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Treatment of complicated case with subclavia steal syndrome and stenosis of common iliac artery Background. The aim of this case report is to describe the realization of complex radiological minimally invasive interventional procedures at the Institute of Radiology in KCU Sarajevo during which we treated a very complicated case with the left subclavia steal syndrome and the stenosis of the left common iliac artery. Case report. The patient was 57 years old with previous history of ischemic lesions in brain, with occlusion of the left arteria carotis communis (ACC) and stenosis of the right arteria carotis interna (ACI), with dizziness and inability to look upward. The patient was treated first with subintimal recanalization and introduction of self-expandable stent into the left subclavia artery to compensate for the very wide remnant of the occluded artery. After four months of follow up with no change, our team attempted to treat stenosis of the right ACI but failed to do so and during this procedure in-stent restenosis in the left subclavia artery was noted. After less than two weeks we performed balloon dilatation of in-stent restenosis of a previously installed stent into the left subclavia artery. The patient underwent CT and CT angiography (CTA), colour Doppler ultrasonography (CDUS), MRI and MR angiography (MRA) before and after the procedures. Conclusions. A follow up and, if needed, a balloon dilation are necessary to prevent the re-occlusion of the previously treated subclavia artery with stenting.

CONFLICT OF INTEREST: NONE DECLARED Neck pain syndrome is described as: Pain in the neck affects at least once in a lifetime every second person, and also 10 % of adult population suffers from chronic pain in this area. It is more often among women. A constant increase of incidence in the industrialized countries is noticed. It is also the leading cause of referral to physical rehabilitation. It is causing huge financial costs in the health care system. There is no consensus regarding Neck pain syndrome management, but many therapeutic modalities are applied: a) to isolate (or manage) rare, but potentially dangerous states that can cause neck pain; b) identify and treat each co morbid state and risk factors; c) provide resources and information’s, especially about regarding use computers in dayly practice. Physical and manual treatments can be: a) physical therapy can assist to achieve early mobilization and return to daily activities; b) active physical therapy , mobilization, manipulation and exercises can assure short time relief of neck pain; c) home based exercises, as shown by this research, can significantly prolong the pain free period, in case of patients with the chronic syndrome; d) Medications, combined with the exercise program and ergonomic improvements can be effective solution for the chronic or recurrent neck pain. Intensive treatments in Neck pain syndrome are: a) Surgical and other intensive treatment (rarely indicated); b) invasive treatments includes and percutaneous radiofrequent neurotomy and cervical epidural analgesis.

CONFLICT OF INTEREST: NONE DECLARED In Bosnia and Herzegovina, Medical informatics has been a separate subject for the last 15 years with regard to Medical curriculum at the biomedical faculties in the country (1,2). Education in the field of Medical informatics is based on the concept which is used in developed countries, according to the recommendations of the working groups EDU – Education of Medical Informatics, of the European Federation for Medical Informatics (EFMI) and International Medical Informatics Association (IMIA). Theoretical and practical teaching and training performance as a whole is performed by use of the computer equipment, and the final knowledge check of the students is also performed using the Data Base Management System MS Access specifically designed to cover full teaching and training material by using question sets in the data base which encircled nearly 1500 question combinations. The distance learning is logical step that can further improve this method of education. In this paper, authors present 15 years of experience of Medical informatics education at biomedical faculties in Bosnia and Herzegovina. Medical Informatics, as an obligatory subject, was introduced to the biomedical faculties in Sarajevo (medical, dental and pharmaceutical as well as the High medical school) in 1992 and 1993. Students have practical computer exercises for a period of 7 weeks. Students had training in Excel, Word etc. During the semester, the students perform specific operation such as creation of data carrier for manipulation with medical information. The information was analyzed by statistical program such as Excel. From 2002 years Medical Informatics is divided in two parts in order to facilitate data processing and other procedure that are necessary to perform at time when student’s knowledge of medicine is sufficient for practicing specific tasks that include management the data about patient, anamnesis and similar parameters cause we noticed that students without such knowledge cannot figure out the whole picture without difficulties. The Theoretical part of examination is done using the multiple choice answer form provided by special software with randomly selected questions for each student. Such way of practical and theoretical path of final exam make possible to perform such procedures such as electronic registration for exam and distance testing. Possibilities of introduction of distance learning in medical curriculum are the title of project which has been realizing at Cathedra for medical Informatics, Medical faculty since year 2002. Our undergraduate and postgraduate students are satisfied with contents and organization of the teaching process.

M. Kling, J. Rauschenberger, A. Verhoef, E. Hasović, T. Uphues, D. Milošević, H. Müller, M. Vrakking

Sub-femtosecond control of the electron emission in above-threshold ionization of the rare gases Ar, Xe and Kr in intense few-cycle laser fields is reported with full angular resolution. Experimental data that were obtained with the velocity-map imaging technique are compared to simulations using the strong-field approximation (SFA) and full time-dependent Schrödinger equation (TDSE) calculations. We find a pronounced asymmetry in both the energy and angular distributions of the electron emission that critically depends on the carrier-envelope phase (CEP) of the laser field. The potential use of imaging techniques as a tool for single-shot detection of the CEP is discussed.

L. Stankovic, M. Daković, Jin Jiang, E. Sejdić

Instantaneous frequency (IF) is a fundamental concept that can be found in many disciplines such as communications, speech, and music processing. In this letter, analysis of an IF estimator, based on a time-frequency technique known as S-transform, is performed. The performance analysis is carried out in a white Gaussian noise environment, and expressions for the bias and the variance of the estimator are determined. The results show that the bias and the variance are signal dependent. This has been statistically confirmed through numerical simulations of several signal classes.

M. Kacila, E. Tahirović, Z. Lazović

In this study we analyzed patients glucose levels taken before and after coronary artery bypass surgery. The data are taken from University of Sarajevo Clinics Centre- medical documentation of Heart Center from January 1st, 2007 to October 31st, 2007. Therefore, the entire study is done retrospectively. The patients considered in this analysis were divided into three groups. The patients in the first group were treated with peroral antidiabetics. The second group included patients treated with insulin while the third group consisted of patients without diabetes and acted as control group. All the patients had increased BMI. In the first two groups glucose levels were elevated before the surgery. Data analysis showed that three patients from the first group changed from peroral antidiabetics to insulin during postoperative period, and they were dismissed from hospital with this therapy. In the control group, peroral antidiabetis were introduced in four patients. The study results show that all the three groups have had high glycaemia on the first postoperative day. This may be caused by a number of reasons: inadequate pre-operative antidiabetic therapy, the impact of stress during surgery, inadequate pre-operative treatment of glycaemia or avoidance of the proscribed therapy by patients themselves. Stress during operation and administration of several medications after operation may also cause increased insulin resistance and distort glycaemia control.

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