Pub Date : 2014-08-16DOI: 10.2478/s11536-013-0319-6
E. Gaszyńska, A. Wieczorek, T. Gaszyński
Awake Fiberoptic Intubation (AFI) is a standard method of airway management in the case of anticipated difficult intubation. It is usually performed with the use of flexible fiberscopes. In this report we have described two methods in which alternative devices to the fiberscope were utilized for awake intubation in patients with severely restricted mouth opening scheduled for craniomaxillofacial surgery: TruView PCD and Levitan FPS. Information about the use of these devices in such conditions has not been previously published in the literature. Some of the possible advantages of these alternative methods for AFI result from the fact that they are easy to use, especially for anesthesiologists who are relatively inexperienced with fiberscope intubation procedures. Additionally, these alternatives are cheaper than fiberscopes and can be used for many AFI procedures.
{"title":"Awake endotracheal intubation in patients with severely restricted mouth opening- alternative devices to fiberscope: series of cases and literature review","authors":"E. Gaszyńska, A. Wieczorek, T. Gaszyński","doi":"10.2478/s11536-013-0319-6","DOIUrl":"https://doi.org/10.2478/s11536-013-0319-6","url":null,"abstract":"Awake Fiberoptic Intubation (AFI) is a standard method of airway management in the case of anticipated difficult intubation. It is usually performed with the use of flexible fiberscopes. In this report we have described two methods in which alternative devices to the fiberscope were utilized for awake intubation in patients with severely restricted mouth opening scheduled for craniomaxillofacial surgery: TruView PCD and Levitan FPS. Information about the use of these devices in such conditions has not been previously published in the literature. Some of the possible advantages of these alternative methods for AFI result from the fact that they are easy to use, especially for anesthesiologists who are relatively inexperienced with fiberscope intubation procedures. Additionally, these alternatives are cheaper than fiberscopes and can be used for many AFI procedures.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"768-772"},"PeriodicalIF":0.0,"publicationDate":"2014-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0319-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68851480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-16DOI: 10.2478/s11536-014-0698-3
Iulian Ghimis, D. Enescu, I. Lascar
The composite allotransplant of tissues was recently introduced on the list of potential procedures for complex face reconstruction. To assess the technical and immunological aspects and the potential of the clinical applicability of this new approach in facial reconstruction, samples of total and hemifacial transplant with rats have been introduced. We have proposed in this study checking the versatility of the facial transplant sample in rats by performing the hemiface transplant between two neco-blood species of laboratory rats. Meanwhile, study included the verification of mono-therapy efficiency with A cyclosporine in inducing immune tolerance against the composite tissue graft, which consists of skin, subcutaneous tissue, blood vessels and ear cartilage, transferred against the hystocompatibility barriers, as well as the verification of the procedures adjacent to transplant: anesthesia and surgical technique. In this study,14 laboratory rats have been included and divided into 3 lots. Lot No. 1 was represented by 2 Brown Norway rats used for the anatomic study of the vascular formations which are going to be coopted during a facial transplant. Lot No. 2 consisted of 3 Brown Norway rats used as donors and 3 Wistar rats used as acceptors, with these transplants being associated immunosuppression protocols postop. Llot No. 3 consisted of 3 Brown Norway rats used as donors and 3 Wistar rats used as acceptors, which, after the intervention, did not receive an immunosuppression treatment. Conclusions. The experimental sample of the facial transplant is an essential and mandatory stage in preparing the clinical application of the face transplant. Our study confirms the good tolerance of the hemiface transplant against the major hystocompatibility complex granted by the immunosuppression with A Cyclosporine in rodents.
