Ugeskrift for laeger
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In modern anaesthesiology fasting preoperatively has been introduced in order to minimise the incidence of aspiration to the lungs. Since the 1990's studies have confirmed the safety of the current fasting regime of six hours for solids and two hours for fluids. By allowing the intake of carbohydrate-rich fluids until two hours before induction of anaesthesia, it has been shown that the negative effects of fasting such as thirst, starvation and anxiety are minimised. In the future, ultrasound technology might be used to assess the gastric volume prior to induction of anaesthesia.
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Ugeskrift for laeger · Sep 2015
Review[Patients with chronic obstructive pulmonary disease and heart disease can benefit from beta-blocker treatment].
Chronic obstructive pulmonary disease (COPD) and coronary heart disease share smoking as the most important common risk factor and there is a high prevalence of cardiovascular disease among COPD patients. Although cardioselective beta-blockers are safe in treatment of COPD, they are often withheld in these patients. In observational studies, beta-blocker treatment is associated with significantly reduced mortality and reduced risk of exacerbations of COPD. This effect may be caused by the beneficial effect of beta-blockers on heart failure, tachycardia and upregulation of beta-receptors in the airways.
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Ugeskrift for laeger · Sep 2015
Case Reports[Early diagnosis and treatment of Boerhaave's syndrome is pivotal for the prognosis].
Hydropneumothorax following oesophageal rupture is very rare and often lethal. We report case of a 78-year-old man with known Barret's oesophagus with increasing shortness of breath and right chest pain followed by increasing emesis. ⋯ Oesophageal perforation can lead to pneumothorax and pleural fluid. Early diagnosis is pivotal to reduce mortality.