Croatian Medical Journal最新文献

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The effect of cooled endotracheal tubes on postoperative sore throat: a randomized controlled study. 冷却气管内管对术后喉咙痛的影响:一项随机对照研究。
IF 2.3 4区 医学
Croatian Medical Journal Pub Date : 2025-08-31
Sibel Çatalca, Özlem Özmete, Oya Yalçın Çok, Caner İncekaş, Nesrin Bozdoğan Özyılkan
{"title":"The effect of cooled endotracheal tubes on postoperative sore throat: a randomized controlled study.","authors":"Sibel Çatalca, Özlem Özmete, Oya Yalçın Çok, Caner İncekaş, Nesrin Bozdoğan Özyılkan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the effect of cooled endotracheal tubes on the incidence of postoperative sore throat, hoarseness, coughing, and dysphagia after endotracheal intubation.</p><p><strong>Methods: </strong>This randomized controlled trial enrolled patients undergoing elective surgery under general anesthesia with endotracheal intubation at Adana Dr Turgut Noyan Hospital between April and September 2023. The patients were randomly assigned to be intubated with endotracheal tubes refrigerated at +4 °C for 4-6 hours before intubation (n=66) or with endotracheal tubes kept at the operating room temperature (+20-23 °C) (n=70). The incidence of sore throat, hoarseness, coughing, and dysphagia was recorded at 1, 4, 12, and 24 hours postoperatively.</p><p><strong>Results: </strong>The groups did not significantly differ in the incidence of sore throat, hoarseness, and coughing at 1 hour and 24 hours. They also did not differ in the incidence of dysphagia at 24 hours.</p><p><strong>Conclusion: </strong>Cooled endotracheal tubes are not superior to tubes kept at operating room temperature in reducing postoperative sore throat, hoarseness, coughing, or dysphagia.</p>","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 4","pages":"256-264"},"PeriodicalIF":2.3,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Breast lump as the initial presentation of metastatic uterine leiomyosarcoma. 乳房肿块为转移性子宫平滑肌肉瘤的初始表现。
IF 2.3 4区 医学
Croatian Medical Journal Pub Date : 2025-08-31
Ilker Sengul, Demet Sengul
{"title":"Breast lump as the initial presentation of metastatic uterine leiomyosarcoma.","authors":"Ilker Sengul, Demet Sengul","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 4","pages":"305"},"PeriodicalIF":2.3,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effect of sleep-oriented non-pharmacological interventions in preventing delirium: a systematic review of randomized controlled trials. 以睡眠为导向的非药物干预在预防谵妄中的作用:随机对照试验的系统回顾。
IF 2.3 4区 医学
Croatian Medical Journal Pub Date : 2025-08-31
Ezgi Mutluay Yayla, Emine Kaplan Serin
{"title":"The effect of sleep-oriented non-pharmacological interventions in preventing delirium: a systematic review of randomized controlled trials.","authors":"Ezgi Mutluay Yayla, Emine Kaplan Serin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To systematically review randomized controlled trials evaluating the efficacy of sleep-oriented non-pharmacological interventions for delirium prevention in intensive care units.</p><p><strong>Methods: </strong>We searched PubMed, Web of Science, Scopus, and the Cochrane Library for randomized controlled trials evaluating the efficacy of sleep-oriented, non-pharmacological interventions for delirium prevention in intensive care units published in English between 2019 and 2024. The methodological quality of the included studies was independently evaluated by two researchers using the Joanna Briggs Institute tool.</p><p><strong>Results: </strong>This review included eight randomized controlled trials (n = 649). Six studies assessed the effect of earplugs and masks on delirium prevention in intensive care patients. Three studies indicated that earplugs and eye masks effectively prevented delirium, while three studies found no effect. One study assessed the use of earplugs and masks as part of a bundle of interventions and reported a positive effect. Four studies showed an effect on sleep. None of the sleep-oriented non-pharmacological interventions assessed in these studies reported any harmful effects.</p><p><strong>Conclusion: </strong>Although several high-quality studies showed that these interventions significantly lowered delirium incidence, some trials found no effect, highlighting variability in outcomes.</p>","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 4","pages":"289-298"},"PeriodicalIF":2.3,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does the effectiveness of neuraxial morphine administration vary across different patient populations, dosing strategies, and delivery techniques? 神经轴向吗啡给药的有效性是否因不同的患者群体、给药策略和给药技术而异?
