Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Mar 1990
Case Reports[Vena cava superior syndrome in total parenteral nutrition. Vena cava superior thrombosis caused by a central venous catheter].
Two patients developed superior vena cava syndrome following total parenteral nutrition through a central venous catheter. Infection may have contributed to the development of the superior vena cava thromboses. ⋯ The other patient had a mural thrombosis with complete occlusion of the superior vena cava. The author emphasizes the importance of early diagnosis and correct treatment in order to reduce the high mortality rate due to this serious complication to central venous catheters.
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Blood conservation in open heart surgery has become mandatory in order to reduce the risk of viral contamination, and because of limited resources. We have performed 100 consecutive coronary artery bypass operations (13 women/87 men, aged 33-73 years, mean 58 years) without using homologous blood. A strict blood conservation programme was applied, with removal of autologous blood prebypass for retransfusion at the end of surgery, retransfusion of the heart-lung machine content to the patient, and autotransfusion of shed mediastinal blood in the postoperative period. ⋯ Five patients received 1-2 units of fresh frozen plasma because of coagulopathy. Mean hemoglobin was 12.0 g/100 ml and mean hematocrit was 36% at discharge from hospital. Elective coronary artery bypass surgery can be performed with little or no transfusions of homologous blood.
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Tidsskr. Nor. Laegeforen. · Feb 1990
[Pharmacies' information pamphlets--what use are they to the patients?].
Information pamphlets about certain drugs on prescription have been distributed to patients by Norwegian pharmacies since 1985. A questionnaire distributed to 500 patients, answered by 48.2%, showed that most patients liked to receive the pamphlets and 85.5% found them useful. However, it was difficult to evaluate the influence of the pamphlets on the patients compliance with instructions on how to use the drug. ⋯ The study showed that physicians informed the patients more about the effects (67.2%) than about the side-effects (49.4%) of drugs. Only 47.7% of the patients had received the pamphlets earlier. However, this percentage varied for the three participating pharmacies, being 20.2, 62.2 and 78.0% respectively.
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Tidsskr. Nor. Laegeforen. · Jan 1990
[Registration of problems during anesthesia. Analysis of risk factors and quality control].
Society continues to increase its demands on the medical profession in regard to quality. We believe this situation should be met by a more systematic approach to risk evaluation and quality assessment of our work. We report an attempt to establish a routine system for recording complications during anesthesia. ⋯ Problems such as drop in blood pressure, intubation, laryngeal spasm and cardiac arrhythmias dominated. Such registration increases awareness for the safety of the patients, and enables us to assess the risk and evaluate the quality of our work. The system is now an integral part of the department's routine.