Medicinski pregled
-
Propofol has proven to be a reliable anaesthetic that can be used for both induction and maintenance purposes in most common surgical procedures, either in standard anaesthetic practice or as part of total intravenous anaesthesia (TIVA). ⋯ Due to greater ease of control in regard to anesthetic depth and more rapid recovery, propofol is superior to other intravenous hypnotics for maintenance of anaesthesia.
-
Otitis media, acute or chronic, is a potentially dangerous disease which may lead to fatal complications. Meningitis is the most common intracranial complication, followed by otogenic brain abscesses while lateral sinus thrombosis is fairly uncommon. Mortality from otogenic brain abscesses remains relatively high. The aim of the study was to investigate mechanisms of development, diagnostic methods and treatment of these complications of otogenic brain abscesses. ⋯ Otogenic brain abscesses imply accumulation of pus in the cerebrum or cerebellum developing after encephalitis, caused by pyogenic microorganisms originating from inflammatory process in the middle ear cavity. This is a severe otogenic complication with high mortality. Even with modern therapeutic alternatives, mortality remained high, about 40% (7). According to the data reported by several authors introduction of antibiotic therapy resulted in drastic fall of associated mortality. The annual risk of otogenic abscess of the brain is 1 per 1000 adults with active chronic otitis. The incidence of abscess is significantly higher in a certain age groups, i.e. 1 per 200 between the ages of 20 and 40 (3). The diagnosis of brain abscess established clinically is not quite reliable. The disease is usually associated with severe meningitis, so that neurological examination usually detects only signs of meningi
-
Postoperative analgesia has been neglected for a long time, whereas postoperative pain has been considered inevitable cost of operations. Postoperative pain causes not only subjective difficulties, but as a stress factor affects functions of the autonomous and endocrine system, which may cause a number of disorders after the surgery. ⋯ Advantages and disadvantages of these techniques in regard to traditional method of parenteral analgesia in the postoperative period have been pointed out. Application of regional analgesia is recommended before the surgery, because it prolongs the time when analgesia is needed for the first time and decreases both pain and postoperative analgesia.
-
In dermatology Isotretinoin has been used for 16 years in cases of serious clinical forms of acne resistant to common therapy. This paper presents actual knowledge on pharmacokinetics of isotretinoin, mechanisms of its action, side effects, the newest clinical indications for its application in acne therapy and other possible indications in the contemporary dermatology.
-
Throughout the course of Vukovar conflict from July, 1991, to May, 1992, there were 37 patients with war craniocerebral injuries evacuated to our Clinic. 29 patients suffered penetrating missile craniocerebral injuries, in 14 (48%) there were fragment wounds and in 15 (52%) gunshot wounds. The series was analyzed according to wounding agents, sites of head penetration, CT scan findings, neurological findings, operative and postoperative complications, and mortality. ⋯ Presence of retained in-driven bone or metal fragments in our series had no influence on development of either seizure disorder or an infectious complication. This supports a thesis of a limited brain debridement as a correct approach in the treatment of penetrating missile injuries.