Lijec̆nic̆ki vjesnik
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Sugammadex is a new pharmacological agent for neuromuscular block reversion. It is a cyclic oligosaccharide, a gamma cyclodextrin with lipophylic inner coat that enables forming of stable complexes with steroidal neuromuscular blocking drugs, especially with rocuronium. A physical encapsulation of the relaxants is a novel elimination pathway and it produces fast and complete reversion of both deep and shallow neuromuscular block. ⋯ After the adjusted dose of sugammadex was given, the duration of action of rocuronium can be made as short as that of succinylcholine. This characteristic is especially important in the 'can't intubate, can't ventilate' situation and after surgical procedure was unexpectedly finished. Clinical studies involving more patients are needed to show the real risk-benefit profile and safety in the special patients' populations.
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Lijec̆nic̆ki vjesnik · Jan 2011
Practice Guideline[European Resuscitation Council guidelines for resuscitation 2010].
All rescuers trained or not, should provide chest compressions to victims of cardiac arrest. The aim should be to push to a depth of at least 5 cm at a rate of at least 100 compressions per minute, to allow full chest recoil, and to minimise interruptions in chest compressions. Trained rescuers should also provide ventilations with a compression-ventilation ratio of 30:2. ⋯ Ideally all citizens should be trained in standard CPR that includes compressions and ventilations. Basic and advanced life support knowledge and skills deteriorate in as little as three to six months. CPR prompt or feedback devices improve CPR skill acquisition and retention.
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Lijec̆nic̆ki vjesnik · Nov 2010
Comparative Study[Radioiodine versus surgery in the treatment of Graves' hyperthyroidism].
The most common etiologic cause of thyrotoxicosis in children and adults is autoimmune Graves' (Basedow's) disease. Antithyroid medications, surgery and radioactive iodine have been used in the treatment of Graves' hyperthyroidism for more than six decades. The use of antithyroid drugs is the most common therapeutic approach. ⋯ The risk of surgical treatment is negatively correlated with the surgeon's experience and nowadays, total or near-total thyroidectomy is preferred surgical approach. End point of both treatment modalities is usually hypothyroidism that should not be considered as the consequence of treatment. Moreover, due to thyroid hormones replacement therapy equilibrium can be easily achieved.
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Lijec̆nic̆ki vjesnik · Nov 2010
Case Reports[Combined penetrating wounds of the heart, abdomen and trunk--case report].
This is an overview of a forty-year-old male with combined penetrating knife inflicted stab wounds to the left chest, heart, abdomen and trunk. Presented are clinical manifestations, course of first aid and overall surgical help given to the injured with multiple stab wounds. Efficiency of rapid diagnostics and surgical approach to penetrating stab wound of the heart is pointed out. Postoperative course and definitive outcome of treatment are presented.