Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Nov 2009
Review[Abdominal aortic aneurysms--endovascular and open surgery].
In Norway, repair of abdominal aortic aneurysms is performed in more than 800 patients annually. Open repair is an established procedure, but an increasing number of patients have undergone endovascular repair during the last decades. The paper delivers an up to date discussion of infrarenal abdominal aortic aneurysm repair. ⋯ Even though perioperative mortality associated with endovascular repair is lower than that of open repair, questions concerning benefit and selection of patients are still left unanswered.
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Intravenous thrombolysis has gained widespread acceptance during the last 10 years, and is the only specific treatment approved for cerebral infarction. Haukeland University hospital introduced thrombolysis in 1998. The aim of this paper is to summarize our experience with the first 100 patients who had stroke caused by middle cerebral artery (MCA) occlusion and were treated with thrombolysis. ⋯ The results for the first 100 acute MCA stroke patients treated with thrombolysis in Haukeland University Hospital compare well with international data, both for clinical outcome and complications. Our results thereby support the notion that intravenous thrombolysis is effective and safe when applied as a routine treatment in a comprehensive stroke unit.
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Patients with dementia are often unable to describe their pain because of memory deficiency and speech problems. This may lead to under-diagnosing and suboptimal pain treatment. The article summarises a thesis on development and testing of a new instrument for pain assessment: Mobilisation-Observation-Behavior-Intensity-Dementia (MOBID-2) pain scale. ⋯ The MOBID-2 pain scale may help to ensure competent pain treatment, and should be available in all Norwegian nursing homes. A multidisciplinary approach is needed for its implementation and use. Physicians in nursing homes should reconsider the staff's observations, perform additional investigations and find the balance between effects and side effects of pain treatment.