scholarly journals Pleural Drainage and its Role in Management of the Isolated Penetrating Chest Injuries During the War Time in Sarajevo, 1992.-1995.

2007 ◽  
Vol 7 (2) ◽  
pp. 152-156
Author(s):  
Ademir Hadžismajlović ◽  
Alen Pilav
Keyword(s):  
Chest Tube ◽  
Massive Bleeding ◽  
Hospital Treatment ◽  
Pleural Drainage ◽  
Average Hospital ◽  
Chest Injuries ◽  
Results Of Treatment ◽  
Clinical Center ◽  
Great Vessels ◽  
The University

Penetrating chest injuries are the most frequent causes of serious demage and death in wounded indivisuals. In reports from the last wars where wounds caused by high velocity projectiles predominated, thoracotomies were perfomed in about 15% of the wounded individuals, mostly encompassing injuries of the heart and great vessels, accomanied by massive bleeding that could not be resolved by chest tube insertion. This retrospective analysis was performed on the medical records of 477 patients tretaed for isolated penetrating chest injuries in Department of Thoracic Surgery Clinical Center of the University in Sarajevo between april 1992 - june 1995. We analised the ways of their menagement with special view on pleural drainage, indication for this method and results of treatment. 398 (83,4%) wounded individuals have been treated with pleural tube inserting as definitive mesaure and for the urgent thoracotomy there were 79 (16,6%) patients left. Average hospital treatment in wounded drained patients was 7,68 days. With shrapnels there were 357 (74,84%) wounded individuals, and with bullet 120 (25,16%) wounded individuals. The complications of plaural tube inserting were - empyema in 34 (7,13%) patients and there were no other complications. Chest tube inserting as definitive mesaure was used in 398 (83,44%) patients. Chest tube inserting as preoperative measure (urgent thoracotomy) was used in 79 (16,56%) patients. There were 460 (96,44%) healed patients. Death occurred in 17 (3,56%) patients.

scholarly journals Prelabour Rupture of Membranes: Mode of Delivery and Outcome

2015 ◽  
Vol 3 (2) ◽  
pp. 237-240 ◽  
Author(s):  
Vlora Ademi Ibishi ◽  
Rozalinda Dusan Isjanovska
Keyword(s):  
Cesarean Section ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Maternal Complications ◽  
Cephalopelvic Disproportion ◽  
Cesarean Section Delivery ◽  
Clinical Center ◽  
Failed Induction ◽  
The University

BACKGROUND: Pre-labour Rupture of Membranes (PROM) is an important cause of maternal and fetal morbidity and increased rate of cesarean section delivery. AIM: The aim of this study is to investigate the clinical characteristics, PROM-delivery interval, mode of delivery, and early maternal neonatal outcome among pregnant patients presenting with pre-labour rupture of membranes.MATERIAL AND METHODS: This prospective case control study is implemented at the Obstetric and Gynecology Clinic of the University Clinical Center of Kosovo. The study included 100 pregnant patients presenting with prelabour rupture of membranes of which 63 were primigravida and 37 patients were multigravida.RESULTS: The incidence of cesarean section in this study is 28 % and the most common indications for cesarean delivery were fetal distress, malpresentation, cephalopelvic disproportion, and failed induction. The most common maternal complications in this study are chorioamnionitis, retained placenta and postpartum hemorrhage. Neonatal infectious morbidity was present in 16 % of cases.CONCLUSION: PROM is a significant issue for obstetricians and an important cause of maternal and neonatal morbidity and increased rate of cesarean section delivery.

scholarly journals Triage at a non-covid hospital during the COVID-19 pandemic

2021 ◽  
Vol 2 (3) ◽  
pp. 220-227
Author(s):  
Marina Đikić ◽  
Dušica Gujaničić ◽  
Ivana Milićević-Nešić ◽  
Marko Ercegovac ◽  
Slobodan Dželebdžić ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Critically Ill ◽  
Main Task ◽  
Emergency Center ◽  
Clinical Center ◽  
Epidemiological Risk ◽  
Body Temperature Measurement ◽  
Spread Of Infection ◽  
The University ◽  
Taking Care

