Acta clinica Croatica
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Acta clinica Croatica · Jun 2011
Case ReportsBenign angiopathy of the central nervous system or reversible cerebral vasoconstriction syndrome.
Benign angiopathy of the central nervous system is a subset of primary angiitis of the central nervous system characterized by "benign" course. It means that changes of cerebral vessels are reversible after treatment with corticosteroids and calcium channel blockers, so these abnormalities are believed to reflect vasospasm rather than true vasculitis. ⋯ We present a young man with acute onset of headache and neurologic impairment secondary to ischemic stroke with intracerebral and subarachnoid hemorrhage. Cerebral angiography showed characteristic findings of diffuse vasculitis but good response to treatment with corticosteroids and calcium channel blockers distinguish this benign angiopathy from the more aggressive form of the central nervous system vasculitis.
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Acta clinica Croatica · Jun 2011
Clinical and electrophysiological signs of diabetic polyneuropathy -- effect of glycemia and duration of diabetes mellitus.
Diabetic polyneuropathy occurs in around 50% of diabetic patients. Its pathophysiological mechanism is not completely clarified and major occurrences boil down to the change in neural phenotype and vasa nervorum. As glucose neurotoxicity has been suggested by plenty of evidence, the aim of the study was to assess the effect of glycemia on the severity of diabetic polyneuropathy. ⋯ Diabetes duration was associated with a growing number of sensory symptoms, among which the sensation of pain similar to electric shock was present in 63% of patients. In addition, it also had negative impact on the sensory and motor nerve conduction velocity. HbA1c influenced the whole range of electrophysiological indicators of diabetic polyneuropathy.
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Acta clinica Croatica · Dec 2010
Review Case ReportsManagement of fournier's gangrene: case report and literature review.
A 65-year-old man was referred to our department with clinical signs of septic shock and necrotizing soft tissue infection of the scrotal, perianal and right inguinal region. Initial presentation was a typical Fournier's gangrene. Because of the life-threatening condition, the initial treatment was extensive removal of necrotic tissue. ⋯ Although rare, it remains a life-threatening disease. Rapid and accurate diagnosis remains the key component in achieving successful outcome. Early aggressive surgical intervention together with fluid, hemodynamic and nutritional support and broad-spectrum antibiotics is the essential management to reduce mortality.
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Acta clinica Croatica · Dec 2010
Case ReportsDRESS syndrome with mild manifestations as a diagnostic and therapeutic problem: case report.
The group of severe cutaneous drug reactions with systemic symptoms includes several syndromes: toxic epidermal necrolysis, Stevens-Johnson syndrome, acute generalized exanthematous pustulosis, and drug reaction with eosinophilia and systemic symptoms (DRESS). These reactions occur several days to six weeks after introducing the incriminating drug. The skin and internal organs (liver, kidneys, lungs, etc.) are usually involved. ⋯ After ten days, the patient came back with worsening condition, general inflammatory response, skin changes, liver and kidney damage, and eosinophilia. DRESS syndrome was diagnosed based on clinical and other findings. The diagnosis and treatment of severe drug reactions with cutaneous and systemic symptoms pose a medical challenge.
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Acta clinica Croatica · Dec 2010
Changes in intra-abdominal, iliac venous and central venous pressures in patients undergoing abdominal surgery due to large tumors of the colon--a pilot study.
Changes in intra-abdominal pressure during bowel tumor surgery have not been documented. The purpose of the present study was to analyze changes in intra-abdominal pressure (IAP), central venous pressure (CVP) and iliac venous pressure (IVP) in patients undergoing laparotomy due to large tumor of the bowel. Twenty-one adult patients undergoing elective abdominal surgery were examined. ⋯ There was a strong overall correlation between IAP and CVP (P = 0.0000; r = 0.7779), as well as between IAP and IVP (P = 0.0000; r = 0.8635). Moreover, IAP correlated with IVP immediately after anesthesia and one hour after anesthesia. In conclusion, induction of anesthesia decreased IAP; excision of large bowel tumors decreased IAP; and IAP strongly correlated with CVP and IVP.