Przegla̧d lekarski
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Comparative Study
[Ultrasound stethoscope in the rapid assessment of left ventricular systolic function and valvular regurgitation--personal experience].
Recent technological advances enabled miniaturization of echocardiographic machines and construction of portable "ultrasound stethoscopes", which enable rapid two-dimensional and color-Doppler imaging and supplement clinical examination of the heart. We present the results of systematic assessment of these devices in comparison with standard echocardiographic machines. ⋯ Results of the systematic evaluation of the use of ultrasound stethoscopes in the rapid evaluation of left ventricular systolic function and valvular regurgitation. Although image quality achieved with the hand-held stethoscope was worse, nevertheless it was adequate for the purpose of performing rapid limited assessment of cardiac and valvular function.
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Comparative Study
[Pediatric open heart surgery on cardiopulmonary bypass without the use of blood products].
Pediatric open heart surgery is associated with the usage of cardiopulmonary bypass. The circuit is primed with blood products because of risk of excessive hemodilution. The aim of the study was to prove the safety of open heart surgery on cardiopulmonary bypass without the use of blood products in the pediatric group. ⋯ Directly after the surgery, group I had significantly higher platelet and leucocyte counts compared to the control group. There were no differences between the confronted populations in regard to postoperative bleeding (4.61 +/- 2.24 vs 4.76 +/- 1.75 ml/kg). The avoidance of using blood products in pediatric patients during open heart surgery with cardiopulmonary bypass is found to be safe, is not correlated with an increased surgical risk, and does not result in a prolonged hospital stay.
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Endocarditis can concern natural as well as artificial heart valves. In conservative treatment mortality reaches 24-60%. Surgical procedure is the only way to save these patients in most cases. ⋯ Our study suggests that patients with endocarditis and compromised hemodynamic status can be operated with acceptable morbidity and mortality. If echocardiography shows the cuspids perforations or vegetations, chords tendinous rupture or perivalvular leak, the patients should undergo cardiac surgery as soon as possible, in order to avoid severe embolic complications.
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Children and adolescents are the subject, which suffers from primary headaches. Type and character of the pain is known only by them and their relations are necessary to know it. This study was performed to establish how children and adolescents express verbally and by paintings their headaches. ⋯ Patients in developmental age more often used verbal than drawing expression of their headaches. Migraine and tension headaches drawing was significantly different. Also verbal expression of migraine was different in localisation and symptoms during pain and accompanied pain. It is necessary to investigate headaches in a subjective and quantitative way.
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Proper tracheal tube cuff pressure (CP) can diminish the risk of side effects. Excessive tracheal tube cuff pressure can cause ischaemic changes in the tracheal mucosa, decubitation, granuloma, rupture of a trachea, tracheo-oesophageal fistulae or tracheal stenosis. Too low CP is also undesirable, because it can increase the leakage of colonized subglottic secretions around the tracheal tube cuff, which is the risk factor of ventilatory associated pneumonia. Accidental extubation may also occur. The aim of the study was to find out if there are any differences in maintenance of the proper CP between the staff of intensive therapy unit (ITU) under the supervision of anaesthesiologists and staff of intensive care units (ICU) led by non-anaesthesiologists. ⋯ The data analysis did not reveal any differences between values of CP in both groups of subjects. Over-inflation was more frequent than under-inflation in both groups of patients. Regular measurement of tracheal cuff pressure was not a routine procedure in the controlled units.