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Background/Aim. The COVID-19 pandemic had a significant impact on the healthcare system, particularly healthcare providers such as nurses/medical technicians, who were obliged to adhere to strict procedures and manage their time effectively during shifts. The aim of this study was to identify internal strengths, weaknesses, threats, and challenges in palliative care management during the C OVID-19 pandemic from the perspective of nurses/medical technicians. Methods. A cross-sectional study was conducted on a 100% sample of nurses/medical technicians working in hospital-based palliative care in two clinics in Belgrade (47 respondents in total). The research instrument was a Questionnaire on Employee Satisfaction. The survey was conducted during September and October 2022. Results. Assessing the job satisfaction of nurses/ medical technicians revealed moderate job satisfaction (3.43), which was mostly influenced by appropriate financial compensation and the implementation of measures to prevent and control the spread of the COVID-19 infection. The dimensions of management that were significantly related to respondents’ satisfaction were motivation and adequacy of hygienic conditions and measures to control COVID-19 (χ2 = 62.83, p = 0.004 and χ2 = 36.42, p = 0.006, respectively). Conclusion. Nurses/medical technicians who experience stress at work in regular conditions tend to react the same way in different conditions, such as those related to COVID-19 infection. The most difficult challenge that the management faces is the recognition of the importance of the work of nurses/medical technicians by the community. Therefore, it is vital to respect and support the most important professional values of nurses/medical technicians, such as valuable achievements, the importance of professional challenges, personal growth and development, and independence in practice.

Background/Aim. Multidetector computed tomography pulmonary angiography (MCTPA) has emerged as the most suitable method for diagnosing acute pulmonary embolism (APE) in hemodynamically stable patients. In addition to its diagnostic role, MCTPA facilitates the measurement and calculation of certain parameters that can be used as prognostic markers for outcomes in APE. Since the introduction of the method, there have been a lot of studies that pointed out there may be a significant difference in the prognostic value of MCTPA for APE concerning sex. Methods. The study population consisted of consecutive patients with a diagnosis of APE confirmed by MCTPA. Positive MCTPA findings and a diagnosis of APE were established if the patient had at least one segmental artery thrombus. APE severity was estimated using the simplified Pulmonary Embolism Severity Index (sPESI). All-cause and APE-related intrahospital deaths were the coprimary outcomes of this study. Results. In total, 1,612 patients were enrolled in the study (750 men and 862 women). Women with a centrally positioned pulmonary thrombus detected on MCTPA were more likely to die from PE-related death than those without one (10.4% vs. 4.2%, respectively; p = 0.016). Women with a right ventricle (RV) and left ventricle (LV) diameter ratio (RV/LV) > 1 died almost twice as often as those with a ratio ≤ 1 (15.5% vs. 8.6%, respectively; p = 0.017). Women with an RV/LV > 1 detected with MCTPA were significantly more likely to die from PE than those with a ratio ≤ 1 (11% vs. 5.2%, respectively; p = 0.017). Women who died from PE-related causes had a significantly higher value of the embolic burden score system (EBSS) than did the surviving women (18.00 vs. 11.00, respectively; p = 0.025). Independently of age, sPESI, and renal function, the presence of a central thrombus [odds ratio (OR) 2.278, 95% confidence interval (CI): 1.050–4.944, p = 0.037] and the RV/LV ratio > 1 (OR 2.015, 95% CI: 1.042–3.893, p = 0.037) were associated with intrahospital PE-related death in women. Conclusion. In women, MCTPA parameters, a centrally placed thrombus, the RV/LV ratio, and the EBSS had prognostic significance for PE-related mortality. The RV/LV ratio had prognostic significance for all-cause intrahospital mortality. In men, the MCTPA parameters had no prognostic significance for both overall and PE-related mortality.

At a time when the use of digital technologies has become totally available to a large number of people, digital transformations in the domain of health enable significant changes when it comes to knowledge, information and provision of healthcare services. Therefore, in the conditions of an increase in the number of people suffering from malignant diseases, the application of digital communications provides new frameworks for the provision of healthcare services as well as the organization of some preventive activities. The paper tests the differences in answers between respondents who have different demographic characteristics, general health assessment, performed screening and received information about malignant diseases. Carrying out this research, the authors want to draw attention to the current issues of the healthcare system, in order to define some strategies for new ways of doing business in healthcare. All their efforts are in that context.

