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Babulovska A, Chaparoska D, Simonovska N, Perevska Z, Kostadinoski K, Kikerkov I, Kuzmanovska S. CREATINE KINASE IN PATIENTS WITH RHABDOMYOLYSIS ACUTELY INTOXICATED WITH PSYCHOTROPIC AND CHEMICAL SUBSTANCES. GEORGIAN MEDICAL NEWS 2022:145-150. [PMID: 35417876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The aim of this study was to determine the CK activity and its association with the length of hospital stay in acutely intoxicated patients with psychotropic and chemical substances. Rhabdomyolysis is defined as a creatine kinase (CK) > 250 U/L. We included adult patients ≥ 18 years of age, with rhabdomyolysis acutely intoxicated with psychotropic and chemical substances in the first 48 hours. We excluded patients with rhabdomyolysis in muscle trauma as a result of a traumatic accident, myocardial infarction, cerebral vascular infarction, cerebral hemorrhage, and chronic hepatic and renal disease. In all patients with rhabdomyolysis, the mean CK on the first, third and fifth day was consequently 5715.9±16088.8 U/L with a maximum value of 129077 U/L vs. 5548.5±9851.5 U/L with a maximum value of 63947U/L vs. 2970.42±7161.68 U/L with a maximum value of 53672 U/L. The comparison for the whole sample in the three measurement times, for p <0.05, showed a significant difference (Friedman Test: N = 62; Chi-Square = 34.935; df = 2; p = 0.00001). For the whole sample of patients with rhabdomyolysis, as well as in the group of psychotropic intoxications, for p < 0.05, the level of CK on the first day was confirmed as an independent predictor that significantly affected the variability of the length of hospitalization by 5.2% (R2 = 0.052) vs. 20% (R2=0.200). In rhabdomyolysis, as a result of acute intoxication with psychotropic and chemical substances it is important to examine the creatine kinase. Creatine kinase levels were higher in rhabdomyolysis in acutely intoxicated patients with psychoactive compared to chemical substances. In the group intoxicated with psychoactive substances creatine kinase as an independent predictor significantly affected the length of hospitalization.
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Petkovska L, Babulovska A, Simonovska N, Kostadinovski K, Brezovska J, Zafirova B. FATAL ACUTE ALIMINIUM PHOSPHIDE POISONING - CASE REPORT AND LITERATURE REVIEW WITH REFERENCE TO CURRENT TREATMENT PROTOCOLS AND OUTCOME. GEORGIAN MEDICAL NEWS 2021:111-115. [PMID: 34897055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Aluminum phosphide (AlP) has been known for more than 80 years as an effective pesticide for grain protection, but also as a suicidal agent used for human self-poisoning. Phosphine gas released in contact with stomach acid after oral ingestion of AlP is responsible for its toxicity. The poison affects all systems, so the mortality rate is quite high, especially after deliberate ingestions. We report the first case of severe AlP poisoning seen in our institution with a fatal outcome and furthermore, we present literature review on existing and newer treatment options. A 35-year-old woman with a history of epilepsy was admitted to the University Clinic for Toxicology in Skopje two hours after deliberate ingestion of one tablet of phostoxin (AlP). The first signs of poisoning were vomiting and abdominal pain, leukocytosis, prolonged PT, as well as inverted T waves in D3, AVF and left precordial leads on ECG. After developing respiratory failure and hypotension she was transferred to the intensive care unit (ICU). Her blood pressure was 80/40 mmHg, pulse rate 120/min. Laboratory findings showed signs of hepatic lesion, rhabdomyolysis and renal failure (AST 2267.42 U/L, ALT 2102.26 U/L, CPK 1334.81U/L, blood urea nitrogen 23.03 mmol/L, creatinine 211.9 µmol/L). Arterial blood gas analyses showed metabolic acidosis (pO2 9.6 kPa, pCO2 4.14 kPa, pH 7.15, bicarbonate 11 mmol/L, BE -15). The patient was placed on mechanical ventilation. Despite fluid supplementation, intensive therapy and inotropic support, hemodynamic instability worsened and cardiopulmonary resuscitation was performed three times. Unfortunately, the patient had a fatal outcome on the fourth day of intoxication. Solid formulations of AlP are very toxic. One tablet of phostoxin containing 3 grams of AlP is sufficient for the progression of life-threatening symptoms and fatal outcome. In the absence of antidote and elucidated mechanisms of toxicity, the key to treatment is rapid decontamination and initiation of resuscitation measures.
