Nordisk medicin
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Review
[New drugs in asthma treatment. Leukotriene receptor blockers and leukotriene synthesis inhibitors].
Asthma is an inflammatory airway disease. The patient is characterised by increased mucus secretion, mucosal oedema, bronchial obstruction of varying degree and bronchial hyperresponsiveness. ⋯ The study of specific leukotriene receptor antagonists and biosynthesis inhibitors has not only shed light on the underlying mechanisms in asthma, but also opened up the way to new treatment alternatives. As zafirlukast, a leukotriene receptor antagonist has just been licensed in Finland, it is a suitable opportunity to review the importance of leukotrienes in asthma and the use of agents that affect them.
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Confusion in the elderly, ie, delirium, is an organic mental disorder often associated with severe somatic disease. Approximately 20-60 per cent of elderly in-patients are afflicted with transient confusion states during hospitalisation, and in more than 50 per cent of cases this escapes the notice of the attending physician. ⋯ The occurrence of confusion in the elderly patient should alert the physician to the need of investigation to detect underlying severe disease without delay. Despite the otherwise poor prognosis, improved diagnosis and treatment should not only yield better results but also economic gain to the community.
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Knowledge of the pathophysiology and aetiology of asthma has expanded greatly during recent years, and hopes are strong that within the foreseeable future it will be possible to alleviate asthmatic symptoms even more effectively. This review covers some of this new knowledge, and presents viewpoints on the practical clinical management of asthma patients.
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An antinociceptive effect of calcitonin has been reported in numerous studies on both animals and humans. In the present article, we review the controlled clinical studies in which calcitonin has been used to relieve skeletal pain (cancer metastases, osteoporotic fractures) as well as extraskeletal pain (phantom limb pain, neurogenic claudication, reflex sympathetic dystrophy, migraine). ⋯ No controlled trials against conventional analgesic treatment is published. Thus, further studies are required before the place of calcitonin in pain therapy can be established.
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Primary fibromyalgia is probably a frequent disregarded disease, making differential diagnostic problems towards other kinds of rheumatologic diseases. The clinical manifestations, pathogenesis and treatment of primary fibromyalgia are discussed and the literature reviewed.