Acta Clinica Croatica[JOURNAL]
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200 papers
EFFECTS OF TREATMENT WITH TEMSIROLIMUS VERSUS INTERFERON ALPHA ON SURVIVAL OF PATIENTS WITH METASTATIC RENAL CELL CARCINOMA - SINGLE-CENTER REAL-WORLD EXPERIENCE.
Levakov I, Vojinov S, Maletin M … +4 more , Jeremić D, Popov M, Levakov O, Grbić D
Acta Clin Croat · 2024 Dec · PMID 41050248 · Full text
Vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) inhibitors are two main groups of drugs for targeted treatment of metastatic renal cell carcinoma (mRCC). Inhibition of angiogenesis and...
Vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) inhibitors are two main groups of drugs for targeted treatment of metastatic renal cell carcinoma (mRCC). Inhibition of angiogenesis and other growth pathways that are pivotal for tumor progression lead to significant improvement of survival in patients with mRCC. The main aim of this study was to compare the effects of temsirolimus (mTOR inhibitor) and interferon alpha-2a (IFN-alpha-2a) on overall survival (OS) and progression-free survival (PFS) in patients with T3 stage mRCC who developed lung metastasis in the first two years after radical nephrectomy. A total of 60 patients diagnosed with T3 stage renal cancer who developed metastases in the lungs within two years after radical nephrectomy were included in a prospective study conducted at the Department for Urology, Clinical Center of Vojvodina and partially retrospective study at the Oncology Institute in Sremska Kamenica. Patients were divided into two groups consisting of 30 patients according to treatment with temsirolimus or IFN-alpha. During the first year of treatment, OS of patients treated with temsirolimus was 23.33%, whereas in patients treated with IFN-alpha it was 16.67%. Median survival in patients treated with temsirolimus was 9.3 months, whereas in patients treated with IFN-alpha it was 6.9 months, yielding a statistically significant difference (p=0.028). Patients treated with temsirolimus showed a statistically significantly longer median PFS compared to patients treated with IFN-alpha (p<0.0085). In conclusion, temsirolimus therapy had a significantly positive effect on survival in patients with mRCC. Patients treated with temsirolimus showed significantly longer median survival and median PFS compared to patients treated with IFN-alpha.
A MAN WITH UTERINE LEIOMYOMA AS PART OF PERSISTENT MÜLLERIAN DUCT SYNDROME - A CASE REPORT AND REVIEW OF THE LITERATURE.
Novak I, Grubišić I, Pezelj I … +5 more , Regović Džombeta T, Svaguša I, Štimac G, Ulamec M, Krušlin B
Acta Clin Croat · 2024 Dec · PMID 41050247 · Full text
We present a clinical case of a 59-year-old man, father of two children, who complained of irritative voiding of the bladder. An unknown retrovesical structure was detected by ultrasound and computed tomography, and was...
We present a clinical case of a 59-year-old man, father of two children, who complained of irritative voiding of the bladder. An unknown retrovesical structure was detected by ultrasound and computed tomography, and was surgically removed later. Histopathologic analysis reported uterine tissue with a leiomyoma, thus the diagnosis of persistent müllerian duct syndrome (PMDS) was established. It is a rare disorder characterized by the appearance of müllerian derivatives (fallopian tubes, uterus, and upper two-thirds of vagina) in males with normally developed external and internal genitalia. Patients usually present with cryptorchidism and inguinal hernia. Irritative voiding has not yet been described as the main symptom of PMDS. The major complications of the disorder are infertility, testicular tumorigenesis, and malignant transformation of müllerian structures. To the best of our knowledge, in addition to our case, only one case of PMDS with uterine leiomyoma has been described in the literature so far.
TRANSIENT HYPOPHOSPHATEMIA AS POSSIBLE ADVERSE OUTCOME AFTER IRON DEFICIENCY ANEMIA TREATMENT WITH FERRIC CARBOXYMALTOSE - SINGLE CENTER EXPERIENCE.
Brkić N, Vučinić Ljubičić I, Holik H … +1 more , Coha B
Acta Clin Croat · 2024 Dec · PMID 41050246 · Full text
The aim of this study was to determine the frequency of hypophosphatemia in female patients with iron deficiency anemia (IDA) treated parenterally with ferric carboxymaltose (FCM). Thirty-two female patients examined for...
