Medicinski pregled
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The prepuce envelops the glans as a variant of a mucocutaneous tissue presenting with a lot offunctions, the most important of them being to protect the infant's glans from feces and ammonia in diapers, to protect the glans from abrasions and trauma throughout life, and to provide sufficient skin in erection. Circumcision was recognized as a method of solving foreskin problems a long time before Christ. Practicing male circumcision in history was customary several thousand years ago and has spread worldwide. Today it depends on races, and it is often an initiation ceremony near the age of puberty. In everyday practice in pediatric urology outpatient department the foreskin problems have been noticed as a phimosis in 9.91% cases and prepuce adhesions in 3.98%. Congenital anomalies are present in different numbers. Other problems, such as paraphimosis, balanoposthitis, are recorded as accidental cases. Over-all prepuce pathology can be observed in 12%-25% of patients. The article presents a review of foreskin conditions, clinical manifestation, therapy and arguments for patient's benefits. ⋯ As a part of external genitalia, the foreskin has a lot of functions. Despite its natural role many advocates routine circumcision due to problematic condition that can develop. Routine circumcision is not generally recommended. Improved education for physicians and parents with regard to the foreskin development and management is required.
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Randomized Controlled Trial
[Effects of epidural analgesia using different concentrations of bupivacaine during combined general and epidural anesthesia].
Thoracic epidural analgesia, combined with general anesthesia, is an established anesthetic choice for abdominal aortic surgery. However, there are controversies about the level of anesthesia as well as the dose and concentration of the local anesthetic used. The aim of the study was to compare the effects of two different concentrations of epidural bupivacaine on sevoflurane requirements and hemodynamic parameters during aortic surgery under combined epidural/general anesthesia. ⋯ When 0.5% bupivacaine is used in combined thoracic epidural/ general anesthesia for aortic surgery, the sevoflurane concentrations are lower and less variable. In addition, the blood loss and fluid requirements are reduced.
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Biography Historical Article
[Personality and work of Florence Nightingale--creator of modern nursing and public health pioneer].
Through her "calling to service", Florence Nightingale worked as a nurse, manager, researcher, reformer, writer and teacher. The aim of this study is to present Florence Nightingale in all these roles, pointing out all complexity and multidimensionality of nursing profession. ⋯ Her complete and lifelong devotion to the ,,calling" directed all her activities, contributions and achievements, not only towards nursing but also towards statistics, epidemiology, public health and social sciences.
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Modern hospital pharmacology insists on assessing each patient's individual characteristics because of their influence on drug pharmacokinetics and pharmacodynamic effect. The study was aimed at evaluating anesthetic doses in patients with benign larynx tumors treated by general endotracheal anesthesia during endoscopic surgery procedures. ⋯ It is possible to overdose anesthetic drug during surgery without using bispectral index technology monitoring during general anesthesia in otorhinolaryngology maxillofacial surgery. Bispectral index monitoring should be the clinical standard in general anesthesia.
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Chronic obstructive pulmonary disease is estimated to become the fifth leading cause of death worldwide by 2020. The mortality and morbidity from chronic obstructive pulmonary disease is getting higher and higher as a result of the epidemics in tobacco consumption all over the world, especially in developing countries. The study objectives were to determine the correlation between the smoking habits and mortality in the patients with chronic obstructive lung diseases, to evaluate the two-year and five-year survival depending on the smoking habits, to compare and correlate the smoking habits and a decrease in the lung function. ⋯ According to this study, the progression to the end stage of this disease is faster in smokers suffering from chronic obstructive pulmonary disease than in the non-smokers and the former smokers who suffer from this disease.