Medicina
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Neurocognitive dysfunction still remains a frequent problem after heart surgery, complicating early recovery and strongly affecting postoperative quality of life. The aim of our study was to determine incidence of cognitive dysfunction after coronary artery bypass grafting for patients of low risk group and to find operative and postoperative factors associated with early cognitive impairment. ⋯ Incidence of cognitive dysfunction for patients of low risk group was 46.3%. Cognitive decline was associated with prolonged coronary artery bypass, operation time and number of grafts.
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Comparative Study
[Laparoscopic repair of perforated duodenal ulcer: early postoperative results and risk factors].
Clear patient selection criteria and indications for laparoscopic repair of perforated duodenal ulcers are still of relevance. The purpose of our paper is to describe the early outcome results after this operation and to define the risk factors influencing the genesis of postoperative morbidity. ⋯ Size of duodenal ulcer perforation and duration of ulcer perforation symptoms were found to be risk factors influencing the rates of conversion to open repair and genesis of postoperative morbidity.
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Comparative Study
[Neuropsychological outcomes after coronary artery bypass grafting].
Neuropsychological (cognitive) dysfunction has been described as an important complication, affecting up to 80% of patients early after cardiac surgery. Also it has been shown that cognitive abnormalities persist in a later postoperative follow up. The aim of our study was to determine incidence of cognitive complications early after isolated coronary artery bypass grafting using cardiopulmonary bypass, and to identify predictive factors, associated with perioperative cerebral dysfunction. ⋯ Cognitive dysfunction is still important complication after coronary artery bypass grafting persisting during the early follow-up in some patients. Symbol Digit Modalities Test was sensitive instrument for diagnostics of postoperative neuropsychological complications reasons.
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Postoperative lung injury is one of the most frequent complications in cardiac surgery that has a significant impact on health care expenditures and largely has been believed to result from the use of cardiopulmonary bypass. Cardiopulmonary bypass induces the whole body inflammatory response leading to postoperative lung dysfunction. Pulmonary complications after these operations take the first place in morbidity and mortality rates. ⋯ Therefore, the prevention of such alterations is an urgent problem worldwide. Still it is not known what is the cause of pulmonary alterations, as well as there are no means to prevent them. In our paper we review the international studies in order to present worldwide practice of prevention of pulmonary alterations using various methods of mechanical lung ventilation.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Intercostal nerve blockade with alcohol during operation for postthoracotomy pain].
Purpose of this study was to evaluate the effectiveness of intraoperative intercostal nerve blockade with alcohol in addition to epidural analgesia with morphine for control of postthoracotomy pain syndrome. ⋯ Additional intraoperative intercostal nerve blockade with alcohol provides an additional benefit for postthoracotomy pain relief, especially for at least one month following the thoracotomy.