Acta Clinica Croatica[JOURNAL]
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200 papers
EXPRESSION OF CONNEXIN-40 AND INTERLEUKIN 6 GENES IN PATIENTS WITH ATRIAL FIBRILLATION.
Sharif S, Ijaz H, Rafaqat S … +3 more , Waris S, Naz S, Klisic A
Acta Clin Croat · 2025 Jun · PMID 41635654 · Full text
Atrial fibrillation (AF) is the outcome of the rapid onset of abnormal electrical impulses in the atria. These impulses prevent the heart natural pacemaker, which normally controls the heart beat, from doing its job.The...
Atrial fibrillation (AF) is the outcome of the rapid onset of abnormal electrical impulses in the atria. These impulses prevent the heart natural pacemaker, which normally controls the heart beat, from doing its job.The heart rate becomes highly asymmetric. The purpose of this case-control study was to determine the role of the connexin-40 () and interleukin-6 () gene expression in patients suffering from AF in Pakistan. There were 200 subjects included in this study. The subjects were categorized into two groups as control and AF groups (n=100 each). RNA separated from blood was used for analysis of the and gene expression by real-time polymerase chain reaction. The gene expression profile was increased 10.2-fold in AF subjects as compared to 1.9-fold in control group. The gene expression profile was decreased 1.5-fold in AF group as compared to 6.1-fold in control group. Results of the study suggest that development of AF in the Pakistani population was linked to the increased expression of gene and lower expression of gene.
COMPARISON OF ENDOVASCULAR INTERVENTION AND DISTAL-LEG BYPASS FOR BELOW-THE-KNEE CHRONIC LIMB-THREATENING ISCHEMIA.
Figl J, Škorak I, Papeš D … +3 more , Romić I, Figl S, Vrkić Kirhmajer M
Acta Clin Croat · 2025 Jun · PMID 41635653 · Full text
Chronic limb-threatening ischemia (CLTI) is the main cause of major amputation and associated morbidity and mortality. Currently, both endovascular and open surgical methods for below-the-knee (BTK) interventions result...
Chronic limb-threatening ischemia (CLTI) is the main cause of major amputation and associated morbidity and mortality. Currently, both endovascular and open surgical methods for below-the-knee (BTK) interventions result in unsatisfactorily short patency rates. The aim of this retrospective single-center study was to evaluate six-month and one-year primary patency and major amputation rate in patients with CLTI treated with distal-leg bypass or BTK endovascular intervention. Overall, 46 patients underwent BTK intervention and 32 were available for follow-up analysis. Nine surgical bypasses and 23 endovascular treatments (balloon angioplasty) were performed. Six-month and one-year primary patency was 5/9 (55%) after bypass and 18/23 (78%) and 16/23 (69%) following endovascular intervention (p=0.20 and p=0.46). Angiography findings, predominantly advanced atherosclerosis, precluded any secondary intervention attempts. At one year post-intervention, the incidence of major amputation was 3/9 (33%) after bypass surgery and 5/23 (22%) following endovascular treatment. Although endovascular intervention for BTK CLTI seems to offer better 12-month patency and lower incidence of major amputation compared to bypass surgery, no statistically significant difference was noted. A randomized trial with more subjects and longer follow-up should be undertaken.
ANAPLASTIC THYROID CARCINOMA DEVELOPED YEARS AFTER THE PATIENT HAD UNDERGONE PARTIAL THYROIDECTOMY DUE TO PAPILLARY THYROID CARCINOMA.
Karapolat B, Yamak YZ, Livaoğlu A
Acta Clin Croat · 2025 Jun · PMID 41635652 · Full text
Thyroid cancers are frequently seen tumors and surgery is the gold standard in treatment. An 80-year-old female patient presented to our department with right side neck swelling and shortness of breath. Her history revea...
Thyroid cancers are frequently seen tumors and surgery is the gold standard in treatment. An 80-year-old female patient presented to our department with right side neck swelling and shortness of breath. Her history revealed that she had undergone a near-total thyroidectomy 10 years before due to papillary thyroid carcinoma and she had a growing swelling in her neck in the last 2 years. A hard mass involving the whole right side of her neck was found on physical examination. Tomography showed a mass on the right side of the neck approximately 10x12 cm in size with heterogeneous density, which was pushing the trachea to the left. Fine needle aspiration biopsy findings suggested undifferentiated malignant tumor, i.e., anaplastic thyroid carcinoma were obtained while her distant organ scans were normal. The patient was operated under general anesthesia; she underwent completion total thyroidectomy and radical neck dissection. As a result of the histopathologic examination, she was diagnosed with anaplastic thyroid carcinoma. The patient received radioactive I-131 therapy and no problems were found at her 3-month follow up examination. In conclusion, when surgical near-total thyroidectomy is performed in patients with papillary thyroid carcinoma, a new malignancy may develop in the residual thyroid tissue even after many years. In such cases, completion total thyroidectomy and adjuvant multimodal treatment methods should be preferred.
A NOVEL SUTURE TECHNIQUE FOR REDUCTION OF A WIDE COLUMELLAR BASE: OUR EXPERIENCE.
Manestar D, Velepič M, Mačkić ML … +3 more , Marnauza D, Litvinenko M, Borović E
Acta Clin Croat · 2025 Jun · PMID 41635651 · Full text
In this article, we describe a suturing technique for narrowing a wide or asymmetric columellar base. The study included 30 patients. The mean nostril measurements preoperatively were as follows: right nostril diameter 8...
In this article, we describe a suturing technique for narrowing a wide or asymmetric columellar base. The study included 30 patients. The mean nostril measurements preoperatively were as follows: right nostril diameter 8.9 mm, left nostril diameter 8.0 mm, and columella width 16.7 mm. Immediately after surgery, we observed significant increases in the mean right and left nostril diameters (11.0 mm and 10.9 mm, respectively, p<0.0001), and a significant reduction in the mean columella width (11.8 mm, p<0.0001). The outcomes were excellent in both functional and cosmetic results.
INTRAOCULAR PRESSURE OF PREMATURE NEWBORNS - A SYSTEMATIC REVIEW WITH META-ANALYSIS.
Trifonova K, Slaveykov K, Mumdzhiev H
Acta Clin Croat · 2025 Jun · PMID 41635650 · Full text
The intraocular pressure (IOP) ranges of premature newborns are not the same as those in full-term newborns and adult population. The exact ranges and causes, however, differ depending on the measurement techniques used...
The intraocular pressure (IOP) ranges of premature newborns are not the same as those in full-term newborns and adult population. The exact ranges and causes, however, differ depending on the measurement techniques used and analysis. Our study aimed to summarize and analyze available information in the up-to-date literature concerning IOP values in premature newborns. We performed a systematic literature review with meta-analysis. Our research showed the mean IOP in premature newborns to range from 10 to 29 mmHg according to different authors, and its mean values were higher in premature compared to full-term newborns. The most commonly analyzed factor that probably affected IOP measurement was central corneal thickness. Longitudinal studies showed that IOP and central corneal thickness declined with maturation of the newborn and both factors were probably correlated. Additional studies with larger sample sizes and better differentiated sample groups need to be performed.
ENDONASAL LEISHMANIASIS IN A FROZEN SECTION BIOPSY SPECIMEN.
Demirović A, Grgić M, Krušlin B … +1 more , Tomas D
Acta Clin Croat · 2025 Mar · PMID 41340807 · Full text
We present a case of endonasal leishmaniasis diagnosed on a frozen section biopsy specimen obtained from a 47-year-old woman treated with corticosteroids and anti-TNF for rheumatoid arthritis. Similar cases of isolated m...
We present a case of endonasal leishmaniasis diagnosed on a frozen section biopsy specimen obtained from a 47-year-old woman treated with corticosteroids and anti-TNF for rheumatoid arthritis. Similar cases of isolated mucosal leishmaniasis have not yet been reported in Croatia. Microscopic analysis of the biopsy specimen sent for frozen sections revealed amastigotes in macrophages infiltrating nasal mucosa. Subsequent communication with the referring clinician revealed that the patient had been diagnosed with visceral leishmaniasis 13 years prior to current biopsy. Thus, the present nasal lesion was interpreted as a solitary lesion related to reactivation of the previous infection. She received liposomal amphotericin B which led to prompt amelioration of the lesion. As shown in the present case, clinical presentation of leishmaniasis is unspecific and can mimic many other conditions, especially in the setting of concomitant immunosuppressive and anti-inflammatory treatment. It is important to be aware of this entity in order to treat such patients properly.
UNILATERAL OPTIC NEUROPATHY AFTER COMPRESSIVE THORACIC INJURY: A CASE REPORT.
Cerovski B, Vidović T, Popović Suić S … +1 more , Škegro I
Acta Clin Croat · 2025 Mar · PMID 41340806 · Full text
Compressive thorax injury is mostly observed in road traffic accidents which lead to multiple traumas. Eye findings after thoracic injury can be Purtscher's retinopathy, Valsalva retinopathy, and even blindness. We repor...
Compressive thorax injury is mostly observed in road traffic accidents which lead to multiple traumas. Eye findings after thoracic injury can be Purtscher's retinopathy, Valsalva retinopathy, and even blindness. We report a rare case of unilateral optic neuropathy associated with compressive chest injury. In our case, a 31-year-old construction worker developed irreversible optic nerve damage after ground collapsed on him and buried him up to his neck. There was no evidence of head trauma and blood loss, but multislice computed tomography showed diffuse brain edema caused by prolonged hypoxia due to compression of the thorax.
EFFICACY OF NASAL IRRIGATION WITH ISOTONIC AND HYPERTONIC SOLUTIONS AFTER ENDOSCOPIC SINUS SURGERY FOR CHRONIC RHINOSINUSITIS WITH NASAL POLYPOSIS.
Penezić A, Kalogjera L, Grgić MV … +4 more , Geber G, Tomljenović D, Alevizopoulos K, Baudoin T
Acta Clin Croat · 2025 Mar · PMID 41340805 · Full text
Endoscopic sinus surgery (ESS) is often involved in the treatment of patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). Nasal irrigation after ESS is recommended to improve healing and nasal symptoms in...
Endoscopic sinus surgery (ESS) is often involved in the treatment of patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). Nasal irrigation after ESS is recommended to improve healing and nasal symptoms in these patients. This study compared the efficacy of nasal irrigation with either an isotonic solution of 0.9% NaCl or a hypertonic solution of 2.3% NaCl comprising algal extracts. This was a randomized cohort study that included patients with CRSwNP after ESS who used isotonic solution and hypertonic 2.3% solution enriched with algal extracts ( and ). Patients filled out the total nasal symptom score (TNSS) questionnaire on visual analog scale of five symptoms, i.e., nasal obstruction, nasal secretion and/or postnasal discharge, sense of pressure in the face, headache, loss of the sense of smell preoperatively, and on postoperative days 7 and 14. Endo- scopic Lund-Kennedy (LK) score was also recorded. The study included 54 patients with CRSwNP that had undergone ESS, mean age 49.5 years. There were 53.7% of male patients. Thirty (55.56%) patients had other comorbidities such as allergic rhinitis, allergy to food, or/and asthma. Five (9.25%) patients had CRSwNP, asthma and allergy to nonsteroidal anti-inflammatory drugs. TNSS improved after 7 and 14 days in both groups; greater improvement of TNSS and LK score was observed in the group of patients that used hypertonic solution with algae, but it did not reach statistical significance. Improvement in particular symptoms was also recorded in the hypertonic solution group both on postoperative days 7 and 14, especially of sneezing and itching. The results of this study confirmed therapeutic benefits of nasal ir- rigation in CRSwNP patients following ESS. Patients who used hypertonic solution enriched with algae experienced greater improvement in sneezing and itching over the 14-day period.
PREVALENCE OF 25-HYDROXYCHOLECALCIFEROL DEFICIENCY AND METABOLIC SYNDROME IN CROATIAN WOMEN WITH NEWLY DIAGNOSED BREAST CANCER.
Vučić K, Mayer L, Štefančić L … +3 more , Tomić S, Kirac I, Šekerija M
Acta Clin Croat · 2025 Mar · PMID 41340804 · Full text
The aim of this study was to determine the prevalence of vitamin D deficiency (VDD) and metabolic syndrome (MetS) including individual MetS components in Croatian women with newly diagnosed breast cancer (BC), exploring...
The aim of this study was to determine the prevalence of vitamin D deficiency (VDD) and metabolic syndrome (MetS) including individual MetS components in Croatian women with newly diagnosed breast cancer (BC), exploring differences according to menopausal status. This cross-sectional, observational study recruited 203 adult female patients with newly diagnosed BC of any stage from all Croatian regions (median age 59, range 28-87 years), hospitalized consecutively for their first treatment between December 2016 and August 2017. We analyzed pretreatment fasting serum concentrations of 25-hydroxycholecalciferol (25(OH)D), high density lipoprotein, low density lipopro- tein, triglycerides, plasma glucose, and measured systolic and diastolic blood pressure, weight and waist circumference; defining VDD as 25(OH)D concentrations <50 nmol/L and MetS according to the 2006 International Diabetes Federation consensus. Consistency of the results was explored according to sampling periods, regions and size of settlements. In total sample, 28.6% of patients presented with concomitant VDD+MetS, whilst VDD was found in 55.1% of women (the finding was consistent by menopausal status), and 48.3% had MetS (65.4% of postmenopausal . 15.7% of premenopausal wom- en). Concomitant VDD+MetS was more frequent in the inland region (p=0.043), and VDD in inland postmenopausal women (p=0.024), whereas in premenopausal women VDD was more frequent during winter period (p=0.038). In conclusion, a high prevalence of VDD and MetS was found in newly diag- nosed BC patients, with some regional and seasonal differences.
VITAMIN D IN PATIENTS WITH INFLAMMATORY SKIN DISEASES.
Lugović-Mihić L, Tolušić Levak M, Špičić S … +3 more , Bulat V, Brkić A, Šešerko A
Acta Clin Croat · 2025 Mar · PMID 41340803 · Full text
In search for the ways to cure and improve skin condition of patients with inflammatory skin diseases, vitamin D supplementation has been shown to be useful, primarily due to its effects on a number of skin functions, e....
In search for the ways to cure and improve skin condition of patients with inflammatory skin diseases, vitamin D supplementation has been shown to be useful, primarily due to its effects on a number of skin functions, e.g., keratinocyte proliferation, differentiation and apoptosis, maintenance of the epidermal barrier, and regulation of immune processes in the skin, among others. Vitamin D is essential for good general health and healthy skin, but deficiency can occur due to various factors that result in increased time spent indoors and limited sunlight exposure, such as geography (place of residence) and genetic factors. Although some results are inconsistent, previous research indicates that multiple inflammatory skin diseases can be affected by vitamin D deficiency, particularly atopic dermatitis, but also other inflammatory skin diseases. There is also evidence for an association between vitamin D deficiency and the risk of worsening of skin diseases such as psoriasis, chronic urticaria, contact dermatitis, etc. For these and several other inflammatory skin diseases, most research suggests that patients benefit from vitamin D supplementation.
DIFFERENCES BETWEEN AQUEOUS HUMOR AND SERUM CONCENTRATIONS OF BDNF AND PPARG GENETIC VARIANTS IN GLAUCOMA PATIENTS.
Križ T, Zorić Geber M, Merkler Šorgić A … +4 more , Kozmar A, Novak-Lauš K, Vatavuk Z, Sertić J
Acta Clin Croat · 2025 Mar · PMID 41340802 · Full text
Brain-derived neurotrophic factor (BDNF) is essential for neuronal development, differentiation and survival, and aberrant BDNF expression in retina is associated with glaucoma. Peroxisome proliferator-activated receptor...
Brain-derived neurotrophic factor (BDNF) is essential for neuronal development, differentiation and survival, and aberrant BDNF expression in retina is associated with glaucoma. Peroxisome proliferator-activated receptor gamma (PPAR-γ) in retinal pigment epithelium plays a significant role in ocular pathophysiology. c.34C>G (rs1801282) (p.Pro12Ala) modulates transcriptional activity. This study aimed to determine whether BDNF in aqueous humor and serum could be used as a biomarker for primary open angle glaucoma (POAG) and to examine differences between genotype and BDNF concentrations in aqueous humor and serum in POAG patients. The study included 140 POAG patients and 87 non-glaucoma controls. BDNF concentrations were measured by ELISA methods and genotype was determined by PCR-RFLP. BDNF concentrations in aqueous humor were significantly higher in POAG patients compared to controls (p=0.001). A significant difference in aqueous humor BDNF concentration was observed between early and moderate (p=0.008) and early and advanced stages of POAG (p=0.022). There was no significant difference between BDNF concentration in aqueous humor and PPARG genotype in POAG patients (p=0.184). BDNF in aqueous humor may serve as a dynamic biomarker for POAG. No significant differences were found between genotypes and BDNF concentrations.
LASER SURGERY FOR PILONIDAL DISEASE - A NOVEL MINIMALLY INVASIVE PROCEDURE.
Grgić T, Grgić D, Žulec M … +4 more , Rašić F, Zadro Z, Golubić K, Šemanjski K
Acta Clin Croat · 2025 Mar · PMID 41340801 · Full text
Pilonidal disease (PD) is a common inflammatory disease of the gluteal region with an incidence of 26/100000 and usually occurs in young males (15-30 years old). The etiology of pilonidal disease is unclear, but literatu...
Pilonidal disease (PD) is a common inflammatory disease of the gluteal region with an incidence of 26/100000 and usually occurs in young males (15-30 years old). The etiology of pilonidal disease is unclear, but literature describes a wide range of factors such as keratin plugs, foreign substance reaction related to hairs, as well as dermatopathy and debris in hair follicles in the natal cleft. PD and also its classic treatment can cause discomfort and very much deteriorate the patient's quality of life. There are many possibilities (conservative or surgical) in the treatment of pilonidal disease, but there is no gold standard. In the acute phase (abscess), surgical incision with pus evacuation and antibiotic therapy is enough. In the chronic phase, there are many possibilities like phenol treatment, surgical excision with lay open and secondary wound healing. There are many reconstructive techniques such as Karydakis, V-Y flap or Limberg flap. A recently minimally invasive technique such as endoscopic surgical procedure or filling pilonidal tract with fibrin glue or phenol have been introduced. We present our experience with laser treatment (Biolitec, Germany) of pilonidal sinus disease.
DISTAL FEMUR AND PROXIMAL TIBIA MORPHOMETRY AFTER TOTAL KNEE ARTHROPLASTY: 3D CT ANALYSIS IN OA NORMAL KNEES.
Jami SA, Sallam Ma'aitah MK
Acta Clin Croat · 2025 Mar · PMID 41340800 · Full text
There is a paucity of data concerning morphological differences in the resected distal femur and proximal tibia between osteoarthritis (OA) and normal knees. The objective of this study was to determine if morphometric d...
There is a paucity of data concerning morphological differences in the resected distal femur and proximal tibia between osteoarthritis (OA) and normal knees. The objective of this study was to determine if morphometric differences existed in the resected distal femur and proximal tibia surface between OA and normal knees in the Chinese population. Ninety-eight OA knees and 96 normal ones taken from the Chinese population were measured by computed tomography for femoral mediolateral (fML), medial anteroposterior (fMAP), lateral anteroposterior (fLAP), medial condylar width (fMCW), lateral condylar width (fLCW) and tibial mediolateral (tML), middle anteroposterior (tAP), medial anteroposterior (tMAP), and lateral anteroposterior (tLAP) dimensions to determine morphological differences between OA and normal knees. The mean tMAP and fMCW dimensions were 50.2±3.3 mm and 28.7±2.3 mm for OA, and 48.8±3.8 mm and 27.1±2.2 mm for normal knees, respectively. There were significant differences between OA and normal knees concerning tMAP and fMCW dimensions (p<0.05). The study revealed morphological differences in tMAP and fMCW between the OA and normal knee groups, which may provide guidelines for designing better knee implants that are more size-matching for OA knees.
SIMULTANEOUS PULMONARY EMBOLISM WITH CARDIAC TAMPONADE AND REPETITIVE ISCHEMIC STROKE AS VASCULAR COMPLICATIONS OF LUNG CANCER: A CASE REPORT AND SYSTEMATIC LITERATURE REVIEW.
Kos N, Vrsalović M
Acta Clin Croat · 2025 Mar · PMID 41340799 · Full text
It is known that patients with lung cancer have a considerably higher incidence of cardiovascular complications that lead to venous or arterial events, and malignant pericardial effusion can often be observed due to peri...
It is known that patients with lung cancer have a considerably higher incidence of cardiovascular complications that lead to venous or arterial events, and malignant pericardial effusion can often be observed due to pericardial metastases. Simultaneous occurrence of cardiac tamponade and venous thromboembolism almost always happens in patients with lung malignancy. Our case report describes a patient with concurrent pulmonary embolism and cardiac tamponade as the initial manifestation of lung cancer, which, apart from pericardiocentesis and symptomatic therapy, was treated at long term with a direct oral anticoagulant (apixaban). Therapy was well tolerated by the patient and there were no bleeding complications related to primary disease and anticoagulant treatment. The course of the disease was complicated by repetitive strokes, which were treated with mechanical thrombectomy. Because of this scenario, a systematic review of the literature was conducted, listing all available case reports of patients with the simultaneous occurrence of cardiac tamponade and pulmonary embolism. In all patients, the underlying condition was lung malignancy, often as the first manifestation of the disease. This is a relatively rare event, and the approach to long-term treatment varied from case to case in the absence of valid guidelines. Our case demonstrated that, in the light of new studies and guidelines, apixaban represented a safe and effective treatment option even in patients at a high risk of bleeding.
FACTORS ASSOCIATED WITH COVID-19 RELATED DEATH IN 2020 IN CROATIA: A NATIONWIDE OBSERVATIONAL COHORT STUDY.
Musić Milanović S, Orešković T, Križan H … +1 more , Vince A
Acta Clin Croat · 2025 Mar · PMID 41340798 · Full text
The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) has had a global effect on mortality. Many attempts were made to identify those at the highest risk of deat...
The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) has had a global effect on mortality. Many attempts were made to identify those at the highest risk of death if infected with SARS-CoV-2, yet the relative importance and global generalizability of individual risk factors remain unclear. At the Croatian Institute of Public Health, electronic health data from multiple databases were combined to examine factors associated with COVID-19 related death. Data on 212 615 patients confir med to have COVID-19 by a positive RT-PCR in 2020 were pseudonymously linked to hospital records and 16 150 hospitalized patients were identified. Apart from older age and male sex, major factors associated with an increased rate of mortality among patients hospitalized with COVID-19 were cardiovascular diseases (adjusted HR: 1.20; 95% CI 1.12-1.28); diabetes (adjusted HR: 1.17; 95% CI 1.09-1.25); and chronic lower respiratory diseases (adjusted HR: 1.10; 95% CI 1.02-1.18). This Croatian study used primary care and hospital data to establish factors associated with COVID-19 related death among patients hospitalized with COVID-19. The results of this study provide rigorous evaluation of the previously defined risk factors and offer guidance for further studies that will create prognostic models based on empirical data from 2020.
EFFECT OF INTRADIALYTIC THERAPEUTIC EXERCISES AND ELECTRICAL STIMULATION ON LEG FUNCTIONAL ABILITY, DIALYSIS EFFICACY AND INTRADIALYTIC HYPOTENSION IN PATIENTS ON CHRONIC HEMODIALYSIS.
Kovačević Totić P, Altabas K, Ivković V … +4 more , Altabas V, Šefer S, Kovačević Čorak K, Grazio S
Acta Clin Croat · 2025 Mar · PMID 41340797 · Full text
Chronic inflammation and protein energy malnutrition in patients on hemodialysis lead to decrease in muscle mass and impaired functional ability. Our goal was to evaluate the effect of a combination of electrical stimula...
Chronic inflammation and protein energy malnutrition in patients on hemodialysis lead to decrease in muscle mass and impaired functional ability. Our goal was to evaluate the effect of a combination of electrical stimulation (ES) with intradialytic therapeutic exercises on dialysis efficacy, ar- terial blood pressure, and functional ability of lower extremities. The study involved 35 patients who were on chronic hemodialysis. The study consisted of two phases. During the first month, no intervention was performed. It was followed by a therapeutic program combining intradialytic resistance exercises with ES on quadriceps muscle, which was performed 3 times a week for 3 months. Functional tests for lower extremity and body composition analysis were obtained at baseline and at the end of the study. Arterial pressure, dialysis efficacy and laboratory parameters were monitored. Functional tests showed significant improvement after the intervention. A significant positive correlation was found in patients who had shown improvement in functional tests, with less intradialytic episodes of hypotension and improvement in dialysis efficacy. This study found a positive effect of combining resistance exercises and ES on dialysis efficacy and functional ability of lower extremities in patients on chronic hemodialysis.
THE EFFECT OF ARTESUNATE ON BLEOMYCIN-INDUCED PULMONARY FIBROSIS.
Şengul A, Okutan O, Altınsoy B … +7 more , Anar C, Yazıcı O, Dede F, Köktürk S, Özer C, Sönmez OF, Metin G
Acta Clin Croat · 2025 Mar · PMID 41340796 · Full text
Despite new drug alternatives, no curative treatment for idiopathic pulmonary fibrosis (IPF) currently exists. This study aimed to evaluate the effects of artesunate on fibrosis, pulmonary hypertension, and inflammation-...
Despite new drug alternatives, no curative treatment for idiopathic pulmonary fibrosis (IPF) currently exists. This study aimed to evaluate the effects of artesunate on fibrosis, pulmonary hypertension, and inflammation-related changes in IPF. We divided a total of 32 male Wistar albino rats into four groups: a control group (group A, n=7), a group receiving artesunate (group B, n=7), a group receiving bleomycin (group C, n=9), and a group receiving both bleomycin and artesunate (group D, n=9). Groups A and B received intratracheal saline (0.1 mL), and groups C and D received intratracheal bleomycin (2.5 mg/kg). Groups A and C received intraperitoneal (i.p.) saline (0.1 mL/day), and groups B and D received i.p. artesunate (30 mg/kg/day) for 21 days. We measured the rats' exercise capacity by using a treadmill. We also examined heart and pulmonary tissues for right ventricular hypertrophy (RVH) and pulmonary arteriolar wall thickness for fibrosis, respectively. Finally, for immunohistochemistry, we performed Masson's trichrome stain and a macrophage marker antibody. The rats' measured exercise capacity was 1665 ± 145 m in the control group, 1142 ± 280 m in the group receiving bleomycin, 1490 ± 185 m in the group receiving artesunate, and 1207 ± 231 m in the group receiving both bleomycin and artesunate. The intergroup difference was statistically significant (p=0.001), but the difference between the bleomycin + artesunate and bleomycin-only groups was not statistically significant (p=0.95). RVH was common in the bleomycin group (0.44 ± 0.02). The difference between the bleomycin + a rtesunate and bleomycin groups was significant (0.37 ± 0.03). The medial wall of the pulmonary arterioles was thicker in bleomycin recipients than in artesunate recipients and controls, whereas it was thinner in bleomycin + artesunate recipients (p<0.001, p=0.026, respectively). Fibrosis and inflammatory changes improved in the bleomycin + artesunate group (p<0.001). The authors conclude that artesunate improved fibrosis, inflammatory changes, medial layer thickness of the pulmonary arterioles, and RVH in rats with bleomycin-induced pulmonary fibrosis.
CONTEMPORARY CONCEPTS AND SURGICAL TECHNIQUES IN FACIAL REANIMATION: A SCOPING REVIEW.
Pegan A, Solter D, Vagić D … +1 more , Košec A
Acta Clin Croat · 2025 Mar · PMID 41340795 · Full text
Paralysis of the facial nerve represents an exceptional functional, social and cos- metic problem for the patient. Loss of function directly leads to the inability to protect the eyes, as well as oral competence, while i...
Paralysis of the facial nerve represents an exceptional functional, social and cos- metic problem for the patient. Loss of function directly leads to the inability to protect the eyes, as well as oral competence, while indirectly affecting breathing and verbal communication. Patients often encounter social stigmatization and isolation, which is direct consequence of the loss of mimic function and disfiguration that is necessary for everyday nonverbal communication. Thus, the quality of life is strongly impaired, and patients are prone to developing depression. The primary goal of reanimation is establishment of facial tone at rest, mimic function, and symmetry. The method of choice is directly dependent on the time elapsed from the onset of paralysis. Facial reanimation methods can be divided into static and dynamic. In reanimation procedures, we usually divide the face into thirds. Procedures for reanimation of the upper third of the face include oculoplastic procedures, which are divided according to the place of intervention into procedures aimed at the eyebrow, upper and lower eyelid. Static methods predominate here, i.e., endoscopic eyebrow lifting, tightening of the upper eyelid, and tightening of the lower eyelid. Procedures for reanimation of the lower third of the face are mainly based on restoring oral competence and smile, therefore the method of choice is dynamic reanimation. Direct repair of the nerve either by direct anastomosis or interposition provides the best results. In the absence of the proximal part of the facial nerve, and functional distal branches, local motor nerves and/or cross facial nerve graft (CFNG) are used as a source. In the case of long-term paralysis of the facial nerve (>2 years), muscle tissues are used in reanimation using local or innervated free flaps. Of the local muscle flaps, we most often use the minimally invasive temporalis tendon transfer (MIT3) method. The gracilis free flap is most often used in younger patients who desire to achieve a more accentuated smile, and the procedure can be performed in one or two acts. Reanimation of the face is an often neglected but extremely important procedure that should provide the patient with partial function resumption while significantly improving the quality of life.
SERUM PHOSPHORUS AS A RISK FACTOR FOR CARDIOVASCULAR MORBIDITY IN TYPE 2 DIABETES MELLITUS PATIENTS.
Katičić D, Josipović J, Lucijanić M … +3 more , Gulin T, Lukšić Puljak M, Pavlović D
Acta Clin Croat · 2025 Mar · PMID 41340794 · Full text
Phosphorus plays an important role in many physiological functions. Numerous studies have linked phosphorus concentration to cardiovascular (CV) disease and mortality rates. In this study, we investigated the association...
Phosphorus plays an important role in many physiological functions. Numerous studies have linked phosphorus concentration to cardiovascular (CV) disease and mortality rates. In this study, we investigated the association between high-normal serum phosphorus levels and CV morbidity in patients with type 2 diabetes. Two groups of patients with type 2 diabetes were studied, comprising both males and females aged 18 years and older. One group (140 subjects) had no CV events, while the other group (140 subjects) had one or more CV events. In both groups, we collected fasting laboratory values, medical history, and examination findings. Serum phosphorus levels were statistically significant- ly higher in patients with CV events and had statistically significant but relatively modest discriminatory properties (AUC 0.591; 95% confidence interval (CI) 0.531-0.649; p=0.008). A univariate logistic re- gression model of serum phosphorus as a continuous variable revealed a statistically significant associ- ation with the presence of a cardiovascular event (odds ratio (OR) 7.1849, 95% CI 1.7728 - 29.1190; p=0.0057). For each 1 mmol/L increase in serum phosphorus, the probability of a CV event increased 7.4-fold. After a multivariable logistic regression model, serum phosphorus was associated with a CV event (p=0.0016, OR 16.6), regardless of age, sex, total cholesterol, and systolic blood pressure.
CROATIAN VERSION OF TINNITUS HANDICAP INVENTORY - THI-HR.
Jelavić B, Čarapina Zovko I, Pehar I … +3 more , Sušac T, Lesko J, Leventić M
Acta Clin Croat · 2025 Mar · PMID 41340793 · Full text
In this study, we translated the Tinnitus Handicap Inventory questionnaire into Croatian language, and determined the reliability and validity of the Croatian adaptation (THI-HR). Tinnitus sufferers (N=130) underwent aud...
In this study, we translated the Tinnitus Handicap Inventory questionnaire into Croatian language, and determined the reliability and validity of the Croatian adaptation (THI-HR). Tinnitus sufferers (N=130) underwent audiometry and completed the THI-HR, the Depression Anxiety Stress Scale (DASS), and the Eysenck Personality Questionnaire Revised/Short Scale (EPQ R/S). Sociodemographic data on the patients and descriptive data on tinnitus were collected. The THI-HR internal consistency, construct validity, factor structure and repeatability were evaluated. The Cronbach's alpha coefficients for the THI-HR Total, Functional, Emotional, and Catastrophic subscales were 0.96, 0.76, 0.78, and 0.76, respectively. Moderate correlations of the THI-HR total and subscales with the three DASS subscales (r=0.42 to r=0.61) and the EPQ R/S-Neuroticism subscale (r=0.56 to r=0.64) were observed. The THI-HR factor analysis revealed that the original THI three-factor solution was a good fit to the data. Three factors explained 48.7% of the total variance. The test-retest reliability was high (r=0.89 to r=0.93). It was established that the THI-HR had high internal consistency reliability and good construct validity. The THI-HR is a valid and reliable measure of tinnitus complaint that can be used for assessment of the impact of tinnitus symptoms in daily life in the adult Croatian population.
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