R. Dmitrović, B. Lazovic, Isidora Simonovic, A. Esquinas, Mersudin Mulić
Introduction and case report: We described a case of primary spontaneous partial pneumothorax in a middle-aged man with COVID-19 pneumonia who presented with fever, loss of appetite, and malaise. Laboratory results revealed higher levels of inflammatory markers, as well as sterile urine and blood cultures. On admission, a chest X-ray revealed bilateral patchy consolidations in the lung parenchyma, as well as a left-sided partial pneumothorax. Throughout his hospitalization, the patient was closely examined by a thoracic surgeon, and a chest X-ray was taken on multiple occasions. There was spontaneous resorption of air from the pleural space. Conclusion: Pneumothorax is a rare but serious complication of the COVID-19 infection that has recently been documented in patients with no comorbidities, requiring various types of ventilatory support. The precise mechanism of primary spontaneous pneumothorax in COVID-19 infection is unknown, but it will undoubtedly pose a challenge to future researchers.
{"title":"PRIMARY SPONTANEOUS PARTIAL PNEUMOTHORAX IN A PATIENT WITH COVID-19 PNEUMONIA. HAVE WE UNDERESTIMATED THIS COMPLICATION? A CASE REPORT","authors":"R. Dmitrović, B. Lazovic, Isidora Simonovic, A. Esquinas, Mersudin Mulić","doi":"10.5937/sanamed17-36543","DOIUrl":"https://doi.org/10.5937/sanamed17-36543","url":null,"abstract":"Introduction and case report: We described a case of primary spontaneous partial pneumothorax in a middle-aged man with COVID-19 pneumonia who presented with fever, loss of appetite, and malaise. Laboratory results revealed higher levels of inflammatory markers, as well as sterile urine and blood cultures. On admission, a chest X-ray revealed bilateral patchy consolidations in the lung parenchyma, as well as a left-sided partial pneumothorax. Throughout his hospitalization, the patient was closely examined by a thoracic surgeon, and a chest X-ray was taken on multiple occasions. There was spontaneous resorption of air from the pleural space. Conclusion: Pneumothorax is a rare but serious complication of the COVID-19 infection that has recently been documented in patients with no comorbidities, requiring various types of ventilatory support. The precise mechanism of primary spontaneous pneumothorax in COVID-19 infection is unknown, but it will undoubtedly pose a challenge to future researchers.","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48492133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emina Hadžimuratović, Admir Hadžimuratović, D. Pokrajac, A. Selimović, Senad Muhasilović
Introduction: Brain MRI scans can predict neurodevelopmental outcomes in neonates treated with therapeutic hypothermia. It is a common clinical practice to perform brain MRI before discharge, but brain MRI scans performed at around four months of age have a better prognostic value for a long-term neurological outcome in asphyxiated neonates. Aim: To identify which of three selected clinical parameters (oral feeding ability, muscle tone, history of seizure) evaluated 10 days after therapeutic hypothermia could predict the primary outcome of an abnormal brain MRI. Methods: We reviewed the medical records of neonates ≥ 36 completed weeks of gestation consecutively treated with therapeutic hypothermia who underwent brain MRI. Clinical parameters on day 10 after therapeutic hypothermia were correlated with brain MRI findings in the first 7-14 days of life. Logic regression analysis was performed using all three covariates of the clinical status, with an abnormal MRI as the primary outcome. Results: Brain MRI was abnormal in 42 (51.85 %) neonates with the following distribution of brain injury patterns: abnormal signal in the basal nuclei in 6, an abnormal signal in the cortex in 16, an abnormal signal both in the cortex and basal nuclei in 20 neonates. Out of three analyzed clinical parameters, feeding difficulty (P < 0.001, OR 8.3, 95% CI 2.9 - 28.9) and a history of seizures (P < 0.001, OR 11.95, 95% CI 3 - 44.5) were significantly associated with an abnormal MRI. Conclusion: Neonates who were capable of full oral feeding by day 10 after therapeutic hypothermia and had no history of seizures were unlikely to have an abnormal MRI. This may be used in selective planning of pre-discharge MRI in asphyxiated neonates.
