Acute Coronary Syndrome with ST-segment Elevation in Pregnancy: Anesthetic Management of Delivery

Acute coronary syndrome (ACS) during pregnancy is rare but may be associated with high risk complications. Approximately 150 myocardial infarctions (MI) during pregnancy have been documented in literature worldwide, but we didn’t find one with myocardial aneurysm. We describe 2 patients with acute MI; both with ST segment elevation (STEMI), 1 case complicated with heart failure, formation of a myocardial aneurysm and broad QRS arrhythmia; another with uncomplicated course, and their anesthetic management during delivery. Acute MI is rare in reproductive age usually developing in women with cardiovascular risk factors. There is concern about its rising incidence due to the increase of average maternal age. Our cases show that there might be some undiscovered risk factors for pregnancy related myocardial infarction

SPECIFICS OF COAGULATION AND REGIONAL ANESTHESIA IN PARTURIENTS

U nemalom broju trudnica mogu biti prisutni poremećaji koagulacijskog sustava koje je nužno poznavati s obzirom da su centralna neuroaksijalna analgezija i anestezija glavne anesteziološke tehnike u zbrinjavanju porođajne boli te boli tijekom carskog reza. Epiduralni i spinalni hematom su rijetke, ali kobne komplikacije spomenutih postupaka. U trudnica s poremećajima koagulacije potrebno je na individualnoj razini procijeniti korist te potencijalne komplikacije centralnih neuroaksijalnih blokova.Coagulation abnormalities are not uncommon during pregnancy and it is necessary to be familiar with such abnormalities because the central neuraxial blocks represent the most common technique for analgesia and anesthesia during delivery or cesarean section because epidural and spinal hematomas are severe complications of the mentioned procedures. In a parturient with coagulation abnormality, it is necessary to estimate, on individual basis, the benefi ts and risks of central neuraxial blocks

SPECIFICS OF COAGULATION AND REGIONAL ANESTHESIA IN PARTURIENTS

U nemalom broju trudnica mogu biti prisutni poremećaji koagulacijskog sustava koje je nužno poznavati s obzirom da su centralna neuroaksijalna analgezija i anestezija glavne anesteziološke tehnike u zbrinjavanju porođajne boli te boli tijekom carskog reza. Epiduralni i spinalni hematom su rijetke, ali kobne komplikacije spomenutih postupaka. U trudnica s poremećajima koagulacije potrebno je na individualnoj razini procijeniti korist te potencijalne komplikacije centralnih neuroaksijalnih blokova.Coagulation abnormalities are not uncommon during pregnancy and it is necessary to be familiar with such abnormalities because the central neuraxial blocks represent the most common technique for analgesia and anesthesia during delivery or cesarean section because epidural and spinal hematomas are severe complications of the mentioned procedures. In a parturient with coagulation abnormality, it is necessary to estimate, on individual basis, the benefi ts and risks of central neuraxial blocks

MULTI-MODAL ANALGESIA AFTER HYSTERECTOMY AND ADNEXECTOMY

Postoperativni bol je najčešći oblik akutnog bola, a nedovoljna analgezija može dovesti do niza komplikacija. Osnovni cilj našeg istraživanja bio je usporediti dvije metode analgezije multimodalnim pristupom i postići odgovarajući analgetski učinak primjenom obiju metoda. Analizirano je 50 slučajno odabranih bolesnica tijekom prvog operacijskog dana, nakon abdominalne histerektomije i adneksektomije. Prema Američkom društvu anesteziologa bolesnice su procijenjene na ASA status I-III. Kod prve skupine od 25 bolesnica, kontinuirano intravenski primijenjeni su metamizol i tramadol, a kod druge skupine od 25 bolesnica ketoprofen i tramadol. Razina boli u svih bolesnica praćena je u prvom, trećem, šestom i devetom postoperativnom satu i zabilježena u tablice pomoću vizualno analogne ljestvice (visual analogue scale – VAS). U obje skupine postignut je zadovoljavajući analgetski učinak. Bolesnice u drugoj skupini (s ketoprofenom) su ranije postigle granicu između umjerene i neznatne boli, te bi stoga, kao nesteroidni antiinflamatorni lijek prvog izbora preporučili ketoprofen kao dodatak tramadolu.Postoperative pain is the most common form of an acute pain and inadequate analgesia can lead to numerous complications. Our goal was to compare two different methods of analgesia by multimodal approach and to optimize pain control in both groups. During the first operative day, 50 randomly chosen patients undergoing abdominal hysterectomy with bilateral adnexectomy were analyzed. According to the American Society of Anesthesiologists (ASA) they were classified to Class I-III. In the first group of 25 patients, metamizol and tramadol were administered in continuous intravenous infusion and in the second group of 25 patients ketoprofen and tramadol were administered. Pain was registered during the first, third, sixth and ninth postoperative hour using visual analogue scale (VAS). In both groups the adequate level of analgesia was achieved, although the patients in the second group have reached moderate level of pain earlier than the second group did. Therefore, as the non-steriod antiiflammatory drug adjuvant to opioid drug we prefer ketoprofen to metamizole

