Medicinski pregled
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Since the outcome in septic patients can significantly be improved if the appropriate therapy is introduced timely early, the early diagnosis of sepsis and its complications is essential. The aim of this study was to compare mean values of the initial blood concentrations of lactate, C-reactive protein and creatinine and the severity of illness and the outcome of sepsis. ⋯ Our results suggest that lactate level is a better parameter of illness severity and outcome of sepsis than levels of C-reactive protein and creatinine. When compared to the above parameters, the septic score determined on the day of admission to hospital is a much better criterion to classify patients into groups with different severity of sepsis, with and without multiple organ dysfunction syndrome and into survivors and non-survivors.
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Chest sonography was used until recently mainly for diagnosis of pleural diseases. High resolution ultrasound machines enable ultrasound application not only in pleural diseases detection, but in diagnosing peripheral lung and mediastinal lesions. Ultrasonography can define the origin and structure of the lesion of thoracic wall, pleural and peripheral lung lesions and mediastinal lesions. ⋯ Ultrasonography is a very useful second line method in diagnosis of chest disease. The advantages of this method include bed, side availability, absence of radiation, and guided aspiration of fluid-filled areas and solid tumors.
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Review
[Takotsubo cardiomyopathy: report of the first case series in Serbia and review of the literature].
Takotsubo cardiomyopathy is a relatively novel cardiac syndrome that is characterized by transient left ventricular asynergy involving apical and mid-ventricular segments. ⋯ Complete recovery usually occurs after dramatic presentation, frequently complicated with acute heart failure. Therapy is empiric and directed towards supportive measures against cardiogenic shock, acute heart failure, dysrhythmias. In-hospital mortality rate is less than 1%, but long-term prognosis is still unknown. In addition to the review of the literature on takotsubo cardiomyopathy, we present the first series of patients with this syndrome detected in Clinical Hospital Center Zemun.
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Thin rubber gloves were used for the first time in the history of medicine at the end of 1889. On the occasion of the 120th anniversary of that event at the end of 2009, the great importance of that discovery for the development of surgery in general should be emphasized once again. The surgical gloves were invented and introduced by a famous American surgeon Dr. William Halsted from Johs Hopkins Hospital in Baltimore (USA). DR. WILLIAM HALSTED AND MISS CAROLINE HAMPTON: This significant innovation actually occured thanks to the romance between Dr. W. Halsted and his scrub nurse Miss Caroline Hampton, later his wife, Mrs C. Halsted. According to the antiseptic practice of that hospital the hands of the operating personnel had to be desinfected in mercuric chloride which damaged the skin of nurse Caroline who developed a bad case of dermatitis, and because of that she considered abandoning the hospital. This prompted Dr. Halsted to contract Goodyear Rubber Company to produce thin rubber gloves to protect Caroline's hands and to keep her in his vicinity. They proved to be very satisfactory and soon Dr. Halsted's assistants too began to wear sterilized rubber gloves routinely. ⋯ Although it was not until later that the importance of rubber gloves in preventing infection was realized these "gloves of love" soon entered into general surgical practice and proved to be of the greatest importance for the development of asepsis and aseptic surgical work.
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Nongonococcal urethritis is the most common sexually transmitted infection in men, with vast majority of the etiological agents such as Chlamydia trachomatis, followed by urogenital mycoplasmas. The aim of this study was to determine the prevalence of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis in nongonococcal urethritis in men, and to examine infections associated with these agents. Material and methods 299 sexually active, heterosexual men with nongonococcal urethritis were included into the study. Urethral samples were taken with a dacron swab placed into the urethra up to 2-3 cm. The Direct immunofluorescence technique was performed for identification of Chlamydia trachomatis. Ureaplasma urealyticum and Mycoplasma hominis were detected with Mycoplasma IST assay. ⋯ These results confirmed the etiological role of Chlamydia trachomatis and urogenital mycoplasmas in nongonococcal urethritis with prevalence of 51.85% in monoinfections and 11.70% in associated infections. In 36.45% of cases the etiology of urethritis was not elucidated. These results suggest that more sensitive diagnostic tool should be applied when searching for the derailed etiology of nongonococcal urethritis.