A Randomised Two-way Comparison of Mastectomy Performed Using Harmonic Scalpel or Monopolar Diathermy

The purpose of this study was to perform an overall evaluation and comparison of the success rate of modified radical mastectomy by harmonic scalpel and monopolar electrocauter. The prospective study included all of the patients that were planned for and mastectiomized because of breast carcinoma during July 1st 2008 until December 21 st 2008 at the Department of Surgery and Urology, University Hospital Mostar. Duration of the surgical procedure, intraoperative blood loss and operational drain secretion was measured and registered. Leukocyte number (Le), interleukin 6 (IL-6), C-reactive protein (CRP) and erythrocyte sedimentation rate was tested and registered out of peripheral venous blood before the operation, 4 hrs after it, as well as on the first, second and third day after the operation. Every patient was tested for postoperative pain intensity, amount of administered analgesics during hospital stay, number and types of postoperative complications; also the time needed for return to everyday activities was registered. 61 patients were included in the study. 31 patients were operated with the harmonic scalpel, and 30 of them with the monopolar electrocauter. There is no statistically significant difference between the operation time in the two groups: 78.50±17.50 minutes by harmonic scalpel and 82.50±18.50 minutes by electrocauter (p=0.796). The smaller amount of intraoperative blood loss is statistically significant in the group of patients mastectomized by harmonic scalpel 78±31 ml compared to 256±112 ml in the group mastectomized by electrocauter (p<0.001); as is the total operational drain secretion: patients mastectomized by harmonic scalpel 540±390 mL compared to 960±710 mL in patients mastectomized by electrocauter (p<0.001). There is no statistical difference in the number of leukocytes in blood after modified radical mastectomy using the harmonic scalpel or electrocauter (p=0.957), or in erythrocyte sedimentation rate (p=0.114), CRP (p=0.071) and IL-6 (p=0.082). The duration of postoperative hospital stay does not differ statistically between the two groups, nor does the postoperative pain intensity, amount of administered analgesics, number or types of postoperative complications, as well as the time needed for return to everyday activities. Therefore using the ultrasound harmonic scalpel in comparison to monopolar electrocauter brings certain advantages, which however do not contribute significantly to the total success rate of the operation

THE INFLUENCE OF DREINAGE IN THE TREATMENT OF CHRONIC PILONIDAL SINUS DISEASE USING MIDLINE CLOSURE

Unsatisfactory postsurgical end results in the treatment of chronic pilonidal sinus disease caused by long term healing, pain, inconvenience and recurrences of the lesion still remain problem after various surgical techniques have been described and used. This study was designed to show results of several aspects of midline closure technique with respect for surgical complications, hospitalization length and recurrence. This study included 90 patients with pilonidal sinus treated by surgery with midline closure at the department of General surgery of Clinical Hospital Mostar between January 2004 and January 2009. The patients were divided in three groups considering the type of drainage used. Data collected retrospectively included demographics, positive diagnosis of chronic pilonidal sinus, operative technique, type of drainage, complications, hospital stay and recurrence of the disease. Mean hospital stay after excision and midline closure technique was 4.68 days Complication rate was 18/90 (20%). Infection occurred in 18 patients (20%), dehiscence occurred in 10 patients (11.1%). Mean recurrence rate during follow up period was 12/90 (13.3%); range, 24-84 months. There was no statistically significant difference among three groups in hospital stay length (p>0.05), in complication rate (χ2=1.66, p>0.05), nor in recurrence rate (χ2=1.91, p>0.05). Statistically significant difference was shown between complication rate among non drained and actively drained patients (χ2=1.11, p<0.05). Primary midline closure is not a satisfactory method in the treatment of chronic pilonidal sinus, especially without drainage, leading to numerous complications and high rate of recurrence

The Relation between the Serum Calcium Level and the Complication Incidence in Haemodialysis Uremic Patients

The mineral metabolism disorder is the most influential factor of the morbidity and mortality incidence of haemodialysis uremic patients. The second most influential factor is the infection, which is the most frequent complication with an undesirable outcome. In recent times, the relation of the increased serum calcium and phosphorus level on the one hand, and the morbidity and mortality of that population in case on the other, has been observed. However, insufficient professional and scientific thought has been given to the relation of the lower serum levels of the aforementioned minerals and the morbidity and mortality incidence. We have researched the relation between lower serum calcium level (hypocalcaemia) and the complication incidence, especially infection. Throughout the time period of 18 months, 120 haemodialysis uremic patients were observed and 76 (63.3%) of them had serum calcium level below the lower threshold of referent values (9.0–9.5 mg/dL). In the patients with a lower serum calcium level (hypocalcaemia) a significant infection incidence (c2=3.99; p=0.0468), a significant sepses incidence (c2=8.016; p=0.04), a significant total complication incidence (p<0.05) were determined, as well as a higher vascular access local infection incidence, but without statistically significant research results of this relation (c2=0.098; p=0.7598). We are of the belief that the incidence of the vascular access local infection should be examined on a greater number of patients; therefore, the significance of the examined relation in such an instance would be expected. The total infection incidence in all 120 observed patients is 3.8 for 100 months. It is to be concluded that the research findings indicate the association regarding the appearance of low serum calcium concentration (hypocalcaemia) and an increased complication incidence, especially the inflammation that leads to the requirement of further research in order to decrease morbidity, and consequently also the mortality of the observed population of patients by means of programmed therapy approach

