Medicina
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Evaluate efficacy of videothoracoscopic operations in diagnosis and treatment of lung and pleural diseases. In 1997-2001 186 operations were performed using videothoracoscopic devices in the Department of Thoracic Surgery, Institute of Oncology, Vilnius University. Fourty eight resections were performed: 4 (8%) lobectomies, 1 (2%) pericardial cystectomy, 3 (6%) simpatectomies, 3 (6%) intrathoracal lipomectomies, 1 (2%) removing calcificate, 3 (6%) resections of pericardium, 15 (30%) removing metastases, 12 (25%) hamartomas, 6 (13%) wedge resections of lungs tissue due to I(st) stage NSCLC performed for the elderly. One hundred thirty eight diagnostic procedures were performed in pts with various lung and pleura diseases: 66 (48%) biopsies of lungs tissue and 72 (52%) biopsies with chemopleurodesis. From oncological point of view videothoracoscopic operations are confirmed. These operations shortens hospitalization and combined treatment starts quicker. Middle period of hospitalization - 5 days. We had complications: 22 pts (12%) postoperative pneumonia, 4 pts (2%) - short duration pneumothorax, 1 pts (0.5%) - pleural empiema 1 pts (0.5%) - drop of the lung 1 pts (0.5%) - bleeding. After resections margins were free of tumor invasion. ⋯ 1. Video-assisted thoracic surgery (VATS) surgery is effective safe method of treatment for lung and pleural diseases. 2. In some cases VATS surgery is the only way to remove tumours, and it shortens hospital stay till 5 days. 3. VATS surgery is very effective in elderly patients with concomitant diseases. 4. Chemopleurodesis is very useful in treatment of pleural fluid.
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Comparative Study
[Application of methods for hemodynamic monitoring in critical cardiac pathology (an experimental model for assessment of hemodynamics)].
Hemodynamic assessment of critically compromised patients with cardiac pathology is one of the goals of recent diagnostics and treatment strategies. Different methods for assessment of hemodynamics are applied in clinical practice. However, applied methods (invasive and noninvasive) have specific advantages and disadvantages. ⋯ It were selected 6 laboratory animals of different weight and sex. 7 measurements of hemodynamics were performed. Standard methodics was successfully applied in the experimental model. Results, method limitations and recommendations for further studies are presented in the article.
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Comparative Study
[Intrathecal morphine for postoperative analgesia in cardiac surgery].
The aim of study was to evaluate features for spinal morphine in undergoing coronary artery bypass surgery in early postoperative time and side effects of opioids. ⋯ Spinal morphine decreased pain after cardiosurgery and don't increased extubation time and side effects of opioids.
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Comparative Study
[Magnesium sulfate usage for patients during cardiopulmonary bypass].
Our study was performed in order to assess the effects of magnesium sulfate during coronary artery bypass surgery to evaluate whether perioperative intravenous infusion of magnesium, as an adjuvant agent for perioperative analgesia, affects a quality of anesthesia, reduces amounts of anesthetic and muscle relaxing drugs needed, affects adrenaline usage and nitroglycerine during anesthesia. ⋯ Perioperative intravenous infusion of magnesium, as an adjuvant agent for anesthetics, does not reduce amounts of anesthetic and relaxant drugs needed, but it stabilized blood pressure fluctuations outside the critical range, without causing the pressure fall to a level that might risk undesirable side effects during surgery.
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Comparative Study
[Clinical information system and its significance in intensive care].
The increasing number of the patients requiring admission to the intensive care unit and growing demand for the outcome analysis was noted over the last decade. The goal of this study was to evaluate the characteristics of the patients, to compare the outcome of surgical and medical patients, and to demonstrate the importance of the clinical information system in the intensive care. During 12-month period 1031 patients were enrolled for the study. ⋯ The underprediction of actual mortality by the SAPS II system was predetermined by this value of the neurological patients. The outcome of the surgical patients was good compared to the results of the studies from other countries. Clinical information system is necessary for comprehensive and objective evaluation of the intensive care unit data and quality of therapy.