Acta clinica Croatica
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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.
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Acta clinica Croatica · Jun 2013
Serum levels of calcium, selenium, magnesium, phosphorus, chromium, copper and iron--their relation to zinc in rats with induced hypothyroidism.
There is an important relation between thyroid hormones and zinc. Establishment of low zinc levels in hypothyroidism and high levels in hyperthyroidism is a significant proof of this relation. The aim of the present study was to explore changes in serum levels of some elements and their relation to zinc in rats with hypothyroidism. ⋯ Study parameters did not differ between groups 1 and 2. Results obtained in this study indicate that hypothyroidism leads to changes in serum levels of some elements in rats. These changes may be associated with reduced zinc levels in hypothyroidism.
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Acta clinica Croatica · Mar 2013
Randomized Controlled Trial Comparative StudyComparison of postoperative analgesic effect of tramadol and bupivacaine subcutaneous infiltration in patients undergoing cesarean section.
Cesarean section is associated with significant postoperative pain. The aim of this study was to evaluate the effects of tramadol versus bupivacaine administration at wound closure on postoperative pain relief in patients undergoing cesarean section. Sixty women undergoing cesarean deliveries were randomly assigned to receive either 10 mL of bupivacaine 0.5% (n = 30) or 50 mg of tramadol in 10 mL of normal saline (n = 30), both as local wound infiltration prior to skin closure at the end of operation. ⋯ Postoperative consumption of analgesic was higher in bupivacaine group than tramadol group but the difference was not significant (p > 0.05; Fisher exact test). No side effects were reported in either group. This study showed that subcutaneous administration of tramadol provided analgesic effect equal to bupivacaine with longer pain relief after cesarean section.
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Acta clinica Croatica · Mar 2013
Access to public healthcare services and waiting times for patients with chronic nonmalignant pain: feedback from a tertiary pain clinic.
Evaluation of healthcare services by patients is an essential component of quality improvement. We studied association between patient satisfaction and accessibility of healthcare services to patients with chronic nonmalignant pain. A hundred patients from the Pain Clinic, Split University Hospital Center, Split, Croatia, completed a 27-item questionnaire about their condition, duration of chronic pain treatment, access to healthcare, waiting times for various healthcare services, and their satisfaction with the pain clinic and health system. ⋯ Negative association was found between waiting time for pain clinic appointment and healthcare system grade (r = -0.34, P = 0.02). Patient suggestions for improving pain clinic were more staff, better approach to each patient, and better organization. In conclusion, access to public healthcare for patients with chronic nonmalignant pain should be better to improve patient satisfaction and provide better care.