Medicinski arhiv
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Isolated thoracic injuries are relatively common and they are on the second place as a cause of death overall trauma. Most patients with isolated thoracic injuries are treated on an outpatient basis while only serious cases are hospitalized. The basis of the treatment of thoracic trauma is efficient cardiopulmonary reanimation followed by an early detection and treatment of life threatening injuries. Less than 15% of patients with thoracic trauma require thoracotomy. ⋯ Based on the results of the initial diagnostic treatment, in majority of injured with isolated thoracic trauma, it was possible to conduct the relevant and appropriate therapeutic procedures. On the basis of relatively short period of thoracic drainage, hospitalization and low rates of morbidity and mortality, it may be confirmed that the application of initial diagnostic and therapeutic protocols of the Clinic for thoracic surgery resulted in the achievement of the successful treatments in majority of the injured for this type of the
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Controlled Clinical Trial
Alpha lipoic acid and glycaemic control in diabetic neuropathies at type 2 diabetes treatment.
Diabetes mellitus is a metabolic, chronic and incurable disease which reduces span and quality of life. Over 50% of diabetic patients have clinical manifestations of diabetic neuropathy. ⋯ Alfa lipoic acid is an effective drug in the treatment of diabetic distal sensory-motor neuropathy and its therapeutic effect is more effective in patients with good glycaemic control.
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Postoperative delirium (POD) is a frequent postoperative disorder to the sick and elderly, and always has been associated with extended of day stay in hospital, and certainly more cost for the hospital as well. Additionally, delirium is associated with increased postoperative complications, longer length of stay, longer intensive care unit stay (ICU), and much higher rates of discharge to a nursing home. As a result, delirium adds significant cost to hospitalization and subsequent medical care. The delirium causes an increased mortality and an increasing of mental status deterioration characterized by reduction of environmental recognition as well as the disorder of alertness. The purposes of this study are: a) the effectiveness of routine screening of postoperative Delirium in the elderly using Confusion Assessment Method (CAM)). In those cases psychiatrists are not necessary; b) understanding of risk factors and strategies for prevention and treatment; c) understanding of the impact of this psychotic disorders in postoperative morbidity and mortality; d) recognition of the economic impact of these disorders in the health service; e) describing of the etiology and incidence of Delirium post-operative. ⋯ Postoperative Delirium occurs as a result of the combination of several factors, not just those related to internal physiological age, but combining of these factors with the diseases which carries this age, with medications used for this age, with surgical stress, with biochemical imbalances, hemodynamic problems, and electrolytic disorders as well.
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Evaluation of neurogenic urination dysfunction by urodynamic examination in patients with spinal cord lesions is essential for ensuring the effective emptying of the bladder and the prevention of urological complications. ⋯ In our sample of patients with spinal cord lesions was demonstrated the impact of low compliance to the occurrence of UUT complications. It is also in case of the areflexic bladder found significant difference in compliance between the groups with and without UUT complications. Maintaining bladder compliance and low values if intracystic filling pressure the most important tasks in maintaining vesico-sfincteral balance, and thus prevention of urological complications in patients with spinal cord lesions.
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For almost 100 years, standard procedure for evaluation of axillary lymph status has been axillary nodes dissection (ALDN)-dissection of 1st, 2nd or possible 3rd level of axilla. Use of less invasive evaluation methods of axillary node pathologically (PH) status of non-invasive breast carcinoma has been started before about 30 year and that new method has been named sentinel lymph node biopsy (SLNB). ⋯ Results of sensitivity (68%), specificity (98%), positive (67%) and negative predictive value (96%) and overall accuracy of method (98%) are comparable and compatible with results from oncological breast cancer centers and allow introducing of SLNB in routine surgical practice in our clinical practice as the alternative for ALND for T1 and T2 breast carcinoma. It also contributes to better co-ordination between specialist of nuclear medicine, surgeon and pathologist.