Acta medica Croatica : c̆asopis Hravatske akademije medicinskih znanosti
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Clinical characteristics and course in a patient with end-stage renal disease and nephrogenic ascites are described. The pathophysiology and current treatment options for this rare condition with poor prognosis are discussed.
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Owing to its technical possibilities, bronchoscopy has also come into frequent use in the treatment of trauma patients, not only for diagnostic but also for therapeutic purposes. It has become a mandatory procedure in the treatment of chest injuries. Following discussion of its history, possibilities and scope, the authors present the results of treatment over the last two years at the University Hospital of Traumatology Zagreb, Croatia. ⋯ According to indications for bronchoscopy, patients were classified into four groups: (a) patients with atelectasis (N = 51), with a total of 68 bronchoscopic procedures (1.33 per patient; (b) patients who developed infiltrates (N = 48) with 162 bronchoscopies (3.37 per patient); (c) patients with excessive secretions (N = 42) with 153 bronchoscopies (3.64 per patient); and (d) patients who developed respiratory insufficiency in the course of treatment (N = 16) with 24 bronchoscopic procedures (1.5 per patient). The best results were achieved in the atelectasis patients--in 74.47% of them there was no need of additional bronchoscopies, whereas in the group with excessive secretions or infiltrates bronchoscopy had to be repeated several times. It may be concluded that today, bronchoscopy is a routine diagnostic and therapeutic method in the treatment of chest injuries.
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The Glasgow Coma Scale (GCS), an indicator of the severity of head injury, may help identify the head injured patients who will eventually undergo tracheotomy. Authors' present retrospective study reveals that the likelihood of tracheotomy is significantly greater in patients with a GCS rating < 7 than in those with a GCS rating > 7 (p < 0.01). In order to minimize complications and make tracheotomy patients feeling more comfortable and communicable, this study argues for early tracheotomy in patients with a GCS score < 7, but never before 72 hours after injury, because it is a time necessary for patient stabilization and elimination of any illicit drugs or alcohol used prior to head injury.
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Historical Article
Urology at the Sestre Milosrdnice University Hospital 1894-1994.
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A prospective study was performed to determine whether the risk factor for hepatitis B, proposed by Centers for Disease Control (CDC), USA, are reliable predictors for the hepatitis B surface antigen (HBsAg) carrier state in an obstetric population. In the period between January 1, 1991 and December 31, 1992, all pregnant women from geographically defined areas of the Istrian and Rijeka districts were routinely screened for hepatitis B surface antigen (HBsAg). Among 10,627 pregnant women, 107 (1%) HBsAg positive cases were registered. ⋯ The other 61 subjects had no recognizable risk factors. The screening of pregnant women for HBsAg only on the basis of the CDC recommended history guidelines, would have left 57% of our HBsAg positive mothers undetected and therefore their children unvaccinated against hepatitis B infection. Our results confirmed the need and value of the new CDC recommendations about routine prenatal screening of all pregnant women for HBsAg until hepatitis B vaccine is included in the scheme of compulsory vaccination of all newborns.