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Obstructive sleep apnoea in extremely obese patient

Author: Ivana Paraničová

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Obstructive sleep apnoea (OSA) is characterized by repetitive episodes of interruption of breathing during sleep due to partial or complete collapse of pharynx. Prevalence of mild OSA is about 9-24%, clinically significant disease is present in about 4% men and 2% women. Morphology of upper airways and body weight are important factors for development of OSA. Approximately 70% of OSA patients are overweight and 40% obese patients suffer from OSA.

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Chronic Respiratory Failure due to Kyphoscoliosis

Author: Ivana Trojová

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Kyphoscoliosis is a well-recognized cause of respiratory failure. Kyphoscoliosis is a chronic disease, occurring in 2-3% of the general population, which leads to a distorted spinal curvature and chest wall deformity. As a consequence, respiratory function is impaired due to reduced chest wall compliance and restrictive lung function pattern arises. The development of noninvasive ventilation (NIV) has made it an accepted standard modality of care at the present time for patients with chronic respiratory failure caused by kyphoscoliosis. The presented case report describes a 49-year-old female with idiopathic kyphoscoliosis who developed chronic hypercapnic respiratory failure with the need of noninvasive ventilatory support.

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Constrictive pericarditis, reoperation

Author: Tomáš Toporcer

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The case report describes the hospitalization of a 50-year-old man who underwent surgery for a constrictive pericarditis at a younger age. Current CT and ultrasonographic findings confirmed the recurrence of this disease. Partial pericardectomy was performed with the release of the left ventricular diaphragm wall in particular. The postoperative period was complicated by ventricular fibrillation with high speed response of chambers. After successful cardioversion, the patient was released to outpatient care on the seventh postoperative day.

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Aortocoronary bypass

Author: Tomáš Toporcer

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The case report describes the hospitalization of a 58 year old male admitted to our department for documented ischemic heart disease with affection of three coronary arteries. The patient underwent a cardiac surgery with the formation of one bypass with arterial graft and one bypass with venous graft. In the postoperative period, fibrillation of atrial fibrillation with successful cardioversion was noted. The patient was admitted to outpatient care on the seventh postoperative day.

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Mitral valve reconstruction because of Barlow's disease with mitral insufficiency, perioperative SAM (systolic anterior motion)

Author: Tomáš Toporcer

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The case report describes the hospitalization of a 26 year old male with M. Barlow. The mitral valvuloplasty was performed. However, the peroperative ultrasonographic finding documented prolapse of the anterior cusp of the mitral valve into the outflow tract of left ventricle. The surgery was supplemented with a suture of the A2-PA segments of mitral valve. The subsequent finding was satisfactory. No more serious postoperative complications were noted. The patient was admitted to outpatient care on the eighth postoperative day.

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Ascending aorta replacement and repair of aortic valve because of ascending aorta aneurysm and bicuspid aortic valve with regurgitation

Author: Tomáš Toporcer

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The case report describes the hospitalization of a patient with an ascending aortic aneurysm and a bicuspidal aortic valve. Valvular surgery with an annular annuloplasty ring implant was performed. At the same time, replacement of the ascending aorta was performed. There were no more serious complications in the postoperative period and the patient was released to outpatient care on the eighth postoperative day.

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Newly diagnosed COPD - obstructive ventilatory impairment

Author: Pavol Pobeha

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Presented case report documents an example of a patient with an accidentally diagnosed chronic obstructive pulmonary disease (COPD) based on clinical signs. Diagnosis was confirmed by a pneumologist using spirometry. A bronchodilation test was carried out to confirm the irreversibility of detected obstructive ventilatory impairment. The patient was given combined bronchodilator treatment with ß2-mimetics and anticholinergics to relieve symptoms, improve functional parameters and prevent subsequent exacerbations.

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Multiple lung abscesses

Author: Ivana Trojová

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Lung abscesses are caused due to microbial infection when an area of infected lung becomes necrotic, which results in the development of a cavity containing pus or necrotic debris within the lung itself (Figure 1). In contrast to pleural infection, the incidence and mortality rate of lung abscesses have steadily declined since antibiotic era. The case report presents a 43-year-old patient with multiple lung abscesses.

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Thoracic empyema

Author: Pavol Pobeha

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Case report presents patient with thoracic empyema, who was admitted in hospital after failure of outpatient antibiotic treatment. Patient suffered from fever, thoracic pain, dyspnea and dry cough. Chest X-ray revealed homogenous shadow in right basal and middle lung zone which was confirmed by CT. According to CT scan we expected presence of empyema. Patient was treated with combination of intravenous antibiotics and pleural puncture was performed. Analysis of sample showed results which met the criteria for empyema and patient was immediately sent to department of thoracic surgery for drainage.

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Posterior wall myocardial infarction

Author: Marianna Vachalcová

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Isolated posterior myocardial infarction is occurring in 3-11% of all infarctions. ST - segment depression in leads V1-V3 suggests myocardial ischaemia, especially when the terminal T - wave is positive (ST - segment elevation equivalent), and confirmation by concomitant ST-segment elevation ≥ 0,5mm recorded in leads V7-V9 should be considered as a mean to identify posterior myocardial infarction. Emergent coronary angiography and percutaneous coronary intervention of the infarct - related artery is indicated.

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