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Management of acute gastrointestinal bleeding in the emergency medicine setting
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Marko Alavanja Gastrointestinal bleeding remains a significant cause of morbidity and mortality worldwide, and contributes significantly to health care costs. GI bleeding can be life threatening, and treatment of this condition remains a significant challenge. Mortality rates have persisted stubbornly for decades; however recent advances in guidelines, pre-endoscopic management, and endoscopic therapies has decreased the death rate for this condition. Gastrointestinal bleeding is commonly divided into...
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Management of advanced melanoma
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Carmen Margrit Thurid Roeper The management of advanced melanoma is complex and differs according to the stage of the tumor. The stage is defined by the 2018 American Joint Committee on Cancer (AJCC) melanoma staging system and utilizes the TNM classification. Complete excision of the primary tumor with one to two-centimeter margins is the gold standard. According to tumor thickness and ulceration, a sentinel lymph node biopsy may be performed. The result from this procedure has the greatest overall prognostic value...
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Management of chronic obstructive pulmonary disease patients in the emergency department setting
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Filip Pajnić Chronic obstructive pulmonary disease is a progressive but preventable and treatable lung disease affecting at least 32 million people in the USA and predicted to be the 4th leading cause of death in the USA. People with a history of dyspnea, increased sputum production, chronic cough with a longstanding past of risk factors should raise the suspicion of the disease. An abnormal chronic inflammatory response leading to persisting airflow limitation concomitant with signs of chronic...
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Management of keloids and hypertrophic scars
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Imane El Mcherqui Excessive healing response poses a huge challenge because it results in the formation of hypertrophic scars and keloids. Patients at high risk of keloids are usually younger than 30 years and have darker skin. Sternal skin, shoulders and upper arms, earlobes, and cheeks are most susceptible to developing keloids and hypertrophic scars. Highrisk trauma includes burns, ear piercing, and any factor that prolongs wound healing. Keloid formation often can be prevented if anticipated with...
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Management of pelvic area trauma
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Hanan El Sana Among the different manifestations of trauma, complex pelvic injuries are some of the most dangerous and deadly trauma related lesions. Pelvic trauma is one of the most complex to manage in trauma care and occurs in 3% of skeletal injuries,, with associated mortality rates of 10-16%. Most pelvis injuries require a significant amount of force. The most common mechanisms of injury include motor vehicle accidents. Due to the high force associated with pelvic fractures, they are commonly...
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Management of pelvic organ prolapse
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Bercem Budak Pelvic organ prolapse (POP) is the herniation or prolapse of pelvic organs through the
vaginal walls. POP is a very common condition among women, especially of older age,
and is one of the main indications for performing gynaecological surgery at present
time. The etiology of POP is still not fully understood, but many predisposing risk
factors have been associated with the weakening or damage of the endopelvic fascia,
such as vaginal delivery, increasing age, obesity, and other...
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Management of pulmonary embolism patients in the emergency department setting
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Kim André Brevik Pulmonary embolism (PE) is a potential fatal disorder. It is the blockage of one of the pulmonary arteries in the lungs. In most cases, blood clots are the reason for the block and often, more than one clot is involved in causing the block. The clot often originates from the deep veins of the lower limbs, a condition known as deep venous thrombosis (DVT). The most common clinical manifestations in PE includes sudden onset dyspnea, tachypnea, pleuritic chest pain, cough and hemoptysis....
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Manfred Kets de Vries i njegov doprinos psihodinamici poslovnih odnosa
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Ivana Škara Ovaj diplomski rad bavi se primjenom psihoanalize na vođama u poslovnom svijetu. Psihoanaliza može osvijestiti vođama uzroke njihovih pogrešnih poteza u rukovođenju i ophođenju s njima podređenima kako bi mogli uspješnije voditi svoj poslovni tim i time pridonijeti uspješnosti kompanije. Psihoanaliza, koju je Sigmund Freud u početku utemeljio kao metodu liječenja prvenstveno neurotičnih poremećaja, danas pronalazi svoju primjenu u puno širem području ljudskog života, pa tako...
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Manjak fibrinogena i primjena viskoelastičnih testova u bolesnika s traumatskom koagulopatijom
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Hrvoje Lasić Uvod: Traumatske ozljede su i dalje vodeći uzrok morbiditeta i mortaliteta kod odraslih, unatoč napretku u kirurškom zbrinjavaju i intenzivnom liječenju. Rana faza traumatske koagulopatije karakterizirana je nemogućnošću postizanja hemostaze, što može dovesti do nekontroliranog krvarenja i protrahiranog stanja šoka. Tijekom teškog krvarenja fibrinogen postiže vrlo niske vrijednosti u plazmi, ranije nego drugi faktori koagulacije. Viskoelastični testovi mogu dati informaciju o...
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Markeri opterećenja desnog srca u akutnoj plućnoj emboliji
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Sara Soraja Nasri Aktuna plućna embolija (PE) i duboka veska tromboza (DVT) dio su entiteta venski tromboembolizam ( VTE). Rizični čimbenici za nastanak VTE su oštećenje endotela, staza krvi i hiperkoaguabilnost krvi, tvz. Virhovljew trijas. U patofiziologiji PE dolazi do ventilacijsko – perfuzijskog nesrazmjera, a kod opsežnije opstrukcije plućne cirkulacije može se razviti i opterećenja desnog srca. Opterećenje desnog srca povezano je s lošijim ishodom bolesti i većom stopom smrtnosti....
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Markeri sepse
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Filip Žigman Sepsa je životno ugrožavajuća disfunkcija organa uzrokovana neprimjerenim odgovorom domaćinovog organizma na infekciju koja godišnje odnosi između 5 i 11 milijuna života. Usprkos velikom napretku u razumijevanju patofizioloških procesa koji dovode do razvoja ovoga teškog stanja, malo toga se promijenilo u procesu postavljanja dijagnoze i liječenja septičnih bolesnika. Naime, najboljom terapijom se i dalje smatra ona koja se započne pravovremeno odnosno što brže nakon pojave...
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Masno tkivo kao endokrini organ
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Anja Purgarić Masno tkivo je visoko aktivan endokrini organ koji ima značajnu ulogu u regulaciji metabolizma i homeostaze energije. Osim što pohranjuje i oslobađa energiju u obliku masnih kiselina, masno tkivo sintetizira i luči biološki aktivne molekule adipokine. Adipokini sudjeluju u regulaciji apetita, metabolizma glukoze i lipida, upalnih procesa te osjetljivosti tkiva na inzulin. Glavna uloga adipokina leptina je regulacija unosa hrane i potrošnje energije, dok je adiponektin homeostatski...
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