The aim of this study was to determine the frequency of hypophosphatemia in female patients with iron deficiency anemia (IDA) treated parenterally with ferric carboxymaltose (FCM). Thirty-two female patients examined for IDA at the Hematology and Oncology Department of one General Hospital were included in the study. The inclusion criteria were hemoglobin <110 g/L, transferrin saturation <50%, ferritin <30 ng/mL, and ineffective oral iron therapy. The hemoglobin values were significantly increased 6 weeks after therapy in comparison with initial values. The onset of the asymptomatic hypophosphatemia was observed in 17 of 32 patients two weeks after the FCM therapy. Only one of 32 patients had severe asymptomatic hypophosphatemia (serum phosphate <0.3 mmol/L). Prolonged hypophosphatemia (6 weeks after FCM therapy) was observed in five of 32 patients, of which only one patient had initial hypophosphatemia. The difference between the phosphate values measured two weeks after the FCM therapy and the phosphate values at the first and last follow-up was statistically significant. Serum phosphate values should be routinely measured before and after parenteral FCM therapy.
DISTRIBUTION OF RESPIRATORY VIRUSES IN CHILDREN ADMITTED TO PEDIATRIC INTENSIVE CARE UNIT.
Ceylan G, Sandal O, Sari F … +6 more , Isguder R, Kara A, Gülfidan G, Ayhan Y, Devrim I, Ağın H
Acta Clin Croat · 2024 Dec · PMID 41050245 · Full text
Acute lower respiratory tract infection (LRTI) is common in children and associated with high morbidity and mortality. The aim of this study was to determine the distribution of respiratory viruses leading to admission o...
Acute lower respiratory tract infection (LRTI) is common in children and associated with high morbidity and mortality. The aim of this study was to determine the distribution of respiratory viruses leading to admission of a child with the diagnosis of LRTI to pediatric intensive care unit (PICU). The distribution of viral pathogens was determined using viral multiplex polymerase chain reaction (PCR) in children with LRTI admitted to PICU at a tertiary-level reference pediatric hospital. The LRTI patients without a positive viral multiplex PCR finding were excluded from the study. Most patients were under 2 years of age (78.3%), and the most common viral pathogen resulting in PICU admission due to viral LRTI was RSV A/B (32.8%). Thirty three patients had an underlying disease. Ten (16.6%) patients required invasive mechanical ventilation (IMV), 37 (61.6%) required high-flow oxygen therapy (HFOT), and two patients (3.3%) progressed to pediatric acute respiratory distress syndrome (PARDS). Underlying chronic disease presence was the highest in the IMV group with 90%, which decreased to 54% and 30.7% in the HFOT and standard oxygen treatment groups, respectively (p=0.018). The patients with IMV requirements had significantly longer hospital stay (median 8 days, range 6-13 days) compared to HFOT group (median 6 days, range 4-7.5 days] and regular oxygen treatment group (median 3 days, range 2-3.5 days) (p<0.001). The use of multiplex PCR for respiratory viruses may help in discriminating etiologic viral agents in patients admitted to PICU and estimating possible complications associated with viral-specific disease. The presence of an underlying disease in a patient with viral LRTI affects the treatment level, and treatment level affects the duration of PICU stay.
MILD COGNITIVE IMPAIRMENT AND CARDIOMETABOLIC RISK FACTORS IN BOSNIAN AND HERZEGOVINIAN PATIENTS WITH HEART FAILURE.
Ibrahimović-Pašić J, Lepara O, Dervišević A … +4 more , Babić N, Avdagić N, Valjevac A, Začiragić A
Acta Clin Croat · 2024 Dec · PMID 41050244 · Full text
The aim of the present study was to assess mild cognitive impairment (MCI) and cardiometabolic risk factors (CMRF) in Bosnian and Herzegovinian patients with heart failure (HF). This study included 80 patients with HF an...
