Biomedical subjects

M Bazardzanović

Publications and source records attributed to M Bazardzanović.

6 recordsLinked to original sources

PubMed2001

Pulmonary function after laparoscopic and open cholecystectomy.

BACKGROUND: Laparotomy causes a significant reduction of pulmonary function, and atelectasis and pneumonia occur after open cholecystectomy. In this prospective, randomized study, we evaluated the hypothesis that pulmonary function is less restricted after laparoscopic cholecystectomy (LC) than after open cholecystectomy (OC). METHODS: Sixty patients underwent laparoscopic (n = 30) or open (n = 30) cholecystectomy. The two groups did not differ significantly in age, sex, intraoperative findings, and preoperative pulmonary function. Pulmonary function tests, arterial blood-gas analysis, and chest radiographs were obtained in both groups before operation and on postoperative day 1. RESULTS: The forced expiratory volume in 1 s (mean +/- SD values; OC, 1.49 +/- 0.77 L/s; LC, 2.33 +/- 0.80 L/s; p > 0.0001) and the forced vital capacity (OC, 2.40 +/- 0.66 L; LC, 2.93 +/- 1.05 L; p > 0.01) were more suppressed in patients having OC than in those having LC. Similar results were found for the peak expiratory flow (OC, 3.51 +/- 1.35 L/s; LC, 4.27 +/- 1.66 L/s; p > 0.05), expiratory reserve volume (OC, 0.73 +/- 0.34 L; LC, 0.92 +/- 0.43 L; p > 0.05), and the midexpiratory phase of forced expiratory flow (FEF25-75) (OC, 1.45 +/- 0.54 L/s; LC, 1.60 +/- 0.73 L/s; NS). Laparoscopic cholecystectomy was associated with a significantly lower incidence of (30 vs 70%) and less severe atelectasis and better oxygenation. CONCLUSION: Pulmonary function is better preserved after LC than after OC.

Cholecystectomy↗

PubMed2000

[Reasons for reoperation after laparoscopic cholecystectomy].

AIMS: Analysis of the reasons for reoperation after laparoscopic cholecystectomy. METHODS AND PATIENTS: Retrospective-prospective analyses of the first 250 patients who undergone laparoscopic cholecystectomy. In 86% cases indication for operation was chronic calculosis of gallbladder. RESULTS: Reoperation was performed at 6 patients (2.4%). The reasons of reoperation were: haematoma of gallbladder's loge (1), biliary fistulas (1), biliary peritonitis (1), abdominal abscesses (2), and perforated peptic ulcer (1). At 2 patients with intraabdominal abscesses, it was solved by laparoscopic drainage. The other complications were solved with laparotomy, also. We did not have lethal cases after reoperation. CONCLUSION: Rate of postoperative complications was 2.4%, and all of them required reoperation. Our results are similar with results of the other authors.

Cholecystectomy, Laparoscopic↗

PubMed1999

[Quality of medical records as a basis for DRG classification in the health care system in Bosnia-Herzegovina].

Medical Record contains data about use of health care services of every member of certain population, no matter if they come from preventive or curative health care. Quality of Medical Records is very often in direct as well as indirect connection with health care quality. Better health care systems usually have better Medical Records. These are computer processed and stored on some of contemporary computer media, like: disks, microfilms, magnetic tapes and so-called "smart cards". Good Medical Record should have at least next characteristics: 1. Time dimension, which should contain chronological: past, present and future data, relevant to health care consumers. 2. It should be complete in a sense that every Medical Record must contain adequate medical and other relevant data for health care planning, organization and control. From the aspects of our research described here, it is very important that Medical Records contain all financial data. These usually are consequences of consumption of health care services from various resources of different levels. The results of our research about the application of DRG classification in B&H health system, that have been done in Tuzla University-Clinical Center, show that hospital Medical Records have many inadequacies, both in respect of medical as well as non-medical part. Physicians use very little ICD coding system. There is no uniform anamnesis, no detailed evidences about all hospital services, no adequately defined severity of disease and patient status at discharge. Due to manual based information system, there is no evidence about spending of resources per patient with financial data. The development and application of computer based health information system must go towards direction of solving these problems.

