| 1. |
- Dahle, L. O., et al.
(författare)
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Problem-based medical education : development of a theoretical foundation and a science-based professional attitude
- 1997
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Ingår i: Medical Education. - : Wiley. - 0308-0110 .- 1365-2923. ; 31:6, s. 416-424
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Tidskriftsartikel (refereegranskat)abstract
- Problem-based learning, combined with early patient contact, integration between different subject areas, elements of multiprofessional education, and special emphasis on the development of communications skills has become the basis for the medical curriculum at the Faculty of Health Sciences in Linköping. Critics have questioned the depth of the scientific and theoretical aspects of the curriculum. Through a series of specific measures in the organization of the curriculum and examinations, and due to the pedagogical principles involved per se, our claim is that students graduating at Linköping do possess the required theoretical knowledge and a scientific attitude to the practice of medicine, at least equivalent to that obtained in a more conventional medical curriculum. One such specific measure is that all students perform one field study and two scientific studies during the course of the curriculum. An investigation of student opinions regarding the value of performing scientific projects of their own have shown that these projects have had a positive impact on the students' general scientific attitude and their willingness to engage in future scientific work. The specific skills acquired, as confirmed by oral examinations, were largely determined by the scientific nature of the chosen field of study. Our graduates have not yet progressed far enough in their careers for comparisons to be made on the basis of the Swedish Licensing Board Internship Examinations, but continuing evaluations of students, graduates and licensed doctors emerging from the curriculum will provide future evi-dence as to whether our present evaluation is correct.
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| 2. |
- Hammar, Mats, 1950-, et al.
(författare)
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Acupuncture treatment of vasomotor symptoms in men with prostatic carcinoma : A pilot study
- 1999
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Ingår i: Journal of Urology. - 0022-5347 .- 1527-3792. ; 161:3, s. 853-856
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Most men who undergo castration therapy for prostatic carcinoma will have vasomotor symptoms that usually persist for years. Vasomotor symptoms are elicited from the thermoregulatory center, possibly due to a decrease in hypothalamic opioid activity induced by low sex steroid concentrations. Acupuncture treatment in women, which stimulates hypothalamic opioid activity, alleviates vasomotor symptoms. We report on men treated with acupuncture for relief of vasomotor symptoms after castration therapy.MATERIALS AND METHODS: We asked 7 men with vasomotor symptoms due to castration therapy to receive acupuncture treatment 30 minutes twice weekly for 2 weeks and once a week for 10 weeks. Effects on flushes were recorded in logbooks.RESULTS: Of the 7 men 6 completed at least 10 weeks of acupuncture therapy and all had a substantial decrease in the number of hot flushes (average 70% after 10 weeks). At 3 months after the last treatment the number of flushes was 50% lower than before therapy. Therapy was discontinued after 10 weeks because of a femoral neck fracture in 1 man and after 3 weeks due to severe back pain in 1.CONCLUSIONS: Acupuncture may be a therapeutic alternative in men with hot flushes after castration therapy and merits further evaluation.
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| 3. |
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| 4. |
- Hammar, Mats, et al.
(författare)
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The Effects of Physical Activity on Menopausal Symptoms and Metabolic Changes around Menopause
- 1995
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Ingår i: Menopause. - : Raven Press. - 1072-3714 .- 1530-0374. ; 2:4, s. 201-209
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Tidskriftsartikel (refereegranskat)abstract
- Perimenopausal women experience symptoms like hot flushes and night sweats, dyspareunia and urethritis, mood swings, and sleep disturbances. Furthermore, the decreasing ovarian steroid hormone production, including both 17 beta-estradiol and progesterone, affects several metabolic systems such as the turnover of bone tissue, lipoprotein metabolism, and also the direct estrogen effects on the vessel walls. Estrogen substitution treatment has been proven to counteract many of these symptoms and metabolic changes, but some women have medical contraindications for estrogen treatment while some other women prefer to avoid such treatment. There is thus a need for alternative treatment. Regular physical exercise counteracts some of the changes due to menopause. Thus, exercise protects against bone loss, changes in lipoprotein metabolism, hypertension, and may even decrease vasomotor symptoms. Exercise also has a positive impact on mental health. This article reviews data concerning the effects of exercise in peri- and postmenopausal women. Exercise may cause the same magnitude of change as that induced by estrogen therapy. Positive effects of exercise are influenced by other factors such as general awareness of lifestyle, diet, smoking habits. There is a need for long-term prospective, randomized studies before definitive conclusions can be drawn as to the benefits of exercise on well-being and various menopause and other age-related health factors.
