Medicina
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Comparative Study
[Use of technologies in maintaining autonomy of frail older persons].
Although Lithuanian population is aging and the number of older persons is increasing, the expectancy of autonomous life is one of the shortest in Europe. An increasing number of the elderly results not only in aging society, but in increasing morbidity as well. Reality of life is encouraging health care systems to take into account the needs of older patients and to seek for comprehensive assessment, which is not limited by physical assessment only but includes evaluation of functional state, cognition, socioeconomic status, home environment, identification of geriatric syndromes and vulnerability factors, and assessment of frailty. ⋯ Gerontechnologies in vulnerable and frail elderly people can compensate impaired orientation and memory, widen the possibility to communicate, exchange information, and move. With the help of gerontechnologies, safe home environment and monitoring of health state can be ensured. In the article, algorithm for maintenance of autonomy in older persons made by the authors is presented.
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Randomized Controlled Trial Comparative Study
The effects of sevoflurane and propofol on cerebral hemodynamics during intracranial tumors surgery under monitoring the depth of anesthesia.
Hemodynamic effects during cerebral tumor resection surgery under monitoring the depth of anesthesia and during recovery in sevoflurane- or propofol-anesthetized patients have not been previously compared. ⋯ At the comparable depth of anesthesia for intracranial tumors surgery and during recovery, sevoflurane had no major effect on cerebral circulation measured by transcranial Doppler sonography as compared with propofol. Our results add to current knowledge on the safety of sevoflurane in neuroanesthesia.
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Major obstetric hemorrhage remains the leading cause of maternal morbidity and mortality worldwide. Even though blood transfusion may be a life-saving procedure, an inappropriate usage of blood products in obstetric emergencies especially in cases of massive bleeding is associated with increased morbidity and risk of death. Thorough knowledge of the etiology, pathophysiology, and optimal therapeutic options of major obstetric hemorrhage may help to avoid lethal outcomes. ⋯ The transfusion of each single blood product must be performed only in case of evaluation of expected effect. The need for blood products and for their combination is necessary to estimate for each patient individually in case of obstetric emergencies either. Indications for transfusion of blood components in obstetrics are presented in order to improve the skills of doctors and to optimize therapeutic options in obstetric emergencies.
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Case Reports Comparative Study
Interventional and surgical management of abdominal compartment syndrome in severe acute pancreatitis.
Management of the abdominal compartment syndrome during severe acute pancreatitis by the open abdomen method is associated with considerable morbidity and resource utilization. Thus, the aim of this study was to evaluate the safety and efficacy of the ultrasound-guided percutaneous interventions and/or minimally invasive surgery in the treatment of abdominal compartment syndrome. ⋯ Both the subcutaneous fasciotomy and ultrasound-guided drainage of intra-abdominal and/or peripancreatic fluid collections seem to be safe and effective alternatives in the management of abdominal compartment syndrome; however, prospective studies are needed to further evaluate their clinical role.
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Review
New insights for adult cardiopulmonary resuscitation. Up-coming resuscitation guidelines 2010.
Despite advances in cardiac arrest care, the overall survival to hospital discharge remains poor. The objective of this paper was to review the innovations in cardiopulmonary resuscitation that could influence survival or change our understanding about cardiopulmonary resuscitation. ⋯ Current trends in cardiopulmonary resuscitation are toward minimizing the interruptions of chest compressions and improving the quality of cardiopulmonary resuscitation. In addition, attention should be paid to all the parts of chain of survival, which remains essential in improving survival rates.