The aim of the present study was to assess mild cognitive impairment (MCI) and cardiometabolic risk factors (CMRF) in Bosnian and Herzegovinian patients with heart failure (HF). This study included 80 patients with HF and 40 healthy controls. Montreal Cognitive Assessment (MoCA) testing was used to evaluate cognitive function. Abdominal obesity was assessed by waist circumference, and hypertension was assessed by the auscultatory method. Data on other CMRF and comorbidities, such as diabetes, smoking, alcohol consumption, and atrial fibrillation (AF), were gathered with a specially designed questionnaire. Lipids, C-reactive protein (CRP), and fibrinogen were assessed with standard laboratory methods. Student, Mann-Whitney, and Chi-square tests were used to determine significant differences between groups. Associations between categorical variables and correlation coefficients were assessed by the Chi-square and Spearman test, respectively. The prevalence of MCI in patients with HF was 77.5%. We found significant associations between MCI and diabetes, hypertension, AF, and smoking in patients with HF. We found no significant associations between MCI, abdominal obesity, and alcohol consumption. A significant positive correlation between MCI and total cholesterol was observed in patients with HF. Furthermore, a lower MoCA score was associated with higher values of CRP and fibrinogen in HF patients. The present study showed a high prevalence of MCI in Bosnian and Herzegovinian HF patients as well as its association with various CMRFs. These results suggest it is necessary to begin MCI screening in HF patients, especially since data from the literature point to improvement in cognitive performance with appropriate HF and concomitant CMRF treatment.
CLINICAL EVALUATION, DIAGNOSIS AND TREATMENT OF PHEOCHROMOCYTOMA.
Marušić R, Turk T, Bačun T
Acta Clin Croat · 2024 Dec · PMID 41050243 · Full text
Pheochromocytomas are rare neuroendocrine tumors that originate in chromaffin cells of the adrenal medulla and excessively secrete catecholamines, which leads to a multitude of different symptoms. The most common symptom...
Pheochromocytomas are rare neuroendocrine tumors that originate in chromaffin cells of the adrenal medulla and excessively secrete catecholamines, which leads to a multitude of different symptoms. The most common symptoms include headaches, palpitations, and sweating. Because of a diverse clinical presentation, pheochromocytomas pose a major diagnostic challenge and often go unidentified. These tumors can occur sporadically or as a part of hereditary syndromes. The diagnosis is confirmed by measuring plasma and 24-hour urinary metanephrine and normetanephrine. Computed tomography, magnetic resonance imaging, and functional morphological examinations are used for tumor localization. The treatment is operative and requires special preoperative patient preparation to prevent hypertensive crisis and arrhythmias. Due to the possibility of recurrence, the patient needs to be monitored. Pheochromocytoma has a high fatality rate if not recognized on time due to the effect of catecholamines on the cardiovascular system.
RELATIONSHIP OF IMMUNOHISTOCHEMICAL EXPRESSION OF CD86/CD163 POSITIVE INTRATUMORAL MACROPHAGES WITH PROGNOSIS OF PANCREATIC DUCTAL ADENOCARCINOMA.
Glavčić G, Zovak M, Sović S … +6 more , Mašić S, Blažević N, Misir Z, Bilić Z, Glavčić M, Radulović P
Acta Clin Croat · 2024 Dec · PMID 41050242 · Full text
Recent studies have shown an association of the number of tumor-associated macrophages (TAM) with the prognosis and treatment outcomes of ductal pancreatic adenocarcinoma. This study aimed to examine the correlation betw...
Recent studies have shown an association of the number of tumor-associated macrophages (TAM) with the prognosis and treatment outcomes of ductal pancreatic adenocarcinoma. This study aimed to examine the correlation between CD86 and CD163 macrophage expression and clinical-pathological characteristics of the disease in patients operated on for pancreatic carcinoma. A retrospective research was conducted in which the archival materials of the Ljudevit Jurak Department of Pathology, Sestre milosrdnice University Hospital Center were used together with all relevant patient clinical data obtained from the Hospital Information System on 76 patients operated on for pancreatic adenocarcinoma. In our study, the number of CD86 macrophages and the CD86/CD163 ratio showed a statistically significant correlation with increasing T and N stages of the disease. The number of CD163 macrophages did not show a statistically significant correlation with the mentioned variables. These results indicated that in our clinical conditions, proinflammatory (M1) macrophages were more expressed in locally advanced tumor stages with worse long-term prognoses. In conclusion, TAMs could be a valid prognostic marker or even a target for therapeutic agents but more studies will be needed to fully comprehend the impact of M1/M2 differentiation.
PERCUTANEOUS CORONARY INTERVENTION ON SAPHENOUS VEIN GRAFT IN SECOND GENERATION DRUG ELUTING STENT ERA.
