Biomedical subjects

R Josefsen

Publications and source records attributed to R Josefsen.

3 recordsLinked to original sources

PubMed2004

Traumatic cervical injuries in ankylosing spondylitis.

PURPOSE: To demonstrate the importance of magnetic resonance (MR) and computed tomography (CT) in the evaluation of cervical traumas in patients suffering from ankylosing spondylitis. MATERIAL AND METHODS: Eleven patients with advanced ankylosing spondylitis were admitted to neurosurgical treatment after trauma to the neck region. All had neurological symptoms and were evaluated with plain X-ray, CT, and MR. RESULTS: CT with reformation sagittal and coronal plane was superior to plain X-ray films in demonstrating fractures and dislocations. MR was considered mandatory when evaluating changes in medulla and epidural hematomas, which were detected in 4 patients. The clinical outcome was poor in 5 patients and good in 6. The poorest outcome was seen in patients with cord contusion and epidural hematoma. CONCLUSION: We conclude that plain X-ray is of no greater importance in the acute phase of highest value in follow-up evaluation of the healing process and final position of the fractured vertebrae. Our protocol in the acute phase in traumatized ankylopoetic patients consists of lateral conventional X-ray, CT with reformatted images, and MR, the last-mentioned being important in detecting epidural hematoma that reduces the clinical outcome further if not removed. In our opinion, MR must be part of the radiological protocol following neck traumas in all patients with ankylosing spondylitis.

Adult↗

PubMed1999

[Cerebellar hemorrhage--a rare, but serious complication in decompression disease].

Since 1978, five conferences on diving-related illness have failed to conclude that diving could lead to brain damage. We present a case history of a diver with decompression disease who also experienced brain damage. He performed a normal dive down to a depth of ten metres, when suddenly he had to go up to the surface. The patient was brought to the nearest hospital with a decompression chamber and treated according to standard procedure, yet his condition did not improve as expected. A CT scan showed bilateral, cerebellar bleeding and a secondary hydrocephalus. A CT scan one year after the accident showed a normalisation. The changes in the cerebellum could be related to decompression disease. Neurosurgery may be necessary in some cases of decompression disease.

Adult↗

PubMed1997

[When a physician makes a mistake].

Inevitably, doctors make mistakes in the normal course of providing care. Making a mistake often causes distress for the doctor involved, but it can also be an important source of knowledge and self-reflection. This article discusses central aspects with respect to mistakes and medical malpractice. The doctor's relationship to ethics and legislation is discussed, and an overview of the administrative action taken by the Norwegian health authorities is presented. The organisations and offices a physician may come into contact with when involved in a patient's complaint are briefly presented. "Meldesentralen" was formed in 1993 by the Norwegian Directorate of Health for the purpose of collecting reports on accidents in medical practice. We argue that the accidents reported to "Meldesentralen" do not reflect the true situation on this issue. We introduce a model for a systematic approach towards a colleague who has made a mistake or who is suspected of having made one.

Ethics, Medical↗