Ugeskrift for laeger
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Ugeskrift for laeger · Oct 1994
Comparative Study[Left ventricular hypertrophy in patients with aortic stenosis. A comparison between electrocardiography and echocardiography].
Using echocardiography (ECHO) as the reference method, the aim of this study was to determine the sensitivity, specificity, and predictive value of the electrocardiogram (ECG) in detection of left ventricular hypertrophy (LVH) in patients with aortic stenosis. Forty-one patients, 18 men and 23 women aged 25-80 years (mean 49 years) with uncomplicated aortic stenosis were studied. ECG-LVH was estimated by standard fixed voltage criteria. ⋯ The positive predictive value of the ECG in detection of LVH was high (100%). We conclude that the sensitivity of the ECG in detection of LV hypertrophy is unsatisfactorily low. Accordingly, it is recommended that echocardiography be performed in all patients suspected of aortic stenosis.
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Ugeskrift for laeger · Oct 1994
Randomized Controlled Trial Meta Analysis Comparative Study Clinical Trial[Low molecular weight heparin versus unfractionated heparin in the treatment of deep venous thrombosis--a meta-analysis].
A review based on 17 randomised studies on low molecular weight heparin (LMWH) versus unfractionated heparin (UFH) in the treatment of objectively verified deep venous thrombosis (DVT) is presented. Long-term treatment with LMWH was compared with long-term UFH in two studies and with warfarin in one study. In the rest of the studies LMWH and UFH were used during initiation of oral anticoagulant therapy, and these studies were included in a meta-analysis. ⋯ There was no significant difference in the reduction of Marder score during treatment (LMWH 5.0 versus UFH 3.8) or in the frequency of new symptomatic, scintigraphically or angiographically verified pulmonary embolism (LMWH 0.6% versus UFH 1.1%). The frequency of complications seemed independent of whether LMWH was administered once or twice daily. Monitoring of LMWH treatment is not considered necessary but determination of anti-factor Xa in plasma is recommended if bleeding occurs during treatment with LMWH.
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Many patients suffering from trauma or acute illness are in need of pain treatment in the prehospital phase, a treatment they seldom receive. In Denmark, it has been considered whether ambulance personnel should be allowed to administer pain treatment. Inhalation of 50% nitrous oxide and 50% oxygen has been administered for many years by non-physicians around the world. ⋯ The few available controlled studies conducted inside the hospital have not shown significant pain-relieving effects of nitrous oxide for patients suffering from pain of acute medical of surgical origin when compared to other methods of pain treatment. Controlled studies of the effects of prehospital treatment with nitrous oxide need to be done. Technical problems and problems concerning indications, side effects, complications, pollution and possible addiction remain to be fully elucidated before prehospital treatment with nitrous oxide can be recommended for routine use in the Danish ambulances.
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Ugeskrift for laeger · Oct 1994
Case Reports[Incarceration of the ventricle through a right-sided Bochdalek hernia with symptoms of tension pneumothorax].
Acute herniations through a posterolateral diaphragmatic defect (Bochdalek hernia) are rare in adults. Most of these hernias are on the left side causing gastrointestinal symptoms. We present af case of a Bochdalek hernia on the right side, where incarceration and distension of the stomach was followed by dyspnoea and haemoptysis. Aetiology, symptoms, diagnosis and treatment are discussed.