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Babulovska A, Caparoska D, Velikj-Stefanovska V, Simonovska N, Pereska Z, Kostadinoski K, Naumoski K. CLINICAL AND BIOCHEMICAL FINDINGS OF RHABDOMYOLYSIS IN ACUTE INTOXICATIONS WITH PSYCHOACTIVE AND CHEMICAL SUBSTANCES. GEORGIAN MEDICAL NEWS 2020:90-96. [PMID: 32383709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of the study is to identify possible differences in demographic, laboratory and clinical characteristics between patients with rhabdomyolysis due to intoxication with psychoactive and chemical substances. The study is a cross-sectional study conducted between 1 January and 30 June 2019. All the patients included during this period were treated due to intoxication (outpatient or hospitalized) at the University Clinic of Toxicology in Skopje. The patients with rhabdomyolysis were divided in two groups according to the nature of the substance used for intoxication: a) psychoactive substances and b) a chemical substance. Rhabdomyolysis was determined with a value of CPK (creatinine phosphate kinase) >250 U/L. Patients with rhabdomyolysis due to intoxication with chemical substances were significantly older than patients with rhabdomyolysis due to intoxication with psychoactive substances. There is a significant difference between the two groups of patients with rhabdomyolysis in terms of CPK, urea, hemoglobin values during the first day with regards to significantly higher values in the group where intoxication occurred with psychoactive substances. Five patients with rhabdomyolysis due to intoxication with psychoactive substances experienced muscle pain (10.9%), and one patient (3.8%) of those with rhabdomyolysis due to intoxication with chemicals, without any significant association between muscle pain and type of intoxication (Fisher exact test: p=0.3003). Muscle weakness and pigmented urine were identified consequently in six patients (13.0%) vs. five (10.9%) of patients with psychoactive intoxication and none with chemical. Rhabdomyolysis caused by psychoactive and chemical substances is associated with clinical manifestations and biochemical abnormalities. The values of CPK, myoglobin, AST, ALT, LDH, urea and creatinine were higher in favor of the group of intoxicated patients with rhabdomyolysis with psychoactive substances. The clinical symptoms of rhabdomyolysis are not present in all intoxicated patients, but are more present in the group intoxicated with psychoactive substances. Biochemical findings are crucial in establishing the diagnosis of rhabdomyolysis. Abnormalities of biochemical findings need to be identified in order to initiate appropriate treatment immediately to prevent mortality and morbidity.
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Chibishev A, Simonovska N. Acute unintentional intoxication with paraffin in a 25-year old patient - clinical case report. J Forensic Leg Med 2014; 26:1-4. [PMID: 25066163 DOI: 10.1016/j.jflm.2014.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 02/26/2014] [Accepted: 04/25/2014] [Indexed: 11/17/2022]
Abstract
"Fire-breathing" or "fire-eating" is a special kind of street art where the acts are always stunning, spectacular and amazing. People exhibiting this kind of show are professionals, not rare amateurs, who use different kind of fuels, usually hydrocarbons, in order to produce a pillar of fire. Intoxications caused by ingestion or inhalation of liquid paraffin, used as a fuel while performing, are numerous and various. We present a clinical case report of a 25-year old, previously healthy, amateur "fire-breather". During October, 2010 this young men arrived at the Emergency Unit of the University Clinic for toxicology and Urgent Internal Medicine in a severe clinical condition, after his unsuccessful attempt to perform real "fire-breathing". He had fever, strong headaches, mild abdominal and chest pain and he also had difficulties breathing and persistent dry cough. The patient was extremely dyspneic with peripheral cyanosis and shortness of breath. "Fire-breathers" must be viewed as a population at risk of paraffin-induced pneumonia, which has low mortality rate, but still is related with numerous and various chronic complications. Our patient was first in a life threatening, extremely serious clinical condition which was urgently treated with appropriate vigorous and effective therapy. This therapeutic protocol led to successful full recovery of these young men, who luckily didn't exhibit any chronic complications.
