Bratisl Med J
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Biography Historical Article
Hippocrates and his principles of medical ethics.
"The Father of Medicine", as Antiquity called Hippocrates has left rich medical and ethical heritage for us. His heritage--the collection of treatises Corpus Hippocraticum, from 5th and 4th centuries BC, comprise not only general medical prescriptions, descriptions of diseases, diagnoses, dietary recommendations etc., but also his opinion on professional ethics of a physician. The Hippocratic Oath, taken by ancient and medieval doctors, requires high ethical standards from medical doctors. Its principles are important in professional and ethical education of medical doctors even today. (Ref. 4.).
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Romanies belong to Indo-European race. The ethnography and anthropology locate their original home to Central Northern India. The highest concentration of Romanies in Europe is in the Balkan and Carpathian regions and they are the second most numerous minority in the Slovak Republic. ⋯ The main causality of a bad health status consists in long-term bad economical situation, low educational level and incorrect lifestyle of the Romany minority. Western authors and politicians claim that at the beginning of 21st Century it is not conceivable for European governments to ignore health needs of a great number of their citizens. The aim of this review is to react to this notice with an analysis of present situation and with presentation of data of our epidemiological investigation on health status, nutrition and lifestyle of Romanies. (Fig. 4, Ref. 35.)
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For many years, the intensivists are searching for an easily measurable and available parameter which might reflect the intensity of stress and/or systemic inflammation in critically ill patients following shock, multiple trauma, major surgery or sepsis. Recently, some authors have described the onset of significant lymphocytopenia after polytrauma, major surgery, endotoxaemia and sepsis. We investigate whether serial examination of white blood cell counts may reflect and clarify the immune response to stressful events in critically ill patients. ⋯ In the population of 90 ICU oncological patients, we observed rapid serial changes in white blood cell populations, as a response of the immune system to surgical stress, systemic inflammation or sepsis. Preliminary results show the correlation between the severity of clinical course and the grade of neutrophilia and lymphocytopenia. The ratio of neutrophil and lymphocyte counts (in absolute and/or relative % values) is an easily measurable parameter which may express the severity of affliction. We suggest the term: neutrophil-lymphocyte stress factor, as a ratio of neutrophil to lymphocyte counts, which can be routinely used in clinical ICU practice in intervals of 6-12 and 24 hours. The prognostic value of neutrophil-lymphocyte stress factor should be evaluated in further studies. (Tab. 6, Fig. 5, Ref. 12.)
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This report presents the results of 44 surgical interventions performed on 44 patients during a period of 15 years, from 1985 to 1999. The report presents the basic lines of surgical treatment performed on a total number of 50 peripheral nerves of lower extremities--nervus ischiadicus and its rami. ⋯ Our results demonstrate that late and inappropriate treatment of injured peripheral nerves has severe and disturbing consequences for the patient. If a complete treatment of the injured nerve is not possible by the first contact physician, it should be performed as soon as possible by a specialist trained for microneurosurgical techniques of the treatment of peripheral nerves. (Tab. 6, Ref. 11.)
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The authors present results of group of 13 neonates treated with high frequency positive pressure ventilation (HFPPV) with high positive end-expiratory pressure (PEEP) for severe respiratory failure. The ventilatory protocol was based on the following principles: a) higher mean airway pressure (MAP) to achieve adequate oxygenation, b) MAP titrated mainly with PEEP, c) fraction of inspired oxygen (FiO2) below 0.6, d) small tidal volumes 3-6 ml/kg, e) ventilatory rates to achieve normocapnia in newborns with persistent pulmonary hypertension and to allow permissive hypercapnia in others. During HFPPV, the maximum values for respiratory rate, PEEP, MAP and peak inspiratory pressures (PIP), the incidence of airleak and the need for inotropic support were recorded. ⋯ Catecholamines were used in 8 patients. The duration of ventilatory support lasted in average 6 days (2-18). All patients were successfully extubated. 5 of them required nasal continuous positive airway pressure (14 hours--7 days). (Tab. 3, Fig. 3, Ref. 19.)