Ugeskrift for laeger
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Ugeskrift for laeger · Aug 1998
Review[Mechanical ventilation in acute respiratory insufficiency in patients with chronic obstructive lung diseases].
Chronic obstructive lung disease (COLD) is a common disease and cause of death. At an advanced stage, acute respiratory failure will repeatedly arise and mechanical ventilation may be the only solution. The best result of treatment is a return to the habitual condition. ⋯ The severity of baseline COLD and comorbidity had significant influence on survival. These factors together with the quality of nursing were predictors of successful ventilator weaning. Knowledge of the patient before the need for mechanical ventilation arises is of decisive importance.
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Ugeskrift for laeger · Aug 1998
Case Reports[Multiple fractures following seizures in a pregnant woman].
A 27-year-old woman, immigrated from Libanon, pregnant and at term was admitted with pain in the lower abdomen. The history was badly recognized because of the patient's inability to speak Danish. X-ray revealed a fracture of the left acetabulum with a minor central dislocation of the femoral head. ⋯ She was then delivered by a caesarean section. The seizures were later found to be due to grand mal type epileptic attacks. This case underlines the importance of a careful clinical and radiological investigation of patients with complaints of pain related to the central joints after seizures.
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Ugeskrift for laeger · Aug 1998
Case Reports[Multiorgan failure and peripheral gangrene following a superficial dog bite].
One case of life-threatening disease caused by the gram-negative rod Capnocytophaga canimorsus and a similar case without verification are presented. The severe diseases developed two to three days after a superficial dog bite and were characterized by acute development of septicaemia and fulminant disseminated intravascular coagulation syndrome. Moreover, the cases were complicated by renal failure, respiratory insufficiency and peripheral gangrene.
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Ugeskrift for laeger · Aug 1998
Comparative Study[The value of palpation as basis for decision on lymph node excision].
The purpose of the study was to evaluate palpation of the regional lymph nodes in control examinations of patients with malignant disease. A retrospective review of the medical records of 188 cases in which the patients had had an extirpation of the regional lymph nodes was performed. We have compared the preoperative findings through palpation with the histological diagnosis. ⋯ The specificity of palpation when the histological diagnosis was malignant was (with 95% confidence limits), in the axilla 0.65 (0.54-0.75), in the inguinal region 0.86 (0.75-0.94) on the neck 0.83 (0.52-0.98) and in the suprahyoid region 0.58 (0.28-0.85). In conclusion, palpation of regional lymph nodes is not a sufficient control examination in the estimation of the course of malignant disease. Supplementary examination methods are recommended.
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Ugeskrift for laeger · Aug 1998
Randomized Controlled Trial Comparative Study Clinical Trial[Atraucan, a new needle for spinal analgesia].
One hundred and six consecutive patients, aged below 40 years, scheduled for surgery in the lower part of the body were chosen for this study. Patients were allocated randomly to have spinal analgesia with either a Sprotte 24G or an Atraucan 26G spinal needle. Incidences of insufficient blocks were higher after dural puncture with the Atraucan needle. ⋯ Eight patients (16%), all in the Atraucan group, required an epidural blood patch. Ease of needle insertion and number of puncture attempts were the same for both needles. We conclude that due to the high incidence of PDPH the Atraucan 26G spinal needle cannot be recommended for spinal analgesia in young patients.