Acta clinica Croatica
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Acta clinica Croatica · Dec 2021
COMPARISON OF DIFFERENT OUT-OF-HOSPITAL AIRWAY MANAGEMENT TECHNIQUES IN PATIENTS WITH CARDIAC ARREST IN SLAVONIA REGION.
Endotracheal intubation is the gold standard in inpatient treatment of cardiac arrest patients; however, there are conflicting research results in out-of-hospital conditions. This prospective study included 92 patients with confirmed cardiac arrest occurring outside a hospital facility, who fulfilled the inclusion criteria and whom the emergency ambulance team reached within 20 minutes from the event. Medical data on each patient (age, gender, cause of arrest, estimated time of arrest, time to arrival of the ambulance team, resuscitation commenced prior to arrival of the ambulance team, initial electrocardiographic rhythm, method of airway management, and success of resuscitation) were recorded. ⋯ The ratio of achieving spontaneous circulation with intubation versus I-gel LMA was 13 (28%) to 11 (24%) (p=0.725). The best return of spontaneous circulation results was recorded in patients suffering from ventricular fibrillation; however, there was no statistically significant difference between the intubation and I-gel LMA treatments (8 (47%) vs. 7 (41%); p=0.916). No statistically significant difference was observed between the outcomes of patients resuscitated by endotracheal intubation and I-gel LMA methods either.
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Acta clinica Croatica · Dec 2021
CROATIAN GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF NONALCOHOLIC FATTY LIVER DISEASE.
Nonalcoholic fatty liver disease (NAFLD) is a term describing excessive accumulation of fat in hepatocytes, and is associated with metabolic syndrome and insulin resistance. NAFLD prevalence is on increase and goes in parallel with the increasing prevalence of metabolic syndrome and its components. That is why Croatian guidelines have been developed, which cover the screening protocol for patients with NAFLD risk factors, and the recommended diagnostic work-up and treatment of NAFLD patients. ⋯ Patient work-up should exclude the existence of other causes of liver injury and determine the stage of fibrosis as the most important factor in disease prognosis. Patients with initial stages of fibrosis continue to be monitored at the primary healthcare level with the management of metabolic risk factors, dietary measures, and increased physical activity. Patients with advanced fibrosis should be referred to a gastroenterologist/hepatologist for further treatment, monitoring, and detection and management of complications.
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Acta clinica Croatica · Dec 2021
CONTINUOUS GLUCOSE MONITORING AND TYPE 1 DIABETES MELLITUS CONTROL IN CHILD, ADOLESCENT AND YOUNG ADULT POPULATION - ARGUMENTS FOR ITS USE AND EFFECTS.
Sensors for continuous glucose monitoring (CGM) in intercellular fluid are used as a contemporary method to achieve better control in type 1 diabetes mellitus (DM), which is best shown through lower glycated hemoglobin (HbA1c) levels. The aim of this study was to assess how many of our patients used CGM (parents were solely financing all the cost of the device) and what was the effect of CGM on the control of DM. Data were retrospectively collected from medical records of patients actively treated at the Division of Endocrinology, Diabetology, Pulmonology and Allergology, Department of Pediatrics, Sestre milosrdnice University Hospital Center. ⋯ The mean HbA1c level 6 months before the introduction of CGM was 8.2%±1.9 and after 12 months of CGM use it was 7.4%±1.2, which was a statistically significant improvement (p=0.026). Furthermore, our results demonstrated that the greatest improvement in HbA1c level was recorded in the groups of young adults (18-25 years) and youngest children (<12 years). We confirmed the efficacy of CGM in achieving better control of type 1 DM by significantly improving HbA1c levels in a population of highly motivated patients.
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Acta clinica Croatica · Dec 2021
AMBULATORY EYE SURGERY AND ANTITHROMBOTIC THERAPY - NEW APPROACHES.
One of the most common surgeries in elderly patients is eye surgery. An increasing number of patients undergoing ambulatory eye surgery are on antithrombotic therapy. These drugs may increase the risk of perioperative bleeding associated with ophthalmic needle blocks and/or eye surgery. ⋯ A comprehensive review of the English-language medical literature search utilizing PubMed, Ovid Medline® and Google Scholar from January 2015 to December 2018 was performed. The database searches included studies providing evidence relevant to ambulatory eye surgery and perioperative antiplatelet medications and anticoagulants. Updated recommendations will be given for continuation, discontinuation, and modification of antithrombotic agents in order to optimize the management of antithrombotic therapies in outpatients scheduled for eye surgery.
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Acta clinica Croatica · Dec 2021
DOES THE TYPE OF SURGERY IN BRAIN ABSCESS PATIENTS INFLUENCE THE OUTCOME? ANALYSIS BASED ON THE PROPENSITY SCORE METHOD.
There are different options for surgical treatment of brain abscess, mainly standard craniotomy and stereotactic aspiration. It has not yet been established which of these options is associated with a more favorable outcome under similar baseline conditions of patients. Demographic characteristics, microbiology, clinical presentation, and treatment outcome were analyzed for surgically treated adult patients with brain abscess over a 14-year period. ⋯ Worse outcome (GOS below 4) was independently associated with Glasgow Coma Score (GCS) on admission (OR 0.787, CI 0.656-0.944). The choice of neurosurgical procedure did not influence the outcome in patients with brain abscess. Patients with brain abscess who had lower GCS on admission also had worse outcome.