Bratisl Med J
-
Portomesenteric vein gas and pneumatosis intestinalis is most commonly caused by mesenteric ischemia and bowel necrosis but may have a variety of other causes. The etiology is multifactorial and the clinical presentation is variable. ⋯ The finding of hepatic portal venous gas alone is not an indication for emergent exploration. We report portomesenteric venous gas as a rare complication after neoadjuvant radiochemotherapy of the oesophageal cancer (Fig. 3, Ref. 12).
-
Evidence-based medicine currently dictates that in children, the controlled hypothermia may be applied only to the first degree and only in cases of neonatal encephalopathy and acute brain injury. Current recommendations are limited in terms of indication as well as by their very low degree of relevance (47.1%). ⋯ The method of therapeutic hypothermia is not a predictor of survival but its proper implementation can be the key to the recovery of functions of body organs and systems after successful cardiopulmonary resuscitation. Unfortunately, this method is associated with adverse effects, namely with myocardial depression during the induction phase, and life-threatening complications after bringing the core of body to normal temperature. To increase the patient safety we have developed a safe strategy. Our protocol provides a relatively rapid induction, short interval of active cooling and passive rewarming over a long period of time (Tab. 3, Fig. 1, Ref. 34). Full Text in free PDF www.bmj.sk.
-
The authors describe a case of 33 year old Caucasian married man with an irregular 6 cm penile mass associated with multiple penile ulcers. He reluctantly admitted that 10 years ago he had multiple mineral oil (Vaseline) self injections into the penis, for penile enlargement purposes. The patient had a surgical intervention 10 years ago, but he has recurrent ulcers on his penis. ⋯ The term paraffinoma describes a distinct histopathological finding that results from the injection of foreign oily substances into the skin. Although such procedure may be considered rare, they are still performed in some countries. The major point we want emphasis is following: a lot of people seek penile augmentations, it is necessary to remind physicians and the public that nonscientific and inadequate procedure such as Vaseline may lead to debilitating and destructive consequences (Tab. 1, Ref. 12).
-
Randomized Controlled Trial
Caesarean section in isobaric spinal anesthesia with and without direct preoperative hydration with crystalloids.
Because the direct preoperative hydration with crystalloids (20 ml/kg) does not adequately prevent spinal hypotension during cesarean section, the authors investigated whether a continuous intravenous infusion of ephedrine (50 mg/500 ml of Ringer solution) without preoperative hydration would prevent the spinal hypotension more effectively. ⋯ The continuous infusion of ephedrine simultaneously with spinal anesthesia is superior to direct preoperative hydration with crystalloids in preventing the spinal hypotension and its clinical manifestations in parturients delivered with C-section (Tab. 3, Ref. 20).
-
Randomized Controlled Trial
Comparison of alfentanil and remifentanil infusions in combination with propofol for the outpatient extra-corporeal shock wave lithotripsy.
The aim of this study is to compare the efficiency of propofol+remifentanil to propofol+alfentanil in reducing pain in patients with urinary system stones undergoing outpatient Extracorporeal Shock Wave Lithotripsy (ESWL). ⋯ We concluded that both methods may be successfully used for patients undergoing ESWL (Tab. 6, Rief. 29).