Ugeskrift for laeger
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Dyspnea is a symptom experienced by more than half of all cancer patients in their terminal illness, and it is thus a severe problem for patients, relatives, and professionals. Dyspnea in a cancer patient may have a non-malignant origin that may be treated causally. If dyspnea is caused directly by the malignant disease, antineoplastic treatment needs to be considered. ⋯ Opioids given systemically cause respiratory depression. Unfortunately, this has given rise to an overly cautious attitude when facing the terminal patient with dyspnea. However, other treatment modalities are often exhausted and opioids, if indicated in combination with anxiolytics, do have a palliative effect on dyspnea.
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The achievements of medical students are decisively dependent on the method of evaluation during their education. Frequent testing of these achievements by well-defined (cross-specialized) problems (involving cases) enables the student to quickly correct own knowledge- or skills-deficiencies, while the relevance of the curriculum is further visualized. ⋯ An insufficient individual performance graded by known minimal specific standards entails a feedback session with a counsellor who pin-points defects in the student's knowledge and suggests methods for correction. This form of evaluation is expected to be costly, but is a necessity to improve the quality of the graduating medical students.