- MeSH
- Anesthesia and Analgesia methods trends utilization MeSH
- Anticoagulants administration & dosage adverse effects therapeutic use MeSH
- Defibrillators, Implantable trends utilization MeSH
- Atrial Fibrillation * diagnosis prevention & control therapy MeSH
- Cardiology methods trends MeSH
- Catheter Ablation * methods trends MeSH
- Congresses as Topic MeSH
- Cryoanesthesia methods trends utilization MeSH
- Humans MeSH
- Meta-Analysis as Topic MeSH
- Registries MeSH
- Arrhythmias, Cardiac * prevention & control therapy MeSH
- Statistics as Topic MeSH
- Check Tag
- Humans MeSH
- MeSH
- Anesthesia and Analgesia methods trends utilization MeSH
- Anticoagulants administration & dosage adverse effects therapeutic use MeSH
- Defibrillators, Implantable trends utilization MeSH
- Atrial Fibrillation * diagnosis prevention & control therapy MeSH
- Cardiology methods trends MeSH
- Catheter Ablation * methods trends MeSH
- Congresses as Topic MeSH
- Cryoanesthesia methods trends utilization MeSH
- Humans MeSH
- Meta-Analysis as Topic MeSH
- Registries MeSH
- Arrhythmias, Cardiac * prevention & control therapy MeSH
- Statistics as Topic MeSH
- Check Tag
- Humans MeSH
- MeSH
- Analgesia * methods utilization MeSH
- Anesthesia and Analgesia methods trends utilization MeSH
- Neck Pain diagnosis therapy MeSH
- Back Pain diagnosis therapy MeSH
- Stress, Physiological physiology drug effects MeSH
- Injections * utilization MeSH
- Collagen * administration & dosage therapeutic use MeSH
- Middle Aged MeSH
- Humans MeSH
- Neuralgia diagnosis therapy MeSH
- Stress, Psychological diagnosis complications therapy MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
- Keywords
- přednemocniční neodkladná péče, sedace, třídění,
- MeSH
- Analgesia MeSH
- Anesthesia and Analgesia methods utilization MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Enteral Nutrition methods utilization MeSH
- Heparin therapeutic use MeSH
- Adrenal Cortex Hormones therapeutic use MeSH
- Immobilization methods utilization MeSH
- Infusions, Intravenous methods utilization MeSH
- Urinary Catheterization methods utilization MeSH
- Cryotherapy methods utilization MeSH
- Humans MeSH
- Oxygen Inhalation Therapy methods utilization MeSH
- Burns classification complications nursing MeSH
- Transportation of Patients methods MeSH
- Triage methods organization & administration MeSH
- Emergency Medical Services methods organization & administration MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Anesthesia and Analgesia methods utilization MeSH
- Administration, Oral MeSH
- Clonidine administration & dosage therapeutic use MeSH
- Persons with Psychiatric Disorders classification psychology legislation & jurisprudence MeSH
- Etomidate administration & dosage therapeutic use MeSH
- Flumazenil administration & dosage therapeutic use MeSH
- Gynecological Examination methods utilization MeSH
- Ketamine administration & dosage therapeutic use MeSH
- Drug Therapy, Combination utilization MeSH
- Humans MeSH
- Midazolam administration & dosage therapeutic use MeSH
- Statistics as Topic MeSH
- Dental Care for Persons with Disabilities methods utilization MeSH
- Outcome and Process Assessment, Health Care MeSH
- Check Tag
- Humans MeSH
- Publication type
- Lecture MeSH
Ošetření pacienta bez projevů stresu a bolesti je optimem v každé stomatologické praxi. Zatímco dospělý je schopen nepříjemné vjemy víceméně dobře kompenzovat, zcela odlišná situace nastává při ošetření dětského pacienta. Dítě je jinak uzpůsobeno, jak anatomicky, tak i fyziologicky. Má rozsahem menší dýchací trakt, snadno hyperventiluje a může se tudíž dostat do hypoxického stavu.
The number of patients with osteoporosis is steadily rising, along with the frequency of related fractures. The economic burden as well as the use of health care resources will increase to unprecedented levels over the next decade. Since patients with osteoporotic fractures are frequently elderly, comorbidities are highly prevalent, leading to an increased risk of perioperative complications. Therefore, a multidisciplinary approach is required in which the orthopaedic surgeon plays a pivotal role, often as the coordinating physician. Apart from advanced skills in fracture management, a thorough understanding of frequent complications and measures that lead to their early detection and prevention are therefore required. This article reviews the most relevant perioperative aspects that affect the preoperative, intraoperative and postoperative periods of fragility fracture management in the elderly population. Preoperative cardiovascular testing is discussed, as well as its effect on surgical timing. Measures to improve outcomes related to frequently found malnutrition and anemia are presented, as are prevention of surgical site infection, deep venous thrombosis, gastrointestinal hemorrhage, urinary retention and delirium. Finally, aspects of fracture management and fixation, as well as the initiation of early measures for subsequent fracture prevention are examined.
