The Effect of Preoperative Administration of Glucocorticoids on the Postoperative Complication Rate in Liver Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

: Glucocorticoids may grant a protective effect against postoperative complications. The evidence on their efficacy, however, has been inconclusive thus far. We investigated the effects of preoperatively administered glucocorticoids on the overall postoperative complication rate, and on liver function recovery in patients undergoing major liver surgery.

Hemoadsorption Therapy for Critically Ill Patients with Acute Liver Dysfunction: A Meta-Analysis and Systematic Review.

Critically ill patients are at risk of developing acute liver dysfunction as part of multiorgan failure sequelae. Clearing the blood from toxic liver-related metabolites and cytokines could prevent further organ damage. Despite the increasing use of hemoadsorption for this purpose, evidence of its efficacy is lacking.

Procalcitonin-guided antibiotic therapy may shorten length of treatment and may improve survival-a systematic review and meta-analysis.

Background: Appropriate antibiotic (AB) therapy remains a challenge in the intensive care unit (ICU). Procalcitonin (PCT)-guided AB stewardship could help optimize AB treatment and decrease AB-related adverse effects, but firm evidence is still lacking. Our aim was to compare the effects of PCT-guided AB therapy with standard of care (SOC) in critically ill patients.

Early prediction of acute necrotizing pancreatitis by artificial intelligence: a prospective cohort-analysis of 2387 cases.

Pancreatic necrosis is a consistent prognostic factor in acute pancreatitis (AP). However, the clinical scores currently in use are either too complicated or require data that are unavailable on admission or lack sufficient predictive value. We therefore aimed to develop a tool to aid in necrosis prediction.

[Role of faith in strategies of healthcare professionals in intensive care units in end-of-life decision making].

Unlabelled: Összefoglaló. Bevezetés: A haldoklást minden korban kulturális és vallási szabályok vették körül, melyek a mai napig hatnak a társadalomban. A 21.

Variations in end-of-life practices in intensive care units worldwide (Ethicus-2): a prospective observational study.

Background: End-of-life practices vary among intensive care units (ICUs) worldwide. Differences can result in variable use of disproportionate or non-beneficial life-sustaining interventions across diverse world regions. This study investigated global disparities in end-of-life practices.

Ethical climate and intention to leave among critical care clinicians: an observational study in 68 intensive care units across Europe and the United States.

Purpose: Apart from organizational issues, quality of inter-professional collaboration during ethical decision-making may affect the intention to leave one's job. To determine whether ethical climate is associated with the intention to leave after adjustment for country, ICU and clinicians characteristics.

Methods: Perceptions of the ethical climate among clinicians working in 68 adult ICUs in 12 European countries and the US were measured using a self-assessment questionnaire, together with job characteristics and intent to leave as a sub-analysis of the Dispropricus study.

Prevalence of Disagreement About Appropriateness of Treatment Between ICU Patients/Surrogates and Clinicians.

Background: ICU patients/surrogates may experience adverse outcomes related to perceived inappropriate treatment. The objective was to determine the prevalence of patient/surrogate-reported perceived inappropriate treatment, its impact on adverse outcomes, and discordance with clinicians.

Methods: We conducted a multicenter, prospective, observational study of adult ICU patients.

Ethical decision-making climate in the ICU: theoretical framework and validation of a self-assessment tool.

Background: Literature depicts differences in ethical decision-making (EDM) between countries and intensive care units (ICU).

Objectives: To better conceptualise EDM climate in the ICU and to validate a tool to assess EDM climates.

Methods: Using a modified Delphi method, we built a theoretical framework and a self-assessment instrument consisting of 35 statements.

[Options for the improvement of communication and self-determination in end-of-life decisions in intensive care units].

The end-of-life decision making process normally based on patient autonomy or substituted judgement. If the patient can express his/her wishes, one must take note of his autonomy. If he/she is unable to self-determination, the importance of advanced directives or substituted judgement increases in the field of end-of-life care.

[Evaluation of the diagnostic value of bedside ultrasonography in the emergency care].

Introduction: Rapid differential diagnosis of circulatory failure (shock) with unknown etiology is a daily challenge in the field of emergency medicine. The Rapid Ultrasound in Shock (RUSH) protocol is well known since 2010. With the use of targeted steps, the 4 forms of shock (cardiogen, distributive, obstructive, hypovolemic) can be separated in a few minutes.

Prevention of tracheal cartilage injury with modified Griggs technique during percutaneous tracheostomy - Randomized controlled cadaver study.

Introduction: Tracheal stenosis is the most common severe late complication of percutaneous tracheostomy causing significant decrease in quality of life. Applying modified Griggs technique reduced the number of late tracheal stenoses observed in our clinical study. The aim of this study was to investigate the mechanism of this relationship.

