Ugeskrift for laeger
-
Ugeskrift for laeger · Nov 2014
Case Reports[No compression of cardiac cavities in transthoracic ultrasound does not exclude cardiac tamponade].
The clinical presentation of cardiac tamponade is difficult to distinguish from other causes of shock. Pericardial fluid is easy to visualize with cardiac ultrasound and a key sign of overt cardiac tamponade is the compression of right side cavities. We present two cases in which cardiac tamponade was present, but where compression of cardiac cavities could not be demon-strated with transthoracic cardiac ultrasound. This emphasizes that cardiac tamponade is still a clinical diagnosis.
-
Ugeskrift for laeger · Nov 2014
Review[Genetic variation may influence the development of persistent postsurgical pain].
Persistent postsurgical pain is a major clinical problem. It is not fully understood why some patients develop persistent postsurgical pain while others do not. ⋯ The evidence in this area is sparse and the results are heterogeneous. Further studies are needed before firm conclusions can be made.
-
Ugeskrift for laeger · Oct 2014
Review[Genetic counselling is relevant in familial as well as sporadic cases of amyotrophic lateral sclerosis].
Amyotrophic lateral sclerosis (ALS) is a progressive and fatal neurodegenerative disease of upper and lower motor neurons which often results in death from respiratory failure within 2-4 years. It has been estimated that 5-10% of ALS patients have a family history with ALS. The genetic background of the disorder is heterogeneous, and recently molecular genetic testing has become increasingly relevant, also in the clinical evaluation. As several genes have been identified in which the pathogenic mutations are characterized by reduced age-dependent penetrance, genetic testing can be relevant to consider, also in isolated cases.
-
Morbid obesity in teenagers has become an increasing problem. Conventional diet has not yet shown effective long-term weight loss. ⋯ Still, surgery performed on adolescents provides ethical challenges such as the unknown long-term prognosis after surgery. Despite these challenges, in cases of severe intractable obesity or development of life-threatening complications due to obesity, surgery should be considered.
-
Ugeskrift for laeger · Sep 2014
Case Reports[Liver lesion in a cardiac arrest patient treated with therapeutic hypothermia.]
Cardiac arrest patients receive cardiopulmonary resuscitation. If resuscitated therapeutic hypothermia (TH) improves outcome. The following coagulopathy caused by TH, antithrombotic drugs and acidosis can induce severe haemorrhage from non-acknowledged organ lesions. ⋯ By coincidence the lesion was found on a computed tomography scan. The patient remained circulatory stabil during TH and was discharged in good cerebral state. However, should these patients rutinely be scanned?