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  • 1
    Online Resource
    Online Resource
    En veltrent mann med mekanisk aortaklaff og leggsmerter
    Norwegian Medical Association ; 2017
    In:  Tidsskrift for Den norske legeforening Vol. 137, No. 2 ( 2017), p. 113-116
    Details
    In: Tidsskrift for Den norske legeforening, Norwegian Medical Association, Vol. 137, No. 2 ( 2017), p. 113-116
    Type of Medium: Online Resource
    ISSN: 0029-2001
    URL: Article
    DOI: 10.4045/tidsskr.15.1337
    Language: Norwegian
    Publisher: Norwegian Medical Association
    Publication Date: 2017
    detail.hit.zdb_id: 2039570-X
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  • 2
    Online Resource
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    Substance abuse‐related admissions in a mixed Norwegian intensive care population
    Wiley ; 2020
    In:  Acta Anaesthesiologica Scandinavica Vol. 64, No. 3 ( 2020-03), p. 329-337
    Details
    In: Acta Anaesthesiologica Scandinavica, Wiley, Vol. 64, No. 3 ( 2020-03), p. 329-337
    Abstract: Alcohol and drug abuse are potentially modifiable risk factors for critical illness. The aims of this study were to describe patients with substance abuse‐related admissions (abbreviated SARA) in a mixed intensive care (ICU) population in Oslo, and to compare these patients with patients with non‐SARA. Methods Cross‐sectional prospective study of a mixed medical and surgical ICU‐population in Oslo, Norway. Data were collected consecutively using a questionnaire, medical records, and toxicology results. SARA included admissions due to acute or chronic complications of alcohol or drug abuse, as well as substance abuse‐related injuries. Results Of the 852 patients included, 168 (20%) had SARA; 102 (12%) alcohol‐related and 66 (8%) drug‐related. Male patients aged 18‐39 had the highest proportion of SARA (47/97, 49%). Among the trauma patients, 69/182 (38%) were influenced by alcohol and drugs at the time of injury. Patients with SARA were significantly younger (median age 48 vs 66), had lower Charlson comorbidity index (mean 1.4 vs 2.5) and shorter length of stay (median days 2.4 vs 4.9), than non‐SARA patients. Hospital mortality was similar when adjusting for age (OR 0.8, P  = .27, non‐SARA as reference). Conclusion Overall, one in five ICU admissions was associated with substance abuse. For male patients aged 18‐39 this ratio was nearly half. More than one third of the trauma patients were influenced by alcohol or drugs at time of injury.
    Type of Medium: Online Resource
    ISSN: 0001-5172 , 1399-6576
    URL: Issue
    URL: Article
    DOI: 10.1111/aas.v64.3
    DOI: 10.1111/aas.13506
    RVK:
    XA 11250
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2004319-3
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  • 3
    Online Resource
    Online Resource
    A one-year observational study of all hospitalized and fatal acute poisonings in Oslo: Epidemiology, intention and follow-up
    Springer Science and Business Media LLC ; 2012
    In:  BMC Public Health Vol. 12, No. 1 ( 2012-12)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2012-12)
    Abstract: Up to date information on poisoning trends is important. This study reports the epidemiology of all hospitalized acute poisonings in Oslo, including mortality, follow-up referrals, and whether the introduction of over-the-counter sales of paracetamol outside pharmacies had an impact on the frequency of poisonings. Methods All acute poisonings of adults (≥16 years) treated at the five hospitals in Oslo from April 2008 to April 2009 were included consecutively in an observational cross-sectional multicentre study. A standardized form was completed by the treating physician, which covered the study aims. All deaths by poisoning in and outside hospitals were registered at the Institute of Forensic Medicine. Results There were 1065 hospital admissions of 912 individuals; 460 (50%) were male, and the median age was 36 years. The annual incidence was 2.0 per 1000. The most frequent toxic agents were ethanol (18%), benzodiazepines (15%), paracetamol (11%), and opioids (11%). Physicians classified 46% as possible or definite suicide attempts, 37% as accidental overdoses with substances of abuse (AOSA), and 16% as other accidents. Twenty-four per cent were discharged without any follow-up and the no follow-up odds were highest for AOSA. There were 117 deaths (eight in hospital), of which 75% were males, and the median age was 41 years. Thus, the annual mortality rate was 25 per 100 000 and the in-hospital mortality was 0.8%. Opioids were the most frequent cause of death. Conclusions The incidence of hospitalized acute poisonings in Oslo was similar to that in 2003 and there was an equal sex distribution. Compared with a study performed in Oslo in 2003, there has been an increase in poisonings with a suicidal intention. The in-hospital mortality was low and nine out of ten deaths occurred outside hospitals. Opioids were the leading cause of death, so preventive measures should be encouraged among substance abusers. The number of poisonings caused by paracetamol remained unchanged after the introduction of over-the-counter sales outside pharmacies and there were no deaths, so over-the-counter sales may be considered safe.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/1471-2458-12-858
