Articles: patients.
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Recent prospective controlled trials of induced moderate hypothermia (32-34 degrees C) for relatively short periods (24-48 h) in patients with severe head injury have suggested improvement in intracranial pressure control and outcome. It is possible that increased benefit might be achieved if hypothermia was maintained for more periods longer than 48 h, but there is little in the literature on the effects of prolonged moderate hypothermia in adults with severe head injury. We used moderate induced hypothermia (30-33 degrees C) in 43 patients with severe head injury for prolonged periods (mean 8 days, range 2-19 days). ⋯ Moderate hypothermia may be induced for more prolonged periods, and is a relatively safe and feasible therapeutic option in the treatment of selected patients with severe traumatic brain injury. Thus, further prospective controlled trials using induced hypothermia for longer periods than 48 h are warranted.
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The National Cancer Institute (NCI) has recently decided to embark on an international partnership with the developing cancer programs on the Island of Ireland (Northern Ireland and the Republic of Ireland) in an attempt to further improve the quality and range of cancer services available for patients. This Transatlantic Partnership called the All Ireland-NCI Cancer Consortium offers exciting opportunities in cancer treatment, education and research as the cancer-caring communities from both the Republic of Ireland and Northern Ireland prepare to join with the U. S. ⋯ Finally, it is hoped that the Conference will be a marker of a very special interaction on the Island of Ireland focused on the overall development of cancer services for patients. It will also signal the start of an important partnership between the NCI and those involved in cancer care and research in Ireland. This tripartite cooperative agreement is a most exciting venture and it will hopefully be an example of how an effort focused on a human problem common to all societies can generate a spirit of cooperation and help to eliminate strife.
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Comparative Study
Patients view of the anaesthetist in a developing country.
The objective of this study was to assess patients regarding their knowledge and perception of the anaesthetists' role in patient care in a developing country. ⋯ The results of this audit show a poor perception of the anaesthetists role both inside and outside the operating room. Although public knowledge surveys have been carried out in developed countries there is a pressing need to repeat these in developing countries since the image as perceived by public may have a direct bearing on the recruitment of young doctors into an already shortage specialty in these less affluent countries.
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Spinal subdural haematoma is a rare entity. Only a few cases have been reported, mainly in patients with coagulopathies or bleeding diathesis, and also in patients undergoing anticoagulant therapy following surgery, trauma, or lumbar puncture. Symptoms of spinal cord compression produced by spinal subdural haematoma may progress rapidly causing complete and irreversible deficits. ⋯ She was discharged to an inpatient rehabilitation facility. Follow-up at 1 year showed significant improvement in motor function, but absence of posterior column function. A follow-up magnetic resonance study demonstrated widening of the spinal cord, advanced myelomalacia and a large, central, multi-loculated syrinx.
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Biography Historical Article
[Expulsion from Leipzig? Hahnemann's medical praxis in Leipzig: reasons for transferring to Kothen in 1821 - frequency of patients and polemics].
Recent research has concurred that Samuel Hahnemann enjoyed a flourishing medical practice in Leipzig. However, a close look at the physician's years in Leipzig reveals that his patient list was not exactly growing. Rather, his medical practice followed a trajectory similar to that of a roller coaster: due to crucial events - successful treatment during the typhus epidemic, lecturing at the University of Leipzig, treating influential public figures - Hahnemann was able to restructure the composition of his clientele. ⋯ Hahnemann's reputation attracted patients from all over Germany and even neighboring countries. The improvement in the social structure of Hahnemann's clientele also reflects important changes in the spread of homeopathy. Hahnemann's transfer to Kothen can be explained by a number of factors: his prohibition against dispensing medicines, declining personal prestige, decreasing number of patients and ensuing financial difficulties, fruitless university employment, continually increasing subjective and objective pressures and last but not least, the privileges of leadership.