Čanković M, Preveden A, Ivanović V … +6 more , Milovančev A, Petrović M, Kovačević M, Miljković T, Bjelobrk M, Velicki L
Acta Clin Croat · 2024 Dec · PMID 41050241 · Full text
The aim of the study was to determine major adverse cardiac events (MACE) related to the percutaneous coronary intervention (PCI) on saphenous vein graft (SVG) with a second-generation drug eluting stents in patients wit...
The aim of the study was to determine major adverse cardiac events (MACE) related to the percutaneous coronary intervention (PCI) on saphenous vein graft (SVG) with a second-generation drug eluting stents in patients with previous coronary artery bypass graft (CABG). The research was conducted as a unicenter retrospective observational study which analyzed consecutive patients of both genders who had PCI on SVG from January 1, 2016 until June 30, 2019. The aim was to investigate the occurrence of MACE defined as development of periprocedural myocardial infarction, acute heart failure in the first 24 hours after PCI, unstable angina after PCI, periprocedural stroke, contrast induced nephropathy, death, acute/subacute/late stent thrombosis, and target lesion revascularization. The study included 97 consecutive patients. MACE was recorded in 20.6% of patients, more often in patients with thrombolysis in myocardial infarction grade flow ≤2. High thrombus burden (HTB) was detected in 44.3% of patients and it significantly contributed to the development of MACE. In conclusion, PCI on SVG is a highly challenging procedure, especially in patients with an acute coronary syndrome. In patients who have HTB recorded in SVG, the usage of thrombus aspiration and distal protection device can reduce the frequency of no-reflow phenomenon and consequential MACE.
EVALUATION OF ULTRASOUND AS AN IMAGING MODALITY IN THE ASSESSMENT OF CAROTID ARTERY INVASION IN PATIENTS WITH HEAD AND NECK CANCER.
Pandurović T, Štimac D, Turk T … +5 more , Pešić S, Zubčić V, Bogović M, Čekić N, Šimić L
Acta Clin Croat · 2024 Dec · PMID 41050240 · Full text
Tumor invasion of carotid arteries (CA) is found in 2%-7% of patients with head and neck cancer (HNC). There are no standardized criteria to evaluate the invasion. Tumor invasion of CA is assessed by using computerized t...
Tumor invasion of carotid arteries (CA) is found in 2%-7% of patients with head and neck cancer (HNC). There are no standardized criteria to evaluate the invasion. Tumor invasion of CA is assessed by using computerized tomography (CT) and magnetic resonance imaging. Ultrasound was also used but the method has not become daily routine. The aim of this study was to examine the effect of tumor invasion on CA dynamics and to evaluate the role of ultrasonography in the diagnosis of invasion. The study was conducted on two groups of 22 patients each. The first group consisted of patients with confirmed HNC and CA infiltration, while the second group consisted of patients without any data of HNC. Motion of the CA wall was assessed using ultrasound from which a CA was segmented and then the amount of motion was assessed by optical flow calculation. All patients with a CT-verified CA infiltration had an altered CA motion. The research showed that tumor-infiltrated CA had an altered dynamic when viewed on ultrasound.
TEN-YEAR OUTCOMES AFTER ACUTE STEMI TREATED WITH PRIMARY PCI - THE ROLE OF ACUTE BIOMARKERS AND OTHER PARAMETERS IN PREDICTING CLINICAL SEVERITY AND PROGNOSIS.
Mornar Jelavić M, Babić Z, Babić D … +3 more , Balenović D, Lipovšćak R, Pintarić H
Acta Clin Croat · 2024 Dec · PMID 41050239 · Full text
This rare prospective study investigated 10-year outcomes of acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), and evaluated the role of acute biomarkers and...
