Ugeskrift for laeger
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Hepatic encephalopathy (HE) is the neuropsychiatric syndrome that occurs as a complication to liver failure in patients with acute or chronic liver disease. Mental status in this syndrome can range from subtle deficits to coma, with respiratory insufficiency and aspiration to the lungs. The mortality is high. ⋯ Transient improvement of the condition is seen in a subgroup of patients after administration of flumazenil, a specific benzodiazepine antagonist. The group of patients with a positive response to flumazenil therapy may have a better prognosis. Flumazenil may be used in patients in the pretransplantation phase.
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Ugeskrift for laeger · Aug 2000
Randomized Controlled Trial Clinical Trial[Neutralization of lidocaine-adrenaline. A simple method for less painful application of local anesthesia].
The amount of sodium bicarbonate necessary to neutralise commercially available lignocaine-epinephrine (pH 4.7) to physiologically neutral pH (7.4) was established. The analysis showed that neutral pH could be accomplished by adding 1.0 ml sodium bicarbonate (8.4 g/l) to 10 ml lignocaine-epinephrine (1%, 5 microgram/ml). Chemical analysis also established that the neutralised lignocaine-epinephrine was stable for 24 hours after adding sodium bicarbonate. A double-blinded randomised clinical trial with crossover design done on volunteers from hospital staff proved that injection of neutralised lignocaine-epinephrine is less painful than commercially available lignocaine-epinephrine (p < 0.001).
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Today most upper respiratory tract infections are mild and of short duration with minor risk of complications. Hence, the effects of antibiotic treatment are marginal. ⋯ A review of the literature about antibiotic treatment of upper respiratory tract infections shows that most published studies exclude two categories of patients: children below the age of 6 months and patients who are severely ill. Therefore, there is an additional need for further studies focused on select groups of patients to investigate the benefit, if any, of antibiotic treatment as well as to study the effect of introducing near-patient-tests and the use of extended microbiological service in daily clinical practice.