Medicinski arhiv
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For almost 100 years, standard procedure for evaluation of axillary lymph status has been axillary nodes dissection (ALDN)-dissection of 1st, 2nd or possible 3rd level of axilla. Use of less invasive evaluation methods of axillary node pathologically (PH) status of non-invasive breast carcinoma has been started before about 30 year and that new method has been named sentinel lymph node biopsy (SLNB). ⋯ Results of sensitivity (68%), specificity (98%), positive (67%) and negative predictive value (96%) and overall accuracy of method (98%) are comparable and compatible with results from oncological breast cancer centers and allow introducing of SLNB in routine surgical practice in our clinical practice as the alternative for ALND for T1 and T2 breast carcinoma. It also contributes to better co-ordination between specialist of nuclear medicine, surgeon and pathologist.
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Randomized Controlled Trial
Glucosa-Insulin-Potassium (GIK) solution used with diabetic patients provides better recovery after coronary bypass operations.
Tight blood glucose control has become a therapeutical goal for anesthetic management for patients scheduled for cardiac surgery, especially if they are diabetic patients. ⋯ Intraoperative GIK solution given to diabetic patients with CABG operation provides more stable CI, shorter time of MV, more stable values of potassium which provides normal rhythm and less AF onset, less insulin to maintain target glycemia. All the above mentioned provides more stable intraoperative hemodynamic and better recovery of diabetic
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Randomized Controlled Trial
Propofol results in higher incidence of bronchoconstriction in allergic patients.
Some reports showed allergic reaction to propofol. However, propofol has bronchodilating effect. The purpose of this study was to elucidate whether propofol is safely used for patients with allergy or bronchial asthma. ⋯ Propofol might induce bronchoconstriction with a higher incidence in allergic patients than in non-allergic patients, and than sevoflurane.
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Isolated thoracic injuries are relatively common and they are on the second place as a cause of death overall trauma. Most patients with isolated thoracic injuries are treated on an outpatient basis while only serious cases are hospitalized. The basis of the treatment of thoracic trauma is efficient cardiopulmonary reanimation followed by an early detection and treatment of life threatening injuries. Less than 15% of patients with thoracic trauma require thoracotomy. ⋯ Based on the results of the initial diagnostic treatment, in majority of injured with isolated thoracic trauma, it was possible to conduct the relevant and appropriate therapeutic procedures. On the basis of relatively short period of thoracic drainage, hospitalization and low rates of morbidity and mortality, it may be confirmed that the application of initial diagnostic and therapeutic protocols of the Clinic for thoracic surgery resulted in the achievement of the successful treatments in majority of the injured for this type of the
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Randomized Controlled Trial
Alterations of short-term heart rate variability in periinduction period of general anaesthesia with two intravenous anaesthetics.
Alterations of the parameters of heart rate variability, phenomenon associated with autonomic nervous system balance, have been shown as a possibly very important factor for monitoring of cardiocirculatory system in the perioperative period. Periinduction period of general anaesthesia is very important with significant changes of haemodynamics what could be reflected in the changes of the parameter of heart rate variability. ⋯ The results have shown that in the groups of patients who underwent induction of general anaesthesia with propofol or thiopentone, there have been reductions of the total spectral power and the power of the spectrum of low frequency components and high frequency components with variations in the relationship between the components in the different periods of periinduction time.