Acta Clinica Croatica[JOURNAL]
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200 papers
TRENDS IN PROSTATE CANCER DIAGNOSIS DURING THE COVID-19 PANDEMIC: SINGLE-INSTITUTION EXPERIENCE.
Ćudina I, Glavčić M, Hrabač P … +2 more , Bulimbašić S, Ćorić M
Acta Clin Croat · 2023 Jul · PMID 38966019 · Full text
The aim of this study was to compare the number of biopsy and surgical procedures on prostate, as well as the number of newly diagnosed, histologically confirmed cases of prostate cancer during the COVID-19 pandemic at Z...
The aim of this study was to compare the number of biopsy and surgical procedures on prostate, as well as the number of newly diagnosed, histologically confirmed cases of prostate cancer during the COVID-19 pandemic at Zagreb University Hospital Center (UHC). We retrospectively collected and processed a total of 1344 histopathologic findings of the prostate at the Zagreb UHC. Our results show that during the COVID-19 pandemic, there was a statistically significant decrease in the absolute number of biopsy and surgical procedures on prostate at Zagreb UHC, and so was the number of newly diagnosed, histologically confirmed cases of prostate cancer. During the observed time of the pandemic (March 19, 2020 to December 31, 2020), there was a 37.5% decrease in the absolute number of newly diagnosed prostate cancer cases compared to the same period of the previous year (March 19, 2019 to December 31, 2019). To our knowledge, this is the first study of this kind that is based on the number of prostate cancer diagnoses in Croatia. By observing the early period of the pandemic, our results provide important guidelines for monitoring and understanding the long-term consequences of the pandemic on the prostate cancer morbidity and mortality.
HISTOPATHOLOGIC FEATURES OF KIDNEY TUMORS AND COMPARISON OF PATIENTS TREATED WITH RADICAL AND PARTIAL NEPHRECTOMY AT OSIJEK UNIVERSITY HOSPITAL CENTER FROM 2017 UNTIL THE END OF 2021.
Sudarević B, Pavoković D, Slobođanac E
Acta Clin Croat · 2023 Jul · PMID 38966018 · Full text
The objective of this study was to present results of kidney tumor treatment at Osijek University Hospital Center over a 5-year period and to compare the outcomes between patients treated with radical nephrectomy (RN) an...
The objective of this study was to present results of kidney tumor treatment at Osijek University Hospital Center over a 5-year period and to compare the outcomes between patients treated with radical nephrectomy (RN) and partial nephrectomy (PN). From November 2016 until the end of 2021, there were 280 consecutive PNs and RNs included in this cross-sectional study. Exclusion criteria were nephrectomies due to non-oncologic reasons and transitional cell carcinoma. There were 229 RNs and 51 PNs, median age of all patients was 62.5 (range 34-84) years. In the RN group, there were 197 renal cell carcinomas (RCC), predominantly clear-cell subtype, while among others there were 8 multilocular cystic renal neoplasms of low malignant potential (MCRNLMP) and 6 oncocytomas and angiomyolipomas each. There were 44 RCCs, 4 oncocytomas, 1 MCRNLMP and 2 cysts removed with PN; median R.E.N.A.L. score was 5. RN group had greater tumor diameters and higher tumor grade, higher postoperative creatinine levels and complications of higher grade. There was no difference in median hospital stay (6 days) and follow-up (20 months). With regard to oncologic safety, preservation of kidney function and lower overall morbidity, PN should be preferred to RN whenever oncologically safe and technically feasible.
KIDNEY CANCER IN CROATIA - TRENDS IN INCIDENCE AND MORTALITY IN THE 21 CENTURY.
Šekerija M, Alfirević M, Čukelj P … +2 more , Brkić Biloš I, Kuliš T
Acta Clin Croat · 2023 Jul · PMID 38966017 · Full text
Kidney cancer is estimated to be responsible for more than 400 000 new cancer cases and 180 000 cancer deaths a year. Its incidence is increasing in the majority of developed countries, due to an increased prevalence of...
