Przegla̧d lekarski
-
Comparative Study
[Evaluation of selected parameters of blood coagulation and the fibrinolysis system in patients undergoing total hip replacement].
Patients undergoing orthopedic surgery, particularly total hip replacement procedure belong to a group of patients with a high risk of thromboembolic complications. Postoperative deep vein thrombosis may occur in 40-80% of these patients. 4-19% of patients develop clinically evident pulmonary embolism and approximately 7% of cases in this group result in death. A thorough evaluation of coagulation disorders in the perioperative period could lead to detecting risk factors of thromboembolic complications development and could facilitate more effective prophylaxis management. ⋯ After 24 hours marked decrease of coagulation parameters was noted. In group A significantly less thromboembolic complications was observed. On the basis of the performed examinations the following conclusions were drawn. (1) during total hip replacement surgery and particularly during the period of the first 12 hours after procedure, marked activation of coagulation and fibrinolysis occurred. (2) the application of the hemodilution procedure does not influence significantly the degree of coagulation and fibrinolysis disorders in the perioperative period.
-
Abnormalities of autonomic nervous system function (ANS) exist in patients with hypertension and have been considered as one of the important factors in developing of essential hypertension. However the information about the effect of antihypertensive treatment (angiotensin-converting enzyme inhibitors--ACEI) on cardiac ANS activity is scarce. The main aim of our study was to evaluate circadian heart rate variability changes in primary hypertension treated with ACE inhibitors. ⋯ Our observations support an attenuation of night vagal activity as an important factor in the pathogenesis of essential hypertension. The lack of effect of ACEI treatment on circadian heart rate variability parameters in patients with essential hypertension, despite long-term normalisation of blood pressure, suggests persistent circadian cardiac autonomic dysfunction in the "dippers" subgroup of patients.
-
Systemic bacterial infections still remain one of the major causes of neonatal morbidity and mortality. Early detection of neonatal sepsis can be difficult, because the first signs of the disease may be unspecific and similar to symptoms of other non-infectious processes. Procalcitonin became a new, sensitive marker of bacterial infections in newborns. The aim of our study was to assess the value of PCT as a diagnostic and prognostic tool of neonatal maternofetal infections. We also tried to estimate normal ranges of PCT in uninfected newborns. ⋯ PCT is a useful tool in early diagnosing and monitoring the course of early-onset infections in neonates, particularly when blood cultures obtained from neonates remain negative. The decreasing concentrations of PCT level in children treated due to infection, indicate successful treatment and may help one to take a decision on termination of antibiotic therapy.
-
Comparative Study
[Early postoperative period in children with hypoplastic left heart syndrome in the comparison of classic and modified Norwood procedures].
The Norwood operation in neonates with hypoplastic left heart syndrome is associated with very high mortality. ⋯ The new modification of the Norwood procedure ensures stable conditions in early postoperative period. We believe that short circulatory arrest time without prolongation of cardiopulmonary bypass time and higher diastolic pressure (the location of the proximal shunt end beneath the valve of the systemic circulation) improves the function of the heart.