Acta clinica Croatica
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Acta clinica Croatica · Apr 2023
Case ReportsNECK HEMATOMA AFTER CENTRAL VENOUS CATHETERIZATION AND AWAKE INTUBATION AS RESCUE AIRWAY MANAGEMENT TECHNIQUE: A CASE REPORT.
Central venous catheterization (CVC) of the internal jugular vein is an invasive procedure commonly performed in anesthesiology practice. Usually it is an uneventful procedure but complications such as bleeding, infection, and potential damage to the surrounding structures can occur. One of the complications is neck hematoma, which can distort airway anatomy and cause upper airway obstruction. ⋯ Awake tracheal intubation (ATI) with video laryngoscopy was the technique of choice for reintubation because of the neck swelling and compression onto laryngeal structures. In this case, rushed extubation put the patient at risk. Video laryngoscopy ATI with appropriate preparation and titrated sedation can enable quick and safe rescue airway management in patients with rapidly developing neck hematoma, along with definitive evacuation and treatment.
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Acta clinica Croatica · Apr 2023
FACTORS AFFECTING PROGNOSIS AND MORTALITY IN SEVERE COVID-19 PNEUMONIA PATIENTS.
Fatality rate in coronavirus disease 2019 (COVID-19) cases has been reported to be 3.4% worldwide. The aim of this study was to evaluate the factors that determine prognosis and mortality in severe COVID-19 pneumonia patients. Eighty adult patients with severe COVID-19 pneumonia hospitalized and monitored at Izzet Baysal State Hospital (Bolu, Turkey) between August and November 2020 were included in this retrospective single-center study. ⋯ Mortality was significantly higher in patients using steroid pulse therapy + tocilizumab, steroid pulse therapy + hydroxychloroquine, or solely steroid pulse therapy, while it was significantly lower in patients receiving azithromycin therapy and those in the plasma + steroid pulse therapy group. The severity of pulmonary involvement, intubation, and increase in inflammation markers such as ferritin, troponin and procalcitonin were found to be significantly associated with mortality (p<0.05). Treatment approaches with azithromycin and plasma + steroid pulse therapy were found to reduce mortality.
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Acta clinica Croatica · Apr 2023
ASSESSMENT OF NEONATAL CARE STANDARD BY THE PREDICTIVE MODEL FOR RETINOPATHY OF PREMATURITY BASED ON WEIGHT GAIN.
Care of extremely premature infants is in constant need for evaluation and progress. WINROP, a predictive model based on weight gain, has been developed to reduce the number of stressful examinations for retinopathy for prematurity. Validation studies of WINROP emphasize the difference of applicability in neonatal units of various practice. ⋯ In conclusion, WINROP is not just a provider of predictive information on the severity of retinopathy of prematurity. High-risk alarm indicates the need of adjustment of nutritional strategies. Infants without pathological growth morbidities who develop severe retinopathy of prematurity in low-risk group point to other risk factors for retinopathy of prematurity to be evaluated and changed in future practice.
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Acta clinica Croatica · Apr 2023
HIPPOCAMPAL GANGLIOSIDE COMPOSITION IS ALTERED BY METFORMIN AND LIRAGLUTIDE TREATMENT IN A HIGH-FAT HIGH-SUGAR DIET RAT MODEL.
Insulin resistance has many deleterious effects on the central nervous system, including the initiation and potentiation of neurodegeneration. While the pathogenesis of Alzheimer's disease has been extensively researched with many insights into the effects of amyloids and neurofibrillary tangles, the connection between the two pathogenic entities has not yet been fully elucidated. Gangliosides are commonly found in neuronal membranes and myelin, specifically in lipid rafts that have been linked to pathological amyloidogenesis. ⋯ Positive immunoreactivity for GM1 was observed in the male group treated with liraglutide in regions where it is not physiologically found. The changes observed following HFHSD and liraglutide treatment were suggestive of ganglioside restructuring that might have implications on pathological amyloidogenesis. Metformin treatment did not significantly alter the hippocampal ganglioside composition in either sex.
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Acta clinica Croatica · Apr 2023
ANALYSIS OF DIAGNOSTIC EXCISIONAL LYMPH NODE BIOPSY RESULTS: 12-YEAR EXPERIENCE OF A SINGLE CENTER.
Lymph node biopsy is indicated in patients with suspected malignancy or lymphadenopathy due to unclarified reasons. Lymph node biopsy can be performed as fine needle aspiration biopsy, core biopsy, or excisional lymph node biopsy. In particular, the diagnosis of malignant lymphoma is considered insufficient for oncological treatment unless classified into subgroups. ⋯ If the core biopsy is insufficient for diagnosis, it is more appropriate to perform surgical biopsy in order to cause no delay in diagnosis and treatment. Excisional biopsy is a method that can be safely performed and does not cause severe morbidity in palpable peripheral lymphadenopathies. Although it does not cause severe morbidity because it is an invasive procedure, excisional biopsy should be performed in a selected patient group.