Lijec̆nic̆ki vjesnik
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Lijec̆nic̆ki vjesnik · Jun 2007
Review[Cervicogenic headache: etiopathogenesis, characteristics, diagnosis, differential diagnosis and therapy].
The term "cervicogenic headache" (CH) implies a chronic hemicranial pain syndrome caused by upper cervical spine disorders. According to the clinical researches, in 15-20% of the patients with chronic unilateral headache, it is the case of the headache of cervical origin. The sources of the referred pain manifested as CH are the disorders of anatomical structures innervated by the first three cervical spinal nerves and/or direct irritation/lesion of these nerves (spinal nerves C1-C3, intervertebral/i.v. joints C0-C3, i.v. disc C2-C3 muscles, ligaments, bony structures, dura mater, vertebral arteries). ⋯ It seems that the best results are achieved by a combination of manual therapy, physical therapy and kinezitherapy. Although the CH has been included into International headache classification, this hemicranial pain syndrome has still been unknown to a wider circle of medical practicioners. That is why the purpose of this article is to describe etiopathogenesis, characteristics, diagnosis, differential diagnosis and therapy of CH.
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Lijec̆nic̆ki vjesnik · May 2007
[Specialty preferences among final-year medical students at Zagreb University Medical School].
The aim of this study was to investigate the sixth-year medical students' specialty preferences, at the Zagreb University Medical School. A total of 603 students were recruited during a three-year period (2003-2005), with a response rate of 83.3%. One third had a preferred specialty upon enrolment at the Medical School. ⋯ Students who were interested in internal medicine reported the best academic performance, while those who were interested in the family medicine (general practice) reported the poorest academic performance. The study indicates that family medicine, anaesthesiology, and radiology were the least commonly reported as specialties of the students' choice, compared to percentage of specialists employed in Croatian health care service. The most wanted specialties were ear-nose-throat and orthopaedics.
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Spontaneous aortocaval fistula is a rare complication of abdominal aortic aneurysm rupture. A definitive preoperative diagnosis sometimes is difficult, because ofnonspecific and highly variable clinical symptoms. Classic signs such as low back pain, palpable pulsatile abdominal mass, abdominal bruit and thrill, dyspnea and high-output cardiac failure are present in less than 50% of cases. In this article we report the case of a 68-year-old patient with an aortocaval fistula who was admitted in hospital because of abdominal pain and hematuria.
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Lijec̆nic̆ki vjesnik · Jan 2007
Review[Vertebrogenic chest pain--"pseudoangina pectoris": etiopathogenesis, clinical manifestations, diagnosis, differential diagnosis and therapy].
Vertebrogenic pain localised in the anterior thorax can imitate anginal pain ("pseudoangina pectoris"). The most common causes of vertebrogenic chest pain are segmental dysfunction and degenerative changes at the level of the lower cervical and upper middle thoracic spine. Segmental dysfunction is a source of pseudoradicular pain, and degenerative changes, before all disc hernia and dorsal osteophytes which are compressing corresponding nerve roots, are the sources of radicular pain which irradiates in the chest. ⋯ From therapeutic aspect it is very important to distinguish vertebrogenic from anginal pain. That is, the change of cardiological therapy will not eliminate possible attacks of vertebrogenic pain in patients with angina pectoris. From the aspect of most recent understandings, the article describes etiopathogenesis, characteristics, diagnosis and therapy of vertebrogenic chest pain, and also the differences between vertebrogenic and anginal pain.
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Good organization and coordination of emergency services are one of the most crucial factors, which influences the number of survivors and severity of incident overall health and structural long-term damages. Different studies showed that poor leadership is the main cause for poor intervention results at mass casualty incidents. This article briefly presents French, American, and English incident command systems at mass casualty incident and other crisis. If the incident command want to achieve the best intervention results then they, independently from command level and formal system, should establish a proper level of flexibility, controllable span of command, use of common terminology, effective use and accountability of resources, integrated and available telecommunications with profound exchange of information and intelligence.