Medicinski pregled
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Fibromyalgia (FM) is a chronic pain condition with spontaneous, chronic, widespread musculoskeletal pain and tenderness accompanied by a number of nonspecific symptoms. The low prevalence of FM is considered an underestimation and results from insufficient knowledge about FM In order to increase the general awareness of the unique nature of pain in fibromyalgia and the right of patients to receive specific attention, EFIC (European Federation of the IASP Chapters) launched the European campaign against pain in fibromyalgia. ⋯ According, to multiple pathophysiological mechanisms, the treatment involves multidisciplinary and multimodal approach, including a combination of pharmacological and non-pharmacological interventions based on EULAR (European League Against Rheumatism) recommendations from 2007. Pharmacological treatment (antidepressants, anticonvulsants and conventional analgesics) is directed toward the control of pain and other symptoms, but nonpharmacological management (aerobic exercise, strength training and cognitive behavioural therapy) is directed to functional consequences of the symptoms. Although the treatment rarely relieves the symptoms completely the active role of an educated FM patient and supportive surrounding are secondary necessary to provide beneficial clinical effects on this complex painful condition.
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A patent foramen ovale has been reported to be more frequently detected in cryptogenic stroke, with paradoxical embolism as the major pathogenetic mechanism. The standard procedure for the detection of a patent foramen ovale is transesophageal echocardiography. Transcranial Doppler sonography with bubble test is almost as reliable as transesophageal echocardiography. ⋯ Both positive and negative predictive values in our group of patients were 1. Transcranial Doppler with bubble test is a reliable method for the detection of a patent foramen ovale, with a high level of sensitivity and specificity which is comparable with transesophageal echocardiography. Moreover, it is cheaper and more comfortable than transesophageal echocardiography, and should be used routinely in neurological practice.
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Biography Historical Article
[Laza K. Lazarević--doctor, lawyer, writer and warrior in three wars].
Laza K. Lazarevic was born on the 13th of May, 1851 in Sabac. He died on the 11th of January, 1891 in Belgrade. Laza K. Lazarevic was a Serb, lawyer, warrior, doctor and writer. He spoke Russian, German and French. Laza Lazarevic's road to the title of doctor of medicine. He studied law in Belgrade and graduated in 1871 and he graduated from the Faculty of Medicine in Berlin on the 28th of January, 1879. He took his doctor's degree in Berlin on the 8th of March, 1879 at the same Faculty. His road to the title of doctor of medicine was thorny and complicated. LAZA K. LAZAREVIC AS A WARRIOR: He took part in the Serbian-Turkish war and the Serbian-Bulgarian war. During the Serbian-Bulgarian War (1885) he was first given the rank of reserve medical major and later the rank of active medical colonel and then he was appointed assistant chief of the Supreme Command of Health Care with the task to establish the Great reserve military hospital in Nis. PROFESSIONAL AND SCIENTIFIC WORK OF DR. LAZA K. LAZAREVIC: He had seventy two professional and scientific medical papers published, a great number of which referring to nervous diseases, such as paralysis agitans, sclerosis of medulla spinalis, aphasia and others. Therefore, it can be rightly said that Dr. Laza K. Lazarevic was the first Serbian neurologist. The very first operation of cataract in Serbia was performed by Dr. Laza K. Lazarevic in aseptic conditions, when cocaine was applied for anesthesia. He was the first doctor to be sent by the Ministry of Internal Affairs to Vienna in 1884 to learn how to prepare animal lymph. In 1879 he was appointed the physician of the Belgrade District and in 1881 he was promoted to the position of head doctor and Chief of Internal Department of the General State Hospital in Belgrade. He was the personal doctor of King Milan Obrenovic. LAZA K. LAZAREVIC AS A WRITER: Laza Lazarevic is considered to be the originator of psychological stories in Serbian realistic literature and had nine stories published, while eight remained unfinished. ⋯ Thanks to his intelligence, hard work, determination and persistence and the financial help of Serbia Medical Colonel Dr Laza K. Lazarevic gained the best of knowledge across Europe, having studied at the most prestigious school in Europe - the fact that can be admired and envied even today.
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Having in mind the rate of occurrence and clinical importance, venous thromboembolism implies venous thrombosis and pulmonary embolism as a result of embolisation of the thrombotic particles from deep veins or pelvic veins. Venous thrombosis of the deep veins may result in chronic vein insufficiency, but the primary medical problem is the possibility of development of pulmonary embolism which may cause permanent respiratory function damage or even fatal outcome. ⋯ Venous thromboembolism prevention in stroke patients is necessary because of a greater risk for venous thromboembolism in these patients according to the nature of illness and functional disability, but also a problem because of limited possibility to recommend the proper medicament according to the risk of serious complications. The necessity of preventing venous thromboembolism and estimation of effectivity-risk ratio in stroke patients, beside plenty of studies and consensus conferences, remain individual and often very difficult.
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Case Reports
Laryngeal mask airway as the only choice for primary airway control in newborn with tracheal stenosis.
Congenital tracheal stenosis is a rare disorder characterized by the presence of focal or diffuse complete tracheal cartilage rings, resulting in afixed tracheal narrowing. The prognosis for this disorder is currently assumed to be poor, with some sources stating that the natural outcome of this problem is inevitably fatal. Tracheal stenosis requires a tracheostomy at delivery for the infant to survive before the definitive reconstruction. ⋯ In this case the laryngeal mask airway was a life saving device for the airway control in the period before tracheostomy was done. Tracheostomy was made in first few hours after birth. In severe tracheal stenosis the laryngeal mask airway can be a device of choice for the initial control of the airway.