Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Dec 2008
[Is registration of multiple myeloma in the Norwegian Cancer Registry good enough?].
The last 15 years several studies have evaluated the quality of the Norwegian Cancer Registry. A pilot study from 1981 showed that the registration quality of non-solid tumours was significantly weaker than that for solid tumours. We wanted to study the registration quality of multiple myeloma in the Norwegian Cancer Registry during the 1990s. ⋯ The quality of multiple myeloma registration in the Norwegian Cancer Registry has improved from the 1970s (the data had a completeness of 77-82%) to the 1990s, but is still not as good as the registration of solid tumours. Increased awareness of this problem at pathological and haematological departments can probably improve the quality of registration further.
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Tidsskr. Nor. Laegeforen. · Nov 2008
Case Reports[A 69-year-old man with temporary left-sided hemiparesis].
A 69-year-old man accidentally disconnected his central venous catheter (CVC) while standing at home. Within the same minute he developed left-sided hemiparesis which lasted for 30 minutes. A CT of the brain three hours later was normal. ⋯ The reason can be paradoxical embolism through an intracardial shunt or through physiological pulmonary arteriovenous shunts, or the air can pass retrogradely from the central vein to the cerebral venous system. When cerebral air emboli is suspected, the CVC must be secured, the patient should be placed in a recumbent position and given 100% O2, and hyperbaric oxygen therapy if symptoms persist. While placing and handling a CVC, the patient should be in a recumbent position, and the increased risk for air emboli in walking patients be taken into account.
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Annual reports from Norwegian Intensive Care Units include risk-adjusted mortality data. Annual variation may be difficult to interpret due to random variation and changes in case mix. Several methods have been developed for continuous monitoring of treatment results in clinical practices where it is possible to calculate a risk for a certain outcome, usually risk of death. We have used the cumulative risk adjusted mortality chart Variable Life Adjusted Display (VLAD) to further illustrate our treatment results. ⋯ The VLAD curve is a very useful supplement to traditional methods of evaluating the performance of intensive care units. The method is useful for showing how treatment results vary over time.