Acta clinica Croatica
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Acta clinica Croatica · Apr 2023
PROCALCITONIN GUIDED ANTIBIOTIC STEWARDSHIP: A BALKAN EXPERT CONSENSUS STATEMENT.
Sepsis as a consequence of infection is a frequent cause of death among critically ill patients. The most common sites of infection are lover respiratory tract, abdominal, urinary tract and catheter-associated blood stream infections. Early empiric, broad-spectrum therapy in those with severe sepsis and/or shock with the aim of reducing mortality may lead to antibiotic overuse, resistance and increased costs. ⋯ In the protocol, they have included the severity of illness, clinical assessment, and PCT levels. Developing a consensus on the clinical algorithm by eminent experts/specialists in various fields of medicine should enable clinicians to use PCT for initiation of antibiotic therapy and monitoring PCT to stop antibiotics earlier. It is crucial that the PCT-guided algorithm becomes an integral part of institutional stewardship program.
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Acta clinica Croatica · Apr 2023
DO THE GUIDELINES GUIDE THE BELGRADE EMERGENCY MEDICAL SERVICE PHYSICIANS THROUGH THE MANAGEMENT OF ACUTE ST-ELEVATION MYOCARDIAL INFARCTION?
The aim of the study was to assess whether current guidelines for diagnosis and treatment of acute ST-elevation myocardial infarction (STEMI) in daily clinical practice are adequately applied in the Belgrade Emergency Medical Service (EMS). A retrospective research included 2,982 STEMI patients who were cared for by EMS teams. Therapy consisting of morphine, oxygen, nitroglycerin and aspirin (MONA) was applied. ⋯ A rapid increase in the use of dual antiaggregation therapy (MONA and clopidogrel or MONA and ticagrelor) was reported from year to year, as well as a dramatic increase in the use of ticagrelor compared to clopidogrel. The time from receiving the call to the arrival on the scene was 13.72 minutes, and the time from receiving the call to hospital arrival was 52.83 minutes. Our physicians care for STEMI patients in accordance with the current international and local recommendations.
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Acta clinica Croatica · Apr 2023
Comparative StudyLARYNGEAL MASK AIRWAY VERSUS ENDOTRACHEAL INTUBATION FOR ADENOIDECTOMY IN OUTPATIENT SURGERY - SINGLE CENTER EXPERIENCE.
Adenoidectomy with or without tonsillectomy remains one of the most routinely performed surgical procedures in children. The duration of the procedure is usually less than half an hour and is done in a day surgery setting. Airway management for adenoidectomy can be especially challenging as the airway is shared between the surgeon and the anesthesiologist. ⋯ The need for neuromuscular blockers was also lower in the LMA group (p=0.01). There was no statistically significant difference in the intraoperative dose of opioid analgesia (p=0.09). Flexible LMA is a satisfactory alternative to endotracheal intubation for outpatient pediatric adenoidectomy.
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A validated questionnaire is required to evaluate scientifically community-based breastfeeding support and promotion. The aim of this study was to create a valid and reliable questionnaire to measure parents' behavior and attitudes about breastfeeding. The items in the questionnaire were selected by the authors according to regular data from the professional literature, and in consultation with three pediatric lecturers at higher and secondary health education, fellow pediatricians, and parents. ⋯ In the study, the desired outcome was defined as exclusive breastfeeding for 5 or 6 months, as well as breastfeeding for 12 months or more. In conclusion, the final instrument is reliable and valid for collecting breastfeeding data and evaluating changes in parents' behaviors and attitudes achieved through participation in breastfeeding promotion and support programs. The questionnaire may, in addition to the BIAKQ questionnaire, support professionals and activists involved in breastfeeding to create methodologically well-conceived programs.
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Acta clinica Croatica · Apr 2023
ANALYSIS OF DIAGNOSTIC EXCISIONAL LYMPH NODE BIOPSY RESULTS: 12-YEAR EXPERIENCE OF A SINGLE CENTER.
Lymph node biopsy is indicated in patients with suspected malignancy or lymphadenopathy due to unclarified reasons. Lymph node biopsy can be performed as fine needle aspiration biopsy, core biopsy, or excisional lymph node biopsy. In particular, the diagnosis of malignant lymphoma is considered insufficient for oncological treatment unless classified into subgroups. ⋯ If the core biopsy is insufficient for diagnosis, it is more appropriate to perform surgical biopsy in order to cause no delay in diagnosis and treatment. Excisional biopsy is a method that can be safely performed and does not cause severe morbidity in palpable peripheral lymphadenopathies. Although it does not cause severe morbidity because it is an invasive procedure, excisional biopsy should be performed in a selected patient group.