Medicinski arhiv
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Heavy menstrual bleeding is one of the common health problems in women. The first-line therapy of heavy menstrual bleeding is the medical therapy, but this is not successful. Currently, global ablation procedures were introduced for treating of heavy menstrual bleeding. The aim of this study was to the analysis of the patient with menorrhagia performed operations of Cavaterm in our university affiliated hospital, and explores its effectiveness and acceptability. ⋯ The findings of this research indicated that outcome with the Cavaterm was as good for women with menorrhagia. Therefore, it is necessary to emphasize on lower operative and post-operative procedural risk and a deleterious effect on patients who were unresponsive to hormone therapy.
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Correction of pediatric spine deformities is challenging surgical procedures. This fragile group of patients has many risk factors, therefore prevention of most fearing complication-paraplegia is extremely important. Monitoring of transmission of neurophysiological impulses through motor and sensor pathways of spinal cord gives us an insight into cord's function, and predicts postoperative neurological status. ⋯ Two of 43 patients or 4.6% in our group experienced significant MEP changes during their major spine reconstructive surgeries. We promptly reduced distractive forces, and MEP normalized, and there were no neurological deficit. Neuromonitoring is reliable method which allows us to "catch" early signs of neurological deficits, when they are still in reversible phase. Although IONM cannot provide complete protection of neurological deficit (it reduces risk of paraplegia about 75%), it at least afford a comfort to the surgeon being fear free that his patient is neurologically intact during long lasting procedures.
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The present study evaluates our experience with aorto-coronary bypass grafting in patients with severe dysfunction of left ventricle (LV) and low ejection fraction-EF(<35%). Revascularization of myocardium in this settings remains contraversial because of concerns over morbidity, mortality and quality of life. ⋯ In patients with left ventricular dysfunction, coronary artery bypass grafting can be performed safely with improvement in quality of life and in left ventricular ejection fraction.
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Comparative Study
Comparison of hydroxyethyl starch 6% and crystalloids for preloading in elective caesarean section under spinal anesthesia.
Although controversial, many studies have shown effectiveness of colloid loading as a substitute for crystalloids on reducing the incidence of hypotension in spinal anesthesia. This study was conducted to compare the effects of three intravenous fluid regimens on hemodynamic changes following spinal anesthesia in cesarean section. The regimens included 6% Hydroxyethylstarch 130/0.4 (HES) as a colloid and two crystalloids (lactated ringer's solution and sodium chloride 0.9%). ⋯ Preloading with HES is more effective than crystalloids in prevention hypotension after spinal anesthesia without significant difference in Apgar score and umblical cord blood pH.
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Comparative Study
Malnutrition at the time of surgery affects negatively the clinical outcome of critically ill patients with gastrointestinal cancer.
Malnutrition is a frequent concomitant of surgical illness, especially in gastrointestinal cancer surgery. The aim of the study was to assess the prevalence of malnutrition in the GI cancer patients and its relation with clinical outcome. We also examined associations between the energy balance and clinical outcomes in these patients. ⋯ This study shows that malnutrition is a significant problem in surgical patients, especially in patients with gastrointestinal cancer. Malnutrition and cumulated energy deficit in gastro-intestinal surgery patients with malignancy is an independent risk factor on increased post-operative morbidity and mortality.