IF 1.5 4区 医学
Croatian Medical Journal Pub Date : 2025-07-05
Nadija Gačo Rački, Miroslav Župčić, Sandra Graf Župčić, Valentino Rački, Tatjana Šimurina, Viktor Duzel
{"title":"Does the effectiveness of neuraxial morphine administration vary across different patient populations, dosing strategies, and delivery techniques?","authors":"Nadija Gačo Rački, Miroslav Župčić, Sandra Graf Župčić, Valentino Rački, Tatjana Šimurina, Viktor Duzel","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 3","pages":"235-237"},"PeriodicalIF":1.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Why we should insist on education about and implementation of ultrasound-guided regional anesthesia in intensive care units. 为什么在重症监护病房要坚持超声引导下区域麻醉的教育和实施。
IF 1.5 4区 医学
Croatian Medical Journal Pub Date : 2025-07-05
Katarina Tomulić Brusich, Mirna Dubrović, Miroslav Župčić
{"title":"Why we should insist on education about and implementation of ultrasound-guided regional anesthesia in intensive care units.","authors":"Katarina Tomulić Brusich, Mirna Dubrović, Miroslav Župčić","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 3","pages":"231-234"},"PeriodicalIF":1.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Regional anesthesia without opioid administration in mastectomy surgeries followed by breast reconstruction with implants: a randomized controlled study. 乳房切除术后乳房植入物重建的区域麻醉无阿片类药物:一项随机对照研究。
IF 1.5 4区 医学
Croatian Medical Journal Pub Date : 2025-07-05
Domagoj Eljuga, Rhea Marie Mužar, Ivo Jurišić, Jasminka Peršec, Ksenija Eljuga, Josip Jaman, Željka Roje, Krešimir Martić, Zlatko Vlajčić, Rado Žic
{"title":"Regional anesthesia without opioid administration in mastectomy surgeries followed by breast reconstruction with implants: a randomized controlled study.","authors":"Domagoj Eljuga, Rhea Marie Mužar, Ivo Jurišić, Jasminka Peršec, Ksenija Eljuga, Josip Jaman, Željka Roje, Krešimir Martić, Zlatko Vlajčić, Rado Žic","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To compare regional anesthesia without opioid administration following subcutaneous mastectomy and breast reconstruction with implants in the pre-pectoral plane with general anesthesia in terms of pain relief, opioid consumption, and hospital stay duration.</p><p><strong>Methods: </strong>This randomized controlled study enrolled patients who underwent mastectomy with reconstruction of the breast either with permanent implants or tissue expander placement in the pre-pectoral plane. A total of 40 patients met the inclusion criteria. The regional anesthesia group (n=20) received a pectoralis muscle block (PECS I), thoracic paravertebral block (TPVB), and serratus anterior muscle plane block (SAP) following a uniform protocol, and the control group (n=20) underwent general anesthesia. Pain was assessed by using the numeric rating scale (NRS) from 30 minutes after surgery up to ten days postoperatively.</p><p><strong>Results: </strong>NRS pain scores were significantly higher in the regional anesthesia group, independent of the patients' physical daily activity level, even up to 10 days after surgery. Opioid consumption and length of hospital stay did not differ significantly.</p><p><strong>Conclusion: </strong>Regional anesthesia using a combination of a TBVP, PECS I, and SAP has a long-lasting and satisfactory analgesic effect without the introduction of opioids. In the future, a novel gold standard protocol should be established that can be offered to every patient undergoing breast surgery.</p>","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 3","pages":"213-219"},"PeriodicalIF":1.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Refining anesthesia practice - regional techniques, risk stratification, and evidence-based analgesia. 改进麻醉实践——区域技术、风险分层和循证镇痛。
IF 1.5 4区 医学
Croatian Medical Journal Pub Date : 2025-07-05
Viktor Duzel, Miroslav Župčić, Tatjana Šimurina, Sandra Graf Župčić
{"title":"Refining anesthesia practice - regional techniques, risk stratification, and evidence-based analgesia.","authors":"Viktor Duzel, Miroslav Župčić, Tatjana Šimurina, Sandra Graf Župčić","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 3","pages":"183-185"},"PeriodicalIF":1.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The application of paravertebral block for open cholecystectomy in a high-risk patient with an implantable cardioverter-defibrillator: a case report. 椎旁阻滞在高危患者植入式心律转复除颤器开腹胆囊切除术中的应用:1例报告。
IF 1.5 4区 医学
Croatian Medical Journal Pub Date : 2025-07-05
Miroslav Župčić, Katarina Tomulić Brusich, Tin Nadarević, Sandra Graf Župčić, Viktor Duzel, Gzim Redžepi
