Reumatizam
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Operative treatment of Ankylosing spondilitis is usually performed in treatment of extraspinal pathology, i.e. in treatment of hip contractures. Operative treatment of fixed spinal kyphosis in AS is rarely indicated, and patients make their decision for the operation when deformation becomes extreme. Instead of several hundred of operated patients in foreign literature, authors describe only 5 operations from 1989 to 2000. ⋯ However, reconstruction of lumbar lordosis significantly improve quality of life in operated patients. It is concluded that indication for the operation in AS should be indicated earlier. Better results with less risk would be achieved.
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Current opinions in chronic pain treatment with opioid analgesics are presented in this review. Justified use of opioid analgesics in treatment of chronic non-malignant pain in inflammatory and degenerative processes is emphasised. Advantages of opioid analgesics compared with non-opiod analgesics are stressed. ⋯ Trial was performed in Pain clinic of Karlovac General Hospital as a part of international multicentric clinical trial. Regarding efficacy, compared to the previous therapy, TTS fentanyl was evaluated positively by patients, both in pain control and ease of use, and by the author, for around the clock, non-invasive administration. Slow dose adjustment in rapid illness progression was recognised as disadvantage.