Acta clinica Croatica
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Acta clinica Croatica · Sep 2014
Randomized Controlled TrialEffect of preoperative administration of intravenous paracetamol during cesarean surgery on hemodynamic variables relative to intubation, postoperative pain and neonatal apgar.
Selection of anesthetic drugs for cesarean section requires many considerations. Anesthetic drugs for this purpose must prevent hemodynamic stress due to tracheal intubation, while inducing neonatal complications. This study was conducted to determine the effects of paracetamol given before induction of anesthesia on cardiovascular responses to tracheal intubation and postoperative pain in the mother, and on neonatal Apgar score. ⋯ The VAS pain score was significantly lower in paracetamol group than in placebo group at all measuring times (P < 0.05). Also, paracetamol caused later first analgesic request and lower dose of analgesic needed to control pain postoperatively (P < 0.05). In conclusion, the results of our study suggested IV paracetamol to be an efficacious agent to decrease hemodynamic responses to tracheal intubation, while providing better postoperative pain management without considerable neonatal complications in women undergoing cesarean section in general anesthesia.
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Acta clinica Croatica · Sep 2014
The effect of post stroke depression on functional outcome and quality of life.
In spite of being a common and important complication of stroke, post stroke depression is often overlooked, so its impact on stroke outcome remains under recognized. The aim of the study was to determine the effect of depression on functional outcome and quality of life in stroke patients. The study included 60 patients treated for their first clinical stroke, 30 of them diagnosed with depression and 30 patients without depression. ⋯ Depression was diagnosed according to the Mini International Neuropsychiatry Interview, DSM-IV diagnostic criteria, and depression severity was quantified by the Hamilton Depression Rating Scale; functional impairment was determined by the Barthel Index; and post stroke quality of life was assessed by the Short Form 36 (SF-36) questionnaires. The patients with depression had significantly more severe functional disability both at baseline and after rehabilitation treatment, although the potential for functional recovery in depressed patients was less than in non-depressed ones. The quality of life in patients with post stroke depression was impaired more severely in all SF-36 domains compared with non-depressed stroke patients, with the domains of the role of emotional functioning and social relations being most severely affected.
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Acta clinica Croatica · Sep 2014
Thoracic epidural analgesia for radical cystectomy improves bowel function even in traditional perioperative care: a retrospective study in eighty-five patients.
Radical cystectomy is associated with significant morbidity and mortality due to complex surgery and comorbidities associated with advanced age of patients. In contrast to the surgery, which is clearly the procedure of choice for patients with invasive bladder cancer, the opti- mal anesthesiologic method is still under debate. Therefore, we retrospectively analyzed 85 patients having undergone radical cystectomy at our institution, either under combined epidural-general anesthesia (CEGA) or opioid based general anesthesia (GA). ⋯ The incidence of postoperative ileus was also lower in CEGA group (p = 0.024). There was no difference in analgesic efficacy, but a trend towards lower incidence of venous thrombosis and infection was noticed. The results of our study suggest that epidural anesthesia might have specific advantages in patients undergoing radical cystectomy.
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Acta clinica Croatica · Sep 2014
Stress and quality of life in patients with gastrointestinal cancer.
This study aimed to answer the question whether it is possible to predict the quality of life in individuals with gastrointestinal cancer based on the number of life events, perceived stress levels and coping strategies. The study included 60 individuals (44 male and 16 female) aged 48 to 87 years, with malignant gastrointestinal tract diseases (56 with colon or rectal cancer, 2 with stomach cancer and 2 with pancreatic cancer). The following instruments were used: Questionnaire on General Information and Lifestyle Habits (developed for the purpose of this study); Scale for Measuring Quality of Life; Coping Inventory for Stressful Situations; and Life Events Scale. ⋯ Task-oriented coping and education were predictors for satisfaction with past life and task-oriented coping was predictive for criterion variables on the Scale for Measuring Quality of Life and for factor related to future expectations and comparison to other people, but the proportion of explained variance was modest. The results of this study suggest that it is important to consider other variables (e.g., personality traits and sociodemographic factors) in predicting the quality of life and psychotherapeutic work with gastrointestinal cancer patients. It is important to bear in mind that there is no universally good individual coping strategy that is acceptable in all situations, but that coping flexibility or the ability to adequately change coping strategies in response to situational demands is by far more important.