Läkartidningen
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The epinephrine myth originated in the 1940s, when acidic (pH 1) procaine-epinephrine was injected into fingers, causing finger necrosis. Today, level 1 evidence exists for the safe use of epinephrine in fingers. ⋯ Furthermore, patients regarded as high-risk can be safely treated without risk of cardiac or pulmonary side effects. In this manuscript, the background of the epinephrine myth is described, as well as recommended use of WALANT in hand surgery and orthopedics.
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Patients with severe sepsis/septic shock have a high mortality. Beta-lactam antibiotics are normally first line treatment. ⋯ We have reviewed 14 randomized controlled studies to investigate whether prolonged infusion provides lower mortality and/or increased clinical cure. In summary, convincing advantages with prolonged infusion could not be found, however randomized studies are heterogeneous, and it cannot be excluded that some subgroups of critically ill patients could benefit from such treatment.
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The main purpose was to study the prehospital and early intrahospital treatment of patients with traumatic brain injury (TBI) in the county of Västerbotten 2011-2012. In total, 162 patients were included. ⋯ Furthermore, most patients were initially relatively unaffected by the injury and around 1/5 of the patients were transported to hospital by private transport. Finally, we observed that most patients were admitted to hospital and computer tomography scan of the head was performed within 4 hours.