Ugeskrift for laeger
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Ugeskrift for laeger · Nov 2014
Review[Genetic variation may influence the development of persistent postsurgical pain].
Persistent postsurgical pain is a major clinical problem. It is not fully understood why some patients develop persistent postsurgical pain while others do not. ⋯ The evidence in this area is sparse and the results are heterogeneous. Further studies are needed before firm conclusions can be made.
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Ugeskrift for laeger · Oct 2014
Review[Genetic counselling is relevant in familial as well as sporadic cases of amyotrophic lateral sclerosis].
Amyotrophic lateral sclerosis (ALS) is a progressive and fatal neurodegenerative disease of upper and lower motor neurons which often results in death from respiratory failure within 2-4 years. It has been estimated that 5-10% of ALS patients have a family history with ALS. The genetic background of the disorder is heterogeneous, and recently molecular genetic testing has become increasingly relevant, also in the clinical evaluation. As several genes have been identified in which the pathogenic mutations are characterized by reduced age-dependent penetrance, genetic testing can be relevant to consider, also in isolated cases.
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Morbid obesity in teenagers has become an increasing problem. Conventional diet has not yet shown effective long-term weight loss. ⋯ Still, surgery performed on adolescents provides ethical challenges such as the unknown long-term prognosis after surgery. Despite these challenges, in cases of severe intractable obesity or development of life-threatening complications due to obesity, surgery should be considered.
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The hospitalized patient is at risk of hyponatraemia caused by reduced electrolyte free water clearance and prescription of hypotonic fluids. Hospital-acquired hyponatraemia is common and associated with increased mortality/morbidity. ⋯ To reduce iatrogenic hyponatraemia the understanding of P-[Na+] is fundamental. Next, meticulously prescription of fluid amount/quality and reevaluation as with any other drug is of paramount importance.
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Ugeskrift for laeger · Jul 2014
Review[Radium-223 treatment of bone metastases from castration-resistant prostate cancer].
The alpha emitter Radium-223 ((22)3Ra-Cl2) is a bone-seeking radionuclide studied as a new treatment for patients with bone metastases from hormone refractory prostate cancer. More than 1,000 patients have been included in clinical phase I-III tests showing significant reduction in alkaline phosphatase- and PSA level and prolonged survival. Adverse events are usually mild to moderate and comprise gastrointestinal and myelotoxic symptoms. Intravenously administered (22)3Ra-Cl2 (half-life 11.4 days) will likely be given every four weeks for six treatments to out-patients.