Ugeskrift for laeger
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An 89-year-old woman was admitted with a fractured hip. For pain relief a femoral catheter was placed. Later, it was not possible to remove the catheter by traction. ⋯ Knotting of catheters for regional anaesthesia is a rare, but known complication which should be suspected when resistance is met during catheter removal. If necessary, the catheter should be removed surgically. The entire catheter should be removed, since any remains may increase the risk of infection.
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Ugeskrift for laeger · May 2010
[Actively induced hypothermia following severe traumatic brain injury].
A Cochrane metaanalysis and a study performed on children have recently confirmed that therapeutic hypothermia does not improve outcome after severe traumatic brain injury (TBI). TBI is not comparable to a short episode of global ischemia, where therapeutic hypothermia has been shown to improve outcome. The difference may be explained by the fact that hypothermia-induced stress after a traumatic brain injury reduces cerebral perfusion in the penumbra zone, where local circulation is already reduced. Thus, to date there is no indication for therapeutic hypothermia in TBI patients.
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Ugeskrift for laeger · May 2010
Case Reports[Thrombolytic therapy after intraventricular haemorrhage].
Intraventricular haemorrhage (IVH) in the brain is associated with high mortality rates. Today, the treatment consists of control of the intracranial pressure and drainage of the blood using an external drain. ⋯ After few days of treatment there was no blood left in the ventricular system. The patient eventually achieved a good neurological outcome.
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Bromo-Dragonfly (BDF) is a designer drug chemically related to LSD and amphetamine. The first registration in Denmark was in October 2007. ⋯ Because of severe hallucinations and agitation the patient was detained at the hospital and received symptomatic treatment with large doses of benzodiazepines. Four days after hospitalization, the patient discharged himself without significant symptoms or paraclinical findings.
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This case-report presents a 5-year-old girl with gastrointestinal symptoms, who became increasingly confused over the last day before admission. She was believed to be in septic shock or have meningitis and was treated with normal saline infusion, glucocorticoid and antibiotics intravenously. A few days later she was diagnosed with primary adrenal insufficiency (Morbus Addison), which is a very rare disorder among children. If untreated, the condition is lethal, and should always be considered as a differential diagnosis in severely ill patients.