Ugeskrift for laeger
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Ugeskrift for laeger · Feb 2010
[Obesity is not associated with an increased mortality in critical disease and intensive care].
The prevalence of obesity is increasing. The mortality and morbidity among obese intensive care unit (ICU) patients has been a matter of concern. ⋯ Obesity was, however, not associated with increased mortality. The results were confirmed by a meta-analysis which showed that obesity was associated with increased morbidity but not with increased mortality.
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Ugeskrift for laeger · Feb 2010
Comparative Study[Obesity: one of this century's greatest health challenge?].
The prevalence of overweight and obesity exceed 50% in many European countries. Obesity is responsible for 2-8% of all health costs and 10-13% of all deaths in Europe. ⋯ Such treatment is hampered by the lack of official guidelines and a relatively limited effect compared to the expectations of patients as well as medical staff. Guidelines and official subsidies are debated.
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A 68-year-old man was referred with progressive dysphagia. During the course, the patient developed muscle fatigue and additional signs of myopathy such as high levels of creatine kinase. ⋯ Cessation of treatment gives quick remission of symptoms and normalization of creatine kinase. As an increasing number of patients are being treated with lipid-lowering drugs, it is important to recall that myopathy is a dangerous side-effect which may have either quick or delayed onset, and that dysphagia can be the initial symptom.
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A 35-year-old male known with bipolar disorder was admitted after a suicide attempt with cuts in both wrists. The patient had a major depression with melancholic symptoms and nihilistic delusions. To relieve the patient's agony in the days before electroconvulsive therapy and to reduce the risk of suicide, the patient was treated with S-ketamine 0,5 mg/kg. The patient's symptoms were reduced two hours after treatment and the effect was measurable for five days.
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Postoperative cognitive dysfunction (POCD) is a frequent complication to surgery. Studies show considerable disagreement concerning the definition of POCD and the methods used for its -assessment. Objectivity may be obtained through neuro-psychological testing, contrary to the use of questionnaires, but several methodological issues can potentially affect the results. Aspects like baseline performance, practice effects and time interval between test sessions all influence the assessment of cognitive function.