Duodecim; lääketieteellinen aikakauskirja
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Cardiac arrest as the first symptom of coronary artery disease is not uncommon. Some of previously healthy people with sudden cardiac arrest may be saved by effective resuscitation and post-resuscitative therapy. The majority of cardiac arrest patients experience the cardiac arrest outside of the hospital, in which case early recognition of lifelessness, commencement of basic life support and entry to professional care without delay are the prerequisites for recovery. After the heart has started beating again, the clinical picture of post-resuscitation syndrome must be recognized and appropriate treatment utilized.
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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.
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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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Extracorporeal oxygenator is used in severe respiratory and/or circulatory failure that is intractable to other therapies. In ECMO therapy, poorly oxygenated blood is pumped through an extracorporeal oxygenator and directed back to the patient's circulation. ⋯ Due to risk of complications, ECMO should be used with caution on carefully selected patients. For a severely ill patient ECMO can be life-saving when started early.
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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.