Medicina
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Randomized Controlled Trial Comparative Study Clinical Trial
[Comparison of two different methods of analgesia. Postoperative course after colorectal cancer surgery].
The purpose of our study is to compare two methods of postoperative analgesia in colorectal cancer patients after resectional operations, and to evaluate advantages and limitations of each method on the postoperative course of these patients. ⋯ Epidural analgesia has demonstrated significantly better effectiveness than intramuscular pethidine analgesia after colorectal cancer surgery with fewer adverse events. Self-assessment manikin scores showed better self-satisfaction in patients of epidural analgesia group as compared to patients in systemic pethidine group.
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Review Comparative Study
[Current treatment options for acute bronchiolitis in children].
Bronchiolitis is the most common lower respiratory tract infection in infants and is responsible for the majority of pediatric hospital admissions in winter. Respiratory syncytial virus has been identified as the main causative agent, causing 50-90% of the cases of bronchiolitis. ⋯ This paper reviews current treatment options for bronchiolitis, including the use of bronchodilators, epinephrine, steroids and ribavirin. Most recent advances, including immunotherapy and intensive care, are discussed.
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Acute respiratory distress syndrome (ARDS) - is a life-threatening acute clinical syndrome of pulmonary insufficiency with high mortality. The causes of the syndrome are of every description - from crustacean poisoning to cardiopulmonary bypass. The rate of ARDS is not clear, because of diagnostical variety of ARDS and acute pulmonary dysfunction. ⋯ Though some authors state that recently the ARDS mortality decreased, but most of the authors did not notice any improvement during the last 20 years. The prognosis is determinated not only by pulmonary insufficiency itself (the cause of death in 5% of patients), but by the ARDS predisposing factor (the worst is sepsis and septic shock), multiple organ dysfunction syndrome, difficult physical state of the patient, sepsis as a cause or as a complication of ARDS, nosocomial pneumonia, progressive fibroproliferation in the lung. Considering the actuality of ARDS, the diagnostical criteria of ARDS, pathogenesis, clinical course and new treatment methods are reviewed in the publication.
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Review Comparative Study
[Treatment and prophylaxis of deep venous thrombosis with low molecular weight heparins (meta-analysis of clinical trials)].
Deep-vein thrombosis is a relevant problem of today's medicine, because the risk to fall ill with this pathology is 2-5%; it increases in senior age. Direct and indirect acting thrombin inhibitors are used for treatment and prevention of vein thrombosis. Though great efficiency and safety of new anticoagulants (especially factor Xa inhibitors) were proven in clinical studies, unfractionated heparin and low molecular weight heparins are still most widely used in clinical practice. ⋯ Due to these characteristics they are convenient, safe and economically worth using (used by subcutaneous injections, prescribed only 1-2 times per day, coagulation control not required, possibility for patient to be treated at home); therefore low molecular weight heparins are more and more often used in treatment of deep-vein thrombosis and also in primary and secondary prevention. They are one of the most efficacious contemporary anticoagulants, which allow to decrease the deep-vein thrombosis treatment and prevention costs. This article presents literature review about low molecular weight heparins, their appliance in treatment and prophylaxis of deep-vein thrombosis.
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Review Comparative Study
[Ventilator associated pneumonia: risk factors, diagnosis, treatment and prevention].
Treatment in the intensive care units has aggressive character. A lot of invasive diagnostic and treatment procedures are used in order to keep vital functions of the patients. Some complications are associated with treatment methods. ⋯ Antibiotic treatment should be chosen on the ground of clinical data, hospital epidemiologic situation and most common pathogens. Prevention of ventilator-associated pneumonia is based on improving basic hygiene and nursing quality. Ventilator-associated pneumonia morbidity could be reduced by identification of risk factors and risk prevention.