Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Sep 2007
Review[Mycoplasma genitalium--aetiological agent of sexually transmitted infection].
Non-gonococcal urethritis/cervicitis (NGU) is now the most common sexually transmitted infection that is possible to treat. Mycoplasma genitalium is a microorganism about to be established as an aetiological agent of NGU and upper genital infection. ⋯ There seems to be sufficient evidence to conclude that Mycoplasma genitalium causes sexually transmitted infection. The microbe is associated with non-gonococcal urethritis in both men and women and cervicitis in women. It may also be the cause of upper genital infection in women. M. genitalium seems to cause more severe urethritis and more often lead to symptomatic urethritis/cervicitis than non-chlamydia-non-gonococcal urethritis/cervicitis that is not associated with M. genitalium. For testing, a cervical/vaginal swab should be used for women and first void urine should be collected for both sexes. Nucleic acid amplification tests are used. Azithromycin is more effective against M. genitalium than doxycycline and erythromycin. Moxifloxacin is effective in cases of azithromycin resistance.
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Involuntary admission to acute psychiatric wards in Norway has not been studied empirically after the introduction of a new Mental Health Act (MHA) 1 January 2001. According to the MHA, observation with coercion can be used to clarify illness. The objectives of this study were to describe scale and circumstances associated with involuntary admissions. ⋯ For about half of those admitted involuntarily the time of coerced observation was less than 24 hours. The out-of-hours emergency service referred more patients than regular GPs and the specialized health service, and it should be clarified whether this may lead to unnecessary involuntary admissions. More specific studies are needed on how to reduce involuntary admissions to psychiatric wards.
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Tidsskr. Nor. Laegeforen. · Jun 2007
Review[Withholding and withdrawing treatment, ethical and legal aspects].
In the wake of medical progress an important ethical discussion has arisen about when to withhold and when to withdraw life-sustaining treatment. ⋯ Norwegian healthcare legislation provides relatively little and to some extent unclear guidance on withholding and withdrawing life-sustaining treatment. National guidelines have not been developed. More attention could be paid to systematic approaches and dialogue with patients, relatives and all healthcare professionals about these issues.