{"title":"The hemiface transplant in rodent model","authors":"Iulian Ghimis, D. Enescu, I. Lascar","doi":"10.2478/s11536-014-0698-3","DOIUrl":"https://doi.org/10.2478/s11536-014-0698-3","url":null,"abstract":"The composite allotransplant of tissues was recently introduced on the list of potential procedures for complex face reconstruction. To assess the technical and immunological aspects and the potential of the clinical applicability of this new approach in facial reconstruction, samples of total and hemifacial transplant with rats have been introduced. We have proposed in this study checking the versatility of the facial transplant sample in rats by performing the hemiface transplant between two neco-blood species of laboratory rats. Meanwhile, study included the verification of mono-therapy efficiency with A cyclosporine in inducing immune tolerance against the composite tissue graft, which consists of skin, subcutaneous tissue, blood vessels and ear cartilage, transferred against the hystocompatibility barriers, as well as the verification of the procedures adjacent to transplant: anesthesia and surgical technique. In this study,14 laboratory rats have been included and divided into 3 lots. Lot No. 1 was represented by 2 Brown Norway rats used for the anatomic study of the vascular formations which are going to be coopted during a facial transplant. Lot No. 2 consisted of 3 Brown Norway rats used as donors and 3 Wistar rats used as acceptors, with these transplants being associated immunosuppression protocols postop. Llot No. 3 consisted of 3 Brown Norway rats used as donors and 3 Wistar rats used as acceptors, which, after the intervention, did not receive an immunosuppression treatment. Conclusions. The experimental sample of the facial transplant is an essential and mandatory stage in preparing the clinical application of the face transplant. Our study confirms the good tolerance of the hemiface transplant against the major hystocompatibility complex granted by the immunosuppression with A Cyclosporine in rodents.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"860-865"},"PeriodicalIF":0.0,"publicationDate":"2014-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-014-0698-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68852801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-16DOI: 10.2478/s11536-013-0326-7
T. Sataieva, Walery Zukow
BackgroundWe studied the individual effect of ethyl alcohol and food extract of polyphenols from grapes “Enoant” onthe single kidney following one-sided left nephrectomy. The aim of our research was to study tendencies in the compensatory — adaptation processes of a single kidney after administration of ethyl alcohol or “Enoant” respectively into experimental animals (white rats) following single nephrectomy.Materials and methodsIn total n=27 white rats (males and females) were used at the age of 3 months and weighing from 160g to 200g. Rats were kept under standard conditions according to the recommendations of Zapadnyuk et al (1983) and divided into three groups. All animals in this study underwent unilateral nephrectomy only The 1st experimental group of animals received ethyl alcohol post-operatively (every day, by gavage. The ethyl alcohol was given in proportion to their body weight-0.005 ml of the 40% ethyl alcohol to every 1 gram of the rat’s weight. In a 2nd experimental group) — animals received Enoant (again using a gastric tube and in proportion to the animal’s body weight, i.e. 0.5 ml/kg).ResultsWhen identifying effects of the ethyl alcohol and “Enoant”on the tissues of a single kidney, (left after a one-sided nephrectomy), it was found that introduction of an agent such as ethyl alcohol interferes with the enzyme activity associated with internal respiration, both acute and chronic alcohol intoxication.ConclusionThe introduction of ethyl alcohol into rats infringed on the microcirculation processes in the tissues of single kidney. Indicated processes have delayed the rate of development and level of compensational hypertrophy in all parts of the renal tube of the kidney, left after the unilateral nephrectomy. Further, introduction of polyphenols from grapes into experimental animals accelerate the speed and level of compensatory hypertrophy of the kidney during the time of experiment. Further, the administration of Enoant accelerated the speed and level of the compensatory hypertrophy of the kidney in the studied rats.
