Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Aim To investigate the role of hypoxia-preconditioned mesenchymal stem cells (H-MSCs) in preventing peritoneal adhesion by regulating IL-6 at days 6 and 12. Methods Twenty-four PAs rat model weighing 250 g to 300 g were randomly allocated into 4 groups: sham (Sh), control (C), H-MSCs treatment group at dose 1.5 x 106(T1) and 3 x 106(T2). To induce H-MSCs, all MSCs population were incubated under hypoxia state (5% O2 ), 5% CO2, and 37oC for 24 hours. ⋯ Interestingly, there was a significant decrease of IL-6 level on day 12 in all treatment groups. Also, no adhesion occurred in T2 group. Conclusions H-MSCs prevent PA development by suppressing the prolonged release of IL-6 at proliferation phase.
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Randomized Controlled Trial
Comparison of early and delayed lumbar disc herniation surgery and the treatment outcome.
Aim To evaluate the influence of preoperative symptoms duration on surgical outcome of one-level lumbar disc herniation surgery. Methods In a prospective randomized study, 67 adult patients with one-level lumbar disc herniation were analysed. The patients whose duration of symptoms was <6 months were included in the case group, while those with the duration of symptoms ˃6 months formed the control group. ⋯ Results A statistically significant difference was recorded between the groups, showing a better decrease of radicular pain intensity and sciatica bothersome, as well as patients disability in the case group (p<0.001). According to the Odom's criteria the outcome was better in the case group, since the difference between the groups was statistically significant too (p<0.05). Conclusion Early lumbar disc herniation surgery performed within the first 6 months from the start of symptoms is beneficial due to decreases of radicular pain intensity, sciatica bothersomeness, and patient's disability.
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Aim To identify laboratory tests for early detection and the development of more severe illness and death in COVID-19 hospitalized patients. Methods A prospective study was done on 66 hospitalized COVID-19 patients (males: 54.5%; mean age 70.1 ± 9.6 years) who were stratified into: moderate (n=36; 54.5%), severe (n=12; 18.2%), and critically ill (n=18; 27.3%). Besides clinical findings, a wide spectrum of laboratory parameters was monitored at admission and control during the first seven days of hospitalization and used to predict progression from non-severe to severe illness and to predict the final outcome. ⋯ Progression from moderate to severe or critical illness was predicted by increasing lactate dehydrogenase (95% CI 0.5803 to 0.8397;p=0.003729), increase in ferritin (95% CI 0.5288 to 0.8221;p=0.03248), and by drop in O2 saturation (95% CI 0.5498 to 0.8179;p=0.01168). A fatal outcome was predicted by increase in ferritin (95% CI 0.5059 to 0.8195;p=0.04985), as well as by drop in O2 saturation (95% CI 0.5916 to 0.8803; p=0.001861). Conclusion Increase in ferritin, and drop in O2 saturation could be the most important prognostic parameters for the development of more severe clinical illness and death in COVID-19 hospitalized patients.
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Observational Study
Risk of surgical site infections after colorectal surgery and the most frequent pathogens isolated: a prospective single-centre observational study.
Aim To identify risk factors for developing surgical site infections (SSIs) based on a prospective study of patients undergoing colorectal surgery. Methods Between November 2019 and January 2021, 133 patients underwent elective operation for colorectal cancer in our institution. The following variables were recorded for each patient: age, gender, body mass index (BMI), American Society of Anesthesiologists Classification (ASA class), duration of surgery, wound classification, skin preparation regimens, surgical approach, comorbidities (hypertension, diabetes, cardiovascular disease, respiratory disease, chronic steroid use), and pathogens responsible for surgical site infection. ⋯ Nineteen patients had diabetes and 36 used steroids continuously; SSI was significantly more frequent in these patients (p=0.021 and p=0.049, respectively). Conclusion Following colorectal cancer procedures SSIs were significantly more common among patients over 70 years old, BMI≥30kg/m2 , ASA score>2, with diabetes and chronic steroid use, undergoing open, dirty or contaminated surgery. Escherichia coli and Enterococcus spp. were the two most common pathogens isolated.
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Aim To investigate the relationship between preoperative level of serum albumin in patients with colorectal cancer (CRC), stage of CRC and postoperative complications. Methods This cross-sectional retrospective study was conducted at the Clinic for General and Abdominal Surgery of the University Clinical Centre Sarajevo (UCCS). A total of 107 patients surgically treated for CRC in the period between 2013 and 2018 were enrolled in this study and divided into two groups: with hypoalbuminemia (group A) and without hypoalbuminemia (group B). ⋯ Patients with hypoalbuminemia (group A) had wound dehiscence more often and more re-interventions compared to group B (p<0.05). Binary logistic regression found that serum protein, albumin and globulin levels were not statistically significant in the prediction of CRC stadium or postoperative complications (p>0.05). Conclusion Study results show that preoperatively measured levels of serum albumin are not associated with the stage of colorectal cancer and cannot serve as predictors for postoperative complications.