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Signa Vitae

Journal of Intensive Care and Emergency Medicine

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Complications after bilateral thoracoscopic sympathicotomy for primary focal hyperhidrosis

Introduction

Primary focal hyperhidrosis is a functional disorder of an excessive sweating that can significantly deteriorate the person’s every day quality of life. It is estimated that there is about 2.8% of world population affected with this unpleasant condition, especially among young people. Bilateral thoracoscopic sympathicotomy is nowadays well established one-day minimal invasive surgical procedure, with very good postoperative results and the opportunity for the patients to be capable for their everyday life and working, a day after the operation, with adequate analgetics if necessary. However, the complications after bilateral thoracoscopic sympathicotomy can seriously worsen their quality of life, beyond this functional disorder of an excessive perspiration.

The aim of this study is to evaluate the postoperative complications after bilateral thoracoscopic sympathicotomy and their influence on person’s quality of life.

Key words: primary focal hiperhidrosis, bilateral thoracoscopic sympathectomy, minimal invasive surgery, complications

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VATS thymectomy in treatment of thymomas

Background

Thymomas are the most frequently occurring tumors of the anterior mediastinum and commonly develop between ages of 35 and 75 years. Approximately 30% to 45% of patients develop symptoms of myasthenia gravis and one third of patients are asymptomatic at the time of diagnosis. Local symptoms such as chest pain, hoarseness, shortness of breath, cough, superior vena cava syndrome, stridorous breathing are due to compression or direct invasion of adjacent structures and are present in as many as 40% of patients. Complete resection is the cornerstone of treatment and several studies have been published comparing different minimally invasive approaches to open resection for thymic malignancies. We present our experiences with minimally-invasive VATS thymectomy.

Key words: Thymectomy, VATS, Thymoma

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Dexmedetomidine and Non-Intubated VATS – Our Experiences in University Medical Centre Ljubljana

Background

Non-intubated thoracic surgery has evolved since the early beginning of 21.century. In University Medical Centre Ljubljana we started with simple non-intubated procedures in October 2015. Many contributung factors are imperative for early start with good results. Surgical technique in VATS procedures has to be fully established. Anesthesiologist, involved in such procedures, has to be confident in thoracic anesthesia with emphasis on airway management. Good technical equipment is fundamental. On the other hand, patient have to be preciselly selected with writen informed conset.

Key words: non-intubated VATS, intercostal blockade, dexmedetomidine, bispectral index, videolaryngoscope

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Simulation teaching and training in thoracic anaesthesia

Introduction

Training of some procedures on live patients is no longer ethically justified or acceptable to the patient. Patients expect that health professionals have fully mastered a procedure before using it in clinical practise. Procedures performed on a patient simulator can be interrupted, improved, repeated and, unlike in real life, no harm is done when a mistake is made. (1)

Key words: clinical simulation, practical skills, lung isolation techniques

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Effect of population-based training programs on bystander willingness to perform cardiopulmonary resuscitation

Abstract

Objective: This study was performed to determine the factors related to unwillingness of bystanders to perform cardiopulmonary resuscitation (CPR), and improvement of willingness among the lay public after CPR training.

Design: Retrospective design

Methods: We collected questionnaires received from laypersons attending CPR training courses implemented by the CPR Improvement Program of Chang Gung Memorial Foundation. Pre- and post-training questionnaires were given to participants attending CPR training courses between September 2013 and January 2014.

Results: Among the 401 respondents at pre-training, higher educational level (odds ratio, 3.605; 95% confidence interval [CI], 3.055 – 8.284) and previous CPR training (odds ratio, 1.754; 95% CI, 1.049 – 2.932) were significantly associated with willingness to perform bystander CPR. Significant improvements in willingness to perform conventional CPR and hands-only CPR on a stranger were observed after training (P = 0.016 and P < 0.0001, respectively). Approximately half of the respondents claimed that fear of doing further harm was the primary reason for their lack of willingness to administer conventional CPR on a stranger.

Conclusions: We showed that CPR training significantly increased the rate of willingness to perform CPR on strangers as well as acquaintances among the lay public. This study also showed that fear of doing further harm was the most significant barrier after training. This concern should be addressed in future training programs.

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