Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Jan 1998
[Chronic lymphatic leukemia. Immunophenotyping as an aid to correct diagnosis].
The purpose of the study was to examine the validity of the primary diagnosis in chronic lymphocytic leukemia based on clinical and morphological criteria, and to examine the role of immune phenotyping for correct diagnosis in an unselected population-based group of patients. Over a 2-year period leukemic cells from 222 of 235 patients in Norway with a recent clinical diagnosis of chronic lymphocytic leukemia (CLL) were immune phenotyped in order to find cases erroneously diagnosed as CLL. Median age was 72.5 years, and the ratio of men to women was 1.47. ⋯ Immune phenotyping, in some patients followed by lymph node or bone marrow biopsy, showed a different diagnosis in 11 (5%) of 222 patients: prolymphocytic leukemia, four patients (three B-cell and one T-cell); morbus Waldenstrøm, one patient; T-cell CLL, one patient; hairy cell leukemia, one patient; mycosis fungoides, one patient; mantle cell lymphoma, one patient; monocytoid B-cell lymphoma, one patient and immunoblastic lymphoma one patient. In eight of these 11 patients, the clinical features or morphology, or both, were atypical for CLL, but this was not recognized at the time of diagnosis. Thus, immune phenotyping is valuable for correct diagnosis in a small subgroup of patients with chronic B- or T-cell leukemia, and it is essential in patients with modest lymphocytosis (lymphocytes < 10. 10(9)/1).
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Tidsskr. Nor. Laegeforen. · Dec 1997
Historical Article[Humanistic medicine--to understand humankind].
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Tidsskr. Nor. Laegeforen. · Nov 1997
Comparative Study[Incidence and content of written guidelines for "do not resuscitate" orders. Survey at six different somatic hospitals in Oslo].
This paper presents the incidence of, and contents of guidelines for do-not-resuscitate orders (DNR orders) in somatic hospital departments in Oslo. Only five out of 14 departments had written guidelines. ⋯ We find that there is a need for written guidelines for the use of DNR orders and present a template for the appropriate use of such orders. The proper use of DNR orders will prevent futile cardiopulmonary resuscitation and hopefully bring about a discussion on the ethical aspects of treatment decisions in hospital departments.
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Tidsskr. Nor. Laegeforen. · Nov 1997
[Musculoskeletal problems and physical activity. Results from a long-term study].
In two Norwegian industrial companies 42 employees (24 female/18 male) with shoulder, neck and back problems took part in a training programme for a period of 12 months. The programme comprised of daily relaxation exercises at work combined with training at home three times a week for about 30 minutes on each occasion. The physical therapy and training apparatus, TerapiMaster, which was constructed in Norway was used both at work and at home. ⋯ The observations of the training programme focused on changes in absenteeism during the training period compared with pre-study absenteeism. For employees with musculo-skeletal ailments the combination of relaxation exercises and physical training with professional instruction and follow-up significantly reduced absenteeism from 11.2 days per year (pre-study) to 0.2 days per year (at the end of the 12-month training period) (p < 0.001). A follow-up 30 months after completion of the formal study showed that absenteeism remained at the reduced rate, probably because positive experiences and "good habits" developed during the study encouraged the participants to continue with the training programme.