Przegla̧d lekarski
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Clinical Trial
[Clinical observations concerning piracetam treatment of patients after craniocerebral injury].
Piracetam (Nootropil) is a cytoprotective to brain tissue and improving cerebral blood flow medicine. In the Department of Neurotraumatology we investigated results of piracetam treatment in a group of 100 succeeding patients admitted between 1995-96 due to craniocerebral injury. High doses (24-30 g per day) of this medicine have a positive effect on final result of treatment, when treatment is initiated immediately after the injury and described conditions are abided. We also showed usefulness of piracetam treatment in posthospital management.
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During the past 10 years, we have treated 11 patients who were admitted with acute respiratory failure due to goiter. Multinodular goiter was examined in four patients, one patient suffered from Graves disease and six patients had malignant thyroid lesions. Four patients required emergency intubation and in two cases we performed tracheostomy because of significant narrowing of trachea lumen. ⋯ The goiters with progress of trachea compression symptoms should be operated in elective surgery to avoid sudden life-threatening complications like severe dyspnea. When the hoarseness is present the possibility of malignant goiter is particularly high. In our opinion patients with suspected respiratory failure should be referred to the centres with special interest in thyroid surgery.
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The objective of the study was to describe epidemiological and clinical data regarding acute carbon monoxide (CO) poisoning in an urban area of North Italy. 95 consecutive adult patients admitted to Milan and Turin Poisons Control Centres (PCC) for CO poisoning between October 1993 and March 1995 were enrolled into the study. Epidemiological and medical parameters were recorded in a standardised collection data sheet, which included age, sex, circumstances of poisoning, severity grading (0-3), blood HbCO level upon admission. ⋯ Carbon monoxide exposure represents a significant cause of severe but potentially preventable accidental poisoning. The study indicates the need for public education campaigns aimed to warn people against the silent killer at home, and to promote preventive measures. The clinical course of CO poisoning is often severe. A standardised collection data system, to record all the cases of acute CO intoxication in Emergency Departments, can help evaluate the real incidence and clinical significance of this poisoning.
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The aim of the research was to verify the procedures of first-aid and treatment in 100 patients with cranial and brain injuries, admitted to the Intensive Care Unit. Material was estimated using Ambulance and Surgical Ambulatory data and Intensive Care Unit case records. Medical procedure at the place of accident and during transport, duration of the transport to the hospital, duration of the diagnostics and morbidity in studied groups were estimated. Considering the analysed material, it seems that following procedures have significant influence on the final outcome: 1. full resuscitation of the patient at the place of accident; 2. correct protection of the injured person during transport and duration of the transport; 3. time necessary for full and correct diagnostics.
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We report organisation principles and three year experience of Acute Pain Service in general surgery clinic. 481 patients were treated after abdominal and vascular interventions, hemorrhoidal varices and mammectomies. Continuous epidural, combined spinal-epidural, intrapleural anaesthesia and continuous brachial plexus block were used for pain control. Time of analgesia varied from 1 to 4 days. ⋯ In 2% of cases cardiovascular complications were observed. Respiratory depression occurred in 1 patient. The work of APS team was assessed as very good by both surgeons and patients.