Makedonski medicinski pregled. Revue medicale macedonienne最新文献_第9页

Perioperative Cardiac Morbidity in Elderly Patients with Epidural versus Systemic Analgesia for Hip Fracture Surgery 老年髋部骨折手术硬膜外与全身镇痛围手术期心脏发病率的比较

Makedonski medicinski pregled. Revue medicale macedonienne Pub Date : 2014-08-01 DOI: 10.2478/mmr-2014-0019

Marina Temelkovska-Stevanovska, Trajkovska Trajanka, Maja Mojsova-Mijovska, M. Jovanovski-Srceva

{"title":"Perioperative Cardiac Morbidity in Elderly Patients with Epidural versus Systemic Analgesia for Hip Fracture Surgery","authors":"Marina Temelkovska-Stevanovska, Trajkovska Trajanka, Maja Mojsova-Mijovska, M. Jovanovski-Srceva","doi":"10.2478/mmr-2014-0019","DOIUrl":"https://doi.org/10.2478/mmr-2014-0019","url":null,"abstract":"Abstract Introduction. Patients with hip fracture are usually older patients. Uncontrolled acute pain and surgical stress in elderly patients may cause increased cardiac morbidity and mortality. Epidural analgesia blocks sympathetic nervous system and reduces the incidence of myocardial ischemia and dysrhythmias as well as the response to stress. Methods. Sixty patients with hip fracture older than 65 years with previously defined high peroperative cardiac risk according to ACC/AHA guidelines were included and were randomly assigned to two groups of 30 patients: SA group-patients with systemic analgesia. niflam 2 × 100 mg/iv and tramadol 1 mg/kg/iv every 8 hours; and EDC group-patients with a continuous epidural analgesia with bupivacaine 0.125%-5 ml/h and fentanyl 3 µg/ml. As end points of the study the incidence of cardiac events in both groups were registered: cardiac death, myocardial infarction, congestive heart failure, unstable angina and new-onset atrial fibrillation. Laboratory parameters and pain intensity were determined in all patients by using Verbal Descriptive Scale. Side effects were also monitored. Results. The epidural analgesia decreased the incidence of peroperative cardiac events in patients with high per-operative cardiac risk for hip fracture surgery (46.6% in SA group vs. 15% in EDC group) and at the same time decreased cardiac mortality (10% in SA group vs. 0% in EDC group). The values of VDS were significantly lower in patients with EDC block versus patients with systemic analgesia in all experimental times and there was a smaller number of side effects. Conclusion. Early administration of continuous epidural analgesia in patients with high peroperative risk with hip fracture decreases the incidence of cardiac morbidity and mortality and provides superior pre- and post-operative analgesia compared to systemic analgesia with minimal side effects.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"68 1","pages":"100 - 93"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69233726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Hodgkin Disease and Pregnancy - A Case Report 霍奇金病与妊娠- 1例报告

Makedonski medicinski pregled. Revue medicale macedonienne Pub Date : 2014-08-01 DOI: 10.2478/mmr-2014-0021

A. Veljanovska, S. Stavrik, Z. Stojanoski, L. Cadievski, A. Stefanija, D. Chaparoska, L. Cevreska, B. Georgievski

引用次数: 0

Differentiating Vascular Dementia from Alzhemer’s Disease with Brief Cognitive Tests 用简短的认知测试鉴别血管性痴呆与阿尔茨海默病

Makedonski medicinski pregled. Revue medicale macedonienne Pub Date : 2014-04-01 DOI: 10.2478/mmr-2014-0011

