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Biomedical subjects

E Turbók

Publications and source records attributed to E Turbók.

At least 19 recordsLinked to original sources

[Treatment options for complications in vascular surgery].

The authors processed the patients' data of the last 10 years and present their experience in treating septic complications in the field of vascular surgery. They analyzed the therapeutic possibilities and reviewed the literature. They suggest the following treatment alternatives for the infection related complications, that they consider the best options these days: 1. Identification of the causative agent by microbiologic methods and determination of the antibiotic susceptibility. 2. In the cases of occluded grafts it is recommended to remove the whole graft and to apply a suction-irrigation drainage. 3. In the cases of patent grafts: (a) If the infections starts in the immediate postoperative period it is suggested to spare the graft, open the wound, perform debridement and apply a suction-irrigation drainage. (b) Late suppurations, confined to the trunk of the graft without affecting the anastomoses, requires extensive debridement and lavage, and the graft could be left in place. (c) Anastomosis infection calls for graft removal, in situ reconstruction and suction-irrigation drainage in one setting. (d) Extraanatomic bypass is indicated when culture proves bacteria producing extraprotease enzymes because in these cases the incidence of repetitive septic bleedings are significantly higher, so in situ reconstructions are not recommended.

Adult↗

[Atrial fibrillation after open-heart surgery--incidence, prevention and treatment].

Atrial fibrillation is a common problem in the postoperative period following open-heart surgery. The pathogenesis of postoperative atrial fibrillation is likely to be multifactorial, however increased sympathetic activation may play a significant role. The aim of the study was to detect the incidence and possible reasons of atrial fibrillation in the first three postoperative days after open-heart surgery. Atrial fibrillation was detected in a total of 48 patients (mean age 64.8 +/- 8.8 years) of the 302 consecutive patients included in the study. The incidence of atrial fibrillation was 15.9%. In the history of patients with atrial fibrillation paroxysmal or persistent atrial fibrillation occurred in 18 cases. Acute ischaemia, hypopotassemia, high dose catecholamines contributed to the development of arrhythmias in 6, 4 and 4 cases, respectively. Lack of perioperative beta-blocker treatment was seen in 35 cases. Postoperative bleeding and reoperation occurred prior to the onset of atrial fibrillation in 9 instances. The applied antiarrhythmic therapy was metoprolol, amiodarone, propafenon and electrical cardioversion in 33, 21, 4 and 2 cases, respectively. Incidence of atrial fibrillation was found significantly lower in patients receiving beta-blocker premedication (13/181 [7.18%] versus 35/121 [28.9%]). There was no correlation between the incidence of atrial fibrillation and the length of the surgery, aortic-cross clamp time and the number of bypass grafts. Absence of preoperative beta-blocker treatment, previous atrial fibrillation and combined surgery were found to be strong predictors of atrial fibrillation. There was weaker association with increased age. On the basis of the outcome of our study beta-blocker premedication is suggested in most patients undergoing open-heart surgery.

Adrenergic beta-Antagonists↗

Effect of reconstructive surgery on the blood flow in the extremities. Early and late results.

The effect of vascular reconstruction on limb blood flow was studied in 20 patients with arterial disease in the lower extremity. Blood flow was determined with isotope dilution technique, ankle systolic pressure was estimated with the aid of Doppler ultrasounds. Circulation was studied prior to the operation (i); immediately afterwards (ii); 2-4 months later (iii); and 12-20 months later (iv). In obliterative limb arterial disease blood flow had remarkably slowed down with high vascular resistance in the limb. After surgery blood flow reached almost normal level and vascular resistance in the extremity also decreased to normal. Both the O2 uptake by the extremital tissues and systolic perfusion pressure in the ankle increased after the operation. At a later phase of the postoperative period blood flow in the limb slightly decreased but even after a year it was greatly improved and vascular resistance was much less as compared to the state before reconstructive vascular surgery.

Adult↗

[Complications of aortoiliac surgery and their postoperative therapy].

Experience in early postoperative treatment of 249 patients who had been subjected to aortoiliacal vascular surgery is reported. The therapeutic principles are outlined and the complications are reviewed. For the prevention of infectious complications the patients are given antibiotic protection, are fed parenterally till passage starts and, to avoid threatening postoperative hypoxaemia in the case of more severe respiratory disorders, prophylactic respiratory therapy is applied, and small doses of heparin are administered to prevent thrombosis. Taking into consideration the high incidence of complications and the advanced age of the patients, it is important to keep these in the intensive ward during the early postoperative period.

Adult↗