University of Medicine, Pharmacy, Science and Technology of

Department of Anesthesia and Intensive Care, University of Medicine, Pharmacy

Department of Simulation Applied to Medicine, University of Medicine, Pharmacy

The Symbiotic Relationship between Authors, Medical Journals, Editors and the Peer Review System

<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Approximately twenty per cent of adults have gallstones making it one of the most prevalent gastrointestinal diseases in Western countries. About twenty per cent of gallstone patients requires medical, endoscopic, or surgical therapies such as cholecystectomy due to the onset of gallstone-related symptoms or gallstone-related complications. Thus, patients with symptomatic, uncomplicated or complicated gallstones, regardless of the type of stones, represent one of the largest patient categories admitted to European hospitals.</p><p>This review deals with the important critical care aspects associated with a gallstone-related disease.</p></abstract>

Critical Care Aspects of Gallstone Disease

<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Lung protective mechanical ventilation (LPV) even in patients with healthy lungs is associated with a lower incidence of postoperative pulmonary complications (PPC). The pathophysiology of ventilator-induced lung injury and the risk factors of PPCs have been widely identified, and a perioperative lung protective concept has been elaborated. Despite the well-known advantages, results of recent studies indicated that intraoperative LPV is still not widely implemented in current anaesthesia practice.</p><p>No nationwide surveys regarding perioperative pulmonary protective management have been carried out previously in Hungary. This study aimed to evaluate the routine anaesthetic care and adherence to the LPV concept of Hungarian anaesthesiologists during major abdominal surgery.</p><p>A questionnaire of 36 questions was prepared, and anaesthesiologists were invited by an e-mail and a newsletter to participate in an online survey between January 1st to March 31st, 2018.</p><p>A total of one hundred and eleven anaesthesiologists participated in the survey; 61 (54.9%), applied low tidal volumes, 30 (27%) applied the entire LPV concept, and only 6 (5.4%) regularly applied alveolar recruitment manoeuvres (ARM). Application of low plateau and driving pressures were 40.5%. Authoritatively written protocols were not available resulting in markedly different perioperative pulmonary management. According to respondents, the most critical risk factors of PPCs are chronic obstructive pulmonary diseases (103; 92.8%); in contrast malnutrition, anaemia or prolonged use of nasogastric tube were considered negligible risk factors. Positive end-expiratory pressure (PEEP) and regular ARM are usually ignored. Based on the survey, more attention should be given to the use of LPV.</p></abstract>

Perioperative Lung Protective Ventilatory Management During Major Abdominal Surgery: A Hungarian Nationwide Survey

<abstract xmlns="http://www.w3.org/1999/xhtml"><p>H1N1 is seen in tropical countries like India, occurring irrespective of the season. Complications of the disease are frequently encountered and there is little in the way or guidelines as to the how these should be managed. The treatment of one such complication, a recurrent pneumiomediastinum is the subject of the current paper. The management followed guidance for the treatment of a similar condition known as primary spontaneous pneumomediastinum, an uncommon condition resulting from alveolar rupture-otherwise known as the Macklin phenomenon.</p></abstract>

Management of Pneumomediastinum Associated with H1N1 Pneumonia: A Case Report

<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_jccm-2019-0004_s_006_w2aab3b7b4b1b6b1aab1c18b1Aa"><h3>Introduction</h3><p>A hypercalcaemic crisis, also called para thyrotoxicosis, hyper parathyroid crisis or parathyroid storm, is a complication of primary hyperparathyroidism (PHPT) and an endocrinology emergency that can have dramatic or even fatal consequences if it is not recognised and treated in time.</p></sec><sec id="j_jccm-2019-0004_s_007_w2aab3b7b4b1b6b1aab1c18b2Aa"><h3>Case presentation</h3><p>Two cases presented in the emergency department with critical hypercalcaemic symptoms and severe elevation of serum calcium and parathyroid hormone levels, consistent with a hypercalcaemic crisis. The first case, a 16-year-old female patient, had imaging data that highlighted a single right inferior parathyroid adenoma and a targeted surgical approach was used. The second case, a 35-year-old man was admitted for abdominal pain, poor appetite, nausea and vomiting. Laboratory tests revealed severe hypercalcaemia, hypophosphatemia and an increased serum iPth level. There was no correlation between scintigraphy and ultrasonography, and a bilateral exploration of the neck was preferred, resulting in the exposure of two parathyroid adenomas. The patients were referred for surgery and recovery in both cases was uneventful</p></sec><sec id="j_jccm-2019-0004_s_008_w2aab3b7b4b1b6b1aab1c18b3Aa"><h3>Conclusion</h3><p>These cases support the evidence that surgery remains the best approach for patients with a hypercalcaemic crisis of hyperparathyroidism origin, ensuring the rapid improvement of both the symptomatology and biochemical alterations of this critical disease.</p></sec></abstract>

Hypercalcaemic Crisis Due to Primary Hyperparathyroidism: Report of Two Cases

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The Journal of Critical Care Medicine

Volume 5 (2019): Issue 1 (January 2019)

Editorial

The Symbiotic Relationship between Authors, Medical Journals, Editors and the Peer Review System

Review

Critical Care Aspects of Gallstone Disease

Research Article

Perioperative Lung Protective Ventilatory Management During Major Abdominal Surgery: A Hungarian Nationwide Survey

Case Report

Management of Pneumomediastinum Associated with H1N1 Pneumonia: A Case Report

Hypercalcaemic Crisis Due to Primary Hyperparathyroidism: Report of Two Cases

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