Ugeskrift for laeger
-
Ugeskrift for laeger · Jun 1998
Review[Lung physiotherapy as prophylaxis against atelectasis and pneumonia after abdominal surgery].
Postoperative pulmonary complications play a significant role for the postoperative morbidity after abdominal surgery. To prevent this, an array of methods, such as lung physiotherapy, incentive spirometry, or mask treatment with positive airway pressure are used. ⋯ Thus, we recommend lung physiotherapy as prophylactic treatment after abdominal surgery. The value of optimized pain alleviation and mobilisation in addition to lung physiotherapy should be evaluated in future trials.
-
Two patients with a lateral tibia avulsion fracture (Ségond fracture) are presented. The correlation between the Ségond racture and rupture of the anterior cruciate ligament is pointed out, as well as the fact that patients with Ségond fracture and rupture of the anterior cruciate ligament often have other injuries such as meniscus lesions and lesion of the medial collateral ligament.
-
The paper reviews the literature relevant to the formation of spinal epidural abscess with or without concurrent meningeal infection following epidural catheterisation. The incidence of spinal epidural abscess lies probably in the area of 1:5000 catheterisations. Immunocompromised patients and patients with catheters in situ for more than 48 hrs. are particularly prone to develop epidural abscesses. ⋯ The treatment consists of removal of the catheter, microbiological studies, surgical decompression of the spinal cord, and prolonged antibiotic treatment. It is suggested that insertion of epidural catheters is performed under strict sterility, and that disposable syringes and unbroken vials are used for each injection, which should be administered through an epidural filter. The dressing should be changed daily simultaneously with review of the patient and the insertion site.
-
Ugeskrift for laeger · Apr 1998
Review[AIDS-related non-Hodgkin lymphomas. Clinical picture and prognosis].
Patients infected with HIV are at high risk for developing non-Hodgkin's lymphomas (NHL). HIV-associated NHLs seem to be increasing in number. They consist of two major histopathological subtypes originating from B-lymphocytes: Burkitt-like lymphomas and diffuse large cell lymphomas. ⋯ Patients with AIDS often have widespread disease at presentation and frequent involvement of extranodal sites (CNS, liver, bone marrow, the digestive tract and skin). The treatment of NHL in AIDS patients is controversial due to their poor response to chemotherapy as well as a tendency to develop severe hematological toxicity. Factors with a negative influence on the prognosis are: Extranodal localisation of NHL including CNS, CD4 count below 200 x 10(6)/l, platelet count below 130 x 10(9)/l, widespread symptoms of disease, presence of EBV in the lymphoma and immunoblastic histology.
-
Cervical necrotizing fasciitis is a rapidly progressive infection that involves the superficial and deep cervical fascia. Underestimation of this severe neck infection can delay diagnosis and treatment of this often fatal disease process. Three new cases, all with mediastinitis and fatal outcome are presented. Early diagnosis, aggressive surgical treatment and antibiotic therapy is essential if the high mortality rate is to be brought down in the future.