I. Barbov, A. Georgievska, S. Arsova, S. Lazarova, I. Petrov

{"title":"Differentiating Vascular Dementia from Alzhemer’s Disease with Brief Cognitive Tests","authors":"I. Barbov, A. Georgievska, S. Arsova, S. Lazarova, I. Petrov","doi":"10.2478/mmr-2014-0011","DOIUrl":"https://doi.org/10.2478/mmr-2014-0011","url":null,"abstract":"Abstract Introduction. Alzheimer’s disease (AD) and vascular dementia (VaD) are the most common causes of dementia in the elderly. The aim of this study was to investigate the diagnostic value of brief cognitive tests investigate the diagnostic value of brief cognitive tests in differentiating vascular dementia from Alzheimer’s disease. Methods. Fifteen patients with mild VaD, 15 patients with probable AD and 30 healthy controls, matched for age, education and dementia severity, were submitted to the following cognitive tests: clock drawing (free drqawing and copy), category of letter fluency, delayed recall test of figures and the EXIT 25 battery. Results. VaD patients performed worse than AD patients in category fluency (p=0.014), letter fluency (p=0.043) and CLOX 2 (p=0.023), while AD cases performed worse than VaD patients in delayed recall (p=0.013). However, Receiver Operating Characteristic (ROC) curves for these tests displayed low sensitivity and specificity for the differential diagnosis between VaD and AD. Conclusions. Altough the performance of VaD and AD patients was significantly different in some cognitive tests, the value of such instruments in differentiating VaD from AD proved to be very limited.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"68 1","pages":"48 - 51"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69234095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quality of Life in Children with Asthma as a Marker of Clinical Stability 哮喘患儿的生活质量作为临床稳定性的标志

Makedonski medicinski pregled. Revue medicale macedonienne Pub Date : 2014-04-01 DOI: 10.2478/mmr-2014-0004

Valentina Cvejoska-Cholakovska, E. Vlaski, Vesna Velic-Stefanovska

{"title":"Quality of Life in Children with Asthma as a Marker of Clinical Stability","authors":"Valentina Cvejoska-Cholakovska, E. Vlaski, Vesna Velic-Stefanovska","doi":"10.2478/mmr-2014-0004","DOIUrl":"https://doi.org/10.2478/mmr-2014-0004","url":null,"abstract":"Abstract Introduction. In order to improve asthma control, in the last decades an emphasis has been put on the assessment of quality of life (QL). The aim of the study was to assess the role of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) in order to assess the QL as a marker of clinical stability in asthmatic children. Methods. A total of 64 asthmatic children aged 7-17 years treated in an outpatient/hospital facility within the University Children’s Hospital in Skopje during 2 years were investigated. The children were assessed 3 times during a period of 3 months. To assess the asthma control the Clinical Stability Score (CSS) was used, and for the assessment of the QL the Macedonian version of the PAQLQ from Elizabeth Juniper was used, consisting of 23 questions organized into three domains: symptoms, activities, and emotions. The data were statistically analyzed using Statistica for Windows, version 7.0 and SPSS 14. Results. An increase in the average values of the PAQLQ scores was established, which means better control of asthma by the end of the 3-month follow-up. There was no statistically significant difference in the QL changes and the age of asthmatic children regarding all three domains and the overall score. Better PAQLQ scores were detected in children with better CSS. A significant improvement of all the PAQLQ scores in the case of beginning the inhaled corticosteroid therapy during the study was found. According to CSS, all of the children were classified as stable (good QL) at the end of the study compared to 78% stability at the beginning of the study. Conclusions. The Macedonian version of the PAQLQ can be used for assessment of the effects of anti-inflammatory therapy and for attainment of complete asthma control in children between 7 and 17 years of age.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"68 1","pages":"21 - 24"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/mmr-2014-0004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69233963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Apoprotein(A) Isoforms Risk Factors for Atherogenesis in Esrd Patients on Haemodialysis 载脂蛋白(A)亚型形成血液透析Esrd患者动脉粥样硬化的危险因素

Makedonski medicinski pregled. Revue medicale macedonienne Pub Date : 2014-04-01 DOI: 10.2478/mmr-2014-0003

