Nordisk medicin
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Psychiatry has derived much benefit from the combat experience of military medicine. The Allies' military psychiatry during the Second World War established cardinal modes of treatment, such as group therapy, the therapeutic community, and crisis intervention. The principles of field psychiatry consist in that the treatment be administered near the scene of the injury, in an early phase, be of short duration, be focused here and now, and be characterised by prognostic optimism; moreover the victim must retain his group identity. Many of these intervention techniques are now successfully used at disaster and crises in peacetime, e.g. at the recent ferry disaster on the Scandinavian Star.
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Primary fibromyalgia is probably a frequent disregarded disease, making differential diagnostic problems towards other kinds of rheumatologic diseases. The clinical manifestations, pathogenesis and treatment of primary fibromyalgia are discussed and the literature reviewed.
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Ketamine has been employed as an anesthetic for 25 years. It is the only PCP-like dissociative anesthetic in clinical use. Favourable experience with ketamine in combat situations and at accidents, together with its ability to block the effect of the excitatory neurotransmitter glutamate on NMDA-receptor mediated neurotransmission, has attracted greater attention to this drug in recent years. ⋯ Recent investigations indicate that the analgesic and anesthetic effects as well as the "dissociative" phenomena seen after analgesic doses are due to PCP receptor mediated inhibition of excitatory amino acid transmission at NMDA synapses. The excitatory effect observed at higher doses, however, may be mediated by the haloperidol sensitive sigma-receptor. The enantiomers of ketamine (R- and S-ketamine) differ in pharmacological profile and may enable improvement of ketamine as a drug.
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Simple linear regression and correlation are frequently used in medical publications. The methods are overused and have become greatly confused, probably because of the close similarity between the mathematical calculations. Simple regression is a method for a mathematical description of the dependence of a random response variable of another variable, a regressor, which is not random. ⋯ This is a completely misguided approach. When both variables are random, least squares estimation, as used in regression, is not appropriate. The correct method is to estimate a linear structural model by maximum likelihood.