Przegla̧d lekarski
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The case of a 67-year-old patient, treated for melanoma, who was given a toxic dose of doxorubicin (600 mg/m2), was described. The haemoperfusion was performed a short time after intoxication. No toxic effects were seen during the observation for three weeks. The catheter was removed from the sitting patient by an oncologist. The patient abruptly lost consciousness, there were also cyanosis, loss of muscle tone and apnea. The reanimation was unsuccessful. The air embolism was probably the cause of death. The diagnosis was confirmed by the sudden attack, wide duct after the removal of catheter, sitting position of the patient and the presence of foramen ovale found during autopsy. ⋯ Cannulation as well as decannulation of the central vessels should be performed by experienced doctors. Decannulation should always be done in the Trendelenburg position.
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Proper tracheal tube cuff pressure (CP) can diminish the risk of side effects. Excessive tracheal tube cuff pressure can cause ischaemic changes in the tracheal mucosa, decubitation, granuloma, rupture of a trachea, tracheo-oesophageal fistulae or tracheal stenosis. Too low CP is also undesirable, because it can increase the leakage of colonized subglottic secretions around the tracheal tube cuff, which is the risk factor of ventilatory associated pneumonia. Accidental extubation may also occur. The aim of the study was to find out if there are any differences in maintenance of the proper CP between the staff of intensive therapy unit (ITU) under the supervision of anaesthesiologists and staff of intensive care units (ICU) led by non-anaesthesiologists. ⋯ The data analysis did not reveal any differences between values of CP in both groups of subjects. Over-inflation was more frequent than under-inflation in both groups of patients. Regular measurement of tracheal cuff pressure was not a routine procedure in the controlled units.
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Randomized Controlled Trial Clinical Trial
[The effect of vitamin, macro and microelement supplementation on markers of iron status in blood of pregnant women].
Interest in assessing iron status in the population of women during their child-bearing age has grown recently both in terms of detecting iron stores and evaluating whether they are sufficient to meet increasing needs during pregnancy. The fact that iron deficiency anaemia often develops in pregnancy indicates that that iron stores and dietary iron are insufficient to requirements and iron supplementation is needed. The aim of the present study was to determine the effect of vitamin, macro and microelement supplementation on iron status of pregnant women and of their newborns. ⋯ In serum of umbilical cord blood concentration of total iron, transferin and ferritin were similar in newborns of both groups of mothers. The above results suggested that vitamin, macro and microelement supplementation of pregnant women improved iron status in mothers and in their children. It seems that administration Vibovitmama formula can be recommended as a dietary supplement in pregnancy in order to prevent subclinical deficiency of iron.
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Comparative Study
[Ultrasound stethoscope in the rapid assessment of left ventricular systolic function and valvular regurgitation--personal experience].
Recent technological advances enabled miniaturization of echocardiographic machines and construction of portable "ultrasound stethoscopes", which enable rapid two-dimensional and color-Doppler imaging and supplement clinical examination of the heart. We present the results of systematic assessment of these devices in comparison with standard echocardiographic machines. ⋯ Results of the systematic evaluation of the use of ultrasound stethoscopes in the rapid evaluation of left ventricular systolic function and valvular regurgitation. Although image quality achieved with the hand-held stethoscope was worse, nevertheless it was adequate for the purpose of performing rapid limited assessment of cardiac and valvular function.
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Randomized Controlled Trial Clinical Trial
[End-tidal sevoflurane concentrations for laryngeal mask airway insertion and tracheal intubation in children].
Sevoflurane, a new inhalation anesthetic agent characterized by a low blood-gas partition coefficient and nonpungent odor, appears suitable as an induction agent for children. This study was conducted to determine the sevoflurane concentration required for tracheal intubation and insertion laryngeal mask in children. ⋯ Laryngeal mask insertion can be performed at a lesser sevoflurane concentration than that required for tracheal intubation.