Srp Ark Celok Lek
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Autonomic dysfunction is present early in the course of heart failure, and has a direct role on deterioration of cardiac function and prognosis. Heart rate variability (HRV) estimates sympathovagal control of heart frequency. The influence of respiratory pattern on HRV is clinically important. Breathing disorders are common in heart failure and highly affect HRV and autonomic evaluation. It was previously shown that slow and deep breathing increased parasympathetic tone, but effects of this respiratory pattern on HRV were not evaluated. ⋯ These data suggest that SDB increases HRV both in healthy and heart failure patients; the highest increment is in LF range. Differences in spectral profile of HRV between healthy controls and heart failure patients become more profound during SDB. Controlled respiration during HRV analysis might increase sensitivity and reliability in detection of autonomic dysfunction in heart failure patients.
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There is no specific injury among fatally injured frontal car-occupants in frontal car collisions, used in forensic expertise. We tried to point out the usefulness of the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS) for the expertise in such cases. ⋯ As the injury of the head is more severe, the deceased is more likely to be the front car-passenger. Severe thoracic and abdominal injuries are more characteristic for car-drivers. A total injury severity is useless for forensic expertise in cases of fatally injured in car collisions.
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Among advances in medicine during the past 150 years, certainly the introduction of surgical anesthesia must be considered the greatest gifts of medical profession to mankind, especially to children. Pediatric anesthesia has progressed rapidly throughout the years. Since the first recorded case of pediatric anesthesia in 1842 to the latest advancement in training, technology, medicine and equipment in the last decades of this century, many historic moments have been following each other. ⋯ In the second, together with further technique and equipment refinement, modern anesthetics and vital system surveillance (monitoring) were introduced into everyday practice. The keyto the advances in pediatric anesthesiology was difficulties leading to new inventions with consequent improvement of techniques and methods. This article reviews the origins and development of anesthesia for infants and children in the world and Serbia, emphasizing the contributions of many devoted physicians that represented the major force leading to inevitable evolution of pediatric anesthesia.
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Slipped capital femoral epiphysis is well known disorder of the hip in adolescents, which is characterized by displacement of the capital femoral epiphysis from the metaphysis through the physeal plate. The incidence of slipped capital femoral epiphysis is about 5-8 cases per 100,000 adolescents. Etiology of slipped capital femoral epiphysis is still unknown, but this disorder is probably combination of genetic, hormonal and mechanical factors. ⋯ Chondrolysis or cartilage necrosis can occur in untreated slips, but is often associated with spica cast imobilization or penetratation of the internal fixation screws into the joint space. The final outcome of avascular necrosis and chondrolysis is extremly poor for a patient. Therefore, the baseline of management of slipped capital femoral epiphysis is treatment by adequate techniques that have high rate of success with minimal risk of complications.
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Randomized Controlled Trial Comparative Study
[Evaluation of the intensive rehabilitation protocol after arthroscopically assisted anterior cruciate ligament reconstruction].
Optimal treatment of ACL (anterior cruciate injury) injuries is one of the most dynamic topics of contemporary orthopedics. Despite huge amount of publications on this subject, golden rehabilitation standard has not been established yet. ⋯ Our investigation has undoubtedly revealed that early intensive rehabilitation approach leads to faster functional recovery without complications compared to conventional rehabilitation treatment.