Acta clinica Croatica
-
Acta clinica Croatica · Sep 2015
SIGNIFICANCE OF FIBROBLAST GROWTH FACTOR 23 IN ACUTE KIDNEY INJURY.
Acute kidney injury is a clinical syndrome associated with increased patient morbidity and mortality, as well as serious short-term and long-term consequences, especially in the perioperative period. Yet, patients having suffering from temporary acute kidney injury and achieving full recovery of kidney function usually complain of poor quality of life associated with loss of energy and limited physical activity. Therefore, there is a necessity for a novel biomarker of acute kidney injury with better features than currently used serum creatinine and urine output. ⋯ It cannot only detect kidney dysfunction at the time but also before the injury process begins. Moreover, serum levels of the fibroblast growth factor 23 can predict adverse progression of the kidney injury. However, the role of the fibroblast growth factor 23 in the acute but also in chronic kidney dysfunction is still a riddle that requires additional research to clarify it.
-
Acta clinica Croatica · Sep 2015
SEVEN-YEAR TRENDS IN THE CROATIAN PRIMARY PERCUTANEOUS CORONARY INTERVENTION NETWORK.
The authors investigated trends in the Croatian primary Percutaneous Coronary Intervention (pPCI) Network results among three consecutive time intervals (2005-2007, first phase; 2008-2009, second phase; and 2010-2011, third phase). Data on 5650 patients with acute myocardial infarction with ST-elevation (STEMI) transferred or directly admitted and treated with pPCI in 11 Croatian PCI centers during the study period were collected and analyzed. The number of patients with acute STEMI treated with pPCI per year rose continuously during the study period (581 vs. 1272 vs. 1949 patients/year). ⋯ In conclusion, the Croatian pPCI Network continuously ensures very good results of STEMI treatment in this economically less developed European country despite worsening of the risk profile in treated patients and opening of new, less experienced PCI centers. The higher percentage of MACE over time could be explained by changes in the pPCI strategy introduced over time (the culprit lesion only) and higher availability of PCI centers for additional PCI after acute STEMI. However, there is room for improvement, especially in reducing prehospital delay.
-
Acta clinica Croatica · Sep 2015
Observational StudyGENDER-ASSOCIATED DIFFERENCES IN ACUTE HEART FAILURE PATIENTS PRESENTING TO EMERGENCY DEPARTMENT.
Little is known about gender-associated differences in characteristics and survival of acute heart failure patients. The increasing incidence calls for investigating the possibilities of improved management. The purpose of the study was to determine gender-associated differences among emergency department acute heart failure patients in order to improve treatment quality and survival. ⋯ Males were more frequently smokers with a history of chronic obstructive pulmonary disease. The importance of treating hypertension and atrial fibrillation in women and acute coronary syndrome and chronic obstructive pulmonary disease in men should be emphasized. Aggressive identification and management of all possible heart failure etiologies should be recommended in the emergency department.
-
Acta clinica Croatica · Sep 2015
CO-OCCURRENCE OF CHRONIC HEAD, FACE AND NECK PAIN, AND DEPRESSION IN WAR VETERANS WITH POST-TRAUMATIC STRESS DISORDER.
This study investigated the relationship between chronic head, face and neck pain, and the level of depression in Croatian war veterans with post-traumatic stress disorder (PTSD). The presence of self-reported pain, pain on digital palpation, and pain severity in masticatory and neck muscles, temporomandibular joints and sinuses, as well as the level of depression were assessed in a group of war veterans with PTSD (n=52). Control groups consisted of war veterans without PTSD (n=50) and healthy men that were not engaged in war actions and were free from PTSD (n=50). ⋯ Furthermore, PTSD patients mostly suffered from severe depression. There was a statistically significant positive correlation between all investigated pain parameters and level of depression. As the most important finding, the present study demonstrated chronic head, face and neck pain to be related to depression in PTSD patients.
-
Labor pain is one of the most severe pains. Labor is a complex and individual process with varying maternal requesting analgesia. Labor analgesia must be safe and accompanied by minimal amount of unwanted consequences for both the mother and the child, as well as for the delivery procedure. ⋯ Cooperation of obstetric and anesthesiology personnel, as well as appropriate technical equipment significantly decrease the need of instrumental completion of a delivery, as well as other complications encountered in the application of epidural analgesia. Our hospital offers 24/7 epidural analgesia service. The majority of pregnant women in our hospital were aware of the advantages of epidural analgesia for labor, however, only a small proportion of them used it, mainly because of inadequate level of information.