Orvosi hetilap
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Review Historical Article
[Role of percutaneous tracheostomy in intensive care: a review].
Performing early tracheostomy is a possible solution during prolonged ventilation in order to decrease late complications. Considering the duration of procedure and the hazards concerning the patient transport the risk of operation is high in the critically ill patients. Therefore bedside percutaneous tracheostomy (PCT) plays an increasing role in intensive therapy. ⋯ According to the international literature the percutaneous tracheostomy is the procedure of choice for prolonged airway management for high-risk intensive care patients. Concerning the elevated risk of operation the percutaneous techniques have significantly shorter duration and lower rate of late complications. Among the different percutaneous techniques the only significant difference was the duration of the procedure. The shortest procedure was the forceps dilatational technique.
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Nausea and vomiting following general anaesthesia are among the most frequent adverse reactions causing complications, the relief of which is an absolute demand. 5-HT3 receptor antagonists, such as ondansetron, belonging to the latest class of antiemetics were launched more than a decade ago. ⋯ Intravenous administration of 4 mg ondansetron effectively reduces vomiting occurring in more than 40% of patients after laparoscopic cholecystectomy, especially the frequency of severe cases, and mainly if administered before operation. The preparation is safe; no clinical or laboratory adverse reactions, complications have been observed in the studied patients.
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Acute lobar nephronia is a focal interstitial inflammation of the kidney healing well on conservative therapy. ⋯ Acute lobar nephronia may mimic both abscess and tumor. Differential diagnosis is very important because treatment of acute lobar nephronia is nonsurgical.