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R Záhorec

Publications and source records attributed to R Záhorec.

8 recordsLinked to original sources
PubMed2005

Epidemiology of severe sepsis in intensive care units in the Slovak Republic.

BACKGROUND: We investigated the number, clinical characteristics, and outcomes of ICU patients, who met precise clinical and physiological criteria for severe sepsis (as defined in the PROWESS study) in Slovak intensive care units. We designed an observational cohort epidemiological study with retrospective analysis of prospectively collected data. 12 adult general intensive care units participated in the Slovak Republic between July and December 2002. PATIENTS AND METHODS: Patients included 1,533 adult ICU admissions during the second half of 2002 in 12 adult ICUs. Descriptive statistical methods (independent sample T-test, chi(2) test, and linear Pearson coefficient of correlation) were used. RESULTS: We found that 7.9% of hospitalized critically ill patients met severe sepsis criteria in the intensive care units. The most frequent primary sources of infection were lungs and abdomen. Hospital mortality of severe septic patients was 51.2% (62 pts/121 pts). Most patients (85.1%) were > 40 years of age. Mortality increased with age; mean average age of survivors (53 years) was significantly lower than in nonsurvivors (61 years, p = 0.01). Factors associated with mortality were age over 50 years, three or more dysfunctional organs, and elevated admission and maximum SOFA scores. Survivors had a significantly lower number of sites with organ system dysfunction (MODS 2.56) than nonsurvivors (MODS 3.98). SOFA score seems to be a valuable tool to differentiate survivors from nonsurvivors. All the septic patients had SOFA scores greater than 4 points. Survivors of severe sepsis were characterized with significantly lower admission and maximum SOFA scores (median 8.7 and 9.4 points, respectively) than septic nonsurvivors (median 11.6 and 14.0 points, respectively, p = 0.001). CONCLUSION: We estimate 1,770 cases of severe sepsis hospitalized at Slovak adult intensive care units per year. Hospital mortality for severe sepsis remains very high (51.2%) and is associated with advanced age (over 50 years), number of failing organs and higher admission and maximum SOFA scores.

Adult↗
PubMed2004

[Radiation navigated reoperations of the thyroid gland in differentiated carcinoma].

Radiation-navigated reoperations of the thyroid gland for the differenciated carcinoma are reserved for such cases of the thyroid gland reoperations aiming to complete a total thyroidectomy and, also, to extirpate metastatically affected lymphonodes. The authors discuss this part of the above surgical procedure, its therapeutic prospects, as well as its cons. They recommend already the primary surgical procedure on the thyroid gland to be conducted carefully--i.e. to conduct at least a lobectomy of the thyroid gland followed by visualization and examination of the recurrent laryngeal nerve and the parathyroid glands. They recommend the reoperations to be concentrated in specialized centres.

Adult↗
PubMed2004

[Completing total thyroidectomy with lymph node dissection using a scintillation probe--case report].

Surgery remains the basic therapeutical method of the thyroid gland papillary carcinoma treatment. It is complemented by the adjacent thyro-eliminating therapy. A remarkable number of the thyroid gland carcinoma cases is still being diagnosed accidentally during the surgery for the thyroid gland benign disorders. The above mentioned patients, then, must undergo a reoperation, in order for the total thyroidectomy (TTE) and the lymphonodes dissection (LU) to be finished. The reoperations should be conducted in specialized clinics by sufficiently proficient teams. Our study reviews a case of a patient who underwent three surgeries on his thyroid gland.

Adult↗
PubMed1997

[Alternative use of the EEA stapler in subtotal esophagectomy].

Authors describe the successful usage of EEA stapling by reconstruction after subtotal oesophagectomy of carcinoma in the middle third of oesophagus. EEA stapling was pushed in transorally and oesophagogastric anastomosis was made. Neither pre- or post-operative complications occurred by this procedure. Patient left the hospital on 14th day afer the operation. Authors consider transoral application of EEA stapling as effective alternative in creation of oesophagogastric anastomosis after subtotal oesophagectomy.

Adult↗
PubMed1995

Biochemical monitoring in patients during revascularization surgery.

Changes in the metabolism of patients with peripheral arterial occlusive disease were studied in the light of biochemical parameters during and after vascular reconstructive surgery (aorto-bifemoral bypass). Biochemical parameters were determined in arterial and regional venous blood in 10 successive intervals covering the period before ischemia, during acute ischemia and in the course of reperfusion of the lower extremity. After successful revascularization of the extremity, marked increases were recorded particularly in the levels of thiobarbituric acid reactive substances and of lactate in the early and late period of reperfusion. Monitoring of the given biochemical parameters may yield an adequate criterion for determining the degree of ischemia-reperfusion injury in vascular reconstructive surgery and may also be of value in assessing the effectivity of the applied mode of protecting the patient against functional and metabolic injury.

Adult↗
PubMed1993

[Biochemical parameters in the blood of patients during open-heart surgery. I. Monitoring changes in energy metabolism].

Levels of lactate, inorganic phosphate and uric acid in arterial, mixed venous and coronary sinus blood were studied in patients during open-heart surgery. It was found that the determination of mentioned biochemical parameters can provide information regarding the energetic metabolism status of the whole organism, but selectively, also of the patient's myocardium. The results of biochemical analyses demonstrate a significant loading of the organism manifested by metabolic alterations, especially after long-term cardiopulmonary bypass. The study of mentioned biochemical parameters can be employed for investigation of a more efficient protection of myocardium against ischemia-reperfusion injury. (Fig. 6, Ref. 18).

Cardiac Surgical Procedures↗
PubMed1993

[Protective effect of Neoton during cardiovascular surgery. Hemodynamic and biochemical aspects].

The authors present the preliminary results of an experimental study where to a group of patients (n = 10) subjected to cardiosurgery, using extracorporeal circulation, to the cardioplegic solution creatine phosphate was added (Neoton of Alfa Schiaparelli Wasserman Co.)--2 g.l-1. The authors investigated haemodynamic and biochemical parameters and compared them on the day of operation with the same parameters assessed in a group of controls operated in the same way but without addition of creatine phosphate to the cardioplegic solution. Apart from insignificant differences in haemodynamic parameters the group of patients given Neoton had a lower malondialdehyde level during the early stage after termination of extracorporeal circulation, spontaneous defibrillation, a lower incidence of dysrhythmias and disorders of the conduction system. It can be assumed that creatine phosphate (Neoton) may be effective in the protection of the myocardium from ischaemia reperfusion damage.

Adult↗