Medicinski pregled
-
The aim of the study was to find out the values of the Alvarado score in diagnosis of acute appendicitis and its clinical applicability in our conditions. ⋯ In diagnosis of acute appendicitis Alvarado score has a high diagnostic value (82.7%). Alvarado score is a noninvasive, safe diagnostic procedure, which is simple, fast, reliable and repeatable, it can be used in all conditions, without expensive and complicated supportive diagnostic methods. Alvarado score increases the diagnostic certainty of clinical examination in diagnosis of acute appendicitis.
-
Case Reports
[The superior vena cava syndrome as a manifestation of dissection of the ascending aorta].
Most clinical manifestations of aortic dissection are due to complications of either ischemic origin or wall rupture of pleural, pericardial, peritoneal or mediastinal cavity. Compression of other blood vessels such as pulmonary artery or superior vena cava is possible, but rarely occurs. ⋯ Superior vena cava syndrome is a rare and slightly known clinical manifestation of ascending aortic dissection. If symptoms rapidly occur, dissection should be considered, particularly in previously surgically treated patients.
-
Review
[Erythropoietin-beta in the treatment of anemia in patients with chronic renal insufficiency].
Anemia is an early sign of chronic renal failure (CRF). Although multifactorial in origin, insufficient erythropoietin (EPO) synthesis is one of the most important factors. Other causes are: decreased erythrocyte survival (from 120 days to 70-80 days), chronic blood loss (mainly gastrointestinal and gynecological), inhibitors of erythropoiesis, inflammatory cytokines (IL-1, TNF-alpha, IFN-gamma) and malnutrition (folic acid, L-carnitine and vitamin B12 deficiency). Chronic blood loss may cause iron deficiency in about 25% of patients. Correlation between EPO level and glomerular filtration rate (GFR) is well preserved, but negative feed-back loop between hemoglobin and EPO is disturbed in patients with CRF. ⋯ The reasons for inadequate erythropoietin response are unrecognized bleeding, iron deficiency and infection/inflammation. Adverse events are very rare and predictable; they can be avoided with careful dosage and follow-up of patients. In conclusion, EPO-therapy is well established and efficient for renal anemia in dialysis and pre-dialysis patients.
-
Acute postoperative pain and its therapy is a great challenge for all health-care providers in operative medicine today. Despite development of new analgesic drugs and different therapeutic modalities in pain treatment, acute postoperative pain represents a negative experience for many surgical patients. ⋯ Anesthesiologists have a central role in perioperative treatment of surgical patients (from the preoperative preparation through anesthesia and intraoperative monitoring to postoperative treatment and monitoring at the department of the intensive care and at the department of postanesthetic care). Due to abovementioned and familiarity with many therapeutic modalities, like spinal/epidural application of analgesics, regional anesthesia/analgesia many clinicians and pain specialists consider anesthesiologists are those who can organize and supervise teams for acute postoperative pain services.
-
Non-Q myocardial infarction is only one of the possible clinical manifestations of acute coronary syndromes. Acute coronary syndrome is the most frequent cause of hospitalization in everyday cardiological practice. ⋯ Both incidence of unstable angina and non-Q myocardial infarction, as manifestations of acute coronary syndromes, and incidence of newly formed ST elevation, which is one of the forms of initial ECG changes in non-Q myocardial infarction, are significantly lower than those found in literature.