This rare prospective study investigated 10-year outcomes of acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), and evaluated the role of acute biomarkers and other parameters in predicting clinical severity and prognosis. We included 250 patients and analyzed their baseline (cardiovascular risk factors), laboratory (maximal CK/TnT, acute inflammatory (white blood cells (WBC), hs-CRP), and liver biomarkers (AST/LDH), glomerular filtration rate (eGFR)) and clinical severity parameters (length of hospital stay, in-hospital complications, coronary angiography, and echocardiography (LVEF)). After hospital discharge, 229 patients were followed-up (2011-2022) and grouped according to the presence of major adverse cardiovascular events (MACE). In the acute phase, WBC, hs-CRP, LDH and AST positively correlated with maximal CK/cTnT and total in-hospital complications, and negatively with LVEF; WBC positively correlated with cardiogenic shock and stent diameter, hs-CRP with cardiac arrest and length of hospital stay, and LDH with stent diameter; total in-hospital complications increased the risk of in-hospital mortality and number of significantly stenosed coronary arteries, risk of heart failure, whereas the length of hospital stay negatively correlated with LVEF (p<0.05 all). During 10-year follow-up, LDH and clinical severity parameters (stenosis of LAD/ACx, multivessel CAD, proximal coronary stenosis, Gensini score, in-hospital complications) increased, while the others (normal eGFR and LVEF) reduced the risk of total MACE (p<0.05). In conclusion, acute biomarkers have a role in predicting clinical severity but they have no role in predicting long-term prognosis (except for LDH). Total in-hospital complications, more severe CAD, systolic dysfunction, and worse kidney function may lead to worse in-hospital and long-term outcomes.
MASS QUARANTINE EXPERIENCE AFTER UMRAH VISIT.
Bekgöz B, Şan İ, Usul E
Acta Clin Croat · 2024 Dec · PMID 41050238 · Full text
This study aimed to determine demographic characteristics, COVID-19 positivity rates of the quarantined individuals, and risk factors between those developing and not developing disease symptoms. The individuals who retu...
This study aimed to determine demographic characteristics, COVID-19 positivity rates of the quarantined individuals, and risk factors between those developing and not developing disease symptoms. The individuals who returned from Mecca, Saudi Arabia to Turkey on March 15, 2020 were transported from the airport to the campus of dormitories and quarantined for 14 days. This study included 2941 passengers who returned from Umrah visit to Turkey and were quarantined between March 15, 2020 and April 2, 2020. There were 1828 (62.2%) women. The polymerase chain reaction (PCR) test was positive in 295 (10%) of those in quarantine, 196 (66.4%) of them women. Among the patients with a positive PCR test result, there was no significant difference between women and men in terms of age and comorbidity. Of the 295 COVID-19 patients detected, 37 (12.5%) had symptoms. There was no significant difference between symptomatic individuals and asymptomatic individuals in terms of age, gender, and comorbidity. Quarantining everyone who has come from risky areas ensures that patients are isolated from the community, which can prevent the spread of the disease.
THYROID-ASSOCIATED OPHTHALMOPATHY IN A HYPOTHYROID PATIENT.
Filipan D, Iveković R, Gregurić T … +2 more , Kusić Z, Jukić T
Acta Clin Croat · 2024 Dec · PMID 41050237 · Full text
Thyroid-associated ophthalmopathy (TAO) is an autoimmune disorder of the orbit that occurs predominantly in Grave's hyperthyroidism, while it is an uncommon clinical finding in patients with Hashimoto's thyroiditis (HT)...
Thyroid-associated ophthalmopathy (TAO) is an autoimmune disorder of the orbit that occurs predominantly in Grave's hyperthyroidism, while it is an uncommon clinical finding in patients with Hashimoto's thyroiditis (HT) and hypothyroidism. We report the case of a 62-year-old female patient who presented with left eyelid edema, proptosis, diplopia, and lateral paralysis of the left eye. Magnetic resonance imaging of the orbits showed retrobulbar mass in the left orbit with hyperintense signals within left medial rectus muscle, offsetting but not infiltrating the optic nerve. An F-fluorodeoxyglucose positron-emission tomography/computed tomography (18F-FDG PET/CT) scan revealed pathological F-FDG uptake of expansive mass within rectus medialis muscle of the left eye (SUVmax=11.0) and similar findings in the right eye (SUVmax=7.1). It also displayed increased glucose metabolism in the thyroid gland (SUVmax=6.4). Laboratory findings showed increased thyrotropin level, while thyroid-stimulating-hormone-receptor antibodies were negative. The patient was diagnosed with HT and TAO, so levothyroxine therapy was introduced. Gradual improvement of TAO symptoms was attained a year later. Diplopia subsided and the patient regained complete eye movements. In conclusion, correction of hypothyroidism can significantly improve symptoms of TAO. Additional value of this case report lies in F-FDG PET/CT images displaying increased metabolic activity, which can advance clinical evaluation; however, further research is needed.
