Skin Sensitization in School Children in Northern and Southern Norway

It has been suggested that environmental exposures and living conditions can explain some of the worldwide variation in atopic disorders. Norway has large environmental contrasts within the country. We compared skin prick sensitization rates among school children living in the southern subarctic and in the northern artic part of Norway. Approximately one quarter of the children were sensitized, mostly against pollen and animal dander, while mite and mould sensitization seemed to be a minor problem. Sensitization rates and profiles were similar in the north and south despite differences in living conditions and environmental exposures.     

A mixed method evaluation of a group‐based educational programme for CPAP use in patients with obstructive sleep apnea

Rationale, aims and objectives Continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) has a low long‐term adherence. Educational interventions are few and sparsely described regarding content, pedagogical approach and participants' perceptions. The aim was to describe adherence to CPAP treatment, knowledge about OSA/CPAP, as well as OSA patients' perceptions of participating in a group‐based programme using problem‐based learning (PBL) for CPAP initiation. Educational programme The PBL programme incorporated elements from theories and models concerning motivation and habits. Tutorial groups consisting of four to eight patients met at six sessions during 6 months. Methods A sequential explanatory mixed method design was used on 25 strategically selected patients. Quantitative data regarding, clinical variables, OSA severity, CPAP use, and knowledge were collected at baseline, after 2 weeks and 6 months. Qualitative data regarding patients' perceptions of participation were collected after 6 months by semi‐structured interviews using a phenomenographic approach. Results 72% of the patients were adherent to CPAP treatment after 2 weeks and 6 months. All patients improved their baseline knowledge about OSA and CPAP after 2 weeks and sustained it after 6 months. Anxiety and fear, as well as difficulties and needs were motivational factors for participation. Patients described the difficulties of behavioural change, an awareness that improvements do not occur immediately, a realization of the importance of both technical and emotional support and the need for a healthier lifestyle. Conclusion and practice implications A group‐based programme using PBL seems to facilitate adaptive and developmental learning and result in acceptable CPAP adherence levels.     

Behavioral goal assessment in patients with persistent musculoskeletal pain

Identification and achievement of behavioral goals is an important issue in pain rehabilitation. For this dual purpose, we developed a patient-specific clinical tool—the Patient Goal Priority Questionnaire (PGPQ). Using the PGPQ, this study identifies patients' behavioral goals for physical therapy (PT) in a primary health care sample of patients with persistent musculoskeletal pain. In addition, this study examines the concurrent validity of the PGPQ in relation to a generic measure of disability, the Pain Disability Index (PDI). In all, 197 subjects participated in the study. The behavioral goals differed among the patients, comprehending several everyday activities and behaviors, and thus an individualized and behavioral focus was relevant for these patients. The PGPQ was negatively and moderately correlated with the PDI, indicating patient-specific properties of the new instrument. An elaborated version of the PGPQ can serve (a) as a clinical tool for identification of the patient's priorities of behavioral goals for PT, (b) as a clinical tool for collaborative formative evaluation during treatment, and (c) as a complementary measure in research for assessment of clinically significant changes related to behavioral performance.     

Alcohol Withdrawal: Effects of Clonidine Treatment on Sympathetic Activity, the Renin-Aldosterone System, and Clinical Symptoms

Twenty male alcoholics with alcohol withdrawal syndrome were randomized to receive either oral clonidine (3-600 micrograms, six hourly) or oral chlormethiazole (500-1000 mg, six hourly) for 4 days. All subjects were also given oral carbamazepine (200 mg, 12 hourly) throughout the study. Nine subjects given clonidine and eight given chlormethiazole completed the study. Clonidine was as effective as chlormethiazole in suppressing the symptoms and signs of alcohol withdrawal. However, plasma catecholamines, blood pressure, and pulse rate fell more rapidly and to a greater extent during clonidine than following chlormethiazole, findings which could have therapeutic implications. It is suggested that activation of brain noradrenergic neurons constitutes a common denominator in the pathophysiology of several withdrawal syndromes.     

Total Corporal Contouring with Megaliposuction (120 Consecutive Cases)

The purpose of this study is to present the authors' long-term experience with total corporal contouring with megaliposuction. The evolution of body reshaping in one operative setting including simultaneous head and neck contouring, upper and lower extremity recontouring, and creation of an aesthetic trunk and abdominal form is discussed. Patient evaluation, operative techniques, postoperative management, and long-term results are emphasized. From February 1994 to February 1997, 120 consecutive patients underwent total corporal contouring with tumescent (Hunstad formula)-technique, classic liposuction. There were 10 males and 110 females. The average age of all patients was 28 years. Preoperative evaluation emphasized corporal shape and proportions. No other open procedures were performed simultaneously in these patients. The authors' postoperative regimen is discussed. The average amount of aspirated material in these series was 14,000 ml (range, 8000–20,000 ml). No blood transfusions were required. Complications included only hypopigmentation (N= 2) and postoperative seromas requiring aspiration (N= 12). Follow-up examination took place at 3 months to 3 years, with an average of 14 months. All patients underwent a metamorphosis from an amorphic shape to one that follows the normal body contours and profiles. The goals of megaliposuction are no longer just to reduce body fat and body mass. Individually planned surgery for these patients should be based upon obtaining normal symmetrical body proportions. Total corporal contouring and reshaping can now be safely performed, offering hope and predictable outcomes to this patient population. Patient evaluation, operative technique, postoperative care, and long-term results are presented.