Ugeskrift for laeger
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Ugeskrift for laeger · Apr 1998
Review[AIDS-related non-Hodgkin lymphomas. Clinical picture and prognosis].
Patients infected with HIV are at high risk for developing non-Hodgkin's lymphomas (NHL). HIV-associated NHLs seem to be increasing in number. They consist of two major histopathological subtypes originating from B-lymphocytes: Burkitt-like lymphomas and diffuse large cell lymphomas. ⋯ Patients with AIDS often have widespread disease at presentation and frequent involvement of extranodal sites (CNS, liver, bone marrow, the digestive tract and skin). The treatment of NHL in AIDS patients is controversial due to their poor response to chemotherapy as well as a tendency to develop severe hematological toxicity. Factors with a negative influence on the prognosis are: Extranodal localisation of NHL including CNS, CD4 count below 200 x 10(6)/l, platelet count below 130 x 10(9)/l, widespread symptoms of disease, presence of EBV in the lymphoma and immunoblastic histology.
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Cervical necrotizing fasciitis is a rapidly progressive infection that involves the superficial and deep cervical fascia. Underestimation of this severe neck infection can delay diagnosis and treatment of this often fatal disease process. Three new cases, all with mediastinitis and fatal outcome are presented. Early diagnosis, aggressive surgical treatment and antibiotic therapy is essential if the high mortality rate is to be brought down in the future.
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Ugeskrift for laeger · Apr 1998
Review[Surgical technique in Cesarean section. Evidence or tradition?].
The literature was reviewed in order to find clinical-epidemiological and physiological evidence for which surgical techniques should be preferred when performing Caesarean section. We found reasonable evidence for the following procedure: spontaneous placenta detachment, uterine repair in one layer and non-closure of the peritoneum.
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Ugeskrift for laeger · Apr 1998
[Five-year survival in persons aged 40 years or over with newly diagnosed diabetes mellitus].
The five- to six-year all-cause mortality is analysed in 1323 newly diagnosed diabetic patients aged 40 years or over. The median age at diagnosis is lower for males (63.6 years) than for females (67.5 years), but more males (24.7%) than females (20.0%) have died (p = 0.04). This male excess mortality can mainly be attributed to the 60-79-year old males. ⋯ For males this excess mortality becomes statistically significant four years after diagnosis for the 40-59 year-olds and after six years for the 60-79 year-olds. For females and very old males no statistically significant excess mortality is observed, but after two to four years there is a tendency for the survival curve of 40-79-year old females to separate from that of the Danish female population to show an excess mortality. In this population-based study the disadvantageous mortality experience of even newly-diagnosed diabetic patients is clearly demonstrated.