Läkartidningen
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Review
[Physical working capacity and muscle strength in chronic renal failure are improved by exercise].
Patients with chronic kidney disease (CKD) show a decline in maximal exercise capacity and muscle strength as renal function decreases. Renal anaemia, skeletal muscle dysfunction, tiredness and increasing inactivity are the major causes of this deterioration. Exercise training improves maximal exercise capacity, muscle strength and endurance in young, middle-aged and elderly patients at all stages of CKD. ⋯ Exercise training should be prescribed by a neph-rologist and administered by a trained nephrological physiotherapist. Exercise training is an integral part of care of the CKD patient. It not only reduces suffering but also costs, resulting in major potential benefits for the patient, the health care system and society.
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Sudden, unexpected cardiac arrest is a common cause of death. Among patients who are successfully resuscitated, a majority dies without regaining consciousness. ⋯ In this review we discuss the theoretical background of hypothermic neuroprotection and therapeutic implications. We propose that victims of cardiac arrest with return of spontaneous circulation and persistent unconsciousness are considered for hypothermia treatment and that data from treated patients are collected in a common website database (see: www.scctg.org) to allow further evaluation of the use of ICU resources, efficacy of hypothermia treatment and potential risks.
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There are several misconceptions even among hospital personnel regarding damages and injuries caused by lightning. Few health care providers have experience from lightning injuries as they are rare and different (DC) from the more common high-voltage (AC) injuries. Furthermore, fatalities are uncommon. ⋯ However, there are some minor points that are different and may be stressed for a favourable outcome. In this paper these are addressed together with the epidemiology, effects and treatment of lightning injuries that are specific for Sweden. Unfortunately, little is known, apart from what is described in smaller case series, of the long time sequelae experienced by this patient population and further research is therefore particularly warranted in this respect.
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Emotional reactions are important sequelae of stroke. Mood disorders, such as depression, anxiety, post-traumatic stress syndrome and emotionalism, occur during the first post-stroke year, each of them in approximately 20-30% of patients. They often overlap, and prevalence estimates differ on account of differences in definitions; study populations; exclusion criteria and time of assessment. ⋯ Some patients recover spontaneously but symptoms persist in up to one third. Pharmacological treatment can have a positive effect that also applies to rehabilitation, quality of life and cardiovascular mortality. However, study findings are not uniform and conclusive therapeutic and preventive intervention trials on mood disorders after stroke are urgently needed.