Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Aim Reporting on an atypical case of a three-year-old patient affected by osteomyelitis of the distal radius, completely healed without antibiotic therapy. Methods The clinical case is related to a three-year-old patient, whose clinical picture began with fever, pain and swelling of the right wrist. After three days, fever and swelling disappeared, but pain persisted. ⋯ Conclusion Patient presented with all characteristics of an osteomyelitis of distal radius, was unexpectedly spontaneously healed, without antibiotic therapy. Two years after the onset of the disease the patient recovered without clinical and radiographic sequelae. No similar cases are found in the literature .
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Aim Recurrent pregnancy loss (RPL) poses a challenge in reproductive medicine because the etiology is often unknown. Here we investigated the frequency of mutations in the Factor V Leiden (FVL), prothrombin (FII), and methylene tetrahydrofolate reductase (MTHFR) genes in women with RPL and healthy women. Methods Blood samples were obtained from patients with ≥2 consecutive pregnancy losses and no identifiable etiology before 12 weeks of pregnancy (n=145). ⋯ For two polymorphisms in MTHFR, genotype frequencies of 89 (61.4%) were found in patients and 55 (52.4%) in controls for 677TT (p=0.322), and 89 (61.4%) and 62 (59%) for 1298CC, respectively (p=0.810). Conclusion Despite a trend towards significance for FII G20210A, no significant differences in genotype frequencies of these polymorphisms between patients and controls was found. No evidence of the role of FVL G1691A, MTHFR C677T, and MTHFR A1298C in RPL in our Turkish cohort was found; however, further investigation of FII as a culprit gene in RPL is warranted.
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Aim To explore the experiences of registered nurses in assessing postoperative pain in hip fracture patients suffering from dementia in nursing homes. Methods The study was designed as a qualitative study using data from a self-reported questionnaire form. Data were collected through the self-administered questionnaire with 23 questions, mainly addressing demographic and social data, information about communication and pain assessment. ⋯ An assessment of pain in patients with dementia and hip fractures was a complex process because cognitive ability of these patients was reduced. Conclusion Registered nurses need to know various and different forms of evaluation and tools to assess the experience of pain in patients with dementia who had undergone surgery for hip fractures. This is a complicated task, which requires a great deal of time, and means that nurses must work together with other medical staff, using a holistic approach.
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Aim Ethical values are the basis of the behaviour and performance of professional care staff. This study aimed to identify inter-professional ethical values in aged care. Methods This qualitative thematic content analysis study was conducted in Khorramabad, Iran, from September 2018 to June 2109, and 36 core members of the aged care team (including 24 nurses, 5 physicians, 3 physiotherapists, and 4 social workers) were selected through the purposive sampling method and interviewed in depth. ⋯ Conclusion The results of this study indicate that providing ethical aged care is influenced by the specific conditions of this age group. In addition to general ethical values such as providing professional care, providing ethical aged care is based on ethical values such as promoting social interaction, promoting peace and comfort, preserving and promoting independence, and autonomy in aged care. Promoting collaborative care and paying more attention to the human dimensions of communication and interaction were other emphasized values.
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Observational Study
Fetuin-A Thr256Ser gene polymorphism as a mortality predictor in patients with chronic kidney disease on maintenance haemodialysis in Medan, Indonesia.
Aim To investigate an impact of Fetuin-A Thr256Ser gene polymorphism on the mortality rate of chronic kidney disease on maintenance haemodialysis patients in Indonesia. Methods This is an analytic-longitudinal observational study using survival analysis with nine-month follow up on 106 maintenance haemodialysis patients. The PCR-RFLP is used to determine Fetuin-A Thr256Ser gene polymorphism and Fetuin-A serum level measured by using ELISA methods. ⋯ The group of patients with IL-6 level ≥86.9 pg/mL had higher mortality with 3.64 times greater risk compared to those with IL-6 level, <86.9 pg/mL (p=0.03). Conclusion This study revealed a significant dominance independent impact of the Fetuin-A Thr256Ser gene polymorphism on the survival rate of maintenance haemodialysis patients. These results suggest that genotype variation of Fetuin-A gene could be a potential marker to identify high mortality risk in Indonesia's maintenance haemodialysis patients, especially in Medan.