[Some suggestions to the medical officer concerning surgical work in the dispensary].
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Biomedical subjects
Publications and source records attributed to M Bervar.
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Cardiogenic shock and apnoea appeared in a 78-year-old woman with a history of biventricular heart failure, following ingestion of a single 80 mg verapamil tablet. She was resuscitated with artificial ventilation, dobutamine, norepinephrine and calcium gluconate. Toxicological analysis revealed unexpectedly high plasma verapamil concentration, which was attributed to the patient's liver failure. In patients with advanced heart failure a single oral therapeutic dose of verapamil may have a severe toxic effect.
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In this report, the authors discuss the organization of experimental microsurgical activities from the standpoint of their own experience. Their opinion is that elementary microsurgical technique and routine could be obtained only in the experimental laboratory. Each institution dealing with microsurgery should organize such a functional unit. The importance of an experimental laboratory is not only for education, but also for basic microsurgical research. To attain adequate results, specially in nonclinical institutions, it is necessary to follow consequently clearly defined principles of organization and provide adequate conditions. The competence of such a concept is illustrated with the results of the authors' own researches during 1987. They completed 44 microvascular anastomoses in rats, on vessels of approximately 1 mm in diameter and obtained initial and early patency rates of 88.6 and 93.2% respectively. These patency rates could be sufficient for the safe clinical application of the microvascular technique.
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