Medicina
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Randomized Controlled Trial Comparative Study
[Postoperative analgesia with intraarticular local anesthetic bupivacaine and alpha2-agonist clonidine after arthroscopic knee surgery].
To evaluate the efficacy of intraarticular 0.5% 20 ml bupivacaine and compound of bupivacaine with alpha2-agonist clonidine for postoperative analgesia after arthroscopic knee surgery. A total of 48 patients, scheduled for knee arthroscopy, were enrolled in the study. Patients were randomly assigned to three different groups: placebo (group C), and two experimental groups that received one of the following double-blinded intraarticular solutions: 0.5% 20 ml of bupivacaine (group B) and 0.5% 20 ml of bupivacaine with l microg/kg of clonidine (group B+C). Patients were asked to evaluate on a visual analogy scale (VAS) the intensity of pain at rest and during motion, satisfaction with postoperative analgesia. Side effects and requirements for supplemental analgetics were recorded at the same time. ⋯ The compound of intraarticular bupivacaine and clonidine suppresses pain better than intraarticular injection of bupivacaine or use of usual systemic analgetics (p<0.05). Intraarticular analgesia assures satisfaction with anesthesiologic procedure.
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Review Comparative Study
Transcranial magnetic stimulation in clinical practice.
Transcranial magnetic stimulation allows a non-invasive and painless stimulation of the human brain and cranial nerves. The method is in use since 1985. Transcranial magnetic stimulation can use single stimuli, pairs of stimuli separated by different intervals (to the same or to several brain areas), or trains of repetitive stimuli at various frequencies. ⋯ Repetitive transcranial magnetic stimulation can modify excitability of cerebral cortex. Repetitive transcranial magnetic stimulation has opened a new field of investigation of the neural circuitry, and is developing into a therapeutic tool. This general review considers basic principles of transcranial magnetic stimulation, discusses methodological aspects and techniques, and analyses their utility in clinical practice.
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Review Comparative Study
[Intra-abdominal hypertension and multiple organ dysfunction syndrome].
In clinical practice, intra-abdominal pressure is usually measured indirectly via the urinary bladder using Foley catheter. This technique is minimally invasive, safe, simple and accurate. Intra-abdominal hypertension is defined as an intra-abdominal pressure above 12 mmHg. ⋯ Intra-abdominal hypertension causes visceral organ hypoperfusion, intestinal ischemia and may also lead to bacterial translocation, release of cytokines and production of free oxygen radicals. All these factors may contribute to the development of multiple organ failure in the critically ill patients. Intravascular fluid replacement and abdominal decompression are the standards of treatment for abdominal compartment syndrome.
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Comparative Study
Risk factors for clinical anastomotic leakage following the resection of sigmoid and rectal cancer.
The aim of the study was to determine the risk factors for the leakage after sigmoid and rectal cancer resections depending on the height of anastomoses. ⋯ Low rectal anastomoses are at risk for anastomotic leakage, especially in males and in generally unfit patients.
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Comparative Study
The prevalence, course and clinical features of post-concussion syndrome in children.
To investigate the clinical features and the prevalence of symptoms of post-concussion syndrome in children with mild traumatic brain injury, and to evaluate their changes over time. ⋯ More than one year after the trauma, the prevalence of the symptoms of the post-concussion syndrome is not significant higher in children with mild traumatic brain injury, compared to children with other mild body injuries, and is comparable by the changes over time.