Croatian medical journal
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Croatian medical journal · Feb 2012
Predictors of positive blood cultures in critically ill patients: a retrospective evaluation.
To identify predictors of bacteremia in critically ill patients, to evaluate the impact of blood cultures on the outcome, and to define conditions for breakthrough bacteremia despite concurrent antibiotic treatment. ⋯ The prediction of positive blood culture results still remains a very difficult task. In our analysis, blood cultures were positive in 20% of ICU patients whose blood was cultured, and positive findings increased with elevated procalcitonin levels, liver failure, and higher severity scores. Blood cultures drawn >4 days after the start of antibiotic therapy and >5 days after surgery could detect pathogens responsible for a new infection complication.
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Croatian medical journal · Feb 2012
Double venous drainage through the superior vena cava in minimally invasive aortic valve replacement: a retrospective study.
To compare the outcomes of patients who underwent upper mini-sternotomy or right mini-thoracotomy and those who underwent full sternotomy and to report a technical improvement in venous drainage by means of double venous cannulation of the superior vena cava (SVC) in mini surgical procedures. ⋯ Our study confirmed that even though technically challenging, upper mini-sternotomy and right mini-thoracotomy approaches for aortic valve replacement have potential advantages over conventional median sternotomy. They were proved to be safe, efficacious, and can significantly reduce surgical trauma and are therefore particularly valuable in some higher risk, obese, diabetic and elderly patients. Using double cannulation of SVC for venous drainage made venous cannulation easier and eliminated the need for obtaining femoral venous access.
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Croatian medical journal · Feb 2012
Osteochondritis dissecans of the elbow: excellent results in teenage athletes treated by arthroscopic debridement and microfracture.
To evaluate the outcome of patients who underwent microfracture procedure on osteochondritis dissecans (OCD) lesions in the elbow, which had already been proven successful on OCD lesions in the knee and ankle. ⋯ We advocate arthroscopic microfracturing, followed by a strict rehabilitation regime, as a highly effective treatment for OCD of the humeral capitellum.
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Croatian medical journal · Feb 2012
Influence of coronary computed tomography-angiography on patient management.
To evaluate how coronary computed tomography-angiography (CCTA) altered the management and treatment of patients with suspected coronary artery disease (CAD). ⋯ CCTA can reliably exclude significant CAD not only in patients with low and moderate risk, but also in those with high risk. It can also reliably replace CC in the majority of elective patients regardless of risk stratification. It can also be useful in risk reclassification and optimization of medical therapy in patients with CAD.