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- Attner, P, et al.
(författare)
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A 4-year consecutive study of post-tonsillectomy haemorrhage
- 2009
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Ingår i: ORL. - : S. Karger AG. - 1423-0275 .- 0301-1569. ; 71:5, s. 273-278
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Tidskriftsartikel (refereegranskat)abstract
- <i>Objective:</i> To analyse consecutive material over a period of 4 years concerning the incidence and consequences of post-tonsillectomy haemorrhages (PTH). <i>Design:</i> Prospective study. <i>Setting:</i> University hospital. <i>Participants:</i> All non-oncological cases of tonsillectomy (TE) and adenotonsillectomy (TA) performed at the ENT department at the Karolinska University Hospital between March 2000 and April 2004. <i>Main Outcome Measures:</i> Rate, timing and classification of PTH. <i>Results:</i> During the study period, 2,813 cases (mean age 13 ± 12.8 years; SD) of TE and TA were included. The majority (62%) were children aged below 12 years, and 69% were performed as day surgery. In total, 212 (7.5%) patients were readmitted due to PTH, of which 98 (3.4%) presented with ongoing haemorrhage. The rates of primary and secondary bleeding were 1.9 and 5.5%, respectively. The PTH occurred in 0–19 days post-operatively, in a typical twin peak mode around the day of surgery and then days 4–7. No case of serious PTH was noted. Multiple bleedings (2–3 times) occurred in 19 patients. Only a minority (31%) of the single PTH patients required active treatment, surgery in the theatre (35 patients) or diathermy under local anaesthesia in the emergency room (24 patients). However, almost all received systemic haemostatic treatment. Three patients required blood transfusion due to repeated PTH. Of the 114 patients that did not present with an active PTH, only 1 returned to the operating theatre due to later bleeding. Almost half (43%) of the patients with multiple episodes of PTH had also experienced primary bleedings. <i>Conclusions:</i> A primary PTH seems to indicate a risk of further episodes of bleedings, and should necessitate extra post-operative observation. Patients with a history of a single self-limiting PTH showed low risk of developing a haemorrhage requiring return to the theatre.
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| 3. |
- Pedroletti, C, et al.
(författare)
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Clinical effects of purified air administered to the breathing zone in allergic asthma : A double-blind randomized cross-over trial
- 2009
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Ingår i: RESPIRATORY MEDICINE. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 103:9, s. 1313-1319
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Tidskriftsartikel (refereegranskat)abstract
- Background: Exposure to inhaled allergens is a pathogenetic factor in allergic asthma. However, most studies that previously looked at air cleaning devices have shown little or no effect on patients with perennial allergic asthma. Aims and objectives: We examined a novel treatment using temperature regulated laminar airflow with a very low particle concentration directed to the breathing zone of teenagers and young adults with mild to moderate allergic asthma during night steep. We hypothesised that the decreased allergen exposure during the night would have an effect on bronchial inflammation and quality of life. Method: Twenty-two patients (mean 18.8 years) were randomized to start with active or placebo treatment for 10 weeks. At( patients received both active and placebo treatment with unfiltered air, with a 2-week wash-out period in between treatments. Maintenance treatment with inhaled corticosteroids was unaltered during the trial period. Health related quality of life (miniAQLQ) was the primary effectiveness measure. Exhaled nitric oxide (FeNO) and spirometry were also investigated. Results: Active treatment resulted in an improved miniAQLQ compared to placebo (mean score 0.54, p andlt; 0.05, n = 20). An effect on bronchial, inflammation was also detected with significantly tower FeNO values during the active treatment period (mean -6.95 ppb, p andlt; 0.05, n = 22). Both effects were evident after 5 weeks. The change in lung function was not statistically significant. Conclusion: Clean air, administered directly to the breathing zone during steep, can have a positive effect on bronchial. inflammation and quality of life in patients with perennial allergic asthma.
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