Navika pušenja na radnom mjestu kod medicinskih sestara - usporedba između Opće bolnice i Doma zdravlja Dubrovnik

Danas kronične nezarazne bolesti uzrokuju 63 % ukupnog mortaliteta, a duhanski preparati jedan su od najvećih rizičnih čimbenika [1] . Pušenje je rizični čimbenik za nastanak velikog broja bolesti koje znatno smanjuju stupanj kvalitete života te uzrokuju prijevremenu smrt

Kroz prostor i vrijeme: Zbornik u čast Miri Menac-Mihalić

Zbornik Kroz prostor i vrijeme posvećen je prof. dr. sc. Miri Menac-Mihalić, dugogodišnjoj profesorici Filozofskog fakulteta Sveučilišta u Zagreba te članici suradnici Hrvatske akademije znanosti i umjetnosti. Prof. dr. sc. Mira Menac-Mihalić iznimno je plodna znanstvenica koja se, uz veliki broj radova iz dijalektologije, smatra i začetnicom hrvatske dijalektne frazeologije. U zborniku posvećenom njezinu radu i djelovanju objavljeni su prilozi koji su grupirani u dvije glavne tematske cjeline (dijalektologija/povijest jezika "O govorima kroz vrijeme" i frazeologija "Živost frazema"). Radovi predstavljaju izniman znanstveni doprinos hrvatskoj filologiji. Velikim su dijelom rezultat terenskih istraživanja kojima se prikupljala građa za obradu. Donose precizne rezultate o fonološkim/morfološkim/leksičkim značajkama hrvatskih mjesnih govora, a istražuju se i frazemi potvrđeni u hrvatskoj nacionalnoj ili dijalektnoj frazeologiji. Dio građe koji se opisuje ekscerpiran je iz postojeće literature te pomno i iscrpno analiziran

Kroz prostor i vrijeme: Zbornik u čast Miri Menac-Mihalić

Zbornik Kroz prostor i vrijeme posvećen je prof. dr. sc. Miri Menac-Mihalić, dugogodišnjoj profesorici Filozofskog fakulteta Sveučilišta u Zagreba te članici suradnici Hrvatske akademije znanosti i umjetnosti. Prof. dr. sc. Mira Menac-Mihalić iznimno je plodna znanstvenica koja se, uz veliki broj radova iz dijalektologije, smatra i začetnicom hrvatske dijalektne frazeologije. U zborniku posvećenom njezinu radu i djelovanju objavljeni su prilozi koji su grupirani u dvije glavne tematske cjeline (dijalektologija/povijest jezika "O govorima kroz vrijeme" i frazeologija "Živost frazema"). Radovi predstavljaju izniman znanstveni doprinos hrvatskoj filologiji. Velikim su dijelom rezultat terenskih istraživanja kojima se prikupljala građa za obradu. Donose precizne rezultate o fonološkim/morfološkim/leksičkim značajkama hrvatskih mjesnih govora, a istražuju se i frazemi potvrđeni u hrvatskoj nacionalnoj ili dijalektnoj frazeologiji. Dio građe koji se opisuje ekscerpiran je iz postojeće literature te pomno i iscrpno analiziran

With food to health : proceedings of the 10th International scientific and professional conference

Proceedings contains 13 original scientific papers, 10 professional papers and 2 review papers which were presented at "10th International Scientific and Professional Conference WITH FOOD TO HEALTH", organised in following sections: Nutrition, Dietetics and diet therapy, Functional food and food supplemnents, Food safety, Food analysis, Production of safe food and food with added nutritional value

THE INFLUENCE OF DREINAGE IN THE TREATMENT OF CHRONIC PILONIDAL SINUS DISEASE USING MIDLINE CLOSURE

Unsatisfactory postsurgical end results in the treatment of chronic pilonidal sinus disease caused by long term healing, pain, inconvenience and recurrences of the lesion still remain problem after various surgical techniques have been described and used. This study was designed to show results of several aspects of midline closure technique with respect for surgical complications, hospitalization length and recurrence. This study included 90 patients with pilonidal sinus treated by surgery with midline closure at the department of General surgery of Clinical Hospital Mostar between January 2004 and January 2009. The patients were divided in three groups considering the type of drainage used. Data collected retrospectively included demographics, positive diagnosis of chronic pilonidal sinus, operative technique, type of drainage, complications, hospital stay and recurrence of the disease. Mean hospital stay after excision and midline closure technique was 4.68 days Complication rate was 18/90 (20%). Infection occurred in 18 patients (20%), dehiscence occurred in 10 patients (11.1%). Mean recurrence rate during follow up period was 12/90 (13.3%); range, 24-84 months. There was no statistically significant difference among three groups in hospital stay length (p>0.05), in complication rate (χ2=1.66, p>0.05), nor in recurrence rate (χ2=1.91, p>0.05). Statistically significant difference was shown between complication rate among non drained and actively drained patients (χ2=1.11, p<0.05). Primary midline closure is not a satisfactory method in the treatment of chronic pilonidal sinus, especially without drainage, leading to numerous complications and high rate of recurrence