Kidney cancer is estimated to be responsible for more than 400 000 new cancer cases and 180 000 cancer deaths a year. Its incidence is increasing in the majority of developed countries, due to an increased prevalence of recognized risk factors such as smoking, alcohol use and obesity, as well as incidental findings on unrelated diagnostic imaging procedures. Mortality is decreasing in the majority of European countries, due to improvements in treatment and stage at diagnosis shift with more tumors being diagnosed at an early stage. In this paper, we present kidney cancer incidence and mortality trends in Croatia using joinpoint regression analysis. The incidence was rising throughout the 2001-2019 period, with an annual percent change (APC) of 2.5%; more so in men (APC of 2.5%) than in women (APC of 2.2%). Mortality increased during the 2001-2014 period (APC of 2.4%), but started to decrease in recent years (APC -2.7%, 2014-2020). Unlike sex differences observed in other European countries, with more favorable mortality trends found in women, our study showed a constant increase in mortality in women (APC of 1.2%) and a recent decrease in mortality in men, starting in 2013 (APC of -2.8%), after a period of increase from 2001 (APC of 3.3%).
OSTEOPROTEGERIN AS AN EARLY SIGN OF CHRONIC KIDNEY DISEASE-MINERAL AND BONE DISORDER.
Gršković A, Ćelić T, Španjol J … +4 more , Markić D, Devčić B, Bobinac D, Rački S
Acta Clin Croat · 2023 Jul · PMID 38966016 · Full text
Chronic kidney disease (CKD) is among the most significant health problems, with the associated cardiovascular disease and bone metabolism disorders being the leading cause of morbidity and mortality in these patients. T...
Chronic kidney disease (CKD) is among the most significant health problems, with the associated cardiovascular disease and bone metabolism disorders being the leading cause of morbidity and mortality in these patients. The aim of the study was to determine markers of bone turnover in patient sera (phosphates, calcium, alkaline phosphatase, parathyroid hormone and osteoprotegerin (OPG)) in all stages of kidney failure including kidney transplant recipients. We also wanted to determine whether dialysis vintage affects recovery of bone markers one year after transplantation. There were 164 study patients, whereas 30 healthy individuals served as a control group. Serum OPG progressively increased with decline of the glomerular filtration rate. The highest OPG concentration was recorded in dialysis group. We observed a statistically significant OPG increase in stage 2 CKD. In kidney transplant group, there was positive correlation between OPG and dialysis vintage. We also found that serum OPG was lower in patients treated with dialysis for less than 4 years prior to transplantation. We confirmed that CKD-mineral and bone disorder began in stage 3 CKD with parathyroid hormone and OPG elevation, and a statistically significant OPG increase in stage 2 CKD might be an early sign of CKD-mineral and bone disorder. Dialysis vintage longer than 4 years is associated with more significant disturbances in mineral and bone metabolism.
FLEXIBLE URETERORENOSCOPY AND LASER LITHOTRIPSY IN A PATIENT WITH A STONE IN THE TRANSPLANTED KIDNEY: A CASE REPORT.
Marić M, Kuliš T, Penezić L … +3 more , Andrijašević V, Mokos I, Kaštelan Ž
Acta Clin Croat · 2023 Jul · PMID 38966015 · Full text
We report a case of a 31-year-old patient with obstructive ureterolithiasis in a transplanted kidney, treated endoscopically with flexible ureterorenoscopy and laser lithotripsy. The patient presented with biochemical si...
We report a case of a 31-year-old patient with obstructive ureterolithiasis in a transplanted kidney, treated endoscopically with flexible ureterorenoscopy and laser lithotripsy. The patient presented with biochemical signs of acute renal failure and ultrasonographically detected hydronephrosis. Emergency nonenhanced computed tomography scan revealed an obstructive 5-mm stone in the ureter of the transplanted kidney with resulting hydronephrosis. The patient received a double J stent to relieve allograft obstruction. Since the stone size was deemed favorable for conservative treatment, the patient was discharged. Two months later, he was readmitted for leucopenia caused by mycophenolate mofetil. After recuperation of his white blood cell count, he was referred to extracorporeal shock wave lithotripsy, but since the stone was radiolucent, an endoscopic procedure was indicated. Retrograde endoscopic flexible ureterorenoscopy with 'dusting' of the stone was successfully performed. One year after the procedure, the patient was stone free and with good allograft function.
SACRAL NEUROMODULATION IN TREATING OVERACTIVE BLADDER PATIENTS - FIRST-TIME APPLICATION IN CROATIA.