D. Labudović, K. Tosheska-Trajkovska, S. Alabakovska

{"title":"Apoprotein(A) Isoforms Risk Factors for Atherogenesis in Esrd Patients on Haemodialysis","authors":"D. Labudović, K. Tosheska-Trajkovska, S. Alabakovska","doi":"10.2478/mmr-2014-0003","DOIUrl":"https://doi.org/10.2478/mmr-2014-0003","url":null,"abstract":"Abstract Introduction. End-stage renal disease (ESRD) patients undergoing hemodialysis are at an increased risk of arteriosclerotic vascular disease (ASVD). The increased risk is commonly attributed to the traditional risk factors related to ESRD. However, interest for more recent risk factors for ASVD, such as the level of lipoprotein(a) and its specific apoprotein(a) has been promoted. The aim of this paper is to determine whether apo(a) phenotype is a risk factor for arteriosclerotic vascular disease in ESRD patients who are on hemodialysis. Methods. Apo(a) phenotypisation was performed by using the Western Blot Technique of blood samples from 96 end-stage renal disease patients who were undergoing hemodialysis, and from 100 healthy individuals. Results. Frequency distribution of the basic apo(a) isoforms calculated by means of the χ2-test has shown that there was no significant statistical difference in distribution among patients on hemodialysis, and healthy carriers (χ2-0.36, p<0.548-for carriers of single apo(a) isoforms, (χ2-0.10, p<0.7545-for carriers of double apo(a) isoforms). The calculated relative risks have demonstrated that apo(a) phenotype was not a risk factor for ASVD in HD patients. Conclusion. Based on the results obtained, it can be concluded that the apo(a) phenotype is not a risk factor for arteriosclerotic vascular disease in patients undergoing hemodialysis.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"68 1","pages":"16 - 20"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69233953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Physical Activity as a Risk Factor for Hypertension and Target Hypertensive Eye Damage in Two Ethnic Groups in Macedonia 体育活动是马其顿两个民族高血压和目标性高血压眼损伤的危险因素

Makedonski medicinski pregled. Revue medicale macedonienne Pub Date : 2014-04-01 DOI: 10.2478/mmr-2014-0006

Zoran Stojanovski

{"title":"Physical Activity as a Risk Factor for Hypertension and Target Hypertensive Eye Damage in Two Ethnic Groups in Macedonia","authors":"Zoran Stojanovski","doi":"10.2478/mmr-2014-0006","DOIUrl":"https://doi.org/10.2478/mmr-2014-0006","url":null,"abstract":"Abstract Introduction. Hypertension is one of the most common chronic, noncommunicable diseases, and it is strongly associated with cardiovascular disease incidence. Lifestyle modifications are most important in HTA management, and physical activity (PA) is crucial among them. It is very difficult to give general recommendation for intensity and duration of the PA, because of the needs to make complete patient evaluation before PA is advised. The general recommendation in most of the national guidelines is to start with moderate PA, 40 min/per day, several times a week. The objectives of our study were: comparison of the physical activity, as a risk factor for hypertension in two ethnic groups in Macedonia, and comparison of the intensity of the target eye damage in the hypertensive subjects in two ethnic communities in Macedonia. Methods. We performed a cross-sectional study with hypertensive Roma patients as a target group, and an equal number of subjects of Macedonian nationality as controls. For both groups we completed a questionnaire where we evaluated the PA. The target eye damage was analyzed according to the Keith-Wagener-Barker categorisation. Results. Hypertensive patients exercised significantly less, or had no physical activity compared with the controls. Conclusions. Physical inactivity is a potential risk for HTA in Roma population. This is a possible cause for the early development, and more severe stage of HTA in Roma ethnic groups, and more intensive target eye damage caused by HTA.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"68 1","pages":"28 - 31"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69234019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dysphagia in Gastroesophageal Reflux Disease (Gerd) 胃食管反流病(Gerd)的吞咽困难

Makedonski medicinski pregled. Revue medicale macedonienne Pub Date : 2014-04-01 DOI: 10.2478/mmr-2014-0007

