Lijec̆nic̆ki vjesnik
-
Bronchiolitis obliterans organizing pneumonia (BOOP) is increasingly recognized in "Jordanovac" Clinical hospital for lung diseases. The characteristic pathohistologic finding is the granulated tissue plugs within the lumen of small airways which extend into the alveolar ducts and alveoli. Numerous conditions and diseases show such histologic picture but the clinician by means of clinical, radiologic and laboratory findings establishes the final diagnosis. ⋯ Corticosteroid therapy causes the complete disappearance of pulmonary infiltrates in 65% to 85% of cases but relapses are common. The therapy of secondary BOOP is less efficient. The aim of this review is to acquaint the readers with the BOOP so it could be incorporated in the differential diagnosis of febrile noninfective diseases that resemble pneumonia.
-
Acute renal failure (ARF) is a common clinical condition with significant mortality. Although intermittent hemodialysis (IHD) represents a standard method of renal replacement therapy in ARF, novel methods of continuous renal replacement therapy (CRRT) are becoming more important. ⋯ Methods of CRRT differ with respect to the predominant way of solute removal, utilizing convective clearance (continuous ultrafiltration and hemofiltration), diffusive clearance (continuous hemodialysis), or a combination of the both (continuous hemodiafiltration). Based on their properties, CRRT represent method of choice in the treatment of hemodynamically unstable patients with ARF.
-
This article is a review of acute postoperative pain pathogenesis and treatment options. It is aimed at clinicians involved in postoperative pain management, for better understanding of the pain treatment strategy. Every procedure of antinociception should include modulation of different target points, because acute pain mechanisms and origins are different. ⋯ We should choose analgesics with two or more intervention levels simultaneously as well as combination of analgesics with different target points. Optimal analgesia with spinal opioids is achieved thanks to addition of supraspinal and peripheral analgesia components. It is considered that optimal acute pain treatment could prevent nerve system dysfunction and evolution of chronic pain syndromE, which is present in some of postoperative patients.
-
Lijec̆nic̆ki vjesnik · Nov 2000
Historical Article[Committee for Human Rights and Medical Ethics of the Croatian Medical Association].
The historical development of ethical standards and institutions of Croatian Medical Association is presented. The first standards were "Medical order and Community" in 1895 and the ethical codex under the name "Main principles of Medical dignity" in 1901 resp. 1921. According to the new Association's Statute in 1990 the first "Committee on Human Rights and Medical Ethics" was founded. ⋯ Since 1999 the Croatian Medical Chamber divorced the cooperation with Croatian Medical Association and founded his own Committee. The Croatian Medical Association is now without ethical committee. The establishment of a new, common Committee of the Medical Association, Medical Chamber and Universities is suggested.
-
Lijec̆nic̆ki vjesnik · Nov 2000
[Drug therapy of hemorrhage in esophageal and gastric varices: role of vasoactive drugs].
Esophageal and gastric variceal bleeding is one of the most severe complications of portal hypertension and with high mortality. The aim of the therapy is to stop bleeding, replace the lost amount of blood and erythrocytes, treat coagulopathy, prevent rebleeding and improve liver function. Commonly accepted method to stop bleeding from varices is endoscopic hemostasis. ⋯ Octreotide is very efficient in long-term therapy of endocrine tumors due to its longer half-life, better hormone inhibition, and simple application compared to somatostatin. Like somatostatin, it can also control variceal bleeding. It appears that the long-term subcutaneous octreotide application prevents rebleeding and improves liver function, all of which yields a new dimension to its use.