Acta clinica Croatica
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Acta clinica Croatica · Jun 2022
DIAGNOSTIC VALUE OF CARDIAC ULTRASOUND IN ESTIMATING THE DURATION OF ARTERIAL HYPERTENSION.
The aim of the study was to assess the correlation between the degree and duration of arterial hypertension and the hypertrophy of the left ventricle and the ejection fraction of the heart, with cardiac ultrasound. Our prospective study included 50 patients with arterial hypertension as leading diagnosis. All 50 patients were consecutively examined in the Emergency Department and then referred to the Cardiac clinic of the Clinical Hospital "Sveti Duh" for further evaluation. ⋯ A statistically significant association was found between the degree and duration of arterial hypertension with the development of left ventricular hypertrophy. Significant association wasn't found between the degree or duration of arterial hypertension and the heart ejection fraction. Our study have shown strong correlation between the degree and duration of arterial hypertension and the development of left ventricular hypertrophy and ultrasound could be a useful method in the evaluation of some patients with arterial hypertension in the emergency department.
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Acta clinica Croatica · Jun 2022
BLOOD PRESSURE IS ASSOCIATED WITH DIABETIC RETINOPATHY IN TYPE 1 BUT NOT IN TYPE 2 DIABETES.
The aim of this study was to investigate the role of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the development of diabetic retinopathy (DR) in type 1 and type 2 diabetes and to determine the differences between these two types of diabetes. This cross-sectional study included 84 patients with type 1 diabetes (T1DM) and 107 patients with type 2 diabetes (T2DM). Ophthalmologic retinal examination included indirect slit-lamp fundoscopy, color fundus photography according to EURODIAB (EUROpe and DIABetes) protocol and optical coherence tomography. ⋯ Binary logistic regression analysis (no DR/DR) showed that diabetes duration and HbA1cmedian were the main predictors of DR in both types of diabetes. In contrast, SBP (OR = 1.05, p = 0.045) and hypertensive retinopathy (OR = 3.75, p < 0.001) were the main predictors/indicators of DR only in T1DM. In conclusion, blood pressure is associated with DR in type 1 but not in type 2 diabetes.
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Acta clinica Croatica · Jun 2022
Case ReportsCAN'T INTUBATE, CAN'T OXYGENATE: A RARE CASE OF A DIFFICULT AIRWAY DUE TO NONHEREDITARY ANGIOEDEMA.
Angioedema is a form of allergic mediated by histamine and non-allergic mediated by bradykinin and can be lethal if not recognized and treated promptly. This case demonstrates the proper diagnosis of and intervention in rapid onset severe angioedema. A 68-year-old male came to the emergency department with a complaint of dyspnea that started two hours before. ⋯ An ampule of icatibant was administered and rapid regression of the edema, along with the stabilization of the patient's vital signs, followed after five minutes. The patient was discharged home after five days with a recommendation of discontinuing the ACE inhibitor. While non-hereditary angioedema is not a rare condition, emergency physicians should be adequately educated about it.
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Coagulation abnormalities are common in bleeding or critically ill patient and hemostatic management remains a major challenge for the emergency physician. Management of bleeding patients consists of bleeding control, restoration of blood volume, and correction of any associated coagulopathy. Traditionally, the fresh frozen plasma (FFP) is used for correction of coagulopathy to manage and prevent bleeding, but today Prothrombin complex concentrates (PCCs) offer an attractive alternative because they offers a number of advantages over FFP, including lower infusion volume, rapid INR normalization, faster availability, lack of blood group specificity, and better safety profile. The aim of the present review is to provide an short overview about using PCC, their indication, efficacy and safety in different bleeding setting's.
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Acta clinica Croatica · Jun 2022
ReviewVENOMOUS SNAKEBITES IN CROATIA, CLINICAL PRESENTATION, DIAGNOSIS AND TREATMENT.
Venomous snake bites are recognized as a major public health problem, affecting mostly poor, underdeveloped areas in the tropical and subtropical areas. Every year, more than three million bite cases and about 100,000 deaths are registered worldwide. Over the past years, 632 people have been hospitalized in Croatia with only 3 deaths due to venomous snake bites. ⋯ There is currently no test to identify patients with a systemic spread of the venom, the diagnosis is made by a combination of diagnostic tests, clinical symptoms and sings of systemic envenomation. Ophidism is a medical condition that requires urgent treatment. Following first aid given at the scene, the patient should be transported to the closest medical facility to assess the severity of the clinical presentation in a timely manner and take the necessary treatment measures.