K. Grivcheva-Stardelova, Rozalinda Popova-Jovanova, G. Deriban, N. Joksimović, M. Zdravkovska

{"title":"Dysphagia in Gastroesophageal Reflux Disease (Gerd)","authors":"K. Grivcheva-Stardelova, Rozalinda Popova-Jovanova, G. Deriban, N. Joksimović, M. Zdravkovska","doi":"10.2478/mmr-2014-0007","DOIUrl":"https://doi.org/10.2478/mmr-2014-0007","url":null,"abstract":"Abstract Introduction. Dysphagia is considered an alarm symptom, raising the question of stricture or malignancy. We sought to determine the prevalence and severity of dysphagia and correlation with severity of gastroesophageal reflux disease and its response to therapy. Methods. A total of 642 patients with endoscopically confirmed erosive esophagitis (Los Angeles grades AD). Esophagitis was classified as mild (grade A or B) or severe (grade C or D). Results. At baseline, of 642 patients 37% had dysphagia, 43% had severe esophagitis, and 35% mild esophagitis (odds ratio, 1.39; 95% confidence interval, 1.27-1.51, p<0.001). Dysphagia resolved in 73% of patients after 4 weeks of proton pump inhibitor (PPI) treatment. Resolution of dysphagia was associated with a mean healing rate of 87% acrossall treatments. Seventeen percent of patients reported persistent dysphagia, and in these patients the healing rates were decreased significantly (mean 72%; p<0.0001). Conclusions. Dysphagia is common in patients with erosive esophagitis but is not a reliable clinical predictor of severe erosive esophagitis. Dysphagia resolved with PPI therapy in most cases, but persistent dysphagia may indicate failed healing.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"68 1","pages":"32 - 35"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69234031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Clinical Outcomes of Three Different Modes of Femoral Hamstring Graft Fixation in Anterior Cruciate Ligament Reconstruction 三种不同方式股骨腿筋移植物固定在前交叉韧带重建中的临床效果

Makedonski medicinski pregled. Revue medicale macedonienne Pub Date : 2014-04-01 DOI: 10.2478/mmr-2014-0010

Hristijan Kostov, I. Kaftandziev, O. Arsovski, E. Kostova, Andreja Gavrilovski

{"title":"Clinical Outcomes of Three Different Modes of Femoral Hamstring Graft Fixation in Anterior Cruciate Ligament Reconstruction","authors":"Hristijan Kostov, I. Kaftandziev, O. Arsovski, E. Kostova, Andreja Gavrilovski","doi":"10.2478/mmr-2014-0010","DOIUrl":"https://doi.org/10.2478/mmr-2014-0010","url":null,"abstract":"Abstract Introduction. There are various methods of anterior cruciate ligament (ACL) reconstruction of which the two main choices in autograft reconstruction involve the use of the bone-patella tendon-bone or hamstring graft. Femoral fixation can be divided into three main types: cortical suspensory devices such as Endobutton (Smith & Nephew, Arthrex), interference screws, and femoral transfixation devices such as Transfix (Arthrex) and Rigidfix (Depuy-Mitek). The aim of this study was to compare the clinical outcome between Rigidfix, Transfix and Endobutton devices for soft tissue femoral fixation in primary ACL reconstruction using the autogenous hamstring graft. Methods. We conducted our study in 48 patients admitted to our clinic, University Traumatology Clinic, Clinical Center \"Mother Teresa\", Skopje for ACL reconstruction from September 2009 to May 2013. The patients with ACL reconstruction were assigned as Rigidfix group (n=28), the second patients to Transfix group (n=13) and the third to Endobutton group (n=7). MRI of the knee joint was done prior to surgery. A data sheet, containing demographic data, examination findings and Tegner & Lysholm score, was completed for each patient. Results. Tegner & Lysholm the average scores before surgery were 2.52 and 34.75 (p>0.05). Six month after arthroscopy, the average value of Tegner and Lysholm scores in patients with ACL reconstruction was 8.37 and 89.08. Comparison among them showed that the operative mode of Endobutton femoral fixation had the highest level of the Lysholm score. Conclusions. Endobutton (Tight rope-RT) yielded a better outcome compared to the other two modes of femoral fixation in terms of instant stability of the graft and the general results.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"68 1","pages":"44 - 47"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/mmr-2014-0010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69234085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Evaluation of the Effectiveness and Safety of Basal Based Therapy with Insulin Glargine and Prandial Insulin in Patients with Type 2 Diabetes Poorly Controlled with Premixed Insulin 2型糖尿病预混胰岛素控制不良患者应用甘精胰岛素和餐后胰岛素基础治疗的有效性和安全性评价

Makedonski medicinski pregled. Revue medicale macedonienne Pub Date : 2014-04-01 DOI: 10.2478/mmr-2014-0008

