[Obstructive sleep apnea and abnormal fatigue]. / Obstruktiv søvnapnø og unormal traethed.

Obstructive sleep apnoea syndrome is characterized by irregular snoring during sleep, excessive daytime sleepiness and in some cases unwanted sleep attacks. The patient has a disturbed night sleep with numerous wakenings. Disturbed sleep at night causes daytime problems with attention, concentration and work performance. Furthermore, it may eventually result in errors and accidents. Excessive sleepiness sometimes necessitates the suspension of the patient's driving license. It is of importance to identify patients with obstructive sleep apnoea and daytime sleepiness, because the condition can be treated effectively. Many Danish patients are still unidentified. Diagnostic and treatment possibilities vary from one part of Denmark to another.

[Aortic dissection--a life-threatening condition requiring immediate treatment]. / Aortadissektion--en livstruende tilstand der kroever hurtig behandling.

We present a retrospective examination of 70 consecutive patients (median age 55 years, range 20-71 years) operated for aortic dissection from January 1981 to October 1992. Four of these patients were operated twice, making a total of 74 operations. The operations were grouped according to the Stanford classification in Type A-acute (53%), type A-chronic (11%), type B-acute (26%) and type B-chronic (10%). Fifty-seven patients were males (81%) and 90% of the operations were performed as emergencies. Eleven percent of the patients had Marfan Syndrome. The peroperative mortality was 23% and the perioperative mortality was 39%. The 10 year survival including the perioperative mortality was 39%. The frequency of operative complications lasting for more than one month was 12% and some of these complications were caused rather by the aortic disease rather than the operation. Further improvement depends on the referral of these patients to cardio-thoracic surgical units on near suspicion of the condition for the earliest possible treatment. Furthermore, patients must be followed lifelong for recurrences in progression of chronic AD.

Elimination of cefuroxime and gentamicin during and after open heart surgery.

In eight consecutive adult heart surgery patients, serum concentrations of cefuroxime and gentamicin were studied during and after operation. Repeated doses of cefuroxime 1.5 g and gentamicin 80 mg were given. Intra-operative concentrations were deemed adequate (cefuroxime Cmin: 16-45 mg/l, gentamicin Cmin: 1.6-2.8 mg/l), and no differences (P = 0.05) could be demonstrated between elimination rates during and after open heart operation (cefuroxime T1/2 101 vs 111 min, gentamicin T1/2 191 vs 193 min).