Ugeskrift for laeger
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Ugeskrift for laeger · Feb 2007
Review[Medical treatment of chemotherapy-induced nausea and vomiting].
Patients consider nausea and vomiting among the worst side effects of chemotherapy. This paper reviews the development of antiemetics during the past 12 years, focusing on the neurokinin (NK)1-receptor antagonist, aprepitant, and the new 5-HT3-receptor antagonist palonosetron. ⋯ Antiemetics are effective in prevention of vomiting, but less effective against nausea. Therefore studies with potential new antiemetics, such as olanzapine and ghrelin are awaited with suspense.
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Ugeskrift for laeger · Feb 2007
Comparative Study[Fast-tracking admission from emergency room to orthopaedic ward in hip fracture patients].
The traditional admission protocol for hip fracture patients often results in long waiting hours in the A&E. The aim of this study was to investigate the effect of an optimised admission protocol on the time spent in the A&E in an already established multimodal rehabilitation program. ⋯ An optimised admission protocol, including nurse requested X-ray for hip fracture patients, led to a reduction in the time spent in the A&E.
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Acute renal failure (ARF) is characterized by a sudden increase in plasma creatinine and a decrease in urine flow. ARF is caused by multiple factors of which the most important are hypovolemia, hypotension, septic mediators and nephrotoxic agents. ARF is observed in 10-23% of critically ill patients. ⋯ If the patient survives, the recovery of renal function is 90-95%. Non-dialytic therapy is early volume resuscitation whereas furosemid may worsen ARF. At the present time the dialytic therapy of choice in ICU patients with ARF is continuous renal replacement therapy (CRRT).
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Critical care research has facilitated the development of clinical guidelines to improve the outcome of critically-ill patients. The high mortality needs to be reduced further, by means of increased research to the benefit of patients, relatives and society. Clinicians, researchers, public officials and politicians at all levels must work together towards this aim.