Medicinski pregled
-
Multicenter Study Meta Analysis
[The use of erythropoietin beta, two to three times per week, once per week and once every other week: meta-analysis of two clinical trials].
Renal anemia is a very common finding in patients with chronic kidney disease (CKD), both in patients not yet requiring dialysis and in patients on hemodialysis. Erythropoietin therapy is a gold standard in the treatment of renal anemia for more than 15 years. The aim of this meta-analysis was to assess the efficacy of different regimes of Recormon (erythropoietin beta, F. Hoffmann-La Roche) in maintaining stable levels of hemoglobin (Hb) and hematocrit (HCT) in patients receiving hemodialysis. ⋯ All three dose regimens of subcutaneous epo beta were statistically equivalent in maintaining the target Hb and HCT levels. The use of epo once weekly or once every other week was not associated with dose increase, proving that optimization of treatment for every patient is possible in everyday clinical practice. The possibility of using 3 different dose regimes of epo beta, without compromising efficacy or increasing costs of treatment may be beneficial in the quest for better patient compliance.
-
Febrile episodes of unknown origin lasting for two weeks require detailed investigation by various medical specialists. Fever of unknown origin is most commonly caused by infections, malignancy, colagenosis and in 5-10% of cases, despite detailed diagnostic assessmnet, the cause remains unknown. In cases of fever of unknown origin, the diagnostic procedures are difficult and complex. ⋯ Despite the fact that the diagnostic investigations of patients with fever of unknown origin are complex and time consuming, detection of the cause is of utmost importance and it is a prerequisite for successful therapy.
-
Accurate evaluation and correct treatment of neonates for possible sepsis still represent the most challenging clinical tasks. Early diagnosis of neonatal sepsis is largely based on the measurement of serum concentrations of different mediators of systemic inflammation, as well as, on a group of proteins named acute phase reactants. Among acute phase reactants, C-reactive protein (CRP) has been the most extensively used and investigated so far. ⋯ In conclusion, we point to the diagnostic accuracy of serial measurements of serum CRP levels. As an alternative, simultaneous measurement of CRP and serum levels using a faster marker, such as procalcitonin, is recommended.
-
It has been established that infrainguinal occlusive disease, type III peripheral obliterative arterial disease (POAD), is more common in diabetics than in non-diabetics. It is presumeable that after surgical treatment of this arterial segment diabetics develop more complications and higher mortality rate than non-diabetics. The aim of this study was to analyze the results of reconstructive surgical treatment of diabetic and non-diabetic patients with type III PAOD. ⋯ Diabetic patients presented with significantly more trophic lesions (IVa stage). The overall complication rate was significantly higher in diabetics, as well as the amputation rate. Finally, the mortality rate was also significantly higher in diabetics than in nondiabetic patients.