Collegium antropologicum
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Collegium antropologicum · Dec 2012
Randomized Controlled Trial Multicenter Study Comparative StudyComparison of two selective muscarinic receptor antagonists (solifenacin and darifenacin) in women with overactive bladder--the SOLIDAR study.
Overactive bladder (OAB) is a common, often debilitating, condition defined as urgency and urge incontinence, usually with frequency and nocturia. The use of muscarinic receptor antagonists are the mainstay of treatment, but their non-selectivity can result in unacceptable adverse effects that limit their usefulness. The purpose of this study was to evaluate 2 of the newer antimuscarinic agents, solifenacin and darifenacin, which demonstrate greater selectivity, in order to compare their tolerance and effectiveness. ⋯ Both treatment groups showing a reduction in all OAB symptoms but with no notable difference being seen between the 2 groups. Solifenacin though showed statistically greater improvements in QOL, better overall treatment satisfaction, and a decreased incidence of dry mouth after 3 months of treatment compared to the darifenacin group. This study demonstrates interesting initial results and indicates that these 2 drugs have a different profile that may confer an advantage to patients, but further methodologically rigorous studies comparing the use of solifenacin and darifenacin in OAB are required to establish the differences between these drugs over longer periods of treatment.
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Collegium antropologicum · Dec 2012
Randomized Controlled Trial Comparative StudyThe effect of spinal versus general anesthesia on postoperative pain and analgesic requirements in patients undergoing peripheral vascular surgery.
The optimal anesthetic technique for peripheral vascular surgery remains controversial. The purpose of this study was to evaluate the effect of spinal versus general anesthesia on postoperative pain, analgesic requirements and postoperative comfort in patients undergoing peripheral vascular surgery. A total of 40 patients scheduled for peripheral vascular surgery were randomly assigned to two groups of 20 patients each to receive general anesthesia (GA) or spinal anesthesia (SA). ⋯ This effect was mainly due to the lower pain score during the first study period. The patients received general anesthesia also reported a significantly higher rate of unsatisfactory postoperative comfort than those receiving spinal anesthesia. We conclude that spinal anesthesia is superior to general anesthesia when considering patients' satisfaction, side effects and early postoperative analgesic management.
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Collegium antropologicum · Dec 2012
ReviewEmergency treatment for clinically unstable patients with pelvic fracture and haemorrhage.
Unstable pelvic fractures very frequently occur with haemorrhage, not only from the broken pelvis but from the presacral venous plexus and/or iliac arterial or venous branches which may cause hypotension and increases the mortality rate. Very often this type of injury is concurrent with injuries in other organ systems. The compounded nature of these injuries makes it necessary for doctors who may encounter this type of patient to be educated in the techniques to effectively stabilise and treat the patient's complex injuries. ⋯ Likewise indication for intervention of pelvic angiography and therapeutic embolisation are also discussed. The direct surgical hemostasis method of pelvic packing is described in detail. All presented methods are mutually complementary in today's treatment of these patients.
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Collegium antropologicum · Dec 2012
Alcohol-related road traffic accidents before and after the passing of the Road Traffic Safety Act in Croatia.
The aim of this study was to gather enough data in order to formulate theory- and research-based recommendations to policy makers with the intention of decreasing the number of alcohol-related accidents and victims on Croatian roads. The data on the injured traffic participants and the share of participants under the influence of alcohol were collected from the police reports of the Traffic Police Department, Ministry of the Interior, written at the scene of the respective accidents. This documentation was then processed by descriptive epidemiology and analysed through a four-year period, before and after the passing of the New Road Traffic Safety Act in the Republic of Croatia, on 20 August 2004. ⋯ A total of 2,314 accidents were caused by drivers with more than 0.5 per thousand and up to 1.5 per thousand in 2005 (in 2006 - 2,582), along with 53 fatalities (1 fewer than in 2006). Drivers with more than 1.5 per thousand participated in 2,809 accidents (2006 - 2,844), with the number of killed drivers amounting to 57, three fewer than in 2006. In light of these facts, alcohol use still remains a significant factor in road traffic accidents and is an important area for injury prevention efforts.
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Collegium antropologicum · Sep 2012
Comparative Study Clinical TrialPredictors of short-term neurocognitive outcome following coronary revascularisation (CABG) depending on the use of cardiopulmonary bypass.
The purpose of our study was to investigate the association between perioperative cerebral microembolization, expressed as high-intensity transient signals (HITS) and postoperative dynamics of the neuromarker S100P in patients operated using cardiopulmonary bypass, and to assess their impact upon the neurocognitive function in the early postoperative stage. The study involved 62 consecutive male patients aged 60 or above, alls scheduled for elective aortocoronary bypass. The patients were recruited from two groups with respect to the use of CPB: on-pump group (CPB+, N = 30) and off-pump group (CPB-, N = 32). ⋯ Neurocognitive status was assessed before and after the surgery and in three cognitive domains. Results of the study have shown that with respect to the short-term postoperative neurocognitive outcome there is no significant difference between the on-pump and off-pump surgical technique of coronary revascularization'. Perioperative cerebral microembolization was significantly more pronounced in the on-pump group yet it did not affect early postoperative neurocognitive function, while the increase in the neuromarker S100beta serum level 48 hours after surgery may have prognostic value as a predictor of postoperative neurocognitive dysfunction.