Ugeskrift for laeger
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Ugeskrift for laeger · Jun 2008
Case Reports[Adrenal insufficiency during inhaled corticosteroid treatment in a child with asthma].
We report a 12 year-old asthmatic girl with adrenal insufficiency during inhaled corticosteroid treatment. Symptoms, investigations and treatment are discussed.
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Biological therapy as treatment of inflammatory bowel diseases has been one of the major achievements since the introduction of steroids. Infliximab has been approved for the treatment of Crohn's disease and ulcerative colitis, and adalimumab for the treatment of Crohn's disease. Both treatments have documented effect for induction of clinical response and remission, and can be used to maintain remission. However, it is important to define the treatment goals before initiation, and whether biologicals should be used alone or together with immunosuppressants as azathioprine.
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Treatment of the hypothermic patient depends more on the clinical condition than on the core temperature. Unconscious patients need thorough investigation, and they can often be rewarmed with warm water in the pleural cavities. ⋯ The diagnosis of death can be difficult in the hypothermic patient. A rescue team is available to assist in rewarming at local hospitals.
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Ugeskrift for laeger · Jun 2008
Comparative Study[Multimodal treatment of pain and nausea in breast cancer surgery].
Every year 4000 women in Denmark undergo surgery for breast cancer. According to published literature approximately 50% suffer from post-operative nausea and vomiting (PONV) and moderate pain. No national guidelines are available regarding the treatment or prevention of pain and PONV associated with surgery for these patients. ⋯ It is possible with a multimodal opioid-sparing prevention and treatment regime for pain and PONV to gain optimal postoperative pain and nausea control without significant problems with respect to sedation.
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Ugeskrift for laeger · Jun 2008
[Respiratory depression in delirium tremens patients treated with phenobarbital. A retrospective study].
Delirium tremens (DT) is the most severe manifestation of alcohol withdrawal which--if untreated--has a high rate of mortality. Barbiturates are the most effective drug but respiratory depression may occur. In the present study we investigated the frequency of respiratory problems in DT patients treated with phenobarbital. ⋯ In conclusion, we found that the frequency of phenobarbital-induced respiratory depression was low. However, if the DT was complicated with pneumonia, life-threatening respiratory insufficiency could be the outcome. An intensive focus on the patient's somatic condition in DT is therefore recommended, and it should always be possible to move the patient to the ICU.