Ugeskrift for laeger
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Ugeskrift for laeger · Mar 2017
Case Reports[Genital actinomycosis and pelvic abscesses in a woman with a 13-year-old intrauterine device].
A 55-year-old woman who had had the same intrauterine device (IUD) for 13 years was referred to the gynaecology outpatient clinic due to constitutional symptoms, abdominal pain and vaginal discharge. Diagnostic imaging showed multiple pelvic abscesses, and severe chronic endometritis with Actinomyces was found in an endometrial biopsy. The patient underwent surgical drainage of the accessible abscesses and started long-term antibiotic treatment. This case report illustrates that actinomycosis is an important differential diagnosis in symptomatic women with IUD and suspected gynaecologic malignancy.
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Ugeskrift for laeger · Jan 2017
Case Reports[Acute monosymptomatic anisocoria after removing a scopolamine patch from a patient].
Acute anisocoria requires timely examination to rule out intracranial pathology. This case report describes a 34-year-old nurse who experienced blurred vision and unilateral mydriasis. ⋯ The symptoms remitted completely within 24 hours. Knowledge of this benign phenomenon is important in order to advise patients and caregivers when handling a scopolamine patch, and in order to avoid unnecessary investigations.
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Ugeskrift for laeger · Jan 2017
Review[Practical management of troponin screening after non-cardiac surgery].
Myocardial injury after non-cardiac surgery (MINS) is associated with significant morbidity and mortality. Routine troponin screening is necessary to identify patients with MINS. Although some evidence indicates benefit with aspirin and statin therapy in these patients, a number of clinical considerations must be done in the practical management of MINS. This article describes current experience with identification and treatment in Denmark of patients with MINS.
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Trauma haemorrhage is a common reversible cause of death. Haemostatic resuscitation focuses on replacing the lost blood with transfusions equivalent to whole blood as early as possible. In Denmark, the optimal ratio for transfusions in massive bleeding is four packs of red blood cells, four packs of plasma and one pool of platelets (equal to ratio 1:1:1 in USA). Haemostatic resuscitation also includes a restricted use of crystalloids, early tranexamic acid, and a goal-directed transfusion therapy by using viscoelastic haemostatic assays to detect coagulopathy and the need for additional transfusions or pro-haemostatics.
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Approximately 0.5-2% of upper viral infections are com-licated by secondary acute bacterial sinusitis and may in rare cases evolve into more serious complications such as meningitis and intracranial abscess. Symptoms are often subtle and nonspecific as fever, headache, scalp tenderness, nausea and altered mental status. In this case report of a 12-year-old boy with an epidural abscess secondary to sinusitis we intend to increase the knowledge to these rare, but potentially life-threatening complications to ensure the optimal and timely treatment.