Danish medical journal
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Danish medical journal · May 2017
Randomized Controlled TrialDeep neuromuscular blockade and low insufflation pressure during laparoscopic hysterectomy.
Establishment of sufficient muscle relaxation is essential in laparoscopic surgery. During laparoscopy, surgeons can experience abdominal contractions in their patients. Deep neuromuscular block (NMB) has the potential to prevent such episodes. In this study, we explored if deep NMB reduces the incidence of sudden abdominal contractions as compared with standard NMB. ⋯ This work was funded in part by a research grant from the Investigator Initiated Studies Program of Merck Sharp & Dohme Corp, USA. The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck Sharp & Dohme Corp.
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Danish medical journal · May 2017
Multicenter Study Observational StudyLaparoscopy in major abdominal emergency surgery seems to be a safe procedure.
Laparoscopy is well established in the majority of elective procedures in abdominal surgery. In contrast, it is primarily used in minor surgery such as appendectomy or cholecystectomy in the emergent setting. This study aimed to analyze the safety and effectiveness of a laparoscopic approach in a large cohort of major abdominal emergencies. ⋯ none.
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Danish medical journal · May 2017
Comparative StudyCardiopulmonary Exercise Testing in Aortic Stenosis.
Patients with moderate to severe aortic stenosis (AVA <1.3 cm2) who were judged, by a referring cardiologist, as asymptomatic or equivocal symptomatic from the aortic stenosis were included in the study. Patients with left ventricular ejection fraction <50% were not included. Twenty-nine percent of the referred patients were judged asymptomatic and 71% equivocal symptomatic from their valve disease. ⋯ A preoperative mean gradient <40 mm Hg across the aortic valve, the presence of atrial fibrillation, and a permanent pacemaker post-AVR all predicted a post-AVR pVO2 <83% of that predicted. For the 37 patients with a pre-AVR CPX, a postoperative decrease >10% in the absolute pVO2 was noted in 30% and an increase >10% in 24% of patients. A decrease >10% in pVO2 was predicted by preoperative mean gradient <40 mm Hg and an increase in pVO2 was predicted by preoperative AVAI <0.4 cm2/m2 and preoperative pO2pulse
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Danish medical journal · May 2017
Health anxiety and illness behaviour in children of mothers with severe health anxiety.
Excessive health anxiety, still designated as hypochondriasis in ICD-10, refers to worries and anxiety about harbouring serious illness. It is common in both primary and secondary health care with prevalence rates up to 9% and causes great suffering for the individual as well as high health care costs when untreated. Growing research suggests that health anxiety may originate in childhood, and studies have demonstrated that cognitive and behavioural features similar to those described for health anxiety in adults may be present. ⋯ They reported a more negative illness perception and more health anxiety on behalf of their child, i.e. health anxiety by proxy, as well as more dissatisfaction with their medical consultation in general practice regarding their child compared to mothers with rheumatoid arthritis and healthy mothers. Thus, although we in the first study did not find that the children of mothers with severe health anxiety themselves reported more physical symptoms compared to children in the control groups, the findings of the second study raise the possibility that the upbringing by a parent with negative illness perceptions and health anxiety in the long run could learn the child that minor bodily changes (i.e. feeling unwell) are unusual and need extra attention. Targeting health anxiety by proxy in the treatment of mothers who suffer from severe health anxiety may therefore be important to prevent not only iatrogenic harm to the child but also the exposure of the child to a maladaptive illness behaviour, which potentially could be a risk factor for the child to develop this behaviour itself when growing up.