Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Apr 2010
Review[Patent foramen ovale and decompression illness in divers].
About 25 % of the population has patent foramen ovale, and the condition has been assumed to be a causal factor in decompressive illness. Transcatheter closure is possible and is associated with a relatively low risk, but it has not been clarified whether there is an indication for assessment and treatment of the condition in divers. The present study explored a possible relationship between a patent foramen ovale and the risk for decompression illness in divers, if there are categories of divers that should be screened for the condition and what advice should be given to divers with this condition. ⋯ We do not recommend screening for patent foramen ovale in divers because the absolute risk of decompression illness is small and transcatheter closure is only indicated after decompression illness in some occupational divers.
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In epilepsy benzodiazepines are mainly used to stop ongoing attacks. In hospitals intravenous diazepam is the drug of choice for status epilepticus. Outside of hospitals buccal midazolam is in the process of replacing rectal diazepam. Clonazepam, clobazam and nitrazepam (to children) are partially used as additional medication to prevent seizures.
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Oslo accident and emergency clinic (Oslo skadelegevakt) treats most scaphoid fractures in Oslo. The objectives of this study were to assess the usefulness of MRI in diagnosing such fractures and to determine the number of scaphoid fractures treated at our clinic, the number of patients treated with a scaphoid cast without having a fracture, the proportion of these fractures diagnosed with conventional radiographs and that diagnosed with MRI in a given period. ⋯ Three of four patients treated with a scaphoid cast due to a suspected scaphoid fracture had no fracture. Early MRI can reduce the time of immobilization for patients without fracture. Use of MRI to diagnose scaphoid fractures probably leads to treatment of some fractures that would heal without immobilization, especially in children who constituted the group most often diagnosed by MRI.