Bosnia and Herzegovina↗

PubMed1999

Penetrating injuries of heart and great vessels in patients wounded during the 1992-1994 war in Bosnia and Herzegovina.

AIM: To present characteristics of heart and great vessel injuries in patients wounded during the 1992-1994 war in Bosnia and Herzegovina and their management in conditions of lack of complex diagnostic and therapeutic procedures. METHODS: Retrospective analysis was performed on the medical records of 31 patients treated for cardiac and great vessel injuries at the Department of Surgery, Tuzla University Hospital, between January 1992 and December 1994. RESULTS: The most frequent localization of the injuries was the right and left ventricles (each 10 cases), left atrium in 5, superior caval vein in 5, and inferior caval vein in 5 cases. Isolated pericardial injury was found in 5 cases. Immediately after injury, 22 injured suffered from shock, 7 from pericardial tamponade, and 2 were in a stable state. The mortality rate was 58%. Eight patients died during the operation as a consequence of bleeding. The highest mortality rate was recorded in the injuries of the left ventricle followed by the injuries of the in right ventricle and of superior caval vein. All 4 patients with multiple heart and great vessel injuries died. Mortality rate was significantly higher in patients who suffered from shock than in those who suffered from tamponade. CONCLUSIONS: Penetrating war injuries of heart and great vessels are among the most serious injuries in war. These injuries require prompt treatment to save life, but this is hardly manageable in hospitals without cardiopulmonary bypass facilities.

Adult↗

PubMed1998

Treatment of penetrating chest injuries during the 1992-1995 war in Bosnia and Herzegovina.

AIM: To assess the need for and significance of immediate thoracotomy compared to conservative treatment (thoracostomy and/or thoracocentesis) of penetrating chest injuries. METHODS: Retrospective analysis was performed on medical records of 743 war wounded patients treated for chest injuries in the Department of Surgery, University Hospital Tuzla, between January 1992 and December 1995. Minimally invasive (tissue saving) surgery was the most frequent method applied, which usually included sutures of the lungs after débridment of margins and hemostasis, followed by atypical resection. RESULTS: Out of 743 patients, there were 414 (55. 7%) cases of immediate thoracotomy, whereas 295 (39.7%) who were treated conservatively, including thoracostomy and/or thoracocentesis. Twenty four (3.2%) patients died at admission, and 10 (1.3%) did not require any surgical treatment. The most frequent complications were secondary wound infection (10.8% in the conservative treatment group and 2. 5% in the group treated by thoracotomy), pleural effusion (19.3% in the conservatively treated group and 10.8% in the group treated by thoracotomy), and empyema (5. 1% in the conservatively treated group and 13.4% in the group treated by thoracotomy). CONCLUSION: Our results are similar to those reported for other war situations but surgeries were very often performed on the basis of subjective judgements on the severity of the patient's clinical condition and necessity for thoracotomy.

Adolescent↗

PubMed1998

Craniocerebral injuries in combat soldiers treated at the Sapna war hospital, Bosnia and Herzegovina.

AIM: To assess the importance of the first aid and medical care administered on the battlefield and at a field surgical unit for the outcome of craniocerebral war injuries. METHODS: State of consciousness of 38 persons with craniocerebral injuries was assessed by the Glasgow Coma Scale (GCS), and follow-up of the vital signs and neurological deficit were determined by GCS outcome scale. RESULTS: Total mortality was 36.8%. The mortality highly correlated with the extent of injury. In general, all patients with Glasgow Coma Scale score of 7 and less died, and those with a higher score survived. CONCLUSION: A strict application of the basic principles of the first aid and medical care is a prerequisite for the improvement of the outcome of craniocerebral injuries.

Adult↗