{"title":"The application of paravertebral block for open cholecystectomy in a high-risk patient with an implantable cardioverter-defibrillator: a case report.","authors":"Miroslav Župčić, Katarina Tomulić Brusich, Tin Nadarević, Sandra Graf Župčić, Viktor Duzel, Gzim Redžepi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We present a case of a 57-year-old male patient (American Society of Anesthesiologists status IV) undergoing open cholecystectomy under unilateral thoracic paravertebral block (TPVB) and sedation. The patient had severe heart failure, a reduced ejection fraction of approximately 16%, and an implanted subcutaneous implantable cardioverter-defibrillator. Using ultrasound, we identified the thoracic (Th) paravertebral spaces on the right side at four levels (from Th6 to Th9) and administered 3.5 mL of 0.5% levobupivacaine per level, for a total of 14 mL. Twenty minutes after TPVB application, we confirmed sensory blockade from the Th5 to Th10 dermatomes. Ten minutes into surgery, during liver capsule retraction, the patient experienced some pain (5/10 on the visual analogue scale, VAS). The pain was successfully treated with rescue analgesia of 10 µg of intravenous (IV) sufentanil and a sedation dose of 50 mg IV propofol. The surgery lasted 45 minutes and was completed uneventfully. For continued intraoperative sedation, we used 10 mg/h remimazolam, maintaining hemodynamic stability. Nine hours after surgery, the patient reported a VAS pain score of 5 and received 75 mg of IV diclofenac sodium, with no further analgesia required. The patient was discharged on postoperative day six. In conclusion, the application of TPVB combined with remimazolam sedation could present a feasible anesthetic and analgesic technique for open cholecystectomy in high-risk cardiac patients.</p>","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 3","pages":"227-230"},"PeriodicalIF":1.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A case for a bigger role of transcutaneous vagus nerve stimulation in brain injury rehabilitation. 经皮迷走神经刺激在颅脑损伤康复中的作用。
IF 1.5 4区 医学
Croatian Medical Journal Pub Date : 2025-07-05
Martina Miklić Bublić, Dinko Tonković, Vilena Vrbanović Mijatović
{"title":"A case for a bigger role of transcutaneous vagus nerve stimulation in brain injury rehabilitation.","authors":"Martina Miklić Bublić, Dinko Tonković, Vilena Vrbanović Mijatović","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 3","pages":"241-242"},"PeriodicalIF":1.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inadequate pain management in prehospital emergency care: a retrospective study from Krapina-Zagorje County. 院前急救中疼痛管理不足:来自Krapina-Zagorje县的回顾性研究
IF 1.5 4区 医学
Croatian Medical Journal Pub Date : 2025-07-05
Morena Milić, Ada Barić Grgurević, Josip Vrdoljak, Krunoslav Fučkar, Ana Brundula
{"title":"Inadequate pain management in prehospital emergency care: a retrospective study from Krapina-Zagorje County.","authors":"Morena Milić, Ada Barić Grgurević, Josip Vrdoljak, Krunoslav Fučkar, Ana Brundula","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To assess the type of analgesics administered and their frequency of administration in pre-hospital pain management in Krapina-Zagorje County, Croatia.</p><p><strong>Methods: </strong>We retrospectively reviewed the data from 86 573 patients treated by the Emergency Department of Krapina-Zagorje County from October 1, 2017 to September 30, 2022. Data were obtained through the \"e-Hitna\" program. The inclusion criterion was a possible occurrence of pain based on the International Classification of Diseases diagnosis in patients who were treated by emergency team 1. We collected data on the type of analgesic and the frequency of administration according to age, the main diagnosis, emergency index, and the visual analog scale (VAS) score.</p><p><strong>Results: </strong>In 75% of the patients (64 938), analgesics were not administered. When analgesics were administered (21 635; 25%), physicians mostly opted for non-opioid analgesics (15480, 71.6%). Opioid analgesia was usually the treatment of choice in palliative care. Tramadol was administered significantly more often than morphine or pethidine (P<0.001, χ2 test).</p><p><strong>Conclusion: </strong>Despite wide accessibility of analgesics, pain is still not treated adequately in the Emergency Department of Krapina-Zagorje County.</p>","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 3","pages":"220-226"},"PeriodicalIF":1.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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