Ugeskrift for laeger
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Ugeskrift for laeger · Dec 2014
Case Reports[Vena cava agenesia presented as incarcerated groin hernia].
The case describes a 45-year-old man with a rare finding of vena cava agenesia presented as incarcerated groin hernia. From childhood the patient had developed dilatation of subcutaneous veins with establishment of aneurismal dilatation in the lower right side of the abdomen and groin. ⋯ The case describes the difficulties of an initially incorrect radiological diagnosis of incarcerated groin hernia and the discrepancy of the clinical findings. The case stresses the importance of a thorough evaluation of each patient.
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Ugeskrift for laeger · Dec 2014
Case Reports[Self-treatment with baking soda can lead to severe metabolic alkalosis].
This case report describes a 66-year-old man, previously healthy besides mild hypertension. He ingested a self-made folk remedy consisting of baking soda and water against acid reflux in dosages that resulted in severe metabolic alkalosis (pH 7.8). ⋯ The challenge is to uncover patients' use of non prescription medications and folk remedies in the diagnostic process. Having this information it is possible to prevent MA in both high- and low-risk patients.
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Ugeskrift for laeger · Dec 2014
Case Reports[Jejunal diverticulitis as the cause of acute abdomen].
We present two patients with jejunal diverticulitis. Diverticula in jejunum and ileum are very rare, occurring with an incidence of 0.07-2% in the gastrointestinal tract. ⋯ If there is an occurrence of peritonitis as a complication of jejunal diverticulitis, laparatomy may be indicated. Both of the patients received a conservative treatment with intravenous fluids and antibiotics with good response.
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Ugeskrift for laeger · Dec 2014
Review[Endoscopic ultrasound-guided coeliac plexus neurolysis to reduce pain in patients with pancreatic cancer].
Pain is among the most common symptoms in patients with pancreatic cancer and up to 80% require analgesics, most often as opioids. Unfortunately the analgesic effect is frequently insufficient, and increasing doses are required, resulting in unpleasant side effects. Endoscopic ultrasound-guided neurolysis is a well established method to alleviate or reduce pain due to pancreatic cancer with a documented effect in 80% of patients. The aim of this review is to draw attention to endoscopic ultrasound-guided neurolysis and to discuss its potential which may not be fully utilized.
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Ugeskrift for laeger · Dec 2014
[Standard ballpoint pens disappear from the coats with a half-life of nine days].
Ballpoint pens are important tools for the daily work of the physicians. However, a practical challenge seems to be that they disappear just when one needs them most. We call this the ballpoint pen paradox. We have studied the fate of 60 ballpoint pens in an outpatient clinical setting. Five physicians, five nurses and five medical secretaries were equipped with four barcode-tagged ballpoint pens. During follow-ups, we systematically searched the participants' coat and the department for the barcode-tagged ballpoint pens. We illustrated the migration of the ballpoint pens using a diagram and tested fit of linear and exponential trend line. The ballpoint pens displayed a tremendous migration in the department. Disappearance from the coat was exponentially with a half-life of 9 days - only 23% were left after 18 days. Disappearance from the department was linear with a 3% loss per day - only 42% were left after 18 days. Ballpoint pens have a high migration and turnover rate. The fate is unknown for a great amount of ballpoint pens. They are treated carelessly, which finally results in waste of time and resources. It may be that the ballpoint pen paradox can be diminished by phasing out ballpoint pens of low quality. ⋯ not relevant.