Lijec̆nic̆ki vjesnik
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Lijec̆nic̆ki vjesnik · Aug 1997
Editorial[What we can learn from refusal of transfusion therapy from experience with Jehovah's Witnesses].
Patients who refuse blood transfusion for personal or religious reasons present complex medical, legal and moral problems. Blood transfusion has been doctrinally forbidden for Jehovah's Witnesses since 1945. Their refusal is based on the strict interpretation of several Biblical passages. ⋯ There are no clear guidelines which physicians can follow in deciding to treat or not treat in the presence of a patient's refusal. However, most authors agree that a competent adult has an absolute right to decline medical treatment, and that it is not morally or ethically correct to force patient to an unwanted treatment. We wished to present the experiences with the use of alternative methods in the treatment of Jehovah's Witnesses and to discuss ethical and legal aspects of treatment decisions in the presence of blood transfusion refusal.
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Lijec̆nic̆ki vjesnik · May 1997
Case Reports[Treatment of malignant bile duct obstruction with a metal stent. Case report].
In the case report we describe endoscopic implantation of endoprosthesis in the periampullar area in a 87 year old female patient with obstructive jaundice and cholangitis caused by pancreatic tumour. This is the first time that this procedure was successfully performed in Croatia.
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Lijec̆nic̆ki vjesnik · Mar 1997
[Pulse oximetry and capnometry in the prevention of perioperative morbidity and mortality].
Oxygen saturation (SaO2) and end tidal CO2 determined by pulse oximetry and capnometry were monitored in 2440 surgical patients during elective head and neck, abdominal, traumatologic and orthopedic surgery. The incidence, severity and duration of hypoxemia and hypercarbia were studied as well as their causes. Equipment disconnections alarmed by capnometry were noted separately. ⋯ Capnometer alarmed disconnections before the signs of hypoxemia and hypercarbia occurred. No morbidity was documented in any patients who suffered an hypoxemia event. Pulse oximetry and capnometry enable early detection and removal of the majority of the ventilation mishaps before damage or even death occur.
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Lijec̆nic̆ki vjesnik · May 1996
[Comparison of auscultation findings using a classic stethoscope (Litmann 2120) and electronically amplified stethoscope (Medmax2)].
Heart auscultation has one of the key roles in beside diagnosis, especially in patients with cardiovascular diseases. Sometimes, because of the human cars' low sensitivity, a problem emerges in the proper evaluation of heart sounds and murmurs of lower frequencies. ⋯ Significantly better detection of low frequency sounds was found in favour of electronic stethoscope (chi 2 = 17.9; p < 0.0001). It is concluded that the selective amplificator improves the stethoscope performance and has its place in everyday bedside practice, especially in departments of cardiology.
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Lijec̆nic̆ki vjesnik · Jun 1995
[Causes of disorders of consciousness in internal medicine intensive care units].
The present study on 5330 patients admitted to the internal intensive care unit over the five year period (1990-1994) indicated that consciousness disorders are most frequently associated with poisoning. On admission, the state of consciousness of 665 of these 5330 patients was retrospectively evaluated. Poisoning by drugs was most common among intoxications (93 patients of 154 cases of poisoning). ⋯ Glycemia disorders, including hypoglycemia, hyperglycemia as well as hyperosmotic state, did not result in lethal outcome, regardless of GCS on admission. The highest death rate was registered in patients with cardiopulmonary arrest and lowest GCS on admission. Patients with cardiogenic shock, despite high GCS on admission, had high death rate.