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master's thesis
Primjena plazmafereze u liječenju akutnog diseminiranog encefalomijelitisa
Zagreb: University of Zagreb, School of Medicine, 2016. urn:nbn:hr:105:788724
Ćoso Mihajlović, Biljana
University of Zagreb
School of Medicine
Department of Infectious Diseases

Institutional repository: Dr Med - University of Zagreb School of Medicine Digital Repository

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Ćoso Mihajlović, B. (2016). Primjena plazmafereze u liječenju akutnog diseminiranog encefalomijelitisa (Master's thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:788724

Ćoso Mihajlović, Biljana. "Primjena plazmafereze u liječenju akutnog diseminiranog encefalomijelitisa." Master's thesis, University of Zagreb, School of Medicine, 2016. https://urn.nsk.hr/urn:nbn:hr:105:788724

Ćoso Mihajlović, Biljana. "Primjena plazmafereze u liječenju akutnog diseminiranog encefalomijelitisa." Master's thesis, University of Zagreb, School of Medicine, 2016. https://urn.nsk.hr/urn:nbn:hr:105:788724

Ćoso Mihajlović, B. (2016). 'Primjena plazmafereze u liječenju akutnog diseminiranog encefalomijelitisa', Master's thesis, University of Zagreb, School of Medicine, accessed 09 November 2024, https://urn.nsk.hr/urn:nbn:hr:105:788724

Ćoso Mihajlović B. Primjena plazmafereze u liječenju akutnog diseminiranog encefalomijelitisa [Master's thesis]. Zagreb: University of Zagreb, School of Medicine; 2016 [cited 2024 November 09] Available at: https://urn.nsk.hr/urn:nbn:hr:105:788724

B. Ćoso Mihajlović, "Primjena plazmafereze u liječenju akutnog diseminiranog encefalomijelitisa", Master's thesis, University of Zagreb, School of Medicine, Zagreb, 2016. Available at: https://urn.nsk.hr/urn:nbn:hr:105:788724

Metadata
TitlePrimjena plazmafereze u liječenju akutnog diseminiranog encefalomijelitisa
Title (english)Therapeutic plasma exchange in the treatment of the acute disseminated encephalomyelitis
AuthorBiljana Ćoso Mihajlović
MentorMarija Santini (mentor)
Committee memberDalibor Vukelić (predsjednik povjerenstva)
Committee memberGoran Tešović (član povjerenstva)
Committee memberMarija Santini (član povjerenstva)
GranterUniversity of Zagreb
School of Medicine
(Department of Infectious Diseases)
Zagreb
Defense date and country2016-09-20, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Infectology
Abstract
Akutni diseminirani encefalomijelitis (ADEM) je teška, najčešće monofazična imunološki posredovana demijelinizacijska bolest središnjeg živčanog sustava koja uglavnom pogađa osobe mlađe životne dobi. Liječi se imunomodulacijom, koja se provodi glukokorirtikoidima, plazmaferezom i intravenskim imunoglobulinima. Do danas nema jasnih smjernica za liječenje, a dokazi o učinkovitosti plazmafereze uglavnom se temelje na kratkim serijama i pojedinačnim prikazima bolesnika. Cilj ovog retrospektivnog opservacijskog istraživanja je prikazati seriju bolesnika s ADEM-om liječenih u Zavodu za intenzivnu medicinu i neuroinfektolgiju Klinike za infektivne bolesti „Dr. Fran Mihaljević“ u Zagrebu, od 1.1.2006. do 30.7.2016. U promatranom periodu liječeno je 9 bolesnika čiji je medijan dobi iznosio 25 godina (minimum 20, maksimum 42 godine). Modificirana Rankinova skala (MRS) na početku liječenja iznosila je u 6 od 9 bolesnika 5 (varirala je od 2 do 5). U svih bolesnika je primjenjena plazmfereza (PF). Do povlačenja simptoma je došlo u pet od devet bolesnika nakon 3 procedure PF. Medijan MRS kod otpusta iznosio je 2 (minimum 3, maksimum 1). Na temelju brzine povlačenja znakova i simptoma nakon primjene PF, te na temelju konačanog poboljšanja stanja bolesnika izraženog putem MRS može se zaključiti da je PF koristan oblik imunomodulacijskog liječenja, ali da su za određivanje optimalnog vremena i režima primjene potrebne prospektivne kontrolirane kliničke studije.
Abstract (english)
Acute disseminated encephalomyelitis (ADEM) is a severe, mostly monophasic central nervous system (CNS) immune mediated demyelinating disease, primarily affecting young patients. Immunomodulating treatment options include glucocorticoids, plasmapheresis (PF) and intravenous immunoglobulins, but there are no clear guidelines for their administration. The evidence for the effectiveness of plasmapheresis is mainly based on case series and individual case reports. The aim of this retrospective observational study is to present ADEM case series treated at the Department of Intensive Care and Neuroinfections of the University Hospital for Infectious Diseases "Dr. Fran Mihaljevic ", Zagreb, from January 1, 2006 to June 30, 2016. In the observed period nine patients were treated whose median age was 25 (minimum 20, maximum 42). The modified Rankin Scale in six of nine patients was 5 (minimum 5, maximum 2). All patients were treated by plasmapheresis (PF). In five of nine patients the improvement was noticed after 3 procedures of PF. Median MRS at discharge was 2 (minimum 3, maximum 1). According to the dynamics of improvement after PF and according to the final treatment outcomes we can conclude that PF is a useful form of immunomodulatory ADEM treatment. But, for its’ timing and optimal regimen prospective controlled clinical studies are needed.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:105:788724
Study programmeTitle: Studies in Nursing
Study programme type: university
Study level: graduate
Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2017-03-15 13:18:09