Hospital medicine (London, England : 1998)
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Mortality associated with febrile neutropenia has dramatically decreased over the last three decades; a pivotal role has been played by the concept of hospital-based empirical therapy with broad-spectrum combinations of antibiotics. Nevertheless, there is evidence that a subgroup of patients with febrile neutropenia might benefit from less aggressive treatments.
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Spinal anaesthesia has evolved as the preferred anaesthetic technique for most cases of caesarean section. Having been extensively studied and refined over the years, there are few situations where a spinal is absolutely contraindicated. While general anaesthesia will always have a place in obstetrics, in experienced hands a spinal offers safety, efficacy and an improvement in maternal morbidity.
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The drug hyoscine has several indications for symptom control for patients with end-stage disease. The transdermal preparation, Scopoderm, is most widely used to control excess salivary secretions but it can also have a role in the management of terminal secretions and in the control of nausea.
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The acute respiratory distress syndrome (ARDS) can arise from a range of predisposing insults. Mortality rates are high for patients with ARDS and survivors require extended and expensive intensive care treatment. This article presents evidence that implicates the production of toxic and damaging reactive oxygen species in the pathogenesis of ARDS.