Ugeskrift for laeger
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Ugeskrift for laeger · Oct 2000
[Unplanned emergency admission of dying patients. Causes elucidated by focus group interviews with general practitioners].
Research indicates that the major part of terminally ill and dying patients wish to die at home, but in 1993 actually only 24% of Danish cancer patients died at home. The aim of this study was to analyse some barriers the general practitioners meet in the care for dying patients. ⋯ In addition, if the general practitioner did not have a central position in home care, we found a greater risk of unplanned hospitalisation. The conditions for improving home care for the dying are better support for the informal carer, ongoing access to experts in palliation and improved communication overall in the health service.
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To investigate the consumption of alcohol among emergency room patients, we included 395 patients above 18 years old entering the emergency room during a period of ten days. The patients completed a questionnaire about alcohol consumption, smoking habits and medication. ⋯ The alcoholic women were characterised by excessive chemical injuries, incisions and stab wounds, and trauma of the upper limb. In conclusion a surprisingly large amount of emergency room patients can be defined as alcohol abusers and drinking is found to be associated with excessive damage.
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Acute pancreatitis is a common disease with significant morbidity and mortality. Despite recent improvements in our understanding of the disease process and the development of a range of supportive measures, today's treatment approaches are still less than ideal. Here I present some of the key points from generally accepted guidelines for the management of acute pancreatitis, including the operational classification system approved in Atlanta, USA, 1992. Moreover, the diagnostic value of magnetic resonance as well as new approaches to treatment, including data on prophylactic antibiotics, selective digestive decontamination, and enteral nutrition in acute pancreatitis, are discussed in more detail.