EFFECT OF USING TOPICAL ANESTHETIC DURING HIGH-SPEED DIGITAL IMAGING ON PHONATION ASSESSED BY DIGITAL KYMOGRAPHY PARAMETERS.
Bilić M, Slipac J, Kovač Bilić L
Acta Clin Croat · 2024 Dec · PMID 41050236 · Full text
High-speed digital imaging (HSDI) is a contemporary method of the phonation process assessment. It records laryngeal images at a rate of up to 8000 frames second. Digital kymography (DK) extracts high-speed images sampl...
High-speed digital imaging (HSDI) is a contemporary method of the phonation process assessment. It records laryngeal images at a rate of up to 8000 frames second. Digital kymography (DK) extracts high-speed images sampled at a single point along the vocal folds and enables objective quantification of the vocal fold movements. According to the literature, usage of topical anesthetic (TA) in oral cavity, oropharynx and laryngopharynx prior to examination, in order to reduce pain and discomfort level, is optional but the effect of using TA on the phonation process is not well investigated. The aim of this study was to investigate the effect of using TA during HSDI on DK parameters. We performed a prospective double-blind randomized controlled study on 58 healthy subjects. All subjects were examined on 2 consecutive days using TA and using saline solution (placebo) by the same experienced examiner. DK images, made on the middle of the vocal folds, were obtained from HSDI. Vocal folds were examined across glottal cycles and glottal width and period irregularities, left-right phase asymmetry, and the open, closed, opening and closing quotient were calculated. Our data showed that using TA during HSDI did not induce statistically significant changes of DK parameters in healthy subjects.
COMPLICATED POSTERIOR STERNOCLAVICULAR JOINT DISLOCATION WITH AORTIC ARCH IMPINGEMENT.
Lemac D, Dumić-Čule I, Legac A … +5 more , Čengic T, Nikolić I, Čikara I, Brkljačić B, Ivanac G
Acta Clin Croat · 2024 Dec · PMID 41050235 · Full text
Posterior sternoclavicular dislocation accompanied by clavicular end fracture is an extremely rare injury according to the available literature. We present a case of a young male with this injury, resulting from a vehicl...
Posterior sternoclavicular dislocation accompanied by clavicular end fracture is an extremely rare injury according to the available literature. We present a case of a young male with this injury, resulting from a vehicle accident, and additionally complicated by a clavicular bone fragment in the proximity of the aortic arch. An initial X-ray showed no signs of bone trauma, which was, however, revealed on a CT scan. Stable fixation of the fragment and sternoclavicular joint was achieved utilizing a plate and screws. The osteosynthetic material was removed after eight weeks due to the plate breaking. There were no complications in the 5-year follow-up period, and a full range of motion was accomplished. We aimed to emphasize the importance of early diagnosis and appropriate surgical management of complicated posterior sternoclavicular dislocations to avoid life-threatening events.
SMOKING EFFECT ON OXIDATIVE STRESS AND ANTIOXIDANT CAPACITY OF CERVICAL MUCUS IN WOMEN WITH PRIMARY IDIOPATHIC STERILITY - OBSERVATIONAL CASE-CONTROL STUDY.
Planinić Radoš G, Duić Ž, Lovrić B … +1 more , Juras J
Acta Clin Croat · 2024 Dec · PMID 41050234 · Full text
The aim of the study was to determine the effects of smoking on cervical mucus in women with primary idiopathic sterility. A prospective, case-control, observational, quantitative, and analytical study was carried out ov...
The aim of the study was to determine the effects of smoking on cervical mucus in women with primary idiopathic sterility. A prospective, case-control, observational, quantitative, and analytical study was carried out over a five-year period through ambulatory care. The first part of the study involved 140 healthy women (85 smokers and 55 non-smokers). The second part included 90 women (58 healthy, 32 suffering from sterility), grouped according to their smoking status. Concentrations of total proteins in cervical mucus solutions and homogenates of cervical surface cells and their mitochondria, thiocyanate and ascorbic acid, rhodanese activity, concentrations of cytochrome P-450 (mitochondria), lipid peroxidation and the total antioxidant capacity in homogenates of cervical surface cells, concentrations of superoxide O2, reduced gluthatione (GSH), advanced oxidation protein products (AOPP), and ferric reducing ability of plasma (FRAP) were measured. The measurements showed higher concentrations of thiocyanate, cytochrome P-450 and lipid peroxidation values, and lower concentrations of ascorbic acid, cytochrome P-450 activity and FRAP in smokers. Higher concentrations of superoxide O2, GSH, AOPP, and lower FRAP were found among smokers and women suffering from sterility. In conclusion, changes in oxidative stress and antioxidant capacity caused by smoking indicate that the quality of cervical mucus among patients suffering from sterility is lower compared to healthy women.
