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Agewall S.,Oslo Universitetssykehus
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række

It is important to measure troponin levels when acute myocardial infarct is suspected. Many other factors that affect the heart can cause an increase in troponin levels, for example extreme physical exertion. Recent studies have shown that more normal physical activity can also lead to increase in troponin levels in healthy individuals. Source

Tjonnfjord G.E.,Oslo Universitetssykehus
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række

The clinical courses of chronic lymphocytic leukaemia (CLL) are very heterogeneous. Biological markers that provide good prognostic information at the time of diagnosis are available. The aim of the study was to determine the prevalence of these markers in a population-based material. Biological markers were examined using standard laboratory methods after obtaining an informed consent statement from patients diagnosed with chronic lymphocytic leukaemia in the period 1.10.2007-31.12.2009. There were 388 new cases of chronic lymphocytic leukaemia during the study period, and 236 patients (61%) were included in the study. Of 222 patients, 178 (80%) were in Binet's stage A, 26 (12%) in stage B and 18 (8%) in stage C. The V(H) gene was mutated in 69% and unmutated in 31% of cases. Cytogenetic aberrations were found in 68%: del(13q14) in 48%, trisomy 12 in 13%, del(11q22) in 10% and del(17p13) in 7%. CD38-positive disease was found in 28% of the patients. The V(H) gene was mutated in 67% of the patients in Binet's stage A, and in the majority of these a mutated V(H) gene was associated with non-expression of CD38 and del(13q14). At the time of diagnosis, most patients are asymptomatic and do not need treatment. The biological markers that indicate a favourable prognosis occur most frequently in this group. Markers that indicate a poor prognosis occur more frequently in the group that has symptoms at the time of diagnosis. Source

Kristjansson S.R.,Oslo Universitetssykehus
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række

Polypharmacy is common among the elderly and consequences may be adverse drug reactions, interactions and toxicity. At the same time it is well documented that elderly patients are suboptimally treated for conditions such as atrial fibrillation and osteoporosis. When assessing medical treatment one must take into account the remaining life expectancy, time to effect, complication risk related to not treating, risks related to adverse drug effects and interactions, patient preferences and treatment goals. Source

Tangen J.M.,Oslo Universitetssykehus
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række

BACKGROUND: The Norwegian treatment protocol for acute lymphoblastic leukaemia in adults was introduced in 1982 and has undergone minor changes thereafter. Earlier studies from The South Eastern Norway Regional Health Authority have reported 50 % five-year overall survival in patients treated according to this protocol. This article presents survival data for Norwegian adults with acute lymphoblastic leukaemia on a national basis. MATERIAL AND METHODS: Data for all patients between 15 and 65 years, who were diagnosed with acute lymphoblastic leukaemia in the period 2000-2007 according to The Norwegian Registry for Acute Leukaemia and Lymphoblastic Lymphoma, and were treated with chemotherapy with a curative intent were analysed for survival. RESULTS: 128 patients were diagnosed with acute lymphoblastic leukaemia in the study period. The overall remission rate was 85.9 %. Five-year survival was 49.2 % overall, 31.4 % for patients 40 years or older and 62.6 % for those younger than 40 years. INTERPRETATION: These results are in line with previous Norwegian studies and show a five- year overall survival which is more than 10 % higher than that reported in international multicenter studies. One explanation can be that the Norwegian treatment program is more intensive than most treatment protocols used in other countries. Source

Saugstad O.D.,University of Oslo | Saugstad O.D.,Oslo Universitetssykehus

Background: The global neonatal mortality of 28/1,000 live births is unacceptably high. Furthermore, the huge difference in mortality between high- and low-income countries and regions is presently one of the most burning human rights issues. The decline in neonatal mortality has been slow and is a main reason the Millennium Development Goal 4 does not seem to have been reached. Objectives: Several countries have shown it is possible to reduce neonatal mortality quickly and dramatically without much cost. Methods: It is important to learn from the successful countries and focus on the 3-4 major causes of neonatal death: asphyxia, infection, low birth weight/prematurity and congenital malformations. Results: A reasonable short-term goal is to reduce global neonatal mortality to 15/1,000 which can be achieved without introduction of high technology medicine. A further reduction of mortality to 5/1,000 should be the next global goal. Reaching this would reduce the present 3.8 million annual deaths by 3 million. In order to do this, regionalization of health care should be implemented. Maternal health should be the focus, with free antenatal care and centralized deliveries with health personnel attending the birth. Education of girls is perhaps the best way to prevent perinatal and neonatal deaths. Ten simple recommendations are given to reduce neonatal mortality. One of these is that each newborn baby in the world should have free access to essential drugs. Conclusions: It is possible to reduce newborn mortality in all countries and regions. Most important to achieve these goals is, however, political will. Copyright © 2010 S. Karger AG, Basel. Source

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