- MeSH
- Anesthesia and Analgesia methods utilization MeSH
- Delirium prevention & control MeSH
- Diagnostic Techniques, Cardiovascular utilization MeSH
- Epidemiologic Studies MeSH
- Fracture Fixation methods utilization MeSH
- Fractures, Bone prevention & control therapy MeSH
- Gastrointestinal Tract pathology MeSH
- Urinary Catheterization MeSH
- Blood Transfusion utilization MeSH
- Hemorrhage MeSH
- Humans MeSH
- Urinary Bladder MeSH
- Osteoporosis complications MeSH
- Perioperative Care MeSH
- Intraoperative Care MeSH
- Postoperative Care MeSH
- Nutrition Disorders MeSH
- Secondary Prevention MeSH
- Venous Thrombosis prevention & control MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Cíl studie: Zjistit bezpečnost a účinnost intramuskulární kombinace dexmedetomidin-ketamin a dexmedetomin-ketamin-midazolam. Typ studie: Prospektivní, randomizovaná, dvojitě slepá studie. Název a sídlo pracoviště: Klinika anesteziologie a resuscitace 3. LF UK v Praze a FNKV, Praha. Materiál a metoda, část 1: Po souhlasu etické komise a poučeném souhlasu byly u popálených pacientů testovány 4 kombinace dexmedetomidinu (D) 2 µg . kg-1, nebo 2,5 µg . kg-1 a ketaminu (K) 2,0 mg . kg-1, nebo 3,0 mg . kg-1 i. m. Výsledky, část 1: Bylo podáno 43 kombinací 18 pacientům. Kombinace D2K2 byla ukončena předčasně pro nedostatečný efekt, D2.5K3 pro dlouhodobou sedaci. Rozdíl mezi D2K3 a D2.5K2 bylo zachované vědomí v D2K3 vs D2.5K2 (p < 0,05). Kromě psychomimetické reakce ve všech skupinách se nikde nevyskytly významné vedlejší účinky. Materiál a metoda, část 2: Pro potlačení psychomimetických účinků jsme podali midazolam (M) jako trojkombinaci DKM: dexmedetomidin (D) 2 µg .kg-1 + ketamin (K) 2 mg.kg-1 + M 1 mg i.m. nebo místo M placebo (P). Výsledky, část 2: Studie byla ukončena předčasně pro významný útlum. Bezvědomí bylo v DKM vs DKP 5/7 vs 0/7 (p < 0,05), kvalita anestezie v DKM se zlepšila u 4 pacientů. U 2 pacientů se zachovaným vědomím v DKM byl při další anestezii podán midazolam 2 mg. Následoval dlouhodobý útlum vědomí provázený bradykardií a hypotenzí. Závěr: Kombinace dexmedetomidinu 2 µg . kg-1 a ketaminu 3,0 mg . kg-1 i. m. vede spíše k anestezii bez reakce na oslovení, kombinace dexmedetomidinu 2,5 µg . kg-1 a ketaminu 2,0 mg . kg-1 i. m. spíše k analgosedaci se spoluprací. Přidání 1–2 mg midazolamu může vést k významnému ovlivnění vitálních funkcí
Objective: The aim was to evaluate the combination of dexmedetomidine and ketamine and dexmedetomidine, ketamine and midazolam. Design: Prospective randomised clinical study. Setting: Department of Anaesthesiology and Intensive Care, University Hospital. Materials and methods Part 1: Following ethics committee approval and written consent, patients treated for burns were divided into 4 groups according to the intramuscular dose of dexmedetomidine (D) 2 µg .kg-1 or 2.5 µg .kg-1 and ketamine (K) 2.0 mg.kg-1 or 3.0 mg.kg-1. Results Part 1: Total 43 anaesthetics were given to 18 patients. Combinations D2K2 and D2.5K3 were stopped for insufficient effect or excessive sedation respectively. No respiratory depression, airway obstruc - tion, bradycardia or hypotension appeared and any combination suppressed the psychomimetic reactions to ketamine. The only difference found between D2K3 vs D2.5K2 was preserved cooperation in the former combination (p < 0.05). Materials and methods Part 2:To suppress the CNS effects of ketamine, either midazolam (M) 1 mg IM or placebo (P) was added to the combination of dexmedetomidine 2 µg . kg-1 + ketamine 2 mg . kg-1 (DKM or DKP combinations). The protocol was identical to Part 1. Results Part 2: The study was prematurely aborted after signs of excessive sedation in 7 patients and airway obstruction in some patients. Unconsciousness appeared in 5/7 vs. 0/7 in the DKM vs. DKP group (p < 0.05), the quality of anaesthesia improved in 4 patients in the DKM group. Conclusions: The combination of intramuscular dexmedetomidine 2.5 µg . kg-1 with ketamine 2.0 mg . kg-1 is more likely to preserve cooperation during anaesthesia than dexmedetomidine 2 µg . kg-1 with ketamine 3.0 mg . kg-1 IM. Adding 1–2 mg of midazolam may result in vital function disturbances.
