Srp Ark Celok Lek
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Despite numerous advances in medicine, the mortality rate of severe sepsis and septic shock remains high, 30-50%. New therapy strategies include: early goal-directed therapy, fluid replacement, early and appropriate antimicrobials, source of infection control, use of corticosteroids, vasopressors and inotropic therapy, use of recombinant activated protein C, tight glucose control, low-tidal-volume mechanical ventilation. They have been shown to improve the outcomes. The adequacy and speed of treatment influence the outcome, too. ⋯ Evidence-based clinical guidelines for management of severe sepsis and septic shock have not been implemented in a widespread, systematic way in the ICU of the Clinical Centre, Kragujevac. Institutional acceptance of this protocol, and education of clinicians may improve survivability for patients with sepsis.
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C-reactive protein (CRP) is the most common diagnostic marker of infection. ⋯ CRP levels are proportional with increasing GA and body weight in EOS. The effects of gestational age do not influence CRP levels in LOS. Maturation changes in the immune system are the most likely explanation for this and partly the organisms responsible for an infection may be different at different gestational ages and also in EOS and LOS. There is no correlation with serum CRP levels and with the severity of the disease and bad prognosis in EOS.
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Multiple trauma is one of the leading causes of mortality and morbidity in the population of people under 45 years of age. The consequences of multiple trauma have huge epidemiological, social and economic significance. ⋯ With respect to sex, in most cases multiple trauma affects males (p < 0.01), with the average age of about 40. With respect to injury mechanism, the main cause of the occurrence of multiple trauma is traffic accidents (p < 0.01). There is a statistically significant difference in the values of GCS and ISS relative to the definitive outcome (p < 0.01). Statistical data processing indicated that there was a statistically significant correlation between mortality and type of injury in a given organic system (p < 0.01), but that there was no statistically significant correlation between mortality and age.
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This paper describes the personal experience of the author with Shoulder Arthro MR. This imaging method is put into perspective with other, more widely used diagnostic methods, which also have their advantages. Indications for Shoulder Arthro MR are discussed and details on the technique and interpretaton are given. ⋯ After x-ray, Shoulder MR is now considered the standard among the imaging methods to diagnose shoulder disorders, as it allows for optimal depiction of pathology and diagnosis in all major imaging planes. At the same time the method gives the arthroscopist an excellent roadmap for his intervention. All in all, the treatment outcome of shoulder trauma has been improved by shoulder MR in conjunction with modern surgical and arthroscopic therapies.
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Glare can be defined as unpleasant sensation caused by a relatively strong source of light, which results in unpleasantness, discomfort and the lowering of optimal vision characteristics. It has been demonstrated that different factors influence the glare in pseudophakic subjects: opacity in vision media, the brightness of the pupil and the design of intraocular lenses. ⋯ In the observed pseudophakic persons, the duration of shine was found to be in correlation with glare.