Vojnosanit Pregl
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Randomized Controlled Trial
Color Doppler ultrasonography and multislice computer tomography angiography in carotid plaque detection and characterization.
Cerebrovascular diseases are the third leading cause of mortality in the world, following malignant and cardiovascular diseases. Therefore, their timely and precise diagnostics is of great importance. The aim of this study was to compare duplex scan Color Doppler ultrasonography (CDU) with multislice computed tomography angiography (MSCTA) in detection of morphological and functional disorders at extracranial level of carotid arteries. ⋯ Atherosclerotic disease of extracranial part of carotid arteries primarily affects population of middle-aged and elderly, showing more associated risk factors. Sensitivity and specificity of CDU and MSCTA regarding plaque composition, the degree of stenosis and plaque localization are almost the same. These results and the fact that there are no adverse effects (high radiation dose) compared to MSCTA indicate that CDU should be the initial method in diagnostic algorythm for carotid arteries.
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Randomized Controlled Trial Comparative Study
The effects of different anesthesia techniques on free radical production after tourniquet-induced ischemia-reperfusion injury at children's age.
Reperfusion of previously ischemic tissue leads to injuries mediated by reactive oxygen species. The aim of the study was to investigate the effects of different anesthesia techniques on oxidative stress caused by tourniquet-induced ischemia-reperfusion (IR) injury during extremity operations at children's age. ⋯ Continuous propofol infusion and regional anesthesia techniques attenuate lipid peroxidation and IR injury connected with tourniquet application in pediatric extremity surgery.
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Randomized Controlled Trial
[Functional effects of preserving the intercostobrachial nerve and the lateral thoracic vein during axillary dissection in breast cancer conservative surgery].
Conventional axillary dissection in breast cancer surgery implicates the section of the neurovascular elements passing through the dissected tissue: the intercostobrachial nerve (ICBN) and lateral thoracic vein (LTV). Preservation of the ICBN during axillary dissection is well documented in the literature, with slightly contradictory results of its influence to postoperative pain. There is no published data, as far as we know, on the functional effects of preserving the LTV. We supposed that ligation of the LTV contributes to the emergence of postoperative breast edema, which is common in breast cancer conservative surgery. The preservation of venous drainage could diminish the frequency of this undesired occurrence. ⋯ The preservation of the ICBN significantly improved the functional effect of the axillary dissection for breast cancer by reducing sensory loss, while there was no difference in pain intensity and duration. Although we did not prove that the preservation of LTV prevents breast edema after conservative surgery for breast cancer, we think that more complex analysis, including parameters such as the extent of resection of breast tissue, the dimension and constitutional characteristics of the breast, tumor location, obesity, and further developments in surgical technique, would reveal at least discrete improvements in the functional results of this surgical approach.
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Randomized Controlled Trial Clinical Trial
[Total intravenous anesthesia with propofol with midazolam coinduction--the anesthesia of choice in cataract surgery].
Comparative clinical investigation was performed in 80 ASA I/II patients undergoing cataract surgery on one eye. Patients were randomly divided in to four groups, according to the method of anesthesia. Intraoperatively (T0-T6), decreasing of intraocular pressure (IOP) to the optimal values at the start of the operation (T3), and the hemodynamic stability of patients after the induction (T1) were evaluated. ⋯ Fast recovery rate was noticed in the first and the second groups (13.9 +/- 1.1 and 14.4 +/- 0.8 min). Vomiting was noticed in 5% patients in the first group, 15% in the third group, and in 20% in the 4th group. The authors have concluded that TIVA fourth propofol and coinduction with midazolam is anesthesia of choice in the cataract surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Adverse effects reported after inductive doses of the intravenous anesthetics, thiopentone, etomidate and propofol].
It was confirmed that even 10 minutes long general anesthesia necessary for surgery can cause postoperative morbidity. This fact is of the utmost importance for the choice of anesthetics, especially when the operation is to take place in out-patient conditions. The aim of this study was to compare clinical efficacy, tolerability and adverse effects of thiopental, etomidate and propofol. ⋯ During anaesthesia, adverse effects were registered in 5.6%, 37.03% and 5.1% of patients in thiopental, etomidate and propofol group, respectively. In the same three groups, frequency of adverse effects in the immediate post-anesthetic recovery period was 15.09%, 62.09% and 17.06%, respectively. It could be concluded that in this study, out of the three anesthetics investigated, propofol had the greatest clinical efficacy and tolerability and the lowest incidence of adverse effects.