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Chibishev AA, Simonovska N, Bozinovska C, Pereska Z, Smokovski I, Glasnovic M. Respiratory complications from acute corrosive poisonings in adults. Mater Sociomed 2014; 26:80-3. [PMID: 24944527 PMCID: PMC4035138 DOI: 10.5455/msm.2014.26.80-83] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 03/15/2014] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Acute corrosive poisonings are caused by ingestion of corrosive chemicals which are most commonly used as household agents. Intoxications with these kind of agents produce numerous and severe post-corrosive complications of the upper gastrointestinal tract. On the other hand, our experience showed that corrosive agents may also cause injuries of the respiratory system, which makes the treatment very hard and additionally complicates the severe clinical condition of the patient. OBJECTIVE The aim of the study is to show the incidence of respiratory complications in acute corrosive poisonings, the need of various clinical investigations and also the treatment and final outcome of these kind of poisoning. METHODS We retrospectively analyzed clinical records of 415 patients hospitalized and treated at the University clinic for toxicology and urgent internal medicine, in Skopje, Republic of Macedonia, in the period between 2007 and 2011. The protocol consisted of methods for analyzing the systemic complications, with an accent on the post-corrosive respiratory complications. RESULTS From the total number of patients even 98 (23.61%) exhibited systemic complications, from which 51 (52.04%) are respiratory complications. The majority of patients are female (n=40, 78.43%) and the most common complication is pneumonia (n=47). The youngest patient in this study was 14 and the oldest was 87 years old. CONCLUSION Besides the gastrointestinal complications in the acute corrosive poisonings respiratory complications are also very often. They complicate the clinical state of patient and very often lead to fatal endings.
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Simonovska N, Bozinovska C, Chibishev A, Grchevska L, Dimitrovski K, Neceva V. Changes of some humoral immunologic indicators and clinical manifestations of cryoglobulinemia in heroin addicts. GEORGIAN MEDICAL NEWS 2012:45-53. [PMID: 23221138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED Different autoantibodies and immunologic abnormalities have been described in heroin addicts. AIMS dpending on the route of heroin application in heroin addicts to determine: 1) immunoglobulins: IgA, IgG, IgM; 2) complement (C3, C4); 3) some other autoantibodies RF, anti β2GP1 fractions: IgA, IgG, IgM, ANA; 4) CIC; 5)monitoring the cryoglobulin presence; 6) clinical manifestations in cryoglobulin positive heroin addicts. A total of 363 heroin addicts were analyzed after previously completed questionnaire; biochemical analyses of blood and urine; creatinine clearance (eC(Cr)) by Cockcroft-Gault formula; proteinuria; 24-hour proteinuria (Uprot/Ucreat); ECG; toxicological analyses; complement (C3, C4); immunoglobulins IgA, IgG, IgM; rheumatoid factor; cryoglobulins; circulating immune complexes; antiphospholipid antibodies (anti β2GP1: IgA, IgG, IgM); antinuclear antibodies. Male patients were predominating (82.09%). Of them 161 were using intravenous heroin (45.4%). IgA was statistically significantly lower in intravenous heroin addicts. Intravenous heroin addicts contrary to those who inhaled heroin had highly significant levels of IgG, IgM, IgG, antiβ2GP1 cryoglobulins; significantly higher mean values of: RF, anti β2GP1 IgA and IgM. Cryoglobulin positive (CP) heroin addicts compared to cryoglobulin negative (CN) presented significantly more frequently with clinical signs of arthralgia, vasculitis, hematuria; whereas highly significantly were manifested respiratory difficulties, neurological disorders, Raynaud phenomenon, proteinuria, 24-hour proteinuria, highly significantly lower mean values of renal clearance. Intravenous heroin addicts compared to the non-parenteral heroin addicts have shown greater changes in certain parameters of humoral immunity. CP heroin addicts have presented with more frequent clinical manifestations than CN heroin addicts.
