Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Aim To compare the outcome of sole dexmedetomidine or with other sedative drugs in paediatric patients during magnetic resonance imaging (MRI). Methods Literature was obtained from PubMed and ScienceDirect from 2010-2020 using key words: sedation, paediatric, dexmedetomidine, ambulatory, MRI, ketamine, propofol, midazolam. The literature selection was based on Participant, Intervention, Comparators, Outcomes (PICO) analysis. ⋯ Intranasal dexmedetomidine is more recommended than its combination with midazolam. Combining dexmedetomidine with ketamine, propofol or midazolam provides a shorter recovery time. Conclusion A combination of dexmedetomidine with other sedatives such as ketamine, propofol and midazolam is better than sole dexmedetomidine for paediatric sedation during magnetic resonance imaging.
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Aim To investigate the relationship between C-reactive protein, anthropometric parameters, and lipids in women in the menopausal transition. Methods This cross-sectional study included 150 women divided into three groups: premenopausal (n=50), perimenopausal (n=50), and postmenopausal (n=50). All women were interviewed, body mass index (BMI) and waist-hip ratio (WHR) values were calculated, and a blood sample was taken for laboratory analysis. ⋯ A significant positive correlation was found between CRP and WHR in the perimenopause and in the postmenopause group. No significant correlation was found between CRP and lipid parameters in any group. Conclusion An increase in body weight or obesity in the postmenopausal period, increase in CRP concentration, and positive correlation between these parameters suggest that entering menopause could mean a potential increase in the risk of developing cardiovascular and metabolic diseases.
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Aim To determine differences between reviparin and dalteparin treatment in patients with extracapsular hip fractures treated with intramedullary nailing and their effects on perioperative blood loss and early postoperative recovery. Methods Retrospective comparative study included 68 patients with extracapsular hip fracture who were divided into dalteparin and reviparin group. Medical records were used to obtain demographic data, laboratory parameters, haemoglobin and haematocrit levels, platelet count, mortality rate and medical complications. ⋯ Conclusion Low-molecular-weight heparin is the drug of choice in patients with hip fractures for thromboprophylaxis. Due to non-antithrombin-mediated actions, reviparin and dalteparin could have different effects on perioperative blood loss. Both dalteparin and reviparin are safe and effective agents for thromboprophylaxis in patients with proximal femur fractures.
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Aim To determine radiologic, clinic and laboratory characteristics of COVID-19 positive patients with acute arterial occlusion and compare them with post COVID-19 and non-COVID-19 patients. Methods In this retrospective study, 53 patients with acute occlusion of peripheral arteries admitted to the University Clinical Hospital Mostar in the period between 29 February 2020 and 30 September 2021 were involved. The first group was made of COVID-19 positive patients, the second group were post COVID-19 patients and a control group were non-COVID-19 patients. ⋯ Acute arterial occlusion occurred about 2 weeks after the beginning of COVID-19 or at the time of the first appearance of symptoms. Conclusion We have to take special care about patients with risk factors for developing acute arterial occlusion due to thromboembolism or thrombosis 10 days after the beginning of the disease. We also recommend the use of low molecular weight heparin (LMWH) and monitoring coagulation state due to anti Xa and thromboelastometry.
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Aim To demonstrate a reduction of risk factors ray-depending in proximal femur nailing of intertrochanteric femur fractures, comparing standard technique with computer-assisted navigation system. Methods One hundred patients hospitalised between October 2021 and June 2022 with intertrochanteric femur fractures type 31-A1 and 31-A2 were prospectively enrolled and divided randomly into two groups. A study group was treated with computer-assisted navigation system ATLAS (Masmec Biomed, Modugno, Bari, Italy) (20 patients), while a control group received the standard nailing technique. ⋯ Results Patients underwent femur nailing with computer-assisted navigation system reported more set-up time of operating room (24.87±4.58; p<0.01), less surgical time (26.15±5.80; p<0.01), less time of radiant exposure (4.84±2.07; p<0.01) and lower dose area product (16.26±2.91; p<0.01). Conclusion The preliminary study demonstrated that computerassisted navigation allowed a better surgical technique standardization, significantly reduced exposure to ionizing radiation, including a reduction in surgical time. The ATLAS system could also play a key role in residents improving learning curve.