Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Even though the BCG vaccine is one of the most used vaccines in the world, tuberculosis is still a major problem worldwide. Research aimed at developing new vaccines against tuberculosis has become more goal-directed during the last 10-15 years, and there are now several vaccine candidates in clinical study phases I and II, that should be in phase III in 2010. It will then still take several years before we know whether a new vaccine will reduce the occurrence of tuberculosis. ⋯ Estimations show that an effective vaccine against latent tuberculosis will give a rapid and considerable reduction in tuberculosis. The current vaccine candidates are however developed to protect against primary tuberculosis and not against reactivated latent tuberculosis. It is important to ensure an optimal experimental basis for new tuberculosis vaccines and to compare them so the best can be selected.
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Jehovah's Witnesses refuse transfusions of the main blood components. This challenges the safety of performing major surgical procedures. At the Norwegian Radium Hospital, we have taken the views of Jehovah's Witnesses regarding blood transfusions into account when planning major surgical procedures and perform these without such transfusions. We present a case and our experiences and routines when performing major cancer surgery on Jehovah's Witness patients. ⋯ Major transfusion-free surgery can be performed successfully on Jehovah's Witnesses. This requires advanced planning, good routines and close collaborative team efforts. The most relevant techniques to make major surgery feasible are preoperative optimalisation of the haemoglobin levels and acute normovolemic haemodilution and the use of cell saver under surgery.
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Tidsskr. Nor. Laegeforen. · Oct 2006
[Quality of life of patients with amyotrophic lateral sclerosis].
Amyotrophic lateral sclerosis (ALS) leads to loss of important body functions, a huge need for assistance and is associated with a low quality of life (QoL). We have investigated QoL in ALS patients treated by a multidisciplinary ALS team, and to which degree this team met the patients' needs. ⋯ Our findings suggest that the patients are content with the ALS team, but that their psychological reactions and information to relatives are not handled well enough. Most ALS patients treated by the ALS team experience their life as meaningful, regardless of their degree of neurological dysfunction.