Medicinski arhiv
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Evaluation of neurogenic urination dysfunction by urodynamic examination in patients with spinal cord lesions is essential for ensuring the effective emptying of the bladder and the prevention of urological complications. ⋯ In our sample of patients with spinal cord lesions was demonstrated the impact of low compliance to the occurrence of UUT complications. It is also in case of the areflexic bladder found significant difference in compliance between the groups with and without UUT complications. Maintaining bladder compliance and low values if intracystic filling pressure the most important tasks in maintaining vesico-sfincteral balance, and thus prevention of urological complications in patients with spinal cord lesions.
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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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Use of thoracic epidurals is widespread for intraoperative and postoperative analgesia. Thoracic epidural anaesthesia (TEA) reduces sympathetic activity and thereby influences perioperative function of vital organ systems. A results of recent studies suggest that TEA decreases postoperative morbidity and mortality. ⋯ Use of TEA is associated with the risk of harm, but also the other methods used to control perioperative pain and stress response carry specific risks. Timely diagnosis and treatment of spinal compression or infection are crucial to ensure patient safety with TEA. The benefits of TEA outweigh the risks with respect to the perioperative outcome and organ protection, if basic guidelines are followed.
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Randomized Controlled Trial Comparative Study
Comparison of the motor and sensory block by ropivacaine and bupivacaine in combination with lidocaine in interscalene block.
The effects of ropivacaine and bupivacaine in interscalene block have been studied, but we usually combine lidocaine with ropivacaine or bupivacaine to fasten the onset. However, the effects of these combinations are not studied. ⋯ In interscalene block combined with lidocaine, ropivacaine had slower onset of motor block and longer duration of both blocks than bupivacaine. Only bupivacaine showed the different duration of the blocks between two concentrations.
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Multicenter Study
Tamsulosin efficiency in treatment of benign prostatic hyperplasia evaluated by determining bladder weight.
INTRODUCTION/GOAL: Bladder wall thickness and bladder mass are higher in patients with subvesical obstruction caused by benign prostate enlargement (BPE) in compensated stage of the disease. The goal of the study was to determine changes of bladder detrusor in patients suffering from benign prostatic hyperplasia (BPH) during tamsulosin treatment. The study was open, prospective and multi-centric. ⋯ During a 24-week treatment of benign prostatic hyperplasia with tamsulosin, the same showed clinical efficiency in the sense of improvement of LUTS and a decrease of bladder outlet obstruction (BOO), without the influence on prostate volume or showing statistically significant vasodilatory effect. The same affected a significant decrease of ultrasound estimated bladder weight (from 65 g to 28 g).