Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Varicella may have a serious and sometimes fatal course, especially in immunocompromised patients. Some patient groups may need prophylaxis after exposure to the varicella-zoster-virus. In this article we review the evidence for usefulness of prophylactic measures after such exposure. ⋯ We believe that acyclovir or valacyclovir can be used as post-exposure varicella prophylaxis in risk patients for whom the time window for VZIG-use has expired.
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Horner's syndrome is characterized by the classic triad of eyelid ptosis, miosis and facial anhidrosis and is caused by an interruption of the oculosympathetic nerve pathway somewhere between its origin in the hypothalamus and the eye. ⋯ The path of the long oculosympathetic fibers is complex and not fully understood. Topographic diagnostics may be challenging, but in most cases a specific cause is identified.
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Low back pain is a challenge in daily clinical activity. The prognosis for single episodes of acute pain is good, but many patients have persistent/recurrent illness, often characterized by a complex pattern of somatic, psychological and social factors. The aim of this article is to present the evidence-based recommendations in the Norwegian clinical guidelines and to discuss new knowledge. ⋯ Low back pain often resolves without treatment within a few weeks. Adequate diagnostic categorization and good pain alleviation is possible with simple means in most patients. Simple diagnostic measures can help to identify individuals with serious pathology.
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Tidsskr. Nor. Laegeforen. · Sep 2010
Review[Mouth-rinsing with chlorhexidine for prevention of pneumonia].
Oral decontamination with chlorhexidine prevents accumulation of pathogens in the oral cavity, and can thereby reduce the risk of translocation to and colonization of the lungs. The antiseptic agent chlorhexidine has been widely used in dentistry, it has an excellent record of safety and efficacy and a broad antimicrobial spectrum. Mouth-rinsing with chlorhexidine may result in 90 % reduction of oral microbes. Cooperation between physicians and dentists is important in this area on the borderline between the two professions.
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Acute liver failure and acute decompensated chronic liver failure are two diseases that demand extensive knowledge of etiology and triggering factors, pathophysiology, diagnosis, prognosis and recommended guidelines for treatment. The article defines the diseases, discusses etiological factors, treatment strategies, indications for referral to the transplantation unit at Rikshospitalet and prognostic factors of importance. ⋯ Patients diagnosed with acute liver failure or acute decompensated chronic liver failure remain a clinical challenge. Optimal treatment requires extensive knowledge of pathophysiological mechanisms and treatment strategies.