我们研究了乙醇和葡萄多酚食物提取物对单侧左肾切除术后单肾的个体影响。本研究的目的是研究实验动物(大鼠)单肾切除后分别给予乙醇或“Enoant”后单肾代偿适应过程的趋势。材料与方法选用3月龄大鼠，雄性和雌性共27只，体重160 ~ 200g。按照Zapadnyuk et al .(1983)的建议，在标准条件下饲养大鼠，分为三组。本研究中所有动物仅行单侧肾切除术。第一实验组动物术后(每天)灌胃给予乙醇。乙醇按体重比例给予，每1克大鼠体重0.005毫升40%乙醇。在第二个实验组中，动物接受Enoant(同样使用胃管，按动物体重的比例，即0.5 ml/kg)。结果在确定乙醇和“Enoant”对单个肾脏(单侧肾切除术后留下的)组织的影响时，发现引入一种剂，如乙醇，会干扰与内呼吸相关的酶活性，无论是急性还是慢性酒精中毒。结论乙醇对大鼠单肾组织微循环过程有影响。这些过程延缓了单侧肾切除术后肾管各部分代偿性肥大的发育速度和水平。此外，在实验期间，从葡萄中引入多酚可以加速肾脏代偿性肥大的速度和水平。此外，Enoant的施用加速了所研究大鼠肾脏代偿性肥大的速度和水平。
{"title":"The respective effects of ethyl alcohol and grape polyphenols upon the morphological index of rat kidneys","authors":"T. Sataieva, Walery Zukow","doi":"10.2478/s11536-013-0326-7","DOIUrl":"https://doi.org/10.2478/s11536-013-0326-7","url":null,"abstract":"BackgroundWe studied the individual effect of ethyl alcohol and food extract of polyphenols from grapes “Enoant” onthe single kidney following one-sided left nephrectomy. The aim of our research was to study tendencies in the compensatory — adaptation processes of a single kidney after administration of ethyl alcohol or “Enoant” respectively into experimental animals (white rats) following single nephrectomy.Materials and methodsIn total n=27 white rats (males and females) were used at the age of 3 months and weighing from 160g to 200g. Rats were kept under standard conditions according to the recommendations of Zapadnyuk et al (1983) and divided into three groups. All animals in this study underwent unilateral nephrectomy only The 1st experimental group of animals received ethyl alcohol post-operatively (every day, by gavage. The ethyl alcohol was given in proportion to their body weight-0.005 ml of the 40% ethyl alcohol to every 1 gram of the rat’s weight. In a 2nd experimental group) — animals received Enoant (again using a gastric tube and in proportion to the animal’s body weight, i.e. 0.5 ml/kg).ResultsWhen identifying effects of the ethyl alcohol and “Enoant”on the tissues of a single kidney, (left after a one-sided nephrectomy), it was found that introduction of an agent such as ethyl alcohol interferes with the enzyme activity associated with internal respiration, both acute and chronic alcohol intoxication.ConclusionThe introduction of ethyl alcohol into rats infringed on the microcirculation processes in the tissues of single kidney. Indicated processes have delayed the rate of development and level of compensational hypertrophy in all parts of the renal tube of the kidney, left after the unilateral nephrectomy. Further, introduction of polyphenols from grapes into experimental animals accelerate the speed and level of compensatory hypertrophy of the kidney during the time of experiment. Further, the administration of Enoant accelerated the speed and level of the compensatory hypertrophy of the kidney in the studied rats.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"63 1","pages":"866-869"},"PeriodicalIF":0.0,"publicationDate":"2014-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0326-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68851873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-16DOI: 10.2478/s11536-013-0344-5
M. Doseděl, J. Malý, A. Kuběna, J. Vlček
The aim of the study was to map and analyze general practitioners` opinions of, attitudes towards and experiences with generic drugs and generic substitution (GS) in the Czech Republic. General practitioners (GPs) who took part in the annual and regional professional conferences of the Society of General Practice in the period from November 2008 until March 2009 were asked to complete the 28-item questionnaire concerning the issue of generic drugs and GS. Questions were organized in 5 sections aimed at assessing the attitude towards GS, understanding the legislation and opinions on statements related to GS. All data were analyzed using descriptive statistics and correlations were tested by selected parametric and non-parametric tests. Total of 263 completed questionnaires were returned (mean age of 52.2 years (SD=13.7), 177 (67.3%) females and 248 (94.3%) GPs having a practice specialization). 99 (37.6%) respondents have considered generic drugs to be bioequivalent to the respective brand name drugs. 121 (46.0%) respondents believed that generic drugs are of lower quality than brand name drugs. None of respondent showed acquaintance with all the legal rules for GS. Awareness of the legislation and attitude towards GS correlated with the age (p<0.001). In conclusion, distrust among GPs in generic drugs derives from poor knowledge and personal experiences.
