Scandinavian journal of clinical and laboratory investigation
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Scand. J. Clin. Lab. Invest. · Oct 2010
Case ReportsHigh-dose fibrinogen concentrate for haemostatic therapy of a major trauma patient with recent clopidogrel and aspirin intake.
We report on a severely injured trauma patient who suffered a high velocity motorcycle accident. The patient was receiving dual antiplatelet therapy with aspirin and clopidogrel. ⋯ This case shows the potential effectiveness of fibrinogen concentrate in improving haemostasis in trauma patients receiving antiplatelet therapy.
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Scand. J. Clin. Lab. Invest. · Jul 2010
Seasonal and age-related differences in serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and parathyroid hormone in patients from Western Norway.
The aim of this study was to investigate the seasonal and age-related variation of vitamin D and PTH serum concentrations in a large general patient population in Western Norway. ⋯ We observed a seasonal variation in 25(OH)D and 1,25(OH)2D with low serum concentrations during winter/early spring while PTH showed an inverse pattern. Higher levels of PTH in winter and the elderly may reflect an impaired vitamin D status that may affect calcium homeostasis and bone health.
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Scand. J. Clin. Lab. Invest. · Feb 2010
Comparative StudyComparison of combined oximetry and cutaneous capnography using a digital sensor with arterial blood gas analysis.
Cutaneous carbon dioxide tension (PcCO(2)) is a promising non-invasive surrogate measure of arterial partial pressure of carbon dioxide (PaCO(2)). ⋯ There is a good agreement between combined cutaneous capnography and oximetry values with ABG analysis. Due to the excellent safety profile and the short time to get a continuous measurement, this technique should be examined in settings where it can complement repeated ABG analysis when ventilatory disturbances are suspected or non-invasive monitoring of ventilation is needed.
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In patients presenting with a possible subarachnoid haemorrhage (SAH), a negative CT scan of the head does not exclude SAH and further investigations are therefore required. Cerebral angiography identifies aneurysms but does not inform on whether they have ruptured and is resource intensive. Examination of the CSF for blood cannot distinguish between an in-vivo bleed and a traumatic lumbar puncture. ⋯ The most appropriate investigation is spectrophotometry of the CSF for the haemoglobin breakdown products, oxyhaemoglobin and bilirubin. Guidelines for the performance of spectrophotometry and interpretation have been produced, modified and are reviewed here. From 5 years' data involving 2302 scans, 92% did not support the occurrence of SAH, 4% indicated the need for angiography to identify a possible aneurysm, while 4% were equivocal due to the presence of oxyhaemoglobin in sufficient concentrations to interfere with the ability to identify bilirubin reliably.
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Scand. J. Clin. Lab. Invest. · Jan 2009
Randomized Controlled TrialEffects of aldosterone blockade on left ventricular function and clinical status during acute myocardial infarction.
Heart failure is frequently a serious complication of acute myocardial infarction (AMI). ACE inhibitors, Angiotensin II receptor blockers, beta-blockers and aldosterone receptor blockers have been shown to improve outcomes in this setting. This study aimed to determine the effect of spironolactone on the frequency of clinical heart failure, mortality, rehospitalization and left ventricular functions determined by echocardiography. ⋯ In concordance with these findings, the ejection fraction was slightly higher in Group A than in Group B, although this was not statistically significant (47% versus 44%). This trend continued during a 6-month follow-up after randomization. Our findings suggest that early administration of aldosterone blockers provides additional benefits after AMI, reducing the incidence of post-MI angina pectoris and rhythm and conduction disturbances.