Background: Acute left ventricular free wall rupture (LVFWR) is a life-threatening complication of myocardial infarction that requires urgent intervention. Surgical repair has continued to be the treatment of choice. Studies suggest a posterolateral or inferior infarction is more likely to result in free wall rupture than an anterior infarction. LVFWR generally results in death within minutes of the onset of recurrent chest pain, and on average was associated with a median survival time of 8 hours. Prompt diagnosis and management can lead to successful treatment for LVFWR. Objective: The aim of this article was to present an emergency case with an LVFWR in a COVID-19 patient who suffers from AMI and was treated with PCI stents in the ramus intermedius and circumflex coronary artery. Case report: We present an emergency case with an LVFWR in a COVID-19 patient who suffers from AMI and was treated with PCI stents in the ramus intermedius and circumflex coronary artery. Although dual antiplatelet therapy introduction and good outcome of PCI were achieved, soon after instant thrombosis of both stents appear to result in transmural necrosis and LVFWR. Urgent catheterization was performed and diagnosed in-stent thrombosis where the ventriculography confirmed LVFWR of the posteroinferior wall. Urgent surgery was performed. Transmural necrosis was noticed alongside the incision line. The incision is sawn with 4 U-stitches (Prolen 2.0 with Teflon buttressed stitches). Another layer of fixation was made by Prolen 2.0 running stitches reinforced with Teflon felts from both sides. A large PTFE patch was fixed to epicardium over the suture line by Prolen 6.0 running stitch and BioGlue was injected in-between patch and LV (Figures 8 and 9). After aortic cross-clamp removal, the sinus rhythm was restored. Conclusion: Despite the high mortality, the urgency and the complexity of surgical treatment the early diagnosis plays a key role in the management of postinfarction LVFWR patients presenting a case of preserved postoperative left ventricular function and accomplished good functional status, as presented in our case.
Background: The use of resolution recovery (RR) in bone and myocardial perfusion imaging is becoming increasingly popular in nuclear medicine departments. RR produces reconstructed images that show improved spatial resolution and signal-to-noise ratio compared with conventional single-photon emission computed tomography (SPECT) images. Objective: To evaluate the impact of the ordered subset expectation maximization (OSEM) RR modality on preserving noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) for short SPECT acquisition. Methods: This prospective study was conducted on 80 patients. Full SPECT acquisition was performed as a standardized protocol, while reduced acquisition was achieved with the Poisson resampling method. Noise, SNR, and CNR were measured for different reconstruction parameters for the same image levels. The impact of surface area and body mass index was also measured for the same reconstruction parameters. Results: The results show significantly higher SNR and CNR for the Evolution for Bone protocol compared to the other two reconstruction protocols for full and reduced SPECT acquisition. With the shortening of the SPECT acquisition, an increase in the value of noise was recorded. SNR and CNR decreased with the reduction in SPECT acquisition. Conclusion: The Evolution for Bone protocol for all three analyzed acquisition protocols had the lowest noise values. The highest SNR and CNR were recorded in the Evolution for Bone protocol for the three acquisition protocols and SPECT acquisition time can be reduced from 20 to 10 min for bone SPECT.
Abstract Objectives The aim of the study was to analyze the occurrence of stress on teeth with abfraction lesions restored with six different restorative materials, and by introducing the tensile strength parameters to calculate the safety factor of the material under the load (ratio between the strength of the material and the maximum stress). Materials and Methods Three-dimensional models of the mandibular premolar are created from a microcomputed tomography images. An abfraction lesion is modeled on the tooth. The stress of the dental tissues and six restorative materials under functional and nonfunctional occlusal loading of 200 (N) are analyzed by finite element method. Statistical Analysis CTAn program 1.10 and ANSYS Workbench (version 14.0) were used for analysis. Results are presented in von Mises stress. Results Oblique loads caused ≈ four times higher stress in restorative materials than the axial ones. It is noticeable that high values of von Mises stress are measured at the bottom of the sharp lesion, even up to 240 MPa, that are significantly reduced after the restoration. The highest stresses at the restorative material are present at the lower (gingival) margin of the restoration. The highest stresses under both types of loads are measured in nanohybrid composite (Tetric EvoCeram, Ivoclar Vivadent). The lowest values of the stress are measured in the flowable composite (Tetric Flow, Ivoclar Vivadent), but at the same time, the highest value of the stress is measured in the surrounding dental tissues on the tooth restored with the flowable composite. The microhybrid composite (Herculite XR, Kerr), with the highest safety factor, is the material that best withstands the stresses it is exposed to. The obtained safety factor did not exceed the critical limit, except for the glass ionomer cement, with the safety factor lower than 1. Conclusion The type of tooth loading has the greatest influence on the intensity of stress. The value of the obtained stresses in the restorative material and dental tissues differ due to the different mechanical properties of the materials. Restoration of noncarious lesions significantly reduces extremely high stress values at their bottom.
