Medicina
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Review Comparative Study
[Current treatment options for acute bronchiolitis in children].
Bronchiolitis is the most common lower respiratory tract infection in infants and is responsible for the majority of pediatric hospital admissions in winter. Respiratory syncytial virus has been identified as the main causative agent, causing 50-90% of the cases of bronchiolitis. ⋯ This paper reviews current treatment options for bronchiolitis, including the use of bronchodilators, epinephrine, steroids and ribavirin. Most recent advances, including immunotherapy and intensive care, are discussed.
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Acute respiratory distress syndrome (ARDS) - is a life-threatening acute clinical syndrome of pulmonary insufficiency with high mortality. The causes of the syndrome are of every description - from crustacean poisoning to cardiopulmonary bypass. The rate of ARDS is not clear, because of diagnostical variety of ARDS and acute pulmonary dysfunction. ⋯ Though some authors state that recently the ARDS mortality decreased, but most of the authors did not notice any improvement during the last 20 years. The prognosis is determinated not only by pulmonary insufficiency itself (the cause of death in 5% of patients), but by the ARDS predisposing factor (the worst is sepsis and septic shock), multiple organ dysfunction syndrome, difficult physical state of the patient, sepsis as a cause or as a complication of ARDS, nosocomial pneumonia, progressive fibroproliferation in the lung. Considering the actuality of ARDS, the diagnostical criteria of ARDS, pathogenesis, clinical course and new treatment methods are reviewed in the publication.
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Review Comparative Study
[Peculiarities of anesthesia for patients with valvular heart disease during non-cardiac surgery].
A careful preview history of disease and thorough physical examination of patients having valvular heart disease using modern instrumental investigation methods are important in assessing preoperative risk. Important factor in the preoperative decision process and the risk assessment is the nature of surgical procedure also. ⋯ Efforts should be joint to avoid these complications, involving both surgeon and cardiologist, anesthesiologist and general practitioner. Survey of available literature provides variable pathophysiological features of cardiac lesions, which are of paramount in importance while choosing methods of anesthesiological management during non-cardiac operations and use of anesthetics and vasoactive drugs as well for patients with aortic and mitral valve diseases.
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Comparative Study
[Treatment of the upper cervical spine injuries with halo vest device].
In the article are described cases, when patients sustained fractures of the first and the second cervical spine vertebrae and were treated with "Halo-vest" device. We performed this investigation in order to establish efficiency of "Halo-vest" immobilization and to establish regression of neurological evaluation, patients feelings and their come back to their usual environment, when 1-2 years passed after fracture and treatment. Investigation was performed in 1999-2001. ⋯ Reposition of fractures in the upper cervical spine can be achieved with "Halo-vest" device. If close fractures repositions failed, then spondylodesis must be performed and alignment during operation can be maintained with "Halo-vest" device. After these injuries and treatment with "Halo-vest" device about 69% patients came back to their usual environment.
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Commotio cordis due to blunt trauma to the precordium is a rare cause of death in young athletes, occurring less frequently than all of the other athletics-related deaths. Commotio cordis is a term used to describe cases of blunt thoracic impact causing fatality without structural damage of the heart and internal organs. Death is attributed to ventricular fibrillation, which is often resistant to resuscitative therapy. In this article we discussed this catastrophic event, its historical development, epidemiology and clinical presentation, mechanisms for sudden death in commotio cordis, limitations of evidence using animal models, autopsy findings, resuscitation and preventive measures.