{"title":"Opinions of Czech general practitioners on generic drugs and substitution","authors":"M. Doseděl, J. Malý, A. Kuběna, J. Vlček","doi":"10.2478/s11536-013-0344-5","DOIUrl":"https://doi.org/10.2478/s11536-013-0344-5","url":null,"abstract":"The aim of the study was to map and analyze general practitioners` opinions of, attitudes towards and experiences with generic drugs and generic substitution (GS) in the Czech Republic. General practitioners (GPs) who took part in the annual and regional professional conferences of the Society of General Practice in the period from November 2008 until March 2009 were asked to complete the 28-item questionnaire concerning the issue of generic drugs and GS. Questions were organized in 5 sections aimed at assessing the attitude towards GS, understanding the legislation and opinions on statements related to GS. All data were analyzed using descriptive statistics and correlations were tested by selected parametric and non-parametric tests. Total of 263 completed questionnaires were returned (mean age of 52.2 years (SD=13.7), 177 (67.3%) females and 248 (94.3%) GPs having a practice specialization). 99 (37.6%) respondents have considered generic drugs to be bioequivalent to the respective brand name drugs. 121 (46.0%) respondents believed that generic drugs are of lower quality than brand name drugs. None of respondent showed acquaintance with all the legal rules for GS. Awareness of the legislation and attitude towards GS correlated with the age (p<0.001). In conclusion, distrust among GPs in generic drugs derives from poor knowledge and personal experiences.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"830-838"},"PeriodicalIF":0.0,"publicationDate":"2014-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0344-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68852470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-16DOI: 10.2478/s11536-013-0315-x
Jelena Ignjatovic, D. Stojanov, N. Stojanović, I. Stefanović, Daniela Benedeto-Stojanov, S. Petrović, A. Kostic, Aleksandra Aracki-Trenkic, N. Ignjatovic
ObjectiveTo verify the reliability of apparent diffusion coefficient (ADC) measurements in determining subtypes of meningiomas.Material and methodsThirty patients (20 women and 10 men; average age, 53±15 years) with meningiomas were prospectively studied using DWI with b values of 0 and 1000. ADC values of the neoplastic tissue were obtained as the mean of measurements from three regions of interests within the mass and compared with histologic subtypes using ANOVA test (SPSS16).ResultsThe meningothelial subtype was found in 15 (50%) patients, fibroblastic in 10 (33.33%) patients and cystic in 5 (16.67%) patients. All meningiomas belonged to the WHO Grade 1 — benign meningiomas. There was no significant statistical difference between meningothelial, fibroblastic and cystic meningiomas when considering mean ADC values (0.000411+/−0.000066 mm2/s vs. 0.000750+/−0.001045 mm2/s vs. 0.000688+/−0.000063 mm2/s (p>0.05). Perifocal edema was present only with fibroblastic meningioma with mean ADC 0.000683 mm2/s. The ADC of the cystic component was statistically significantly higher in cystic meningeomas (0.001283 mm2/s) compared with fibroblastic (0.000224 mm2/s) and meningothelial meningiomas (0.000088 mm2/s) (p<0.001). The ADC of meningiomas was higher compared with contralateral healthy brain tissue (0.000642 mm2/s vs. 0.000404 mm2/s; n.s).ConclusionADC measurement do not seem reliable in identifying histological subtypes of Grade I meningiomas.
目的验证表观扩散系数(ADC)测定测定脑膜瘤亚型的可靠性。材料与方法30例患者(女性20例，男性10例;采用b值分别为0和1000的DWI对平均年龄53±15岁的脑膜瘤患者进行前瞻性研究。肿瘤组织的ADC值作为肿块内三个感兴趣区域测量的平均值，并使用ANOVA检验(SPSS16)与组织学亚型进行比较。结果脑膜上皮型15例(50%)，成纤维型10例(33.33%)，囊性5例(16.67%)。所有脑膜瘤均属于WHO一级良性脑膜瘤。当考虑平均ADC值时，脑膜上皮瘤、纤维母细胞瘤和囊性脑膜瘤之间无显著统计学差异(0.000411+/ - 0.000066 mm2/s vs. 0.000750+/ - 0.001045 mm2/s vs. 0.000688+/ - 0.000063 mm2/s)。仅纤维母细胞脑膜瘤存在病灶周围水肿，平均ADC为0.000683 mm2/s。囊性成分的ADC在囊性脑膜瘤中(0.001283 mm2/s)高于成纤维性脑膜瘤(0.000224 mm2/s)和脑膜上皮性脑膜瘤(0.000088 mm2/s) (p<0.001)。脑膜瘤的ADC高于对侧健康脑组织(0.000642 mm2/s vs. 0.000404 mm2/s;n)。结论adc测定对ⅰ级脑膜瘤的组织学亚型鉴别不可靠。
