Browsing by Author "Jovičić, Nevena (57204552756)"

Introduction/Objective Cardiovascular disease is one of the most common comorbidities among subjects with chronic obstructive pulmonary disease (COPD). The aim of this study is to evaluate electrocardiogram (ECG) parameters and mortality predictors in COPD patients. Methods A total of 835 consecutive patients were included. The patients were classified to suffer from COPD if the forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) was < 70% in three consecutive postbronchodilator measurements. The following ECG changes were observed: axis, P wave, low ORS complex, transitional zone, left bundle branch block (LBBB), right bundle branch block (RBBB), incomplete RBBB, S1S2S3 configuration, negative T in V1–V3. The patients were followed up for mortality over a five-year period. Results Both survivors and non-survivors were of similar age, sex, and COPD status. FVC and FEV1, as well as Global Initiative for Chronic Obstructive Lung Disease stadiums were significantly higher in the survivor group (p < 0.016, p < 0.001, p < 0.001, respectively). Normal axis was in significantly higher percentage in non-survived patients (p = 0.020). RBBB and incomplete RBBB are more frequent findings in patients who died (p < 0.001, p < 0.05, respectively). LBBB, S1S2S3 configuration is in significantly higher percentage present in non-survivors (p < 0.016, p < 0.001, respectively). In the multivariable logistic model, patients with LBBB have two times higher chance of mortality compared to patients without LBBB. In contrast, patients with RBBB have 1.6 times lower chance of having death outcome. Conclusion The main ECG predictors of COPD patients’ five-year mortality are LBBB and RBBB, but according to statistical model, ECG should be further explored and possibly obligatory involved in a routine clinical practice as an easy and low-cost screening method. © 2021, Serbia Medical Society. All rights reserved.

Introduction Celiac crisis is a rare and life-threatening complication of celiac disease. Although it occurs in all ages, the most common affects children within the first two years. Outline of cases We report three infants (two female, one male, age range 9–12) with celiac crises as an initial presentation of celiac disease precipitated with rotavirus gastroenteritis. Celiac crisis was preceded by failure to thrive caused by anorexia, occasional vomiting and frequent abundant stools for 4–8 weeks, and 1–2 days before admission with fever, frequent vomiting and profuse watery diarrhea. They were admitted in a very severe general condition, severely dehydrated, markedly malnourished, with an enormously distended abdomen, edema of the lower legs and feet, and perianal erythema. After correction of dehydration and hypoalbuminemia, they were placed on a gluten-and disaccharide-free diet and within the first two weeks on additional parenteral nutrition. The applied therapeutic measures resulted in stabilization and further rapid improvement of the patient’s condition. In all three patients the latex agglutination test for rotavirus was positive, IgA anti-TTG antibodies elevated (58.6–78 U/ml) and all three were homozygous carriers of the HLA DQ2 gene. Enterobiopsy was performed two weeks after the admission and total villous atrophy (Marsh IIIc) was registered in all three patients. In the further course, the complete recovery of the patient was accomplished by a strict gluten-free diet. Conclusion Our experience indicates that rotavirus gastroenteritis in timely unrecognized classical celiac disease in infants can lead to celiac crisis. © 2021, Serbia Medical Society. All rights reserved.

Introduction/Objective Pain is a disturbing experience associated with existing or potential tissue damage, with a sensory, emotional, cognitive, and social component. The aim of this study was to show the efficiency of regional anesthetic techniques in postoperative pain in children. Methods The retrospective cohort study was conducted on a group of 564 pediatric patients during the period from 2013 to 2016. Types of regional anesthesia were classified into the following six groups: caudal, epidural, spinal block, upper limb blocks, lower limb blocks, and truncal nerve block. From statistical methods, we used descriptive statistical methods of absolute and relative numbers, measurements of variability, central tendencies for numerical features, and methods of inferential statistics. We used the ?2 test for the attributive features of observations. Results In relation to the postoperative time when an analgesic was required, a statistically significant difference was observed in the age of children (p = 0.000), disease diagnosis (p = 0.000), type of block (p = 0.000), type of local anesthetic (p = 0.000), and type of anesthesia or sedation preoperatively (p = 0.005). Conclusion Postoperative analgesia was most needed by older children and children who were awake during surgery. Children with injuries and tumors need postoperative analgesia the earliest. The longest postoperative analgesia was recorded in patients who received caudal block. The longest postoperative analgesia can be seen in patients who received levobupivacaine, bupivacaine or levobupivacaine combined with lidocaine to perform the block. © 2019, Serbia Medical Society. All rights reserved.