Analiza učinkovitosti ratnog zdravstva - 2. dio (Health Care System Efficiency in War - part 2)

4. REZULTATI4.1 Ešalon zbrinjavanj

Analiza učinkovitosti ratnog zdravstva - 3. dio (Health Care System Efficiency in War - part 3)

5. OZLJEDE 5.1 Ozljede koštanog sustav

Analiza učinkovitosti ratnog zdravstva - 1. dio

Zdravstveni sustav u obrambenom ratu mora se prilagoditi novim okolnostima pojačane potrebe za svim oblicima zdravstvene skrbi i smanjenim mogućnostima za cjelokupnu organizaciju. U takvim posebnim uvjetima pred zdravstvenom službom su najteži zadaci bitke za spašavanje ranjenika, zdravstvene zaštite civila u ratnim uvjetima i uspostavom preventivnih mjera za suzbijanje zaraznih bolesti u uvjetima njihova olakšanog širenja. Jednako važna zadaća ratne organizacije saniteta je i organizacija uspješne toksikološke službe. Sve zemlje zato imaju poseban sustav pripreme svojeg saniteta za moguće ratne uvjete, ali isti služi i za slučaj drugih masovnih nesreća. Priprema saniteta za izvanredne okolnosti obuhvaća edukaciju medicinskog kadra, osiguranje zalihe lijekova i sanitetskog materijala, pripremu ratnih bolnica i transporta u posebnim uvjetima. Složenost sustava uvježbava se i održava u visokom stupnju pripravnosti, kako bi se izbjegle nepotrebne žrtve u slučaju nastupa hitnog stanja

The Possibilities and Limitations of Direct Digital Radiography, Ultrasound and Computed Tomography in Diagnosing Pleural Mesotelioma

The goal of this study was to compare the possibilities and limitations of direct digital radiography of the chest (DDR), the use of ultrasound of the chest (US) and single slice computed tomography of the chest (CT) in diagnosing pleural mesothelioma. The study was conducted during the course of one year, on 80 patients who were successively referred to a specialized institution, under clinical suspicion of mesothelioma. The method of investigation was the comparison of findings, obtained by the reviewed methods of examination, with the pathohistologic results of a biopsy performed on each patient. The findings that were obtained by the enumerated methods were classified according to the radiologic signs that were found in each individual patient. We evaluated following radiological findings (signs), on each of the investigated methods: plaques, localized and generalized pleural thickenings, calcifications of the pleura, pleural effusions, parapneumonic effusions, pleural empyema, (round) atelectasis, pneumothorax, tumor mass or node, inflammatory infiltrate, elevation of the hemidiaphragm and osteolysis. The results of these were compared with pathohistologic findings and analyzed by means of standard statistical methods. The highest sensitivity was found for CT (94.4 %), followed by US (92.6%), and by DDR (90.7%). The highest specificity was obtained with DDR (46.2 %), followed by CT (35.5%) and US (23.8%). The comparison of these methods showed 90% diagnostic accuracy for DDR in relation to CT. CT as an individual method best satisfied most of the criteria for diagnosing mesothelioma. No pathognomonic radiologic sign for mesothelioma was found

Atherosclerotic lesions of supra-aortic arteries in diabetic patients

The aim of this prospective study was to determine the prevalence and localization of stenotic atherosclerotic lesions of supra-aortic arteries in diabetic patients according to age and sex. Angiograms obtained by digital subtraction angiography were analyzed in 150 diabetic patients (study group) and 150 non-diabetic patients (control group) with symptoms of cerebral ischemia. Diabetic patients were found to have a significantly higher prevalence of stenotic atherosclerotic lesions of the internal carotid artery. Lesions of the large supra-aortic arteries were significantly more common in the left than in the right side of the neck (p < 0.001), but the difference between the diabetic and the non-diabetic group did not reach statistical significance. Hemodynamic conditions were found to be more important than diabetes for the occurrence of atherosclerotic lesions in these arteries. Changes in the proximal segment of the left common carotid artery were the most common finding in diabetic patients, hence attention should be paid to this localization on control examinations