Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Euthanasia, i.e. active termination of life in a seriously ill patient, is not performed in Norway at present. Between active and so-called passive euthanasia there is a "grey zone", and it is discussed where the border should be drawn, how and by whom. ⋯ There is increasing sympathy for the view that it is not the duty of the medical profession to prolong the life of patients under all circumstances. The present paper discusses such problems in relation to hospitalized patients in an acute life-threatening situation, and in patients with, known, chronic disabling, or malignant disease.
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Tidsskr. Nor. Laegeforen. · May 1990
[Triage. Initial diagnosis of life-threatening injuries based on functional state and mechanism of injury].
Functional status expressed as Trauma Score (TS) and mechanism of injury were evaluated as criteria for diagnosing severe trauma in 253 traffic accident victims. An Injury Severity Score (ISS) of greater than or equal to 16 was considered a severe, potentially life-threatening injury. In 67 patients with ISS greater than or equal to 16, either TS was less than or equal to 13 or the history suggested risk of high energy trauma in 72%. ⋯ Identifying severely injured patients by assessment of function and mechanism of injury gave an overtriage of 46%, which is acceptable, and an undertriage of 12%. Caution should be exercised in excluding severe trauma on these criteria. Considered together, decreased TS and a history indicating high energy injury, gave high sensitivity (72%) and specificity (78%) for diagnosing severe trauma, ISS greater than or equal to 16.
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Tidsskr. Nor. Laegeforen. · May 1990
Comparative Study[Transportation of newborn infants. A 6-year case load].
We have evaluated neonatal transports to Ullevål hospital over a six-year period. These were either carried out by helicopter, using a trained transportation team, or by ambulance, the transport being improvised from one transport to another. ⋯ In addition to generally rather casual and often hazardous transport, particular problems arose in connection with maintaining an adequate body temperature. In addition, the transports were very inadequately documented.
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Tidsskr. Nor. Laegeforen. · May 1990
[Alcohol withdrawal--biological background, diagnosis and treatment].
Alcohol withdrawal reveals a condition of central nervous system (CNS) hyperexcitability opposite to that of the primary effect of the drug. Adaption to the decreased activity of the CNS during chronic ethanol ingestion may at least partly explain several of the symptoms of alcohol withdrawal. Benzodiazepines are therefore useful in the withdrawal state. ⋯ This treatment should then be combined with benzodiazepines. Most patients with mild withdrawal symptoms respond to non-pharmacological supportive care, except for those with a history of withdrawal seizures. These patients may need treatment with carbamazepine or diazepam.
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Bulimia is an eating disorder characterized by binge eating followed by purging, i.e. self-induced vomiting, abuse of cathartic or diuretic drugs, increased activity or periods of restrictive dieting. Studies show that persons with bulimia are prone to a number of medical complications as a result of binge-eating, vomiting and drug abuse. Vomiting is the most harmful in terms of medical risk, and also the most common source of complications. ⋯ Gastric dilatation is the only complication directly associated with binge-eating. Harmless symptoms, such as abdominal pain, diarrhoea, constipation and neuromuscular symptoms are common. This article discusses the pathophysiology behind the complications and their treatment.