Ugeskrift for laeger
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Ugeskrift for laeger · Jun 1996
Case Reports[Large epiglottic lipoma. Intubation method for large tumors in the pharynx and larynx].
Large benign tumours in the aperture of the larynx are uncommon, and they are especially rare on the epiglottis. They are, however, important as they may cause fatal airway obstruction particularly at induction of general anaesthesia. We present a patient with a large lipoma originating in the vallecula epiglottica and the lingual surface of the epiglottis. ⋯ A commissure laryngoscope was used for visualisation of the laryngeal inlet and a flexible bougie was inserted into the trachea. After removal of the laryngoscope a 7 mm ID endotracheal tube was advanced over the bougie into the trachea. After securing the airway in this way general anaesthesia was induced and the table tennis ball sized lipoma was uneventfully removed.
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During pregnancy haemodynamic changes are a stress to the cardiovascular system. Women with previously asymptomatic cardiovascular disease may develop life-threatening cardiac failure because of the extra demands of pregnancy. Early diagnosis, close control and treatment during pregnancy, delivery and the postpartum period are essential. We report a case where a woman with a mitral stenosis and insufficiency of the mitral and aortic valves gave birth to a child by caesarian section.
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Postoperative pain management in children has been subject to increasing interest during the last decade, but is still insufficient. A survey is presented concerning postoperative pain management in children. The value of monitoring the pain as well as the opioid side effects in children is stressed, and such methods are presented. ⋯ It is concluded that the present insufficient management of postoperative pain in children is not due to the lack of methods and techniques, but rather to lack of sufficient utilization and comprehension of the possibilities. Moreover, pain management in children should be individualised. It is also necessary to be more aware of side effects of the pharmacological treatment.
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Ugeskrift for laeger · Apr 1996
Comparative Study[Mortality differences associated with moderate consumption of beer, wine and spirits].
In a prospective population study of 7,234 women and 6,051 men aged 30-79 years, information on beer, wine, spirits and tobacco consumption, and on education, income and body mass index were assessed in the period 1976-1978, and the population was followed until 1.1.1988 for mortality. With increasing intake, the wine-mortality risk function steadily decreased from a relative risk of 1.00 for those who never drank wine through 0.51 (95% confidence limits; 0.32-0.81) among those who drank three to five glasses per day. ⋯ For spirits consumption the relative risk of dying increased from 1.00 among those who never drank to 1.34 (1.05-1.71) among those with an intake of 3-5 drinks per day. Wine drinking showed the same relation to risk of death from cardio- and cerebrovascular disease as to mortality from all causes.