Lijec̆nic̆ki vjesnik
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Lijec̆nic̆ki vjesnik · Jan 2013
Review[Piriformis muscle syndrome: etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis and therapy].
The term 'piriformis syndrome' (PS), introduced by Robinson in 1947, implies a group of signs and symptoms caused by piriformis muscle (PM) disorders. Since PM disorders lead to irritation/compression of the anatomic structures passing under its belly, the main clinical PS signs and symptoms are actually the clinical signs and symptoms of irritation/ compression of neural and vascular structures passing through the infrapiriform foramen: sciatic nerve/SN, inferior gluteal nerve, posterior femoral cutaneous nerve, pudendal nerve, inferior gluteal artery and vein and inferior pudendal artery and vein. The clinical picture is usually dominated by signs and symptoms of irritation/compression of SN (SN irritation --> low back and buttock pain, sciatica,paresthesias in distribution of SN; SN compression --> low back and buttock pain,sciatica, paresthesias and neurologic deficit in distribution of SN). ⋯ In 5-6% of patients with low back pain and/or unilateral sciatica, the pain is caused by PM disorders. PS diagnosis can be made on the basis of anamnesis, clinical picture, clinical examination, EMNG, perisciatic anesthetic block of PM and radiological exams (pelvis/PM MRI; MR neurography of LS plexus and SN). PS therapy includes medicamentous therapy, physical therapy, kynesitherapy, acupuncture, therapeutic perisciatic blocks, botulinum toxin injections and surgical treatment (tenotomy of PM, neurolysis of SN).
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Lijec̆nic̆ki vjesnik · Jan 2013
Comparative StudyTreating acute kidney injury using continuous and intermittent renal replacement therapy.
Acute kidney injury (AKI) is the sudden kidney excretory function loss. Patient data of patients hospitalized on intensive care unit from 2009 to 2011 and had to undergo one sort of renal replacement therapy (RRT)--continuous or intermittent--was used. 63 patients were in this study, 46 on continuous RRT (CRRT) and 17 on intermittent RRT (IRRT). ⋯ Results have shown that mortality rate was higher at patients on CRRT. However, these patients were haemodynamically unstable compared to patients on IRRT.