that this treatment is associated with reduced hospitalisation, faster recovery and reduced costs compared with treatment in traditional hospital acute wards. Because of insufficient research, it was not possible to draw conclusions on the effects of residential or domestic care. We identified six randomized controlled studies and four quasiexperimental studies of Crisis Resolution Teams. These studies indicate that Crisis Resolution Teams or other forms of assertive homebased mobile/outreach treatment, is an acceptable alternative to hospitalization for many patients. The clinical effect of such treatment seems to be comparable with traditional treatment, and are associated with reduced hospitalizations and rehospitalizations, and with reduced costs. None of the reviewed treatment can replace traditional acute hospital treatment. Although studies of alternatives to acute hospitalization have congruent results, there are few studies and methodological weaknesses make it difficult to draw firm scientific conclusions about the effect of such interventions.