Aims Fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) and sigma‐1 receptor agonist, has so far shown promise in the prevention of COVID‐19 progression as an early treatment option in three trials. The aim of this study was to evaluate the safety and efficacy of fluvoxamine in COVID‐19 patients if administered later in the course of the disease. Methods The study was designed as an open‐label, prospective cohort trial with matched controls. In April and May 2021, 51 ICU COVID‐19 patients hospitalised in the University Hospital Dubrava and University Hospital Centre Zagreb, Croatia, were treated with fluvoxamine 100 mg three times daily for 15 days in addition to standard therapy and they were prospectively matched for age, gender, vaccination against COVID‐19, disease severity and comorbidities with 51 ICU controls. Results No statistically significant differences between groups were observed regarding the number of days on ventilator support, duration of ICU or total hospital stay. However, overall mortality was lower in the fluvoxamine group, 58.8% ( n = 30/51), than in the control group, 76.5% ( n = 39/51), HR 0.58, 95% CI (0.36–0.94, P = .027). Conclusion Fluvoxamine treatment in addition to the standard therapy in hospitalised ICU COVID‐19 patients could have a positive impact on patient survival. Further studies on the effects of fluvoxamine in COVID‐19 patients are urgently required.

No abstract

SummaryDuring neurosurgery procedures it is vital to assure optimal cerebral perfusion and oxygenation. Despite physiological autoregulation of brain perfusion, maintaining hemodynamic stability and good oxygenation during anesthesia is vital for success. General anesthesia with mechanical ventilation and current drugs provide excellent hemodynamic condition and it is the first choice for most neurosurgery procedures. However, sometimes it is very hard to avoid brief increase or decrease in blood pressure especially during period of intense pain, or without pain stimulation. This could be detrimental for patients presented with high intracranial pressure and brain edema. Modifying anesthesia depth or treatment with vasoactive drugs usually is needed to overcome such circumstances. On the other hand it is important to wake the patients quickly after anesthesia for neurological exam. That is why regional anesthesia of scalp and spine could show beneficial effects by decreasing pain stimuli and hemodynamic variability with sparing effect of anesthetics drugs. Also regional techniques provide excellent postoperative pain relief, especially after spinal surgery

Background/Aim. Secondary lymphedema of the arm is one of possible side-effects and complications of breast cancer and its treatment which can contribute and precipitate to a number of new psychosocial problems. The aim of this study was to examine the differences in quality of life of patients suffering from breast cancer, with arm lymphedema and those without lymphedema, and to determine the significance of the perception of the disease, depressive symptoms and self-efficacy contribution to overall quality of life. Methods. The research was designed as a cross-sectional study, which included 64 patients-34 with arm lymphedema and 30 without lymphedema. Questionnaire FACT-B + 4 was applied to assess the quality of life, BIPQ for the perception of the disease, depression was measured by DASS-21 scale, while self-efficacy was tested by SGSE scale. T-test, Mann Whitney U Test, χ 2 test and hierarchical regression analysis were applied to data processing. Results. There was not any significant difference between the groups in the total score of quality of life (t = 0.469, p > 0.05), or in the individual subscales: physical well-being (t = 0.535, p > 0.05), social/family well-being (t = 1.43, p > 0.05), emotional well-being (t = 1.35, p > 0.05), functional well-being (z =-0.243, p > 0.05), breast cancer scale (t =-0.839, p > 0.05) and arm scale (t =-0.514, p >0.05), while the perception of the disease (β =-0.603, t =-5.958, p < 0.001) and depression (β =-0.411, t =-4.101, p < 0.001) proved to be significant predictors of quality of life and explain 50.2% variance of overall quality of life. Conclusion. The results of our study indicate the importance of a comprehensive rehabilitation program, directed both at functional and psychosocial aspects.

The conclusion of our study is that high levels of serum GST Pi in the first 6 h after birth are associated with an increased mortality and development of AKI in prematurely born neonates.

The results suggest that PDR/ICG and ICG R15 are useful dynamic tests for evaluation of complex liver function and survival prediction after major abdominal surgery in patients with IAH.

No abstract

Elevated intraabdominal pressure (IAP)