Bratisl Med J
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Biography Historical Article
John Heysham Gibbon and the 60th anniversary of the first successful heart-lung machine: brief notes about the development of cardiac surgery in Europe and Slovakia.
The development of the heart-lung machine and its first successful clinical application in 1953 was the culmination of Dr. Gibbon's lifetime research project. Despite many technical obstacles, financial problems, and discouragement from colleagues, his goal was achieved after twenty tedious years of tireless work. ⋯ In Eastern Europe and particularly in the former Czechoslovakia, the lack of access to foreign medical literature forced a group of emerging young physicians from the Second Department of Surgery at Comenius University to furtively collect data on the topic. After building the Simkovic-Bolf heart-lung machine, the first successful open-heart surgery with the new device was performed only 5 years after Dr. Gibbons' experience (Tab. 1, Fig. 4, Ref. 22).
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AAA repair is associated with high rate of mortality and morbidity. Oesophageal Doppler (OED) can offer a less invasive cost-effective tool for intraoperative monitoring of haemodynamic changes. The aim of the study was to confirm the benefits of haemodynamic optimisation in patients undergoing AAA repair using OED monitoring. We assumed that haemodynamic parameters of patients with OED would be better optimised; they would probably get more fluids during the operation, and their ICU and hospital stay would be shorter as a result of having fewer postoperative complications and lower mortality. ⋯ The haemodynamic monitoring by oesophageal Doppler can improve the outcome of patients with AAA repair (fewer major complications, shorter ICU and hospital stay) (Tab. 4, Fig. 4, Ref. 25).
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The course of the brachial plexus, its relations with surrounding structures and unique primary and secondary divisions result in its wide range of anatomical variations. Most of these variations were detected during anatomical dissections and studies. It has been found that 53% of studied brachial plexuses contained variations. The communication between musculocutaneous and median nerves is the most common variation of infraclavicular part of brachial plexus. ⋯ Variable interconnections between musculocutaneous and median nerve have to be considered in diagnosis of nerve lesions in axillary and arm regions. Compound musculocutaneous and median nerve neuropathy would occur in lesions of the interconnecting branches. Injuries of musculocutaneous nerve proximal to these branches can cause particular and unexpected symptoms, such as weakness of forearm flexors and thenar muscles (Fig. 6, Ref. 28).
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The main aim of the early treatment of polytrauma is recovery of patient's physiological functions. The early achievement of therapeutic goals, mainly adequate tissue perfusion and repayment of oxygen debt, are postulated. The aim of the study was to confirm whether blood lactate level as a quantifier of oxygen deficit, as well as normalization of blood lactate level within the first 24 hours, have an impact on the mortality and morbidity of seriously injured patients. ⋯ The patients, who repaid oxygen debt within first 24 hours, have lower morbidity and mortality (Tab. 6, Ref. 19).
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The aim of prospective study was to evaluate the therapeutic efficacy of piritramide in patients after removal of parathyroid glands in relation to MDR1 genotype. In the treatment of moderate acute postoperative pain, piritramide plays a major role. It is difficult to predict its optimal therapeutic efficacy and tolerability in individual patients. ⋯ We observed a better analgesic effect of piritramide and a decreased incidence of side effects in the wild-type genotype (2677GG) group, when compared with variant-allele carrying patients (Tab. 2, Fig. 1, Ref. 7).