Acta medica Croatica : c̆asopis Hravatske akademije medicinskih znanosti
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Case Reports
A life-threatening complication of extreme hyperkalemia in a patient on maintenance hemodialysis.
A 68-year-old female on two-year chronic hemodialysis for chronic renal failure due to chronic pyelonephritis, was admitted to hospital for weakness, dulled sensorium and dizziness. On examination the patient was in a state of circulatory collapse, the electrocardiogram showed an accelerated idioventricular rhythm and laboratory analysis revealed extreme hyperkalemia (K+ 10.1 mmol/l). ⋯ At the end of the hemodialysis session, the patient was in a clinically good condition, blood pressure was 160/90 mm Hg and the serum K+ concentration was normal. The case appeared to suggest that extreme hyperkalemia may have direct effects on vascular resistance, causing hypotension and shock.
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Fourteen casualties with penetrating injuries to the colon caused by firearms in combat zones have been treated according to the principles accepted today for the treatment of such injuries acquired in civilian violence. The patients were treated by primary resection of the injured part of the intestine, without relieving colostomy, providing that the time interval between the moment of injury and admittance to the hospital was less than six hours. ⋯ Complications related to colon surgery occurred in one patient (7%). Primary resection without relieving colostomy for the colon injuries caused by firearms is a safe procedure providing that the time interval between wounding and surgery does not exceed six hours.
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During the war in Croatia so far, more than 250 casualties having missile wounds of the brain, spinal chord and peripheral nervous system were admitted to the Neurosurgical Clinic, University Hospital-Rebro. These injuries were mainly caused by low-velocity missiles. However, the high-velocity ones, used nowadays, in direct injury to the head, cause destruction of the brain that is incompatible with survival in most of the cases. ⋯ The mechanism of the brain destruction is not completely clear since the missile was found at the very entrance of the missile wound, while the brain was destroyed up to the opposite side of the endocranium. Four mechanisms of the missile's effect aimed at explaining the cause of death of the patient, as well as the bizarre position of the missile, were taken into consideration. The review shows how perilous a wound from a direct missile injury to the head could be, regardless of its speed.
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Editorial Historical Article
A brief review of Croatian medical history until the 19 century--Part 1.
The purpose of this study is to remind the contemporary readers of the role and contribution of Croatian medical heritage in the development of medicine in Europe and the World, as well as of the development of medical concepts and medical practice on the territory of what is Croatia today. Selected examples are presented of the famous events and notable persons from the ancient time until the middle of the 19th century.