{"title":"A PREDICTIVE VALUE OF EARLY CLINICAL PARAMETERS FOR ABNORMAL BRAIN MRI SCAN IN NEONATES TREATED WITH THERAPEUTIC HYPOTHERMIA","authors":"Emina Hadžimuratović, Admir Hadžimuratović, D. Pokrajac, A. Selimović, Senad Muhasilović","doi":"10.5937/sanamed17-36698","DOIUrl":"https://doi.org/10.5937/sanamed17-36698","url":null,"abstract":"Introduction: Brain MRI scans can predict neurodevelopmental outcomes in neonates treated with therapeutic hypothermia. It is a common clinical practice to perform brain MRI before discharge, but brain MRI scans performed at around four months of age have a better prognostic value for a long-term neurological outcome in asphyxiated neonates. \u0000Aim: To identify which of three selected clinical parameters (oral feeding ability, muscle tone, history of seizure) evaluated 10 days after therapeutic hypothermia could predict the primary outcome of an abnormal brain MRI. \u0000Methods: We reviewed the medical records of neonates ≥ 36 completed weeks of gestation consecutively treated with therapeutic hypothermia who underwent brain MRI. Clinical parameters on day 10 after therapeutic hypothermia were correlated with brain MRI findings in the first 7-14 days of life. Logic regression analysis was performed using all three covariates of the clinical status, with an abnormal MRI as the primary outcome. \u0000Results: Brain MRI was abnormal in 42 (51.85 %) neonates with the following distribution of brain injury patterns: abnormal signal in the basal nuclei in 6, an abnormal signal in the cortex in 16, an abnormal signal both in the cortex and basal nuclei in 20 neonates. Out of three analyzed clinical parameters, feeding difficulty (P < 0.001, OR 8.3, 95% CI 2.9 - 28.9) and a history of seizures (P < 0.001, OR 11.95, 95% CI 3 - 44.5) were significantly associated with an abnormal MRI. \u0000Conclusion: Neonates who were capable of full oral feeding by day 10 after therapeutic hypothermia and had no history of seizures were unlikely to have an abnormal MRI. This may be used in selective planning of pre-discharge MRI in asphyxiated neonates.","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45535675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Burns, depending on the degree of severity, induce a significant pathophysiological response in the body. The complement system participates in the body's defenses as well as in immune responses after burn-induced trauma. Objectives: The main objective of the study was to examine how burn severity affects serum C3 and serum C4 complement values; whether burn severity correlates with serum C3 and C4 complement, and establish the predictive value of the serum C3 complement and serum C4 complement for assessing the severity of the burn. Patients and methods: According to the degree of TBSA, patients were classified into three groups: group with %TBSA<15% (30 patients), group with %TBSA >15% -25% (30 patients), and group with %TBSA > 25% to 40% (30 patients). According to the depth of burns, patients were classified into two groups partial-thickness burns (39 patients) and full-thickness burns (51 patients). We followed laboratory parameters: value serum C3 complement and serum C4 complement on the first and seventh day after burn trauma. Results: Serum C3 complement was significantly lower in patients with %TBSA>25%-40% and in the group with %TBSA>15%-25% compared to patients with %TBSA<15% on the first and seventh day after burn trauma. Serum C3 complement was significantly lower in patients with %TBSA >15%-25% compared to patients with %TBSA<15% on day one and day seven after burn trauma. Serum complement C4 was not significantly different between burn groups on the first and seventh day. Full-thickness burns have significantly lower levels of serum complement C3, compared to partial-thickness burns, on the 1st and 7th day. Full-thickness burns result in a decrease in serum C4 complement compared to partial-thickness burns on the 7th day after burn trauma, but this decrease is not significant. On the 1st day after burn trauma, we found a negative correlation between %TBSA with serum C3 complement. Serum C4 complement was not correlated with %TBSA on the day 1st. Conclusions: %TBSA and depth of burn result in a significant decrease in serum C3 complement but not serum C4 complement. There is a negative correlation of %TBSA and C3 complement but not serum C4 complement on the 1st day after burn trauma. Serum C3 complement is a significant predictor of burn severity. The predictory significance of the C4 complement is not statistically significant.
