Hippokratia
-
The worldwide incidence of kidney failure is on the rise and treatment is costly. Kidney failure patients require either a kidney transplant or dialysis to maintain life. This review focuses on the economics of alternative dialysis modalities such as haemodialysis (HD) and peritoneal dialysis (PD). ⋯ The cost effectiveness of alternative modalities is reviewed. Examples of statistical models and simulation approaches, studying the increase of the life expectancy in terms of the quality adjusted life years (QALYs) and the incremental cost paid are also presented. Corresponding results originated from different regions of the world are also briefly shown.
-
A lumbar epidural catheter inserted in a 29-year-old woman for labor analgesia. The catheter failed to provide adequate analgesia. ⋯ After computer tomography (CT) and magnetic resonance impedance (MRI) examination the course of the catheter was visible, the entrapped catheter was dislodged intact, revealing a kinking near its distal tip. Kinking of an epidural catheter leading to entrapment is an unusual complication of epidural catheterization.
-
Cerebral visual impairment (CVI) is one of the leading causes of severe visual impairment in childhood. This article was written to highlight any new knowledge related to cerebral visual impairment in childhood. The international literature was searched to describe the type of visual, oculomotor and / or visuo-perceptual disturbances and to discuss the prognosis. ⋯ The visual function seems to improve in CVI children, especially in the cortically damaged, mainly due to brain plasticity. The increased survival rate of very premature infants during the last decades has increased the incidence of CVI in childhood. Better understanding of the pathophysiological mechanisms of CVI, early diagnosis and early intervention could lead to a better quality of life of these children.
-
Beta-blockers are a multiform group of drugs with multiple applications in the treatment of patients with cardiovascular disease. Their adverse actions are multiple and relate mainly to the β-adrenergic receptor blockade. ⋯ However, because of side effects, they should be used with caution, especially in hemodynamically unstable patients. Therefore, the choice of the appropriate β-blocker for each patient will result in the best possible results with fewer side effects.
-
Brugada syndrome is an inherited autosomal dominant-type disease characterized by ST-segment abnormalities and increased fatal ventricular tachyarrhythmias. We hereby present a 57-years-old patient with no symptoms or history of cardiovascular disease, diagnosed with febrile respiratory infection (39℃). Electrocardiographic (ECG) findings were typical of Brugada-like type I syndrome that gradually turned to Brugada type II and III, following fever remission, and finally became normal. Other clinical evaluation tests (echocardiographic evaluation, treadmill stress test, Holter ECG, procainamide provocation test) did not relate to Brugada syndrome.