Medicinski arhiv
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Heart rate variability which denotes variations of the length of consecutive heart cycles has been suggested to reflect the modulation of heart rate by autonomic nervous system. ⋯ The results have shown that during balanced anaesthesia with two different inhalation anaesthetics there are variations of haemodynamic variables and parameters of heart rate variability without statistically significance that could show the difference between the groups and different agents administered.
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Left ventricular pseudoaneurysm is a rare condition because in most instances ventricular free-wall rupture leads to fatal pericardial tamponade. Rupture of the free wall of the left ventricle is a cata-strophic complication of myocardial infarction, occurring in approximately 4% of pa-tients with infarcts, resulting in immediate collapse of the patient and electromechanical dissociation. In rare cases the rupture is contained by pericardial and fibrous tissue, and the result is a pseudoaneurysm. The left ventricular pseudoaneurysm contains only pericardial and fibrous elements in its wall-no myocardial tissue. Because such aneurysms have a strong tendency to rupture, this disorder may lead to death if it is left surgically untreated. ⋯ In this case report, we present a patient who underwent successful repair of a left ventricular pseudoaneurysm, which followed a myocardial infarction that was caused by occlusion of the left circumflex coronary artery. Although repair of left ventricular pseudoaneurysm is still a surgical challenge, it can be performed with acceptable results in most patients.
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Spinal pain is the most common of all chronic pain disorders. Imaging studies can be used to determine whether a pathological process is associated with the patient's symptoms. ⋯ Our study suggests that needle instillation of steroid and lidocaine is effective in short-term pain occurs in different painful spine conditions (Sy cervicale, lumbare and radiculopathy). It is valuable alternative to the classic methods of physical and drug therapy. It can also postpone surgical treatment, and it is very useful in situations of diffuse degenerative changes when is very important to define exact source of pain, like for instance in hip-spine syndrome.
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Non-alcoholic (NAFLD) encompasses a spectrum of disease states, from steatosis (fatty liver) to non-alcoholic steatohepatitis (also called NASH steatosis with inflammatory changes) followed by progression to fibrosis and cirrhosis and hepatocellular carcinoma Excess liver fat is believed to be a manifestation of the metabolic syndrome and not surprisingly NASH is associated with obesity, insulin resistance, dyslipidemia and type 2 diabetes in humans. ⋯ Patients with non-alcoholic fatty liver are excessively obese, have greater waist line extent, consequently insulin resistance and impaired glucose metabolism, insulin resistance, dyslipidemia, risk factors known to be associated with the development of cardiovascular disease.
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Case Reports
Anesthetic management of hysterosalpingooophorectomy in a case with severe idiopathic dilated cardiomyopathy.
Idiopathic dilated cardiomyopathy is a primary myocardial disease with unknown aetiology. This disease follows a prospective course that is characterized by ventricular dilation and impaired myocardial dilation. ⋯ Because of the increased risks of perioperative complications, anesthetic management of this disease requires the application of a specific technique. This case report demonstrates the application of successful regional anesthetic management (thoracic epidural anesthesia) in a patient who had been diagnosed with severe idiopathic dilated cardiomyopathy.