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2012
    detail.hit.zdb_id: 2041338-5
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  • 4
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    Online Resource
    Fatal liver failure after therapeutic doses of paracetamol in a patient with Duchenne muscular dystrophy and atypical pharmacogenetic profile of drug‐metabolizing enzymes
    Wiley ; 2020
    In:  Basic & Clinical Pharmacology & Toxicology Vol. 127, No. 1 ( 2020-07), p. 47-51
    Details
    In: Basic & Clinical Pharmacology & Toxicology, Wiley, Vol. 127, No. 1 ( 2020-07), p. 47-51
    Abstract: Paracetamol has a good safety profile, but pharmacogenetic differences in drug‐metabolizing enzymes may have an impact on its risk of hepatotoxicity. We present a case of fatal acute liver failure (ALF) after therapeutic doses of paracetamol in a patient with Duchenne muscular dystrophy, where pharmacogenetic screening was conducted. This 30‐year‐old man was electively admitted for a tracheostomy. A total of 14.5 g paracetamol was given over four days. He developed a severe ALF and died 11 days after admission. Pharmacogenetic screening showed absent CYP2D6 metabolism and increased CYP1A2 activity, which may have increased the formation of toxic intermediate metabolite, N‐acetyl‐p‐benzo‐quinone imine (NAPQI). He also had decreased function of UGT2B15, which increases the amount of paracetamol available for metabolism to NAPQI. Having a reduced muscle mass and thus a reduced glutathione levels to detoxify produced NAPQI may add to the risk of toxicity. This case may indicate that pharmacogenetic variability is of potential relevance for the risk of paracetamol‐induced hepatotoxicity in patients with neuromuscular diseases. Further studies should investigate if pharmacogenetic screening could be a tool to detect potentially increased risk of hepatotoxicity in these patients at therapeutic doses of paracetamol and hence provide information for selection of analgesic treatment.
    Type of Medium: Online Resource
    ISSN: 1742-7835 , 1742-7843
    URL: Issue
    URL: Article
    DOI: 10.1111/bcpt.v127.1
    DOI: 10.1111/bcpt.13389
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2151592-X
    SSG: 15,3
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  • 5
    Online Resource
    Online Resource
    A one-year observational study of all hospitalized acute poisonings in Oslo: complications, treatment and sequelae
    Springer Science and Business Media LLC ; 2012
    In:  Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Vol. 20, No. 1 ( 2012-12)
    Details
    In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2012-12)
    Abstract: Changes in poisoning trends may affect both complications and outcomes in patients with acute poisoning. This study reports the treatments given and the frequency of complications, also related to treatment, mortality and sequelae related to various toxic agents. Methods All acute poisonings in adults (≥16 years) admitted to the five hospitals in Oslo were included consecutively during one year (2008 to 2009) in an observational cross-sectional multicenter study. A standardized form was completed by the treating physician, which covered the study aims. Results There were 1065 admissions in 912 patients. The median length of hospital stay was one day, and 49% were observed in an intensive care unit (ICU). Active treatment was given to 83%, and consisted of supportive therapy (70%), antidote(s) (38%), activated charcoal (16%) and gastric lavage (9%). The most commonly used antidotes were flumazenil (19%), naloxone (17%) and N-acetylcysteine (11%). The rate of treatment-related complications was 2.4% (21/884). Neither flumazenil, naloxone, nor the combination, was associated with convulsions or other complications. Among those receiving N-acetylcysteine, 5% (6/120) developed allergic reactions, one of which mandated discontinuation of treatment. Nineteen percent presented in a coma. Complications developed in 30%, compared with 18% in a 2003 study, mainly respiratory depression (12%), prolonged QTc interval (6%) and hypotension (5%). Eight patients died (0.8%) and five (0.5%) survived with permanent sequelae, mainly anoxic brain damage. Discussion Few patients stayed more than two days. The use of the ICU was liberal, considering that only one out of five presented in a coma. Antidotes were frequently given diagnostically. Although N-acetylcysteine induced allergic reactions, most were mild and treatment discontinuation was only necessary once. The frequency of complications had almost doubled in five years, although the poisoning pattern was largely unchanged. However, few patients developed permanent sequelae.
    Type of Medium: Online Resource
    ISSN: 1757-7241
    URL: Article
    DOI: 10.1186/1757-7241-20-49
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2012
    detail.hit.zdb_id: 2455990-8
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