Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Aug 2001
Case Reports[Skin biopsy for quantification of intraepidermal nerve fibers].
Skin biopsy for quantification of intraepidermal nerve fibre density has recently been introduced as a method for diagnosis of peripheral neuropathies. Immunostaining by antibody to protein gene product 9.5 has proved particularly useful because it selectively visualizes the epidermal nerve fibres. ⋯ Skin biopsy for determination of intraepidermal nerve fibre density is a simple and non-painful procedure. Skin biopsies can be done repeatedly and may be used for the purpose of monitoring potential therapeutic agents.
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Tidsskr. Nor. Laegeforen. · Aug 2001
Case Reports[Acute dystonia caused by metoclopramide (Afipran) therapy].
Metoclopramide is an antiemetic drug used frequently both in general practice and hospitals. The drug has few side effects, mainly drowsiness, and can be used both in pregnancy and breastfeeding. Acute dystonia is a rare side effect mostly affecting children and young adults within 1-3 days after start of the medication. Women are more frequently affected than men. ⋯ Metoclopramide-induced dystonia is frightening both for the patient and the family. Because of concomitant anxiety and psychiatric symptoms, individuals are often regarded as hysterical. The attack can be abbreviated by parenteral administration of anticholinergic drugs. It is important that all doctors prescribing metoclopramide know of this side effect, especially when their patients are young females.
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Tidsskr. Nor. Laegeforen. · May 2001
[Norwegian medical students abroad--career plans, personality, smoking and alcohol use].
More than 30% of Norwegian physicians have graduated from medical schools outside Norway, and the number of Norwegian students that attend medical schools abroad is increasing, particularly in Hungary, Poland and the Czech republic. There is a need to know more about these future Norwegian doctors, what their motives and plans are, and how they differ from students at home. ⋯ Norwegian medical students abroad do not particularly prefer specialties like general practice and psychiatry, where the demand for medical manpower is highest. They seem to have quite traditional preferences according to gender.
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Tidsskr. Nor. Laegeforen. · May 2001
Case Reports[Is the epidural analgesia to blame when it comes to neurological complications following labor?].
One of every four parturient in Norway receives epidural analgesia during labour. Even though epidural analgesia is considered very safe, there is a tendency to blame the epidural whenever there are neurological complications after labour. ⋯ Gynaecologists, neurologists, mid-wives and even anaesthesiologists seem unaware of the fact that the incidence of neurological complications are four to five times higher as a result of the labour per se than complications caused by the epidural. Peripheral neurological symptoms after labour occur in 1:2-3,000 labours. Postpartum drop-foot and femoral mononeuropathy are the most frequent complications. Half of all parturients will experience low back pain during pregnancy and/or labour, and one in four will complain of headache in the immediate postpartum period. Urinary bladder dysfunction after pregnancy is not uncommon, but the incidence is the same among mothers who have received epidural analgesia and those who have not. Complications after epidural analgesia, such as haematoma, abscesses and direct nerve damage are extremely rare, but need immediate treatment.
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Tidsskr. Nor. Laegeforen. · Apr 2001
[Inhalation of a prostacyclin analog (iloprost) in primary and secondary pulmonary hypertension].
Vasodilative therapy in the form of calcium channel blockers and, recently, continuous intravenous prostacyclin has improved exercise capacity and reduced mortality in primary pulmonary hypertension. Their clinical value is limited by either low rate of response or serious side effects. These shortcomings could be overcome by the use of iloprost, a stable prostacyclin analogue. Administering it by inhalation, we assessed its short-term efficacy in patients with primary and secondary pulmonary hypertension. ⋯ Drug testing with inhalation of iloprost is safe and causes beneficial haemodynamic changes with selective pulmonary vasodilatation. Since the long-term effect of medical intervention is based on the degree of acute pulmonary vascular reactivity, inhalation of iloprost may be a new therapeutic option for severe pulmonary hypertension.