Postoperative Atrial Fibrillation Prophylaxis and Lung Resection – Our Experience with 608 Consecutive Patients.

Postoperative atrial fibrillation is a common complication after lung resection. It is burdened by increased mortality and morbidity, prolonged hospitalization, and higher resource utilization in thoracic surgery patients. Therefore, some kind of pharmacological prophylaxis is recommended.

Gastric tube ulcer perforating the pericardium after subtotal esophagectomy.

Subtotal esophagectomy with retrosternal transposition of the gastric tube to the neck was performed in a 62-year-old patient with squamous cell carcinoma of the proximal third of the esophagus. He developed a salivatory fistula in the early postoperative period that healed spontaneously. Five months later, the patient developed partial stenosis of the esophagogastric anastomosis which required recervicotomy and excision, after numerous failed dilatation attempts.

Waist circumference does not correlate with functional lung capacity in moderate and severe chronic obstructive pulmonary disease.

Waist circumference is a good predictor of the risk of heart diseases, but data on the relationship between waist circumference and pulmonary diseases are sparse. The aim of this study was to investigate its influence on pulmonary function regarding exercise capacity in moderate and severe chronic obstructive pulmonary disease (COPD), according to Global Initiative for Lung Diseases (GOLD) stages. During 2009, a total of 70 COPD patients aged 33 to 80 years were stratified into GOLD 2 and GOLD 3 stages.

Prognostic performance of the Simplified Acute Physiology Score II in major Croatian hospitals: a prospective multicenter study.

Aim: To perform an external validation of the original Simplified Acute Physiology Score II (SAPS II) system and to assess its performance in a selected group of patients in major Croatian hospitals.

Methods: A prospective, multicenter study was conducted in five university hospitals and one general hospital during a six-month period between November 1, 2007 and May 1, 2008. Standardized hospital mortality ratio (SMR) was calculated from the mean predicted mortality of all the 2756 patients and the actual mortality for the same group of patients.

Immeasurable levels of serum phosphate--an unidentified cause of respiratory failure in a diabetic patient.

We report a case of immeasurable levels of serum phosphate in a patient with juvenile type Diabetes mellitus and diabetic ketoacidosis who developed respiratory failure. A 27-year-old female with juvenile type insulin-dependent Diabetes mellitus was admitted because of suspected acute mediastinitis and respiratory failure, probably, among other responsible factors, caused and complicated by undetectable levels of serum phosphate. The serum phosphate concentration three days after aggressive treatment was only 0.

Successful use of activated recombinant factor VII in life threatening bleeding after thoracic surgery.

We present three patients in whom life-threatening haemorrhage following lung resection was successfully managed using activated recombinant factor VII (NovoSeven). In one case, activated recombinant factor VII was the only therapy administered to manage bleeding, and in the two remaining cases, activated recombinant factor VII was administered after patients failed to respond to conventional therapy. All patients demonstrated effective haemostasis and improved coagulation parameters as a result of treatment with activated recombinant factor VII.

Influence of oral hygiene on oral health of recruits and professionals in the Croatian Army.

Objectives: Good oral health of soldiers would decrease the number of urgent dental interventions and absences from training and the battlefield and would improve the security of the whole formation. This study shows the habits for maintaining oral health and the oral status of the examined population in the Croatian Army.

Methods: The data were obtained from examinations and questionnaires of 912 Croatian soldiers, 650 of whom were recruits and 262 professional soldiers of the Croatian Army land forces.

[Impact of dental emergencies on combat readiness in Croatian Army].

Aim: The potential of dental emergencies to reduce combat readiness is a major concern of military planners. Dental fitness classification is the primary measure of a soldier's dental readiness.

Methods: The teeth and mouth of 400 soldiers, 200 of them recruits and 200 active duty military personnel, were prospectively examined.

[Unsuspected posterior mediastinal paraganglioma--anesthetic risk].

A 70-year old female patient was admitted to the hospital because of scheduled thoracotomy and biopsy of posterior mediastinal retrocardiac tumor of unrecognized etiology. The patient had no complaints regarding the tumor. Routine anesthesiological preoperative examination revealed status ASA III.

[Anesthesia and perioperative management of patients with resection for esophageal carcinoma].

The current approach to the anesthetic procedure and postoperative intensive therapy after esophageal resection for esophageal carcinoma, as well as characteristic perioperative pathophysiological events are presented. The contributory factors of severe postsurgical morbidity are considered too. Esophagectomy is an extented procedure which includes laparotomy, thoracotomy and often cervicotomy, and carries a great surgical stress with a huge fluid shift.

[Role of transthoracic echocardiography in evaluation of cardiac risk in thoracic surgery].

Background And Objective: It is not precisely defined which group of non-cardiac surgery patients should undergo transthoracic echocardiography in preoperative preparation. This study was prospectively performed to find out whether the routine use of echocardiography is justified in patients scheduled for lung resection, and to assess its role in cardiac risk evaluation.

Methods: Patients classified as ASA III who were identified as having minor or intermediate predictors of cardiac risk were included in the study.