Medicinski pregled
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Multicenter Study
THE PREVALENCE OF STRESS AND BURNOUT SYNDROME IN HOSPITAL DOCTORS AND FAMILY PHYSICIANS.
Introducti on. Burnout syndrome is the result of chronic emotional stress. It is characterized by high levels of emotional exhaustion and depersonalization, and reduced level of personal accomplishment. The aim of this study was to determine the level of stress and risk ror burnout syndrome in doctors employed in health centers and hospitals, and to investigate the impact of socio-derrdgraphic characteristics on the level of stress and the o ccurrence of burnout syndrome.
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The rupture of infrarenal abdominal aortic aneurysm is a surgical emergency condition with a high rate of mortality before the patients arrive at hospital. The signs and symptoms of abdominal aortic aneurysm rupture into the retroperitoneal cavity are pulsatile mass, abdominal pain, hypotension and shock, but sometimes silent symptoms also hide a dangerous and life threatening condition, such as chronic aneurysm rupture of abdominal aorta into the retroperitoneal cavity. ⋯ We present a patient having had the lower back pain for 4 months, which had been recognized and treated as lumbar ischialgia but which was eventually diagnosed to be chronic infrarenal abdominal aortic aneurysm rupture by computed tomography angiography. The surgical intervention was successful and the patient was discharged from hospital after 6 days without any clinical complications. Preoperative imaging by computed tomography angiography of ruptured abdominal aortic aneurysm is highly sensitive for detection of several specific signs for rupture. This condition leads to urgent vascular surgery.
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Massive transfusion is defined as blood transfusion in quantities equal to or greater than the estimated patients' blood volume over a relatively short period of time (3-4 hours). The study was aimed at analyzing the application of chemotherapy in treatment of patients with acute massive bleeding and evaluating the results of hemostasis and platelet counts screening tests in the patients receiving massive transfusions. ⋯ In our study we have confirmed the pathophysiological mechanism shown in the available medical literature that after transfusion of a large red blood cell concentrate volume, dilutional coagulopathy develops, caused by a sharp drop in platelet count and the significantly reduced activity of unstable coagulation factors in the patient's circulation.
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Randomized Controlled Trial
EFFICIENCY OF ULTRASOUND GUIDED LOWER LIMB PERIPHERAL NERVE BLOCKS IN PERIOPERATIVE PAIN MANAGEMENT FOR KNEE ARTHROSCOPY IN CHILDREN. A RANDOMIZED STUDY.
Ultrasound guided lower limb peripheral nerve blocks are efficient for perioperative pain treatment in children. The aim was to see if lower limb peripheral nerve blocks reduced the amount of propofol and opioid analgesics used intraoperatively, as well as the level of pain and consumption of systemic analgesics postoperatively. ⋯ Ultrasound guided lower limb peripheral nerve blocks are an efficient technique of regional anesthesia in children. They reduce the amount of general anesthetics and opioid analgesics needed intraoperatively as well as the level of postoperative pain and consumption of analgesics postoperatively.
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During liver transplantation, continuous laboratory monitoring of complex changes of the hemostatic system is necessary. The aim of this study was to compare two methods of monitoring: standard coagulation tests and rotational thromboelastometry. ⋯ For an adequate perioperative monitoring of the dynamic intraoperative hemostatic changes and the optimal use of blood derivatives during liver transplantation, the combined application of standard coagulation tests and rotational thromboelastometry should be considered whenever possible.