[Cannabis and psychoses]. / Cannabis og psykoser.

Patients with the combination of cannabis abuse and psychosis are difficult to treat. The intoxicated state has many similarities to schizophrenia. Like other drugs with abuse potential cannabis affects the brain's reward system. It has not been possible to show major structural changes in the cerebrum, but by electron microscopy structural changes can be shown in animals especially in the hippocampus. The drug is taken in order to escape reality, and a vicious circle tending to maintain the person's abuse pattern which includes reduced energy, judgment and memory may be established. Cannabis may cause toxic psychosis, with a tendency to recurrent psychoses with continued abuse. There is no convincing support for the assumption that cannabis can cause chronic functional psychosis following cessation of abuse. Schizophrenic patients who use cannabis are often trying to reduce the discomfort caused by symptoms in the prodromal phase. By continued abuse positive psychotic symptoms are worsened. Antidepressant drugs may diminish the depressive elements of the disease. Some cannabis users are especially sensitive and develop toxic psychosis. Patients with repeated toxic psychosis may erroneously be diagnosed as schizophrenics. It is therefore important to be aware that a psychotic state may be caused by abuse of cannabis, and adjust treatment to this fact.

[Plastic surgical reconstruction in microtia. A follow-up study]. / Plastikkirurgisk rekonstruktion ved mikroti. En efterundersøgelse.

During the period 1967-1987, 26 ear reconstructions were carried out in the Department of Plastic Surgery, Rigshospitalet, Copenhagen. These 26 patients were followed up, partly from the hospital records and partly by means of a questionnaire. Twenty-two patients replied to the questionnaire. The average age was 8.8 years at the commencement of the reconstruction and the average duration of hospitalization was 41 days. The reconstructions employed autologous costal cartilage. Minor complications were observed in approximately half of the patients. One patient developed pneumothorax postoperatively and one lost the grafts on account of repeated infections. 77% of the patients stated that the operation had been worthwhile. 37% found the result disappointing while the remaining 63% considered that the results were better than they had anticipated or as they had anticipated. The operation had no effect on teasing by peers. It is concluded that ear reconstruction should be postponed till an older age and that thorough preoperative information to the patients is important. The operation of surgical ear reconstruction is regarded as a valuable offer to patients with microtia.