Khirurgii͡a
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Acute coagulopathy with exsanguinating bleeding occurs in 2-5% of all trauma cases carrying mortality rate near 100% after conventional management. In the last few decades, the development of damage control surgery (DCS) in combination with the technique of open abdomen led to significantly improved survival among these patients. ⋯ Despite the small sample size, our series clearly demonstrate the benefits of DCS and open abdomen in trauma patients with exsangiunating bleeding. The survival rate is highly dependent on the rapid implementation of DCS in properly selected patients. V.A.C. and VP provide a high rate of primary fascial closure in trauma.
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Despite the increased volume of patients undergoing selective reconstruction on the occasion of abdominal aortic aneurysms (AAA) in the last decades, the number of patients with rupture of abdominal aortic aneurysms (RAAA) is not significantly decreased. RAAA is catastrophic and life-threatening condition. It remains a challenge to every practitioner. To optimize the surgical practice we studied the literature for the treatment of symptomatic and rupture aneurysm of the abdominal aorta.
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Comparative Study
Dynamics of Parecoxib or Meloxicam effect on acute postoperative pain after orthopedic surgical interventions: comparative study in hospitalized women and men.
The dynamics of Parecoxib or Meloxicam analgesic effect on acute postoperative pain was studied in 48 patients (22 female and 26 male) sustaining arthroprosthetic (Parecoxib analgesia) or arthroscopic (Meloxicam analgesia) orthopedic surgery. The results show higher postoperative pain and slower dynamics of Parecoxib and Meloxicam analgesia in women than in men, which necessitates supplementation of the applied analgesic medication in the female patients.
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Ischemic stroke is the third most common cause of death right after myocardial infarction and malignancies. Most cases of stroke are due to extracranial carotid atherosclerotic disease. ⋯ Carotid stenting with or without the use of neuroprotection devices proves to be effective in high-risk patients with carotid stenosis. Nevertheless, there is no clear proof that endovascular techniques outmatch the classic surgical methods.
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Sepsis is defined as a clinical syndrome of systemic response to infections. With progression of the disease develop organ failure (i.e. severe sepsis) and hypotension (i.e. septic shock) and mortality increases significantly. Sepsis is an interdisciplinary problem, cause significant morbidity and mortality and higher hospital costs. ⋯ Proper diagnosis of sepsis requires an understanding of risk factors, a high index of suspicion and anatomic approach to the localization of the infectious focus. Early detection of septic patients is crucial for the outcome of disease in the application of reasoned therapy. Future treatment of sepsis associated with a better understanding of the molecular bases of pathological process.