Bratisl Med J
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Diffuse alveolar haemorrhage (DAH) is a serious pulmonary complication seen in patients with autoimmune disorders and patients treated with chemotherapy or after hematopoietic stem cell transplantation. The clinical management of DAH is complex and the condition has a high mortality rate. During inflammation, tissue factor is expressed in the lung alveoli and therefore pulmonary administration of human recombinant activated factor VIIa (rFVIIa) could be a rational treatment option (4.1). ⋯ Symptomatic therapy--intrapulmonary administration of one dose of rFVIIa was found to have an excellent haemostatic effect in the patient with DAH. The intrapulmonary administration of rFVIIa seemed to have a high benefit-to-risk ratio. These findings warrant further exploration (Ref. 12).
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Stroke is an emergency which threatens life and the third leading cause of death in developed countries and the leading cause of long-term disability. By means of this study, it was aimed to evaluate the position of triage stroke panel in differential diagnosis of acute hemorrhagic stroke and ischemic stroke and sub-types of ischemic stroke. ⋯ A total of 100 consecutive patients with a diagnosis of stroke were evaluated. Of these, 29 (29%) patients had brain hemorrhages on the computed tomography scan performed the Emergency Department, 71 (71%) patients had ischemic stroke. It was observed that the intercept obtained as a result of jointly evaluating BNP, D-dimer, MMP9 and S100b is more important in differential diagnosis (p < 0.005). We suggest that using a combination of plasma biomarkers may be usefull to ischemic or hemorrhagic stroke for differential diagnosis (Tab. 4, Ref. 22).
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Randomized Controlled Trial Comparative Study
Postoperative intrathecal analgesia for primary total hip arthroplasty--comparative clinical examination of two different small doses of morphium hydrochloride.
To prospectively compare the spinal analgesia with two different small doses of morphium hydrochloride after primary total hip arthroplasty. ⋯ Intrathecal usage of 0.05 mg and 0.1 mg of MCh provides a long-lasting postoperative analgesia. It is a practical method to be provided after primary total hip arthroplasty. The efficacy of 0.1 mg of MCh is greater compared to that of 0.05 mg of MCh. These doses of MCh do not cause respiratory depression but cause nausea, vomiting and itching (Tab. 4, Fig. 1, Ref. 11).
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Evidence-based medicine currently dictates that in children, the controlled hypothermia may be applied only to the first degree and only in cases of neonatal encephalopathy and acute brain injury. Current recommendations are limited in terms of indication as well as by their very low degree of relevance (47.1%). ⋯ The method of therapeutic hypothermia is not a predictor of survival but its proper implementation can be the key to the recovery of functions of body organs and systems after successful cardiopulmonary resuscitation. Unfortunately, this method is associated with adverse effects, namely with myocardial depression during the induction phase, and life-threatening complications after bringing the core of body to normal temperature. To increase the patient safety we have developed a safe strategy. Our protocol provides a relatively rapid induction, short interval of active cooling and passive rewarming over a long period of time (Tab. 3, Fig. 1, Ref. 34). Full Text in free PDF www.bmj.sk.
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Randomized Controlled Trial
Caesarean section in isobaric spinal anesthesia with and without direct preoperative hydration with crystalloids.
Because the direct preoperative hydration with crystalloids (20 ml/kg) does not adequately prevent spinal hypotension during cesarean section, the authors investigated whether a continuous intravenous infusion of ephedrine (50 mg/500 ml of Ringer solution) without preoperative hydration would prevent the spinal hypotension more effectively. ⋯ The continuous infusion of ephedrine simultaneously with spinal anesthesia is superior to direct preoperative hydration with crystalloids in preventing the spinal hypotension and its clinical manifestations in parturients delivered with C-section (Tab. 3, Ref. 20).