G. Pemovska, G. Petrovski

{"title":"Evaluation of the Effectiveness and Safety of Basal Based Therapy with Insulin Glargine and Prandial Insulin in Patients with Type 2 Diabetes Poorly Controlled with Premixed Insulin","authors":"G. Pemovska, G. Petrovski","doi":"10.2478/mmr-2014-0008","DOIUrl":"https://doi.org/10.2478/mmr-2014-0008","url":null,"abstract":"Abstract Introduction. Type 2 diabetes mellitus (T2DM) is a progressive disease, requiring treatment intensification and exogenous insulin therapy in many patients. The aim of the study was to evaluate the effectiveness and safety of insulin glargine in combination with prandial insulin in poorly controlled type 2 patients previously treated with premixed insulin. Methods. A total of 200 type 2 diabetic patients in Macedonia (male 37.5%; female 62.5%, aged 61.1±0.5 years) poorly controlled (HbA1c>7%) were included in this observational multicenter prospective study. Before enrolment, all patients were treated with premixed insulin (88% with 2 and 12% with 3 injections per day, respectively). During the study, patients received once-daily glargine plus pre-prandial short-acting insulin analogues at investigators’ discretion. Primary end-point included percentage of patients achieving HbA1c <7% at study end. In addition, changes in mean HbA1c and fasting plasma glucose (FPG) during the study duration as well as frequency of hypoglycaemic episodes were evaluated. Results. After 9 months of follow-up, 100 patients (50%) achieved target HbA1c <7%. Mean HbA1c decreased from 9.5±1.5% at the beginning to 6.9±0.8% (p<0.001) at study end and mean FPG decreased from 11.0±3.3 mmol/l to 6.1± 0.9 mmol/l (p<0.001). 50.5% of the patients were treated with basal insulin in combination with OADs and 49.5% required addition of one or more prandial insulin injections. No episodes of severe hypoglycaemia were documented. Conclusions. Basal based insulin treatment with insulin glargine alone or in combination with prandial insulin improved glycaemic control in type 2 diabetics previously poorly controlled with premixed insulin with a low risk of hypoglycaemia and weight gain.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"68 1","pages":"36 - 39"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69234070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Iatrogenic Complication of Colorectal Surgery: Bilateral Lesion of the Ureters with Consequent Obstructive Nephropathy 结直肠手术的医源性并发症:双侧输尿管病变伴梗阻性肾病

Makedonski medicinski pregled. Revue medicale macedonienne Pub Date : 2014-04-01 DOI: 10.2478/mmr-2014-0012

Zorica Jakimovska, Maja Tutureska, Meri Milchevska, S. Stavridis, J. Masin‐Spasovska, G. Spasovski

{"title":"Iatrogenic Complication of Colorectal Surgery: Bilateral Lesion of the Ureters with Consequent Obstructive Nephropathy","authors":"Zorica Jakimovska, Maja Tutureska, Meri Milchevska, S. Stavridis, J. Masin‐Spasovska, G. Spasovski","doi":"10.2478/mmr-2014-0012","DOIUrl":"https://doi.org/10.2478/mmr-2014-0012","url":null,"abstract":"Abstract Introduction. In colorectal surgery iatrogenic ureteral injuries are possible, but in small percentage. Although rare, bilateral ureteral injuries are recognized early due to the development of clinical presentation of obstructive nephropathy. Radiodiagnostic procedures determine location of ureteral injuries but for solving the dilemma the most precise is the intraoperative exploration, which is presented in our case. Case report. We present a patient who underwent surgery due to colorectal cancer. Postoperatively the patient was aenuric, with increase of the degradation products and need of hemodialysis on the second day of hospitalization. The CT of abdomen showed hydronephrotically changed kidneys. An attempt to place a J-J stent was made, but it was unsuccessful. MRI urography revealed hydronephrotically changed kidneys, but with interruption in continuity of both ureters. An abdominal surgeon and an urologist were consulted and revision was made because of ureteral obstruction and an iatrogenic occlusion of both ureters. The condition was surgically resolved. In the postoperative period the patient was with normal diuresis and no need of hemodyalis. Conclusions. Iatrogenic injury of the ureters after resection of the rectum is a possible consequence, which is presented with signs of obstructive nephropathy in the early postoperative period. Routine diagnostic procedures do not always help to establish a relevant diagnosis. Therefore, surgery might have a double role, both diagnostic and therapeutic, but prevention is needed by placing stents in ureters and urinary catheter in the preoperative period.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"169 1","pages":"52 - 55"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69234126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0