Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
-
Tidsskr. Nor. Laegeforen. · Sep 1998
Case Reports[Two patients with chlorhexidine allergy--anaphylactic reactions and eczema].
A 14 year-old girl experienced a combined delayed and immediate type of allergy to chlorhexidine. She first developed an eczematous reaction in the face following the long-term application of an antiacne preparation. Use test (repeated Open Application Test, ROAT) on the forearm was positive. ⋯ Prick tests were positive to 0.05% chlorhexidine gluconate and to 0.01% of the acetate solution. A 30 year-old man developed anaphylactic symptoms following treatment with an antiseptic dental gel containing 1% chlorhexidine gluconate. Prick test was positive to the gel and to chlorhexidine gluconate 0.5%.
-
Tidsskr. Nor. Laegeforen. · Sep 1998
[Continuous intrathecal infusion of baclofen. A new therapeutic method for spasticity].
Intrathecal administration of baclofen is now generally accepted as a powerful treatment of spasticity caused by spinal lesions. 35 patients with severe spasticity, 29 of spinal origin and six of supraspinal origin resistant to conservative treatment, had a programmable pump (Synchromed, Medtronic) for continuous intrathecal baclofen infusion implanted. The patients were followed-up for an average of 29 months (0-68). The initial effect of the treatment was positive for all patients; spasms were less frequent, there was remission of pain caused by cramps, and in some cases improved ambulation. ⋯ Three patients died of the underlying disease. The majority of patients became accommodated to intrathecal baclofen and it was necessary to administer increasingly larger doses to maintain the clinical effect. Long-term control of spinal spasticity by intrathecal baclofen can be achieved in most patients, but close follow-up is necessary for assessing efficacy and refilling the pump.
-
Tidsskr. Nor. Laegeforen. · Aug 1998
Review[Folate and health--new knowledge and new recommendation].
The dietary intake of folate in Norway is not optimal with regard to minimizing the risk of birth defects (especially neural-tube defects), and poSsibly also cardiovascular diseases and other diseases. The National Nutrition Council has therefore initiated a project to evaluate the status of folate in Norway and to recommend actions for necessary improvement. A protective effect of folic acid supplements on neural-tube defects has been found in observational studies and clinical trials. ⋯ Because it may be difficult to achieve this through diet alone, and because an additional risk-lowering effect of folic acid supplementation has been shown, a folic acid supplement of 400 micrograms per day is recommended for this group. The supplement should be taken one month before conception and during the first two months of pregnancy. Fortification of foods with folate is not recommended because some groups may then exceed the recommended upper intake level.
-
Cerebral amyloid angiopathy affects the cerebral vasculature selectively, and there is no systemic amyloidosis. Amyloid is deposited in small and medium-sized vessels of the cortex and leptomeninges. Cerebral amyloid angiopathy is a common cause of spontaneous lobar haemorrhage in elderly patients. ⋯ One patient experienced an acute headache attack and classical lobar haemorrhage. The other patients had various neurological symptoms and signs, such as seizure, disturbed vision, pareses, aphasia, and dementia that were initially diagnosed as cerebral infarction or tumour. Two patients with cerebral amyloid angiopathy and granulomatous angiitis responded to immunosuppressive treatment.
-
Tidsskr. Nor. Laegeforen. · Jun 1998
Case Reports[The chain that saves life. Prehospital treatment of myocardial infarction].
A 53-year old woman living in a rural area 220 km from the nearest hospital experienced an acute myocardial infarction. The local doctor contacted the emergency service and requisitioned an air ambulance. 29 minutes later the physician-manned helicopter arrived, and thrombolytic treatment was started after 15 minutes. ⋯ The patient was discharged from hospital ten days later with no cerebral sequelae, and left ventricular ejection fraction 49%. This example shows that active use of emergency communications systems and air ambulances enables both prompt thrombolytic treatment and the effective treatment of complications associated with myocardial infarction to be accomplished.