Przegla̧d lekarski
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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.
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Comparative Study
[Pediatric open heart surgery on cardiopulmonary bypass without the use of blood products].
Pediatric open heart surgery is associated with the usage of cardiopulmonary bypass. The circuit is primed with blood products because of risk of excessive hemodilution. The aim of the study was to prove the safety of open heart surgery on cardiopulmonary bypass without the use of blood products in the pediatric group. ⋯ Directly after the surgery, group I had significantly higher platelet and leucocyte counts compared to the control group. There were no differences between the confronted populations in regard to postoperative bleeding (4.61 +/- 2.24 vs 4.76 +/- 1.75 ml/kg). The avoidance of using blood products in pediatric patients during open heart surgery with cardiopulmonary bypass is found to be safe, is not correlated with an increased surgical risk, and does not result in a prolonged hospital stay.
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Endocarditis can concern natural as well as artificial heart valves. In conservative treatment mortality reaches 24-60%. Surgical procedure is the only way to save these patients in most cases. ⋯ Our study suggests that patients with endocarditis and compromised hemodynamic status can be operated with acceptable morbidity and mortality. If echocardiography shows the cuspids perforations or vegetations, chords tendinous rupture or perivalvular leak, the patients should undergo cardiac surgery as soon as possible, in order to avoid severe embolic complications.
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Endogenous evoked potentials (P300) are elicited by several stimuli, and are electrophysiological consequence of cognitive processing. Abnormalities have often been reported in dementive syndromes, demyelinating diseases, metabolic disorders, CNS tumors, phacomatoses, neuroinfections, attention deficit hyperactivity disorder and epilepsy. The role of this element of neurophysiological characteristics is debated in migraine, pato-genetically undefined, and other primary headaches. ⋯ The findings of shortened latency of P300 potentials in children with migraine, esp. migraine with aura may contribute to migraine pathogenesis. There were no significant differences in the latency and amplitude of P300 potentials in children with migraine without aura compared with the frequent ETTH. This finding does not add further information to the differentiation of both types of primary headaches.