Simple Summary In order to compare responses to different therapies among clinical trials and to differentiate between therapy-induced changes and true tumor progression, reliable response parameters are crucial. With the advent of targeted and immunologic treatments, several assessment tools have been proposed. In this post hoc analysis we compared assessment criteria according to MacDonald, RANO, mRANO, iRANO as well as Vol-RANO and Vol-mRANO in patients with newly diagnosed glioblastoma treated with standard of care (SOC) ± tumor lysate-charged autologous dendritic cells (Audencel). We found that the best correlation between progression-free survival (PFS) and overall survival (OS) was seen for mRANO and Vol-mRANO. Interestingly, iRANO was not superior for predicting OS in patients treated with Audencel. Abstract Introduction: In this post hoc analysis we compared various response-assessment criteria in newly diagnosed glioblastoma (GB) patients treated with tumor lysate-charged autologous dendritic cells (Audencel) and determined the differences in prediction of progression-free survival (PFS) and overall survival (OS). Methods: 76 patients enrolled in a multicenter phase II trial receiving standard of care (SOC, n = 40) or SOC + Audencel vaccine (n = 36) were included. MRI scans were evaluated using MacDonald, RANO, Vol-RANO, mRANO, Vol-mRANO and iRANO criteria. Tumor volumes (T1 contrast-enhancing as well as T2/FLAIR volumes) were calculated by semiautomatic segmentation. The Kruskal-Wallis-test was used to detect differences in PFS among the assessment criteria; for correlation analysis the Spearman test was used. Results: There was a significant difference in median PFS between mRANO (8.6 months) and Vol-mRANO (8.6 months) compared to MacDonald (4.0 months), RANO (4.2 months) and Vol-RANO (5.4 months). For the vaccination arm, median PFS by iRANO was 6.2 months. There was no difference in PFS between SOC and SOC + Audencel. The best correlation between PFS/OS was detected for mRANO (r = 0.65) and Vol-mRANO (r = 0.69, each p < 0.001). A total of 16/76 patients developed a pure T2/FLAIR progressing disease, and 4/36 patients treated with Audencel developed pseudoprogression. Conclusion: When comparing different response-assessment criteria in GB patients treated with dendritic cell-based immunotherapy, the best correlation between PFS and OS was observed for mRANO and Vol-mRANO. Interestingly, iRANO was not superior for predicting OS in patients treated with Audencel.
Acta Informatica Medica journal (www.actainformmed.org), as Biomedical Informatics journal, during past 30 years of existing played important role in distribution of knowledge and experience within this scientific field, by publishing contributions of the biomedical experts from worlwide and spreading of Biomedical informatics knowledge and experiences in scientific and academic community. Acta Informatica Medica journal has been founded in the year 1993 by Izet Masic and Zoran Ridjanovic, as official journal of Bosnian-Herzegovinan Society of Medical Informatics (BHSMI). In the year 2019 Acta Informatica Medica has been accepted as official journal of the European Federation for Medical Informatics (www.efmi.org), besides 3 other journals: International Journal of Medical Informatics, Methods of Information in Medicine and European Journal of Biomedical Informatics. Journal Acta Informatica Medica is abstracted and indexed in 30 on-line data bases, including Pubmed, Pubmed Central, Scopus, Embase, Hinari, etc. The journal follows the Guidelines and recommendations of ICJME, COPE, EASE, WAME, etc. as well as the recommendations of the “Sarajevo Declaration on Integrity and Visibility of Scholarly Journals”, accepted by 17 Editors of biomedical journals at “SWEP 2018” Conference held in Sarajevo and printed in the countries in South-Eastern Europe. The journal supports presentations at conferences held in Bosnia and Herzegovina. The abstract papers presented at “The Mediterranean Seminar on Science Writing, Editing and Publishing“ – “SWEP 2016”, “SWEP 2018”; “SWEP 2020” and “SWEP 2021”, also found its place in the journal, by which we met our goal of promoting science and scientific publication at the area of Bosnia and Herzegovina and other countries in the region. Acta Informatica Medica has been ranked: Highest Impact Factor for 2011–2022 was 1.496 and Lowest Impact Factor for 2011–2022 was 0.59. During the year 2021 in Acta Informatica Medica journal was published 46 papers. From total amount published papers, 67,39% was original papers, where it was more published original papers in the journal than in the year 2020. Acta Informatica Medica has value of important metrics (last updated on November 16, 2021): Impact Score - 1.50, h-Index - 20, Rank - 15980, SJR - 0.267.
