Medicina
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Comparative Study
Impedance cardiography for aortic balloon counterpulsation impact assessment on patients hemodynamics during acute myocardial infarction.
The evaluation of hemodynamics in patients with acute myocardial infarction is crucial. Intra-aortic balloon pumping or counterpulsation in patients with cardiogenic shock is supposed to be monitored exceptionally by invasive methods for assessment of hemodynamics. However, noninvasive methods might have place in monitoring these patients. The objective of the study was to evaluate the possibility of applying noninvasive methods for evaluation of hemodynamics during acute myocardial infarction complicated by cardiogenic shock and managed by intra-aortic balloon pumping. ⋯ Significant correlation of cardiac output values was observed between the impedance cardiography and intermittent thermodilution techniques during intra-aortic balloon counterpulsation. Noninvasive evaluation of hemodynamic indices by continuous monitoring of impedance cardiography during acute myocardial infarction, complicated by cardiogenic shock and managed by intra-aortic balloon counterpulsation is a reliable method for further application.
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There are still many discussions among physicians how heart failure should be defined. Despite many suggested traditional classifications, majority of definitions circulating in clinical practice and their appropriate usage remain unclear. ⋯ Diagnostic strategy of acute heart failure as well as recommendations for prehospital and inpatient treatment of its forms (pulmonary edema and cardiogenic shock) are presented in the article. Application of new medications, recently introduced to the clinical practice for treatment of acute heart failure, is discussed.
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Comparative Study
[Bleeding after cardiac surgery: risk factors, frequency, and outcomes].
According to the data from different cardiac surgery centers, the incidence of urgent repetitive resternotomy for bleeding after cardiac on-pump operations varies from 2 to 5%. The aim of the study was to determinate the risk factors influencing resternotomy after cardiac surgery, features of early postoperative period, and outcomes. ⋯ The use of antiaggregants and anticoagulants before surgery increases the incidence of resternotomies in the early postoperative period. Postoperative infections that require more expensive treatment with antibiotics are detected much more frequently in patients after resternotomies comparing to the remaining postoperative cardiac patients (15/37 and 69/819, respectively). However, longer hospitalization length (15.8 and 58.0 days, respectively) and higher mortality rate (4.5 and 10.8%, respectively) were observed in patients after resternotomy.
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Comparative Study
Effects of parathyroid hormone on newly regenerated bone during distraction osteogenesis in a rabbit tibial lengthening model. A pilot study.
The overall purpose of the study is to determine the effects of parathyroid hormone (PTH) (1-34) on bone formation in regenerated and surrounding bone of distracted callus during limb lengthening in rabbits. Additionally the aim of the pilot study is to titrate the optimal dose of PTH for distraction osteogenesis treatment in rabbits' tibial lengthening model. ⋯ PTH (1-34) treatment improved mineralization, structural indices of regenerated distracted rabbits' tibiae, whereas treatment at a dose of 25 microg/kg/day PTH (1-34) was significantly more effective than 5 microg/kg/day PTH(1-34) dose treatment when compared to control group. Bigger dose has been chosen for the main study.
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The aim of this study was to analyze the effects of the various traumas on mother and fetus and to present the solutions of trauma management. ⋯ A review of data archive of Kaunas University of Medicine Hospital and articles published during the last 13 years (1990-2003) and selected by computerized Medline search. Trauma affects 7-8% of all pregnant women; motor vehicle accidents account for 42%, falls--for 34%, and violence--for 18% of the most frequently cited cases of injuries. Of the 27,715 pregnant females attending antenatal clinics, 372 (1.3%) experienced trauma: 84% of women had blunt injuries and 16% had penetrating injuries. There were 14 maternal deaths (3.8%) and 35 fetal deaths (9.4%). The success of pregnancy is associated with severity of maternal trauma. The survival of the fetus after trauma depends on the mother's condition in regard to respiratory passage, oxygenation, and hypovolemia. During 1990-2003, six pregnant patients with severe trauma were treated at Kaunas University of Medicine Hospital. Traumatic separation of placenta was observed in two cases. Three women and three fetuses died.