Ugeskrift for laeger
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Ugeskrift for laeger · May 2011
Case Reports[Venovenous hemodiafiltration for patient with baclofen intoxication].
Twice a young man was admitted to hospital upon having taken baclofen overdoses by intention. The ingested dose was 1,850 mg at the first episode and up to 2,500 mg at the second. ⋯ The elimination pharmacokinetics and toxicokinetics for baclofen is not fully known. During the second submission a shorter elimination half-life time was observed and it might be due to either compartmental distribution of baclofen, or more likely caused by an advantageous effect of the CVVHDF.
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Presenting two cases of spontaneous dissection of cervical arteries. A 54 year-old male suffered from left-sided Horner syndrome and severe headache. MR cerebrum revealed a left internal carotid artery dissection. A 57 year-old female with left vertebral artery dissection was admitted to hospital due to repeated attacks of total blindness preceded by weeks of moderate headache.
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Modern patient care requires collaboration among health-care workers belonging to various functional units, departments and hospitals. When the responsibility for patients is handed over, information is easily lost. ⋯ We reviewed 417 papers and the analysis comprises 29 papers. The paper points out numerous problems in connection with the transfer of responsibility, showing the importance of focusing on patient handover as a vulnerable phase in patient care.
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Ugeskrift for laeger · May 2011
Review[Etomidate can not be recommended to patients with septic shock].
Due to a low cardiovascular complication rate even in patients with shock, etomidate is often used for intubation. Etomidate inhibits the steroid synthesis. A single bolus injection of etomidate has so far been considered to be safe. However, new investigations have shown that even a single bolus dose of etomidate inhibits the steroid synthesis and is associated with increased mortality in patients with septic shock.
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Ugeskrift for laeger · May 2011
Review[Remifentanil may in certain cases be used as an alternative to epidural analgesia for parturients].
Epidural analgesia remains the gold standard during labour, but is contraindicated in several clinical settings due to increased risk of serious complications. There are few effective alternatives to epidural analgesia. ⋯ Remifentanil appears to have a potential as labour analgesic. Careful monitoring of the parturient and the newborn is advised.