Ugeskrift for laeger
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Ugeskrift for laeger · Jul 2000
Review[Scandinavian guidelines for management of head injuries. Evidence-based management of minimal, mild and moderate head injuries].
The Scandinavian Neurotrauma Committee (SNC) was created by the Scandinavian Neurosurgical Society in order to develop evidence-based guidelines for improved care of neurotrauma patients. A MEDLINE search identified 475 papers dealing with the management of minimal, mild and moderate head injuries. Forty-two studies presenting Class II evidence on the initial management of such injuries were reviewed, and management guidelines were developed. ⋯ All patients with additional risk factors should be scanned and admitted. A flow-chart for clinical decision making and a Head Injury Instruction card is introduced. The SNC suggests guidelines that should be safe and cost-effective for the initial management of minimal, mild and moderate head injuries.
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Ugeskrift for laeger · Jun 2000
Review[Circulatory support with the mechanical heart, "HeartMate"].
Treatment with the mechanical heart, HeartMate, has been introduced in Denmark. Short-term circulatory support can be obtained by intraaortic balloon counterpulsation, an external centrifugal pump and the total artificial heart. Long-term circulatory support can be established by treatment with the HeartMate. ⋯ The patient's own heart improved during the treatment and the native heart functioned again after the system was explanted. The main complications during treatment are bleeding, infection, thromboembolic events and systemic failure. Permanent, fully implantable mechanical circulatory pumps are under development--which may herald the beginning of a whole new era for treatment of cardiac failure.
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The overall risk of premature death in patients with epilepsy is two to three times that of the general population. The mortality risk is highest in patients with symptomatic epilepsy, but the mortality rate is also increased in patients with idiopathic epilepsy, indicating that epilepsy itself carries an increased risk of premature death. Cerebrovascular disease and primary brain tumours are common causes of death in patients with symptomatic epilepsy, while sudden unexplained death (SUDEP), accidents, suicide and status epilepticus are important causes of epilepsy related deaths. Prevention of accidents and suicide in patients with epilepsy and further knowledge on SUDEP is essential in order to reduce the mortality rate of epilepsy.