{"title":"ADC is not reliable in determinating subtypes of meningiomas","authors":"Jelena Ignjatovic, D. Stojanov, N. Stojanović, I. Stefanović, Daniela Benedeto-Stojanov, S. Petrović, A. Kostic, Aleksandra Aracki-Trenkic, N. Ignjatovic","doi":"10.2478/s11536-013-0315-x","DOIUrl":"https://doi.org/10.2478/s11536-013-0315-x","url":null,"abstract":"ObjectiveTo verify the reliability of apparent diffusion coefficient (ADC) measurements in determining subtypes of meningiomas.Material and methodsThirty patients (20 women and 10 men; average age, 53±15 years) with meningiomas were prospectively studied using DWI with b values of 0 and 1000. ADC values of the neoplastic tissue were obtained as the mean of measurements from three regions of interests within the mass and compared with histologic subtypes using ANOVA test (SPSS16).ResultsThe meningothelial subtype was found in 15 (50%) patients, fibroblastic in 10 (33.33%) patients and cystic in 5 (16.67%) patients. All meningiomas belonged to the WHO Grade 1 — benign meningiomas. There was no significant statistical difference between meningothelial, fibroblastic and cystic meningiomas when considering mean ADC values (0.000411+/−0.000066 mm2/s vs. 0.000750+/−0.001045 mm2/s vs. 0.000688+/−0.000063 mm2/s (p>0.05). Perifocal edema was present only with fibroblastic meningioma with mean ADC 0.000683 mm2/s. The ADC of the cystic component was statistically significantly higher in cystic meningeomas (0.001283 mm2/s) compared with fibroblastic (0.000224 mm2/s) and meningothelial meningiomas (0.000088 mm2/s) (p<0.001). The ADC of meningiomas was higher compared with contralateral healthy brain tissue (0.000642 mm2/s vs. 0.000404 mm2/s; n.s).ConclusionADC measurement do not seem reliable in identifying histological subtypes of Grade I meningiomas.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"773-777"},"PeriodicalIF":0.0,"publicationDate":"2014-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0315-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68851656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-16DOI: 10.2478/s11536-013-0342-7
A. Jaroszyński, A. Jaroszyńska, A. Szcześniak, A. Szymczyk, T. Zaborowski, T. Zapolski, A. Wysokiński, W. Załuska
The spatial QRS/T angle (QRS/T) has been identified as a strong and independent predictor of adverse cardiac events. QRS/T can be determined from the electrocardiogram (ECG) by matrix transformation methods or formula which uses a combination of net QRS and T-wave amplitudes (QRS/Tsimple). Amplitudes can be measured automatically by using dedicated software (QRS/Tauto) or can be manually measured on a computer screen (QRS/Tmanual). This latter method allows analysis of QRS/T, when digital ECGs are not available. The aim of the study was to determine the agreement in the measurements between automatically derived QRS and T amplitudes and manually measured on the computer screen amplitudes. The relative error of the QRS/T between the two methods was estimated in 73 patients. In the case of QRS/Tmanual the inter-observer as well as intra-observer variability was estimated. The relative error between QRS/Tauto vs. QRS/Tmanual was 3.51%. Inter-observer and intra-observer variability of the QRS/Tmanual was 1.19% and 1.18% respectively. Manual measurement of the QRS/T is reliable, however, the predictive value of this parameter should be tested in clinical trials, before QRS/Tmanual can be considered a useful tool in clinical practice or retrospective studies.
{"title":"Agreement between manual and automated measurements of simple QRS/T angle","authors":"A. Jaroszyński, A. Jaroszyńska, A. Szcześniak, A. Szymczyk, T. Zaborowski, T. Zapolski, A. Wysokiński, W. Załuska","doi":"10.2478/s11536-013-0342-7","DOIUrl":"https://doi.org/10.2478/s11536-013-0342-7","url":null,"abstract":"The spatial QRS/T angle (QRS/T) has been identified as a strong and independent predictor of adverse cardiac events. QRS/T can be determined from the electrocardiogram (ECG) by matrix transformation methods or formula which uses a combination of net QRS and T-wave amplitudes (QRS/Tsimple). Amplitudes can be measured automatically by using dedicated software (QRS/Tauto) or can be manually measured on a computer screen (QRS/Tmanual). This latter method allows analysis of QRS/T, when digital ECGs are not available. The aim of the study was to determine the agreement in the measurements between automatically derived QRS and T amplitudes and manually measured on the computer screen amplitudes. The relative error of the QRS/T between the two methods was estimated in 73 patients. In the case of QRS/Tmanual the inter-observer as well as intra-observer variability was estimated. The relative error between QRS/Tauto vs. QRS/Tmanual was 3.51%. Inter-observer and intra-observer variability of the QRS/Tmanual was 1.19% and 1.18% respectively. Manual measurement of the QRS/T is reliable, however, the predictive value of this parameter should be tested in clinical trials, before QRS/Tmanual can be considered a useful tool in clinical practice or retrospective studies.