A calibrated dose dispenser for gaseous 133Xe.

A device that permits accurate dispensing of individual doses of 133Xe from multicurie ampuls is described. The advantages include economy, flexibility in dose selection, and radiologic safety.

An instrument for aligning patient-positioning lasers.

The accurate adjustment of patient-positioning lasers is difficult and tedious. An optical instrument has been developed which enables rapid and extremely accurate adjustment of these. The instrument may be applied to several other tests of the alignment and adjustment of teletherapy and simulator machines.

Prophylactic antibiotics and wound infections following laminectomy for lumber disc herniation.

The authors review 531 consecutive operations for lumbar disc herniation performed on 496 patients by one neurosurgeon to determine the effect of prophylactic antibiotics upon postoperative wound infections. In this retrospective analysis 16 instances of sepsis were found, 11 considered to be major and five minor. In the 128 cases in which no antibacterial agents were given, 11 major and 1 minor infection occurred. Four minor infections developed in the 402 occasions when antibiotics were given in the perioperative period. Men had a significantly greater risk of developing infection than women. These data suggest that pre- and postoperative antibiotic therapy directed at a narrow spectrum of microorganisms reduced the incidence of significant wound infections in patients undergoing laminectomy for lumbar disc herniation.

Acute obstructive hydrocephalus caused by cerebellar infarction. Treatment alternatives.

The treatment alternatives for the patient who becomes comatose following nontraumatic infarction of the cerebellum are discussed. The acute hydrocephalus produced by the swollen cerebellum is readily diagnosed by computed tomography scan and is identified as a hypodense mass without contrast medium uptake that obliterates the fourth ventricle. Two typical cases are described, one managed medically and one surgically. All available reports in the world literature of similar patients treated surgically are reviewed. Based on the outcome analysis of the foregoing, a strategy is offered for the handling of future cases.

[The geriatric clinical picture in a department of internal medicine]. / Det geriatriske sygdomsbillede i en intern-medicinsk afdeling.

In order to assess the proportion of geriatric patients in a medical department, all of the inpatients admitted to the Medical Department of Hørsholm Hospital during the period 19.3.1987-15.4.1987 were assessed in view of the geriatric clinical picture. The criteria for assessment as a geriatric patient were established in advance and included: Presence of several medical problems inhibition of functions and social problems and an estimated need for prolonged hospitalization to solve these problems, including rehabilitation. Out of 191 inpatients, 15 (8%) were considered to be geriatric patients. These 8% were all aged 60 years or more, were hospitalized for an average of 23 days and used 21% of the total number of bed days. The remaining patients aged more than 60 years were hospitalized for an average of nine days and comprised 47% of the total number of inpatients and used 49% of the bed days. The geriatric patients differed, in addition, from the other patients aged over 60 years in that 85% compared with 58% were readmitted within a period of two years. No difference in the mortality was observed during a period of two years. This investigation supports previous suppositions about the proportion of geriatric patients and indicates that assessment as to whether a geriatric patient is concerned or not may be made already during the first 24 hours in hospital.

[Hearing in a geriatric perspective]. / Hørelse i geriatrisk perspektiv.

To assess whether hearing rehabilitation of older people can be improved by co-operation between the audiology and geriatric departments and the home service, 139 old and frail audiological patients were allocated to three groups with three different fitting procedures: 1) conventional fitting including verification of acoustical gain in the patient's ear; 2) home-fitting by hearing therapists, and 3) home-fitting by a specially trained geriatric nursing assistant, the home help also being present. Outcome was assessed by the ordinary questionnaire mailed to hearing aids users three to four months after fitting and by a geriatric evaluation procedure. The response rate in the conventionally fitted group was highly unsatisfactory (36%) and too small for further data-analysis. In the educational group a tendency was found towards better manipulation skills and significantly higher hearing aid use. However, the response rate was lower than in the geriatric group (71% compared to 81%), and no knowledge of hearing aid use was registered in the home service by this procedure. In the geriatric group a correlation was found between practical ability and use and satisfaction with the hearing aid. However, two thirds of the group were dependent on lasting help for the handling of the aid. Most patients in this group were already known by the hospital and home service, and the individual home help showed an interest in learning about hearing aid use. Home fitting by a joint audiological and geriatric effort in collaboration with the home help has proven feasible and valuable to both patient and home help. Extended co-operation is recommended between the health care and the social sector concerning hearing aid use.