Medicinski pregled
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Neuropathic pain, or pain associated with disease or injury to the peripheral or central nervous system, is a common symptom of a heterogeneous group of conditions, including diabetic neuropathy; trigeminal neuralgia, postherpetic neuralgia and spinal cord injury. Chronic neuropathic pain should not be thought of as a symptom. It should truly be thought of as a disease with a very complicated pathophysiology. ⋯ There are many new agents and new applications of the existing agents being currently studied which will most certainly lead to even more improved ways of managing this very complicated set of disorders.
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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.
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Historical Article
[Historical and medical review of syphilis-afflicted army leaders, rulers and statesmen].
Syphilis has changed the course of history. It is a sexually transmitted disease caused by spiral-shaped bacterium, Treponema pallidum. The disease has been known under many names during history, and has had a prominent role in history and literature for the last several hundred years. ⋯ Syphilis exists even nowadays and according to the World Health Organization estimates, there are 12 million new cases of syphilis occurring each year. While syphilis eradication seems a biologically plausible goal, the major political, cultural, and logistic difficulties involved make it unlikely. Regrettably, rather than becoming an infection of historical significance, syphilis continues to challenge researchers and clinicians in the era of HIV.
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Patients with severe traumatic brain injury are at a risk of developing ventilator-associated pneumonia. The aim of this study was to describe the incidence, etiology, risk factors for development of ventilator-associated pneumonia and outcome in patients with severe traumatic brain injury. ⋯ The development of ventilator-associated pneumonia in patients with severe traumatic brain injury led to the increased morbidity due to the prolonged mechanical ventilation, longer stay at intensive care unit and chest injury, but had no effect on mortality.
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According to the World Health Organisation, counterfeit medicines are medicines that are mislabelled deliberately and fraudulently regarding their identity and/or source. All kinds of medicines have been counterfeited, both branded and generic ones. Counterfeit medicines may include products containing correct or wrong ingredients; without active or with insufficiently or over-active ingredients, or with fake packaging. ⋯ Pharmacists and doctors should stay vigilant and report suspicious products, and consider counterfeits as a possible cause of adverse reactions or therapeutic failure. Patients should inform their pharmacists and doctors if they suspect any irregularity concerning their medication, if they experience side effects or a decrease in beneficial effect. The crucial step in the prevention of counterfeit medicines is to get supplied from reliable sources, i.e. licensed pharmacies.