Duodecim; lääketieteellinen aikakauskirja
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The central aim of Current Care Guidelines for resuscitation is to guarantee effective resuscitation for all cardiac arrest patients as carried out by both laymen and professionals. Basic health care training does not guarantee sufficient competence. ⋯ Every health care professional should at least once a year attend the continuing education arranged by persons in charge of resuscitation. New technology will facilitate the reception of feedback from both training sessions and actual resuscitation situations.
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The lifetime prognosis of people with Down's syndrome has improved. Development of the services that health care and society can offer to such people is ongoing. These guidelines are targeted at defining what is required to further increase the lifespan and quality-of-life of people with Down's syndrome.
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Botulinum toxin type A treatments in children were started nearly 20 years ago. The first and still most common indication is spastic equinus gait in cerebral palsy, but other indications have emerged, such as idiopathic toe-walking, peri- and post-operative pain, drooling and idiopathic congenital torticollis. The official indication for botulinum toxin treatment is spastic equinus gait in children over 2 years of age. ⋯ However, it has proved to be safe and well tolerated among paediatric patients. Adverse events are infrequent, mostly bruising and limited, temporary muscle weakness. With higher doses the risk for generalized adverse events increases.
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Meta-analysis allows the quantitative combination of results of multiple studies that address similar research questions. Traditional meta-analysis of studies involving a direct comparison of two treatment alternatives can be applied to estimate the overall relative efficacy of these two treatment alternatives. ⋯ To use all relevant evidence from both direct and indirect comparisons of treatment options, advanced methods of meta-analysis have been developed. These so-called network meta-analyses extend the traditional meta-analysis to cases where a network of studies enables different pair-wise direct and indirect comparisons between multiple treatment alternatives, thereby forming a network of relevant evidence.
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The review presents the main aspects of a new international statement on idiopathic pulmonary fibrosis (IPF), therapeutic trials with a new drug, pirfenidone, and a new Finnish IPF register. It is desirable to have patients reported to the register with the best possible coverage in order to obtain a view about the prevalence of the disease in Finland. In the future, the register can be utilized to standardize the diagnostics and treatment of IPF, and to rapidly launch therapeutic trials and investigations with new drugs.