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"737-740"},"PeriodicalIF":0.0,"publicationDate":"2014-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0342-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68852383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-16DOI: 10.2478/s11536-013-0336-5
Volker Gebhardt, B. Beilstein, A. Herold, C. Weiss, G. Fanelli, M. Dusch, M. Schmittner
BackgroundThe aim of this randomised, clinical trial was to compare safety and efficiency of hyperbaric prilocaine and mepivacaine at a dosage of 0.5 ml each for perianal outpatient surgery in terms of transient neurologic symptoms (TNS) and postoperative recovery.Methods160 patients aged 18–80 years were randomized to receive a spinal anaesthesia (SPA) with 0.5ml of mepivacaine or prilocaine. We measured the expansion of the block, evaluated postoperative recovery times and determined the incidence of TNS one week after surgery.Results160 patients (93 male / 67 female) were available for analysis. Prilocaine led to shorter times from SPA to micturition (prilocaine: 178 (110–254) min vs. mepivacaine: 195 (130–305) min, p=0.0008) and discharge (prilocaine: 192 (126–267) min vs. mepivacaine: 220 (140–320) min, p<0.0001). 152 / 160 patients were available for the telephone follow-up. Six patients (9%) receiving mepivacaine compared to zero patients of the prilocaine group announced typical symptoms of TNS (p=0.0284).ConclusionBoth, hyperbaric mepivacaine 40 mg/ml and hyperbaric prilocaine 20 mg/ml can be used at a dosage of 0.5 ml each for SPA in perianal outpatient surgery. Due to the faster recovery profile and a lower incidence of TNS, we recommend the use of 10mg hyperbaric prilocaine 20 mg/ml for this indication.
本随机临床试验的目的是比较高压压丙洛卡因和甲哌卡因各0.5 ml用于肛周门诊手术的短暂性神经系统症状(TNS)和术后恢复方面的安全性和有效性。方法160例18 ~ 80岁的患者随机接受甲哌卡因或丙罗卡因0.5ml的脊髓麻醉。我们测量了阻滞的扩张，评估了术后恢复时间，并确定了术后一周TNS的发生率。结果160例患者(男93例，女67例)纳入分析。Prilocaine从SPA到排尿(Prilocaine: 178 (110-254) min vs. mepivacaine: 195 (130-305) min, p=0.0008)和排出(Prilocaine: 192 (126-267) min vs. mepivacaine: 220 (140-320) min, p<0.0001)。有152 / 160例患者可进行电话随访。甲哌卡因组有6例(9%)出现TNS的典型症状，而丙洛卡因组为0例(p=0.0284)。结论高压氧丙哌卡因40mg /ml和高压氧丙洛卡因20mg /ml各0.5 ml均可用于门诊肛周手术的SPA。由于恢复更快，TNS发生率更低，我们建议使用10mg高压丙胺20mg /ml用于该适应症。
{"title":"Spinal hyperbaric prilocaine vs. mepivacaine in perianal outpatient surgery","authors":"Volker Gebhardt, B. Beilstein, A. Herold, C. Weiss, G. Fanelli, M. Dusch, M. Schmittner","doi":"10.2478/s11536-013-0336-5","DOIUrl":"https://doi.org/10.2478/s11536-013-0336-5","url":null,"abstract":"BackgroundThe aim of this randomised, clinical trial was to compare safety and efficiency of hyperbaric prilocaine and mepivacaine at a dosage of 0.5 ml each for perianal outpatient surgery in terms of transient neurologic symptoms (TNS) and postoperative recovery.Methods160 patients aged 18–80 years were randomized to receive a spinal anaesthesia (SPA) with 0.5ml of mepivacaine or prilocaine. We measured the expansion of the block, evaluated postoperative recovery times and determined the incidence of TNS one week after surgery.Results160 patients (93 male / 67 female) were available for analysis. Prilocaine led to shorter times from SPA to micturition (prilocaine: 178 (110–254) min vs. mepivacaine: 195 (130–305) min, p=0.0008) and discharge (prilocaine: 192 (126–267) min vs. mepivacaine: 220 (140–320) min, p<0.0001). 152 / 160 patients were available for the telephone follow-up. Six patients (9%) receiving mepivacaine compared to zero patients of the prilocaine group announced typical symptoms of TNS (p=0.0284).ConclusionBoth, hyperbaric mepivacaine 40 mg/ml and hyperbaric prilocaine 20 mg/ml can be used at a dosage of 0.5 ml each for SPA in perianal outpatient surgery. Due to the faster recovery profile and a lower incidence of TNS, we recommend the use of 10mg hyperbaric prilocaine 20 mg/ml for this indication.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"754-761"},"PeriodicalIF":0.0,"publicationDate":"2014-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0336-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68852556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-16DOI: 10.2478/s11536-013-0333-8
