RESUMEN
BACKGROUND: The guidelines for diagnosis and treatment of neonatal hyperbilirubinaemia were changed at Vestfold Hospital, Norway in 1994 and 2007. Universal screening for ABO-immunization was implemented in 2006. This article describes effects of these changes. MATERIAL AND METHODS: Blood-type immunization, phototherapy and exchange transfusions were prospectively recorded in the 21-year period 1988-2008. Three cohorts comprised the basis for the analyses: infants born in the time-periods 1988-93, 1994-2006 or 2007-2008. RESULTS: 6.2 % of the infants born 1988-93 and 6.7 % born 1994-2006 received phototherapy. Physiological hyperbilirubinaemia in term infants was the main reason for phototherapy in the first cohort, while it was hyperbilirubinemia in preterm infants in the second cohort. 4.8 % of the infants born 2007-8 received phototherapy. Exchange transfusion was performed in 0.02 % born 1994-2008 and 0.2 % born 1988-93. Such transfusions were undertaken more frequently in cases with RhD-immunization (7.8 %) than in those with ABO-immunization (2.0 %). Universal screening for ABO-immunization increased the percentage of diagnosed cases in the population from 2.1 % to 3.6 %. No case of kernicterus was diagnosed. INTERPRETATION: Fewer term infants were treated with phototherapy for hyperbilirubinaemia after the changes of therapeutic guidelines in 1994, while more preterm infants were treated after this change. Far less exchange transfusions are performed nowadays than before 1994. ABO-immunization has been diagnosed more often after implementation of universal screening.
Asunto(s)
Hiperbilirrubinemia Neonatal , Sistema del Grupo Sanguíneo ABO/inmunología , Estudios de Cohortes , Recambio Total de Sangre , Humanos , Hiperbilirrubinemia Neonatal/diagnóstico , Hiperbilirrubinemia Neonatal/inmunología , Hiperbilirrubinemia Neonatal/terapia , Inmunización , Recién Nacido , Tamizaje Masivo , Noruega , Fototerapia , Guías de Práctica Clínica como Asunto , Estudios ProspectivosRESUMEN
BACKGROUND: The two major therapeutic options for early diagnosed prostate cancer are radical prostatectomy or radiation therapy. The National Program for Prostate Cancer in Norway conducted this study in order to document the use of treatment with curative intention in five geographical regions in Norway. MATERIAL AND METHODS: The study is based on data from the Cancer Registry of Norway on patients diagnosed with prostate cancer in 1998 and 2001. The departments of oncology have provided relevant information about radiation therapy. Treatment with curative intention is defined as radical prostatectomy or radiation therapy with > or = 64 Gy. RESULTS: About one third of all patients under the age of 75 years with recently diagnosed prostate cancer were treated with curative intention in 1998 and 2001 (1998: 28%, 2001: 33%); the total number increased from 440 in 1998 to 556 in 2001. There were marked variations between the geographical regions in the use of treatment with curative intention and in the use of radical prostatectomy versus radiation therapy. INTERPRETATION: The fact that no more than one third of the patients were treated with curative intention is probably due to uncertainty about the therapeutic benefit in relation to side effects. The regional variations probably reflect different opinions on the true effect of early diagnosis and treatment.