{"title":"SERUM C3 AND SERUM C4 COMPLEMENT IN PATIENTS WITH BURN TRAUMA AND CORRELATION WITH BURN INJURY SEVERITY","authors":"S. Arslanagic, J. Karamehić","doi":"10.5937/sanamed17-36526","DOIUrl":"https://doi.org/10.5937/sanamed17-36526","url":null,"abstract":"Introduction: Burns, depending on the degree of severity, induce a significant pathophysiological response in the body. The complement system participates in the body's defenses as well as in immune responses after burn-induced trauma. \u0000Objectives: The main objective of the study was to examine how burn severity affects serum C3 and serum C4 complement values; whether burn severity correlates with serum C3 and C4 complement, and establish the predictive value of the serum C3 complement and serum C4 complement for assessing the severity of the burn. \u0000 Patients and methods: According to the degree of TBSA, patients were classified into three groups: group with %TBSA<15% (30 patients), group with %TBSA >15% -25% (30 patients), and group with %TBSA > 25% to 40% (30 patients). According to the depth of burns, patients were classified into two groups partial-thickness burns (39 patients) and full-thickness burns (51 patients). We followed laboratory parameters: value serum C3 complement and serum C4 complement on the first and seventh day after burn trauma. \u0000Results: Serum C3 complement was significantly lower in patients with %TBSA>25%-40% and in the group with %TBSA>15%-25% compared to patients with %TBSA<15% on the first and seventh day after burn trauma. Serum C3 complement was significantly lower in patients with %TBSA >15%-25% compared to patients with %TBSA<15% on day one and day seven after burn trauma. Serum complement C4 was not significantly different between burn groups on the first and seventh day. Full-thickness burns have significantly lower levels of serum complement C3, compared to partial-thickness burns, on the 1st and 7th day. Full-thickness burns result in a decrease in serum C4 complement compared to partial-thickness burns on the 7th day after burn trauma, but this decrease is not significant. On the 1st day after burn trauma, we found a negative correlation between %TBSA with serum C3 complement. Serum C4 complement was not correlated with %TBSA on the day 1st. \u0000Conclusions: %TBSA and depth of burn result in a significant decrease in serum C3 complement but not serum C4 complement. There is a negative correlation of %TBSA and C3 complement but not serum C4 complement on the 1st day after burn trauma. Serum C3 complement is a significant predictor of burn severity. The predictory significance of the C4 complement is not statistically significant.","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45057372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-22DOI: 10.24125/sanamed.v16i3.524
M. Sartelli
{"title":"LEVERAGING THE SYNERGY BETWEEN ANTIMICROBIAL STEWARDSHIP AND INFECTION PREVENTION AND CONTROL IN FIGHTING ANTIMICROBIAL RESISTANCE","authors":"M. Sartelli","doi":"10.24125/sanamed.v16i3.524","DOIUrl":"https://doi.org/10.24125/sanamed.v16i3.524","url":null,"abstract":"","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42939462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-22DOI: 10.24125/sanamed.v16i3.526
R. Dmitrović, B. Lazovic, Isidora Simonovic
: In the last few decades, different devices for oxygen application have become available, such as low flow systems, high flow systems (HFNO), and non-invasive ventilation (NIV). They are widely applicable and have many advantages as well as disadvantages. HFNO modalities decrease dead space, improve alveolar ventilation, and apply oxygen up to 60 l/min, delivering it humidified and heated opposite NIV, which increases anatomical dead space, main - tains adequate minute ventilation, and is used in more conditions than HFNO, etc. In our research, we included 12 articles. The study was conducted using literature published up from 2013 to July 2020. In our research we used following
{"title":"HIGH FLOW NASAL OXYGEN THERAPY (HFNO) IN OPPOSITION TO NON-INVASIVE MECHANICAL VENTILATION (NIV) ADVANTAGES, DISADVANTAGES AND THEIR USE IN COVID-19 INFECTION: BRIEF REVIEW","authors":"R. Dmitrović, B. Lazovic, Isidora Simonovic","doi":"10.24125/sanamed.v16i3.526","DOIUrl":"https://doi.org/10.24125/sanamed.v16i3.526","url":null,"abstract":": In the last few decades, different devices for oxygen application have become available, such as low flow systems, high flow systems (HFNO), and non-invasive ventilation (NIV). They are widely applicable and have many advantages as well as disadvantages. HFNO modalities decrease dead space, improve alveolar ventilation, and apply oxygen up to 60 l/min, delivering it humidified and heated opposite NIV, which increases anatomical dead space, main - tains adequate minute ventilation, and is used in more conditions than HFNO, etc. In our research, we included 12 articles. The study was conducted using literature published up from 2013 to July 2020. In our research we used following","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42687884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-22DOI: 10.24125/sanamed.v16i3.520
