Triiodothyronine hormone supplementation therapy in septic shock patients with euthyroid sick syndrome: two pilot, placebo-controlled, randomized trials.

Background: To assess 28-day survival in two pilot groups of septic shock patients with euthyroid sick syndrome (ESS) supplemented with triiodothyronine (T3).

Methods: A total of 95 septic shock patients with ESS were divided according to values of the thyroid hormones into low T3 and low T3T4 groups. Among 48 patients with low T3, 24 (50%) were randomized to T3 for 4 days and 24 (50%) to placebo.

Epidemiology of geriatric patients presenting to emergency departments in Europe: EGERS study.

Background And Importance: Patients aged 65 and above constitute a large and growing part of emergency department (ED) visits in western countries.

Objective: The primary aim of this European prospective study was to determine the epidemiologic characteristics of elderly patients presenting to EDs across Europe. Our secondary objective was to determine the hospitalization rate, characteristics, and in-hospital mortality rates of geriatric patients presenting to EDs.

Clinical Characteristics and Management of Patients with a Suspected COVID-19 Infection in Emergency Departments: A European Retrospective Multicenter Study.

Background: Our aim is to describe and compare the profile and outcome of patients attending the ED with a confirmed COVID-19 infection with patients with a suspected COVID-19 infection. Methods: We conducted a multicentric retrospective study including adults who were seen in 21 European emergency departments (ED) with suspected COVID-19 between 9 March and 8 April 2020. Patients with either a clinical suspicion of COVID-19 or confirmed COVID-19, detected using either a RT-PCR or a chest CT scan, formed the C+ group.

BILATERAL PNEUMOTHORAX AS A COMPLICATION OF PERCUTANEOUS TRACHEOSTOMY: CASE REPORT.

Percutaneous dilatational tracheostomy is a common surgical procedure that is becoming the method of choice in critically ill patients whenever prolonged airway secure and/or ventilation support is needed. Although adverse events are relatively uncommon, serious life threatening complications can arise from this bedside procedure. We report a case of a 70-year-old female who developed extensive subcutaneous emphysema and bilateral pneumothorax immediately after a percutaneous dilatational tracheostomy procedure.

Atmospheric pressure changes are associated with type a acute aortic dissections and spontaneous abdominal aortic aneurysm rupture in tuzla canton.

Aim: The aim of this study was to investigate a relationship between seasonal variation and incidence of type A acute aortic dissection (AAD) and spontaneous abdominal aneurysm rupture (rAAA) in Canton Tuzla, Bosnia and Herzegovina.

Patients And Methods: A total of 81 cases, 41 AAD and 40 of ruptured AAA were identified from one center over a 6-year, from 2008 till 2013. In 2012 were admitted (45.

Atmospheric pressure changes are associated with type A acute aortic dissections and spontaneous abdominal aortic aneurysm rupture in Tuzla Canton.

Aim: The aim of this study was to investigate a relationship between seasonal variation and incidence of type A acute aortic dissection (AAD) and spontaneous abdominal aneurysm rupture (rAAA) in Canton Tuzla, Bosnia and Herzegovina.

Patients And Methods: A total of 81 cases, 41 AAD and 40 of ruptured AAA were identified from one center over a 6-year, from 2008 till 2013. In 2012 were admitted (45.

Paraneoplastic limbic encephalitis in a patient with adenocarcinoma of the colon: a case report.

Paraneoplastic limbic encephalitis is a rare clinical entity characterized by the development of neuropsychiatric symptoms associated with malignancies. A case of a woman who presented to the Emergency Department with abdominal pain, hyperglycemia, and altered mental status is presented. After initial stabilization and correction of hyperglycemia the patient underwent emergency surgery.

[Perioperative disorders of mental functions].

Mental disorders are characterized by disturbances of thought, perception, affect and behavior, which occur as a result of brain damage. Recognizing and treating these conditions is necessary not only for psychiatrists but for all physicians. Disorder of mental function is one of the most common associated conditions in intensive care unit (ICU) patients.

[Delirium assessment scoring scales].

Delirium is a significant psychiatric disorder in intensive care units that has negative impact on morbidity and mortality of intensive care patients. Subjective clinical assessment of patients by non-psychiatric health professionals in intensive care units is not sufficient for detection and measurement of delirium. Therefore, different scoring scales for delirium assessment have been developed.

[Paraneoplastic limbic encephalitis].

Paraneoplastic limbic encephalitis (PLE) is a condition characterized by nervous system damage or dysfunction without indication that the nervous system is directly affected by tumor cells. Since it is clinically presented with an array of neuropsychiatric symptoms that usually precede the occurrence of malignant disease, and because of mimicking a psychiatric disease, it can sometimes make the diagnosis difficult and can be overlooked. Typical presentations consist of progressive confusion and deficits in short-term memory, which worsen over days to weeks.

