Medicina
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Review Comparative Study
[Guidelines for the diagnosis and management of brain metastases].
Brain metastases are one of the most common palliative oncologic problems. Approximately 20% to 40% of all cancer patients eventually develop metastases to the brain. In this review, we discuss the clinical presentation, diagnostic work-up, prognostic factors and appropriate therapeutic choices for these patients. ⋯ Radiosurgery, treatment that is a possible replacement for surgery, is not yet established as an effective treatment. Chemotherapy is not the primary therapy for these patients. The overall prognosis for patients with brain metastases remains poor.
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Comparative Study
[Morphometric heart changes and left ventricular function in Duchenne's muscular dystrophy].
Heart lesion is characteristic in Duchenne's muscular dystrophy, however there is no unanimous opinion about its appearance time. ⋯ There were no changes of the left ventricular morphometric parameters, systolic and diastolic function observed in young age patients with Duchenne's muscular dystrophy.
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Comparative Study
[Personality correlations with depressiveness among adolescents].
The aim of the study was to assess personality correlates of depressiveness as well as their relationships with the level of depressiveness. ⋯ Depressive adolescents, boys and girls, differ from non-depressive ones by worse psychological adjustment. The level of depression did not differ from depressive girls (having high scores on Minnesota Multiphasic Personality Inventory Depression scale) in their non-adaptive personality characteristics, but markedly differed from that of other girls irrespective of theirs Minnesota Multiphasic Personality Inventory Depression scale scores.
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Angioneurotic edema is a rare (0.1-0.2%) but potentially life-threatening side effect of angiotensin-converting enzyme inhibitors. It can result in serious respiratory distress, airway obstruction and death. Angiotensin-converting enzyme inhibitors associated angioedema is clinically poorly recognized and frequently underestimated condition. ⋯ Pharmacological action of angiotensin-converting enzyme inhibitors on bradykinin and substance P, immunological mechanisms and disarrangements in complement system are discussed. Treatment includes immediate withdrawal of angiotensin-converting enzyme inhibitors and acute therapy with epinephrine 0.3-0.5 ml subcutaneous, 50 mg diphenhydramine s/c or i/v, 40-50 mg methylprednisolone. Future treatment with angiotensin-converting enzyme inhibitors is contraindicated.
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This review explores the effects of central neural blockade on cardiovascular system in healthy patients and for patients with common cardiovascular disease (ischemic heart disease, rheumatic valve disorders, cardiomyopathy). Central regional blockade poses these patients at some extent of risk due to possible hemodynamic instability because of effects of blockade on peripheral vessels and heart. ⋯ It increases diameter of epicardial coronary stenosis, reduces the ST segment depression, provides pain relief for patients with unstable angina, does not affect myocardial contractility. Recommendations are made about applying the central regional anesthesia for these patients; prevention and treatment of hypotension are discussed; and peculiarities of central regional anesthesia for patients taking anticoagulants are highlighted.