Yasemin Demir Yiğit, Ebral Yiğit
{"title":"THE EFFECT OF AGING ON THE DEMOGRAPHIC, INJURY AND HEALING PATTERNS OF BURN PATIENTS","authors":"Yasemin Demir Yiğit, Ebral Yiğit","doi":"10.24125/sanamed.v16i3.520","DOIUrl":"https://doi.org/10.24125/sanamed.v16i3.520","url":null,"abstract":"","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47914586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-22DOI: 10.24125/sanamed.v16i3.528
E. Jordanova, V. Samardžić, Gordana Pekovic-Perunicic, Jelena Tica-Jevtić, S. Simić-Ogrizović
{"title":"THE IMPORTANCE OF DETERMINING THE UROMODULIN SERUM CONCENTRATION IN DIABETES MELLITUS TYPE 2 PATIENTS","authors":"E. Jordanova, V. Samardžić, Gordana Pekovic-Perunicic, Jelena Tica-Jevtić, S. Simić-Ogrizović","doi":"10.24125/sanamed.v16i3.528","DOIUrl":"https://doi.org/10.24125/sanamed.v16i3.528","url":null,"abstract":"","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49318955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.21203/rs.3.rs-1748853/v1
Baytugan Nart, Inan Aziz, Bezgin Tahir
Background: Enlargement of the pulmonary artery (PA) could be helpful in risk stratification by the chest CT on the admission of COVID-19 patients. Methods: This study aimed to associate PA diameter and overall mortality in COVID-19 pneumonia. We designed a retrospective study between January 2021 and May 2021 in tertiary-level hospitals in Gebze, Turkey. Subjects were evaluated in two groups according to their survivor status (survivors and non-survivors). Then biochemical, demographic, and clinical values were compared via the groups to define the predictive value of PA diameter on chest CT images. Results: In the enrolled 594 COVID-19 in-hospital patients (median age was 45 (34-58) years, 263patients (44.3%) were female. 44 patients (7.4%) died during hospitalization. Multivariate Cox-proportion regression model yielded main PA ≥ 29 mm on admission showed that as independent predictors of death (long rank <0.001, median survival time 28 days). Cumulative survival rates were MPAD ≥ 29 mm 45% and < 29 mm 90% yielded (p < 0.001) Conclusions: PA dilatation is strongly linked with in-hospital mortality in hospitalized patients with COVID-19 infection. Thus increased PA diameter on chest CT at admission may guide rapid and early diagnosis of high-risk patients.
背景:新冠肺炎患者入院时胸部CT显示肺动脉扩张有助于风险分层。方法:本研究旨在探讨冠状病毒肺炎患者PA直径与总死亡率之间的关系。我们于2021年1月至2021年5月在土耳其Gebze的三级医院设计了一项回顾性研究。根据幸存者状态分为两组(幸存者和非幸存者)。然后通过组间比较生化、人口学和临床值，确定胸腺直径在胸部CT图像上的预测价值。结果:纳入的594例新冠肺炎住院患者中位年龄45岁(34 ~ 58岁)，女性263例(44.3%)。44例(7.4%)患者在住院期间死亡。多因素cox - ratio回归模型显示，入院时主PA≥29 mm是死亡的独立预测因子(长秩<0.001，中位生存时间28天)。累积生存率为MPAD≥29 mm 45%， < 29 mm 90% (p < 0.001)。结论:冠状动脉扩张与COVID-19感染住院患者的住院死亡率密切相关。因此，入院时胸部CT增加胸腺直径可指导高危患者的快速早期诊断。
{"title":"Pulmonary artery diameter on chest CT predicts in-hospital mortality in patients with COVID-19 pneumonia","authors":"Baytugan Nart, Inan Aziz, Bezgin Tahir","doi":"10.21203/rs.3.rs-1748853/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-1748853/v1","url":null,"abstract":"Background: Enlargement of the pulmonary artery (PA) could be helpful in risk stratification by the chest CT on the admission of COVID-19 patients. Methods: This study aimed to associate PA diameter and overall mortality in COVID-19 pneumonia. We designed a retrospective study between January 2021 and May 2021 in tertiary-level hospitals in Gebze, Turkey. Subjects were evaluated in two groups according to their survivor status (survivors and non-survivors). Then biochemical, demographic, and clinical values were compared via the groups to define the predictive value of PA diameter on chest CT images. Results: In the enrolled 594 COVID-19 in-hospital patients (median age was 45 (34-58) years, 263patients (44.3%) were female. 44 patients (7.4%) died during hospitalization. Multivariate Cox-proportion regression model yielded main PA ≥ 29 mm on admission showed that as independent predictors of death (long rank <0.001, median survival time 28 days). Cumulative survival rates were MPAD ≥ 29 mm 45% and < 29 mm 90% yielded (p < 0.001) Conclusions: PA dilatation is strongly linked with in-hospital mortality in hospitalized patients with COVID-19 infection. Thus increased PA diameter on chest CT at admission may guide rapid and early diagnosis of high-risk patients.","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67956423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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