Duodecim; lääketieteellinen aikakauskirja
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Natalizumab medication used in the treatment of active relapsing-remitting multiple sclerosis is associated with a risk of contracting progressive multifocal leukoencephalopathy (PML). Current risk of the PML disease in connection with natalizumab therapy in multiple sclerosis patients is 2.77/1,000. ⋯ There are 350 multiple sclerosis patients receiving natalizumab in Finland. We describe the first one of the two Finnish multiple sclerosis patients having so far been diagnosed with PML disease as a complication of natalizumab therapy.
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Short lingual frenulum is a common structural abnormality with unknown mechanisms of origination. The frequency of occurrence among newborn infants can be as high as 4%. Short lingual frenulum may cause problems, if it restricts the movements of the tongue. Therapeutic indications for short lingual frenulum in newborn infants are mainly breastfeeding problems, whereas in children of preschool age and older the indication is defective pronunciation.
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Posterior dislocation of the sternoclavicular joint is a rare injury. It can be associated with life-threatening complications. Computed tomography is the imaging modality of choice with which possible associated injuries can be detected. ⋯ A fracture-dislocation is inherently more unstable than an isolated dislocation. Surgical treatment is advocated in cases of delayed diagnosis or failed closed reduction. With early diagnosis and treatment, the long-term outcome of this injury is good.
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Respiratory symptoms cause much of suffering in palliative care. Opioids are the first-line drugs in symptomatic treatment, and a therapeutic intervention with benzodiazepines may also be justified. ⋯ Physical therapy and methods of respiratory management are profitable in the treatment of respiratory symptoms. Radiation therapy relieves cancer-induced hemoptysis, cough, chest pain and dyspnea.
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The health-promoting effects of physical exercise are scientifically proven, but the health risks of sitting still remain rather poorly known. Technological development of the society will by no means cut down sitting. Should too much sitting be considered as one of the independent factors increasing the risk of metabolic diseases and its reduction as a health-promoting measure? Innovative solutions made possible by the new technology to cut down on sitting and to increase physical activity may prove to be important future tools for promoting health.