Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za biološki i medicinski nauki = Contributions / Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences
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(Full text is available at http://www.manu.edu.mk/prilozi). Patients with chronic obstructive pulmonary disease (COPD) are characterized by an impaired lung function and limited exercise tolerance. Medication and rehabilitation programmes are generally directed towards relief of symptoms and improvement of lung function and exercise tolerance. 130 patients were included in the examination with diagnosed chronic obstructtive pulmonary disease, stable form, 114 male and 16 female, of whom 121 were smokers and 9 were non-smokers. ⋯ Patients with malnutrition (BMI < 21kg/m2) have lower values of FEV1, and they have higher SGRQ scores of quality of life. High levels of SGRQ scores are associated with lower values of FEV1. Key words: COPD, therapy, quality of life, forced expiratory volume in one second, body mass index.
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(Full text is available at http://www.manu.edu.mk/prilozi). Introduction. Blood group antigens as integrated parts of the red cell membrane have many essential functions for the cell as well as for the organism, but they are recognized as unique antigens for the purpose of safe blood transfusion. ⋯ Extended blood typing should be implemented for some categories of polytransfused patients as well. This strategy is another step forward to improve the safety of blood transfusion with optimal blood grouping. Key words: Kell phenotypes frequency, alloimmunization, blood grouping, safe transfusion.
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The optimal time for lumbar discectomy due to sciatica is still under discussion. We examined a group of 177 consecutive patients with lumbar disc herniation, who underwent lumbar discectomy. According to the duration of the sciatica, patients were divided into 3 groups: 31 (17.5%) patient with a duration of sciatica from 0 to 3 months, 82 (46.3%) patients with a duration from 4 to 10 months, and 64 (36.2%) with a duration longer than 10 months. ⋯ There was also a significant difference between the patients operated on in the period from 4-10 months and those operated > 10 months (p < 0.001). This goes in favour of achieving the best results in patients with a duration of sciatica from 0 to 3 months. The worst results were obtained in those with a duration of sciatica > 10 months.
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Acute kidney injury (AKI) is encountered in a variety of settings (e.g., hospitalized and outpatient, non-intensive and intensive care unit patients, pediatric, adult, and elderly), with varied clinical manifestations ranging from a minimal elevation of serum creatinine (SCr) to anuric renal failure and/or multi organ failure (MOF), and a wide variation in causes, risk factors and comorbiditis. There is no hard and fast rule as to when renal replacement therapy (RRT) should be initiated, but is clearly not sensible to wait until an obvious uremic complication arises. Modern practice is to initiate RRT sooner rather than later, for example, when the SCr concentration reaches 500-700 micromol/L, perhaps even earlier, unless there is clear evidence that renal function is about to recover. ⋯ Hybrid therapies using a variety of machines are safe and convenient, providing excellent control of electrolytes and fluid balance, and offers several advantages over CRRT, including less cumbersome technique, patient mobility, and decreased requirements for anticoagulation, while providing similar hemodynamic stability and volume control. Currently, it has been found no difference in mortality or renal recovery between hybrid RRT, CRRT or IHD for critically ill patients with AKI. However, future investigations should collect detailed information on long-term costs and the relative likelihood of renal recovery associated with dialysis modality.
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In the day-to-day practice of answering questions from the area of medicine today, there is a growing need for forensic medical expertise in bodily injuries in criminal procedure. Furthermore, when qualifying a bodily injury, the expert must possess knowledge and experience not only medical, but s/he must also be aware of the legal requirements and norms of the Code of Criminal Procedure and the Criminal Code of R. Macedonia. ⋯ The aim of this paper is to outline the method of performing this forensic medical expertise, i.e. by whom and when can expertise in bodily injuries be sought and, moreover, what is the legal and ethical responsibility of the expert during the execution of the expertise. Additionally, the steps that the expert should follow when preparing a written statement and opinion on the type of the bodily injury are explained. More specifically, emphasis is placed on the expert's requirements after examination of the injured individual; after revision of the medical documentation during expert assessment of bodily injuries in the case of criminal subjects; and providing oral statements and opinions during the criminal procedure.