Vesterhunter0174

The risk of every procedure must be carefully considered in relation to the benefits, especially when large numbers of patients are affected. For our patient, the likelihood of COVID-19 infection was low, and the risk of complications was high.

Poisonings by substances of abuse are potentially dangerous and indicate risky substance use behaviour. To be prepared to handle patients with poisonings by substances of abuse, we need updated knowledge about the kinds of substances we can be expected to encounter. Most substance use-related poisonings in Oslo are treated at the OAEOC, and we describe the poisonings observed there in the period 2014-2018.

We included all patients treated for poisoning by substances of abuse at the OAEOC in the years 2014-18, with the exception of lone ethanol poisonings. For 2018, these were also included. The patients were identified retrospectively by a review of the patient registration lists in the clinic's electronic records system. The diagnosis of the substances involved was based on the clinical assessment made by the doctor responsible for treatment.

In the period 2014-18, altogether 8116 cases of poisoning by a substance of abuse were treated at OAEOC, lone ethanol poisonings not included. The most frequently occurring intoxicants were heroin (3237 cases), benzodiazepines (2196), amphetamine/methamphetamine (1827), cannabis (1081), gamma-hydroxybutyrate (GHB) (904), cocaine (569) and unspecified opioids (546). There was an increasing trend in number of cases per year for central stimulants, cannabis and GHB, and a decreasing one for benzodiazepines. The number of heroin poisonings fell until 2017, but rose again in 2018. In 2018 there were 4021poisonings by substances of abuse, of which 2022 were lone ethanol poisonings.

The number of poisonings increased for most substances in 2014-18, but fell for heroin and benzodiazepines.

The number of poisonings increased for most substances in 2014-18, but fell for heroin and benzodiazepines.

The Scandinavian guidelines for initial management of minimal, mild and moderate head injuries in adults aim to identify patients at risk of developing intracranial haematoma, while also avoiding unnecessary computed tomography (CT) scans and hospital admissions. We examined compliance with the guidelines at the University Hospital of North Norway, Tromsø.

A search in the patient administration system identified 448patients with a diagnosis code for head injury. We excluded 298 who met one or more exclusion criteria, and included 150 with minimal, mild or moderate injuries in a retrospective study. Management was categorised as being either compliant or non-compliant with the guidelines. We defined non-compliance as overtesting (unnecessary CT scan and/or hospital admission) or undertesting (omission of necessary CT scan and/or hospital admission).

Management was in accordance with the guidelines for 96/150 (64%) patients. This proportion increased with the severity of the injury (minimal 4/12 (33%), mild 76/119 (64%) and moderate 16/19 (84%)). A total of 54/150 (36%) patients were not managed in accordance with the guidelines. This was due to unnecessary CT scans and/or hospitalisation in 39/54 (72%) patients and undertesting in 15/54 (28%). Among patients with low-risk mild head injuries, 35/57 (61%) underwent analysis of the brain injury marker S100B, as per the recommendations.

Compliance with the Scandinavian guidelines could be improved.

Compliance with the Scandinavian guidelines could be improved.

Subcutaneous contraceptive implants are recommended to be placed in the medial upper arm. Here, the implant lies close to important neurovascular structures.

We have treated two women with ulnar nerve injuries after removal of such implants. Patient 1 sustained a near complete nerve injury. Despite nerve grafting and a distal nerve transfer, she had a poor outcome. Patient 2 had a partial injury and has made a reasonable recovery after neurolysis of the ulnar nerve that was entrapped in scar tissue.

Prognosis after peripheral nerve injuries in the upper arm in adults is poor, and as such these injuries are particularly serious. Any patient with an implant that is not readily palpable in the subcutaneous tissue should be referred to a hand surgeon who has training in exploring peripheral nerves. If emergent nerve injury is suspected, referral to a department of hand surgery is vital.

Prognosis after peripheral nerve injuries in the upper arm in adults is poor, and as such these injuries are particularly serious. Any patient with an implant that is not readily palpable in the subcutaneous tissue should be referred to a hand surgeon who has training in exploring peripheral nerves. If emergent nerve injury is suspected, referral to a department of hand surgery is vital.

Pheochromocytoma is referred to as 'the great mimic' with a broad spectrum of presenting symptoms. In the following case, the diagnosis had an unusual presentation as a medical emergency - pheochromocytoma crisis.

A previously healthy woman in her fifties was admitted due to abdominal pain and dyspnoea. At admission she was haemodynamically stable, with stable respiration, but arterial blood gas showed serious lactic acidosis with pH 6.8 (7.35-7.45), HCO33mmol/l (22-26) and lactate 28mmol/L (0.4-1.8). Her haemoglobin level was 12g/dl (11,7-17,0). Further examination with CT and gastroscopy confirmed a duodenal bleeding. The lactic acidosis was corrected quickly, but the patient developed acute kidney injury, rhabdomyolysis and increased liver enzymes. The complex composition of organ manifestations could not be explained by the duodenal bleeding alone. An adrenal mass with high density was identified through re-evaluation of the CT scans. In the following case, a duodenal bleeding provoked catecholamine-induced haemodynamic instability and end-organ damage in a patient with an undiagnosed pheochromocytoma.

