Ugeskrift for laeger
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Ugeskrift for laeger · Oct 2013
Case Reports[Hypoglossus and laryngeal nerves palsy after an intubation for Legionella infection].
Extracranial involvement of the hypoglossal nerve and recurrent laryngeal branch of the vagal nerve can be a complication of anaesthetic airway management (Tapia's syndrome) or focal involvement due to Legionella infection. We present a patient with bilateral hypoglossal and unilateral recurrent laryngeal nerves palsy after a complicated intubation and a Legionella infection. ⋯ Within months, tongue mobility and swallowing gradually improved. Two months after discharge persisting unilateral recurrent nerve palsy was observed.
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Restoration of sinus rhythm should be considered in patients with atrial fibrillation. Prior to cardioversion, each patient must be assessed individually. ⋯ In patients who are candidates for elective treatment, cardioversion can be performed pharmacologically or by DC cardioversion. The choice of the cardioversion method is based on advantages and disadvantages of each method, although both methods are safe and effective in most patients when used correctly.
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Ugeskrift for laeger · Oct 2013
Case Reports[Spontaneous rupture of the spleen after infectious mononucleosis].
Non-traumatic rupture of the spleen (NRS) is a rare but serious complication to infectious mononucleosis (IM) and it is important to have in mind, when patients have IM. Although splenectomy has been advocated as the appropriate treatment for this problem, the trend goes towards conservative treatment of the haemodynamically stable patients, but because of its rarity no clear guidelines have been suggested. We present a case of a 18-year-old boy with IM who had NRS with subcapsular haematoma and was treated conservatively. He recovered completely.
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Ugeskrift for laeger · Oct 2013
Case Reports[Coincidental ipsilateral Colle's fracture and scaphoid fracture after low energy trauma].
Distal radius fractures are frequently seen in the emergency room. Scaphoid fractures are frequently seen as well. ⋯ He had pain in his right wrist, and an X-ray examination revealed a Colles' fracture with a 30 degree dorsal angulation and an undislocated transverse fracture of the scaphoid bone. The case illustrates that special attention should be given to the examination of the wrist and the first finger beam to exclude associated injuries.
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Based on 19 studies (7,238 participants) a Cochrane review concludes that the addition of caffeine to an analgesic drug provides superior analgesia compared with the analgesic drug alone. The benefit is small, with a number needed to treat of approx. 16. The use of analgesics containing caffeine is associated with an increased risk of the development of physical dependence, overuse headache, and withdrawal symptoms upon abrupt discontinuation. Combination analgesics with caffeine should only be used temporarily and exclusively for the treatment of acute pain conditions.