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Background/Aim. Total knee replacement (TKR) surgery is one of the most frequent and the most extensive procedures in orthopedic surgery, accompanied with some serious complications. Perioperative blood loss is one of the most serious losses, so it is vital to recognize and treat such losses properly. Autologous blood transfusion is the only true alternative for the allogeneic blood. The aim of this study was to to examine if autologous blood transfusion reduces usage of allogenic blood in total knee replacement surgery, as well as to examine possible effect of autologous blood transfusion on postoperative complications, recovery and hospital stay of patients after total knee replacement surgery. Methods. During the controlled, prospective, randomised study we compared two groups of patients (n = 112) with total prosthesis implanted in their knee. The group I consisted of the patients who received the transfusion of other people’s (allogeneic) blood (n = 57) and the group II of the patients whose blood was collected postoperatively and then given them [their own (autologous) blood] (n = 55). The transfusion trigger for both groups was hemoglobin level of 85 g/L. Results. In the group of patients whose blood was collected perioperatively only 9 (0.9%) of the patients received transfusion of allogeneic blood, as opposed to the control group in which 98.24% of the patients received the transfusion of allogeneic blood (p ≤ 0.01). The patients whose blood was collected stayed in hospital for 6.18 days, while the patients of the control group stayed 7.67 days (p < 0.01). Conclusion. Autologous blood transfusion is a very effective method for reducing consumption of allogenic blood and thus, indirectly for reducing all complications related to allogenic blood transfusion. There is also a positive influence on postoperative recovery after total knee replacement surgery due to the reduction of hospital stay, and indirectly on the reduction of hospital costs.

Study aim: Dietary and non-dietary weight loss methods are highly prevalent among combat sports athletes (CSA). Most CSA undergo rapid weight loss (RWL) usually a week before the competition to reduce their body mass and thus compete in the lowest weight category possible. The objective of the study was to distinguish the impact of high-intensity sport-specific training (HISST) combined with RWL (phase 1 – P1) on muscle damage markers as well as the effects of HISST alone (phase 2 – P2).

Background and Objectives: Total knee arthroplasty (TKA) is sometimes associated with significant perioperative bleeding. The aim of this study was to determine the efficacy of tranexamic acid (TXA) in reducing perioperative blood loss in patients undergoing primary TKA. The secondary objectives were to assess the efficacy of TXA in reducing the need for blood transfusion in these patients and to determine its effect on verticalization and ambulation after TKA. Materials and Methods: This study included 96 patients who were randomly assigned to two groups, each containing 48 patients. The study group received intravenous TXA at two time points: immediately after the induction with doses of 15 mg/kg and 10 mg/kg 15 min before the release of the pneumatic tourniquet. The control group received an equivalent volume of 0.9% saline solution via the same route. Results: TXA markedly reduced (Z = −6.512, p < 0.001) the total perioperative blood loss from 892.56 ± 324.46 mL, median 800 mL, interquartile range (IQR) 530 mL in the control group, to 411.96 ± 172.74 mL, median 375 mL, IQR 200 mL, in the TXA group. In the TXA group, only 5 (10.4%) patients received a transfusion, while in the control group, 22 (45.83%) received it (χ2 = 15.536, p = 0.001). Patients in the study group stood (χ2 = 21.162, p < 0.001) and ambulated earlier postoperatively, compared to the control group (χ2 = 26.274, p < 0.001). Patients who received TXA had a better overall postoperative functional recovery. There was a statistically significant difference in all the above results. Conclusions: TXA is an effective drug for reducing the incidence of perioperative bleeding, decreasing transfusion rates, and indirectly improving postoperative functional recovery in patients undergoing primary TKA. [ABSTRACT FROM AUTHOR]

