Przegla̧d lekarski
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Life saving surgery is the surgery which has to be performed during the acute or reanimation period (1 to 3 h) and during the primary or stabilisation period (first day surgery). During the reanimation period lifethreatening conditions are identified and management is begun simultaneously. Many trauma surgeons talk about the first "golden hours" as the time interval starting immediately after the injury when rapid intervention will save lives and a lack of intervention will result in life loss. ⋯ This period consists of further diagnostic procedures and treatment of injuries that are not directly life-threatening, but which may become life endangering or severely disabling if not treated promptly. The priorities of the surgical treatment are: brain injuries, eye- and facial injuries, progressive compression of the spinal cord, visceral injuries, musculoskeletal injuries. By improving prehospital care, rapid transport and last but not least immediate life saving surgical treatment preventable deaths can be reduced from 20-30% to 2-9% (5).
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Trauma is a third killer of modern european and world societies. Everywhere in Europe there is the great necessity of having an efficient emergency prehospital and hospital trauma care organization which will reduce mortality and invalidity of the trauma critical patients. Three objectives are the most important: 1) defining of the lines guide (e.g. ⋯ Emergency Surgical Training should be established on three levels namely; 1) within the undergraduate medical curriculum 2) complementary training in emergency surgery during the general surgery specialization 3) additional theoretical and practical training for emergency nurses. There are many cultural and organizational differences among the "old and new" European Countries. The most important and special objective is the evolution of a correct and equal education in training care in order to improve our situation.
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Trauma remains one of the three main causes of death all over the world. In Poland severe trauma is also an important public health problem which should be fully recognised in the changing system of our health service. ⋯ Certain recommendations of treatment of patients following severe trauma have been discussed concerning anti-shock therapy, diagnostic and operative management in polytraumatized patients with major head trauma, thoracic and abdominal trauma and also operative stabilization of fractures of bones. It has been concluded that in our country, especially in bigger cities, patients following major trauma should be treated in specially designed units (centers) integrated with emergency medicine departments providing competent intensive therapy and surgical interventions of well trained trauma teams introducing optimal modern trauma algorithms.
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Adequate body hydration is considered the key element of fluid management in critically ill patients including group with end stage renal failure. Bioimpedance technique is widely used as a non-invasive, simple and accurate method to measure body composition. The purpose of the paper was to prescribe the using of single, and multifrequency bioimpedance spectroscopy technique for estimation of fluid balance in end-stage renal patients. We also discussed some measurements and data modelling problems, including postural change effect, and intercompartmental fluid shift during dynamic monitoring of fluid balance.
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Sarcoidosis is a multi-organ granulomatous disorder of an unknown cause. Skin sarcoidosis occurs in about 20-35% of patients with systemic disease and may also arise in isolation. ⋯ The diagnosis rests on the presence of non-caseating granulomas on skin biopsy. Treatment and overall prognosis of cutaneous sarcoidosis is primarily dependent on the degree of systemic involvement.