Medicina
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Comparative Study
[Stair climbing test in prediction of postoperative complications after lung cancer surgery].
Preoperative physical state of a patient is very important for adaptation of the patient after lung resections. Purpose of this work is to evaluate an information factor of a stair-climbing test while predicting of postoperative complications after lung cancer surgery. Fifty two patients were examined, who passed lung surgery of different volume. ⋯ Postoperative course was normal for those patients (n=11) who were able to climb five or more flights of stairs. It was noticed that duration of postoperative period has an inverse proportion to a number of the climbed up footsteps. The stair-climbing test is a simple, safe, cheap and informative enough for prediction of postoperative cardiopulmonary complications after lung cancer surgery.
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Penetrating injury of neck is a complicated pathology, and there is more than one opinion of its treatment tactic in nowadays. Our recomendation is to refuse mandatory surgical exploration. ⋯ In cases with possibilities of full investigation of patients (panendoscopy, X-ray investigations, ultrasound investigations, angiography), we suggest the model of active observation. If there are no possibilities of full investigation, we prefer mandatory surgical exploration.
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Comparative Study
[Analysis of treatment outcomes after electric injuries (1991-2000)].
During the 1991-2000 year period 1728 children and 1967 adults have been treated in the Unit of Plastic Surgery and Burns of Kaunas Medical University Hospital. A retrospective analysis of patients who sustained electric injuries during these years period was carried out. Among all patients 93 (2.517%) were injured by electricity. 38 (40.86%) of them were children and 55 (59.14%)--adult patients. ⋯ Five patients of adult high voltage injury group needed amputation. Three of them needed amputation of forearm, one--of upper arm and one--of the calf. From low voltage injury group 3 patients needed amputations of one or two fingers and only one patient needed amputation of upper arm.
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Although albumin (A) may be considered an ideal natural colloid, the clinical importance efficacy of A administration in the treatment of critical illness have changed considerably of late years. This article reviews data about the use of A at present. ⋯ There are at the present time no clear indications for A administration. Albumin can be used only as a second-choice infusion solution when other products are not indicated, are contraindicated or have been used up their maximum dose.
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Review Comparative Study
[Procalcitonin: a new infection marker. Its use in intensive care].
In daily routine diagnosis, there are few parameters available to monitor critically ill patients and to control the course of therapy in severe inflammations. There are also few reliable parameters differentiating acute bacterial infection from other types of inflammation. Most of the presently used indicators of the inflammatory response, like body temperature, white cell count, erythrocyte sedimentation rate or C reactive protein are unspecific parameters with changing reliability. ⋯ The incidence of noninfectious systemic inflammatory response syndrome associated with coronary artery bypass surgery and the potential role of several inflammatory parameters as early markers of pulmonary dysfunction induced by cardiopulmonary bypass were investigated. Procalcitonin seems to be appropriate parameter indicating the early development of severe noninfectious systemic inflammatory response syndrome and for predicting pulmonary dysfunction secondary to cardiopulmonary bypass. Hence, the review of the data of different authors may lead to the conclusion that because of wide spectrum of indications procalcitonin concentration can be used for differential diagnosis of bacterial versus non-bacterial inflammation, as monitoring parameter in critically ill patients, the course of disease, treatment control evaluating the effectiveness of antibacterial treatment, for evaluation of high risk patients to see if there are no postoperative bacterial complications as a prognostic indicator.