The treatment of synonyms in Croatian terminological dictionary

U članku se definira terminološka istoznačnost. Opisuje se obradba istoznačnica u nekim hrvatskim terminološkim rječnicima te se navode pravila za odabir i navođenje istoznačnica u budućim terminološkim rječnicima.The authors analyze the lexicographic treatment of synonymous terms in a few existing Croatian terminological dictionaries. On the basis of the analyzed dictionaries they give a few rules on the treatment of synonyms which could serve as guidelines for future compilers of terminological dictionaries

Metaforizacija kao terminološki postupak u engleskom i hrvatskom

U radu se analizira metafora u hrvatskom i engleskom nazivlju. Analiziraju se tipovi metafora u nazivlju i navode primjeri iz tehničkoga (posebno računalnoga) nazivlja. Pokušava se objasniti metaforizacija kao terminološki postupak u postanku engleskih i hrvatskih tehnič- kih naziva

TERMINOLOŠKA ANTONIMIJA

Problemu antonimije u nazivlju dosad u terminološkoj literaturi nije posvećivana veća pozornost. Ipak većina objasnidbenih terminoloških rječnika uz sinonime bilježi i antonime. U radu se analiziraju terminološki antonimi i njihova obradba u postojećim općim i terminološkim rječnicima i uočavaju se problemi i nedosljednosti pri njihovu navođenju. Na kraju se daju upute za navođenje antonima u budućim rječnicima

HRVATSKE ISTOVRIJEDNICE STRANIH NAZIVA

U članku su analizirani slučajevi u kojima naziv kao prva oznaka pojma nastaje najprije na kojem stranome jeziku, pa se hrvatski znanstvenici susreću s novim pojmom i njegovim stranim nazivom i tek tada stvaraju hrvatski naziv hrvatskim jezičnim sredstvima. Takav naziv može biti doslovan prijevod stranoga naziva (primjerice engl. mouse – hrv. miš, engl. four little tigers – hrv. četiri mala tigra, engl. card row – hrv. redak kartice, engl. card scanner – hrv. pretraživač kartica) ili može biti drukčije tvoren (primjerice engl. printer – hrv. pisač, engl. tie-break – hrv. razigravanje, engl. hardware – hrv. strojevina, engl. double addition – hrv. pribrajanje u dvostrukoj točnosti). Postavlja se pitanje je li moguće pronaći hrvatski naziv za svaki strani naziv. U članku se pokušava odgovoriti na postavljeno pitanje s pomoću primjera iz raznih struka

Metaforizacija kao terminološki postupak u engleskom i hrvatskom

U radu se analizira metafora u hrvatskom i engleskom nazivlju. Analiziraju se tipovi metafora u nazivlju i navode primjeri iz tehničkoga (posebno računalnoga) nazivlja. Pokušava se objasniti metaforizacija kao terminološki postupak u postanku engleskih i hrvatskih tehnič- kih naziva

Vasoactive stress hormone (adrenaline, noradrenaline and cortisol) concentration in plasma after administration of low doses of S-(+)-ketamine epidurally

Background and Purposes: The aim of this study was to investigate the effect of epidurally administered S-(+)-ketamine on vasoactive stress hormones. It was a prospective study conducted after approval of the Ethical Committee and informed consent of patients. Materials and Methods: The study was performed on 80 patients: 40 patients in Group 1 (0.5% bupivacaine) and 40 patients in Group 2 (0.5% bupivacaine + 25 mg S-(+)-ketamine – 0.326 mg/kg-bm). All patients were adults aged between 18 and 45 years, ASA I and II with epidural anaesthesia for a surgical procedure. Vasoactive parameters: concentrations of adrenaline, noradrenaline and cortisol were measured 30 minutes before setting the vein pathway and 17–25 min. after application of anaesthetics. Results: There were no statistically significant changes in vasoactive stress hormones (adrenaline, noradrenaline and cortisol) plasma concentrations after administering 0.5% bupivacaine, 0.5% bupivacaine + S-(+)- -ketamine epidurally. Conclusion: Setting central nervous block before skin incision, using local anaesthetic, and S-(+)-ketamine, leaves concentrations of stress hormones in plasma within referent values. Adding a low dose of S-(+)- -ketamine into the epidural space in combination with 0.5% bupivacaine does not have an effect on the concentration of stress hormones in plasma