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Biomedical subjects

A Janda

Publications and source records attributed to A Janda.

At least 19 recordsLinked to original sources
PubMed2004

Long-term retention of knowledge after a distance course in medical informatics at Charles University Prague.

BACKGROUND: Distance education is instructional delivery that does not constrain the student to be physically present in the same location as the instructor. The electronic distance learning called e-learning has evolved with the development of computer technologies and electronic communication. PURPOSE: Before setting the distance way of teaching as a standard part of medical schools' curricula, the impact of number of factors on the effectiveness of this way of teaching should be considered. METHODS: A group of 38 students went through a distance course of medical informatics. The course consisted of 10 lessons. At the end of the course the students sat for a final test that contained 60 multiple-choice test questions. There was always one correct answer. Time limit for test completion was 60 minutes. After 12 months, 31 students from the original group sat for the same test. The topics of the course were not repeated in the meantime. The students were not aware that their knowledge would be tested after 1 year. RESULTS: The average retention of knowledge expressed as a percentage of the students' performance in the first test was 66.8%. The knowledge retention correlated significantly with the statement "I liked the online course more than the classroom course" and positively with the number of hours spent with the computer weekly. CONCLUSIONS: Retention of knowledge after the electronic distance course after 12 months is close to 67%. Other results indicate that we can expect better retention of knowledge from independent, responsible, and positively motivated students who can easily operate information technologies.

Computer-Assisted Instruction↗
PubMed1990

[Compression of the trachea by a hematoma caused by an internal jugular vein catheter].

In a patient with thrombocytopenia, respiratory obstruction because of a hematoma occurred following internal jugular vein cannulation. This patient recovered completely after surgical intervention. With the following precautions in mind, puncture of the internal jugular vein in patients with coagulopathies has a high success rate and does not result in severe complications: Internal jugular vein cannulation by an experienced physician; optimal conditions for puncture by increasing venous pressure and diameter with slight Trendelenburg position and Valsalva maneuver in patients with spontaneous breathing, or positive end-expiratory pressure in patients with artificial ventilation; catheter insertion by the Seldinger technique; manual compression of the puncture site for 10-15 min; and vein puncture with ultrasonographic aid if possible.

Catheterization, Central Venous↗
PubMed1990

[Atracurium--increased duration of its effect following alcuronium].

The duration of action of a supplementary dose of Atracurium 0.125 mg/kg after an initial dose of Atracurium 0.5 mg/kg respectively Alcuronium 0.25 mg/kg was investigated in 2 groups of 7 patients each. The average duration of action of Atracurium after Alcuronium (44.62 +/- 9.95 min) was 1.75 times longer than that of Atracurium after Atracurium (25.49 +/- 4.08 min). The difference is statistically significant (p = 0.05). For the clinical application of a combination of Atracurium with Alcuronium, 2 conclusions which might appear contradictory can be considered: 1. the pretreatment with Alcuronium can enhance intentionally the duration of action of Atracurium and spare total dosage of muscle relaxants at the same time. Prompt antagonism of muscle blockade of Atracurium remains unchanged according to our experience. 2. the pretreatment with Alcuronium may be dangerous whenever Atracurium is administered close to the end of the operation because of the possibility of prolonged postoperative muscle relaxation.

Adult↗
PubMed1988

[Surgical tactics in acute mesenteric artery occlusion].

Operations were performed on 52 patients for acute mesenteric embolism, between 1980 and 1988. The average age of 48 of them was 75.8 +/- 7.3 years. Only four patients were below 60 years of age. Only exploratory laparotomy was possible in 20 cases, and all of these patients died. Six of eight patients (75 per cent) did not survive embolectomy from the superior mesenteric artery. Seven of twelve patients (58 per of eleven patients (27 per cent) died after embolectomy and resection of subtotal parts of the small intestine. Death occurred also to one patient with acute iliaco-mesenteric bypass. Hence, total mortality of all 52 patients amounted to 71.1 per cent. The mortality rate for 32 patients with attempted restitutional surgery amounted to 53.1 per cent, exploratory laparotomy unconsidered. This was certainly attributable to 73 per cent of survivors of embolectomy combined with removal of somewhat extended intestinal sections. Follow-up checks in short intervals of serum lactate have proved to provide reliable diagnostic parameters and means for postoperative appraisal with a view to making an informed estimate of changes of a second-look operation for acute intestinal ischaemia. The lactate mean value for mesenteric embolism was 8.88 +/- 4.43 mmol/l. However, lactate values were normal, between 1 mmol/l and 2 mmol/l, in acute abdominal processes with non-ischaemic causes and in cases of ischaemia of extremities.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1986

[Hypoglycemia caused by lidocaine overdosage].

Hypoglycaemia with manifest clinical symptoms has been observed in four patients with cardiac insufficiency after infiltration of high doses of lidocaine prior to surgery. The depressing influence of lidocaine on blood glucose levels has also been seen in six out of 12 patients to whom a pacemaker was implanted in local anaesthesia. The interaction between hepatic glucose- and lidocaine-metabolism could possibly be responsible for this effect. Therefore the evaluation of blood glucose level and iv. administration of glucose is advisable in patients with systemic toxic reactions following lidocaine overdosage to avoid unnecessary symptomatic therapy.

Aged↗
PubMed1985

[Obstruction of bacterial filters in general anesthesia].

3 cases of impaired ventilation during general anaesthesia caused by obstruction of bacterial filters on the expiratory limb of the anaesthesia circuit are reported. For explanation, faulty cleaning procedures or defects by manufacturing of bacterial filters possibly have been responsible for these dangerous complications. Finally, the risks and questionable hygienic efficacy of bacterial filters are discussed.

Adolescent↗
PubMed1984

[Lactate in the diagnosis of acute intestinal vascular occlusions].

The diagnostic value of lactate in acute occlusion of intestinal vessels was investigated in two groups of patients: Group 1 included 86 patients with reconstructions of aorta and intestinal arteries: The lactate-concentrations measured during uncomplicated postoperative course over 24 hours remained within the normal range of 4.31 +/- 1.06 mmol/l. Only in 3 patients with acute postoperative occlusion of intestinal arteries, lactate rose to high pathologic levels up to 59.94 mmol/l. In 10 patients after reconstruction of acute mesenteric artery occlusion the postoperative lactate levels enforced the decision in 9 cases against and in one patient to second look operation. Group 2 included 36 patients with acute abdomen: In 18 patients with intestinal vascular occlusions the mean value of lactate was 7.45 +/- 2.86 mmol/l, in 18 patients without intestinal ischemia lactate was only 1.94 +/- 1.02 mmol/l. The statistical difference is significant. In summary, the results of this study document the reliable value of lactate for the diagnosis of acute occlusions of intestinal vessels during pre- and postoperative course.

Abdomen, Acute↗
PubMed1983

[Anesthesia adjacent to the spine in vascular surgery in high-risk patients].

From 1978 to 1982, 515 patients underwent vascular surgery with 230 operations performed under epidural analgesia and 330 operations under spinal anaesthesia. In the case of vascular surgery on the lower limbs epidural analgesia was effective in 168 patients (97.1%) and ineffective in five (2.9%), spinal anaesthesia was effective in 312 patients (98.7%) and ineffective in four (1.3%). Epidural analgesia was effective for vascular surgery on the lower abdomen in 40 patients (70.2%), and inadequate in 17 patients (29.8%), whilst spinal anaesthesia was adequate in 9 patients (64%) and inadequate in 5 patients (36%). Nevertheless, lumbar spinal and epidural analgesia may be the method of choice in high-risk patients undergoing vascular surgery, especially on the lower limbs.

Abducens Nerve↗
PubMed1983

[Lumbar spinal and epidural anesthesia for vascular surgery].

From 1979-1981, a total of 355 high risk patients were scheduled for vascular surgery under lumbar spinal or epidural anaesthesia. 201 patients were given spinal anaesthesia and 140 patients continuous epidural anaesthesia. 14 patients had punction failure. The analgesia for vascular surgery on the lower extremities done under spinal anaesthesia was adequate in 193 patients (98%) and insufficient in only 4 patients (2%). Epidural anaesthesia was adequate for 117 patients (96%) and insufficient in 5 (4%). The analgesia for vascular surgery on lower abdomen done under spinal anaesthesia was adequate in 9 patients (64%) and insufficient in 5 patients (36%), epidural anaesthesia, being adequate for 31 patients (65%) and insufficient for 17 patients (35%). Lumbar spinal and epidural anaesthesia are therefore alternative methods to general anaesthesia for high risk patients undergoing vascular surgery, especially on lower extremities. Spinal anaesthesia offers reliable surgical analgesia and good muscle relaxation but it is limited in time. Continuous epidural anaesthesia on the other hand does guarantee unlimited operating time and provides pre- and postoperative pain relief.

Adult↗
PubMed1978

[Insertion and removal of intravaginal tampons during estrus synchronization in heifers].

In eight trials, 197 heifers were synchronized with gestagen chlorsuperlutin (CSL). The intravaginal tampons soaked with chlorsuperlutin were introduced in the vagina by means of an applier by a vaginal speculum. Silon threads were attached to the tampons, by which they were pulled out after treatment. The mentioned method of application removes the great physical exertion needed for manual application and increases labour productivity in tampon application by about 200%. The hazard of tampon contamination is reduced to the minimum. Of the two tampon types tested (ester and ether type) the ester type was found to be better for not needing sterilization if the disinfectant Aseptin is dropped upon it prior to application. The retention of the tampons was 94.9%. Eighty-four per cent of the retained tampons could be removed by pulling the silon threads. About 40 to 60% of CSL is excreted from the tampons during the treatment. If the initial content of CSL is increased, its excretion is raised as well.

Animals↗