Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Aim To determine risk factors responsible for developing postoperative complications after the thoracic aorta reconstructive surgery. Methods Medical records of 100 patients, who had undergone elective or emergency thoracic aorta reconstructive surgery at the Clinic for Cardiovascular Surgery, University Clinical Center Tuzla, were analysed. Intraoperative data as cross-clamp time (CCT), duration of cardiopulmonary bypass (CPBT) and hypothermic circulatory arrest time (HCAT) were evaluated. ⋯ The results showed that CPBT>180 minutes was a risk factor for respiratory (p=0.034), cardiac (p=0.020) and renal (p=0.027) postoperative complications after acute type A aortic dissection surgery. Conclusion CPBT > 180 min is a risk factor for postoperative development of respiratory, cardiac and renal complications. Postoperative cardiac and renal complications were associated with longer HCAT.
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Aim Given the impact of vascular comorbidities (VC) on the diagnosis, treatment, and outcome of multiple sclerosis (MS), we examined the incidence and correlation of VC and risk factors for vascular disease in people with MS (PwMS) compared to the general population, and the impact on the physical disability of patients. Methods Cross-sectional study involved 100 patients with MS and 50 healthy people from the general population, matched by sex and age. The values of demographic, biochemical, and anthropometric parameters, the presence of VC and risk factors for vascular diseases in both groups, and clinical parameters in PwMS were analysed. ⋯ Total body weight and BMI were statistically significantly higher in the control group (p=0.000). The increase in Expanded Disability Status Scale (EDSS) score was associated with higher levels of total (p=0.001) and low-density lipoprotein (LDL) cholesterol (p=0.003), and activated partial thromboplastin time APTT (p=0.002). Conclusion In PwMS it is necessary to pay attention to the higher frequency of smoking than in general population, and the impact of total cholesterol, LDL and APTT levels as significant parameters that affect physical disability.
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Aim To determine a prognostic value of cerebral blood flow parameters for the development of neurological sequelae in term neonates with hypoxic ischaemic encephalopathy (HIE). Methods We reviewed medical records of 47 term neonates with HIE who survived until the age of 12 months of life. According to the Sarnat and Sarnat clinical score, neonates were divided into 3 groups: mild HIE, moderate HIE and severe HIE. ⋯ The values of cerebral blood flow parameters and resistance index (RI) significantly correlated with the neurological impairment at the age of 12 months of life (p<0.001). The limit value of RI indicating the poor neurodevelopmental outcome was 0.81, sensitivity 80%, specificity 85.3%, positive predictive value 52.2% and negative predictive value 95.2%. Conclusion The cerebral blood flow parameters measured with colour doppler brain sonography are good indicators of the severity of HIE and later neurodevelopmetal outcome.
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Aim To investigate the relationship between adherence to preventive behaviors and risk of COVID-19 infection. Methods In this case-control study, 491 participants were selected through convenience sampling. First, the samples of the case group (COVID-19 patients) were selected, and then the control group was matched with the case group based on age, gender, and occupation. ⋯ The participants who never observed physical distancing and handwashing were 2.25 times more likely to get COVID-19 than those who always observed (95% CI:1.719-4.954; OR=2.258). Conclusion Participants who fail in following the protective measures, especially wearing a mask regardless of its type, had a higher risk of COVID-19 infection. Therefore, it is recommended to use a mask consistently, especially during the peak of COVID-19 waves.
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Obstetric shock (OS) has been defined as a life-threatening cardiovascular collapse syndrome associated with pregnancy, childbirth and puerperium (obstetrics causes), and is the most significant cause of high maternal mortality (MM) throughout human history. Shock in obstetrics (SIO) refers to indirect causes of non-obstetrics causes in pregnancy, childbirth and puerperium (polytrauma, aesthetic incidents, cardiovascular or cerebrovascular incidents, other septic syndromes). ⋯ Surgical treatment of septic shock includes exploratory laparotomy (laparoscopy), ectomy or resection of the necrotized organ, abdominal lavage with multiple drainages, continuous peritoneal drainage with lavation, extensive triple antibiosis per admission or per antibiogram and thromboprophylaxis. OS seems to remain a permanent miasma in practical clinical obstetrics, which we will not be able to influence, because we have obviously caused today's increase in MM from haemorrhagic OS by iatrogenic increase in the number of caesarean sections, especially elective ones.