Results of this study indicate that arm and upper body exercises in addition to the standard rehabilitation programme improve outcomes 12 weeks after hip arthroplasty.

Purpose: Previous research has shown that poor health-related quality of life (HRQOL) is associated with adverse long-term prognosis in patients with heart failure (HF); however, there have been inconsistencies among studies and not all of them confirmed the prognostic value of HRQOL. In addition, few studies involved elderly patients and most focused on all-cause mortality and HF-related hospitalization as outcomes. The aim of our study was to determine whether HRQOL is a predictor and an independent predictor of long-term cardiac mortality, all-cause mortality, and HF-related rehospitalization in elderly patients hospitalized with HF. Patients and methods: This prospective observational study included 200 elderly patients hospitalized with HF in Serbia. HRQOL was measured using the Minnesota Living with Heart Failure questionnaire (MLHFQ). The median follow-up period was 28 months. The primary outcome was cardiac mortality, and all-cause mortality and HF-related rehospitalization were secondary outcomes. Survival analysis was conducted using the Kaplan–Meier method and Cox-proportional hazards regression. Results: Subjects with poor HRQOL (higher than the median MLHFQ score) had a higher probability of cardiac mortality ( P =0.029) and HF-related rehospitalization ( P =0.001) during long-term follow-up. Poor HRQOL was an independent predictor of cardiac mortality (HR: 2.051, 95% CI: 1.260–3.339, P =0.004), all-cause mortality (HR: 1.620, 95% CI: 1.076–2.438, P =0.021), and HF-related rehospitalization (HR: 2.040, 95% CI: 1.290–3.227, P =0.002). Conclusion: HRQOL is an independent predictor of long-term cardiac mortality in elderly patients hospitalized with HF. It also independently predicts all-cause mortality and HF-related rehospitalization. HRQOL could be used as a complementary clinical predictive tool in this patient population.

Adresa autora: Dragana Mitrović, Služba za zdravstvenu zaštitu predškolske i školske dece sa medicinom sporta i savetovalištem za mlade, Zdravstveni Sažetak:Sindrom amnionskih brida (SAB) je grupa retkih kongenitalnih anomalija nastalih obuhvatanjem delova fetusa od strane fibroznih amnionskih traka tokom intrauterinog života. Cilj rada je da se kroz prikaz slučaja ukaže na značaj blagovremenog dijagnostičkog i terapijskog pristupa kod ovakvog pacijenta. Materijal i metode: Korišćeni su podaci iz medicinske dokumentacija u toku hospitalizacije novorođenčeta na Klinici za dečije interne bolesti Niš, a rad je napisan deskriptivnom metodom. Prikaz: Muško novorođenče, rođeno u 33. gestacionoj nedelji, sa APGAR skorom na rođenju 7/8, porođajnom masom 1550g, porođajnom dužinom 43cm, u prvom danu života je prevedeno sa Ginekološko-akušerske klinike u Nišu na Kliniku za dečje interne bolesti Niš, zbog sumnje na infekciju i razvijanje respiratornog distresa, uz prisustvo vidljivih kongenitalnih anomalija ekstremiteta u smislu odsustva i nepravilnog oblika određenih falangi prstiju šaka. Porođaj je završen carskim rezom zbog prolapsa pupčanika, beba prodisala nakon kratke reanimacije, a prenatalni ultrazvučni pregled nije ukazivao na postojanje anomalija ploda. Kod novorođenčeta su, na prijemu, sem prisutnih znakova konjuktivitisa u oba oka, nedostatka falangi šaka, slabijeg izazivanja primitivnih refleksa, ostali fizikalni nalazi bili uredni. Radiološki nalaz šaka je ukazivao na odsustvo ili smanjene dimenzija pojedinih falangi prstiju, te deformitete glave i dijafizu pojedinih falangi obe šake, kao i prisustvo mekotkivne senke u regiji distalne falange trećeg prsta leve šake. Dečiji hirurg je potvrdio prisustvo amnionskih brida kod novorođenčeta fizikalnim pregledom, nakon radiološkog nalaza. Citogenetsko istraživanje je dokazalo normalan muški kariotip. Kardiološkom, neonatološkim i nefrološkim pregledom isključeno je prisustvo anomalija drugih organskih sistema. Zaključak: Kod novorođenčadi sa anatomskim anomalijama, prilikom postavljanja dijagnoze, treba misliti na sindrom amnionskih brida. Ultrazvučna prenatalna dijagnostika je veoma bitna, ali nije uvek dovoljno senzitivna u otkrivanju manjih anomalija. Od značaja je multidisciplinarni pristup, kako u dijagnostici sindroma, tako i u terapiji, u zavisnosti od kliničke slike. Ključne reči: anomalije novorođenčeta, amnion, amnionske bride.

Introduction/Objective. The aim of this study is to identify and evaluate the use of New Mobility Score in estimating functional recovery 3 months after total hip arthroplasty (THA). Methods. Seventy patients, aged > 60, who underwent THA. Treatment group was subjected to the comprehensive rehabilitation program and control group to the standard one. Primary outcome was assessed with Harris Hip Score (HHS) and New Mobility Score (NMS), and secondary one by Medical Outcomes Health Survey (Short Form Health Survey - SF-36). Questionnaires were collected before and three months after hip surgery. Results. Treatment group showed significant improvement 3 months postoperatively. The correlation in both groups between HHS and NMS was very strong (r > 0.700). Treatment group following surgery showed strong correlation between Recovery through Personal Care Services (PCS) and HHS and NMS (r > 0.700), moderate to strong between pain categories and HHS (r = 0.380; r = 0.583) and NMS (r = 0.424). Control group showed strong correlation between PCS and HHS (r = 0.704), and NMS (r = 0.568) and moderate to pain categories and HHS (r = 0.546; r = 0.466). The area under the curve (AUC) described the inherent validity of all measurement used AUCNMS = 0.724, p = 0.001, AUCHHS = 0.788, p = 0.000 and AUCPCS = 0.747, p = 0.001. Conclusion. The NMS could be successfully used in routine clinical assessment of elderly patients following THA. The trial is registered in ISRCTN Register with https://doi.org/10.1186/ISRCTN73197506

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