Nordisk medicin
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In animal stroke models, treatment with mild hypothermia (30-34 degrees C) for 3-4 hours may reduce the size of cerebral infarction if started within three hours of the initiation of cerebral ischaemia. The mechanism by which hypothermia exerts its neuroprotective effect is unknown, but experimental studies have shown the release of neurotoxic excitatory amino acids and free oxygen radicals to be reduced during hypothermic ischaemia. ⋯ Due to the unpleasantness of cooling and side effects as shivering, hypothermia may not be tolerated by stroke patients without sedation of light anaesthesia which may increase the risk of hypotension and respiratory complications. However, lowering body temperature by 1-2 degrees C may suffice to improve functional outcome in acute stroke patients, and such mild hypothermia should be tested in randomized controlled clinical trials.
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Review
[New drugs in asthma treatment. Leukotriene receptor blockers and leukotriene synthesis inhibitors].
Asthma is an inflammatory airway disease. The patient is characterised by increased mucus secretion, mucosal oedema, bronchial obstruction of varying degree and bronchial hyperresponsiveness. ⋯ The study of specific leukotriene receptor antagonists and biosynthesis inhibitors has not only shed light on the underlying mechanisms in asthma, but also opened up the way to new treatment alternatives. As zafirlukast, a leukotriene receptor antagonist has just been licensed in Finland, it is a suitable opportunity to review the importance of leukotrienes in asthma and the use of agents that affect them.
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A review is presented of injuries sustained at an ice rink and treated at the emergency room, Odense University Hospital in Denmark, during 1993. Of the 105 patients treated, 67 (64 per cent) were 10-19 years of age. ⋯ In seven cases the patient had been cut on the hand by the blade of another participant's skate, two patients had tendon lesions and in 16 cases the patient had sustained a fracture of the forearm or hand as the result of a fall. Many of the injuries could have been prevented by the use of protective gear (helmet, gloves and knee and elbow pads).
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Confusion in the elderly, ie, delirium, is an organic mental disorder often associated with severe somatic disease. Approximately 20-60 per cent of elderly in-patients are afflicted with transient confusion states during hospitalisation, and in more than 50 per cent of cases this escapes the notice of the attending physician. ⋯ The occurrence of confusion in the elderly patient should alert the physician to the need of investigation to detect underlying severe disease without delay. Despite the otherwise poor prognosis, improved diagnosis and treatment should not only yield better results but also economic gain to the community.
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The abuse of women is a global problem, a women's health problem, and an egalitarian issue. In Sweden alone, 15,000 cases of the abuse of women, where victim and perpetrator were acquainted, were reported in 1994. ⋯ Every abused woman coming to the hospital is now taken care of by specially trained personnel. The centre works in close cooperation with the police and the voluntary crisis centre, where battered women can receive support and help--for instance with temporary accommodation.