PROGNOSTIC VALUE OF TUMOR BUDDING IN SPORADIC COLORECTAL CANCER STAGE II PATIENTS WITH A LOW NUMBER OF LYMPH NODES EXAMINED.
Baković J, Tomasović-Lončarić Č, Pačić A … +5 more , Škifić I, Lisek V, Krstanac K, Čičak P, Konjevoda P
Acta Clin Croat · 2024 Dec · PMID 41050233 · Full text
Stage II colorectal cancer (CRC) is a major therapeutic challenge because it is not easy to decide whether patients will benefit from adjuvant chemotherapy or not. This study was designed as a retrospective prognostic st...
Stage II colorectal cancer (CRC) is a major therapeutic challenge because it is not easy to decide whether patients will benefit from adjuvant chemotherapy or not. This study was designed as a retrospective prognostic study combining standard histopathologic parameters with tumor budding and microsatellite instability. The study included 89 patients on elective treatment for stage II primary colorectal adenocarcinoma from January 2011 to December 2015. Study results indicated that the prognosis of patients with stage II CRC depended on the combination of three factors, (in the order of importance): number of lymph nodes examined; total number of buds 0.785 mm2 (≥5.5); and positive lymphovascular invasion. There is increasing evidence that tumor biology and non-anatomic characteristics are important in the prognosis and treatment of CRC. One of them is tumor budding which is not yet an integral part of the AJCC staging system. A low number of the lymph nodes examined is associated with high-risk patients. All patients without an adequate number of lymph nodes examined (less than 8 lymph nodes) should be considered a very high-risk group, with a very low survival rate, and chemotherapy should be used.
ENDOSCOPIC RECTAL ULTRASOUND IN RECTAL ADENOCARCINOMA STAGING: CAN A SURGEON RELY ON ENDOSCOPIC FINDINGS BEFORE THE SURGERY? - COMPARISON WITH POSTOPERATIVE PATHOLOGICAL DIAGNOSIS.
Ražov Radas M, Lisica Šikić N
Acta Clin Croat · 2024 Dec · PMID 41050232 · Full text
Our aim in this study was to demonstrate the usefulness of endoscopic rectal ultra- sound scan (ERUS) in providing information that can help surgeons decide on therapeutic approach and type of surgical procedure in patie...
Our aim in this study was to demonstrate the usefulness of endoscopic rectal ultra- sound scan (ERUS) in providing information that can help surgeons decide on therapeutic approach and type of surgical procedure in patients with rectal cancer. We compared ERUS findings with postoperative pathological data in 41 patients with endoscopic and pathological (PH) diagnosis of rectal cancer. These patients underwent ERUS examination to determine the extent of the disease and the findings were subsequently compared with postoperative pathological diagnosis. After ERUS examination, there were three patients in group T0, five in group T1, 12 in group T2, 17 in group T3, two in group T4, and two patients had a mucinous metastatic type of cancer. After excluding 15 patients who met the exclusion criteria, we compared ERUS findings of 26 patients with their pathological diagnosis to determine the sensitivity and accuracy of ERUS. The total sensitivity of the ERUS in preoperative staging of the tumor stage T0-T4 was 96%. Accuracy was 89%. This study showed that a surgeon can rely on the findings of ERUS performed by an experienced endoscopist before deciding of type of surgical procedure for T0-T2, and even T3 degree of rectal cancer. T3 rectal cancers are in the "gray zone", so both procedures, ERUS and nuclear magnetic resonance imaging (NMR), are needed to decide on the final therapeutic approach. NMR remains the gold standard for staging T4 rectal cancer.
THE EFFECTS OF INTRAARTICULAR AND PERIARTICULAR KNEE PAIN MANAGEMENT ON THE REHABILITATION OF PATIENTS WITH KNEE OSTEOARTHRITIS AFTER CEPHALOMEDULLARY FIXATION OF PERTROCHANTERIC FRACTURES.
