Duodecim; lääketieteellinen aikakauskirja
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Plantar fasciopathy is the most frequent reason for foot pain. It is characterized by degeneration of the insertion of the plantar fascia on the medial process of the calcaneal tuberosity. Palpation over plantar fascia insertion reproduces the pain and may reveal swelling. ⋯ Initial treatment consists of anti-inflammatory medication, stretching exercises, night splints and shoe inserts. If these fail, steroid injections, custom made orthotics, and extra corporeal shock wave therapy may be tried. If disabling pain persists for more than one year, surgery may be indicated.
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A previously quite healthy 65-year-old woman sought emergency hospital care due to fatigue, weight loss and sensation of thirst appearing over a couple of months. Further analysis revealed a process affecting the neurohypophysis and extensive lytic sclerotic bone lesions. Eventually a rare generalized underlying disease was unraveled: the diagnosis included both Langerhans cell histiocytosis and Erdheim-Chester disease.
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Both mechanical and pharmacological methods are used for induction of labour. ⋯ Labour induction with Foley catheter is as safe and effective as induction with misoprostol.
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Trampolines for home use have become common in Finland during the past ten years, being especially favored by children. Trampoline jumping is beneficial and constructive physical exercise, but poses a significant risk for injuries. The most common injuries include sprains and strains. ⋯ Fractures are by far the most common trampoline injuries requiring hospital care. Injuries can be prevented by using safety nets. Only one child at a time is allowed to jump on the trampoline.
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The pathophysiology of delirium is poorly known and scientific evidence of effective forms of treatment is scarce. Detection of triggering factors and their appropriate treatment still constitute the cornerstone of the treatment. ⋯ The use of restraint systems should be avoided. The delirium experience is often gravely traumatizing for the patient, and the psychological aftercare of delirium must therefore not be ignored.