Endocrine emergencies are important differential diagnoses in critically ill patients. Pheochromocytoma crisis most commonly presents as hypertensive crisis or catecholamine cardiomyopathy but can also lead to lactic acidosis and multi-organ failure.

Endocrine emergencies are important differential diagnoses in critically ill patients. Pheochromocytoma crisis most commonly presents as hypertensive crisis or catecholamine cardiomyopathy but can also lead to lactic acidosis and multi-organ failure.Alzheimer's disease is the most common cause of dementia globally. Its prevalence will increase considerably in the years to come, in pace with the increasing proportion of older people. No disease-modifying treatment is currently available. Measures to mitigate risk in mid-life may potentially prevent or postpone up to 40 % of dementia cases at group level.

The I-iothalamate clearance and Tc diethylenetriamine-pentaacetic acid (Tc-DTPA) split scan nuclear medicine studies are used among living kidney donor candidates to determine measured glomerular filtration rate (mGFR) and split-scan ratio (SSR). The CT-derived cortical-volume ratio (CVR) is a novel measurement of split-kidney function and can be combined with predonation estimated GFR (eGFR) or mGFR to predict postdonation kidney function. Whether predonation SSR predict postdonation kidney function better than predonation CVR and whether predonation mGFR provides additional information beyond predonation eGFR is unknown.

We performed a single-center retrospective analysis of 204 patients who underwent kidney donation between 06/2015-03/2019. The primary outcome was 1-year postdonation eGFR. Model bases were created from a measure of predonation kidney function (mGFR or eGFR) multiplied by the proportion that each nondonated kidney contributed to predonation kidney function (SSR or CVR). Multivariable elastic net regression with 1,000 repetitions was used to determine the mean and 95%CI of R, root mean square error (RMSE), and proportion overprediction ≥15 mL/min/1.73m between models.

In validation cohorts, eGFR-CVR models performed best (R 0.547, RMSE 9.2 mL/min/1.73m, proportion overprediction 3.1%) whereas mGFR-SSR models performed worst (R 0.360, RMSE 10.9 mL/min/1.73m, proportion overprediction 7.2%) (P<.001 for all comparisons).

These findings suggest that predonation CVR may serve as an acceptable alternative to SSR during donor evaluation and furthermore that a model based on CVR and predonation eGFR may be superior to other methods.Supplemental Visual Abstract; http//links.lww.com/TP/C140.

These findings suggest that predonation CVR may serve as an acceptable alternative to SSR during donor evaluation and furthermore that a model based on CVR and predonation eGFR may be superior to other methods.Supplemental Visual Abstract; http//links.lww.com/TP/C140.

We report a squeaking knee complication on weight-bearing and active flexion-extension because of a migrating nonabsorbable FiberWire suture in a 16-year-old boy who underwent anterior cruciate ligament (ACL) reconstruction surgery. Although not physically limiting, the noise caused psychological distress in our patient as a young adult. As the noise did not resolve with nonsurgical treatment, we performed arthroscopic surgical correction and removed loose FiberWire strands protruding from the femoral tunnel which completely eliminated the sound.

Squeaking knee complications because of migrating nonabsorbable sutures post-ACL reconstruction surgery do not heal with time and can be corrected surgically.

Squeaking knee complications because of migrating nonabsorbable sutures post-ACL reconstruction surgery do not heal with time and can be corrected surgically.

In renal transplant recipients (RTRs), cardiovascular (CV) complications are associated with non-traditional risk factors, such as a decline in graft function, immunosuppressive therapy, time of dialysis before transplantation, inflammation and anemia. Higher value of arterial stiffness is the consequence of risk factors and it can lead to CV events. The aim of this study was the assessment of the arterial stiffness in RTRs with different value of estimated glomerular filtration rate (eGFR) and its correlation with classical and non-classical CV risk factors.

344 stable RTRs were enrolled in this study. The arterial stiffness was measured in all participants. The study population was divided in two groups based on the value of eGFR 201 (≥45 ml/min/1,73 m2) and 143 (<45 ml/min/1,73 m2). Demographic, immunosuppression status, clinical and biochemical information were referred to a single assessment obtained from medical records in the patients' medical files. Vascular stiffness was determined by an automness, represents an easy and cost-effective tool.

Significant influence of age and CVD on arterial stiffness in RTRs was confirmed and PWV did not differ depending on eGFR. Our findings suggest that PS, as a marker for arterial stiffness, represents an easy and cost-effective tool.Since the U.S. Supreme Court issued its landmark decision in 1973 to legalize abortion, over 60 million preborn have been killed by elective abortion. While alive in the womb, these preborn are abandoned and not protected under current law. But once aborted, their body parts are a highly esteemed and prized commodity amongst certain members of the scientific community. Moral discourse is disregarded for the sake of science. The public have been lulled and lured into believing that this practice must continue in order to understand and develop cures for some of the most debilitating diseases of our day. But they are mistaken. This practice is not necessary, especially in light of numerous noncontroversial alternatives. Here, we expose and consider the false and misleading claims regarding human fetal tissue (HFT) in research from scientific, legal, and ethical points of view. We endeavor deeply to understand the depth of the injustice in this practice and what forces promote and maintain it; and by revealing and understanding these forces, we set forth how these inhumane practices can be ended.