Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Sep 1990
Review[Treatment of heart failure with angiotensin converting enzyme inhibitors].
Stimulation of the renin angiotensin system, catecholamines and antidiuretic hormone causes prominent vasoconstriction in severe heart failure. Angiotensin converting enzyme inhibitors reverse these effects, and thus ameliorate cardiac function and reduce mortality in severe heart failure. Angiotensin II is an important regulator of renal function in diseases with renal hypoperfusion, and treatment with angiotensin converting enzyme inhibitors may cause a serious decrease in glomerular filtration and hyperkalemia. Asymptomatic heart failure, acute heart failure and acute myocardial infarction are areas where angiotensin converting enzyme inhibitors may prove beneficial in the future.
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Tidsskr. Nor. Laegeforen. · Sep 1990
Case Reports[Lung shock in connection with acute myocardial infarction. Adult respiratory distress syndrome, ARDS].
We describe the case of 42 year-old male patient who developed adult respiratory distress syndrome (ARDS) during an acute myocardial infarction. He was treated with positive pressure ventilation for 23 days. Chest X-ray showed multiple, bilateral infiltrates for several weeks. ⋯ The therapeutic consequences involve positive pressure ventilation with increased inspired oxygen concentration and positive end-expiratory pressure. ARDS in patients with impaired myocardial function can be difficult to recognize. It is an alternative diagnosis to pneumonia and ordinary heart failure when patients are seen to be suffering serious hypoxemia.
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Tidsskr. Nor. Laegeforen. · Jun 1990
[Bicycle injuries. Hospital based registration of injuries during 1985-89].
We analyze the results of 4 1/2 years of prospective registration of accidents to cyclists. 252 injured were treated at our hospital some as in-patients, some as out-patients. About 30% of all traffic injuries relate to cyclists. The true amount of these injuries is more than ten times the figure in the Norwegian official statistics. ⋯ Accidents involving motor vehicles are more serious than other types of accidents and constitute about 17% of all injuries to cyclists. A lot of helmets have been sold, but no reduction in head injuries has been observed. The classical spoke injuries continue.
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Tidsskr. Nor. Laegeforen. · Jun 1990
[A basic course in pulmonary diseases as part of specialist training in internal medicine].
According to the new plan for specialist training in internal medicine in Norway eight different basic courses are planned. The first course in pulmonary medicine was arranged in 1988 and was attended by doctors from all parts of Norway. ⋯ The participants asked for more case presentations and plenum discussions. A systematic educational system in each department of medicine which trains candidates for internal medicine, may further increase the benefit obtained from these basic courses.
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Tidsskr. Nor. Laegeforen. · Jun 1990
Case Reports[Extreme disorders of acid-base and electrolyte balance. Diagnosis and treatment illustrated by two cases].
There are multiple causes of acid-base disturbances. We report on two patients with serious imbalance in electrolyte- and acid-base status. ⋯ According to the literature, this was unexpected. The article focuses on the importance of relating electrolyte- and acid-base disturbances.