Ugeskrift for laeger
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The current clinical and biological knowledge about radiation myelopathy is reviewed. Transient myelopathy with Lhermitte's sign develops within months after irradiation. Symptoms generally disappear within months without treatment. ⋯ There is no effective treatment. Analysis of clinical reports shows that the risk of developing chronic myelopathy is less than 2% after 55 Gy, given in 2 Gy daily fractions. Other important radiobiological risk factors (dose per fraction, interfraction interval and volume) are discussed.
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Ugeskrift for laeger · Jan 1993
Case Reports[Toxic shock syndrome in group A streptococcal infection].
Three new cases of toxic shock syndrome due to infection with group A beta-hemolytic streptococci are described and similar cases in the literature are reviewed. The typical features of this disease include rapid development of multiorgan failure with renal impairment and, in many patients, also the respiratory distress syndrome. ⋯ In patients with initial soft tissue infection this is rapidly progressive and often associated with necrotizing fasciitis and myositis, which may give rise to a compartment syndrome with rhabdomyolysis. In addition to conventional therapy with antibiotics, fluid replacement and inotropics, most patients with extensive soft tissue infection also require surgical intervention with debridement and occasionally fasciotomy.
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Ugeskrift for laeger · Jan 1993
[Description of activities in the neonatal department at Rigshospitalet during the period 1983-1990].
Since 1983, the gestational age (GA in completed weeks), use of mechanical ventilation, duration of hospitalization and the diagnosis-related group were registered routinely for all infants admitted to the Neonatal Department, Rigshospitalet, Copenhagen. The data were analysed concerning the 6,636 infants treated during the seven-year period until the end of 1991. The annual number of admissions decreased during the period (p < 0.001) whereas the number of extremely preterm infants (GA < 28 weeks) increased from 30 to 45 annually (p < 0.05). ⋯ The cost of treatment increased by 40% in fixed prices to DDK 4,000 per day (approximately 333 pounds). The authors conclude that the introduction of nasal continuous positive airway pressure (CPAP) has permitted treatment of moderately preterm infants in county hospitals and has also resulted in avoidance of mechanical ventilation in extremely preterm infants without preventing improved survival. Although the patients have become more selected, the duration of hospitalization remains unchanged.