Medicina
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Randomized Controlled Trial Comparative Study
[Combined anesthesia for esophageal resection operations].
To view combined anesthesia benefits versus general anesthesia and to compare postoperative epidural analgesia and patient-controlled analgesia with intravenous morphine. ⋯ Combined anesthesia and epidural analgesia improve overall outcome, provide better postoperative pain relief, shorten the intubation time and intensive care stay in patients undergoing esophageal resection operations.
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The aim of this prospective study was to review incidence of neurological and cognitive complications after coronary artery bypass graft surgery and find out predictive factors, associated with perioperative cerebral dysfunction. ⋯ The Canadian Stroke Scale and The Confusion Assessment Scale are sensitive and objective methods for diagnostics of postoperative neurological dysfunction. To characterize the incidence and severity of neuropsychological dysfunction, a concise battery of neuropsychologic tests that provides reliable evidence of subtle brain trauma should be used.
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Diabetic ketoacidosis is an emergency medical condition that can be life-threatening if not treated properly. Diabetic ketoacidosis occurs most often in patients with type 1 diabetes (formerly called insulin-dependent diabetes mellitus); however, its occurrence in patients with type 2 diabetes (formerly called noninsulin-dependent diabetes mellitus) is not as rare as was once thought. ⋯ The review discusses diagnostic procedures, laboratory evaluation, differential diagnosis and treatment: replacement of fluid and electrolytes, low-dose insulin therapy and recommendations for use of bicarbonate. A discussion of complications management of diabetic ketoacidosis (hypoglycemia, hypokalemia, cerebral edema, hyperchloremic metabolic acidosis, pulmonary edema, adult respiratory distress syndrome), mortality rate and prevention are included in this review.
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From January 1974 trough August 2002 184 neonates with congenital heart disease underwent surgical repair in Heart Surgery Clinic of Vilnius University. It came to 3.8% of all 4813 procedures of congenital heart diseases performed. Number of neonates operations considerably increased in the latter's years, because special Department with proper technique was established. ⋯ Unsatisfactory results of neonates operations with cardiopulmonary bypass, especially such as left heart hypoplasia syndrome is the main problems. The group of specialists performing repair of congenital heart diseases is working actively in the heart Surgery Clinic of Vilnius University. Improvement of surgery methods and results, following the best Heart Surgery Clinics of the world, is the main purpose of this group.
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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.