Ugeskrift for laeger
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Ugeskrift for laeger · Apr 1991
Comparative Study[Burn injuries due to fireworks during New Year holiday. A 10-year case load].
Minor burns due to fireworks which are treated in the Casualty Department have remained constant during the past ten years. The injured patients are boys and young men between 7-19 years. Boys are injured ten times as frequently as girls. ⋯ The number of patients admitted to hospital on account of serious burns has increased. These are most frequently caused by clothes catching fire from fireworks which have been hidden under outer clothes or in trouser pockets. In order to avoid the serious burns caused by burning clothes, it is recommended that fireworks should not be concealed under clothes but carried away from the body possibly in a container made of non-inflammable material.
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We investigated 131 consecutive patients who were submitted to orthopaedic surgical interventions under spinal anaesthesia during a period of 12 months. Prior to operation, all of the patients were classified according to the Boston Cardiac Risk Index. Immediately before operation, approximately 500 ml sodium chloride solution was infused. ⋯ In Boston group III, the postoperative mortality was 42% as compared with 1% and 7% in the Boston groups I and II, respectively (p less than 0.05). It is concluded that the risk of fall in blood pressure during spinal anaesthesia may be predicted by the Boston Cardiac Risk Index and that patients who develop haemodynamic instability during spinal anaesthesia have an increased risk of developing complications. These patients should be offered maximal postoperative observation and care.
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Ugeskrift for laeger · Apr 1991
Review[Therapeutic pleurodesis in spontaneous pneumothorax, malignant pleural effusion, heart insufficiency and chylothorax].
Treatment with pleurodesis is employed in spontaneous pneumothorax, in pleural effusion due to neoplastic disease, intractable transudate and chylothorax. When this treatment is employed in spontaneous pneumothorax, randomized studies show a lower recurrence rate when drainage is supplemented by a sclerosing agent. Pleurodesis alone scarcely alters the recurrence rate in pneumothorax. ⋯ No randomized studies of pleurodesis in congestive heart failure and chylothorax were found. Pleurodesis is not recommended in the treatment of congestive heart failure because of reports of development of contralateral pleural effusion after successful pleurodesis. In chylothorax, pleurodesis is the last resort.
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Ugeskrift for laeger · Mar 1991
Review[Health risks of obesity. Significance of the regional distribution of adipose tissue].
This review concentrates on recent prospective studies concerning evaluation of the health risk of obesity with special reference to the impact of the distribution of the adipose tissue. Analysis of the data indicates that adipose tissue localized to the abdominal region (especially intraabdominal fat) is associated with an enhanced risk profile including elevated levels of triglycerides and insulin, low levels of high density lipoprotein-cholesterol and elevated blood pressure. Abdominal obesity, determined by the waist/hip ratio, was associated with cardiovascular disease, premature death and non-insulin demanding diabetes mellitus. ⋯ In conclusion, obesity and the abdominal localization of adipose tissue seem to be two separate entities with different pathogenesis and clinical consequences. The abdominal obesity is the type which is predominantly associated with enhanced health risks. These associations may result in an altered strategy of treatment of the obese population.
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Ugeskrift for laeger · Mar 1991
[Serum concentration of lidocaine and its active metabolite monoethylglycinexylidine during fiberoptic bronchoscopy under local anesthesia].
Fiberoptic bronchoscopy was performed in local anaesthesia with lidocaine in 16 patients. Serum concentrations of lidocaine and its active metabolite monoethylglycinexylidide (MEGX) were measured at regular intervals up to 120 min. after administration. Lidocaine was administered as aerosol in the upper respiratory tract and as solution in the bronchial tree. ⋯ The highest median S-MEGX concentration, 1.7 mumol/l, was measured 120 min. after administration. The highest individual S-MEGX was 3.5 mumol/l. The highest, although insignificant, correlation coefficients were found between lidocaine dose expressed in mg/kg body weight and S-lidocaine and S-MEGX.