Ugeskrift for laeger
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Ugeskrift for laeger · Jun 2016
Review[Laparoscopic ultrasound imaging in colorectal cancer resection may increase the detection rate of small liver metastases].
Up to 20% of the patients with colorectal cancer (CRC) will have liver metastases at the time of the diagnosis, and some of these metastases may be missed during preoperative evaluation. While intraoperative ultrasound is considered the gold standard for liver evaluation during primary open CRC surgery, laparoscopic ultrasound (LUS) is not performed routinely during laparoscopic CRC surgery. Based on the available literature LUS had a higher detection rate for especially small liver metastases compared to preoperative imaging modalities, but better prospective trials are needed.
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Chewing of leaves from the Catha edulis (khat) plant has amphetamine-like, stimulating effects and is used in rituals among East African men. In recent years, a possible liver-toxic effect has been observed in Somali immigrants in Western countries and has in severe cases led to death or liver transplantation. It is discussed whether the liver insufficiency represents a severe ethnic variant of autoimmune hepatitis, or a khat-induced hepatitis with autoimmune features. We describe six patients with Somalian background and possibly khat-induced toxic hepatitis.
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Tranexamic acid inhibits the degradation of a newly formed fibrin clot. The drug reduces blood loss and transfusion requirements in a wide range of different clinical scenarios and patient settings. So far, tranexamic acid is not part of standard treatment among patients with gastrointestinal bleeding. ⋯ Tranexamic acid seems appropriate as adjuvant treatment during upper gastrointestinal bleeding. However, these patients are often old and have several co-morbidities. Therefore, thromboembolic risk and tranexamic acid dosage should be carefully evaluated.
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Ugeskrift for laeger · Apr 2016
Review[The use of chewing gum stimulates bowel motility after gynaecological surgery].
Post-operative ileus is a condition which occurs after abdominal surgery. The incidence of post-operative ileus after gynaecological surgery is estimated to be 10-15% (range: 5-25%). ⋯ Data on reduction in ileus symptoms and reduced hospital stay are not sufficient. Chewing gum is well tolerated and this article recommends it for post-operative optimization.