Oskrba dihalne poti pri otrocih

Dihalna pot pri otrocih se pomembno razlikuje od dihalne poti pri odraslih. Obstajajo anatomske in fiziološke posebnosti, na katere moramo biti posebej pozorni. Na prvem mestu sta dobra anamneza in klinični pregled, s katerima lahko predvidimo možno težko predihavanje z masko ali težave pri intubiranju. Obstajajo številni dejavniki, s pomočjo katerih lahko napovemo možnost težke intubacije, žal pa niso vsi vedno zanesljivi. Za vzpostavitev dihalne poti uporabljamo različne pripomočke, med katerimi ima vsak svoje mesto, svoje pozitivne in svoje negativne lastnosti. Endotrahelni tubus pa je edini pripomoček, ki varuje pred aspiriranjem. Ob težki intubaciji so nam v pomoč algoritmi za hitro in učinkovito reševanje težav. Pri otrocih lahko zaradi večje odzivnosti zgornjih dihal pride do laringospazma, kar je urgentno stanje in lahko hitro vodi v dihalni in celo srčni zastoj

Nutritional Therapy for Inflammatory Bowel Disease

The components of a diet influence intestinal microbiota, epithelial barrier function, immune system, and many other factors that play important role in both development and treatment of inflammation in gastrointestinal tract. We briefly review potential role of specific dietary compounds as a risk or protective factor, but we predominantly concentrate on nutritional status and nutritional intervention in patients with inflammatory bowel disease. Besides exclusive enteral nutrition as a potential first-line treatment in active Crohn’s disease, other nutritional therapeutic modalities such as partial enteral nutrition, parenteral nutrition, diets based on carbohydrate modifications, anti-inflammatory diet, and the use of specific dietary compounds with anti-inflammatory properties, known as pharmaconutrition, are presented

Thermal model of through flow universal motor by means of lumped parameter network

Biti u stanju predvidjeti porast temperature unutar stroja jednako je važno kao i predvidjeti njegovo djelovanje i radni vijek. Budući da mjerenja temperature i toplinske simulacije računalom mogu zahtijevati puno vremena, putovi topline unutar protočnog univerzalnog motora su opisani jednostavnom toplinskom mrežom skupnog (lumped) parametra. Jednom kad je model izgrađen, njegovi nepoznati koeficijenti konvekcije su usklađeni s alatom genetičkog algoritma u MatLab. Model je primijenjen i uspješno provjeren mjerenjima na dva različita tipa motora usisivača za prašinu. Uzimajući u obzir gibitke rotora kao jednog od ulaza modela, procjene temperature su točnije bez obzira na radni režim stroja.Being able to predict temperature rise inside a machine is as important as predicting its performance and life. Because temperature measurements and computational thermal simulations can be time consuming, thermal paths inside the through-flow universal motor were described by means of simple lumped parameter thermal network. Once the model was built, its unknown convection coefficients were tuned with the genetic algorithm tool in MatLab. The model has been applied and successfully verified with measurements on two different types of a vacuum cleaner motor. Taking account of impeller losses as one of the model inputs makes temperature estimates more accurate regardless of machine’s operational regime

Failure modes and life prediction model for high-speed bearings in a through-flow universal motor

The focus of this study was the empirical modelling of the high-speed bearings life and failure modes of a through-flow universal motor. An approach was used facilitating predictions of the life through-range of various conditions. The model estimates bearing life for the survival probability of 50% % L50. It influences parameters such as bearing temperature, speed factor, equivalent load, grease fill amount, type of oil, type of bearing cage, type of seals, tolerance class, and side of the motor, all of which are considered in the model. Initial empirical data consisted of 4672 test populations, involving 38,021 vacuum cleaner motors. Strict filtering requirements of all the available test data resulted in 170 final populations, consisting of 1385 tested and 638 failed bearings, which were used for building a Weibull database and for developing the models. The paper`s key contributions are the empirical models gained with multiple linear regression and the obtained database of tested bearings

DataSheet_1_Comparison of general anesthesia and continuous intravenous sedation for electrochemotherapy of head and neck skin lesions.docx

BackgroundElectrochemotherapy of cutaneous tumor nodules requires local or general anesthesia. For multiple and larger nodules, general anesthesia is recommended by standard operating procedures. The choice of general anesthesia is at the discretion of the treating center. Continuous intravenous sedation is also an option. Our study aimed to elucidate the tolerability, safety and possible advantages of continuous intravenous sedation in comparison to general anesthesia in patients undergoing electrochemotherapy.Patients and methodsIn the prospective study, 27 patients undergoing electrochemotherapy were either under general anesthesia or under continuous intravenous sedation. Evaluated were different endpoints, such as feasibility and safety, duration of anesthesia and compliance with the patients.ResultsTen patients were treated under general anesthesia, and 17 patients were under continuous intravenous sedation. The comparison of the approaches indicated that continuous intravenous sedation required a lower overall dosage of propofol, a shorter duration of anesthesia, a shorter time to reach an Aldrete score >8, and greater satisfaction of the patients with the procedure compared to general anesthesia.ConclusionThe results indicate the feasibility and safety of continuous intravenous sedation for patients undergoing electrochemotherapy of cutaneous tumor nodules. This proved the preferred choice of anesthesia due to its shorter duration and better compliance with the patients compared to general anesthesia.</p

National reccomendations for the management of patients with haemophilia

The document presents recommendations for the comprehensive treatment of patients with haemophilia in Slovenia. It enables health workers at all three levels of health care to become well-acquainted with all the possible aspects of treatment based on the best practices of major centres worldwide, and on the studies and experience of health professionals at the National Haemophilia Centre, University Medical Center Ljubljana. The document contains definitions, treatment algorithms and lists of medications with their characteristics and appropriate dosages. It specifically defines indications for the exclusive competence of the tertiary level in Ljubljana due to the actual availability of teams and laboratory options. It also contains an extensive list of the literature on haemophilia

Military dictionary by students of defence studies

The military dictionary by students of defense sciences was created during the course Slovenian language and Slovenian military idioms (2012/13 and 2013/14) at the Faculty of Social Sciences. It was created by second-year students under the supervision of Dr. Nataša Logar and Dr. Erik Kopač. The starting point for the selection of terms was the Military Doctrine (2006) and the Military Logistics Doctrine (2008). The dictionary consists of 192 terms with definitions and English equivalents. The dictionary is distributed in XML using the TBX (TermBase eXchange) standard for representing and exchanging information from termbases

Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients’ preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings Between June 16, 2014, and April 29, 2015, data from 22803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj –4·4%, 95% CI –5·5 to –3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj –2·6%, 95% CI –3·9 to –1·4) and the administration of reversal agents (1·23, 1·07–1·41; –1·9%, –3·2 to –0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj –0·3%, 95% CI –2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; –0·4%, –3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications