Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Aim To evaluate the efficacy of systemic plus local tranexamic acid (TXA) in reducing post-operative bleeding, haemoglobin loss and the need for allogeneic blood transfusion (ABT) in total knee arthroplasty (TKA). Methods All patients undergoing TKA between January 2017 and September 2019 were retrospectively evaluated. Exclusion criteria were cardiovascular comorbidities, diabetes and the assumption of any anticoagulant/antiaggregant therapy in the pre-operative period. ⋯ Each patient in group A received 2 red blood cells (RBCs) units, while in group B 2 patients received one RBCs unit and one patient 4 RBCs units, for a total of 4 and 32 RBCs units in group A and B, respectively (p=0.0006). The minimum haemoglobin level was observed at 48 hours post-operatively in both groups: mean decrease was 3.54 and 4.64 g/dL in group A and B, respectively (p=0.0126). Conclusion The association of systemic and local TXA administration seems to significantly reduce post-operative bleeding and the need for RBCs transfusions after TKA in patients not assuming any anticoagulant / antiaggregant therapy and without cardiovascular and diabetic morbidities.
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Randomized Controlled Trial
Comparison of analgesic efficacy of acetaminophen monotherapy versus acetaminophen combinations with either pethidine or parecoxib in patients undergoing laparoscopic cholecystectomy: a randomized prospective study.
Aim To investigate analgesic effect of three different regimens of combination of analgesics administered to patients undergoing laparoscopic cholecystectomy. Methods Patients undergoing laparoscopic cholecystectomy were randomly allocated to one of three groups on admission, depending of a prescribed post-operative analgesic regimen. Patients allocated to the group A received a combination of intravenous (IV) acetaminophen and intramuscular (IM) pethidine, patients in the group B received a combination of IV acetaminophen and IV parecoxib, and the patients of the group C received IV acetaminophen monotherapy. ⋯ The analgesic regimens of groups A and B (combination regimens consisting of IV acetaminophen and intramuscular pethidine and IV acetaminophen and IV parecoxib, respectively) were found to be of equivalent efficacy (p=1.000). In contrast, patients in group C (acetaminophen monotherapy) had higher NRS scores, compared to both patients in groups A (p<0.01) and B (p<0.01). Conclusion This study confirms the notion of a significant opioid-sparing effect of parecoxib in postoperative pain management after laparoscopic cholecystectomy.
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Aim To present haemoglobin and ferritin parameters in donors to highlight the importance of serum ferritin testing for the purpose of evaluating iron depots in order to make recommendations for preserving a population of blood donors. Method A prospective study was conducted on 80 blood donors divided in two groups: group I (regular donors, n =40) and group II (irregular donors, n=40). Haemoglobin and ferritin were measured twice every 45 days, before two consecutive blood donations. ⋯ Measurement of ferritin before and after donation revealed statistically significant loss of ferritin in all examinees (p=0.011). The decline in haemoglobin after donation, although significant, did not fall below the reference value for donation in either women or men. Conclusion Results indicate the need for periodic monitoring of the plasma value of ferritin in voluntary donors who donate blood more than twice a year and the possible oral supplementation with iron.
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Aim Uncommon and rare hip diseases are sources of pain and functional limitation particularly in young patients. Some of these conditions may be nowadays treated by arthroscopy due to the expertise and technical tips that high-volume hip arthroscopies have achieved during the last decades ensuring a wider range of indications for such a procedure. The aim of this study was to evaluate clinical results of arthroscopy in treating uncommon or rare diseases of the hip at a single Institution. ⋯ No complications were reported at the latest follow-up. The NAHS and mHHS showed good improvements and all patients referred high satisfaction. Conclusion Hip arthroscopy performed by expert and high-volume surgeons may ensure good results in patients affected by uncommon and rare hip diseases.
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Aim A SARS Coronavirus 2 (COVID-19) pandemic drastically changed the way the health system works. In Croatia, lockdown measures to curb virus spread lasted from March to May 2020, and all non-essential medical procedures and patients' visits have been cancelled. The study aimed to compare patients' flow and interventions in the surgical department before, during and after the lockdown period. ⋯ A significant decrease in outpatient visits and hospital admissions continued after the lockdown (p<0.001). Conclusion A decrease in the number of outpatient visits, hospitalizations, and tumour removals may result in larger proportions of patients with advanced cancers in the future. The second wave of COVID-19 pandemic is ongoing, and special effort must be paid to reduce the number of cancer patients receiving suboptimal treatment.