At the time of the COVID-19 pandemic, the Emergency Center of the University Clinical Center of Serbia (EC-UCCS), although a non-covid hospital, had to adapt to taking care of a large number of critically ill and, at the same time, potentially contagious patients. In this paper, we present the ways that the EC-UCCS has adjusted to the conditions of the pandemic, where no precise protocols had previously been established for acting in these types of situations. In March 2019, the Admissions Triage Facility of Emergency Medicine (ATFEM) was established. The main task of this facility was to separate patients with epidemiological risk (ER) from patients without risk and to carry out their further isolated care. ER assessment involves completing an epidemiological questionnaire, a targeted brief history, body temperature measurement, and assessment of the patient's respiratory status. The complete triage process, initial diagnosis, and treatment of patients with ER is the task and responsibility of emergency medicine specialists. Between March 15, 2020 and March 15, 2021, about 155,000 patients were examined in triage, of whom 9,519 had ER and were taken care of in the ATFEM. This triage method minimizes the spread of infection while taking care of all critically ill patients, regardless of ER. However, both patients with low and high risk of COVID-19, were all admitted to the same facility, due to the shortage of available space. Also, triage relates only to "covid triage" and not to triage according to the degree of urgency of the patients, which is the primary task of every modern emergency center.

scholarly journals Analysis of epidemiological characteristics and surgical treatment of patients with pressure ulcer

2021 ◽  
pp. 93-93
Author(s):  
Dragana Petrovic-Popovic ◽  
Milan Stojicic ◽  
Maja Nikolic-Zivanovic
Keyword(s):  
Surgical Treatment ◽  
Pressure Ulcer ◽  
Traffic Accidents ◽  
Pressure Ulcers ◽  
Stage Iv ◽  
Clinical Center ◽  
Bony Prominence ◽  
The University ◽  
Epidemiological Characteristics ◽  
Reconstructive Methods

Introduction/Objective. A pressure ulcer is a localized injury to the skin and/or underlying tissue, usually over a bony prominence. It appears as a result of pressure or combination of pressure and shear. Pressure ulcers can be identified within a wide variety of patient subpopulations and a major role in their treatment plays epidemiological and etiological aspects. Methods. A retrospective study of data analysis included 72 patients with pressure ulcers that were hospitalized and surgically treated during a five-year period at the Clinic for Burns, Plastic and Reconstructive Surgery of the University Clinical Center of Serbia in Belgrade. Main data features used in the analysis were: gender, age, principal diseases, comorbidities and biochemical indicators of malnutrition. The patients' data was obtained from the existing patients? records. Additionally, the study analyzed the method of treating pressure ulcers, types of reconstructive methods in surgical treatment, as well as the incidence rate of partial osteotomy. Results. A total of 72 patients with pressure ulcers were included into this study with 54.7 ? 16.1 mean age. Three times more patients injured in traffic accidents were male (75% vs. 25%), while the most of the patients with multiple sclerosis were female (85.7%). More than 95% of patients who had pressure ulcers of III or IV stage were treated surgically with a reconstructive method of transposition or rotation myocutaneous flap. The patient with pressure ulcer of stage IV was usually treated with partial osteotomy. Conclusion. A surgical reconstructive treatment with fasciocutaneous and myocutanaeous flaps represents a gold standard for treating patients with pressure ulcers. These procedures provide reconstruction with adequate flap coverage and obliteration of dead space with well-vascularized tissue but with necessity of further implementation of antidecubitus measures.

scholarly journals Modern approaches to the treatment of retrosternal goiter

2021 ◽  
Vol 88 (1-2) ◽  
pp. 45-49
Author(s):  
V. V. Grubnik ◽  
R. S. Parfentiev ◽  
V. M. Kosovan ◽  
N. D. Parfentieva
Keyword(s):  
Massive Bleeding ◽  
Parathyroid Glands ◽  
Recurrent Nerve ◽  
Endoscopic Techniques ◽  
Results Of Treatment ◽  
Retrosternal Goiter ◽  
Duration Of Surgery ◽  
Group 3 ◽  
Group 2 ◽  
Standard Techniques

