Acta chirurgica Iugoslavica
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Trauma is disease of the young, mainly affecting people between 15-40 years of age. Uncontrolled massive bleeding is the leading cause of early in-hospital mortality, within 48h of admission, and the second leading cause of prehospital death in victims of both military and civilian trauma, accounting for 40-45% of the total fatalities. Coagulopathy develops early after injury and is present in 25-36% of trauma victims upon admission to the emergency department. ⋯ The coagulopathy in the trauma patient is complex and multifactorial. It includes: dilutional coagulopathy, hypothermia, acidosis, hyperfibrinolysis, anemia and consumption coagulopathy. When the patient develops the so called "lethal triad" of hypothermia, acidosis and coagulopathy, surgical restoration of vascular integrity may be insufficient to achieve a deffinitive control of blood loss and non-mechanical bleeding from small vessels, usually terminated by spontaneous coagulation, becomes a life-threatening condition.
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Randomized Controlled Trial
Does epidural anaesthesia and analgesia really improves surgical outcome after colorectal cancer surgery?
Lithuanian Cancer Register has registered 1443 new cases of colorectal cancer in 2004 and this value constantly increases about 200 cases per year. Colorectal cancer is on the third place among all cancer patients in our country. ⋯ Majority of recent randomized clinical trials (RCT) has shown that combined general--epidural anaesthesia and postoperative epidural analgesia has demonstrated some beneficial effects and improved surgical outcome in various fields of surgery. However controversies still exist about epidural anaesthesia and analgesia effects on colorectal anastomosis and it's influence on patients' outcome.
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Intubation and airway control of injured children is of vital importance, but despite its advantages is associated with meny risks when is performed outside the hospital and by the untrained physicians. Aim of this study was to determine the importance for the survival of the children with craniocerebral injuries, and also for final outcome of treatment. ⋯ Endotracheal intubation should be performed by an experienced physician with an adequate equipment.
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The dilemma whether to use the mesh or non mesh technique in the management of umbilical, epigastric and small incisional hernia is slowly fading away. The open preperitoneal "flat mesh" technique performed as ambulatory surgery may be one of the solutions. ⋯ The open preperitoneal "flat mesh" technique performed in local anesthesia as an ambulatory surgery provides good results in the management of umbilical, epigastric and small incisional hernia.
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The article describes injuries of soft and bone structures of the shoulder region, with special emphasis on the following clinical forms: instabilities and luxations of the glenohumeral joint, fractures of the proximal humerus, clavicle and the states of painful shoulder. Fractures and dislocations, but also significant entities - painful states caused not only by fractures but also by minor trauma such as tendinitises and m.supraspinatus tendon and bicipital tendon ruptures are discussed in more detail. Moreover, their consequences - painful and stiff shoulder - as well as modern diagnostic and therapeutic procedures applied in the painful shoulder treatment are also discussed.