Ugeskrift for laeger
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Arterial hypoxaemia is observed during operation and also in the recovery room. Hypoxaemia during operation may be due to altered pulmonary mechanical conditions, drug-induced physiological changes and technical errors. Early postoperative hypoxaemia is frequently observed after general anaesthesia and may, among other things, be due to diffusion hypoxaemia, hyperventilation-induced hypoventilation, residual curarization, hypoventilation induced by sedatives or analgesics and ventilation/perfusion alterations. The clinical significance of peroperative and early postoperative hypoxaemia is not yet elucidated and treatment consists primarily of increasing the oxygen concentration in the inspired air.
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A total of 243 medical students in the third term, phase I, the University of Copenhagen, completed a questionnaire about health, health behaviour, including smoking during autumn 1988 and spring 1989. This investigation aimed at elucidation of the smoking habits of the medical students and their attitudes to smoking in the medical profession. Attempts were made to test the following hypotheses: 1. ⋯ That smokers consider that smoking is the doctor's own business while non-smokers consider that doctors have a professional responsibility. The investigation shows that 36% of the smokers consider that smoking is the doctor's own business in contrast to 64% of the non-smokers. The main result of the analysis is that smokers and non-smokers resemble one another socially and as regards health behaviour in the majority of respects but that smokers, as a whole, have poorer health behaviour and poorer self-assessed health than non-smokers.
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Ugeskrift for laeger · Apr 1991
Comparative Study[Burn injuries due to fireworks during New Year holiday. A 10-year case load].
Minor burns due to fireworks which are treated in the Casualty Department have remained constant during the past ten years. The injured patients are boys and young men between 7-19 years. Boys are injured ten times as frequently as girls. ⋯ The number of patients admitted to hospital on account of serious burns has increased. These are most frequently caused by clothes catching fire from fireworks which have been hidden under outer clothes or in trouser pockets. In order to avoid the serious burns caused by burning clothes, it is recommended that fireworks should not be concealed under clothes but carried away from the body possibly in a container made of non-inflammable material.
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We investigated 131 consecutive patients who were submitted to orthopaedic surgical interventions under spinal anaesthesia during a period of 12 months. Prior to operation, all of the patients were classified according to the Boston Cardiac Risk Index. Immediately before operation, approximately 500 ml sodium chloride solution was infused. ⋯ In Boston group III, the postoperative mortality was 42% as compared with 1% and 7% in the Boston groups I and II, respectively (p less than 0.05). It is concluded that the risk of fall in blood pressure during spinal anaesthesia may be predicted by the Boston Cardiac Risk Index and that patients who develop haemodynamic instability during spinal anaesthesia have an increased risk of developing complications. These patients should be offered maximal postoperative observation and care.
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Ugeskrift for laeger · Apr 1991
Review[Therapeutic pleurodesis in spontaneous pneumothorax, malignant pleural effusion, heart insufficiency and chylothorax].
Treatment with pleurodesis is employed in spontaneous pneumothorax, in pleural effusion due to neoplastic disease, intractable transudate and chylothorax. When this treatment is employed in spontaneous pneumothorax, randomized studies show a lower recurrence rate when drainage is supplemented by a sclerosing agent. Pleurodesis alone scarcely alters the recurrence rate in pneumothorax. ⋯ No randomized studies of pleurodesis in congestive heart failure and chylothorax were found. Pleurodesis is not recommended in the treatment of congestive heart failure because of reports of development of contralateral pleural effusion after successful pleurodesis. In chylothorax, pleurodesis is the last resort.