Ugeskrift for laeger
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Seventy-eight patients with culture-positive epidural catheters were studied. Fifty-nine had symptoms of exit site infection and 11 patients had clinical meningitis, two of whom also had en epidural abscess. This corresponds to a local infection incidence of at least 4.3% and an incidence of central nervous system infection of at least 0.7% at Odense University Hospital. ⋯ The microorganisms isolated from the epidural catheters were coagulase- negative staphylococci (41%), Staphylococcus aureus (35%), Gram-negative bacilli (14%) and other bacteria (10%). The Gram-negative bacilli and S. aureus caused serious infections more frequently than the others. We discuss the symptoms and diagnosis of spinal epidural abscess and propose prophylactic and diagnostic guidelines for epidural catheter-related infections.
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Ugeskrift for laeger · Jul 1996
[Evaluation of trainees' stay in general practice by the young physicians and their tutors].
In 1991 a new reform for postgraduate trainees was introduced in Denmark. Since the reform all young doctors-as a compulsory part of their vocational training-have had to work for six months as general practice trainees, no matter their wishes for future specialization. The reform furthermore led to the general practice trainees being considerably younger than previously-the average length of postgraduate experience before working as a trainee declined from six to seven years to one to two years. ⋯ Ninety-five percent of the questionnaires were returned, thus it was possible to evaluate the new compulsory training in general practice. In conclusion, the main part of the trainees had a positive assessment of the work conditions in general practice. However, a large part of the trainees indicated that their tutor doctors had set aside too short a time for supervision.
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Ugeskrift for laeger · Jul 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Nasal catheters versus Hudson face mask in oxygen therapy].
Thirty-two females, ASA class I, scheduled for termination of pregnancy before the 13th week participated in the study. After induction of anaesthesia, a soft plastic catheter was inserted in the oropharynx and the patients were postoperatively monitored with a capnograph, which sampled in- and expired air from the catheter. In a randomized cross-over design the patients received oxygen therapy by the Hudson face-mask and a nasal cannula. ⋯ The nasal cannula resulted in a significantly higher expired end-tidal O2-fraction (FETO2) compared to the Hudson mask. During the nasal cannula period the respiratory rate was significantly lower than during the face mask period. The end-tidal CO2 pressure (PETCO2) remained constant.
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Ugeskrift for laeger · Jul 1996
[Continuous monitoring of end-tidal CO2-tension in non-intubated patients].
We describe and evaluate a method for continuously monitoring end-tidal CO2 (PETCO2) in non-intubated, spontaneously breathing patients. In 18 ASA I patients scheduled for minor surgery a 3.3 mm (10 CH) soft plastic catheter was preoperatively inserted through one nostril placing the tip at the level of the epiglottis. In the recovery room a capnograph was connected to the catheter for monitoring PETCO2. ⋯ We tested the possibility of mixing expired air with supplementary oxygen via the other nostril at a flowrate of 15 litres min-1, and found no significant difference in PETCO2 with or without flow (0.0 +/- 0.9 mmHg). Values are mean +/- SD. In conclusion we find that this method allows accurate monitoring of PETCO2 in non-intubated, spontaneously breathing patients even at supplementary oxygen flow-rates of up to 15 litres min-1.