Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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The neuroprotective effects of hypothermia have been shown in case reports and animal studies. Therapeutic hypothermia is used to provide neuroprotection during certain types of surgery and after serious events that pose a threat to the brain. The aim of this review is to describe the efficacy of such treatment in adults. ⋯ It remains uncertain how best to implement therapeutic hypothermia to achieve neuroprotection after acute events that pose a threat to the brain. Hypothermia during aortic surgery seems to provide adequate neuroprotection for prolonged interventions.
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Tidsskr. Nor. Laegeforen. · Oct 2014
Review Comparative StudyAssociation between mode of delivery and pelvic floor dysfunction.
Normal vaginal delivery can cause significant strain on the pelvic floor. We present a review of the current knowledge on vaginal delivery as a risk factor for urinary incontinence and pelvic organ prolapse compared to caesarean section. ⋯ The prevalence of urinary incontinence and pelvic organ prolapse is lower in women who have only delivered by caesarean section than in those who have delivered vaginally. For urinary incontinence this difference appears to level out with increasing age. There is no basis for identifying sub-groups with a high risk of pelvic floor injury, with the exception of women who have previously had an anal sphincter rupture. Caesarean section will have a limited primary preventive effect on pelvic floor dysfunction at a population level.
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Tidsskr. Nor. Laegeforen. · Feb 2014
Review[Genetic coherence between hereditary amyotrophic lateral sclerosis and frontotemporal dementia].
Amyotrophic lateral sclerosis (ALS) has traditionally been considered purely as a motor condition with a progressive loss of upper and lower motor neurons, and without cognitive or behavioural impairment. In 2011 a new genetic mutation that may cause both ALS and frontotemporal dementia (FTD) was detected. In light of this discovery, the article describes genetic and clinical characteristics of ALS and frontotemporal dementia. ⋯ Cognitive and behavioural changes in amyotrophic lateral sclerosis are common, and can appear along a clinical continuum with development of frontotemporal dementia over time. Detection of the C9ORF72 mutation poses a challenge to our knowledge and management of patients with both hereditary and sporadic ALS.
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Tidsskr. Nor. Laegeforen. · Jan 2014
Review Case ReportsIschaemic stroke with patent foramen ovale.
There is no sound scientific documentation of current guidelines for the treatment of cerebral infarction assumed to be due to patent foramen ovale. In this article, we present a young patient with this condition. In addition, we provide a general overview of the prevalence, recommended assessment and indications for treatment of patent foramen ovale in ischaemic stroke patients. ⋯ For stroke patients with patent foramen ovale, the choice between lifelong antithrombotic therapy alone and transcatheter closure is a difficult one. Treatment with antiplatelet agents remains the first choice in most cases. Well-designed studies are needed to identify which patients will benefit most from closure.
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Dabigatran, rivaroxaban and apixaban are three new oral anticoagulants that have recently been approved in Norway. The aim of this article is to provide an overview of the mechanisms of action, the most important indications and practical advice on the use of these drugs. ⋯ It is important to limit the use of these drugs to approved indications, to select patients who show good compliance, to rule out contraindications and to identify drug interactions. Monitoring of coagulation is not required, but patients should be followed up regularly to detect conditions that may lead to changes in the expected efficacy or safety.