Introduction/Objective Convalescent plasma (CP) has been used in the past to treat several infectious diseases. It was hypothesized that CP could have a positive impact on severely ill patients with COVID-19 infection. The aim of the study was to present the results of CP application in patients with severe acute respiratory distress syndrome (ARDS) caused by COVID-19 infection. Methods. This is an observational study of critically ill patients who received CP according to the National Protocol for the Treatment of COVID-19 Infection at the University Clinical Center of Vojvodina in Novi Sad, Serbia, in 2020. Clinical outcomes were monitored before and after CP administration. Results. A total of 14 patients with severe life-threatening COVID-19 infection were included in the study. The patients age ranged 53–79 years. Most of them had two or more comorbidities, and more than half of them had blood type A Rh positive. Prior to CP administration, all patients received antibiotic therapy for severe pneumonia, corticosteroids, and anticoagulant therapy. Twelve out of 14 patients (85.7%) required endotracheal intubation and mechanical ventilation of the lungs, while two patients were on non-invasive mechanical ventilation. CP was administered 2–13 days after the confirmed diagnosis of COVID-19. The PaO2/FiO2 ratio before CP administration ranged 49.5–78.6. Twelve patients (85.7%) died during the course of the study. Conclusion. The use of CP in cases of severe ARDS caused by COVID-19 infection does not impact survival or lead to other forms of clinical improvement.

Introduction: It is important to measure intracranial pressure because traumatic brain injuries lead to intracranial hypertension and ischaemic brain lesions. The gold standard for measurement of intracranial pressure is invasive methods, but they can lead to complications and are not always available. Measurement of the optic nerve sheath diameter is a useful noninvasive way to estimate intracranial pressure and it can be done via ultrasonography, computed tomography and magnetic resonance imaging. Increased optic nerve sheath diameter on computed tomography can help to diagnose intracranial hypertension and to verify the need for urgent therapy and invasive measurements. Case report: We present 74 years old patient with traumatic brain injury and intracranial bleeding. Optic nerve sheath diameter was 6.81 mm on the left and 6.83 mm on the right side on the initial scan. In the coming days, existing haematomas were enlarged and there were newly formed haematomas, so there were changes in the optic nerve sheath diameter. After the haematoma evacuation, the sheath diameter was 6.56 mm on the left and 6.47 mm on the right side. At the time of the second neurologic deterioration, the sheath diameter was 7.43 mm on the left and 7.25 mm on the right side. On the 25th day, the diameter was 6.72 mm on the left and 6.41 mm on the right side. Conclusion: Measurement of the optic nerve sheath diameter is a significant additional diagnostic method for the assessment of intracranial hypertension and can help to decide on further treatment.

Background/Aim. Working with people in medical practice requires knowledge of the basic principles of personality psychology. The aim of this research was to examine the influence of moral foundations and personality dimensions of health workers on patient satisfaction with health service, as well as determining the factors influencing their satisfaction. Methods. The research was conducted using the Big Five Inventory (BFI), the Moral Foundations Questionnaire (MFQ) and the Questionnaire of patient satisfaction with healthcare service, from October 2014 to March 2016. The survey involved 693 respondents: 329 healthcare workers (44 males and 285 females) and 364 patients (154 males and 210 females). Results. With the increase of the openness of healthcare professionals, the patients' satisfaction was also growing. Regarding moral foundations of healthcare workers, there was an opposite trend ‒ with lower authoritativeness of healthcare workers, patient satisfaction was greater. Finally, with more pronounced purity of healthcare workers there was a decrease in the level of patientsʼ satisfaction with the received healthcare service. Conclusion. There is a direct association between the moral foundations and personality dimensions of health workers, and patientsʼ satisfaction with healthcare service. Thus, any strategy for improving the quality of healthcare service should take into account personal characteristics of healthcare workers. Healthcare professionals are expected to fulfill their life and professional tasks in as a human way as possible, since preservation of the health and helping to overcome an illness, in case it develops, are the basic values of every human being. It should result in more clearly defined priorities for improvement of the quality of work of healthcare workers.