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Chibishev A, Pareska Z, Chibisheva V, Simonovska N. Clinical and epidemiological features of acute corrosive poisonings. Med Arch 2012; 66:11-5. [PMID: 22937683 DOI: 10.5455/medarh.2012.66.s11-s15] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND the ingestion of chemical agents, of caustic nature, represents a serious problem for clinical toxicology. If the ingestion doesn't cause death during the acute period, it will most often cause severe side effects in the upper gastrointestinal tract during the chronic phase. AIMS The purpose of this study is to show the clinical, epidemiological and socio-economical characteristics seen in acute corrosive poisonings such as ingested caustic agents, causes for abuse and most consequential complications. MATERIAL AND METHODS a ten year medical data was constructed and collected (2000-2009) from patients with acute corrosive poisonings who were hospitalized and treated in the University Clinic of toxicology and urgent internal medicine in Skopje, Republic of Macedonia. The variables included were: age, sex, type of poisonings and percentage of late post-corrosive complications. RESULTS In the study, 735 patients files were analyzed, collected in a period often years. The mean age of patients is 32.9 +/- 15.6 years. Majority of patients ingested hydrochloric acid (HCl; n = 354; 48,16%). CONCLUSION Demographic, diagnostic and therapeutic findings in acute corrosive poisonings are found to be similar to the findings observed in the referenced literature. Conclusively, women between 14 and 30 years old represent a high risk group; hydrochloric acid is the most often abused agent; and high percentage of post-corrosive complications are
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Simonovska N, Chibishev A, Bozinovska C, Grcevska L, Dimitrovski K, Neceva V. Evaluation of circulating immune complexes and antiphospholipid antibodies (anti beta 2 glycoprotein 1) in heroin addicts and their clinical significance. Med Arch 2012; 65:324-6. [PMID: 22299289 DOI: 10.5455/medarh.2011.65.324-326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Earlier studies have reported that heroin might cause the structural and antigen changes on numerous tissues, organs and subsequent development of autoimmune reactions (production of antibodies and creation of immune complexes) as a result the immunotoxic effect of heroin. The aims of our study were to: a) Evaluate CIC and antibeta2GP1 in heroin addicts; b) Correlate between the values of the obtained CIC and antibeta2GP1 (stratified by the duration and route of heroin application); c) Compare the CIC and antibeta2GP1 in heroin addicts and the control group and d) Assess the clinical importance of CIC and antibeta2GP1 in heroin addicts. PATIENTS AND METHODS This was a cross-sectional study performed at the University Clinic of Toxicology and the Institute of Transfusiology, Skopje, Republic of Macedonia. Patients referred to the Clinic for clinical examinations who met the inclusion criteria were analyzed. Protocol for work was the following: 1.) detailed anamnestic data, 2.) a whole set of laboratory biochemical blood and urine analyses, 3.) examination with the Schiller's twelve-channel ECG; 4.) toxicological analyses for opioids in a urine sample; circulating immune complexes and 5.) antiphospholipid antibodies (antibeta2GP1, fractions: IgA, IgG, IgM). The obtained results were statistically analyzed. RESULTS We included 37 heroin addicts and a control group of 27 healthy subjects. Male abusers predominated over female in--28 (76%) subjects; mean age being 26 +/- 5.06. The results which refer to the increased values of circulating immune complexes have shown a high statistically significant dominance of heroin addicts, in comparison with the control group (p < 0.01) and increased values above the reference ones of IgG antibeta2GP1, alone in the group of intravenous heroin abusers (p < 0.025). The mean duration of the heroin use in intravenous abusers was 6.21 +/- 3.25 years, whereas in those snorting heroin was 5.15 +/- 2.26 years. Duration of heroin application was in a positive correlation with IgG antibeta2GP1 (p = 0.35). CONCLUSIONS Our data showed that heroin-dependent patients in our study had increased values of circulating immune complexes and changes in IgG and IgM antibeta2GP1 with significantly increased values of IgG antibeta2GP1 in the intravenous heroin abusers. The duration of heroin application is in direct proportional relationship with IgG antibeta2GP1. Heroin addicts had significantly higher values of circulating immune complexes and statistically significant difference in IgG antibeta2GP1, in comparison with the control group. Changes in the fractions of antibeta2GP1 and CIC suggest a possible relation with the somatic changes found in heroin addicts (i.e. thrombocytopenia, reduced renal clearance, etc).