A detailed semiologic analysis of childhood psychogenic nonepileptic seizures.

Purpose: Psychogenic nonepileptic seizure (PNES) is an important differential diagnostic problem in patients with or without epilepsy. There are many studies that have analyzed PNES in adults; currently, however, there is no systematic assessment of purely childhood PNES semiology. Our study based on a large pediatric video-electroencephalography (EEG) monitoring (VEM) cohort, provides a detailed analysis of childhood PNES and assesses the usability of the current classification system described in adults.

[General anesthesia during double balloon enteroscopy--Hungarian experiences].

Unlabelled: Double balloon enteroscopy needs sufficient sedation technique, because the examination is uncomfortable and lengthy. The most prevalent sedation method is conscious sedation world-wide.

Aim: To demonstrate that double balloon enteroscopy examination can also be safely performed in general anesthesia with intubation and that this method can be an option in patients with severe multiple morbidities.

[Practice of treatment restriction in Hungarian intensive care units].

Unlabelled: End of life decisions affect most of patients in intensive care units, thus, it is important to know both local and international practice in accordance with law and ethical principles for intensive care physicians.

Aim: To search for local customs of end of life decisions (withholding or withdrawing the therapy, shortening of the dying process), and to compare the data with the international literature.

Methods: In 2007-2008 the first Hungarian survey was performed with the purpose to learn more about local practice of end of life decisions.

Double balloon enteroscopy examinations in general anesthesia.

Aim: To demonstrate that the double balloon enteroscopy (DBE) can be safely performed in general anesthesia with intubation.

Methods: We performed a retrospective examination between August 2005 and November 2008 among patients receiving intubation narcosis due to DBE examination. The patients were grouped based on sex, age and physical status.

Double-balloon endoscopy for small intestinal disease: a single-center experience in Hungary.

Background: We report on our experience with the Fujinon EN-450 T5 therapeutic double-balloon endoscope (DBE) and compare our findings with the results of earlier capsule endoscopy.

Material/methods: Between August 2005 and July 2009, 150 DBE procedures were conducted in 139 consecutive patients (M/F: 67/72, age: 51.1 years, SD: 18.

[Wilkie's syndrome].

Loss of retroperitoneal fatty tissue as a result of a variety of debilitating conditions and noxa is believed to be the etiologic factor of superior mesenteric artery syndrome. A case of a 35 years old female patient with severe malnutrition and weight loss is presented, who developed superior mesenteric artery syndrome. Various theories of etiology, clinical course and treatment options of this uncommon disease are discussed.

Double-balloon enteroscopy for the diagnosis and treatment of obscure bleeding, inflammatory bowel diseases and polyposis syndromes: we see more but do we know more?

Background/aims: Our aim was to report our experience with the Fujinon EN-450 T5 therapeutic double-balloon endoscope (DBE) in the diagnosis of small bowel diseases.

Methodology: Between August 2005 and October 2006, 52 DBE procedures were conducted on 47 consecutive patients (M/F: 22/25, age: 51.6 SD 19.

[Ethical and legal problems of informed consent].

Introduction: The previously accepted paternalistic relationship between patients and doctors has changed in last century. The expectation for patients to be involved in medical decisions is growing, but this involvement cannot be imagined without informed consent, hence it became one of the most important elements of a physician's responsibilities. Although informed consent is broadly regulated legally in Hungary, experiences show that practical realization is insufficient.

[Double-balloon endoscopy for the diagnosis and treatment of small intestinal disease: an initial experience from 25 examinations].

Unlabelled: Until recently, only the proximal small bowel was accessible for diagnostic and therapeutic endoscopy. Endoscopic evaluation of this organ has often required open laparotomy with surgically assisted passage of the endoscope through the intestine. Recently, Yamamoto et al have developed a new method, double-balloon endoscopy (DBE) that allows high-resolution visualization and therapeutic interventions in all segments of the GI tract.

[Ethical aspects of resuscitation].

The former typically paternalistic physician-patient relationship has changed gradually toward an autonomy based one in the second half of the 20th century. Patient's autonomy includes the right to refuse life-saving therapy in modern constitutional states. Hungarian law assures the right to refuse life-saving treatment as well.

[Femoral neuropathy caused by retroperitoneal hematoma].

Iliacus hematoma causing femoral neuropathy are mostly seen as a result of anticoagulation. Hematoma can occur even while correctly managed anticoagulant treatment because of drug interactions and/or coagulopathies caused by liver disease. Between 1999 and 2001 a 81 and a 68-year-old man were treated in our department because of retroperitoneal hematoma on the left side.