Læknablađiđ
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Modern medical practice has changed dramatically during the past decades because of improved technology. Still, fetal surveillance during labor is relatively unchanged since 1960 s when fetal heart rate monitoring (FHR) became standard practice. Newborn infants are still suffering from birth asphyxia and in severe cases leading to hypoxic ischemic encephalopathy (HIE) which sometimes results in permanent neurological damage. The incidence of birth asphyxia and HIE in Iceland is unknown and so are the risk factors for severe asphyxia. The objective of this study was to assess the incidence, obstetric risk factors and the sequela of severe asphyxia at Landspitali university hospital (LSH). ⋯ The incidence of birth asphyxia is higher in LSH compared with the incidence found in other studies. Signs of fetal distress on CTG and delivery with operative interventions are common. With current available methods to detect intrapartum asphyxia there is a poor correlation with CTG and the development of HIE after severe asphyxia. The presence of severe maternal diseases does not correlate with increased incidence of asphyxia, presumably due to increased surveillance of these pregnancies and a lower treshold for intervention during delivery. In low risk pregnancies there is a lack of appropriate methods with high sensitivity and specificity to detect intrapartum asphyxia.
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Review Case Reports
[Spontaneous intracranial hypotension--a case report and discussion].
Thirty-three year old woman came to the emergency room with 3 days' history of worsening headache which was relieved by lying down. Examination was normal. Magnetic Resonance Imaging (MRI) of the head showed an enhancement of the meninges. ⋯ A fibrinogen patch was done at this level. The patient became symptom free and was finally discharged home. We present a case of complicated spontaneous intracranial hypotension and review of the literature.
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To investigate the prevalence of chronic obstructive pulmonary disease (COPD) in Iceland and possible risk factors. ⋯ Our results show a high prevalence of COPD among Icelanders 40 years and older when internationally accepted criteria and methods are used. These results are useful for heath authorities when planning and giving priority in our future health care system.
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Spontaneous pneumothorax is a relatively common disease primarily affecting young and otherwise healthy individuals. Chest pain and dyspnea are the most common presenting symptoms and in majority of cases only a chest X-ray is needed to confirm the diagnosis. ⋯ Today, video-assisted thoracoscopic surgery has in most centers replaced open surgery for spontaneous pneumothorax. In this article the presentation, diagnosis and treatment of spontaneous pneumothorax, including different surgical strategies, are reviewed in an evidence-based approach.