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Chibishev A, Pereska Z, Chibisheva V, Simonovska N. Corrosive poisonings in adults. Mater Sociomed 2012; 24:125-30. [PMID: 23678319 PMCID: PMC3633385 DOI: 10.5455/msm.2012.24.125-130] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 05/15/2012] [Indexed: 12/23/2022] Open
Abstract
Ingestion of corrosive substances may cause severe to serious injuries of the upper gastrointestinal tract and the poisoning can even result in death. Acute corrosive intoxications pose a major problem in clinical toxicology since the most commonly affected population are the young with psychic disorders, suicidal intent and alcohol addiction. The golden standard for determination of the grade and extent of the lesion is esophagogastroduodenoscopy performed in the first 12-24 hours following corrosive ingestion. The most common late complications are esophageal stenosis, gastric stenosis of the antrum and pyloris, and rarely carcinoma of the upper gastrointestinal tract. Treatment of the acute corrosive intoxications include: neutralization of corrosive agents, antibiotics, anti-secretory therapy, nutritional support, collagen synthesis inhibitors, esophageal dilation and stent placement, and surgery.
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Chibishev A, Pereska Z, Simonovska N, Babulovska A, Chibisheva V. The Role of Urgent Esophagogastroduodenoscopy in Prognosis of Acute Caustic Poisonings. Acta Inform Med 2011. [DOI: 10.5455/aim.2011.19.80-84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Simonovska N, Chibishev A, Babulovska A, Pereska Z, Jurukov I, Glasnovic M. Program of the University Clinic of Toxicology, Skopje, Republic of Macedonia, in Treatment of Drug Addiction (Buprenorfin Treatment Protocol). Mater Sociomed 2011; 23:232-4. [PMID: 23678303 PMCID: PMC3633544 DOI: 10.5455/msm.2011.23.232-234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 11/26/2011] [Indexed: 11/21/2022] Open
Abstract
The program of our Clinic includes, not only treatment of acute intoxication with opioids and other drugs, but also comprehends clinical investigations and treatment of the somatic complications of this population. For the first time in our country our Clinic offers to this population the alternative way of treatment with Buprenorfin. The Clinic started with this protocol on August 1, 2009. During a period of two years, the treatment with Buprenorfine has been initiated in 353 patients, of which 211 regularly attend the medical check ups. This model is used according to the national clinical guidelines and procedures for the use of buprenorfine in the treatment of opioid dependence The dose of this medicament depends on the evolution of the withdrawal symptoms. We have used the objective and subjective opioid withdrawal scale for the observation of these symptoms (OOWS ; SOWS – Handelsman et al 1987). This protocol starts with a complete clinical investigations, (i.e. where all patients undergo the inclusion and exclusion criteria with a written consent). Afterwards, the patients are hospitalized and start with a Buprenorfin teratment. After period of 7-10 days hospitalization they come to our Clinic, like outpatients for a regular controls. We have precise evidence for every patient who comes for control (e.g. medical record with all biochemical and toxicological screenings). All patients are recommended a tight cooperation with psychiatrists who are specialized to treat the problematic drug addictions.