B. Būdienė, R. Liutkeviciene, D. Zaliuniene
Best vitelliform macular dystrophy (BVD) is a slowly progressive form of macular dystrophy. In most cases this disease begins in childhood although sometimes it can develop in later age. The diagnosis of BVD is based on family history, clinical and electrophysiological findings. Clinical signs are variable, yet the majority of patients have a typical yellow yolk-like macular lesion in the eye fundus. Lesions are usually bilateral, but in rare cases can be unilateral. Atrophy of the macula may develop after many years. The mutations responsible for Best vitelliform macular dystrophy are found in a gene called VMD2, which encodes a transmembrane protein named bestrophin-1 (hBest1) that is a Ca2+-sensitive chloride channel. Most reported cases causing the disease are in exons 2, 4, 6 and 8 in patients with BVD. In this article we discuss the etiology of Best’s vitelliform macular dystrophy, clinical presentation, diagnostics, genetic and current treatment possibilities.
{"title":"Best vitelliform macular dystrophy: literature review","authors":"B. Būdienė, R. Liutkeviciene, D. Zaliuniene","doi":"10.2478/s11536-013-0333-8","DOIUrl":"https://doi.org/10.2478/s11536-013-0333-8","url":null,"abstract":"Best vitelliform macular dystrophy (BVD) is a slowly progressive form of macular dystrophy. In most cases this disease begins in childhood although sometimes it can develop in later age. The diagnosis of BVD is based on family history, clinical and electrophysiological findings. Clinical signs are variable, yet the majority of patients have a typical yellow yolk-like macular lesion in the eye fundus. Lesions are usually bilateral, but in rare cases can be unilateral. Atrophy of the macula may develop after many years. The mutations responsible for Best vitelliform macular dystrophy are found in a gene called VMD2, which encodes a transmembrane protein named bestrophin-1 (hBest1) that is a Ca2+-sensitive chloride channel. Most reported cases causing the disease are in exons 2, 4, 6 and 8 in patients with BVD. In this article we discuss the etiology of Best’s vitelliform macular dystrophy, clinical presentation, diagnostics, genetic and current treatment possibilities.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"784-795"},"PeriodicalIF":0.0,"publicationDate":"2014-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0333-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68851829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-16DOI: 10.2478/s11536-013-0335-6
M. Mitrović, Đorđe S. Popović, D. Naglić, Jovanka Novaković Paro, T. Ilić, Branka Kovačev Zavišić
AimsLong-term hyperglycemia, characteristic for type 1 diabetes, causes enhanced oxidative stress, chronic inflammation and endothelial dysfunction which are the key events in the development of vascular complications. On the other hand, some data shows that existence of chronic degenerative complications may cause increased inflammatory marker levels in diabetic patients, mainly as a repercussion of malfunctioned endothelial repair process. Our study aims to determinate a degree of inflammation in type 1 diabetes patients and to investigate its relation to development of the chronic microvascular complications.MethodsGeneral information, anthropometric, glucose metabolism, lipid and lipoprotein parameters, levels of C reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were analyzed and screening tests for detection of the chronic microvascular complications were conducted in 76 type 1 diabetes patients.ResultsForty six patients had at least one of the complications. They were older and had longer duration of diabetes (p=0.015; p<0.0001) and higher values of total (p=0.021), LDL-cholesterol (p=0.048) and triglycerides (p=0.002). Levels of CRP (p=0.004) and TNF-α (p=0.048) were higher in patients with chronic microvascular complications in regard to patients without diagnosed microangiopathy.ConclusionLow grade chronic inflammation is characteristic for type 1 diabetes patients with developed chronic microvascular complications.
