Folia medica
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This study pinpoints the necessity to constantly monitor local approaches in undergraduate medical education on an inter-European scale. Traditional undergraduate medical curricula need restructuring to account for the increasing amount of medical knowledge and rapid changes and developments in societies, nosology, therapy and IT. European undergraduate medical curricula should be harmonized not egalized, with a focus on inter-European sharing of resources, mobility, credit (allocation, accumulation and transfer), definition of European and trans-European mission statements, identification of quality metrics, advice on dealing with conflicting aims such as specialization and generalization, on communicating core knowledge instead of providing overabundance of information, and on introducing multifaceted teaching and learning methods, as well as providing strategies for life long learning. ⋯ Specific links of the Bonn undergraduate medical curriculum with credited and evaluated CME and imminent European strategies are detailed. The authors conclude that European universities not adapting at least some of the outlined curricular necessities will rapidly lose their competitiveness compared to other national and international Medical Schools. Harmonized European ethical mission statements and consequent utilization of IT deserve special considerations in this context.
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The present study aimed at investigating phalloid mushroom poisoning and the toxicological aid services in Plovdiv region as this pathology shows in this country high mortality rate (40-100%) and increasing incidence; it is difficult to diagnose and is far from featuring adequately in the literature in our country. ⋯ The acute mushroom poisoning cases in adults comprise 7.01% of the total acute poisoning caseload. The phalloid poisoning accounts for 9.26% of the total number of patients with mushroom poisoning admitted for treatment. The application of contemporary diagnostic-therapeutic protocol lowers the hospital lethality rate from phalloid poisoning to 40%. There were no statistically significant differences in the compared parameters between the subgroups of patients with favorable and lethal outcome and between the subgroups of men and women--most probably due to the small sample. In order to lower the incidence and mortality rate from phalloid mushroom poisoning the authors recommend preventive health education on the problem, targeting the population at risk and the introduction of contemporary diagnostic and treatment methods--determining the amatoxins, intravenous application of Silibinin and liver transplantation.
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Comparative Study
A comparative study of the effect of halothane, isoflurane and propofol on partial arterial oxygen pressure during one-lung ventilation in thoracic surgery.
Conducting one lung ventilation (OLV) in thoracic surgery highlights the issue of the onset (prevention and treatment) of clinically significant arrhythmogenic hypoxemia. The halogenated volatile anaesthetics are the drugs of choice in thoracic surgery despite the numerous experimental data showing their inhibiting effect on the hypoxic pulmonary vasoconstriction (HPV). The intravenous anaesthetic agent propofol has not been shown to influence this reflex mechanism. The object of the present study was to compare in clinical conditions the arterial oxygenation in patients undergoing noncardiac thoracic procedures, requiring a period of one lung ventilation during general anaesthesia with volatile anaesthetics halothane, isoflurane and total intravenous anaesthesia (TIVA) with propofol/fentanyl. ⋯ TIVA with propofol/fentanyl can be successfully applied in thoracic surgery as an alternative of general anaesthesia with halogenated volatile anaesthetics.
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According to data reported in literature tidal breathing parameters and especially tidal expiratory flow pattern parameters can be useful in distinguishing airflow obstruction. The purpose of the present study was to investigate the parameters of the tidal breathing in healthy people and patients with chronic obstructive pulmonary disease. The study sample included 158 patients with COPD in clinically stable condition and different degree of functional disturbances (FEV1% pred. = 42% +/- 15%; ATS dyspnea scale = 2.5 +/- 0.9; mean +/- SD). ⋯ Minute ventilation, mean expiratory flow, mean inspiratory flow and tidal volume; 4. Parameters of the expiratory flow VPTEF/VE and TPTEF/TE. The parameters of forced expiration and those of tidal breathing are separate dimensions of the functional profile of patients with COPD.
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To study the association of a positive family history of glaucoma with age, systemic hypertension, diabetes and refraction in patients with primary open angle glaucoma (POAG). ⋯ The results of the study suggest that there is no association of family history of glaucoma with sex, systemic hypertension, diabetes and refraction. They show that the disease has an earlier onset in cases with positive family history of glaucoma.