Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Aim To develop and validate a screening questionnaire for migraine without aura with sufficient diagnostic accuracy to be used in primary care settings. Methods The study was designed as cross-sectional, multicentric, diagnostic accuracy trial of new questionnaire for screening patients who visit general practitioners, with an aim to reveal migraine without aura. The instrument was constructed for the purpose of this study, and validated on the sample of 429 primary care outpatients. ⋯ The study also confirmed a high percentage of patients with hidden migraine without aura (MWA) (52.9%) revealed by the BMSQ and the ICHD-III criteria that would otherwise remain undiagnosed. Conclusion The BMSQ is a valid and reliable clinical instrument for revealing migraine without aura, which could be easily selfadministered by patients. It has high screening yield, discovering majority of patients with previously undiagnosed migraine without aura, whose definite diagnosis should later on be confirmed by the attending physicians using the ICHD-III criteria.
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Aim To evaluate the efficacy, safety and feasibility of mediastinoscopy in 107 cases with mediastinal lesions that could not be diagnosed histopathologically with other methods. Methods A total of 107 cases (73 males, 34 females; mean age 57.4, range 30-88 years) with mediastinal lymphadenopathy, who underwent mediastinoscopy between 12 September 2012 and 29 November 2018 were examined retrospectively. The cases were evaluated in terms of age, gender, complaint, operation time, histopathological diagnosis, postoperative morbidity and mortality parameters. ⋯ In 25 (23.5%) cases biopsy results were reported as reactive lymph nodes. In addition, 23 (21.4%) patients had sarcoidosis, 16 (15%) had tuberculosis lymphadenitis, seven (6.5%) had lymphoma, one of each (0.9%) had benign epithelial cyst (0.9%), malign epithelial tumour (invasive ductal carcinoma of breast), chronic lymphocytic leukaemia (CLL), and adenocarcinoma metastasis (renal cell cancer). Conclusion When other non-invasive procedures are ineffective, mediastinoscopy is an efficient diagnostic method with high diagnostic value, which is applicable also in places other than advanced centres, with low morbidity and mortality.
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Early complications in ascending aortic aneurysm surgery: a single centre experience of 81 patients.
To investigate major in-hospital complications of ascending aorta reconstruction and to identify factors associated with these complications. Methods All consecutive patients admitted to our clinic for aortic aneurysm repair from June 2005 to June 2009 were enrolled in this retrospective study. Demographic data, details of the surgical procedures and major in-hospital complications were assessed and recorded from the institutional electronic database. ⋯ Cross-clamp time was significantly higher in patients with major in-hospital complications (107±34 vs. 79±26 (p<0.001). Presence of CRD (r=0.308; p=0.005) and CAD (r=0.244; p=0.028), previous cardiac surgery (r=0.266; p=0.022), cross-clamp time (r=0.349; p=0.001) and IABP requirement (r=0.308; p=0.005) were significantly correlated with the development of major in-hospital complications. Conclusion Our results show that presence of underlying CRD and CAD, previous cardiac surgery, length of cross-clamp time and IABP requirement were significantly associated with the development of in-hospital complications in patients undergoing surgical reconstruction for ascending aortic aneurysm.
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Aim To determine the prevalence of new-onset atrial fibrillation (NOAF) following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) and its effect on 6-month cardiovascular outcomes. Methods This prospective study included 40 patients diagnosed with LMCAD, in the period from 2017 to 2018. The patients with LMCAD and low or intermediate SYNTAX score were randomized to PCI with zotarolimus-eluting stents versus CABG. ⋯ One patient died 2 months after the operation, and one developed stroke 5 months after the CABG operation. Conclusion The NOAF was common after CABG, but extremely rare after PCI, and it occurred almost exclusively following CABG. There was a clear statistical tendency for all-cause death, cardiovascular death and stroke at 6-month follow-up period.
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Randomized Controlled Trial
Effect of intracuff alkalinized 2% lidocaine on endotracheal tube cuff pressure and postoperative throat symptoms in anaesthesia maintained by nitrous oxide.
Aim To compare the effects of endotracheal tube cuff inflation media, air, saline and alkalinized 2% lidocaine on increase of cuff pressure (CP) during nitrous oxide maintained anaesthesia and on incidence of postoperative throat symptoms (PTS), and to evaluate the incidence of postoperative throat mucosal injuries (PTMI) depending on cuff inflation medium. Methods Ninety patients who had undergone elective surgery were randomly allocated into 3 equal groups per cuff inflation media: air (group A), saline (group S) and alkalinized 2% lidocaine (group L). The CP was monitored immediately after cuff inflation and further 5, 15, 30, 60 and 90 minutes after intubation. ⋯ Conclusion The increase of CP contributed to incidence of PTS. The intracuff alkalinized 2% lidocaine was superior to saline and air in the prevention of an increase of CP and reduction of the PTS incidence. There was a strong correlation between the incidence of PTS and PTMI.