Introduction:The small intestine is a challenging organ for clinical and radiological evaluation, and by introducing imaging radiological techniques, not significantly disturbing the comfort and safety of patients, it attempts to obtain adequate diagnosis and valuable information.Aim:The research was conducted with the aim of checking the comparability and potential of diagnostic modality of ultrasound and dynamic contrast enhanced MR Enterography (DCE-MR) in patients with Crohn’s disease.Methods:55 patients were examined prospectively, and ultrasound examination of the abdomen was performed for all patients before the MR enterography. They were subsequently endoscopically examined or treated surgically, which was taken as a reference. Four parameters characterizing the disease itself were analyzed: bowel wall thickening, presence of abscess, fistula and lymphadenopathy.Results:Comparing the accuracy of the results of ultrasound findings and findings of MR enterography, it was found that there is a significant difference in the results obtained. The study found that the sensitivity for MR enterography for bowel wall thickening was 97.8%, and the specificity was 70%, while the sensitivity for ultrasound for the bowel wall thickening was 51% and the specificity was 100%. In the diagnosis of abscess, there was no significant difference between the results obtained by ultrasound and magnetic resonance imaging (MRI) findings, while in fistula and lymphadenopathy there was a significant difference.Conclusion:Conventional ultrasound is a good orientation method in the initial evaluation of patients with Crohn’s disease, while contrast enhanced MR enterography provides an excellent assessment for disease activity as well as the complications that accompany it.
Introduction:Stroke is one of the largest socio medical problems of modern times. In addition to the third leading cause of death, it is the first cause of non-trauma disability. Numerous studies show a correlation of risk factors and arteriosclerotic lesions in the coronary arteries and carotid arteries.Patients and methods:Study was conducted at the Clinical Center University of Sarajevo, Clinic for Cardiology surgery, methodologically cross-sectional study and partly manipulative and clinical prevention study, conducted on a representative sample of 100 patients. The subject was divided into 2 groups, coronary and non-coronary patients. Both groups of patients underwent color Doppler of carotid arteries, medical history and laboratory analysis.Results:The results confirm the hypothesis that the critical carotid artery stenosis is more present in patients with coronary disease, while the association of risk factors has been demonstrated for diabetes, hypertension and dyslipidemia.Conclusion:Screening of carotid arteries in patients scheduled for coronary revascularization is essential. With the presence of critical stenosis of the carotid artery, surgery of carotid artery should be done before coronary revascularization. The implementation of aggressive education and prevention of risk factors for cardiovascular disease is needed.
Introduction:Atherosclerosis blood vessels, be it on extra-cranial or intra-cranial circulation, the most common cause of incidents such as cerebro-vascular insult (ICV). Carotid endarterectomy (CEA) is a preventive operation to reduce the risk of stroke and it can be performed by eversion carotid endarterectomy (E-CEA) or a classical carotid endarterectomy (C-CEA). The aim of this study was to investigate the influence of the used techniques in basic perioperative results and the incidence of postoperative complications.Materials and Methods:It was retrospective-prospective study that involved 173 patients, with carotid stenosis, who underwent CEA, in the period of time December 2013 till December 2016. Subjects were divided into two groups in respect of technique: 90 patients were treated with E-CEA and 83 patients were treated with C-CEA.Results:Between two groups revealed a significant difference in favor of the patients from group E-CEA in the length of the surgery (92.56 ± 29.11 min. vs. 104.04 ± 18.01 min., P = 0.000), the time of clamping the carotid arteries (11.83 ± 1.81 min. vs. 23.69 ± 5:39 min., p = 0.000), the amount of post-operative drainage (25.33 ± 24.67 ml. vs. 36.14 ± 14:32 ml., p = 0.001), time spent in the intensive care unit (± 25.43 vs. 13:51 hours 34.54 ± 35.81 hours, p = 0.000), and the length of stay (4.60 ± 0.90 days vs. 5:42 ± 1.80 days, p = 0.001). In the patients of the group E-CEA, fewer number of individual postoperative complications without statistical significance: ICV (2.2% vs. 4.8%, p = 0.351), cardiac arrhythmia (2.2% vs. 4.8%, p = 0.351), transitory ischaemic attack (TIA) and cognitive disorder (2.2% vs. 7.2%, p = 0.117), mortality (1.1% vs. 1.2%, p = 0.954); and the total number of postoperative complications was significantly less in the same patients (7.77% vs. 18.7%, p = 0.042).Conclusion:The results of this study clearly indicate that operating techniques affects the specified monitored outcomes of vascular treatment of carotid arteries in favor of E-CEA technique. It would be ideally that the conclusions of this study contribute to broader use of E-CEA in treatment of carotid stenosis.
Introduction:Androgenic-anabolic steroids are rarely used by sportsmen who want to improve physical performance in competition sport. Despite that they are well aware of the side effects of anabolic steroids, many young athletes in Bosnia and Herzegovina without competition motivation come in temptation, trying to achieve better muscle proportion and physical performance unknowing consequence of side effects and what is hiding behind. Risk factors such as increasing of lipid levels and arterial hypertension are major factors which have important role in the Pathogenesis of atherosclerosis and are responsible for occurrence of cardiovascular disease even causing a sudden death in young athletes.Objective:The aim of the study was to estimate the frequency of misusing of androgenic anabolic steroid drugs in young recreational sportsmen without competition motivation. This study will try to estimate vascular and lipid status, analyzing the side effects of steroids in young recreational athletes under the age of 35, in Bosnia and Herzegovina.Methods:The study included 70 individuals in period of 2010 till 2015 on recreational exercising program; 35 individuals misusing androgenic anabolic steroids during the period of 5 years were compared with 35 individuals which do not use androgenic anabolic steroids. Non-invasive methods were used in all individual (clinical examination and vascular ultrasound examination of vein system). The routine of training units in both groups was approximately two hours 4-6 times per week.Results:Final analysis has reveal that in androgenic anabolic steroids group in 18 individuals or 55.7% arterial hypertension with hyperlipidemia was more represented, compared with the group without using anabolic steroids, represented by 2 individuals or 5.7% and it was statistically considered significant by using p value less than 0.05. (p<0.05). Statistically dominant population using anabolic steroids drugs are males (100%) or 35 individuals; we did not find females using anabolic steroids and that is why our research was limited to male population.Conclusion:Recreational male sportsmen are dominant androgenic anabolic steroids misusers, trying to achieve better muscle proportion and physical performance, they neglect the anabolic steroids side effects which have devastating consequence on vascular system. Benefits of misusing drugs in recreational exercising program in young sportsmen are mostly connected with development of arterial hypertension and hyperlipidemia and the variety of serious health disorders, progressing the pathogenesis of cardiovascular disease.
RP approach in vascular reconstructive surgery in AIOD offers better postoperative results when compared to TP approach.
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