Acta chirurgica Iugoslavica
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In some surgical patients immunosuppression is easily apparent and directly caused by known underlying disease or treatment. In others, although induced by the underlying disease, immunosuppression may be less obvious. Perioperative management of immunocompromised patient is mostly directed by the fact that immunosuppression itself does not cause pathology, but does leave the patient prone to infection. ⋯ They can be present both in children and adults, in a huge variety of patients that are presented preoperatively. Most of them do not require different than usual perioperative anaesthetic management. However, in some of them specific aspects of treatment should be considered, such as HIV infected, cancer, transplant patients, and those scheduled for organ transplantation.
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In the Western countries, the incidence of esophaeal carcinoma is 3-6 cases per 100,000 persons. g Despite tremendous success of other therapeutic options, surgical treatment still represents the best therapeutic option whenever possible. For the long period, debate has centered on which of the a vailable surgical procedures is superior-transhiatal or transthoracic esophagectomy. ⋯ It is procedure reserved for the surgeons experienced in open esophagectomy for cancer, and specially trained in advanced minimally invasive procedures. Even in that case, learning curve is steep.
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Drug abuse is related to many medical complications, which depend on the drug type, dose injected, the method of delivery and site of injection. We report a case of psoas abscess in young heroin addict, HIV negative, who was admitted in Emergency Center of Clinical Center in Belgrade because of fever, anaemia, prostration and right groin pain. Clinical and radiological examination were performed. ⋯ Treatment included percutaneous drainage and administration of iv antibiotics. There is regression of inflamation. At discharge patient was in good condition without signs of infection.
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When treating complex regional pain syndrome (CRPS) a positive outcome can be expected when the condition is identified and therapy is begun in the first six months. Nevertheless, symptoms may not improve by standard treatment as expected. One of the possible reasons for this is the coexistence of associated compressive neuropathies in the affected hand. ⋯ Failure of therapy response in CRPS should alert the clinican to check for associated compressive neuropathy. Detection of this complication can prevent further damage of the nerve, hasten recovery of CRPS, and prevent eventual permanent disability of the hand.
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In order to study the historical relationship of early medical professional codex and contemporary demands and challenges, which are currently being placed before physicians, the first such text, known as Hippocratic Oath has been re-translated. According to the source, it is clear that this is a Code of professional conduct, primarily for the welfare of patients, and in order to maintain and preserve medical authority. All parts of the Oath have been discussed and presented, as well as the historical data from which one can see how the system in ancient Greece and Rome worked. ⋯ Requirements set to a doctor were realistic, modest and appropriate to the call, with the main purpose of protecting the reputation and dignity of the profession. Despite the historical distance, classical text of the Oath is still up to date. In this context, ambiguities and errors result from not being familiar with the both, the basic text, and the circumstances prevailing at the time and society, in which the Oath was made.