Lijec̆nic̆ki vjesnik
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Lijec̆nic̆ki vjesnik · Sep 2000
Editorial[Continuing medical education in Croatia and the European Union].
The Continuing Medical Education (CME), with attention to other forms of Continuing Professional Development (CPD) in Croatia and the today endeavors in the European Union, are presented. In European Union the formal CME is in its starting. The "European Accreditation Council for Continuing Medical Education" (EACCME) of the UEMS is established, which has formulated the principles of continuing education, the credit hours and their realizing, that would enable the mutual recognition of education in all European countries. ⋯ The number of CME meetings during 1998 is presented. The approximate calculation for needed annual courses of CME for all medical specialties in Croatia is presented. The formation of the National Authority for CME is suggested, in which all the interested institutions should be represented.
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Lijec̆nic̆ki vjesnik · Jul 2000
Randomized Controlled Trial Clinical Trial[Effect of the menstrual cycle and ondansetron on postoperative nausea and vomiting].
The incidence of postoperative nausea and vomiting (PONV) has been studied in a prospective group of 92 female patients in the generative period, undergoing thyroid surgery. In a subgroup of 47 examinees we analyzed PONV incidence according to the surgery time within the frame of their menstrual cycle. The highest number was observed in periovulatory and premenstrual periods (p < 0.02). In the formal trial, 24 patients that randomly received ondansetron (8 mg in 4 mL i.v.) and significantly less PONV than their 21 placebo controls (4 mL saline i.v.): 4 or 16.8% vs. 11 or 53.6% (p < 0.04).
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Lijec̆nic̆ki vjesnik · Jan 2000
Historical Article[Ether and chloroform narcosis in the pages of Zagreb newspapers from 1847 to 1849].
Overviews of the development of anesthesiology in Croatia always emphasize that the first report on the employment of ether anesthesia was published on March 13, 1847, in the Zadar newspaper Gazzeta di Zara. In the world as well, daily newspapers played an important part in spreading the news about the discovery and first use of ether anesthesia. This fact stimulated us to do a systematic search through Zagreb press of that time. ⋯ Regarding total number of texts dedicated to the topic of painless surgery, culmination was reached in 1847, and afterwards the interest of press in this field decreased. In the period from 1847 to the beginning of 1849, not one article was followed by subsequent comments of Croatian readers, either lay people or medical practitioners. Texts were not written sensationally, but with the aim to objectively inform the public by communicating experience and attitudes of contemporary reputable surgeons, including all professional details which might be useful for potential users--patients, as well as for Croatian physicians, surgeons, obstetricians, dentists and veterinarians.
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Lijec̆nic̆ki vjesnik · Nov 1999
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison between the rubber Carlens tube and the polyvinylchloride Robertshaw tube for endobronchial intubation].
The aims of the study were to compare prospectively two double-lumen endobronchial tubes (DLTs): red rubber Carlens and left polyvinylchloride Robertshaw DLT with regard to difficulties in intubation and complications during one-lung ventilation. Sixty-two adult patients were randomly intubated with Carlens tube (31 patients) or Robertshaw tube (31 patients). Correct placement of DLTs was assessed using clinical signs and in some patients in the Robertshaw group fiberoptic bronchoscope was used. ⋯ In both groups hypoxemia was related to the right side of the operation. Fiberoptic bronchoscope was used in 18 out of 31 patients intubated with the Robertshaw tube. Its use was not correlated with decreased incidence of complications compared to intubation in which tube position was assessed by clinical signs only.
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Lijec̆nic̆ki vjesnik · Jul 1999
Review[Development of beta-lactam antibiotic resistance in gram-negative bacteria and the impact of resistance on therapy].
Bacterial resistance to antibiotic is the inevitable consequence of the utilization of antimicrobial agents all over the world, particularly in developed countries. It is particularly evident with beta-lactam agents because they are among most frequently prescribed drugs. The resistance is mainly attributable to production of various types of beta-lactamases but other mechanisms like alterations in PBP molecules or in outer membrane proteins can play a significant role. ⋯ Recently, the emergence of E. coli strain resistant to combination of amoxycillin and clavulanate, due to hyperproduction of TEM-1 beta-lactamase, was observed. Inducible beta-lactamases mediate beta-lactam resistance in Pseudomonas aeruginosa which often develops during therapy of P. aeruginosa infections. Imipenem resistance is increasingly prevalent among P. aeruginosa isolates nowadays, but can be detected in K. pneumoniae due to the production of novel beta-lactamases and changes in outer membrane proteins.