Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Salivary cortisol reflects the free and biologically active fraction of cortisol in serum. We evaluated the usefulness of salivary cortisol measurements in the assessment of Cushing's syndrome and adrenal insufficiency. ⋯ The method is simple and we recommend saliva cortisol as a first line screening method for Cushing's syndrome. The method may simplify and improve the assessment of adrenal insufficiency.
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Cannabis has been used throughout human history. Delta (9)-tetrahydrocannabinol (THC) is the primary psychoactive component of cannabis. THC metabolises to 11-OH-THC and further to THC-acid, which is an inactive metabolite. We present an overview of the pharmacokinetics and pharmacodynamics of cannabinoids. ⋯ It has been demonstrated that mammalian tissues express cannabinoid receptors (CB1, CB2 and most probably CB3) and endogenous ligands for these. Knowledge of these receptors has lead to the development of components that stimulate (CB-agonists) or block their function (CB-antagonists). This opens up for the study of any potential therapeutic effects of cannabinoids. Research on a possible therapeutic potential of cannabinoids should however not overshadow the well-documented negative effects of cannabis; i.e. impaired cognitive functions, intoxication and an increased risk for development of psychosis and psychotic symptoms.
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Tidsskr. Nor. Laegeforen. · Mar 2007
Review[Rehabilitation of patients with chronic obstructive lung disease].
Pulmonary rehabilitation is well established and is increasingly prescribed as part of the treatment for chronic obstructive pulmonary disease (COPD). ⋯ The essential elements of rehabilitation include a multidisciplinary approach; focus on the individual patient; and emphasis on emotional, social, and physical health aspects. The selected patients have COPD symptoms; are fully aware of their physical limitations and motivated to take an active part in the treatment. Pulmonary rehabilitation is also beneficial for patients with other chronic lung diseases A systematic programme includes a detailed clinical examination of the patient, teaching, training in mucus mobilization and breathing techniques, exercise training and psychosocial support. Evidence-based effects of rehabilitation include symptom relief, increased exercise performance, improved quality of life and reduced use of health services. Pulmonary rehabilitation is also necessary before and after lung transplants and in connection with volume reducing surgery for emphysema.
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Chronic musculoskeletal pain of diffuse origin affects many, and at a significant cost. Evidence-based guidelines for therapeutic interventions are presented and exemplified. ⋯ Our findings confirm the existing evidence-based guidelines by showing that multidimensional rehabilitation is an effective intervention for patients with widespread chronic pain. It is a challenge for health politicians to change today's common practice towards that described in evidence-based guidelines.