Khirurgii͡a
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The main treatment for most types of malignant tumors is their surgical removal. During the past years there has been a growing interest in the anesthesia effects on long-term surgery results in connection with cancer. Modern clinical and laboratory data indicate that the anesthetic technique may play a role in tumor dissemination and recurrence. The purpose of this study is to review the available literature data on the anesthetic techniques applied in oncology surgery, long-term consequences of anesthesia/analgesia and their relation to tumor progression. ⋯ Further randomized controlled trials are required for extensive research of this problem.
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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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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.
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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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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.