Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
-
Tidsskr. Nor. Laegeforen. · Jan 2005
Randomized Controlled Trial Comparative Study Clinical Trial[Buprenorphine and methadone to opiate addicts--a randomized trial].
There are approximately 12,000 opioid dependants in Norway. Methadone-assisted treatment was approved in Norway in 1998, buprenorphine in 2000. This study compares the efficacy of methadone (n = 25) and buprenorphine (n = 25) assisted maintenance treatment in a group of long-term (> 10 years) opioid dependant. ⋯ After 180 days, patient retention was highest in the methadone group (85 % vs. 36 %, p < 0.0005). Days in treatment were 167 vs. 114 (95 % CI for difference 53 days (26-80), p < 0.001). Positive urine test rates for opiates (20 % vs 24 %, p < 0.01) and cannabis (33 % vs 45 %, p < 0.001) were lower in the methadone group which also had lower self-reported risk behaviour and psychological distress. However, only those on buprenorphine reported significant improvement in physical health. For older, long-term opioid dependants with significant co-morbidity and unsuccessful medication-free treatment, high-dose methadone maintenance appears to be the treatment of choice. However, in cases where methadone is poorly tolerated, buprenorphine therapy may be a good alternative.
-
Tidsskr. Nor. Laegeforen. · Jan 2005
Review[Application of pupillometry and pupillary reactions in medical research].
The iris is a dynamic organ in which the autonomic nervous system regulates the activity. Iris activity reflects physiological reactions to different sensory stimuli, resulting in a variation in pupil size. There are many different diagnostic tools which assess iris activity. The present paper reviews the methods of pupillary assessment as a research tool and in clinical use. ⋯ Pupillometry is a research tool that is adopted in an increasing number of medical fields. In the past this method was used mostly within ophthalmology and neurology; today it has spread to a wide range of medical fields, for instance pharmacology and physiology. There are continuous improvements in the flexibility and recording capacity of pupillometers and they are used in an increasing number of medical fields, though they are still most useful within research.
-
Tidsskr. Nor. Laegeforen. · Dec 2004
Comparative Study[Diagnosis in metabolic acidosis of unknown origin].
Obtaining a precise diagnosis in patients presenting with metabolic acidosis of unknown origin is difficult. Poisoning with methanol or ethylene glycol should be suspected in cases with a combined increase of osmolal and anion gaps. ⋯ The osmolal and the anion gaps are both helpful tools in the diagnosis of patients with metabolic acidosis of unknown origin, especially for identifying patients poisoned with methanol or ethylene glycol.