Medicina
-
Randomized Controlled Trial Comparative Study Clinical Trial
[Comparison of two different methods of analgesia. Postoperative course after colorectal cancer surgery].
The purpose of our study is to compare two methods of postoperative analgesia in colorectal cancer patients after resectional operations, and to evaluate advantages and limitations of each method on the postoperative course of these patients. ⋯ Epidural analgesia has demonstrated significantly better effectiveness than intramuscular pethidine analgesia after colorectal cancer surgery with fewer adverse events. Self-assessment manikin scores showed better self-satisfaction in patients of epidural analgesia group as compared to patients in systemic pethidine group.
-
Review Comparative Study
[Treatment and prophylaxis of deep venous thrombosis with low molecular weight heparins (meta-analysis of clinical trials)].
Deep-vein thrombosis is a relevant problem of today's medicine, because the risk to fall ill with this pathology is 2-5%; it increases in senior age. Direct and indirect acting thrombin inhibitors are used for treatment and prevention of vein thrombosis. Though great efficiency and safety of new anticoagulants (especially factor Xa inhibitors) were proven in clinical studies, unfractionated heparin and low molecular weight heparins are still most widely used in clinical practice. ⋯ Due to these characteristics they are convenient, safe and economically worth using (used by subcutaneous injections, prescribed only 1-2 times per day, coagulation control not required, possibility for patient to be treated at home); therefore low molecular weight heparins are more and more often used in treatment of deep-vein thrombosis and also in primary and secondary prevention. They are one of the most efficacious contemporary anticoagulants, which allow to decrease the deep-vein thrombosis treatment and prevention costs. This article presents literature review about low molecular weight heparins, their appliance in treatment and prophylaxis of deep-vein thrombosis.
-
Review Comparative Study
[Mental disorders and their relation to brain lesion location: diagnostic problems].
Knowledge of symptoms of appropriate brain areas lesion helps to differ psychiatric and neurological disorders. The objective of our work was to find out the situation in scientific research about mental disorder relation to brain lesion location and to except the location of lesions, which are most complicated in differential diagnosis. We discussed the relation of most important mental disorders to brain lesion location. ⋯ The differential problems appear because various structural brain lesions provide symptoms, similar to mental disorder symptoms. The development of mental disorders and lesion location questions are very urgent. While analyzing the location of lesion, it is important to motivate the theories of development of schizophrenia, organic depression, emotional lability and other disorders.
-
Review Comparative Study
[Ventilator associated pneumonia: risk factors, diagnosis, treatment and prevention].
Treatment in the intensive care units has aggressive character. A lot of invasive diagnostic and treatment procedures are used in order to keep vital functions of the patients. Some complications are associated with treatment methods. ⋯ Antibiotic treatment should be chosen on the ground of clinical data, hospital epidemiologic situation and most common pathogens. Prevention of ventilator-associated pneumonia is based on improving basic hygiene and nursing quality. Ventilator-associated pneumonia morbidity could be reduced by identification of risk factors and risk prevention.
-
Hyperglycemic hyperosmolar nonketotic syndrome and diabetic ketoacidosis are two of the most serious acute complications of diabetes. Hyperglycemic hyperosmolar nonketotic syndrome is found mostly in type 2 diabetic patients. It is characterized by extreme dehydration and neurologic symptoms, which are related directly to the degree of hyperosmolarity. ⋯ This article reviews data about precipitating factors, pathogenesis, carbohydrate, water and electrolyte metabolism in this hyperosmolar hyperglycemic state. The review discusses diagnostic procedures, laboratory evaluation, differential diagnosis and treatment: replacement of fluid and electrolytes, low-dose insulin therapy. A discussion of complications management of hyperosmolar hyperglycemia, mortality rate and prevention are included in this review.