- MeSH
- Anesthesia and Analgesia methods utilization MeSH
- Dexmedetomidine administration & dosage pharmacology therapeutic use MeSH
- Financing, Organized MeSH
- Injections, Intramuscular utilization MeSH
- Ketamine administration & dosage pharmacology therapeutic use MeSH
- Humans MeSH
- Midazolam administration & dosage pharmacology therapeutic use MeSH
- Burn Units organization & administration trends MeSH
- Check Tag
- Humans MeSH
- Publication type
- Comparative Study MeSH
Cíl. Přes pokroky v chirurgické a medikamentózní onkologické léčbě je karcinom pankreatu v zásadě nevyléčitelné onemocnění. Role radiologie spočívá v precizní diagnóze tumorózního procesu a v řešení komplikací nádorového onemocnění. Preoperačně se jedná zejména o lokalizaci pankreatické léze, staging a určení lokální resekability. Metoda radiofrekvenční ablace pankreatu má za cíl prodloužit přežívání pacientů s inoperabilním stadiem tumoru. Metoda. K alternativní intervenci jsou indikování pacienti s inoperabilním tumorem pankreatu, bez vzdálených metastáz. Od roku 2007 byla ablace provedena u šesti pacientů - 5x duktální adenokarcinom hlavy, 1x maligní neuroendokrinní tumor těla pankreatu. Výsledky. Článek referuje první klinické zkušenosti s metodou radiofrekvenční ablace u inoperabilního tumoru pankreatu. Technický úspěch byl zaznamenán ve všech případech. Celkový pooperační průběh byl komplikován u dvou pacientů, u jednoho došlo jen k prodloužení času hospitalizace z důvodu duodenální sekrece z drénu, u druhého byla nutná intervence v celkové anestezii - evakuace subfasciálního abscesu s prodloužením času hospitalizace na 38 dnů. Závěr. Radiofrekvenční ablace lokálně pokročilých, inoperabilních tumorů pankreatu v našem souboru se ukázala jako relativně bezpečná paliativní léčebná modalita.
Aim. Despite advances in surgical and pharmaceutical oncologic treatment, pancreatic carcinoma is in principle incurable disease. Role of radiology lies in precise diagnosis of tumor process and in treating of cancer disease complications. In preoperative phase it means mostly localization of pancreatic lesion, staging and determining local resecability. The method of radiofrequency ablation of the pancreas focuses on extension of survival of the patient with inoperable state of tumor. Method. The alternative intervention is indicated to patients with inoperable pancreatic tumor without distant metastases. Since 2007 radiofrequency ablation was performed on six patients, five ductal adenocarcinoma of pancreatic head and one with malignant neuroendocrine tumor of body. Results. Article presents frst clinical experience with radiofrequency ablation in inoperable pancreatic tumors. The technical success was achieved in all cases. Postoperative phase was complicated in 2 patients. In the frst case hospitalization time was prolonged due to duodenal secretion from drain. In the second case following intervention under general anaesthesia was necessary - evacuation of subfascial abscess with prolongation of hospitalization time to 38 days. Conclusion. In our group of patients radiofrequency ablation of locally advanced inoperable pancreatic tumors proves to be relatively save palliative procedure.
- MeSH
- Anesthesia and Analgesia utilization MeSH
- Diagnostic Techniques, Digestive System instrumentation utilization MeSH
- Catheter Ablation methods instrumentation utilization MeSH
- Humans MeSH
- Pancreatic Neoplasms diagnosis therapy MeSH
- Palliative Care methods utilization MeSH
- Tomography, X-Ray Computed utilization MeSH
- Postoperative Complications MeSH
- Check Tag
- Humans MeSH