{"title":"Markers of inflammation and microvascular complications in type 1 diabetes","authors":"M. Mitrović, Đorđe S. Popović, D. Naglić, Jovanka Novaković Paro, T. Ilić, Branka Kovačev Zavišić","doi":"10.2478/s11536-013-0335-6","DOIUrl":"https://doi.org/10.2478/s11536-013-0335-6","url":null,"abstract":"AimsLong-term hyperglycemia, characteristic for type 1 diabetes, causes enhanced oxidative stress, chronic inflammation and endothelial dysfunction which are the key events in the development of vascular complications. On the other hand, some data shows that existence of chronic degenerative complications may cause increased inflammatory marker levels in diabetic patients, mainly as a repercussion of malfunctioned endothelial repair process. Our study aims to determinate a degree of inflammation in type 1 diabetes patients and to investigate its relation to development of the chronic microvascular complications.MethodsGeneral information, anthropometric, glucose metabolism, lipid and lipoprotein parameters, levels of C reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were analyzed and screening tests for detection of the chronic microvascular complications were conducted in 76 type 1 diabetes patients.ResultsForty six patients had at least one of the complications. They were older and had longer duration of diabetes (p=0.015; p<0.0001) and higher values of total (p=0.021), LDL-cholesterol (p=0.048) and triglycerides (p=0.002). Levels of CRP (p=0.004) and TNF-α (p=0.048) were higher in patients with chronic microvascular complications in regard to patients without diagnosed microangiopathy.ConclusionLow grade chronic inflammation is characteristic for type 1 diabetes patients with developed chronic microvascular complications.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"748-753"},"PeriodicalIF":0.0,"publicationDate":"2014-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0335-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68852030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-16DOI: 10.2478/s11536-013-0334-7
V. Samartsev, A. Kuchumov, V. Gavrilov
The aim of this study is to improve treatment results and SSI prevention by differential usage of the contemporary suture materials and choice of proper suturing technique. To simulate suturing process and compared two suturing techniques, two FE models were developed. Finite-element analysis (FEA) was based on experimental data of contemporary commercial sutures and soft tissue properties. We applied obtained results for abdominal wall closure in rats and compared non-absorbable suture (capron) with absorbable suture (PDS Plus) for chosen technique. Cross-sections were examined by lighting electron microscope. Afterwards, the results of patients’ treatment are also presented. It was shown that running sew was more appropriate for aponeurosis suturing compared to interrupted sew. The optimal parameters of suturing techniques were computed. Single-row running sew by PDS Plus was proved to hold wound edges for 90 days with less inflammatory response compared to other suture in the result of histological analysis. Application of contemporary synthetic absorbable suture materials with antibacterial coating for laparotomic wounds closure and anastomosis decreases local inflammatory reaction and provides the successful tissue regeneration. Application of advanced SSI prophylactics algorithm was shown to decrease risk of post-operative suppurative complications from 14.2 to 1.6 %.
{"title":"Sutures in abdominal surgery: biomechanical study and clinical application","authors":"V. Samartsev, A. Kuchumov, V. Gavrilov","doi":"10.2478/s11536-013-0334-7","DOIUrl":"https://doi.org/10.2478/s11536-013-0334-7","url":null,"abstract":"The aim of this study is to improve treatment results and SSI prevention by differential usage of the contemporary suture materials and choice of proper suturing technique. To simulate suturing process and compared two suturing techniques, two FE models were developed. Finite-element analysis (FEA) was based on experimental data of contemporary commercial sutures and soft tissue properties. We applied obtained results for abdominal wall closure in rats and compared non-absorbable suture (capron) with absorbable suture (PDS Plus) for chosen technique. Cross-sections were examined by lighting electron microscope. Afterwards, the results of patients’ treatment are also presented. It was shown that running sew was more appropriate for aponeurosis suturing compared to interrupted sew. The optimal parameters of suturing techniques were computed. Single-row running sew by PDS Plus was proved to hold wound edges for 90 days with less inflammatory response compared to other suture in the result of histological analysis. Application of contemporary synthetic absorbable suture materials with antibacterial coating for laparotomic wounds closure and anastomosis decreases local inflammatory reaction and provides the successful tissue regeneration. Application of advanced SSI prophylactics algorithm was shown to decrease risk of post-operative suppurative complications from 14.2 to 1.6 %.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"849-859"},"PeriodicalIF":0.0,"publicationDate":"2014-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0334-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68851844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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