Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Aug 2000
Comparative Study[Can postoperative nausea or vomiting be predicted?].
In order to identify patients who may benefit from prophylactic anti-emetic medication during surgery, it is of interest to evaluate risk factors for postoperative nausea and vomiting preoperatively by a simple scoring system. ⋯ We suggest that patients with a U-score > 7 should receive effective prophylaxis against PONV, i.e. not droperidol only. Further evaluation of different scoring systems should be carried out in larger patient populations. Simplified systems, such as the A-score or K-score or simplified U-score, may be sufficient in uniform surgical populations. The U-score may be more universal because anaesthetic method and use of postoperative opioids are also included.
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Tidsskr. Nor. Laegeforen. · Aug 2000
Case Reports[Intraspinal infections in patients treated with epidural analgesia].
Intraspinal infections (meningitis, epidural abscess) may occur spontaneously or present as a complication of epidural analgesia. ⋯ Because of the danger of infection related to epidural analgesia, all patients have to be properly monitored as long as they have epidural catheters and also after the removal of catheters. Some epidural abscesses spread longitudinally and may present as a diffuse process on MR without mechanical compression of the medulla, and may be interpreted as negative findings. Myelography with CT scan is an alternative method of investigation in such cases. Early neurosurgical diagnosis and intervention may prevent serious complications.
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Tidsskr. Nor. Laegeforen. · Aug 2000
Case Reports[Genetic counseling in presymptomatic testing for Huntington disease].
Norwegian law and international guidelines require genetic counselling before, during and after presymptomatic testing for Huntington's disease. The genetic counselling of at-risk persons who considers taking tests, includes explanation of the possible implications of a test result for both participant and relatives. The test is performed only when explicitly requested by the participant and after informed consent. ⋯ The participant also has major influence on the timing of the consecutive phases of the testing procedure, in compliance with medical and ethical recommendations. This paper reviews main issues raised during genetic counselling and the preparation period preceding the test and communication of the test result. We illustrate different individual situations and backgrounds for considering presymptomatic testing for Huntington's disease by describing three anonymized cases and associated pedigrees.
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Tidsskr. Nor. Laegeforen. · Aug 2000
Comparative Study[Students' attitudes toward active euthanasia, assisted suicide and proposed amendments to the penal code].
Attitude surveys in the Norwegian population show a majority supporting active euthanasia for patients with terminal disease, while among physicians, only a minority do so. ⋯ The study indicates stable and differentiated attitudes towards euthanasia with significantly greater (nearly ten percentage points) support of assisted suicide compared to active euthanasia for both terminal and non-terminal disease. This probably reflects a view of the patient's own right to participate in making decisions in a critical situation.