Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Improvements in diagnostics and treatment in perinatal medicine have enabled us to save more premature and critically ill infants and infants born with severe congenital anomalies. However, some of these children often develop complications with a poor prognosis both for survival and quality of life. An active decision to withdraw treatment is common practice in such cases. Little is known about the impact of this problem in neonatal care in Norway. ⋯ Death after withdrawal of treatment was identified in 65% of the cases and was mainly seen in critically ill immature and premature infants (74%). The parents were usually involved in the decision, though documentation in patient records of the decision making process was generally poor. The ethical, legal and practical implications of this state of affairs probably need to be reviewed.
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Fibromyalgia is a chronic widespread unexplained musculoskeletal pain syndrome with decreased pain threshold. Because the etiology of fibromyalgia is unknown and the pathogenesis is unidentified, treatment is largely symptomatic and not standardised. The pain and fatigue reported by individuals with fibromyalgia results in a relative sedentary lifestyle, hence also a decrease in the fitness level of skeletal muscles. ⋯ The group exercises varied from 1-3 times per week, sessions from 25 minutes to 90 minutes; the duration of the programmes from 6 weeks to 6 month. Most of the programmes were low-intensity dynamic endurance training with a working rate at 50-70 % of maximal heart rate in relation to age.