Bakula M, Hauptman D, Hudolin T … +4 more , Škegro SN, Tudor KI, Bakula B, Kaštelan Ž
Acta Clin Croat · 2023 Jul · PMID 38966014 · Full text
Sacral neuromodulation (SNM) is a safe, efficacious, and minimally invasive advanced therapy that involves electrical stimulation to sacral nerve root to modulate neural pathway. Indications for SNM include symptoms of o...
Sacral neuromodulation (SNM) is a safe, efficacious, and minimally invasive advanced therapy that involves electrical stimulation to sacral nerve root to modulate neural pathway. Indications for SNM include symptoms of overactive bladder (OAB), urinary incontinence, urinary retention, urgency and frequency and, regarding bowel dysfunction, fecal incontinence . In Europe and Canada, indication is also established for chronic constipation. The mechanism of action is still not fully elucidated and complete understanding is yet to be determined. It is proposed that SNM modulates neural circuits in both central and peripheral pathways, thus having an impact on the brain, as well as on the bladder-targeting neuronal activity. Another possible significant effect on irregular bladder activity is through inhibition of the bladder afferent pathways by stimulation of the pudendal nerve. Over the past two decades, with more than 300 000 treated patients, SNM has confirmed its efficacy to relieve refractory OAB symptoms, as well as urinary retention or fecal incontinence. First SNM applications in Croatia were uneventful and we are glad to offer our patients this novel therapy in the future.
THE ROLE OF INTERVENTIONAL RADIOLOGISTS IN THE TREATMENT OF COMPLICATIONS IN UROLOGIC PATIENTS.
Kopačin V, Turk T, Pavlović O … +3 more , Perković J, Krajina V, Pavoković D
Acta Clin Croat · 2023 Jul · PMID 38966013 · Full text
Higher turnaround of urologic patients in the tertiary clinical center can lead to more accompanying complications, ranging from 1% to 55% for various procedures, with the incidence of vascular injuries varying from 0.43...
Higher turnaround of urologic patients in the tertiary clinical center can lead to more accompanying complications, ranging from 1% to 55% for various procedures, with the incidence of vascular injuries varying from 0.43% up to 9.5%. In patients with impaired renal function, it is imperative to prevent the loss of normal kidney function and potential hemodialysis. Being minimally invasive, endovascular procedures such as renal artery embolization (RAE) can treat major and life-threatening complications, but good and prompt communication between urologists and interventional radiologist is necessary for fast and effective treatment. Absolute contraindications for RAE are the presence of acute infection and previously known anaphylactic reaction to the iodine contrast media, while previous mild or moderate allergic reactions to iodine contrast media are not contraindications for RAE. Currently used embolic agents can be divided into temporary and permanent embolization agents. While the temporary embolization agent available is a gelatin sponge that could be used as complementary material or stand-alone, for permanent embolization interventional radiologists use microparticles, microspheres, liquid embolic agents, coils, and microcoils. RAE procedures are considered to be safe with a low incidence of complications, with non-target embolization being the most serious one. Postembolization syndrome is considered to be the most common adverse effect and it involves around 90% of patients. The overall results show that RAE is a safe, minimally invasive procedure that can effectively treat significant complications caused by other urologic procedures, with the reported success rates of 87%-100%.
THE EFFECT OF PALPEBRAL FISSURE HEIGHT IN PRIMARY GAZE POSITION ON TEAR FILM STABILITY.
Čović A, Petriček I, Tomić M
Acta Clin Croat · 2023 Aug · PMID 38549607 · Full text
This study aimed to investigate the effect of palpebral fissure height in primary gaze position in healthy individuals on tear film stability. In this cross-sectional study, 120 subjects (60 male and female each) were en...
This study aimed to investigate the effect of palpebral fissure height in primary gaze position in healthy individuals on tear film stability. In this cross-sectional study, 120 subjects (60 male and female each) were enrolled and divided according to age into two groups, i.e., group 1 (aged 18-50 years) and group 2 (aged 51 and older). Palpebral fissure height on both eyes was measured in primary gaze position with a clear plastic ruler held in a central vertical position between the upper and lower lid margin, and the standard tear break-up time (TBUT) test was performed to evaluate tear film stability. Palpebral fissure height was significantly higher in younger than older subjects in all measurements on both eyes (p<0.001), and TBUT was shorter in older than in younger subjects. In all subjects included in the study, palpebral fissure height was not related to TBUT (p=0.589). However, analyzing the two age groups separately, a significant negative correlation was found between the palpebral fissure height and TBUT in both groups of younger (p<0.001) and older (p=0.009) subjects. In conclusion, an enlarged exposed ocular surface due to higher palpebral fissure height in healthy individual's primary gaze position negatively affects tear film stability expressed by TBUT.
TREATMENT OF CONGENITAL LARYNGEAL CYSTS IN NEWBORNS.
Baljošević I, Perić A, Sovtić A … +1 more , Antić S
Acta Clin Croat · 2023 Aug · PMID 38549606 · Full text
Congenital laryngeal cysts are rare lesions that may occur in newborns, characterized by symptoms of respiratory obstruction and severe dyspnea. The aim of this study was to indicate optimal surgical treatment of congeni...
Congenital laryngeal cysts are rare lesions that may occur in newborns, characterized by symptoms of respiratory obstruction and severe dyspnea. The aim of this study was to indicate optimal surgical treatment of congenital laryngeal cysts in newborns. We present a case series of five neonates treated for congenital laryngeal cysts during the 2011-2017 period at our pediatric tertiary care hospital. Patient age ranged from one day to 14 days. All patients had unilateral cysts. After surgical excision, burning of the walls of the cysts was performed by a CO2 laser. In one case, after four months, a recurrent cyst appeared, and re-operation was performed. Our relatively small case series indicates that symptoms such as stridor and labored breathing can occur already during the first days of life and potentially endanger the patient's life. Complete excision of the cyst and burning of its walls with CO2 laser leads to complete cure and prevent recurrence of the lesion.
UROMODULIN - A LINK BETWEEN SODIUM EXCRETION AND ALTERATION IN CIRCADIAN BLOOD PRESSURE PATTERN IN PREHYPERTENSIVES.
Josipović J, Šimičević L, Dika Ž … +3 more , Bulj N, Vrsalović M, Jelaković B
Acta Clin Croat · 2023 Aug · PMID 38549605 · Full text
Although changes in dietary sodium intake alter blood pressure (BP) in salt-sensitive individuals, pathophysiological mechanisms are still unknown. It has been reported that uromodulin is involved in sodium tubular trans...
Although changes in dietary sodium intake alter blood pressure (BP) in salt-sensitive individuals, pathophysiological mechanisms are still unknown. It has been reported that uromodulin is involved in sodium tubular transport, and genome-wide association studies pointed to gene as one of the most important gene candidates for arterial hypertension. Our aim was to analyze urinary uromodulin, salt intake and BP in 326 young middle-aged subjects (mean age 36±8 years, 49.4% male). In a subgroup of 175 individuals, ambulatory blood pressure monitoring and echocardiogram were performed. Uromodulin was determined by ELISA. According to the JNC-7 criteria, subjects were classified as optimal BP (n=103, men 72%), prehypertension (PHT) (n=143, men 43%) and hypertension (HT) (n= 80, men 38%). There were no differences in age, salt intake, estimated glomerular filtration rate, sodium excretion and uromodulin among BP groups. However, in PHT subjects, uromodulin was positively associated with fractional sodium excretion and negatively with 24-h sodium excretion and diastolic BP dip. These findings point to the effect of uromodulin on sodium reabsorption along the nephron and consequently circadian BP alteration in prehypertensives.
UNDERSTANDING DEMOGRAPHIC AND EPIDEMIOLOGIC CHARACTERISTICS OF HOSPITALIZED IMMIGRANT FEMALE PATIENTS: A RETROSPECTIVE OBSERVATIONAL STUDY.
Karnjuš I, Ličen S, Prosen M
Acta Clin Croat · 2023 Aug · PMID 38549604 · Full text
Precise epidemiologic and demographic characteristics of immigrant women admitted to gynecology or obstetrics departments are rarely explored. The aim of this retrospective observational study was to analyze the epidemio...
Precise epidemiologic and demographic characteristics of immigrant women admitted to gynecology or obstetrics departments are rarely explored. The aim of this retrospective observational study was to analyze the epidemiologic and demographic characteristics of immigrant female patients hospitalized between 2012 and 2017 in one maternity hospital in south-west Slovenia. Clinical data retrieved from hospital electronic information system were used to analyze these characteristics. In the mentioned period, 605 immigrant women were hospitalized, most of them originating from countries of the former Yugoslavia (60.50%) or former Eastern Bloc (14.05%). The results show that in recent years there has been a constantly growing trend of immigrant women being admitted compared to the total number of hospitalizations. No statistical differences were established in the incidence of abortion, preterm delivery or vacuum extraction between Slovenian and immigrant women, although the analysis revealed a higher rate of cesarean section among immigrant women (χ2=26.960, p<0.01). Education level seems to be a significant predictor of the likelihood of an abortion in the group of immigrant women (B=-0.492, p=0.015), where less educated women are at a greater risk. To improve what is known about the sexual and reproductive health-related problems of immigrant women, a large-scale epidemiologic study is needed in the near future.
SERUM URIC ACID TO HDL CHOLESTEROL RATIO IS ASSOCIATED WITH DIABETIC CONTROL IN NEW ONSET TYPE 2 DIABETIC POPULATION.
Kosekli MA, Aktas G
Acta Clin Croat · 2023 Aug · PMID 38549603 · Full text
Since uric acid to HDL cholesterol ratio (UHR) is proposed as a novel predictor of metabolic and inflammatory disorders, we aimed to study UHR levels in patients with new onset type 2 diabetes mellitus (T2DM) and compare...
Since uric acid to HDL cholesterol ratio (UHR) is proposed as a novel predictor of metabolic and inflammatory disorders, we aimed to study UHR levels in patients with new onset type 2 diabetes mellitus (T2DM) and compare them to those in healthy controls. Patients with new onset T2DM were enrolled and control subjects were volunteers to participate without any established diseases. Laboratory data including UHR, fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) were compared. The mean UHR of the T2DM and control groups was 16±8% and 10±3%, respectively (p<0.001). Moreover, UHR was significantly and positively correlated with HbA1c (r=0.75, p<0.001), FBG (r=0.64, p<0.001), waist circumference (r=0.35, p<0.001), body mass index (r=0.20, p=0.002) and inversely correlated with glomerular filtration rate (r=-0.24, p<0.001). High levels of UHR might be associated with increased mean blood glucose levels for a long time, since UHR was correlated with both FBG and HbA1c in patients with new onset T2DM.
THE IMPACT OF TOTAL PHYSICAL ACTIVITY ON MICROVASCULAR COMPLICATIONS IN TYPE 1 DIABETES MELLITUS PATIENTS.
Turčinović K, Cigrovski V, Bilić-Ćurćić I … +4 more , Mrzljak A, Kuna L, Klobučar S, Cigrovski Berković M
Acta Clin Croat · 2023 Aug · PMID 38549602 · Full text
The incidence of diabetes is increasing worldwide, emphasizing an emerging need for blood glucose control optimization to prevent the development of chronic complications and improve the quality of life. This retrospecti...
The incidence of diabetes is increasing worldwide, emphasizing an emerging need for blood glucose control optimization to prevent the development of chronic complications and improve the quality of life. This retrospective cohort study aimed to investigate the effects of total physical activity on microvascular diabetic complication development in patients with type 1 diabetes mellitus (T1DM). The study included 71 T1DM patients, average age 41 years and HbA1c 7.78%. Most patients (82.1%) reported having hypoglycemia, while the minority of patients developed microvascular complications, mostly nonproliferative retinopathy (17.7%). All subjects included in the study were moderately or vigorously physically active. No association was observed between total physical activity and regulation of glycemia, hypoglycemic incidents, or development of microvascular complications. Until sufficient data from prospective studies become available, our data support the findings of no negative effect of higher intensity physical activity on the development of microvascular complications in T1DM patients.
IS FLEXIBLE BRONCHOSCOPY A SAFE PROCEDURE FOR CRITICAL CARE PATIENTS WITH RESPIRATORY FAILURE?
Kaya AG, Öz M, Dilegelen U … +5 more , Ecer D, Erol S, Çiftçi F, Çiledağ A, Kaya A
Acta Clin Croat · 2023 Aug · PMID 38549601 · Full text
Flexible bronchoscopy (FB) plays an important role in critical care patients. But, critical care patients with respiratory failure are at an increased risk of developing complications. Considering the developments in int...
Flexible bronchoscopy (FB) plays an important role in critical care patients. But, critical care patients with respiratory failure are at an increased risk of developing complications. Considering the developments in intensive care unit care in recent years, we aimed to evaluate the use of FB in these patients. We retrospectively reviewed patients who underwent FB in critical care between 2014 and 2020. A total of 143 patients underwent FB during the study period. Arterial blood gas measurement on the FB day revealed a mean PaO/FiO of 186.94±28.47. Eighty-one (56.6%) patients underwent an fiberoptic bronchoscopy procedure under conventional oxygen supplementation, 10 (7%) on noninvasive ventilation, 13 (9.1%) on high flow nasal cannula, and 39 (27.3%) on invasive mechanical ventilation. During and immediately after bronchoscopy, none of the patients experienced life-threatening complications. Fifty-five (38.5%) patients developed complications that could be controlled. Multivariate analysis indicated that increased Apache-II score and presence of cardiovascular disease were significantly associated with an increased complication risk. Although critical care patients with respiratory failure are more prone to complications, diagnostic and therapeutic bronchoscopy may be performed following appropriate patient selection, without leading to major complications.
MULTIDIMENSIONALITY AND MULTIDISCIPLINARITY OF CHRONIC NEUROPATHIC NONODONTOGENIC OROFACIAL PAIN.
Šklebar D, Šklebar I, Cesarik M … +4 more , Čatipović V, Barada A, Milošević M, Bašić Kes V
Acta Clin Croat · 2023 Aug · PMID 38549600 · Full text
This study compared the self-assessed health-related quality of life (HRQoL) and degree of depression between patients with chronic neuropathic nonodontogenic orofacial pain (NOFP) and healthy controls using the Short Fo...
This study compared the self-assessed health-related quality of life (HRQoL) and degree of depression between patients with chronic neuropathic nonodontogenic orofacial pain (NOFP) and healthy controls using the Short Form Survey (SF-36) health status questionnaire and Beck Depression Inventory II (BDI-II). This controlled cross-sectional study included 100 patients and 119 healthy controls. The diagnostic protocol recorded the following: 1) pain intensity using a visual analog scale for the time of examination and during the one-month prior; 2) evidence for neuropathic pain using the Leeds questionnaire for neuropathic signs and symptoms (LANSS); 3) emotional status using the BDI-II; and 4) HRQoL using the SF-36 questionnaire. The mean LANSS score was 17.18 in the patient group and 0.0 in the control group. The mean BDI-II score was 18.31 in the patient group and 5.87 in the control group. The SF-36 scores were shown with Mann-Whitney U testing to have statistically significant differences between the patient and healthy control groups in all categories. Vitality was the only SF-36 category in which the patient group scored higher than the control group. In conclusion, NOFP significantly reduces the self-reported HRQoL. NOFP is also related to the development of depression, but does not affect its severity. There is a significant correlation between depression and low quality of life in patients with NOFP.
FADI EVALUATION OF THE EFFECTS OF KINESITHERAPY AFTER ANKLE FRACTURE.
Omeragić VZ, Tanović E, Mešanović E … +1 more , Pecar M
Acta Clin Croat · 2023 Aug · PMID 38549599 · Full text
The aim of the study was to analyze the values of Foot and Ankle Disability Index (FADI) after kinesitherapy in subjects with bimalleolar or trimalleolar fracture of the ankle after surgery treatment and the obtained val...
The aim of the study was to analyze the values of Foot and Ankle Disability Index (FADI) after kinesitherapy in subjects with bimalleolar or trimalleolar fracture of the ankle after surgery treatment and the obtained values of manual muscle test (MMT) and range of motion (ROM) after rehabilitation, compared with the obtained values of FADI index and on that basis evaluate its possibility in assessing the functionality of the respondents after surgery for bimalleolar or trimalleolar fracture of the ankle. The sample included 60 subjects over the age of 18 who underwent surgery for osteosynthesis due to bimalleolar or trimalleolar fracture of the ankle. All subjects were treated with kinesitherapy as part of the postoperative rehabilitation program. The research was conducted from 2013 to 2018 at the Department of Orthopedics of Dr. Safet MujiÊ Cantonal Hospital in Mostar and Mostar University Clinical Hospital. A statistically significant correlation was found between FADI index values group and average percentage recovery MMT (p<0.05), as well as a statistically significant correlation between FADI score values group and mean percentage ROM value (p<0.05). A statistically significant association was found between mean percentage recovery ROM and MMT (p<0.05). The conducted research confirmed the working hypothesis of the conducted study. The effects of kinesitherapy after ankle surgery can be evaluated using the FADI index, as well as by manual muscle test and ROM measurement.
DETERMINATION OF THE PRA POSITIVITY PERCENTAGE IN MALE PATIENTS WITH CHRONIC KIDNEY DISEASE BY USING FLOW CYTOMETRY TECHNIQUE.
Merdin FA, Koçak H, Köksoy S
Acta Clin Croat · 2023 Aug · PMID 38549598 · Full text
The antibodies directed against human leukocyte antigen (HLA) molecules, which play a crucial role in allograft histocompatibility, are called anti-HLA antibodies. Anti-HLA antibodies against foreign HLA molecules may be...
The antibodies directed against human leukocyte antigen (HLA) molecules, which play a crucial role in allograft histocompatibility, are called anti-HLA antibodies. Anti-HLA antibodies against foreign HLA molecules may be present in patients with chronic kidney disease even before transplantation. The panel reactive antibody (PRA) test is used to measure the renal transplant candidate's immune sensitivity to HLA molecules other than their own HLA molecules by assessing the diversity of anti-HLA antibodies in the blood of these patients. This study aimed to determine the PRA values and the percentage of PRA positivity of Turkish male patients with chronic kidney disease (CKD), who had not been sensitized by the major known causes (those with no history of organ or tissue transplantation, those with no history of blood transfusion), who had not been diagnosed with any autoimmune diseases, and who had not been under immunosuppressive treatment. The study included 60 male patients aged over 18 years. All of the patients were followed up with a diagnosis of CKD at the Nephrology Clinic, Internal Medicine Department, Akdeniz University Medical Faculty Hospital. None of the patients included in the study was sensitized by a known mechanism previously (they did not have blood transfusion or organ transplantation). Glomerular filtration rate (GFR) levels of all patients were below the level of 60 mL/min/1.73 m. Patient data including their age information, etiology of CKD, accompanying diseases, and information about dialysis modalities were recorded. HLA antibody percentage was determined by the flow cytometry technique. Statistical data analysis was performed by using SPSS 22.0 (Statistical Package for Social Sciences, Version 22.0). The values of p less than 0.05 were considered statistically significant. Twenty patients were receiving dialysis treatment due to end-stage renal disease. Of the 60 patients included in the study, 25% showed PRA positivity; 28.3% of all study patients were found to be positive for anti-HLA class I antibodies and 26.7% of all study patients were found to be positive for anti-HLA class II antibodies on separate analysis for anti-HLA class I and anti-HLA class II antibody positivity. When the patients were categorized as PRA negative and PRA positive in two groups, there were no differences between the groups according to mean age, percentage of hemodialysis patients, percentage of peritoneal dialysis patients and presence of accompanying chronic diseases (such as hypertension, type 2 diabetes mellitus, hyperlipidemia, nephrolithiasis, coronary artery disease). In addition to this, evaluation of the GFR levels showed that the PRA positive group contained a significantly higher percentage of end-stage renal disease patients (GFR <15 mL/min/1.73 m) as compared with the PRA negative group. Detailed analysis of the percentages of PRA levels in the PRA positive patients, which was carried out to determine the degree of sensitization, showed that the PRA values were over 80% in 11.77% of the patients positive for anti-HLA class I antibodies. On the other hand, PRA values were within the range of 15%-80% in 88.23% of the patients who had anti-HLA class II antibodies. The PRA values were below 80% in all of the patients positive for anti-HLA class II antibodies and those positive for both anti-HLA class I and class II antibodies. In conclusion, PRA levels of the candidates for kidney transplantation should always be measured to assess their state of sensitization before transplantation, even though they have no risk factors known to cause anti-HLA antibody development.
THE USE OF TRANEXAMIC ACID IN DERMATOLOGY.
Gaćina K, Krstanović Ćosić A
Acta Clin Croat · 2023 Aug · PMID 38549597 · Full text
Tranexamic acid is a synthetic derivative of the amino acid lysine, an antifibrinolytic that is primarily used to reduce bleeding in surgery, trauma, and dental procedures. Its anti-inflammatory and anti-angiogenic prope...
Tranexamic acid is a synthetic derivative of the amino acid lysine, an antifibrinolytic that is primarily used to reduce bleeding in surgery, trauma, and dental procedures. Its anti-inflammatory and anti-angiogenic properties, as well as its ability to suppress melanogenesis have enabled it to be used in dermatology in the treatment of skin conditions such as melasma, acne, post-inflammatory hyperpigmentation, rosacea and angioedema. Tranexamic acid can be used by various routes of administration including oral, topical and intradermal injection, and in combination with other treatment methods. This review article presents evidence for the effectiveness of tranexamic acid in the treatment of various skin disorders.
CHARACTERISTICS OF HEARING RECOVERY IN CHILDREN WITH CHRONIC OTITIS MEDIA WITH EFFUSION AFTER VENTILATION TUBE INSERTION.
Dželalija A, Klančnik M, Krnić OM
Acta Clin Croat · 2023 Aug · PMID 38549596 · Full text
The objective was to determine the range of hearing improvement (in dB) post ventilation tube insertion in children with chronic otitis media with effusion (COME), and whether there was a difference in hearing improvemen...
The objective was to determine the range of hearing improvement (in dB) post ventilation tube insertion in children with chronic otitis media with effusion (COME), and whether there was a difference in hearing improvement between age groups and genders. This study also investigated whether there was a difference in the mean hearing improvement between the left and right ear, how many months passed before recovery of eustachian tube function, and how long the aeration of the middle ear lasted. The children included in the study were between six and twelve years of age, diagnosed with COME by audiological processing (type B tympanometric recording and conductive hearing loss up to 40 dB on pure tone audiometry) and underwent surgical insertion of ventilation tubes in both ears. Patient data included preoperative tympanometric records, preoperative and postoperative tone audiometry findings, tubometry findings 6 and 10 months after insertion of ventilation tubes, age and gender data, and length of time during which the tubes were in place. The mean hearing improvement of the included patients was 24.2 dB on the right ear and 24.5 dB on the left ear. There was no statistically significant difference between the left and right ear or between the genders. Older age groups had a higher mean hearing improvement compared with the younger age group. Younger age groups had a longer expected period of eustachian tube function recovery, and were expected to have ventilation tubes inserted for a longer period of time. Treatment with ventilation tube insertion resulted in significant improvement in hearing in children where previous conservative therapy failed to recover eustachian tube function and improve hearing. Although children of older age groups had greater preoperative hearing impairment, the recovery of both eustachian tube function and hearing improvement was faster, and the mean length of time that the ventilation tubes had to be inserted was shorter.
THE CONCENTRATION OF INTERLEUKIN 6 AND TUMOR NECROSIS FACTOR ALPHA IN SALIVA AND BLOOD OF PATIENTS WITH INACTIVE MULTIPLE SCLEROSIS AND COEXISTING HASHIMOTO'S THYROIDITIS.
Šiško Markoš I, Franceschi M, Vidranski V … +4 more , Markoš P, Jukić T, Fröbe A, Bašić Kes V
Acta Clin Croat · 2023 Aug · PMID 38549595 · Full text
The concentration of interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α) in the blood is higher in patients with active multiple sclerosis (MS) compared to those with inactive disease. The concentration of IL-6...
The concentration of interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α) in the blood is higher in patients with active multiple sclerosis (MS) compared to those with inactive disease. The concentration of IL-6 and TNF-α in the blood is higher in patients with Hashimoto's thyroiditis (HT) compared to those with a healthy thyroid. The aim of the study was to assess whether serum IL-6 and TNF-α levels correlated with saliva in patients with inactive MS and whether there was a difference in these groups of patients depending of thyroid status. We also examined the correlation of thyroid stimulating hormone (TSH) levels with thyroid status. The study included 54 patients in the inactive phase of MS. The level of cytokines in the blood was determined by chemiluminescence, and in saliva by ELISA. Blood and saliva IL-6 levels showed positive correlation, while blood and saliva TNF-α levels were not correlated. There was a significantly higher TSH level in patients with inactive MS with positive thyroid antibodies, without therapy, compared with those with negative antibodies.
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