Casopís lékar̆ů c̆eských
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Adverse cardiac outcomes continue to be an important cause of perioperative morbidity and mortality in the non-cardiac surgery. This is related to the high prevalence of coronary artery disease in the aging surgical population. Beta-blockers were proved useful and efficacious in the treatment of perioperative myocardial ischaemia and arrhythmia. ⋯ However, one recent meta-analysis and several new studies have not confirmed the postulated beneficial effects of perioperative betablockade and gave rise to an animated controversy. Until the finalization of ongoing large trials in the next two years, the decision to start prophylactic perioperative beta-blockade remains at the discretion of the responsible physicians. This decision should be based on the patient's risk, the type of surgery and on the consideration of potential interactions and side-effects of the selected beta-blocker.
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Casopís lékar̆ů c̆eských · Jan 2007
Case Reports[Decompressive craniectomy in the treatment of posttraumatic edema and the contribution of new diagnostic methods].
The authors present a case report of a young male who suffered a brain injury complicated with malignant posttraumatic edema managed with bilateral decompressive craniectomy after conservative treatment failure. They further discuss current surgical approach to posttraumatic brain edema and contribution of new diagnostic methods in secondary brain damage management.
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Casopís lékar̆ů c̆eských · Jan 2007
[Surgery tracheostomies and percutaneous dilatation tracheostomies--retrospective study].
Surgical tracheostomy (ST) is replaced by percutaneous dilatation tracheostomy (PDT), namely because the second one requires less equipment and it consumes less time. PDT is indicated and performed mostly in intensive-care units. We focused on the type of technique of both methods and on the frequency of their complications. ⋯ During the last five years an increase of PDT performed to secure airways was observed. When performing ST, horizontal incision of the skin and division of the thyroid gland isthmus were used most frequently. Griggs' technique was used to perform PDT. PDT was associated with the higher rate of early complications and there was no significant difference in late complications in both groups.
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Casopís lékar̆ů c̆eských · Jan 2007
Review[Thrombotic complications of sepsis and their pharmacological prophylaxis].
Patients with severe sepsis are at increased risk for developing thrombembolic phenomena. This article aims to clarify the association between systemic inflammation activation and coagulation, pathogenesis of coagulation abnormalities during severe sepsis. The article reviews incidence and deep venous thrombosis risk factors among these patients and summarizes recent evidence-based guidelines for deep venous thrombosis prophylaxis.
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Casopís lékar̆ů c̆eských · Jan 2007
Review[Ten years since the successful introduction of the first monoclonal antibody (rituximab) into the therapy of lymphomas].
Cancer treatment is based on combination of systemic chemotherapy and radiotherapy. The new methods of therapy based on biological priniciples have been introduced within last decade. The monoclonal antibody rituximab was launched ten years ago in 1997. ⋯ Rituximab has become the inevitable part of therapeutic regimens for other B-cell lymphomas, chronic lymphocytic leukaemia as well as for some non-malignant diseases. The important milestones, the therapeutic results of rituximab and other approved monoclonal antibodies (alemtuzumab, ibritumomab tiuxetan 90Y) is reviewed in this paper as well as short compendium of new antibodies is given. The cost effectiveness of the new therapy is discussed.