Collegium antropologicum
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Sacral perineurial (Tarlov) cysts are rare lesions. Over a seven year period 4000 patients underwent surgery for lumbar disk herniation. In three patients neurological symptoms were caused by large sacral perineurial cysts. ⋯ In case of large (> or = 1.5 cm) and symptomatic perineurial cyst, as in three patients reported in this article, microsurgical treatment was successful. Although rare, perineurial (Tarlov) cysts must be taken into consideration when approaching to patient with low back and radicular pain. Authors review the medical literature, pathological and pathophysiological features and treatment options of sacral perineurial cysts.
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Collegium antropologicum · Dec 2009
Case ReportsLife threatening complications after unsuccessful attempt of the guidewire dilating forceps tracheostomy in multi-trauma patient with cervical spine injury.
Percutaneous tracheostomy (PCT) is a safe method under proper patient selection, increased technical experience and bronchoscopy- or ultrasound-guided procedure. Trauma patients with cervical spine fractures and spinal cord injury are at a high risk for respiratory failure and require a definitive airway followed by prolonged mechanical ventilation. We would like to present multiple, life- threatening complications after unsuccessful attempt of the guidewire dilating forceps tracheostomy (GWDF) in one trauma patient with a cervical spine injury. With this case report we would like to lay emphasis on the importance of continuously bronchoscopy- or ultrasound-guided PTC in trauma patients, especially with cervical spine injury, as the need to respect the steep-learning curve in its performance.
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Collegium antropologicum · Dec 2009
Depression and anxiety in patients on chronic hemodialysis in University Clinical Hospital Mostar.
Depression and anxiety are prevailing mental problem in patients on chronic hemodialysis and they have great influence on outcome of illness. Additionally, these disorders are rarely identified in that population of patients and they are insufficiently treated. The aim of this study was to assess the prevalence of depression and anxiety in patients on chronic hemodialysis in University Clinical Hospital Mostar and to examine the correlation between the demographic variables and the time spent on dialysis with depression and anxiety levels. ⋯ Trait anxiety level was significantly higher in hemodialysed patients compared to the other two groups (p = 0.006) but there were no significant differences in state anxiety level. The study has not shown any significant difference in the prevalence of depression and anxiety level regarding the differences in sex, gender and education level, apart from a higher level of state anxiety in patients with a lower education level (p = 0.032). These results indicate that patients on hemodialysis have a significantly higher level of depression and a higher level of trait anxiety compared to patients with chronic illnesses and especially compared to general population.
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Collegium antropologicum · Dec 2009
Historical ArticleEvolution of management and investigations of cerebrovascular diseases in Croatia.
The author presents the history of management of cerebrovascular diseases (CVD) in Croatia since the beginning of medical health service in the country in the 19th and its evolution to the end of the 20th century. The foundation of the Zagreb School of Medicine in 1917 had paramount importance for the development of neurology, during the first period within the common specialty of neuropsychiatry. The interest for the CVD in Croatia became evident in the sixties of the past century, particularly when neurology has become a separate specialty in 1974. ⋯ The concept of comprehensive care for CVD patients was promoted, as a continuum of prevention, early treatment--if necessary in the ICU followed by modern rehabilitation. The described efforts were stopped due to the wars in the former Yugoslavia in the last decade of the 20th century. The process has been reinstated with new enthusiasm and new teams at the beginning of the 21st century after the postwar consolidation in Croatia and in the region.