Ugeskrift for laeger
-
Ugeskrift for laeger · Apr 2000
Comparative Study[Big differences in the frequency of polypharmacy between physicians].
Polypharmacy, the simultaneous use of multiple drugs, is associated with adverse drug reactions, medication errors, and increased risk of hospitalisation. When the number of drugs is five or more (major polypharmacy), a significant risk may be present. We analysed the prevalence of major polypharmacy among listed patients, and identified possible predictors of major polypharmacy related to the practice. ⋯ Possible predictors of major polypharmacy related to the GPs were analysed by backward stepwise linear multiple regression. A six-fold variation between practices in the prevalence of major polypharmacy was found, i.e. from 16 to 96 per 1000 listed patients (median: 42). Predictors related to the practice structure, workload, clinical work profile, and prescribing profile could explain 56% of the variation.
-
Traumatic abdominal hernia remains a rare clinical entity despite an overall increase in blunt abdominal traumas. A case is presented, in which the left colonic flexure herniated due to direct trauma to the left side of the abdomen. The diagnosis of traumatic hernia may be established by CT scan and due to a high incidence of associated intraabdominal injuries, early exploration and repair is advocated.
-
Inhaled nitric oxide (iNO) has been extensively used in the treatment of severe hypoxaemic respiratory failure and/or pulmonary hypertension. Although the majority of studies have almost consistently demonstrated a beneficial effect on oxygenation and a reduction in pulmonary artery pressures, none of the randomised trials have reported a reduced mortality using iNO on patients with severe respiratory failure. In neonates with severe respiratory failure and pulmonary hypertension, however, iNO can reduce the need of extracorporal membrane oxygenation. Prior to using iNO on adult patients we suggest other measures to be taken (i.e. optimising ventilator settings, ventilation in prone position).
-
Ugeskrift for laeger · Jan 2000
Clinical Trial Controlled Clinical Trial[Predictive factors of the effect of multidisciplinary, intensive rehabilitation of back pain. Demographic, socioeconomic and physical factors].
In order to identify possible predictive factors for success from rehabilitation in a functional restoration (FR) program for patients with chronic low back pain, pre-treatment baseline variables were correlated to different outcome parameters following treatment in either a FR program or control programs. A prospective clinical trial involving 816 patients was carried out. Of the total cohort 621 patients participated in a FR program and 195 in control groups. The results showed that different factors could be identified as useful in predicting outcome from a FR program, but most of these factors were also shown to predict success for controls of shorter outpatient programs or of no treatment.