Ugeskrift for laeger
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Ugeskrift for laeger · Feb 2008
Review[Hemodynamic monitoring with the lithium dilution cardiac output system].
The lithium dilution cardiac output (LiDCO) system measures cardiac output beat-to-beat with high precision. The system is based on an arterial pulse power analysis which is calibrated every eight hours with a small non-pharmacological dose of lithium. The system is minimally invasive; it requires only a peripheral arterial catheter and a venous access. Dynamic parameters for early goal-directed therapy are also provided.
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Regional nerve blocking techniques offer a suitable alternative to local infiltration anaesthesia for facial soft tissue-surgery. Moreover, they present several advantages over general anaesthesia, including smoother recovery, fewer side effects, residual analgesia into the postoperative period, earlier discharge from the recovery room and reduced costs. The branches of the trigeminal nerve and the sensory nerves originating from the upper cervical plexus can be targeted at several anatomical locations. We summarize current knowledge on facial nerve block techniques and recommend ten nerve blocks providing efficient anaesthesia for the entire head and upper-neck region.
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Ugeskrift for laeger · Feb 2008
[Hospital staff's different attitudes and experiences with regard to immigrant patients].
The study investigates hospital staff's different attitudes and experiences with regard to immigrant patients as a basis for educational initiatives. ⋯ There is a need for educational interventions relating to major issues such as communication and culture and to specific issues of immigrants' health and disease patterns in a global perspective. The starting point of interventions should be the specific interests and needs of the different groups of professionals.
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Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare conditions with high mortality. IAH is an intraabdominal pressure (IAP) above 12 mmHg and ACS an IAP above 20 mmHg with evidence of organ dysfunction. IAP is measured indirectly via the bladder or stomach. ⋯ When the content exceeds the compliance of the abdominal wall, the IAP rises. Increased IAP affects the functioning of the brain, lungs, circulation, kidneys, and bowel. The treatment of ACS is a reduction of IAP.
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Ugeskrift for laeger · Feb 2008
Review[Neisseria meningitidis. The pathophysiological role of lipopolysaccharides in association with meningococcal disease and septic shock].
A major pro-inflammatory and toxic component of N. meningitidis is lipopolysaccharide (LPS). LPS contributes to severe symptoms of meningococcal disease, septic shock and severe coagulopathy, in part by increasing pro-inflammatory mechanisms and reactive oxygen species. Recent technologies have increased the likelihood of developing an anti-meningococcal immunization strategy based upon the virulence of LPS which may lead to a vaccination against this important pathogen including serogroup B disease. This review summarizes recent findings that may provide a safe, effective prophylaxis and therapy.