Acta medica Croatica : c̆asopis Hravatske akademije medicinskih znanosti
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The final goal of palliative care is symptom relief and improving the quality of life. Around 70% of cencer patients suffer pain. Therapy and care provided for dying cancer patients by general practitioners at Dugave-Travno GP Office were investigated. ⋯ Study results showed a high rate of associated diseases and diseases related to malignant disease in cancer patients. The collaboration between general practitioners and family members was satisfactory. Community health services should be improved, and the World Health Organization guidelines on palliative care, management of malignant pain in particular, should be more thoroughly followed.
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The importance of sports dentistry has become even greater due to the role that sports have in modern society. As the risk of sports-related injuries appears already in the period of children's play and is constantly present in various risk-related sporting activities, the role of dental profession has become extremely important. Custom-made mouthguards are the most highly recommended mouthguards used for successful prevention of orofacial and dental injuries. ⋯ Only a half of the examined professional basketball players wore mouthguards, and none of the examined tae-kwon-do players. Clinical value of intraoral custom-made mouthguards was proven. Dentists play the key role in the prevention and treatment of sports-related dental and orofacial injuries, collection and dissemination of relevant information, as well as promotion of research on the preventive procedures related to injuries of such a specific aetiology.
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Case Reports
[Sepsis caused by Fusobacterium necrophorum (Lemierre syndrome): a rare complication of acute pharyngotonsilitis].
Lemierre syndrome is defined as an acute pharyngotonsillar infection that has spread into the lateral pharyngeal space causing thrombophlebitis of the internal jugular vein with consecutive metastatic emboli. The syndrome is most often caused by Fusobacterium (F.) necrophorum and usually involves young, previously healthy people. We present a healthy 20-year-old man who suddenly developed with high fever and sore throat followed by dyspnea, tachypnea and cough on the third day of illness. ⋯ F. necrophorum was isolated from blood culture. Swelling of the neck was also observed on the fourteenth day of illness, however, thrombophlebitis of the jugular vein was not diagnosed on ultrasound examination. The patient was treated with clindamycin for five weeks and recovered completely.
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Despite recent advances in surgical techniques and intensive care management, infectious complications and sepsis remain significant problem after abdominal surgery. Therefore, inflammatory parameters were looked for that could help achieve an early and more reliable diagnosis of postoperative infections. C-reactive protein (CRP) is a nonspecific inflammatory mediator which is significantly increased postoperatively, regardless of the type of operation and the presence or absence of complications. Procalcitonin (PCT), the prohormone of calcitonin, referred to as a marker of sepsis, is increased significantly in severe bacterial and fungal infections. Quantitative PCT measurements in surgical patients have shown that postoperative PCT concentrations depend on the type and extent of surgery. PCT increased most after major abdominal surgery, although PCT concentrations were significantly higher in patients with complications compared to patients with uneventful postoperative course. The aim of the study was to determine PCT concentrations with a rapid semiquantitative PCT-Q test in the early postoperative period after colon surgery and to investigate its potential use in the diagnosis of infectious complications compared to CRP. ⋯ In the early postoperative period after major abdominal surgery, CRP is invariably increased and cannot help in recognizing infectious complications. In our study, which included a relatively small number of patients after colon surgery, PCT >2 ng/mL, as measured with semiquantitative PCT-Q test on postoperative days 1-5, or >0.5 ng/ml after postoperative day 3, was rarely recorded in patients with normal postoperative course. We conclude that PCT-Q test can be helpful in the early diagnosis of infectious complications after abdominal surgery.
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Standardization of education process and almost every aspect of life in EU moved the authors of this paper to evaluate medical informatics education at medical schools in Bosnia and Herzegovina. A very complex political structure and existence of two entities, one district and ten cantons in the Federation of Bosnia and Herzegovina caused great differences in the curricula, teaching methods and quality of acquired knowledge among medical schools in the country. Also, on the example of the teaching process at the Medical School, University of Sarajevo, the authors propose a future united and integrated system in the area. ⋯ Medical informatics education at Medical School, University of Sarajevo, is based on the same concept as on prestigious universities all over the world and in accordance with recommendations of the working groups on education of EFMI and IMIA. Other medical schools in Bosnia and Herzegovina should employ the same methodology and system of work in order to have standardized education in medical informatics and to achieve high quality in education. To enable us to follow the European and global achievements in this area, the power of fact should predominate in the education system as well as in the health system.