Bratisl Med J
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Fractures of the metacarpals and phalanges are the most common fractures of the upper extremity. Hand fractures can be complicated by deformity because of no treatment, stiffness due to overtreatment, and both due to inappropriate treatment. "Boxer's" fractures of the fifth metacarpal neck are rarely seen in professional boxers, they are fare more common in people who hit solid objects such as walls. Controversy exists regarding the optimum treatment. ⋯ When all previous attempts to restore painless motion fail, arthrodesis of the joint becomes the method of choice. The most commonly arthrodesed finger joints are distal interphalangeal (DIP), proximal interphalangeal (PIP) and the interphalangeal (IP) joint of the thumb. The position of joint arthrodesis should be individual depending on the patient's needs. (Fig. 13, Ref. 6).
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Severe impairment of lung functions in meconium aspiration syndrome (MAS) often needs the application of combined therapeutic approach. In our recent study, surfactant lung lavage during asymmetric high-frequency jet ventilation (HFJV) removed more meconium than surfactant lavage during conventional ventilation, however, after the lavage excessive CO2 elimination was observed during HFJV. ⋯ Surfactant lung lavage by asymmetric HFJV followed by conventional ventilation is advantageous combination in rabbits with MAS and may be tested in neonatal MAS (Tab. 2, Fig. 2, Ref. 12).
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The differentiation of congestive heart failure from pulmonary cause of dyspnea is of extreme importance in patients presenting with acute shortness of breath. It seems that the use of B-type natriuretic peptide (BNP) can speed up the diagnostic process significantly. ⋯ The rapid, highly sensitive and specific measurement of BNP concentrations in the patients with dyspnea can significantly help to differentiate the cardiac and pulmonary causes of dyspnea (Tab. 1, Fig. 1, Ref. 24).