Adv Clin Exp Med
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Fournier's gangrene is a necrotizing, life-threatening fasciitis of the perineal, genital and perianal region which can spread to the abdominal wall, causing soft-tissue necrosis and sepsis. It is usually a polymicrobial infection. The prevalence of the disease is low, but the mortality rate remains high. ⋯ The treatment consists mainly of aggressive surgical debridement, broad-spectrum antibiotic combinations and hyperbaric oxygen therapy. The Fournier's gangrene severity index (FGSI) score can be used to evaluate patients. Because of its heterogeneity and aggressiveness, Fournier's gangrene is a very serious and complex medical condition that should be under the care of an interdisciplinary team with access not only to the best surgical and critical care but also to a hyperbaric chamber.
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Randomized Controlled Trial
Different remifentanil doses in rapid sequence anesthesia induction: BIS monitoring and intubation conditions.
The aim of this prospective, randomized, double blind trial was to investigate the effects of two different doses of remifentanil on bispectral index (BIS) values and intubation conditions in a simulated model of rapid sequence anesthesia induction (RSAI). ⋯ 1 µg/kg of remifentanil compared to 0.5 µg/kg of remifentanil provides similar hemodynamic profiles and BIS scores, but 1 µg/kg of remifentanil was associated with superior endotracheal intubation conditions. According to this study design and medications used, a relation between BIS scores and intubation conditions couldn't be demonstrated.
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Randomized Controlled Trial Comparative Study
Comparison of two doses of tranexamic acid on bleeding and surgery site quality during sinus endoscopy surgery.
One of the main concerns in sinus surgery is blood loss due to the high vasculature of the mucosa. Tranexamic acid (TA) is an antifibrinolytic agent which reduces bleeding following certain surgical procedures. ⋯ Administration of 15 mg/Kg TA intravenously is more effective than 5 mg TA to achieve hemostasis and improving the quality of surgical field, surgeon satisfaction, less surgery period and bleeding volume during endoscopic sinus surgery without any significant side effects.
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Myofascial pain located in the area of the head is a very common disease of the stomatognathic system. The fact that the mechanism of its development is very complex may cause a variety of problems in diagnosis and therapy. Patients diagnosed with this type of affliction usually need a variety of different therapies. ⋯ That kind of therapy is clinically useful as it improves the subjective and objective health status of the patient and is easy to follow. The aim of this paper is to show the physiological effect and different massage techniques applied in myofascial pain treatment. The authors would also like to present the protocol for dealing with patients who demand that kind of therapy for masseter and temporal muscles.
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The implementation of new diagnostic and therapeutic technologies is related to expanding financial needs. The escalation of expenses for health protection and simultaneous economic problems has resulted in an interest in the subject of economic assessment. Decision makers in the health sector should have reasonable tools that will allow them to make complex evaluations of the economic suitability of health technologies. Economic analysis should also prove that launching new procedures can save money. Numerous studies indicate that chronic pain and psycho-sociological variables lead to a worse quality of life. Chronic pain issues are a major public health problem, by virtue of the difficulties in efficient therapy and the social costs reflected in incapability of work and disability. Spinal cord stimulation is the most efficacious procedure in the treatment of chronic pain. ⋯ SCS in both neuropathic pain and refractory angina pectoris is a procedure that brings benefits in the form of savings. After using SCS in both cases, the quality of life improved and the level of pain was reduced.