Objective. To analyze the results of treatment of patients with retrosternal goiter. Materials and methods. During the period from 2010 to 2019, 62 patients with thoracic goiter were operated on, which was 6.2% of all patients operated in relation to goiter. There were 48 women (77.4%) and 14 men (22.6%). Age of patients varied from 21 to 87 years (average age - 47 years). Computed tomography was mandatory in terms of research. The size of the sternal goiter and the degree of operative risk were determined by G. Mercante (2011). Results. In 39 patients (1st group) the operation was performed by cervicotomy according to standard techniques. Video endoscopic support was used in 23 patients, thanks to which in 15 patients (group 2) it was able to cross all blood vessels with the help of an electro coagulator and isolate nerve structures and parathyroid glands. In 8 patients (group 3) there was a massive bleeding after attempts of finger dissection. They underwent tamponade and temporarily stopped bleeding. After that, a video endoscope was inserted into the wound and hemostasis was performed with the help of an electrocoagulation. Bleeding from the surgical wound, which required revision, was not observed. Temporary tracheostomy in the postoperative period was imposed in 3 patients, later it was closed. Hypocalcemia occurred in 12 (19.3%) patients (in 11 it was transient). Transient paresis of the recurrent nerves was observed in 3 patients of the 1st, 2 of the 2nd and 2 of the 3rd groups. Permanent paresis of the recurrent nerve occurred in only 1 patient of the 3rd group. According to histological examination, 21 patients were diagnosed with cancer (19 - papillary, 2 - follicular). They subsequently underwent standard treatment for highly differentiated thyroid cancer. Conclusions. The use of cervical access with video endoscopic support during surgery for thoracic goiter avoids performing a sternotomy, reduces blood loss and operational trauma, improves the nerve structures and parathyroid glands identification, and reduces the duration of surgery. The use of modern methods of electrocoagulation significantly expands the capabilities of endoscopic techniques.

scholarly journals Pre-Hospital and In-Hospital Thoracostomy: Indications and Complications

2008 ◽  
Vol 90 (1) ◽  
pp. 54-57 ◽  
Author(s):  
Christopher J Aylwin ◽  
Karim Brohi ◽  
Gareth D Davies ◽  
Michael S Walsh
Keyword(s):  
Emergency Department ◽  
Chest Tube ◽  
Tension Pneumothorax ◽  
Tube Placement ◽  
Thoracic Injury ◽  
Complication Rates ◽  
Pleural Drainage ◽  
Chest Tubes ◽  
Chest Tube Placement ◽  
Output State

INTRODUCTION Pleural drainage with chest tube insertion for thoracic trauma is a common and often life-saving technique. Although considered a simple procedure, complication rates have been reported to be 2–25%. We conducted a prospective cohort observational study of emergency pleural drainage procedures to validate the indications for pre-hospital thoracostomy and to identify complications from both pre- and in-hospital thoracostomies. PATIENTS AND METHODS Data were collected over a 7-month period on all patients receiving either pre-hospital thoracostomy or emergency department tube thoracostomy. Outcome measures were appropriate indications, errors in tube placement and subsequent complications. RESULTS Ninety-one chest tubes were placed into 52 patients. Sixty-five thoracostomies were performed in the field without chest tube placement. Twenty-six procedures were performed following emergency department identification of thoracic injury. Of the 65 pre-hospital thoracostomies, 40 (61%) were for appropriate indications of suspected tension pneumothorax or a low output state. The overall complication rate was 14% of which 9% were classified as major and three patients required surgical intervention. Twenty-eight (31%) chest tubes were poorly positioned and 15 (17%) of these required repositioning. CONCLUSIONS Pleural drainage techniques may be complicated and have the potential to cause life-threatening injury. Pre-hospital thoracostomies have the same potential risks as in-hospital procedures and attention must be paid to insertion techniques under difficult scene conditions. In-hospital chest tube placement complication rates remain uncomfortably high, and attention must be placed on training and assessment of staff in this basic procedure.

Chemotherapy plus cyclosporine A for the treatment of intraocular retinoblastoma: The University of Miami Miller School of Medicine experience

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 20005-20005
Author(s):  
C. E. Fernandes ◽  
A. C. Schefler ◽  
T. G. Murray ◽  
J. A. Davis ◽  
O. A. Alvarez ◽  
...  
Keyword(s):  
Cyclosporine A ◽  
Standard Of Care ◽  
Local Ablation ◽  
Results Of Treatment ◽  
School Of Medicine ◽  
Steady State Levels ◽  
University Of Miami ◽  
Intraocular Retinoblastoma ◽  
The University ◽  
Salvage Rate

