Ugeskrift for laeger
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Ugeskrift for laeger · Oct 2010
[Treatment of neuroendocrine tumours of the gastrointestinal tract].
The prognosis of neuroendocrine tumours of the gastrointestinal tract and pancreas is difficult to estimate due to their heterogeneous nature. Survival without dissemination may reach 90%, while metastases reduce the 5-year survival to less than 50%. ⋯ Palliative therapy includes surgery and intra-arterial embolization of hepatic metastases, chemotherapy, biotherapy with interferon-alpha and radionuclear treatment. Tumour-targeted therapy with tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors or monoclonal antibodies are under investigation in phase-III studies.
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Ugeskrift for laeger · Oct 2010
Review[Unfractionated heparin and low molecular weight heparin for acute coronary syndromes--assessment of a Cochrane review].
In aspirin-treated patients with acute coronary syndromes without ST-segment elevation unfractionated heparin (UFH) or low molecular weight heparin (LMWH) treatment < 7 days significantly reduce the risk of acute myocardial infarction (AMI), and LMWH furthermore reduces revascularisation. There is a non-significant effect on mortality compared with placebo and an insignificantly increased risk of haemorrhagic complications. No net clinical benefit of LMWH was found compared to UHF, but LMWH has pharmacokinetic advantages. The optimal duration of heparin treatment remains controversial.
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Ugeskrift for laeger · Aug 2010
[Preoperative functional magnetic resonance imaging in patients with brain tumors].
Functional Magnetic Resonance Imaging (fMRI) allows important functions in the brain cortex to be mapped noninvasively. The purpose with this work was to investigate a possible correlation between the distance from the tumour margin to fMRI activity and postoperative neurological deficits by means of a standardised method for measurement of distance. A second purpose was to investigate the influence of preoperative fMRI on the neurosurgical decision-making process. ⋯ The standardised method for measurement of distance between tumour margin and fMRI activity can contribute to the preoperative risk assessment in patients with brain tumours.
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Ugeskrift for laeger · Aug 2010
Case Reports[Renal and urethral gas production as a complication to infection of the urinary tract].
Emphysematous pyelonephritis (EPN) is a bacterial infection characterised by gas production in the renal parenchyma. We present a case with EPN caused by Klebsiella pneumoniae sepsis. ⋯ Treatment consisted of three types of antibiotics and intravenous fluids. She was discharged two months later without need for surgical treatment or haemodialysis despite the seriousness of her initial condition.
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Ugeskrift for laeger · Aug 2010
Case Reports[Influenza A H1N1v treated with extracorporeal membrane oxygenation].
A 37-year-old woman with body mass index > 30 was admitted to hospital with severe pneumonia due to H1N1v. Thoracic X-ray showed bilateral, diffuse infiltrates. There was no sign of complicating bacterial infection and all microbiological tests of tracheal secretion, blood and urine were negative. ⋯ The patient was given oseltamivir tablets and inhalable zanamivir as well as antibiotics. The patient was treated with extra-corporal membrane oxygenation (EcmO) for 12 days followed by ventilator weaning. The patient had no neurological sequelae.