Danish medical journal
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A cross-sectional study was performed at Rigshospitalet, Copenhagen, a Danish tertiary university hospital, to describe current postoperative pain and nausea treatment with a view to identifying areas with improvement potential. ⋯ not relevant.
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Danish medical journal · Apr 2012
Low confidence among general practitioners in end-of-life care and subcutaneous administration of medicine.
Most terminally ill patients prefer to die at home, and the general practitioner (GP) is central in making this possible. However, knowledge is needed about the GP's level of confidence in assuming this task and with subcutaneous (SC) administration of medicine in end-of-life care. The aim of this study was to determine if GPs used SC needle and medication in end-of-life care, if they felt confident about being principally responsible for palliative trajectories and whether such confidence was associated with GP characteristics. ⋯ Danish General Practitioners' Educational and Development Fund.
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Danish medical journal · Apr 2012
Large discrepancy between prehospital visitation to mobile emergency care unit and discharge diagnosis.
In Copenhagen, Denmark, patients in need of prehospital emergency assistance dial 112 and may then receive evaluation and treatment by physicians (from the Mobile Emergency Care Unit (MECU)). ST-elevation myocardial infarction (STEMI) is a severe condition leaving only a limited time frame to deliver optimal care in the form of percutaneous transluminal coronary angioplasty. In theory, all patients with chest pain could have STEMI. The aim of this study was to study which of the patients suspected of having acute cardiac disease based on the 112 calls and met by the MECU were given a cardiac diagnosis on the scene and, furthermore, to compare these on-scene diagnoses with the primary discharge diagnoses from hospital. ⋯ not relevant.
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Repaired aortic coarctation(CoA) is associated with high long-term cardiovascular mortality and morbidity. Persisting hypertension and left ventricular dysfunction are possibly associated with residual or recurrent aortic arch obstruction (ReCoA) and abnormal activation of vasoactive hormones. Furthermore, knowledge regarding these patients' functional health status late after repair is missing. ⋯ Surgical correction of CoA only repairs the anatomical narrowing, but not the associated vasculo- and valvulopathy. Increased left ventricular mass, systolic and diastolic dysfunction, aortic valve dysfunction, aortopathy, and hypertension are common. Morbidity is only weakly associated with mild and moderate degrees of ReCoA, and not associated with changes in vasoactive hormone levels and renal function. Despite late morbidity, functional health status is overall only slightly impaired in patients after surgical correction of CoA compared with healthy subjects. Nevertheless, the subgroup with reduced exercise capacity and need for cardiovascular medications have a considerable impairment of both physical and mental aspects of functional health.
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Danish medical journal · Apr 2012
Comparative StudyDetection of risk factors for difficult tracheal intubation.
Several studies have identified difficult airway management including a difficult tracheal intubation of patients undergoing general anaesthesia as a major cause of anaesthesia-related morbidity and mortality. Therefore it is presumed that a difficult tracheal intubation is a surrogate marker for morbidity and mortality, and by reducing the prevalence of difficult tracheal intubation then morbidity and mortality will be reduced as well. From the Danish Anaesthesia Database (DAD), we retrieved a cohort of consecutive patients planned and attempted for tracheal intubation by direct laryngoscopy. ⋯ Therefore it seems rational to focus on the development, testing and modification of multivariate models from large scale cohort studies, hereby making the prognostication operational in everyday clinical practice. From there the challenge may be to test the effectiveness of the use of such a model in order to evaluate whether it actually has the capability to reduce difficult tracheal intubation, complications, and mortality. It seems that such a trial should and could be conducted as a cluster randomized trial of anaesthesia departments within the framework of the DAD.