Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Oct 2005
Review[Pain treatment in patients on chronic opioid therapy and in drug abusers].
Substance abuse in pain management can undermine treatment compliance, the effectiveness of therapies, and social support and functioning. ⋯ Assessment and treatment plans for this patient group require an understanding of tolerance, physical dependence and drug abuse. It is imperative that the patient's ongoing treatment is planned in a multidisciplinary setting, so as to assure a consistent, structured and shared approach by all caregivers.
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The organisation of delivery care engages both professional and laypersons. When the Norwegian princess Märtha Louise in 2005 chose to give birth at home instead of in hospital, the intensity of the debate in media increased. ⋯ The Norwegian National Advisory Committee for Maternal Care is an important contributor to this debate. The Committee should, however, pay more respect to the scientific disagreement within the field.
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Tidsskr. Nor. Laegeforen. · Oct 2005
Case Reports Comparative Study[Human metapneumovirus--occurrence and clinical significance].
Human metapneumovirus (hMPV) was isolated for the first time in 2001 from young children with acute respiratory tract infection. ⋯ Human metapneumovirus is an important cause of acute respiratory tract infection in children. The virus may cause severe disease in patients at risk. We recommend identification and isolation of hospitalized hMPV-infected patients.
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Tidsskr. Nor. Laegeforen. · Oct 2005
Case Reports[Malignant hyperthermia--a hereditary and potentially life-threatening condition].
Malignant hyperthermia is a rare and possibly life-threatening complication to anaesthesia. It manifests in susceptible individuals as a hypermetabolic response on exposure to halogenated anaesthetics and depolarising muscle relaxants. Susceptibility to malignant hyperthermia is inherited as an autosomal dominant disorder and is associated with myopathies. ⋯ Modern medical treatment, including the use of dantrolene, has significantly reduced the mortality of malignant hyperthermia. The identification of susceptibility to malignant hyperthermia in patients can possibly further reduce the risk of death during and after anaesthesia. A contracture test of muscular tissue is performed in patients with suspected malignant hyperthermia and should be considered in family members. Molecular genetic examinations might be considered in some cases.
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Tidsskr. Nor. Laegeforen. · Oct 2005
[Thoracoscopic sympathectomy in the treatment of palmar hyperhidrosis and facial blushing].
Severe palmar hyperhidrosis and facial blushing are conditions connected with considerable psychosocial burden. Conservative treatment is often of limited value. Several reports have demonstrated high success rates in thoracoscopic sympathectomy. Treatment results from Norwegian centres have not previously been published. ⋯ Thoracoscopic sympathectomy markedly reduces palmar hyperhidrosis and facial blushing, but the indication should be strong and the information thorough because of compensatory hyperhidrosis.