Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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The increasing use of ambulatory surgery has led to greater focus on the rationale for preoperative screening tests. What pre-operative tests are selected depends on the patient's history and a clinical examination with the focus on general health. A preoperative ECG of patients older than 60 years of age is the only test which should be performed as a routine prior to ambulatory surgery.
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Tidsskr. Nor. Laegeforen. · Jan 1996
Case Reports[Guillain-Barré syndrome. Variation on the theme].
Guillain-Barré syndrome, or acute inflammatory demyelinating polyneuropathy, is a frequent cause of acute onset of flaccid paresis and areflexia. Electrophysiological studies show demyelination, sometimes with varying degrees of axonal degeneration. In some cases axonal degeneration apparently develops rapidly, without signs of primary demyelination. ⋯ We report on clinical and electrophysiological findings in three patients with variants of Guillain-Barré syndrome. These include pure demyelination, combined demyelination and axonal degeneration and possible primary axonal degeneration. Electrophysiological studies can differentiate between the variants of Guillain-Barré syndrome, and thus give indications of pathogenesis and prognosis.
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Tidsskr. Nor. Laegeforen. · Jan 1996
[Increasing use of cesarean section, even in developing countries].
At Kaziba hospital in rural Zaire, the frequency of deliveries by Caesarean section rose from 6.2% in 1971 to 12% in 1992, and the fraction of repeated sections rose from 17% to 49%. During the same period, the overall maternal mortality decreased from 0.3% to 0.12%, and deaths connected with Caesarean section from 3.2% to 0.7%, but still the risk of dying remained 13 times higher for births by Caesarean section compared with vaginal deliveries. The frequency of vacuum deliveries was halved during the period, and mean birth weight decreased by about 100 g. ⋯ Operations carried out by persons other than physicians were complicated by wound infections at a higher rate (20.8%) than those carried out by experienced doctors (11.2%). In areas with a poorly developed health system, a high rate of Caesarean section represents a hazard to maternal health. The need for knowledge about alternative methods like vaginal extraction, symphyseotomy and active management of labour is underlined.
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Tidsskr. Nor. Laegeforen. · Nov 1995
Case Reports[Spinal puncture in suspected purulent meningitis].
Today, CT scan of the brain is performed as a routine a the first diagnostic procedure in cases of suspected acute subarachnoid haemorrhage. Subarachnoid blood is demonstrated in a high percent of these cases provided that the scan is carried out within the first few days after the bleeding. Furthermore, the scan may also disclose localised intracranial haematoma or other expansive lesions with brain shift. ⋯ Two case histories are described. Both patients had brain abscesses and deteriorated dramatically after lumbar puncture. The role of brain CT scanning in the management of such patients is discussed.
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Tidsskr. Nor. Laegeforen. · Nov 1995
Review[Infections in intensive care units. A challenge for the specialist of infectious diseases?].
There is an obvious need for teamwork between different specialists on the diagnosis and treatment of patients in an intensive care unit. The infectious disease specialist must contribute by establishing definite and quick diagnosis of infections and by employing an adequate and sensible antibiotic policy for successful treatment. The local microbiological flora should be kept at an acceptable level of resistance to antibiotics, and preventive measures should be chosen carefully. To achieve this goal, extensive knowledge on antibiotics and microbial epidemiology is essential.