Ugeskrift for laeger
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Ugeskrift for laeger · Apr 1998
Review[Surgical technique in Cesarean section. Evidence or tradition?].
The literature was reviewed in order to find clinical-epidemiological and physiological evidence for which surgical techniques should be preferred when performing Caesarean section. We found reasonable evidence for the following procedure: spontaneous placenta detachment, uterine repair in one layer and non-closure of the peritoneum.
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Ugeskrift for laeger · Apr 1998
[Five-year survival in persons aged 40 years or over with newly diagnosed diabetes mellitus].
The five- to six-year all-cause mortality is analysed in 1323 newly diagnosed diabetic patients aged 40 years or over. The median age at diagnosis is lower for males (63.6 years) than for females (67.5 years), but more males (24.7%) than females (20.0%) have died (p = 0.04). This male excess mortality can mainly be attributed to the 60-79-year old males. ⋯ For males this excess mortality becomes statistically significant four years after diagnosis for the 40-59 year-olds and after six years for the 60-79 year-olds. For females and very old males no statistically significant excess mortality is observed, but after two to four years there is a tendency for the survival curve of 40-79-year old females to separate from that of the Danish female population to show an excess mortality. In this population-based study the disadvantageous mortality experience of even newly-diagnosed diabetic patients is clearly demonstrated.
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Ugeskrift for laeger · Mar 1998
[The emotions of physicians. Significance of physicians' emotional reactions to the patients].
During the last thirty years there has been a growing interest in research into physician-patient interaction. This article highlights the research which concerns the physician's countertransference feelings. The concept of countertransference is described and a classification with relevance for physicians in general is explained. ⋯ Examples are given of categories of patients, who often evoke specific countertransference feelings in the physician. The consequences of the countertransference feelings for the physician himself are discussed and examples are given of particular situations where countertransference feelings could be of importance. Finally, the existing possibilities to learn about handling countertransference feelings are surveyed and the authors emphasize the need for more research in this particular field.
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Ugeskrift for laeger · Mar 1998
[Percutaneous blood exposure among Danish physicians. Mechanisms and prevention].
The study describes the mechanisms of percutaneous blood exposure (PCE) among Danish doctors and discusses rational strategies for prevention. Data were obtained as part of a nation-wide survey of occupational blood exposure. The most recent percutaneous or mucocutaneous exposure within the previous three months was described. ⋯ Up to 53.3% of PCE on hollow-bore needles could be attributed to unsafe routines only. In conclusion, education in safer working routines are needed in all specialties. Introduction of safer devices should have a high priority in surgical specialties, and should be considered in non-surgical specialties too.
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Ugeskrift for laeger · Feb 1998
Comparative Study[Quantitative EEG in assessment of anesthesia depth. Methods of comparison].
Methodology for assessment of depth of anaesthesia based on analysis of the electroencephalogram (eeg) is controversial. Techniques range from display of single measures, for example median value of the frequency spectrum, to dedicated pattern recognition systems based on measures of several eeg features. We have compared the performance of four techniques using tape-recorded data from 23 patients anaesthetised with either halothane or isoflurane using standardised regimens. ⋯ Dose-response curves are presented for stepwise increases in stable end-tidal concentrations of each agent. Results indicated considerable inter-patient variability and showed the limitations of single eeg measures, particularly with deeper anaesthesia producing burst suppression patterns in the eeg. Pattern recognition techniques reduced these difficulties and appeared to be promising over a wide range of anaesthetic levels.