Lijec̆nic̆ki vjesnik
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Lijec̆nic̆ki vjesnik · Nov 2011
Comparative Study[Comparison of new and old tests for the diagnosis of latent tuberculosis infection (quantiferon and TST)].
Tuberculosis (TB) is the second most common contagious disease, caused by Mycobacterium tuberculosis (M. tuberculosis). Besides a rare laryngeal tuberculosis, pulmonary tuberculosis is the only one contagious form of the disease, although it can affect any organ of the human body. TB represents a new challenge to the doctors because it appears with numerous chronic diseases, affects immunocompromised hosts, elderly people and because nonadequate therapy could create drug resistant tuberculosis. ⋯ TB) now exist. This paper presents advantages and disadvantages of both methods. IGRA tests are considered to have higher specifity and sensitivity than TST.
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Lijec̆nic̆ki vjesnik · Sep 2011
Review[Lumbosacral facet syndrome: functional and organic disorders of lumbosacral facet joints].
Disorders of lumbosacral (LS) facet joints are manifested by low back pain with or without referred leg pain and decreased mobility of the LS spine (LS facet syndrome). The most frequent causes of LS facet syndrome are functional disorders (functional blockade or dysfunction of facet joint=reversible restriction of facet joint movements caused by meniscoid entrapment) and degenerative changes of facet joints while the others are less frequent (spondyloarthropathies, infection, tuberculosis, synovial cyst, injury). Although it has been proven that the facet joints are one of the most frequent sources of chronic low back pain (15-45%), the fact is that the facet syndrome has been frequently overlooked in patients with chronic low back pain. ⋯ Acute LS facet syndrome caused by dysfunction of facet joints responds very well to manual therapy. The most important therapeutic options in patients with chronic LS facet syndrome caused by degenerative changes and/or dysfunction of facet joints are manual therapy, kinesiotherapy (flexion exercises), therapeutic blocks and radiofrequency denervation. The article describes etiopathogenesis, clinical manifestations, diagnosis, differential diagnosis and therapy of LS facet syndrome with emphasis on functional disorders of facet joints that can cause particular diagnostic and therapeutic problems.
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Lijec̆nic̆ki vjesnik · May 2011
Review[Vitamin D: vitamin from the past and hormone of the future].
In the last decade there has been a rising recognition of potential clinical significance of the vitamin D. Vitamin D regulates about 3% of the human genome. ⋯ In this paper vitamin D metabolism and up to date knowledge of vitamin D function in calcium metabolism, muscular function and in prevention of infection, malignancy, autoimmune and cardiovascular diseases is presented. Reasons for pandemic vitamin D deficiency and guidelines for vitamin D supplementation are given.
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Lijec̆nic̆ki vjesnik · Mar 2011
Editorial Practice Guideline[European guidelines on the diagnosis and management of pulmonary embolism].
We report on the 2008 update of Guidelines on the diagnosis and management of acute pulmonary embolism (PE) of the European Society of Cardiology that have been endorsed and recommended by the Croatian Cardiac Society. The guidelines focus on currently available and validated methods of diagnosis, prognostic assessment (prediction of outcome and death risk), treatment of pulmonary embolism and management in specific settings including pregnancy, malignancy, non-thrombotic PE, right heart thrombi, heparin-induced thrombocytopenia, chronic thromboembolic pulmonary hypertension. The novelty of these guidelines is the stratification of PE into high-risk, low-risk and intermediate-risk of PE-related early death, which has important consequences for treatment, rather than the use of misleading terms such as zmassive', zsubmassive' and znon-massive' pulmonary embolism. The anticoagulants remain the mainstay of therapy, with thrombolytic therapy being an therapeutic option in patients with high-risk PE presenting with cardiogenic shock and/or persistent arterial hypotension.