Central European Journal of Medicine最新文献

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}