Lijec̆nic̆ki vjesnik
-
Lijec̆nic̆ki vjesnik · Jan 2010
Review[Lipopeptides and oxazolidinones--novel antibiotics in MRSA infection treatment].
Last few years vancomycin-intermediate S. aureus and vancomycin-resistent S. aureus have emerged, giving us a task to reevaluate susceptiblity to vancomycin in treatment of methicillin-resistent S. aureus (MRSA) infections. It is also oportunity to review necessity for new generation of antibiotics in treatment of MRSA infections. Efficacy of vancomycin treatment in MRSA bacteriemia is associated with minimal inhibitory concentration (MIC) and speed of killing colonies. ⋯ That's one of the reasons why there is novel antibiotic therapy for MRSA investigated, especially daptomycin and linezolid. Daptomycin is lipopeptide and an important optional antibiotic in MRSA infections treatment: bacteremia and endocarditis, even the tricuspidal valve endocarditis. Linezolid, as novel oxazolidinon, has shown good activity against gram-positive bacteria, especially in treatment of nosocomial pneumonia and complicated skin and soft tissue infections caused by MRSA.
-
Careful assessment of fluid balance is required in the perioperative period since appropriate fluid therapy is essential for successful patient outcomes. Volume status is frequently assessed by different hemodynamic variables that could be targeted as endpoints for fluid therapy and resuscitation. Goal directed fluid therapy is a method for correction of fluid status in individual patients that includes invasive hemodynamic monitoring and aggressive perioperative correction of hemodynamics. ⋯ It is associated with a variety of patophysiological disturbances, hydro-electrolyte balance disorders and compensatory mechanisms. Heart failure indicates careful assessment of fluid balance in perioperative period. The aim of this article is to describe actual techniques of hemodynamic measurements as well as main principles of fluid therapy to maintain hydro-electrolyte balance in patients with heart failure.
-
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.
-
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.
-
Lijec̆nic̆ki vjesnik · Jan 2009
Review[Tako-Tsubo cardiomyopathy; reversible left ventricular dysfunction mimicking acute myocardial infarction with ST-elevation].
Tako-Tsubo cardiomyopathy is still en entity of unknown etiology and pathophysiology which clinically manifests with sudden, severe chest pain and/or dyspnea. It is generally triggered by emotional or physical stress and most cases are reported in postmenopausal women. ⋯ Generally, Tako-Tsubo cardiomyopathy has a good prognosis, in-hospital mortality rate is about 1%. In this article, we present a review about todays knowledge on Tako-Tsubo cardiomyopathy.