Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Aim To create a predictive score based on functional parameters of the liver and determine its prognostic value in survival of patients with decompensated cirrhosis. Methods Retrospective observational study included 91 consecutive patients with decompensated cirrhosis. Functional parameters (bilirubin, AST - aspartate aminotransferase, ALT - alanine aminotransferase, ALP - alkaline phosphatase, GGT - gammaglutamyltranferase, albumin, prothrombin time, platelet count, haematocrit and creatinine), Child-Pugh (CP) and Model of EndStage Liver Disease (MELD) scores have been measured at first hospitalization and at every exacerbation episode over follow-up period of 24 months. ⋯ Age (OR=1.120; p=0.006; 95% CI=1.033- 1.214), serum bilirubin (OR=1.021; p=0.0001; 95% CI=1.010- 1.032), GGT (OR=1.007; p=0.023; 95% CI=1.001-1.014), INR (OR=9.571; p=0.001; 95% CI=2.610-35.098), haematocrit (OR=0.695; p=0.001; 95% CI=0.559-0.864) and serum creatinine (OR=1.023; p=0.0001; 95% CI=1.011-1.035) showed an increased the risk for a 24-month lethal outcome. Predictive score derived from liver functional parameters, CP and MELD scores, each independently has shown a high degree of death prediction after 6 or 24 months in patients with end-stage liver disease. Conclusion Predictive score derived from liver functional parameters had a better prognostic value for short-term and long-term mortality comparing to MELD and Child-Pugh score.
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Aim This study provides a comprehensive review of the current literature on the use of ChatGPT, a generative Artificial Intelligence (AI) tool, in neurosurgery. The study examines potential benefits and limitations of ChatGPT in neurosurgical practice and education. Methods The study involved a systematic review of the current literature on the use of AI in neurosurgery, with a focus on ChatGPT. ⋯ The study also identifies potential benefits of ChatGPT, such as providing personalized treatment plans, supporting surgical planning and navigation, and enhancing large data processing efficiency and accuracy. Conclusion The integration of AI technologies into neurosurgery should be approached with caution and careful consideration of ethical and validation issues. Continued research and development of AI tools in neurosurgery can help us further understand their potential benefits and limitations.
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Aim Haglund's syndrome may be responsible for chronic pain in the ankle and hindfoot. Although numerous therapeutic approaches have been described in the literature, to this date no consensus over a surgical treatment has been established. We report our experience in the treatment of Haglund's syndrome and pre-insertional calcifications of the Achilles tendon using an open surgical approach and platelet rich plasma (PRP) membranes as a local adjuvant. ⋯ No patient had major intraoperative or postoperative complications. After the surgery, the mean AOFAS score increased from 44.1 to 92.0, resulting in a statistically significant increase in patient functionality after the treatment (p=0.001). Conclusion Our results suggest that an open surgical approach consisting of a combination of bursectomy, resection of the calcaneal deformity, and topical administration of PRP membranes may be effective for the treatment of Haglund's disease.
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Aim Kyphoplasty and vertebroplasty are minimally invasive procedures used in bone augmentation following vertebral fractures when conservative management has failed. Cement injection could leak into surrounding structures leading to post-operative sequelae, which could be symptomatic. This study compared the rate and site of cement extravasation in vertebroplasty, kyphoplasty, and a combined approach. ⋯ Bone metastases were the aetiology with the highest cement leakage rate (27.5%). Conclusion The use of kyphoplasty alone or in conjunction with vertebroplasty decreases the risk of cement extravasation and subsequent complications compared to vertebroplasty alone. The use of pedicle screws appears to be safe and was not found to increase the risk of cement extravasation.
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Aim To evaluate changes of retinal microcirculation in mild cases of recovered COVID-19 patients at least three months after the infection by optical coherence tomography angiography (OCTA) non-invasive method. Methods In this prospective cross-sectional study, 50 right eyes of 50 recovered COVID-19 patients were compared with 50 right eyes of age and gender-matched healthy controls. After the complete ophthalmological examination, all participants underwent OCTA measurements (RTVue XR Avanti, Optovue, Fremont, CA, USA). ⋯ Significantly reduced superficial (p=0.046) and deep (p=0.044) macular vessel density (VD) in foveal region in the eyes of the recovered COVID-19 patients was found compared with healthy controls. Significantly enlarged foveal avascular zone (FAZ) area and perimeter in the eyes of the recovered COVID-19 patients (p<0.001) were found too. Conclusion Recovered COVID-19 patients have impaired retinal microcirculation, which can be a cause of the development of retinal vascular diseases.