Medicina
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In the current article, 3 cases of aortic aneurysm and dissection in pregnant patients with Marfan's syndrome are reported. It is well known that pregnancy is a risk factor for the development of aortic aneurysm and dissection in women with Marfan's syndrome since it is shown that dissection can develop both before and after labor. Marfan patients with an aortic root diameter greater than 4 cm should undergo preconceptual counseling for surgical aortic repair before pregnancy. Pregnant Marfan patients with an aortic aneurysm should be closely and continuously evaluated by multidisciplinary specialists in order to prevent possible aortic dissection that could be fatal for both the mother and the fetus.
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Combined oral contraceptives have been known as a well-established contraceptive method already more than 50 years. Unfortunately, this method is not absolutely safe. Combined oral contraceptives include estrogens and progestagens, which may stimulate the blood coagulation and promote the occurrence of deep-vein thrombosis; adverse effects of oral contraceptives are also notably associated with increased risk of stroke and myocardial infarction. The risk of hypercoagulation and venous thrombosis is most likely to be influenced by the dose of estrogens, but recent investigations have showed that the type of progestagens is very important as well.
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To describe a pattern of antibiotic prescription during root canal treatment procedures based on the reports of Lithuanian general dental practitioners. ⋯ Lithuanian dentists, particularly those with longer duration of professional activity, tended to exceed general recommendations for the antibiotics prescription in cases of endodontic infections. However, a trend toward prescription of broader spectrum antibiotics by younger dentists, compared with those with longer professional activity, was observed.
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Randomized Controlled Trial Comparative Study
The influence of dexamethasone and ketolgan on postoperative nausea and vomiting and estimation of risk factors in women undergoing gynecologic laparoscopic surgeries.
The aim of this study was to determine the effect of dexamethasone and ketolgan on postoperative nausea and vomiting and to evaluate risk factors for postoperative nausea and vomiting. ⋯ Preoperative medication with dexamethasone significantly reduces the incidence of postoperative nausea and vomiting. Avoidance of opioids for postoperative analgesia reduces the incidence of postoperative nausea and vomiting. Migraine and motion sickness are independent risk factors for postoperative nausea and vomiting.
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Review Comparative Study
[Postoperative cognitive dysfunction of older surgical patients].
Light changes in mental function after operation occur in patients of all ages, but more frequent they are observed in older patients. The incidence of early postoperative cognitive dysfunction varies depending on surgical procedure and may be as high as 20-90% in aged patients, and occurs most often in patients undergoing cardiovascular surgery. Early postoperative cognitive dysfunction is a predictor of late postoperative cognitive dysfunction. ⋯ An assessment of cognitive function should be completed as a routine in older patients, and effective prevention requires the identification of risk factors for delirium: advanced age, preexisting dementia and depression, visual and hearing impairment, Parkinson disease, emergency operation, anticholinergic drugs, and others. After operation, elderly patients must be carefully monitored for probable postoperative delirium. It is important to deepen health care professionals' knowledge of postoperative cognitive complications in older surgical patients.