Ugeskrift for laeger
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Ugeskrift for laeger · Jan 2010
Review[Chemotherapeutic wafers in treatment of malignant cerebral glioma. Assessment of a Cochrane review].
The present Cochrane review deals with implantation of chemotherapeutic wafers in the surgical cavity after resection of a malignant glioma. The authors found two controlled, randomised studies concerning this treatment modality after first-time surgical treatment and one study dealing with treatment of recurrent tumour. An effect was shown in the first with an increase in median survival of 2 months equivalent to the survival seen after standard (concomitant) treatment. No effect was shown in recurrent tumour.
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Ugeskrift for laeger · Jan 2010
[Early identification and treatment of cardiovascular failure in severe sepsis].
Severe sepsis is a leading cause of death characterised by infection-induced endothelial and cardiac dysfunction leading to hypovolaemia, maldistribution of flow, tissue ischaemia and organ failure. A clinical approach with focus on cardiovascular diagnostics and rational goal-directed therapy is likely to reduce the high mortality. The treatment involves focus control, broad-spectrum antibiotics, target-oriented fluid therapy and vasopressor and inotropic agents guided by frequent reassessments of the patient's response to treatment.
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The article defines sexual violence and discusses the prevalence here of in conflict areas including the methodological challenges of studying the issue. Moreover, we describe possible physical and mental consequences of sexual violence as well as relevant medical assistance to the victims immediately after the assault and in the longer term. In conclusion, more research is needed about the extent and consequences of the problem, including research on male victims. Knowledge is also relevant in a Danish context where many refugees and immigrants come from conflict areas.
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Ugeskrift for laeger · Jan 2010
[SPECT combined with CT angiography yield better diagnostic accuracy of pulmonary embolism--secondary publication].
The aim of our study was to perform a prospective study that compared the diagnostic ability of V/Q single photon emission computer tomography (V/Q-SPECT), V/Q-SPECT combined with low-dose computed tomography (CT) and pulmonary multidetector computed tomography(MDCT)-angiography in patients suspected of having pulmonary embolism (PE) using a dedicated combined SPECT/MDCT-scanner. V/Q-SPECT in combination with low-dose CT had a sensitivity of 97% and a specificity of 100%. MDCT angiography had a sensitivity of 68% and a specificity of 100%. We conclude that V/Q-SPECT in combination with low-dose CT without contrast has an excellent diagnostic performance and should be considered the first-line imaging technique in the work-up of PE in most cases.