#1
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Трудности перевода...
Уважаемые коллеги, насколько я заметил, здесь много знатоков английского языка, многие также любят жанглировать англоязычной терминологией. по сему интересно было бы услышать ваше мнение по поводу такого вот заголовка в одном зарубежном руководстве:
EXOTIC COMPLEX INTERVENTIONS FOR THE WEEKEND URBAN WARRIORS |
#2
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ИМХО. Weekend Urban Warrior подразумевает персону, которая чем то рутинно занята в течении недели и позволяет себе дико оторваться в выходные. В книге в этой главе приводятся примеры комплексных (экзотических? тут не моя епархия) вмешательств, которые по какой то причине проводились одномоментно. Отрыв выходного дня? Нет времени так погулять в другое время?
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#3
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Наиболее близкое значение - отмороженные. WUW, например, английские футбольные фанаты. Те, которые в нормальной жизни вполне благовоспитанные менеджеры среднего звена.
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Абугов Сергей Александрович. Российский Научный Центр Хирургии им. академика Б.В. Петровского. |
#4
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Рекомендуется
Iron Maiden — Weekend Warrior mp3
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#5
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#6
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Не-не, именно комплексные
Цитата:
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#8
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И тем не менее, это слеговое выражение относится к тем кому проводят эти вмешательства или это "монстры-операторы" отрывающиеся на больных во время дежурств?
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#9
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Вот такое длинное обьяснение этому термину:
One who has obligations during the week, i.e. job or school etc., but he/she enjoys being belligerently drunk and high all weekend to the extent of passing or blacking out. These people are notorious for staying up until sunrise and wearing the same clothes into the next day. They only qualify if he/she parties on all nights of the weekend - no days off - This requires much will power and obedience to binge drinking and smoking. However these people are not only limited to partying on weekends, weekdays are acceptable too. В общем, этот термин применим скорее к молодежи, которая отрывается с пятницы вечера по воскресенье без перерыва на сон с эксцессом алкоголя, курения и порой всяких психостимуляторов типа экстази.
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Искренне, Вадим Валерьевич. |
#10
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Цитата:
Хотя, могу и ошибаться. Т.к. "for" скорее относится к врачам. К больным, скорее, должно бы было относиться "in". Надо взглянуть на текст.
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Абугов Сергей Александрович. Российский Научный Центр Хирургии им. академика Б.В. Петровского. |
#11
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Сергей Александрович:
EXOTIC COMPLEX INTERVENTIONS FOR THE WEEKEND URBAN WARRIORS 1 Hybrid MIDCAB and PCI: A patient with severe co-morbidity had severe lesion at the bifurcation of the LAD, large ramus and distal LM. The risk of mortality was too high for the patient to undergo conventional CABG, so the patient was scheduled for left internal mammary artery (LIMA) graft to LAD surgery, while the Ramus and LM lesion is to be dealt with by PCI. Under general anesthesia, a LIMA to LAD anastomosis was performed via a 2-inch left lateral intercostal incision (minimal invasive bypass surgery (MIDCAB). Patency of the LIMA to LAD graft was confi rmed. Then the patient was prepared for PCI of the LAD on the table in the operating room. With the LAD territory protected by the newly placed graft, the ostia ramus and circumfl ex disease was approached with a provisional bifurcation stent strategy. The patient had been pretreated with aspirin. Unfractionated heparin was used to maintain the active clotting time (ACT) at 250 sec. The ramus branch was stented successfully. A follow-up angiogram revealed a widely patent stent with plaque shift to the LAD ostium which was protected by the LIMA graft. The appearance of the circumfl ex ostium was satisfactory and therefore felt not in need of intervention. The patient was extubated in the operating room [20]. 2 PCI with a PVAD: The TandemHeart is a left ventricular assist device (PVAD) that can be implanted percutaneously. The device decompresses the left ventricle and maintains adequate perfusion of major organs. A transseptal puncture is performed initially, then a 21Fr cannula is advanced from a femoral vein to the left atrium. The infl ow into the centrifugal pump, therefore, is oxygenated blood from the left atrium. The pump can deliver up to 3.5 L through a 15Fr or 17Fr femoral arterial cannula. The disadvantages of the TandemHeart include procedural complexity, vascular complications and high cost. An initial transseptal puncture is required. Interventional cardiologists who have not participated in radiofrequency ablations or septal closures may have limited experience performing transseptal punctures. Many operators will prefer intracardiac ultrasound guidance to advance a large 21Fr catheter safely across the interatrial septum. The 21Fr venous cannula may cause a venous thrombus while implanted, or an iatrogenic atrial septal defect when removed. Similarly, the large arterial cannula may be associated with bleeding, traumatic arterial injury or limb ischemia. Finally, it should be recognized that there is a signifi cant expense associated with this technology. The disposables for the TandemHeart now costs $15,000 per case. There is also an initial capital investment for the console, although that cost may be included in the disposables for institutions with high caseload. Perhaps high-risk PCI patients should receive a provisional TandemHeart. A smaller 6Fr catheter could be placed in the left atrium and a 5Fr sheath inserted into the contralateral femoral artery. An iliac angiogram would be performed to insure that it was feasible to insert High-Risk Patients 153 a 15Fr arterial sheath. The TandemHeart itself would only be implanted in those who did not tolerate transient ischemia during the PCI [21]. 3 Combined CABG and Carotid Stenting: In patient with symptomatic CAD and carotid artery disease, more than 30 days wait for surgery was considered a high-risk situation; similarly, a combined 30-days antiplatelet treatment after stenting with a subsequent staged cardiac procedure within the fi rst months after carotid stenting was also considered a potentially dangerous strategy, because of the higher incidence of bleeding complications after cardiac surgery. Cardiac surgery was indicated when two or three major coronary vessels had 50% stenosis and PCI treatment was not feasible, and/or severe mitral and/or aortic valve diseases were present. Consequently all patients were pretreated with aspirin and none of the other oral antiplatelet agents (clopidogrel, nor ticlopidine). Full dose of unfractioned heparin (UFH) was always used (usually 10,000 IU) when the introducer set was inserted in the femoral artery; an additional bolus was applied if the procedure lasted more than an hour. The carotid lesion was stented successfully. Immediately after stenting, all patients were transferred to the operating room for planned and subsequent uneventful CABG [22]. 4 Closure of Atrial Septal Defect and PCI at the Same Session: In a case report from Tomai et al. a patient had PCI of lesions in the LAD and LCX then had closure of an atrial septal defect (ASD) with an Amplatzer. After the procedure, the patient was transferred to the ICU. One hour later, the patient developed severe shortness of breath, rales and pulmonary edema requiring intubation and mechanical ventilation. 12 hours later the patient slowly recovered with medical treatment. The problem is that closure of ASD can cause abrupt increase in LV preload and myocardial oxygen consumption, on a LV with possible transient dysfunction from slow fl ow. The lesson is not to perform PCI in the same time with closure of ASD. Wait until the patient hemodynamic recovers well after closure of the ASD [23]. |
#12
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Экзотические сложные вмешательства - для безбашенных
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#13
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Да, действительно, "выходные городские войны" все-таки врачи. А вот башню им починить было бы неплохо. Кто бы мне объяснил высокий смысл первого случая... Самое забавное, что в этом случае, слово complex может иметь оттенок комплексности.
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Абугов Сергей Александрович. Российский Научный Центр Хирургии им. академика Б.В. Петровского. |
#14
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Цитата:
Спасибо за помощь в переводе! |