Medicina
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Comparative Study
[Autotransfusion of red blood cell from cardiopulmonary bypass circuit blood after cardiac surgery].
The aim of this study was to evaluate the effect of autologous centrifuged residual cardiopulmonary bypass blood on patients' hematocryte value, donor blood product requirements, postoperative blood loss, hospitalization time and the development of infective complications. ⋯ We found that autologous centrifuged residual cardiopulmonary bypass blood was useful in avoiding infective complications, decreasing need of donor blood product requirement and postoperative length of stay in the hospital. This method increases hematocryte value after 12 hours postoperatively.
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Comparative Study
[Clinical information system and its significance in intensive care].
The increasing number of the patients requiring admission to the intensive care unit and growing demand for the outcome analysis was noted over the last decade. The goal of this study was to evaluate the characteristics of the patients, to compare the outcome of surgical and medical patients, and to demonstrate the importance of the clinical information system in the intensive care. During 12-month period 1031 patients were enrolled for the study. ⋯ The underprediction of actual mortality by the SAPS II system was predetermined by this value of the neurological patients. The outcome of the surgical patients was good compared to the results of the studies from other countries. Clinical information system is necessary for comprehensive and objective evaluation of the intensive care unit data and quality of therapy.
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Comparative Study
[Stair climbing test in prediction of postoperative complications after lung cancer surgery].
Preoperative physical state of a patient is very important for adaptation of the patient after lung resections. Purpose of this work is to evaluate an information factor of a stair-climbing test while predicting of postoperative complications after lung cancer surgery. Fifty two patients were examined, who passed lung surgery of different volume. ⋯ Postoperative course was normal for those patients (n=11) who were able to climb five or more flights of stairs. It was noticed that duration of postoperative period has an inverse proportion to a number of the climbed up footsteps. The stair-climbing test is a simple, safe, cheap and informative enough for prediction of postoperative cardiopulmonary complications after lung cancer surgery.
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Evaluate efficacy of videothoracoscopic operations in diagnosis and treatment of lung and pleural diseases. In 1997-2001 186 operations were performed using videothoracoscopic devices in the Department of Thoracic Surgery, Institute of Oncology, Vilnius University. Fourty eight resections were performed: 4 (8%) lobectomies, 1 (2%) pericardial cystectomy, 3 (6%) simpatectomies, 3 (6%) intrathoracal lipomectomies, 1 (2%) removing calcificate, 3 (6%) resections of pericardium, 15 (30%) removing metastases, 12 (25%) hamartomas, 6 (13%) wedge resections of lungs tissue due to I(st) stage NSCLC performed for the elderly. One hundred thirty eight diagnostic procedures were performed in pts with various lung and pleura diseases: 66 (48%) biopsies of lungs tissue and 72 (52%) biopsies with chemopleurodesis. From oncological point of view videothoracoscopic operations are confirmed. These operations shortens hospitalization and combined treatment starts quicker. Middle period of hospitalization - 5 days. We had complications: 22 pts (12%) postoperative pneumonia, 4 pts (2%) - short duration pneumothorax, 1 pts (0.5%) - pleural empiema 1 pts (0.5%) - drop of the lung 1 pts (0.5%) - bleeding. After resections margins were free of tumor invasion. ⋯ 1. Video-assisted thoracic surgery (VATS) surgery is effective safe method of treatment for lung and pleural diseases. 2. In some cases VATS surgery is the only way to remove tumours, and it shortens hospital stay till 5 days. 3. VATS surgery is very effective in elderly patients with concomitant diseases. 4. Chemopleurodesis is very useful in treatment of pleural fluid.
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The problems of diagnosis and treatment of Failed Back Surgery Syndrome are briefly analyzed in this article. Literature overview and analysis is supplemented by the data collected at the Spinal Neurosurgery Department in Kaunas University of Medicine Hospital during the study in which clinical findings and data were analyzed and compared to the answers of patients in the special questionnaires about pain specially designed for the patients with low back pain and the Failed Back Surgery Syndrome. ⋯ The most important clinical aspects of diagnosis and treatment of Failed Back Surgery Syndrome are discussed in this article and compared to the clinical trial in order to point out the real their value, effectiveness and long term results. In addition, the clinical value and use of special pain questionnaires is discussed and their auxiliary role is established.