Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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A Regular General Practitioner Scheme was introduced in Norway in 2001. One aim was to restrict patients from "shopping" doctors and prescription drugs. ⋯ The occurrence of prescription drug shopping in the Norwegian population was limited. Among the few patients who used many physicians for prescription of drugs, the phenomenon was much more frequent for users of addictive drugs than for users of the non-addictive drugs. The study suggests that prescription drug shopping may be an indicator of a drug abuse potential.
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Bariatric surgery is increasingly used to treat morbidly obese patients. Fertility in women may be enhanced after these procedures, owing to substantial weight loss and possibly a decreased absorption of oral contraceptives. We report a pregnancy that occurred two months after biliopancreatic diversion with duodenal switch in a 32-year-old woman. ⋯ Severe metabolic aberrations may complicate pregnancies after malabsorptive bariatric surgery. Patient preparations before weight-loss operations should include information on fertility and birth control in the postoperative period. Protocols for monitoring of patients that become pregnant after bariatric surgery are needed.
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Patients with suspected scaphoid fractures usually have their arm immobilised in a cast for two weeks, even in the absence of radiographic signs of fracture. After two weeks a new radiographic examination is performed. Our objective was to assess the extent of unnecessary cast immobilisation and to describe existing diagnostic practice in our hospital. ⋯ Only 23 % of patients treated with cast immobilisation for two weeks were ultimately diagnosed with scaphoid fracture. The extent of unnecessary cast immobilisation indicates a need to use better diagnostic tools early after the injury.
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The aim of this paper is to assess the substance pregabaline's potential for abuse. Little information is available on the subject and that retrieved is in part conflicting. Pregabaline is likely to be abused for its positive psychological effects, e.g. euphoria. ⋯ Pregabaline is therefore likely to have a lower potential for abuse than benzodiazepines. In clinical studies, symptoms suggestive of physical dependence (e.g. insomnia, nausea, headache, diarrhoea) have been observed in some patients after abrupt discontinuation of pregabaline. However, available documentation indicates that pregabaline is associated with less physical and psychological dependence than benzodiazepines.