Grle M, Moro S, Franjić D … +4 more , Vladić D, Karlović R, Grle I, Prlić J
Acta Clin Croat · 2024 Dec · PMID 41050231 · Full text
The gold standard for pertrochanteric fractures is closed reduction with traction and intramedullary osteosynthesis. A significant number of patients report knee pain after surgery, which could be associated with gonarth...
The gold standard for pertrochanteric fractures is closed reduction with traction and intramedullary osteosynthesis. A significant number of patients report knee pain after surgery, which could be associated with gonarthrosis and traction. In this research we wanted to determine if managing knee pain affects the rehabilitation of patients. There were three groups: the first group received a post-operative intra-articular (IA) injection containing methylprednisolone with lidocaine; the second group received the same combination periarticularly (PA); and the control group did not receive any form of injection. We measured the Visual Analogue Scale (VAS) score on the 3rd and 12th postoperative days, as well as six weeks after surgery. We measured knee range of motion (ROM) on the 12th postoperative day and six weeks after surgery. We calculated the Harris Hip Score (HHS) on the 3rd day and six weeks postoperatively. There were 27 patients. Preoperative Kellgren-Lawrence and VAS pain scores were similar. The IA group demonstrated the lowest VAS pain score after six weeks. ROM did not improve between groups on the 12th day and six weeks postoperatively. HHS was best in the IA group after 6 weeks. Injection of methylprednisolone with lidocaine into the knee improved postoperative rehabilitation in patients with knee osteoarthritis undergoing ipsilateral cephalomedullary fixation for a pertrochanteric fracture.
ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS (AGEP) CAUSED BY ANTIBIOTIC POLYTHERAPY: A CASE REPORT.
Jolić S, Šitum Čeprnja Z, Čeprnja T … +2 more , Jolić O, Šitum M
Acta Clin Croat · 2024 Dec · PMID 41050230 · Full text
Acute generalized exanthematous pustulosis (AGEP) is a rare disease, usually associated with drug intake or infections. It is characterized by generalized acute pustules and non-follicular exanthema together with systemi...
Acute generalized exanthematous pustulosis (AGEP) is a rare disease, usually associated with drug intake or infections. It is characterized by generalized acute pustules and non-follicular exanthema together with systemic symptoms. Histologically, it is characterized by a subcorneal intraepidermal spongiform pustule, papillary edema and dermal vasodilatation surrounded by a polymorphous infiltrate of neutrophils, eosinophils and mononuclear cells. The aim of this article is to present current knowledge regarding the etiology and treatment, as well as the clinical and histologic features of AGEP. We present a case of a 50-year-old male patient who was prescribed several antibiotics and developed a drug-related cutaneous adverse effect. Treatment involved rapid identification of the causative agent and its discontinuation together with supportive measures, with resolution of symptoms within two weeks. Early diagnosis and timely treatment result in a favorable outcome and prevent systemic complications.
THE IMPACT OF ENDODONTIC STATUS ON QUALITY OF LIFE.
Dijanić P, Ivanišević A, Jukić Krmek S … +3 more , Perica Pavešić J, Karlović Z, Matijević J
Acta Clin Croat · 2024 Dec · PMID 41050229 · Full text
The influence of endodontic status on quality of life has not been fully clarified. The aim of this study was to quantify the effect of endodontic status on everyday functioning using the psychometric instrument Oral Imp...
The influence of endodontic status on quality of life has not been fully clarified. The aim of this study was to quantify the effect of endodontic status on everyday functioning using the psychometric instrument Oral Impacts on Daily Performances (OIDP) and to correlate endodontic status with quality of life using the OIDP questionnaire. A total of 600 participants were referred to dental radiography for digital orthopantomograms and asked to fill out the OIDP questionnaire. Digital orthopantomograms were analyzed and compared with OIDP results. The correlation between endodontic status and quality of life was tested. The statistical analysis consisted of descriptive statistics, non-parametric statistics, hierarchical multiple regression analysis by enter method, and correlation analysis. The results showed that quality of life was significantly affected by tooth loss (p<0.05). Endodontic treatment on canines and incisors positively correlated with higher OIDP scores, indicating an effect on quality of life (p<0.05). In conclusion, the correlations between variables describing the endodontic status and the quantitative results of the OIDP questionnaire indicate a measurable effect of endodontic disease/health on everyday functioning.
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