Ugeskrift for laeger
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Ugeskrift for laeger · May 2011
[Hyperfibrinolysis as the cause of haemorrhage and increased mortality in trauma patients].
Trauma-associated coagulopathies are at times present upon arrival at the emergency department. Hyperfibrinolysis is a condition in which the natural ability to dissolve blood clots is pathologically enhanced. ⋯ The condition is treated with antifibrinolytics such as tranexamic acid--whereas transfusion with blood products is inefficient. This article explores the mechanisms and diagnostics of hyperfibrinolysis in trauma patients and the relevant treatment options.
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Ugeskrift for laeger · May 2011
[Functional haemostatic tests are fast and reliable by transfusion demanding bleeding].
Viscoelastic haemostatic tests (VHT) like thrombelastography (TEG) and rotationel thrombelastometry (ROTEM) are cell-based whole blood assays, which assess the viscoelastic properties of coagulation. The focus of this narrative review is to describe the TEG/ROTEM methodology and interpretation of the TEG/ROTEM results. Current clinical applications and limitations are also discussed. It is concluded that VHT are inexpensive point of care assays that allow quick assessment of the haemostatic function and thereby allow faster and more focused interventions than traditional coagulation tests do.
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Persons with a mental illness and their relatives experience discrimination and expect to be discriminated. The public regards them as unpredictable and dangerous and do not wish to have any relation with them neither in private nor at work. ⋯ The myth of dangerousness is out of proportion and the media is to blame as they most often mention persons with mental illnesses as dangerous. Many countries make a great effort to reduce stigma and this is also under planning in Denmark.
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Autoinflammatory diseases are characterized by attacks of apparently unprovoked inflammation without significant levels of autoantibodies or antigen-specific T-cells. Within the past decade, a number of different genetic causes of fever syndromes have been identified: familial Mediterranean fever (FMF), hyper IgD syndrome, cryopyrin-associated periodic syndromes and tumour necrosis factor receptor-associated periodic syndrome. The recent awareness and recognition of pathogenic mechanism of these diseases have led to new possibilities for medical treatment with targeted biological agents.