Lijec̆nic̆ki vjesnik
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Lijec̆nic̆ki vjesnik · Jul 2009
Editorial[Medical error--professional liability for malpractice in Bosnia and Herzegovina].
Medical care is frequently compared to aviation, as many of the factors which lead to errors in both fields are similar. In this article we review the literature on such events and discuss the ethical, legal and practical aspects of civil liability in the case of medical error. Ethics, professional policy and the law, as well as the relevant empirical literature, suggest that timely and candid disclosure should be standard practice. ⋯ Civil liability is one of the most important parts of law that regulates health care service. Medical chambers could be having a very important role in alternative methods of medical error disciplinary screening proceedings. Guidelines for disclosure of medical error to patients, and their families if necessary, are proposed.
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Lijec̆nic̆ki vjesnik · May 2009
Review[The role of taxanes in breast cancer chemotherapy: what's new 15 years after?].
Taxanes were established as leading drugs in chemotherapy of breast cancer. In the first line chemotherapy of advanced disease taxanes were combined with other cytostatics. Taxane-based combinations in comparison with taxanes in sequential use were observed. ⋯ Paclitaxel is treatment schedule dependent, because its weekly administration setting may result in better treatment outcome. Docetaxel may be more effective if given every 3 weeks rather than weekly. Targeted therapy in combination with taxanes improves survival rate in adjuvant setting as in advanced disease.
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Lijec̆nic̆ki vjesnik · Mar 2009
[Croatian guideliness for prevention of chemotherapy induced nausea and vomiting].
Approximately 70-80% of all cancer patients receiving chemotherapy experience nausea and/or vomiting. Nausea and vomiting are important side effects of cancer treatment, which can significantly affect a patient's quality of life, leading to poor compliance with further chemotherapy treatment. The main principle of emesis control is prevention. ⋯ Antiemetic regimen should be chosen based on the emetogenic potential of the chemotherapy regimen, previous experience with antiemetics, and patient-specific risk factors. Newer agents, including second generation 5-HT3 receptor antagonist palonosetron and the NK-1 antagonist aprepitant, offer additional clinical benefit in highly and moderately emetogenic therapy, especially in delayed nausea and vomiting. The aim of this Guidelines is to achieve same standards of care in the treatment of nausea and vomiting across Croatia that are applicable in our environment--only available drugs are included in the Guidelines.
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Lijec̆nic̆ki vjesnik · Mar 2009
Review[Iliopsoas muscle syndrome. Functional disorders: shortening, spasm and weakness of a structurally unchanged muscle].
Functional (non-organic) disorders of the iliopsoas muscle (IPM), i.e. the shortening, spasm and weakness of the structurally unchanged IPM, can be manifested as abdominal and/or pelvic pain, pain in areas of the thoracolumbar (ThL) and lumbosacral (LS) spine, sacroiliac (SI) joint, hip, groin and anterior thigh on the side of the affected muscle as well as gait disturbances (iliopsoas muscle syndrome). By clinical examination of the IPM, including the transabdominal palpation, stretch and strength tests, pathological masses, shortening, painful spasm, weakness and tendon tenderness of that muscle can be diagnosed. The IPM is, like other postural muscles, inclined to shortening. ⋯ Reasons for overlooking these disorders are: 1) a nonspecific and variable clinical picture presenting the IPM functional disorders, 2) the IPM functional disorders are a neglected source of pain, 3) the inaccessibility of the IPM for inspection, 4) the lack of knowledge of the IPM examination techniques and 5) the IPM functional disorders cannot be discovered by radiological examinations of the abdomen. From a therapeutic point of view, it is important to recognise the IPM functional disorders since these disorders respond very well to appropriate therapy. Etiopathogenesis, clinical picture, diagnosis, differential diagnosis and therapy of the IPM functional disorders are described in the article.
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Lijec̆nic̆ki vjesnik · Jan 2009
Emergency medicine in Slovenia--emergency center, prehospital emergency medicine and academic emergency medicine.
Public health service is organized in such a manner so as to ensure all the inhabitants of the Republic of Slovenia the emergency medical assistance available at all times, including emergency transport and provision of emergency medicinal products as soon as possible and as close to the date of their manufacture as possible and during transport. Emergency medical assistance means the implementation of necessary measures by doctors and their teams with persons whose life is imminently threatened due to illness or injury and persons, respectively, who could be affected by such a risk in a short period of time according to the symptoms. Emergency calls are received and processed by the emergency medical assistance service which forms an integral part of the public health service network. ⋯ Slovenia has very well organised prehospital on-physician based emergency service and new qualification criteria for those physicians in emergency departments, therefore, need to be developed with primary education trainers for emergency medicine. In the model of integration of prehospital and hospital emergency medicine in academic emergency centers, emergency physicians work equal in ED and in the field on the method of rotation without changes of actual prehospital on-physicians based EMS. The integrative model have one in-door for emergency patients, mobility ofprehospital emergency physicians, a nurse-driven triage system and support of primary care physicians as gatekeepers.