[Wernicke's encephalopathy as a complication of bariatric surgery].

Wernicke's encephalopathy is an acute, serious brain disorder resulting from thiamine deficiency, which is important as a cofactor in several enzymes associated with carbohydrate metabolism. The encephalopathy is most often associated with severe alcohol abuse, but thiamine deficiency can be caused by many other medical conditions. Bariatric surgery is listed among the causes of Wernicke's encephalopathy.

[Altered mental status in intensive care unit patients].

Altered mental status is one of the most common disorders encountered by doctors in intensive care units and one of the most recognizable signs of serious illness. It can be caused by an organic, functional (psychiatric), or mixed disorder. There are two components of altered mental status, i.

[Acute compartment syndrome as a complication of prolonged surgery in the Lloyd Davies position].

Acute compartment syndrome of the muscle is condition in which prolonged increase of tissue pressure in closed unyelding fascial compartments reduces capillary perfusion below a level necessary for tissue viability leading to muscle and nerve ischaemia for few hours. There are wide variety different clinical settings associated with compartment syndrome. Acute lower limb compartment syndrome that occur during and after prolonged surgical procedures in Lloyd Davies position is rare but potentially devastating complication that can lead serious local complications and life threatening situations as, rabdomyolysis, kidney failure and death.

[Laparoscopic cholecystectomy in patients with ventriculoperitoneal shunt].

Because of development of laparoscopic surgery and by knowing of its pathophysiological effects on organism, indications for laparoscopic surgery have become more extensive, so this method is today used for therapeutic and diagnostic procedures. Although ventriculoperitoneal shunt is not normally considered a contraindication for laparoscopic surgery, pneumoperitoneum is described as a cause of raised intracranial pressure. Since 1992 when the first laparoscopic cholecystectomy was done at the University Department of Surgery of Sveti Duh Clinical Hospital in Zagreb, three patients with implanted ventriculoperitoneal shunt were managed successfully laparoscopically.

Efficacy of antimicrobial triclosan-coated polyglactin 910 (Vicryl* Plus) suture for closure of the abdominal wall after colorectal surgery.

This study compared Triclosan coated polyglactin 910 (Vicryl* Plus) with polyglactin 910 (Vicryl*) on abdominal wall healing in colorectal surgery patients. 184 patients with colorectal cancer were included in the study. In 91, the abdominal wall was closed with the Vicryl* Plus, and in 93 patients with Vicryl*.

[Acute compartment syndrome of the muscle in intensive care patients].

Acute compartment syndrome of the muscle occurs when elevation of tissue pressure in closed fascial compartments results in muscle and nerve ischemia. Prompt diagnosis and decompression is essential to avoid the devastating local complications with permanent disabilities and systemic even lethal complications. Despite its drawbacks, clinical assessment is still the diagnostic cornerstone of acute compartment syndrome.

[Effects of pneumoperitoneumon liver function].

Effects of pneumoperitoneum on liver function during laparoscopic procedures in most patients have no clinical relevance. However, with increasing number and types of surgical procedures the laparoscopic operation is now performed in high-risk patients, including patients with pre-existing liver disease. In these patients laparoscopic procedures may lead to serious complication, including acute liver failure.

[Iatrogenic injury of the brachiocephalic arterial trunk and its branches--case report].

Iatrogenic vascular traumas are increasing and their proportion exceeds 40% of all vascular injuries. We report on a rare case of iatrogenic injury of the brachiocephalic arterial trunk during surgical intervention due to postirradiation arteriopathy, which was successfully treated with a silver prosthesis graft. A 58-year-old male underwent surgery for metastases of papillary carcinoma of the thyroid gland, located in lymph nodes adjacent to the right common carotid artery and right subclavian artery.

A rare case of multiple aneurysms in a young patient.

Multiple aneurysms are clinically common in population aged over sixty and are caused mainly by atherosclerosis. When occurring in young population other etiologies such as trauma, infections, Bechet's disease, Marfan syndrome, neurofibromatosis or inflammatory disease are responsible for the development of arterial aneurysms. A rare case of multiple aneurysms in a 40-year-old man, affecting the infrarenal part of abdominal aorta, both iliac arteries, common femoral arteries, left femoral superficial and popliteal arteries on, both legs, is reported.

[Laparoscopic surgery during pregnancy].

Unlabelled: With the development oflaparoscopic surgery, number of contraindications has become less and less. At the beginning of laparoscopic surgery pregnancy was considered an absolute contraindication to laparoscopic surgery, because of unknown influence of CO2-pneumoperitoneum on fetus. Over the past few years, in literature there have been several case reports of successful laparoscopic surgery in pregnancy.