Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Jan 1991
[Ambulance helicopters in the mountains. An evaluation of the 1-year activity at the Dombås base].
On 1 January 1988 the Norwegian Air Ambulance Plan was put into effect. The operational base for the regional counties Oppland, parts of South Trøndelag, Møre and Romsdal and Hedmark was established in the township of Dombås. The base had a helicopter staffed with a specialist in emergency medicine. ⋯ The service costs during the year were approximately NOK 10 million. The cost-benefit ratio is judged to be too high. In inland-Norway, with a widely scattered population, it is probably better to improve the quality of the emergency services offered by general practitioners and ordinary road ambulances than to use a helicopter staffed with a specialist in emergency medicine.
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Tidsskr. Nor. Laegeforen. · Nov 1990
Review[Transfusion therapy and volume treatment in elective surgery and traumas].
New light has recently been shed on transfusion therapy. Early recurrence of cancer, ill effects on the immune system and increased incidence of postoperative infections have all been suggested as possible complications of overenthusiastic transfusion therapy. ⋯ With this in mind, blood component therapy, giving erythrocytes and plasma components according to documented need, has been started. The article describes our institution's suggested policy for transfusion therapy and volume treatment in elective and trauma surgery.
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Tidsskr. Nor. Laegeforen. · Nov 1990
Review[Conscious and unconscious awareness during anesthesia--how deep is the patient's sleep?].
A review is given over the aspects of awareness during general anaesthesia. Traditional clinical signs for evaluating depth of anaesthesia can be supplemented by objective methods such as EEG, cerebral function monitor and sensory evoked potentials. ⋯ Awareness can be graded from the obvious form, with recall of intraoperative events, to an unconscious form where the memory can be activated through special psychological techniques. We discuss the possibility of using unconscious perception of auditory signals for positive instructions to patients under anaesthesia.
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Discography means imaging of the intervertebral discs by intradiscal contrast injections. Discography with a combined CT/discography allows a more detailed classification of annular disruption and degeneration. Combined with a pain response registration, discography can be of value in the diagnosis of chronic low back pain with signs of sciatica in cases where other x-ray modalities have failed to explain the source of pain. Among 20 discography examinations there was a correlation between radicular symptoms and annular disruption with contrast leakage to the epidural space, and disc protrusion on CT scanning.
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Chronic low back pain is lumbar-sciatic pain of more than 3 months duration. It is necessary to classify back conditions into conditions with and without nerve root affection. ⋯ Symptoms and signs, x-ray investigations, and laboratory data are dealt with in the structural and focal etiology of the pain. The relationship between psycho-social factors and low back pain is discussed.