Introduction. Portal vein (PV) thrombosis (PVT) is a partial or complete obstruction of blood f low as a result of a thrombus mass in the lumen of PV. In the acute phase, the symptoms such as right upper quadrant pain, nausea, and fever are unspecific. A diversity of subacute and chronic symptoms is associated with complications related to PVT and portal hypertension. Case report. A 50-year-old female was admitted to the hospital due to acute abdominal cramping pain. The pain lasted for 15 to 20 min and was followed by defecation of normal stool and hematochezia on three occasions. The abdominal pain recurred after several hours, again followed by hematochezia and tenesmus every 10 min. After admission, a colonoscopy was performed, and it revealed vulnerable, erythematous mucosa of the colon with contact bleeding from the lienal flexure to the rectosigmoid junction. During the colonoscopy, a biopsy was performed. A computed tomography (CT) scan revealed partial PVT of intrahepatic branches of PV, and thrombosis of the inferior mesenteric vein. After conservative treatment with low molecular weight heparin (LMWH) and other supportive measures, the digestive bleeding ceased, and defecation became normal. During the one-month follow-up, the patient had no complications, and the control CT scan revealed normal PV flow without thrombosis. Conclusion. Although rare, a non-malignant and non-cirrhotic PVT should not be neglected in the differential diagnosis because timely and vigilant therapy with LMWH can lead to complete resolution without serious complications.

Nowadays, pain along with respiratory rate, body temperature, hart rate, arterial blood pressure breathing, temperature, pulse and pressure is considered the fifth vital sign. It is often stated that the pain is the most common symptom in clinical practice, a frequent cause of functional impairment of individual inability to function in a normal way, and the most common reason for seeking medical help. In patients who suffer from a long-term feeling of intense pain, efficiency and working ability are reduced and their emotional state is damaged as well. Due to long-term treatment and damaged everyday functioning, these patients often find themselves as social and financial issues. Knowledge about pain goes back far into the history of medical science and says that pain is a symptom of disease and will disappear when the underlying disease is cured. Nowadays, especially the chronic pain is identified as an independent health issue that can and must be treated. The pain is not only the transmission of impulses from the place of injury to the perception area of the brain but a phenomenon that is influenced by factors quantitative, qualitative and sensory, as well as cultural, social and economic. In addition to physical damage, the combination of psychological, social and spiritual component leads us to the concept of total pain definition. Therefore, it is necessary to act to all these causes for complete pain relief. Pain is an important public health issue worldwide. Despite the tremendous progress of science with new technological discoveries and pharmacological agents, pain is still a worldwide problem. It is a basic human right to live without pain, which means that the health care system is responsible to provide help to anyone who feels pain.

Background/Aim. Paragongliomas are rare hypervascular neoplasms. The aim of this study was to present the experience in the treatment of paragangliomas using preoperative embolization. Methods. This retrospective cross-sectional study included 10 patients (7 women and 3 men; median age 55 years) with paragangliomas that were embolized before surgery. Results. Three patients had tympanicum paragangliomas, two carotid bodies, three jugular and two jugulare-tympanicum paragangliomas. During the operation, only one out of 10 patients had bleeding which required blood transfusion. This patient received 1,130 mL of blood transfusion due to surgical complication. Conclusion. Adequate preoperative selective embolization of paragangliomas is essential in the preoperative preparation of these patients, because this strategy is feasible with low complication rates.

Introduction. Pulmonary arteriovenous malformation (PAVM) is pathological communication between pulmonary artery and pulmonary vein, in way that it shunts normal alveolar capillary membrane resulting in inadequate blood oxygenation in this part of the lung parenchyma Modern therapy of PAVMs includes surgical treatment or endovascular embolization. Case report. A 30-year-old female patient had signs of parestesia and weakness of the extremities on the left side of her body. On physical examination there was only cyanotic discoloration of her lips and clubbing fingers. On the chest x-ray, in the right hemithorax, in the inferior region of the lung, there was relatively homogeneous and well defined shadow, intensity of the soft tissue, which was about 35 mm. A multislice computed tomography pulmonary angiography was performed and showed, in lung parenchyma on both sides, many PAVMs, of which the largest (35 mm) was in inferior right region of the lung on crossing between apical and posterior basal lung segment with 7 mm diameter feeding artery and 9 mm diameter draining vein. The selective pulmonary angiography was per-formed by Seldingers technique. Through sheath, we placed a plug with a diameter of 10 mm. The plug was expanded and a complete occlusion of the final part of the feeding branch of this PAVM was achieved (confirmed by control angiography). In that way, the PAVM was fully shut off from the circulation. In 3 months follow-up, the patient was feeling well, without any recorded complication. Conclusion. Endovascular embolization is recommended as therapy of the first choice for all of PAVMs that have feeding artery greater than 2 mm. Endovascular embolization has high success rate with minimal complications.

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Copyright of Acta Facultatis Medicae Naissensis is the property of Nis University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)