20005 Background: In the past decade chemotherapy and focal control became the standard of care in retinoblastoma. The ideal chemotherapy regimen has not yet been determined. We analyzed the results of treatment at the University of Miami Miller School of Medicine using the regimen carboplatin (20 mg/kg, day 1), vincristine (0.05 mg. /kg, day 1), etoposide (5 mg / kg, days 1 and 2) with or without cyclosporine A (10 mg. /kg over 2 hours followed by 45 mg/kg over 31 hours) every 3–4 weeks. We attempted to maintain peak CSA levels between 2,400 and 6,000 and steady state levels between 2,400 and 4,200 ng/ml. When CSA was given, vincristine was started at 0.0125 mg /kg. The dose was escalated by 25% with each cycle of therapy, as tolerated. Methods: A retrospective analysis was performed in 41 patients diagnosed with bilateral retinoblastoma from Dec 1996 to Jan 2006. Only eyes with intraocular disease (76 eyes) were included in this analysis. Before each cycle of chemotherapy ophthalmologic examination under anesthesia was performed and active tumor and seeding were treated with local ablation using laser therapy. Eyes in which enucleation was planned at diagnosis were excluded from this analysis. Results: Most patients received 9 cycles of chemotherapy. Sixty percent (46/76) of the eyes were treated with chemotherapy and CSA. The eye salvage rate for eyes classified by the International Classification of Retinoblastoma (ICRB) as groups A, B, C and D was 100%. The eye salvage rate for the 21 eyes classified as ICRB group E was 29%. No difference in salvage rate was observed in eyes treated with or without CSA. One patient died from disease progression. Only one patient required radiation therapy to both eyes. To date there have been no reports of development of secondary malignancies. Conclusion: The addition of CSA to the treatment of the eyes classified as ICRB groups A, B, C and D made no difference in the eye salvage rate. Also, we were not able to demonstrate any benefit from the addition of CSA in patients with stage E eyes- although our sample size was quite small. Aggressive focal control and chemotherapy beginning at diagnosis may be the reason for the excellent EFS in group A, B, C and D eyes. No significant financial relationships to disclose.

scholarly journals Influence of Gender and Age on Average Dimensions of Arteries Forming the Circle of Willis Study by Magnetic Resonance Angiography on Kosovo’s Population

2017 ◽  
Vol 5 (6) ◽  
pp. 714-719 ◽  
Author(s):  
Jeton Shatri ◽  
Dorentina Bexheti ◽  
Sadi Bexheti ◽  
Serbeze Kabashi ◽  
Shaip Krasniqi ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Collateral Circulation ◽  
Descriptive Study ◽  
Circle Of Willis ◽  
Clinical Center ◽  
Gender And Age ◽  
Left And Right ◽  
Cadaver Studies ◽  
The University ◽  
The Brain

BACKGROUND: Circulus arteriosus cerebri is the main source of blood supply to the brain; it connects the left and right hemispheres with anterior and posterior parts. Located at the interpenducular fossa at the base of the brain the circle of Willis is the most important source of collateral circulation in the presence of the disease in the carotid or vertebral artery.AIM: The purpose of the research is to study the diameter and length of arteries and provide an important source of reference on Kosovo’s population.METHODS: This is an observative descriptive study performed at the University Clinical Center of Kosovo. A randomised sample of 133 angiographic examinations in adult patients of both sexes who were instructed to exploration is included.RESULTS: The diameters and lengths measured in our study were comparable with other brain-cadaver studies especially those performed by MRA. All dimensions of the arteries are larger in male than female, except the diameter of PCoA that is larger in female (p < 0.05) and length of the ACoA (p < 0.05). Significant differences were found in diameters of arteries between the younger and the older age groups.CONCLUSION: Knowing the dimensions of the arteries of the circle of Willis has a great importance in interventional radiology as well as during anatomy lessons.

Recurrent Massive Bleeding from an Intercostal Artery Aneurysm Through an Empyema Chest Tube

CHEST Journal ◽  
1993 ◽  
Vol 104 (2) ◽  
pp. 637-639 ◽  
Author(s):  
Petham Muthuswamy ◽  
Jacob Samuel ◽  
Barry Mizock ◽  
Patrick Dunne
Keyword(s):  
Chest Tube ◽  
Artery Aneurysm ◽  
Massive Bleeding ◽  
Intercostal Artery ◽  
Intercostal Artery Aneurysm
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