Ugeskrift for laeger
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Ugeskrift for laeger · Apr 2009
[Mild therapeutic hypothermia after cardiac arrest through continuous dialysis].
Mild therapeutic hypothermia (32-34 degrees C) after resuscitation from cardiac arrest to protect the brain against global ischaemia was first described in two independent randomized controlled studies in 2002. This manuscript describes a method to induce and maintain a target temperature of 32-33 degrees C after cardiac arrest for 24 hours with continuous renal replacement therapy (CRRT). ⋯ The described CRRT cooling method is a useful method for reaching and maintaining the target temperature. The method is especially suitably for intensive care units that use CRRT on a daily basis for patients with acute renal failure.
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Ugeskrift for laeger · Apr 2009
Randomized Controlled Trial[Reasons for non-attendance and cancellations in a paediatric outpatient clinic].
It is important to identify reasons for non-attendance and late cancellations in the health care system to be able to plan possible interventions. ⋯ In the control group more than 70% of late cancellations and non-attendances could have been predicted by the parents, receiving a mailed reminder reduced this proportion significantly. It remains a challenge to reduce the number of non-Danish speaking patients not attending.
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Ugeskrift for laeger · Apr 2009
Case Reports[Acute hyperphosphatemia in a dialysis patient after administration of sodium phosphate].
We describe a case of severe hyperphosphatemia due to phosphate-based enema for the preparation of coloscopy. A 39-year-old man with end-stage renal failure was admitted with bloody diarrhoea. ⋯ The patient recovered after daily dialysis and administration of intravenous calcium. The case demonstrates the need to avoid using phosphate-based laxatives in patients with impaired renal function.
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Ugeskrift for laeger · Apr 2009
[Minor dentoalveolar surgery in patients ungergoing antithrombotic therapy].
Minor oral dentoalveolar surgery can be performed safely without interrupting treatment with vitamin K antagonists provided the INR is within therapeutic range. Platelet inhibitors such as aspirin and clopidogrel may increase the risk of bleeding, but the risk of disabling or fatal sequelae is generally higher if the treatment is stopped. Application of local haemostatic agents and postoperative mouthwashes with tranexamic acid are recommended. Any changes in antithrombotic therapy must be undertaken in collaboration with the patient's prescribing physician.
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Ugeskrift for laeger · Apr 2009
[Endoscopy in patients receiving anticoagulation or antiplatelet therapy].
Drugs that interfere with haemostasis are widely used for thromboembolic diseases and cardiovascular protection. Gastrointestinal bleeding is a well-known complication, and endoscopists are often faced with decisions concerning the safety of endoscopic procedures in these patients. Based on expert opinion and on data from observational studies, we suggest algorithms for the approach to acute and elective procedures based on procedural risk and on risks for thromboembolic episodes.