Khirurgii͡a
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Functional renal disorders commonly complicate cirrhosis and ascits, and in its terminal stage is known as hepatorenal syndrome (HRS). HRS is defined as the development of renal failure in patients with advanced liver failure (acute or chronic) in the absence of other identifiable causes of renal pathology. It is a syndrome characterized by oliguria, severe renal sodium retention, circulatory instability with marked systemic arterial vasodilatation and activation vasoactive systems. ⋯ Theoretically the ideal treatment for patients with HRS is liver transplantation. The prognosis for HRS is poor and treatment almost always unsatisfactory when liver transplantation is excluded. The best treatment of HRS is preventing precipitating factors.
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Between 1988 and 2000 a total of 33 patients with traumatic tracheobronchial lesions were diagnosed and treated. The trauma was penetrating in 7 (stab and gun-shot), blunt in 10 (car accidents, compression and falling from heights) and iatrogenic in 16 of them (postintubational--15, after foreign body extraction--1). The main clinical and radiological features were subcutaneous emphysema, hemoptysis, respiratory insufficiency, pneumomediastinum and pneumothorax. ⋯ The operative mortality was 9%. The cause of death in these 3 patients were associated brain and spinal cord injuries. In the rest of patients the early and long-term postoperative results were considered very good.