Acta medica Croatica : c̆asopis Hravatske akademije medicinskih znanosti
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The aim of the study was to assess the impact of the family socioeconomic status (SES) on health related quality of life (HRQoL) in children operated on for congenital heart defects. ⋯ The results of HRQoL according to parental proxy report indicated low SES to influence various aspects of HRQoL in children operated on for congenital heart defects. This could be explained by the fact that the risk factors associated with low SES may directly or indirectly affect not only family HRQoL but also HRQoL of children operated on for congenital heart defects. Therefore, it appears necessary for the low SES families with a child suffering from chronic disease to receive help from wider community to solve the above mentioned problem.
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Brain death is a clinical diagnosis and must be confirmed by one paraclinical test. This report presents the usefulness of paraclinical tests applied during a 4-year period. Forty-four patients with severe brain lesions leading to brain death were treated during the 2004-2007 period. ⋯ Four patients where TCD was used died during the observation period, and in one patient the hemodynamic spectrum was inconclusive. In most patients (65%), TCD confirmed the clinical diagnosis of brain death, and in 61% the diagnosis was confirmed within a 2-hour period. TCD was the most useful confirmatory test for cerebral circulatory arrest in brain death diagnosis.
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The aim of this paper is to present the latest developments in therapy and prophylaxis of deep vein thrombosis and other pregnancy complications in women with inherited or acquired thrombophilia and in women with mechanical heart valves. The data presented in the paper have been extracted from the Current Contents database. It is well known that the hypercoagulable state in pregnant women, caused either by the physiological changes of pregnancy or by inherited thrombophilia, increases the risk of venous thromboembolism (VTE), pulmonary embolism (PE), preeclampsia, recurrent early and late fetal loss, intrauterine growth retardation (IUGR), placental abruption, and other less probable complications of pregnancy and its outcome. ⋯ If the risk of thromboembolism in patients with mechanical heart valves is considered very high, and efficacy or safety of prophylaxis with UFH or LMWH is not satisfactory (older-generation prosthesis in the mitral position or history of thromboembolism), administration of vitamin K antagonists throughout pregnancy is recommended with replacement by UFH or LMWH close to delivery. It should be considered that limited effectiveness of UFH or LMWH in patients with mechanical heart valves might be due to inadequate dosing. The necessity of anticoagulation therapy in women with inherited or acquired thrombophilia is biologically plausible; nevertheless, optimum management in such cases remains unknown.
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More than 20 viruses have been reported to cause myopericarditis, a rare but potentially dangerous complication. To our best knowledge only a few dozen cases of myopericarditis caused by varicella zoster virus have been reported, most frequently in children, seldom in immunocompetent adults. We report on a case of a myopericarditis caused by varicella zoster virus in a previously healthy young man, with a typical development and a fast and complete recovery. ⋯ Due to its rarity there are no guidelines regarding therapy of varicella myocarditis, but there is a consensus that these patients should receive intensive care unit. The basis of the therapy are certainly the NSAIDs, but also a combination of acyclovir and hyperimmunoglobulins has been reported which in this mild case was not necessary. With this report we want to point out that varicella zoster virus can cause myopericarditis in immunocompetent adults, which must be taken into consideration in differential diagnosis, and that an early diagnosis and adequate therapy can help achieve a fast and complete recovery.
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Renal transplantation is a method of choice for treatment of patients with end-stage renal disease. Anemia may complicate post-transplantation course. It is a significant correctable risk factor for development of cardio-vascluar diseases. ⋯ Etiology of PTA is commonly multifactorial and includes graft function, immunosuppressive drugs, infections and renin-angiotensin system. Treatment of anemia in renal transplant recipients demands an individual approach, with searching for the etiology of anemia. According to the current knowledge, renal transplant recipients with anemia should be treated in the same way as other patients with chronic renal failure.