Ugeskrift for laeger
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Ugeskrift for laeger · Oct 2005
Case Reports[Don't always rely on PACS: undetected loss of a central venous catheter guide wire].
A 74-year-old woman had a CVC inserted. Unfortunately, the guide wire was lost under the procedure, and despite a chest X-ray control it was not detected. The reason the guide wire was not identified was insufficient fine-tuning of the >local< PC monitor. We recommend regular fine-tuning of monitors used for X-ray control.
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Ugeskrift for laeger · Oct 2005
[Does evidence lead to a change in clinical practice? Danish anaesthetists' and nurse anesthetists' clinical practice and knowledge of postoperative residual curarization].
Recent studies have shown a high incidence of postoperative residual curarization (PORC). The reason for this is unclear. The purpose of this study was to evaluate whether the methods used by Danish anaesthetists to exclude PORC are evidence-based and, if they are not, to determine the reasons why. ⋯ The results indicate that Danish anaesthetists" clinical practice regarding residual curarization is often not evidence-based. The reason for this seems to be a lack of knowledge, rather than lack of resources and/or a negative attitude toward neuromuscular monitoring.
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Ugeskrift for laeger · Oct 2005
Review[Surgery on articular cartilage: from debridement to tissue engineering].
Articular cartilage is a complex tissue with a limited endogenous repair capacity. Surgical strategies to stimulate repair of damaged cartilage are presently evolving extensively. New techniques based on tissue-engineering principles with cultured cells and scaffolds are challenging established techniques based on generating a repair response from the bone marrow. ⋯ Debridement and marrow stimulation can provide significant relief of symptoms. Recently, randomized studies have uncovered some of the clinical effects of the new biotechnology-based surgical methods. However, no significant advances over the established surgical techniques have been developed.
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Ugeskrift for laeger · Sep 2005
Case Reports[Imiquimod treatment of lentigo maligna to dermoscopic and histologic clearance].
Imiquimod is an immune system-modifying drug that switches the immune system to a Th1 response, enabling it to defeat virus-infected and neoplastic cells. We report on a 94-year-old woman with a large lentigo maligna (LM) on her cheek whom we treated with imiquimod 5% cream. ⋯ By week 19 the lesion was cleared, and no remnants of the lesion were seen by dermoscopy or histology. Published LM cases treated with imiquimod are reviewed.
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Propofol infusion syndrome, characterised by cardiovascular collapse, metabolic acidosis, hepatomegaly, renal failure and rhabdomyolysis, is a rare and often fatal syndrome seen in critically ill children undergoing long-term propofol sedation. Propofol may impair mitochondrial free fatty acid metabolism, resulting in an imbalance between energy demand and utilisation and thus compromising cardiac and peripheral muscle cell function. Propofol should be used with caution for sedation in critically ill children, as well as for long-term anaesthesia in otherwise healthy children, and doses exceeding 4 mg/kg/h should be avoided.