Ugeskrift for laeger
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The neurointensive care field emerged as a separate medical speciality in the 1980s, driven by the development of new monitoring tools. The most important goal of neurointensive care is avoiding secondary brain injuries or detecting them in time to implement effective treatment. Understanding cerebral metabolism is key in the care of neurocritical patients, and continuous monitoring through intracerebral microdialysis allows for differentiation of different pathological mechanisms, in turn catalysing development of novel treatments.
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Ugeskrift for laeger · May 2018
Review[Background, diagnosis and treatment of platypnoea-orthodeoxia].
Platypnoea-orthodeoxia (PO) is a condition with dyspnoea and arterial deoxygenation during orthostasis, which is relieved in the supine position. This is a review of the background of PO, which is always an orthostasis-related right-to-left shunt of deoxygenated blood either across a persistent foramen ovale/atrial septal defect or an anatomical or functional pulmonary shunt, and diagnosis and management is discussed. PO is considered to be rare but will presumably be diagnosed increasingly frequently with increased use of pulse oximetry and functional imaging including echocardiography with bubble-contrast.
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Ugeskrift for laeger · Apr 2018
Review[Telepsychiatry provides new opportunities for the prevention and treatment of mental health disorders].
Digital technologies in mental healthcare are envisioned to offer easier, faster and more cost-effective access to mental healthcare. The scope for integrating digital technology into mental healthcare is vast: video conferencing, developing novel treatments using interactive software, mobile applications, and sensor technologies. We outline technology-based interventions, which are relevant to clinical practice, and present the evidence base for using digital technology as well as emerging challenges for their implementation in clinical practice.
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Ugeskrift for laeger · Mar 2018
Review[Small amounts of milk added to coffee or tea can be allowed before surgery].
The ingestion of milk is not allowed within six hours before elective procedures requiring anaesthesia or sedation, because milk is considered a solid food. However, the impact of milk suspended in coffee or tea consumed up to two hours before anaesthesia is less certain, yet fasting guidelines demand surgery to be delayed or rescheduled. Studies investigating ingestion of liquids with small amounts of milk have not demonstrated delayed emptying of the stomach, thereby increasing the risk of aspiration in elective procedures. Maybe it is time to adjust the fasting recommendations.