Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Sep 2006
Case Reports[A 54-year-old man with a large subcutaneous skull erosion and focal epileptic seizures].
Extracranial metastases from meningioma are rare, and are reported to occur in less than 1 per 1000. ⋯ Risk factors for metastasis of cerebral meningiomas have been suggested to be histological malignancy grade, venous sinus invasion, and local recurrences after previous craniotomy.
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Tidsskr. Nor. Laegeforen. · Sep 2006
[Daptomycin--a new antibiotic for the treatment of skin and soft tissue infections].
Daptomycin (Cubicin) is a bactericidal lipopeptide antibiotic that was approved in February 2006 for the European market, including Norway, for the treatment of patients with complicated skin and soft tissue infections caused by Gram-positive cocci. Daptomycin is administered intravenously and eliminated mainly by the kidneys. Dose reduction is therefore necessary in patients with impaired renal function. ⋯ Daptomycin therapy of patients with complicated skin and soft tissue infections caused by Gram-positive cocci, is as effective as standard therapy with intravenous semi-synthetic penicillin or vancomycin. The agent is usually well tolerated, but side effects in skeletal muscles are more prevalent than with semi-synthetic penicillins or vancomycin. To prevent development of daptomycin resistance, the agent should be reserved for the treatment of patients with infections caused by Staphylococcus aureus that are resistant to antibiotics commonly used for the treatment of skin and soft tissue infections, e.g. penicillins or clindamycin.
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Haemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome is a severe form of preeclampsia. It is often manifested clinically by elevated blood pressure, proteinuria and abdominal pain. Women diagnosed with the HELLP-syndrome normally show evidence of recovery within the first 48 hours after delivery. There is however a small group of patients in which no arrest or reversal of the HELLP process can be seen after 72 hours post partum. These patients have a high incidence of maternal morbidity and mortality. Several studies have shown benefits to HELLP patients after administration of corticosteroids. ⋯ None of the studies show statistically significant differences in maternal morbidity or mortality by administering corticosteroids to patients with HELLP syndrome. Treatment can give a faster increase in the platelet count for patients with platelets < 50 (10(9)/L), but larger trials are needed to support the use of corticosteroids for treatment of HELLP-syndrome.