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Chibishev A, Simonovska N, Shikole A. Post-corrosive injuries of upper gastrointestinal tract. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2010; 31:297-316. [PMID: 20693948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Acute poisonings with corrosive substances may cause serious chemical injuries to upper gastrointestinal tract, the most common location being the esophagus and the stomach. If the patient survives the acute phase of the poisoning, regenerative response may result in esophageal and/or gastric stenosis and increased risk for esophageal cancer. Acute corrosive intoxications pose a major problem in clinical toxicology since the most commonly affected population are the young with psychic disorders, suicidal intent and alcohol addiction. In establishing the diagnosis of acute corrosive poisonings, the severity of the post-corrosive endoscopic changes of the esophagus, stomach and duodenum is of major importance. According to Holinder and Fridman classification, post-corrosive endoscopic changes are classified in three degrees: First degree--superficial damage associated with hyperthermia, epithelial desquamation and mucous edema. Second degree--transmucous damage affecting all of the mucosal layers, followed by exudation, erosions and ulcerations. Third degree--transmural damage associated with ulcer's penetration in the deep layers of the tissue and neighboring organs. Severity of the lesions depends on the nature, quantity and concentration of the corrosive substance, the duration of exposure and current state of the exposed organs. Most often caustic injuries occur to the esophagus and stomach since the corrosive substance remains there for a longer period of time. Treatment of the acute corrosive intoxications include: neutralization of corrosive agents, antibiotics, corticosteroids, anti-secretory therapy, nutritional support, collagen synthesis inhibitors, esophageal dilation and stent placement, and surgery. The most common complications that may appear are: perforation, gastrointestinal bleeding, sepsis, esophageal strictures and stenosis, stenosis of gastric antrum and pylorus, cancer of the esophagus and the stomach. Today, owing to the substantially enhanced diagnostic and therapeutic approach, the mortality percentage has been reduced from 20% to 1-5%. Women more often than men are intoxicated with corrosive substances; suicidal poisonings prevail; the most abused agents are hydrochloric acid (HCl) and sodium hydroxide; intoxications are more common in children (80% out of the total number of intoxications). In spite of the preventive measures for restriction of the trade with corrosive substances, standardization of their concentration and protective safety bottle caps, still the number of corrosive intoxications, the percentage of post-corrosive complications and the handicap are high. Acute corrosive intoxications are the leading cause of death in clinical toxicology.
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Blazhevski B, Filipche V, Cvetanovski V, Simonovska N. Predictive value of the duration of sciatica for lumbar discectomy. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2008; 29:325-335. [PMID: 19259056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The optimal time for lumbar discectomy due to sciatica is still under discussion. We examined a group of 177 consecutive patients with lumbar disc herniation, who underwent lumbar discectomy. According to the duration of the sciatica, patients were divided into 3 groups: 31 (17.5%) patient with a duration of sciatica from 0 to 3 months, 82 (46.3%) patients with a duration from 4 to 10 months, and 64 (36.2%) with a duration longer than 10 months. The assessment of postoperative health status was done with the Oswestry Disability Index 2.0 (ODI scoring) one year after the surgery. Statistical data have shown that there was no significant difference between the patients operated on in the period from 0-3 and 4-10 months (p > 0.05). There was a significant difference between the patients operated on in the period from 0-3 months and > 10 months (p > 0.001). There was also a significant difference between the patients operated on in the period from 4-10 months and those operated > 10 months (p < 0.001). This goes in favour of achieving the best results in patients with a duration of sciatica from 0 to 3 months. The worst results were obtained in those with a duration of sciatica > 10 months.
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