Vojnosanit Pregl
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BACKROUND/AIM: Sedation is necessary in children undergoing magnetic resonance imaging (MRI) to ensure motionless. The success of sedation is typically measured by two factors: safety (lack of adverse events) and effectiveness of the procedure (successful completion of the diagnostic examination). Propofol is frequently used to induce deep sedation in children. However, increased doses of propofol may lead to oversedation and respiratory depression. The aim of the study was to investigate sedation in children using propofol with midazolam in regard to efficacy, adverse events and time to return to presedation functional status. ⋯ The presented sedation technique for children undergoing ambulatory MRI of the brain is safe and adequate. This sedation regiment provides short induction time, fast recovery, stable cardiorespiratory conditions and rarely demans additional sedation.
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Persistent left superior vena cava, a rare congenital abnormality, can complicate placement of pacemaker leads through the subclavian vein. A left-sided approach is usually preferable in such cases. ⋯ To our knowledge, this is the first reported case of pacemaker implantation, with passive electrode, through a persistent left superior vena cava via the right subclavian vein. This case demonstrates that such an approach, when necessary, can be used successfully.
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Randomized Controlled Trial
Short-term use of continuous glucose monitoring system adds to glycemic control in young type 1 diabetes mellitus patients in the long run: a clinical trial.
Balancing strict glycemic control with setting realistic goals for each individual child and family can optimize growth, ensure normal pubertal development and emotional maturation, and control long term complications in children with type 1 diabetes (T1DM). The aim of this study was to evaluate the efficacy of short-term continuous glucose monitoring system (CGMS) application in improvement of glycemic control in pediatric type 1 diabetes mellitus (T1DM) patients. METHODS. A total of 80 pediatric T1DM patients were randomly assigned into the experimental and the control group. The experimental group wore CGMS sensor for 72 hours at the beginning of the study. Self-monitored blood glucose (SMBG) levels and hemoglobin A1c (HbA1c) levels were obtained for both groups at baseline, and at 3 and 6 months. RESULTS. There was a significant improvement in HbA1c (p < 0.001), in both the experimental and the control group, without a significant difference between the groups. Nevertheless, after 6 months the improvement of mean glycemia was noticed only in the experimental group. This finding was accompanied with a decrease in the number of hyperglycemic events and no increase in the number of hypoglycemic events in the experimental group. ⋯ The results suggest that the CGMS can be considered as a valuable tool in treating pediatric T1DM patients, however further research is needed to more accurately estimate to what extent, if any, it outperforms intensive self-monitoring of blood glucose.
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Randomized Controlled Trial
The effects of education with printed material on glycemic control in patients with diabetes type 2 treated with different therapeutic regimens.
Diabetes mellitus (DM) is considered to be an epidemic, chronic and progressive disease. The treatment of DM reqiures substantial effort from both the diabetes treatment team and a patient. Patient education is one of the treatment elements. The most efficacious form and content of education has not yet been established. However, every DM education must include introduction to a substantial number of facts about diabetes. The aim of our study was to estimate the levels of DM knowledge and glycemic control in Serbian patients with DM type 2 as well as to estimate the effects of education using printed material on the levels of glycemic control and knowledge about DM. Also, the effects of education on glycemic control and the level of knowledge in differently treated patients were estimated. ⋯ Education with printed material led to improvement in glycemic control and level of DM knowledge in our patients. Education with printed material may be a useful adjunct to DM treatment and should be structured according to the treatment modality.
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Pancreatic pseudocyst presented as pseudoaneurysm of the splenic artery is a potential serious complication in patients with chronic pancreatitis. ⋯ Angiography is the most reliable and the safest method for diagnosing hemorrhagic pseudocysts when they clinically present as pseudoaneurysms. A potentially dangerous complication in the presented case was treated surgically with excellent postoperative results.