Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Sep 1996
[Homocysteine and methylmalonic acid. New tests--for what benefit?].
A serum cobalamin level lower than 250 pmol/l combined with high values of plasma homocysteine and serum methylmalonic acid confirms the diagnosis of vitamin B12 deficiency. A low serum and erythrocyte folate level and high plasma homocysteine confirm folate deficiency. ⋯ In patients with neurologic or psychiatric disorders combined with elevated levels of homocysteine and methylmalonic acid, cobalamin deficiency is likely if these levels decrease during vitamin B12 therapy. The causes of elevated homocysteine levels are often obscure, and homocysteine should therefore not be used as a screening test.
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Tidsskr. Nor. Laegeforen. · Aug 1996
Review[Radiologic examination of patients with head injuries. Late sequelae of minor head injuries, a radiological challenge].
We give a brief summary of the use of computerized tomography and magnetic resonance imaging (MRI) in cases of cranial trauma. The authors advocate more extended use of MRI in this connection; even in less severe cases. The method is much more sensitive than computer tomography, and thus provides a sounder basis for diagnosis and treatment in patients suffering from late sequelae of cranial injuries.
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Tidsskr. Nor. Laegeforen. · Aug 1996
[Pyuria, bacteriuria and urinary tract infections in hospitalized patients with spinal cord injuries].
Urine specimens from 15 patients with paresis of the urinary bladder following injury of the spinal cord were examined weekly for a total number of 352 weeks. Pyuria was found in 103 specimens. In more than 95% there was concordance between microscopic and chemical evaluation. ⋯ However, almost one of every two cases with bacteriuria showed no pyuria. It is concluded that clinical symptoms of urinary tract infection together with identification of pyuria call for antibacterial treatment. Bacterial examination, should always be undertaken given symptoms of infection with no presence of pyuria.
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Tidsskr. Nor. Laegeforen. · Jun 1996
[Reduced prescription of benzodiazepine preparations in general practice. Much to gain with little effort].
Many patients experience side effects from prolonged use of benzodiazepines and analgesics containing codeine. Therefore 66 daily users of these drugs (average dose before intervention 34 DDD/month) were encouraged to take part in a cessation experiment. ⋯ Over two years the prescriptions (measured in DDD) for this group were reduced by 57%, and 26% of the patients stopped taking these medicines. A strategy is proposed for cessation of use of benzodiazepines and codeine-containing analgesics in general practice.