Srp Ark Celok Lek
-
Randomized Controlled Trial Clinical Trial
[Renal protection during surgical procedures on the infrarenal aorta].
Despite the progress in surgical and anaesthetic management, decreased renal function is still observed after abdominal infrarenal aortic surgery and remains an important problem in postoperative period. Although data regarding the efficacy of perioperative renal protection are conflicting, it is widely believed that renal protection before aortic cross-clamping is beneficial and therefore is commonly used. The aim of this study was to evaluate the impact of renal protection in patients undergoing elective infrarenal aortic surgery (1ARS). ⋯ Patients in groups A and B were similar regarding the age (64.32 vs. 62.00), sex (males 35, females vs. males 34, females 6) and preoperative diseases. (Tab. 2) No difference was found between groups regarding any of the parameters (BUN, serum creatinine, electrolytes, volume load, creatinine and free-water clearance, haemodynamic parameters, plasma and urine osmolality). Urinary output was higher in group B during and 2 hours after ACC. (Graph 1.) ACC time was similar in two groups (24.1 min vs 24.5 min). (Graph. 2) Only one patient in group B revealed transitory renal insufficiency, not requiring special treatment. These data indicate that renal protection did not influence renal function. Short ACC time may have impact on the obtained results. Our results suggest that renal protection should not be considered as mandatory for elective infrarenal aortic surgery. Because of the short ACC time observed in this study (in comparison to other studies), further studies of renal protection in patients with longer ACC time are needed.
-
Relief of pain after tonsilloadenoidectomy in preschool children is the precondition of good postoperative recovery of that group of patients. The aim of this project is to study, to estimate and to relieve the pain. It focuses on dosage and ways of using medication, and establish the difference between Paracetamol and Ibuprofen i.e. their respective effects after oral, rectal or rectal-oral application. ⋯ In this study Ibuprofen proved to be a stronger, more efficient and longer active drug compared to Paracetamol. There was no irritation in the digestive system and there was a small number of side effects. In conclusion, using Ibuprofen first orally then rectally proved to provide a quick and long painless period of postoperative recovery provided that children do not swallow it.
-
Surgical tracheotomy in newborn children is a rare intervention. It is reserved for heavy pathological disorders that cause obstruction of airways. In the Mother and Child Health Institute over the period from 1992 to 2001 we treated 141 children with congenital laryngeal anomaly. ⋯ Tracheotomy was performed in 11 (8%) infants, because their breathing was difficult, and they were at risk from suffocation. In six infants we made successful disannulment and in the others treatment still continues. We decided that surgical tracheotomy must be carried out just in cases with acute respiratory insufficiency, as a step in later treatment.
-
Diabetes mellitus is frequently accompanied by cardiac rhythm disorders. On the other hand, atrial fibrillation is the most frequent cardiac arrhythmia in adult population [1, 2]. According to some of the large epidemiological studies diabetes mellitus is among independent risk factors for development and persistence of atrial fibrillation [3]. Both diabetes mellitus and atrial fibrillation independently increase the risk of thromboembolism, especially of stroke [3-5]. It is obvious that rhythm control, i.e. restoration and maintenance of sinus rhythm, may be essential for prevention of thromboembolism in these patients. ⋯ We concluded that diabetes mellitus independently predicts the presence of recurrent atrial fibrillation but does not influence the possibility of sinus rhythm restoration. The relationship between atrial fibrillation and diabetes mellitus needs further investigation.
-
The authors have examined frequency of dysmorphological signs by POSSUM at the Home for developmentally handicapped children and adults in Vetemik--Novi Sad. The aim was to establish possible different hereditary and congenital skin diseases and genetic syndromes in this population. The study was based on the following methods: method of family history including genealogy; dermatoglyphic methods; screening tests methodology in medical genetics; method of cytogenetic analysis; histo-pathological analysis; method of dermatovenerologic, genetic and dysmorphologic examinations of skin diseases by analysis of dysmorphological signs on the skin using a special computer programme. ⋯ Non-parametric statistics and Log-linear analysis revealed a statistically significant difference between the incidence of dysmorphological signs in the studied group and the Vojvodina population. The obtained incidence of dysmorphological signs in the examined group is presented in tables. Our results regarding the incidence of dysmorphological signs in the examined group showed significantly increased values in comparison to the population of Vojvodina.