Wiadomości lekarskie (Warsaw, Poland : 1960)
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2-3% of patients after cardiac procedures with the use of cardiopulmonary by-pass develop neurological complications with focal symptoms. Also to there may be mental, emotional and intellectual disturbances. This kind of complications occurs in 33-83% of patients. ⋯ Confusion, hallucinations, paranoid illusions, psycho-motoric excitation, fear may also occur. A high level of serotonin and overstimulation of 5-HT2 receptors in the central nervous system are the reason of delirium. The relief of symptoms may be achieved by intravenous administration of Ondansetron, an antagonist of 5-HT2 receptors.
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Randomized Controlled Trial Clinical Trial
[Prolongation of Bupivacaine spinal anaesthesia by oral and intramuscular Clonidine].
The effect of oral and intramuscular clonidine premedication on the duration of sensory and motor blockade and postoperative analgesia during bupivacaine spinal anaesthesia was studied in 102 ASA physical status I-II patients scheduled for lower limbs orthopaedic surgery. In all cases one hour before anaesthesia midazolam (0.1-0.15 mg/kg) was applied orally and isotonic saline solution (10 ml/kg) was infused intravenously. The patients were randomly allocated into one of the following groups: oral (A) or intramuscular (B) clonidine premedication (0.15 mg) (n = 33) and oral or intramuscular premedication by placebo (C) (n = 36). ⋯ The authors conclude that prolongation of bupivacaine sensory analgesia may be produced by premedication with 0.15 mg of oral and intramuscular clonidine. The application of clonidine reduces the early postoperative analgesic requirements. The side effects are more pronounced with the intramuscular route of administration.
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The authors presented the clinical and anatomopathological description of Arnold-Chiari anomaly at 25 years old man, which caused cerebellar manifestation and sudden death. At the base of anatomopathological study the first type of Arnold-Chiari anomaly with dislocation of cerebellum tonsils into foramen magnum was recognized.
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Burning mouth syndrome (BMS) is currently described as a burning pain in the tongue or other parts of mucous cavi oris without pathological signs of mucous cavi oris and changes in laboratory blood tests. On the basis of the current literature and our patients' examinations we described the incidence, etiology, symptoms and offered model of treatment of BMS.
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Transfusion related acute lung injury (TRALI) is a relatively rare but potentially severe complication of blood transfusion. Acute respiratory distress syndrome in this case is due to noncardiogenic pulmonary oedema without hypervolaemia. The passive transfer of anti-human leukocyte antigen (HLA) or antineutrophil antibodies in the donated blood products are responsible for the pathophysiological process in TRALI. ⋯ The only therapy which can be recommended as standard treatment of TRALI is ventilatory assistance and saline infusion. The case of 70-year-old woman with the fracture of the right femoral bone, who developed TRALI after transfusion of packed red cells is presented in the paper. It is the first case of TRIALI reported in our department.