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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Review Case Reports
["Spice"--synthetic cannabinoids with dangerous effects].
Synthetic cannabinoids are a large group of chemicals functionally related to delta-9-tetrahydrocannabinol (THC) found in Cannabis sativa. These compounds are full agonists on cannabinoid receptors, therefore more potent than THC. Products marketed over the Internet intended for abuse usually consist of dried inert plant material sprayed with different kinds of cannabinoids. ⋯ Other reported serious effects of this group of substances are acute psychosis, unconsciousness, cardiac ischemia, seizures and stroke. The vendors are very aware of the legal situation in each country and adjust their supply according to current narcotics classifications. New, previously unknown cannabinoids are constantly appearing on the market.