Acta clinica Croatica
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Acta clinica Croatica · Sep 2013
Randomized Controlled TrialThe effect of preemptive intravenous low-dose magnesium sulfate on early postoperative pain after laparoscopic cholecystectomy.
As an N-methyl-D-aspartate antagonist, magnesium sulfate has analgesic properties and reduces noxious input during surgery. The aim of the study was to determine the effect of preemptive intravenous low-dose magnesium sulfate on early postoperative pain after laparoscopic cholecystectomy. In this prospective, randomized study, 60 ASA I-II patients undergoing elective laparoscopic cholecystectomy were assigned to three groups (n = 20 each). ⋯ After 6, 9 and 24 hours postoperatively, there were no differences in VAS scores among the groups. In conclusion, preemptive intravenous administration of both 5.0 mg/kg and 7.5 mg/kg of magnesium sulfate significantly reduced early postoperative pain after laparoscopic cholecystectomy, but 7.5 mg/kg was found to be more effective. There was no effect on pain reduction at 6, 9 and 24 hours after surgery and no adverse effects were recorded.
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Acta clinica Croatica · Sep 2013
Case ReportsAn unusual clinical presentation of subacute granulomatous thyroiditis.
Subacute granulomatous thyroiditis is an inflammatory thyroid condition that is presumed to be caused by a viral infection or postviral inflammatory process. It is characterized by neck pain, usually a tender diffuse goiter, and thyrotoxicosis. ⋯ After the diagnosis had been established, she was treated with propranolol and acetylsalicylic acid, and has fully recovered. In conclusion, this disease may be difficult to diagnose, especially if there is a combination of fever and increased aminotransferases, which can lead to a wrong diagnostic approach.
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Acta clinica Croatica · Sep 2013
Randomized Controlled Trial Comparative StudyComparison of the effects of land-based and water-based therapeutic exercises on the range of motion and physical disability in patients with chronic low-back pain: single-blinded randomized study.
The aim of the study was to compare the effect ofwater-based exercise in thermal mineral water versus land-based exercise therapy on the lumbar spine range of motion and physical disability in adult patients with chronic low back pain. Out of 72 patients hospitalized for inpatient treatment in a special rehabilitation hospital, 36 patients performed a 3-week standardized program of group water-based exercises and the other 36 performed a program of group land-based exercises. All patients were also treated with electro analgesic therapy and underwater massage. ⋯ At the end of treatment, there was no statistically significant difference between the two exercise treatments in any parameter of interest (p < 0.01). In conclusion, in our sample of patients with chronic low back pain, exercise treatment improved lumbar motion and decreased the level of physical disability. However, comparison of land-based exercises and water-based exercises in thermal mineral water did not demonstrate any significantly different result.
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Acta clinica Croatica · Sep 2013
Combined sleeve gastrectomy and mini-gastric bypass in a new bariatric procedure of mini-gastric bypass and proximal sleeve gastrectomy.
Surgery is the most effective method for the treatment of morbid obesity. Beneficial effects of bariatric surgery are due to both changed anatomy and consequential alterations in hormonal and metabolic status. ⋯ The procedure is a hybrid of sleeve gastrectomy and mini-gastric bypass, therefore uniting advantages of both procedures: one anastomosis, achieved effects of restriction and malabsorption and affection of both dominant endocrine systems that result in an increase in incretin level and a decrease in ghrelin level. However, the procedure is yet a novel one and these hypotheses are about to be examined in the already announced research project.