Medicinski pregled
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Review
[Prevention of multiple organ dysfunction syndrome in severely injured patients--current approach].
Multiple organ dysfunction syndrome (MODS) is frequent after trauma. Predisposing factors for MODS after trauma are: hypovolemic shock, massive volume replacement, time of resuscitation before hospitalization, systemic inflammatory response syndrome, infection, sepsis. Prevention of tissue hypoxia is a priority in prevention of MODS. ⋯ Tissue hypoxia and oxygen debt in injured patients are major factors which determine development of MODS. Prevention of MODS starts with respiratory and circulatory resuscitation and monitoring of tissue oxygenation prehospitally and hospitally. The first line therapy, "goal directed therapy" is not obligatory. Nutritional support, antibiotic therapy, analgesia, sedation and other therapeutic modalities contribute the ability of injured patients to survive and decrease the incidence of MODS.
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Case Reports
[Hereditary angioedema in organs of the head and neck as an indication for emergency tracheotomy].
Angioedema (angioneurotic edema) is often associated with urticaria, but edema is located deeper in the skin and mucous membranes. There are limited, painless, soft and medium hard swellings. Lack of general symptoms is evident, except if mucous membranes of the gastrointestinal system are affected and pain appears. It is particularly dangerous if located in the brain or larynx when there is a risk of suffocation. In 20% cases with laryngeal involvement intubation or tracheotomy is necessary. ⋯ In differential diagnosis of laryngeal edema, hereditary angioedema should be considered. Therapy of acute hereditary angioedema attacks should involve antihistamines, corticosteroids and adrenaline, as well as administration of fresh frozen plasma or infusion of C 1 inhibitor concentrate. Hereditary angioedema of the head and neck causing airway obstruction, is an indication for emergency tracheotomy.
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ETIOLOGY OF ONYCHOMYCOSES: Onychomycoses can be caused by dermatophytes, molds and yeasts. However, dermatophytes appear to be the chief organisms capable of a primary attack on the nail. By far the most frequent dermatophytes isolated from nails are Trichophyton rubrum, T. mentagrophytes var. interdigitale and Epidermophyton floccosum. ⋯ Histological examination is a routine technique useful for defining the nature and localization of fungi in the nail plate. Immunohistochemistry applied to onychomycosis is an experimental approach bringing prominent information about identification of fungi. In vivo confocal microscopy represents a technique of the future.
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This study uses bibliometric analysis to evaluate scientific biomedical literature published on the territory of Vojvodina and its impact on researchers in Yugoslavia and in the world. The study sample comprised 6.979 publications from the territory of Vojvodina published in the period 1986-1997. The following parameters were determined: productivity of authors and institutions where they were employed and some other bibliometric parameters. ⋯ Most of the cited references belong to a small number of authors. Thus, according to bibliometric criteria the impact of medical science and professional practice in Vojvodina on international scientific streems is negligible, as well as the impact of papers published in Vojvodina on researchers in the world. Only 0.4 works published in Vojvodina, 0.87% papers from journals published in Vojvodina and written by 0.59% authors were cited in SCI.
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There are three types of congenital diaphragmatic hernias (DH): posterolateral (Bochdalek) diaphragmatic hernia, subcostosternal (Morgagni's) hernia and esophageal hiatal hernia. The posterolateral (Bochdalek) diaphragmatic hernia is the result of a congenital diaphragmatic defect in the posterior costal part of the diaphragm in the region of 10th and 11th ribs, which allows free communication between the thoracic and abdominal cavity. The defect is usually found at the left side (90%) but may occur on the right side, where the liver often prevents detection. ⋯ The posterolateral right congenital DH is a rare diaphragmatic defect. The symptoms are noncharacteristic and patients with this disease can be without symptoms for a long period. The main tool for diagnosis of congenital DH is radiography, whereas treatment is surgical.