Background: We could say that traditional healing is a way of healing that has been common since ancient times. It has been passed down from generation to generation for many centuries. Magic medicine, although not approved by any of the monotheistic religions present in Bosnia and Herzegovina, and strictly prohibited by Islam, in the form of various magical acts and spells, exists among the people. Some of these magical practices have their roots in the pre-Christian Slavic period and earlier. Objective: The aim of this article was to provide the review of the traditional medicine during the history and today in Bosnia and Herzegovina. Methods: Review of the available literature, personal contacts and personal experience in contact with the traditional medcine. Discussion: Some of these magical practices have their roots in the pre-Christian Slavic period and earlier. Since the cause of the disease was usually associated with evil beings of supernatural powers, a deity or God’s will or punishment, it is understandable that priests have long been engaged in healing. Especially in the mentally ill, there seemed to be a certain divine or demonic origin of the disease. Muslim folk medicine divides diseases into two groups; in fevers and obsessions with unclean spirits. Folk medicine knows the healing properties of herbs and other substances of animal or mineral origin. The medicinal properties of simple foods that can be found in every home are also widely used, such as: milk, honey, vinegar, oil, onion, and garlic. Prescription books, known as “ljekaruše”, were created by collecting and writing down folk remedies. They were written mostly by Catholic priests. “Witch doctors” or “healers” have been preserved in Orthodox monasteries. Conclusion: Traditional medicine is important for history of medicine, ethnology, anthropology, and abounds in folklore elements. It is an area that leads to knowing, understanding or feeling the very nucleus of a nation.
Background: After the World Health Organization declared the outbreak of a new coronavirus on 30 January 2020 a public health emergency of international importance, health authorities in Bosnia and Herzegovinaas in other countries around the world, have ordered active surveillance, early detection, isolation and management, cases, contact monitoring and prevention of the spread of infection. Objective: The aim of this study was to describe and analyze of the organization of family medicine during COVID-19 pandemic in Canton Sarajevo with its positive and negative aspects. Methods: The case study design provided an ideal framework for systematic research into the organization of primary health care in Sarajevo Canton during the COVID-19 pandemic as it is an empirical study exploring a contemporary phenomenon within its real-life context when the boundaries between phenomenon and context are not clearly visible. Multiple sources of evidence are used. Data were collected in several different ways: analyzing policies, laws, regulations, decisions related to the COVID pandemic, insight into changes in the health information system, collecting data from reports, and through a group interview (Delphi exploratory) with eleven family medicine specialists. Results: Primary care was organized as two parallel systems with family medicine in the center. The first system was COVID-19 primary care and the second was regular care for non-COVID-19 patients. Family medicine physicians despite a numerus setbacks provide health care for 106346 COVID-19 cases. Discussion: Every principal (first contact access, person-centered care, comprehensiveness, continuity of care, community based, coordination of care, and holistic modeling) of family medicine was interrupted with consequences for patients and family physicians. Conclusion: Additional research is needed to examine all facets of the family medicine and primary health care response to the COVID-19 pandemic in Sarajevo Canton.
This study was intended to determine the effect of adding flax seeds to a concentrate for lamb fattening on the fatty acid composition of the omental fat depot in Pramenka lambs reared indoors. A total of 63 lambs (10±3 kg of live body weight, 30±7 days of age, 30 males and 33 females) were used. They were divided into two groups: a control (CON) fed on hay, ewe's milk, and a 300-g daily ration of a commercial concentrate, and an experimental group (FS) fed on hay, ewe's milk and 300 g/day of the concentrate enriched with 5% of flax seeds. After a 60-day fattening period for each group, 10 lambs (5 males and 5 females) were selected and omental fat samples were analysed for fatty acid composition. Highly significant differences (p⟨0.001) were found between CON and FS in α-linolenic acid, the sum of n-3 fatty acids, and the ratio n-6/n-3 fatty acids. The effect of sex on the fatty acid content in the fat depot was only significant for C20:0 fatty acid (p⟨0.05).
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