Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Randomized Controlled Trial
Endovascular or open surgical treatment of high-risk patients with infrainguinal peripheral arterial disease and critical limb ischemia.
Aim To determine preferable type of treatment in our clinical circumstances by following two groups of patients with critical limb ischemia (CLI), who were treated endovascularly and surgically. Methods Research was carried out in the form of a prospective study of 80 patients with CLI and Trans-Atlantic Inter-Society Consensus (TASC) C or D type of arterial disease, with American Society of Anesthesiology (ASA) class III risk, who were randomly divided in two groups as per the treatment they received, surgical and endovascular. ⋯ Also, there was no difference in the overall survival of patients (100% vs. 97.5%; p=0.317). Conclusion Initial endovascular treatment is a preferred form of the treatment for selected patient population.
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Aim To assess ten-year risk of diabetes mellitus type 2 (T2DM) using the Finnish Diabetes Risk Score (FINDRISC) in respondents over 18, in Primary Health Centre in Banja Luka. Methods A prospective study was conducted using data from a population with undiagnosed T2DM in Primary Health Centre in Banja Luka. Eligible respondents were those aged 18 to 70 years. ⋯ A moderate risk occurred in 31.4% females with waist circumference >88 cm. Half (50%) males with waist circumference >102 cm and 33.2% respondents who were not eating fruits and vegetables every day had a slightly increased risk of developing T2DM (p<0.05). Conclusion The FINDRISC may be used as a tool which would help general practitioners in everyday work, to detect patients with T2DM risk factors and to encourage them to change life style towards healthy habits.
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Aim Multifragmentary segmental femoral shaft fracture is a high energy injury frequently associated with life-threatening conditions. The aim of this study was to compare the use of bio metallic open reduction internal fixation (ORIF) (plate with allograft bone strut) with minimally invasive plate osteosynthesis (MIPO) fixation for the treatment of multi-segmental femoral shaft fracture in terms of outcomes, bone healing and complications. Methods Forty patients with segmental femoral shaft fractures were included and divided into two groups: 20 patients treated with ORIF+, 20 with MIPO. ⋯ Results Better results of ORIF in terms of complication rate, RUSH, VAS, regression between RUSH and VAS, average correlation clinical-radiographic results and patients' outcomes (Cohen k) were obtained, and similar results for the length of follow up, surgery duration, perioperative blood transfusion, wound healing. No statistical difference for Harris Hip Score (HHS), Knee Society Score (KSS), quality of life (SF-12). Conclusions The ORIF and bone strut allograft technique had better results compared to the MIPO technique with regards to complication rate, RUSH, VAS, regression between RUSH and VAS, and average correlation clinical-radiographic results and patients' outcomes (Cohen k) in the surgical treatment of multifragmentary segmental femoral shaft fractures.
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Case Reports
Pectoralis (PecS) nerve block 1 for port-a-cath removal and central venous catheter (CVC) replacement.
Aim The use of PecS block 1 as perioperative analgesia for a central catheter removal -reimplantation combined procedure. Methods A 55-year-old woman suffering from peritoneal metastases from gastric cancer needed to have a port-a-cath implanted for infection removed and to have a central venous catheter (CVC) implanted in the homolateral axillary vein due to patient's history of deep vein thrombosis of the right upper limb. ⋯ Conclusion The PEC1 block was effectively and safely used to remove an infected port-a-cath and to place a CVC on the same side. We hypothesize that it may be useful also for simple port-acath positioning.
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Aim The outbreak of the COVID-19 pandemic has had a major impact on the delivery of elective, as well as emergency surgery on a world-wide scale. Up to date few studies have actually assessed the impact of COVID-19 on the postoperative morbidity and mortality following emergency gastrointestinal surgery. ⋯ Results The occurrence of a 5% overall respiratory complication rate postoperatively, with 3% infection rate for COVID-19 was found; no patient had unplanned return to intensive care for ventilator support and there was no mortality related to COVID-19 infection. Conclusion When indicated, emergency surgery should not be delayed in favour of expectant/conservative management in fear of COVID-19-related morbidity or mortality risks.