Ugeskrift for laeger
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Free light chains of the immunoglobulin are identical to the Bence Jones protein. In 2001, a commercially available assay for the measurement of free light chains in serum (sFLC) became available (FreeLite Free Kappa & Free Lambda assay). Evidence from the use of the sFLC analysis is rapidly building, and the analysis is a potentially powerful supplement to the diagnostic tools already used in the diagnosis and monitoring of patients with monoclonal plasma cell disorders. However, there are several unsolved aspects for the use of this analysis which must be considered before sFLC can be used optimally in a daily clinical setting.
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Ugeskrift for laeger · Aug 2010
[Description of a U.S. emergency department and its patient population during a year].
In the United States, Emergency Medicine (EM) is recognized as an independent medical speciality, which focuses on the initial evaluation and treatment of all patients with acute illness or injury. Patients have free access to the emergency department (ED), which serves as the main portal of entry for most acute patients coming into the hospital. The ED is staffed with EM specialists at all hours. The purpose of this study was to describe a U.S. tertiary care hospital ED and the patient population that is cared for there. ⋯ A broad range of patients are seen in the ED, which sets high demands for the knowledge and skills of the ED staff as well as co-operation between the ED and other specialties and hospital departments.
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During the last two influenza seasons, one of the predominant influenza A types (H1N1) has developed complete resistance to oseltamivir, the primary treatment option. The virus does, however, remain sensitive to zanamavir and amantadine. ⋯ The best prevention strategy remains vaccination of the general population to avoid immunity. Future antiviral treatment calls for knowledge about resistance to existing types of influenza and the availability of all three types of antiviral medication.
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Ugeskrift for laeger · Aug 2010
Case Reports[Compartment syndrome in upper arm in anticoagulant therapy after minor trauma].
Compartment syndrome can be a complication of warfarin treatment after a minor trauma. We report a case of an elderly woman who had an uncontrolled, high Internationalised Normalized Ratio (INR) level and had incurred a large haematoma on the left upper arm after a fall. ⋯ It is essential to be aware of symptoms and signs of compartment ischaemia, as early fasciotomy can prevent late complications such as muscle necrosis and contracture or at worst amputation. The patient should be hospitalized for observation for compartment syndrome and control of the INR level.
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We present a Danish algorithm for the neurointensive care of patients with severe traumatic brain injury. The primary goal is to avoid cerebral ischaemia and hypoxia and secondarily brain injury. ⋯ Treatment aiming at diminishing increased intracranial pressure should be initiated early. Early critical care management of patients with severe traumatic brain injury should be performed in a teamwork comprising various specialties.