Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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One specific institution reports 310 cases of reuse of pacemakers from 1974 to 1993. 111 were obtained after replacement, and 199 after the death of the first user. The average duration of the primary implant was 12 months (0-53 months). 177 functioned up to time of death, 43 months (0-177 months). In 107 cases the cause of death was unrelated to use of a pacemaker, was unknown in 61, and was sudden in 9 patients. 64 pacemakers were replaced, 14 because of infections or skin erosions. The causes of death and the prevalence and indications for generator replacement coincided with those in our population of new pacemaker-users in 1988-93. ⋯ Pacemaker re-use in our hospital is safe and cost-effective.
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Both MRI, CT and sonography will give a good presentation of fluid collection in pleura and pericardium. Sonography is the ideal imaging method for monitoring interventional procedures. Its ability to visualize superficial fluid collection and its real-time capability allows precise control of needle and catheter insertions. ⋯ If complications occur, it is mainly the pneumothorax that has to be treated. This can be managed directly under the procedure as the drainage catheter is attached to continuous pleural suction, or a catheter can be inserted in the pleural space after diagnostic punction. Patients with coagulation abnormalities must be evaluated especially before any intervention, otherwise there are no contraindications for these image-guided percutaneous procedures.
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Percutaneous drainage of abdominal abscesses has proved to be one of the most successful and gratifying of all interventional radiology procedures. Collections of intra-abdominal fluid can be detected easily with computer tomography and sonography. Diagnostic aspiration is done under guidance of sonography or computer tomography. ⋯ The procedure is carried out under local anaesthesia. Most complications are minor and can be treated conservatively. Coagulation abnormalities must be corrected, but there are no other contraindications to these image-guided percutaneous procedures.