Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Aim To compare hospital costs of acute limb ischemia treatment in two periods of time and to show evidence of long-term repercussions on reducing costs during successful treatment. Methods Retrospective analysis of data obtained from 100 patients' medical history in the period 2000-2016 at the Clinic of Vascular Surgery Sarajevo: group A - 60 patients with acute limb ischemia in the period 2005-2016 and group B - 40 patients with acute limb ischemia (ALI) in the period 2000-2005. From 2000 to 2005 conservative treatment method was used, invasive diagnostic and surgical procedures were often delayed for a shorter or longer period of time. ⋯ Results Better health service for the patients with acute limb ischemia was offered in the period 2005-2016, which relied on proven medical treatment trends. The largest share of the total costs of each patient included costs of hospital bed with significant difference between the period 2005-2016 and 2000-2005, mean of 1398.71 KM and 2480.45KM, respectively (p<0.0001), indicating rationalization of time that patients spend at the Vascular Clinic. Conclusion This trend of money/fund savings is an example of good practice, effectiveness and efficiency in the treatment of ALI and as such was used in patients with other vascular diseases.
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Aim To determine a degree of change in the bones of workers who spend their full time job in sitting position and to find a correlation between smoking and changes in bone structure. Methods Examinees were 213 female workers who worked full time sedentary work in front of computer. Each worker was subjected to physical examination and ultrasonic osteodensitometry of calcaneus. ⋯ It is worrying that 10 out of 22 persons in the group up to 30 years of age have osteopenia. Conclusion Recommendation for regular annual control of bone density of the working group at risk regardless of age should be followed. Prescribing exercise for the working group at risk should be a significant part of preventive work in clinics of occupational medicine and sports.
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Aim To examine the effects of therapeutic hypothermia on the outcome of patients with the diagnosis of out-of-hospital cardiac arrest (OHCA). Methods The study included 76 patients who were hospitalised at the Medical Intensive Care Unit (MICU) of the Clinical Centre University of Sarajevo, with the diagnosis of out-of-hospital cardiac arrest, following the return of spontaneous circulation. Therapeutic hypothermia was performed with an average temperature of 33oC (32.3 - 34.1o C) on the patients who had coma, according to the Glasgow Coma Scale (GCS). ⋯ Moreover, other physiological factors such as the pH and the lactate serum levels significantly affected patients' survival (p=0.012 and p=0.01, respectively). Conclusion In patients with the diagnosis of OHCA who underwent to the treatment with therapeutic hypothermia, verified VF as a presenting rhythm was a positive predictive factor for their outcome. Therefore, therapeutic hypothermia represents an option of therapeutic modality for this type of patients.
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Aim To determine the prevalence of new-onset atrial fibrillation (NOAF) following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) and its effect on 6-month cardiovascular outcomes. Methods This prospective study included 40 patients diagnosed with LMCAD, in the period from 2017 to 2018. The patients with LMCAD and low or intermediate SYNTAX score were randomized to PCI with zotarolimus-eluting stents versus CABG. ⋯ One patient died 2 months after the operation, and one developed stroke 5 months after the CABG operation. Conclusion The NOAF was common after CABG, but extremely rare after PCI, and it occurred almost exclusively following CABG. There was a clear statistical tendency for all-cause death, cardiovascular death and stroke at 6-month follow-up period.
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Aim To analyse potential clinical implications of the distance between large retroperitoneal vessels and lower segment of the lumbar spine in the supine and prone position. Methods Prospective, non-randomised study included 40 patients of different age and gender. For all patients magnetic resonance imaging of the lumbar spine was performed in supine and prone position. ⋯ There was a statistically significant difference between the distance from the left common iliac artery to the anterior contour of L4/L5 intervertebral disc (p<0.05). Conclusion Knowledge of the anatomic relationship between iliac vessels and structures of the lower segment of the lumbar spine is very important in the prevention of a potentially severe complication, such as artificial common iliac vessels rupture. Our study showed that the risk of lesions of the common left iliac artery was lesser in the prone position.