Bratisl Med J
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Biography Historical Article
Hippocrates and his principles of medical ethics.
"The Father of Medicine", as Antiquity called Hippocrates has left rich medical and ethical heritage for us. His heritage--the collection of treatises Corpus Hippocraticum, from 5th and 4th centuries BC, comprise not only general medical prescriptions, descriptions of diseases, diagnoses, dietary recommendations etc., but also his opinion on professional ethics of a physician. The Hippocratic Oath, taken by ancient and medieval doctors, requires high ethical standards from medical doctors. Its principles are important in professional and ethical education of medical doctors even today. (Ref. 4.).
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Review
The role of the initial 12-lead ECG in risk stratification of patients with acute coronary syndrome.
This article reviews the prognostic significance of the initial 12 lead ECG in acute coronary syndrome (ACS). In patients with non ST segment elevation ACS, the initial ECG may vary from a normal one to an ECG which demonstrates T wave inversion and ST segment deviation. Patients, who present with either a normal ECG or T wave inversion in less than 5 leads, are considered to be at low risk. ⋯ Less frequently ST segment elevations may be present in lead V1 and V2. Patients with posterolateral wall extension can be identified by the presence of ST segment depression in the right precordial leads. Finally, distortion of the terminal portion of the QRS complex is an important indicator of poor outcome. (Fig. 3, Ref. 42.)
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The results of a merely pharmacological therapy in patients with advanced left ventricular dysfunction are unsatisfactory. Coronary artery bypass grafting is frequently the only therapeutic option, but ventricular dysfunction is generally considered to be a risk factor. ⋯ Successful results of surgical revascularization in patients with severe impairment of left ventricular function can be achieved by careful selection of patients (the presence of viable myocardium is necessary) and management. Early mortality and morbidity was higher than in patients with normal ventricular function. Age and low cardiac output syndrome were revealed as risk factors of early mortality. Long-term prognosis for hospital survivals was satisfactory. (Tab. 5, Fig. 1, Ref. 13.)
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Teaching subject physics at the university level represents a specific didactic transformation of the scientific field--physics. The determination of the content, extent, used methods, mutual relation to other subjects of curriculum as well as to the entrance knowledge of students are the most important parts of pedagogical activities in the educational process. ⋯ Some changes in the structure of physics education are recommended. The usefulness of the international collaboration in the framework of projects such as TEMPUS, ERASMUS is also remembered.
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For many years, the intensivists are searching for an easily measurable and available parameter which might reflect the intensity of stress and/or systemic inflammation in critically ill patients following shock, multiple trauma, major surgery or sepsis. Recently, some authors have described the onset of significant lymphocytopenia after polytrauma, major surgery, endotoxaemia and sepsis. We investigate whether serial examination of white blood cell counts may reflect and clarify the immune response to stressful events in critically ill patients. ⋯ In the population of 90 ICU oncological patients, we observed rapid serial changes in white blood cell populations, as a response of the immune system to surgical stress, systemic inflammation or sepsis. Preliminary results show the correlation between the severity of clinical course and the grade of neutrophilia and lymphocytopenia. The ratio of neutrophil and lymphocyte counts (in absolute and/or relative % values) is an easily measurable parameter which may express the severity of affliction. We suggest the term: neutrophil-lymphocyte stress factor, as a ratio of neutrophil to lymphocyte counts, which can be routinely used in clinical ICU practice in intervals of 6-12 and 24 hours. The prognostic value of neutrophil-lymphocyte stress factor should be evaluated in further studies. (Tab. 6, Fig. 5, Ref. 12.)