Ugeskrift for laeger
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Ugeskrift for laeger · Jan 2008
Case Reports[Post-tonsillectomy haemorrhage treatment with activated factor VII].
Tonsillectomy is a common procedure in otorhinolaryngology and postoperative haemorrhage is a well-known complication. In this case, a 34 year-old male with obstructive sleep apnoea and no coagulation defects was operated; 30 minutes after the operation he presented with primary post operative haemorrhage and surgical haemostasis was not possible. After one hour of secondary surgery tranexamacid 1 g and phytomenadione 10 mg was given, but the diffuse bleeding continued until recombinant factor VIIa 96 mg/kg was administered.
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Ugeskrift for laeger · Jan 2008
[Early supported discharge for patients with exacerbations of chronic obstructive pulmonary disease].
Hospital admissions due to exacerbations of COPD are frequent. UK studies have shown that early supported discharge (ESD) for patients with exacerbations of COPD can reduce the length of stay without adversely affecting mortality or readmission rates. However, experience of ESD in Denmark has not been reported. ⋯ Almost 20% of all admissions were eligible for ESD. Compared to British studies on ESD, our patients had more severe COPD. We cannot determine whether this model of care has reduced days in hospital, but costs and income seem to balance.
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Ugeskrift for laeger · Dec 2007
[Methicillin resistant S. aureus and multi-resistant Enterobacteriaceae. Two of the most significant resistance problems in Denmark].
The frequency of multi resistant bacteria (MRB) is also increasing in Denmark. This creates problems in hospitals as well as in primary health care. This paper focuses on the increase in MRSA and resistance against beta-lactams and quinolones in Enterobacteriaceae, including infection control measures against the transmission of these bacteria. The increase in MRB is a direct threat against the Danish antibiotic policy and MRB should continuously be handled without hesitation.
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Ugeskrift for laeger · Dec 2007
[Prevention of ventilator associated pneumonia in an intensive care unit].
Important pathogenic mechanisms in ventilator associated pneumonia (VAP) are pharyngeal colonization, micro-aspiration, and exogenously acquired pathogens. Semirecumbent positioning, subglottic suctioning, non-invasive ventilation, oropharyngeal application of chlorhexidine or antibiotics, and selective digestive decontamination (SDD) have all been shown to lower the incidence of VAP. However, regular use of SDD is not recommended in recent guidelines due to the risk of antimicrobial resistance. High hygienic standards and routine surveillance of VAP incidence are mandatory.
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Ugeskrift for laeger · Dec 2007
Comparative Study[Firework injuries in Denmark in the period 1995/1996 to 2006/2007].
The purpose of this study was to observe the occurrence and character of firework injuries on the two days around New Year in Denmark over the last decade. ⋯ Firework injuries are now half of the level in 1996/1997. Injuries caused by illegal fireworks and serious injuries have shown a downward tendency throughout the period. The actual number of severe injuries from illegal fireworks is now only 10% of the level in the mid-1990s. This reduction can be attributed to preventive campaigns, greater knowledge of the risk of fireworks in general as well as legislation. Continued focus on preventive campaigns, control of fireworks for the general public and control of firework distribution to professionals is recommended.