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| 5. |
- Wyon, Yvonne, et al.
(författare)
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Effects of acupuncture on climacteric vasomotor symptoms, quality of life, and urinary excretion of neuropeptides among postmenopausal women
- 1995
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Ingår i: Menopause. - 1072-3714 .- 1530-0374. ; 2:1, s. 3-12
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Tidskriftsartikel (refereegranskat)abstract
- Most perimenopausal women suffer from vasomotor symptoms. Changes in central opioid activity have been proposed to be involved in the mechanisms of hot flushes after menopause. Because acupuncture increases central opioid activity, it may affect postmenopausal hot flushes. The aim was to study if and to what extent two different kinds of acupuncture affected postmenopausal hot flushes, urinary excretion of certain neuropeptides, and quality of life in a group of postmenopausal women. Twenty-four women with natural menopause and hot flushes were included. Twenty-one women completed the study. One group was randomized to electroacupuncture at 2 Hz, whereas the other group was treated with another form of acupuncture (i.e., superficial needle insertion) for a total of 8 weeks. All women daily registered the number and severity of flushes from 1 month before to 3 months after treatment. They completed Quality of Life questionnaires before, during, and after treatment. Twenty-four-hour urine was sampled before, during, and after treatment and analyzed for neuropeptides using radioimmunoassay methods. The number of flushes decreased significantly by >50% in both groups and remained decreased in the group receiving electroacupuncture, whereas in the superficial-needle-insertion group, the number of flushes increased again during the 3 months after treatment. The Kupperman Index decreased significantly in both groups during and after treatment. The excretion of the potent vasodilating neuropeptide calcitonin gene-related peptide-like immunoreactivity decreased significantly during treatment. Acupuncture significantly affects hot flushes and sweating episodes after menopause, with effects persisting at least 3 months after the end of treatment. Changes in calcitonin gene-related peptide, which is a very potent vasodilator, could be involved in the mechanisms behind hot flushes.
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| 6. |
- Wyon, Yvonne, et al.
(författare)
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Postmenopausal women with vasomotor symptoms have increased urinary excretion of calcitonin gene-related peptide
- 1998
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Ingår i: Maturitas. - 0378-5122 .- 1873-4111. ; 30:3, s. 289-294
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To establish whether 24 h urinary excretion of the potent vasodilator calcitonin gene-related peptide (CGRP) was higher in postmenopausal women with vasomotor symptoms compared to the level in women without symptoms. We also wanted to establish whether urinary excretion of CGRP changed during the menstrual cycle in women of fertile age.Material and methods: Thirteen postmenopausal women with and 13 women without vasomotor symptoms were included. Urine was collected over 24 h and CGRP excretion was measured utilizing radio-immuno assay technique. Twenty-four hour CGRP excretion was also measured in ten fertile women with regular cycles in early follicular, preovulatory and midluteal phase.Results: Twenty-four hour urinary excretion of CGRP was significantly higher in women with vasomotor symptoms compared to non-flushing women (median 7.16 vs 5.15 pmol/24h; P=0.028). CGRP concentrations were stable throughout the ovulatory cycles.Conclusion: The 24 h urinary excretion of CGRP is higher in women with vasomotor symptoms than in women without these symptoms. CGRP may be the mediator of vasodilator signals originating from the thermoregulatory center.
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