Medicinski pregled
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Chronic obstructive pulmonary disease is estimated to become the fifth leading cause of death worldwide by 2020. The mortality and morbidity from chronic obstructive pulmonary disease is getting higher and higher as a result of the epidemics in tobacco consumption all over the world, especially in developing countries. The study objectives were to determine the correlation between the smoking habits and mortality in the patients with chronic obstructive lung diseases, to evaluate the two-year and five-year survival depending on the smoking habits, to compare and correlate the smoking habits and a decrease in the lung function. ⋯ According to this study, the progression to the end stage of this disease is faster in smokers suffering from chronic obstructive pulmonary disease than in the non-smokers and the former smokers who suffer from this disease.
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Stroke is the most frequent neurological disorder, and the most common cause of severe disability compared to other diseases. Recombinant tissue plasminogen activator (rt-PA) is the only approved specific therapy for acute ischemic stroke. Hemorrhage is a significant complication of thrombolytic treatment. ⋯ The death rate related to hemorrhage after thrombolysis was 3%. The frequency of hemorrhagic events (hemorrhagic infarctions type 1 and 2, parenchymal hematomas type 1 and 2) was 16%. The study results have shown that the intravenous recombinant tissue plasminogen activator (rt-PA) therapy is safe.
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Application of blood and blood components throughout decades is very successful and mostly safe procedure in patients' therapy. However, it may lead to unfavourable effects, such as transfusion reactions. ⋯ To improve and make blood transfusion safer it is necessary to respect all pre-transfusion procedures, constant follow up of blood transfusion must be done and patients with diagnosed non-haemolytic transfusion reaction should be given leukocyte reduced blood components.
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Randomized Controlled Trial
Prognostic significance of intracranial pressure monitoring and intracranial hypertension in severe brain trauma patients.
Since without prospective randomized studies it is not possible to have a clear attitude towards the importance of intracranial pressure monitoring, this study was aimed at examining the prognostic effect of the intracranial pressure monitoring and intracranial pressure oriented therapy in severe brain trauma patients, and at defining optimal intracranial pressure values for starting the treatment. Two groups of patients were treated in the study, one consisted of 32 patients undergoing intracranial pressure monitoring and the second group of 29 patients without intracranial pressure monitoring in the control group. ⋯ The average intracranial pressure in the patients with intracranial hypertension who died was 27 mm Hg, while in the patients who survived the average intracranial pressure was significantly lower (Student's t test: t=2.91; p=0.008; p<0.01) and it was 18 mm Hg. We recommend starting intracranial pressure oriented therapy when the patient's intracranial pressure exceeds 18 mmHg during 2 hours of monitoring.