Acta Clinica Croatica[JOURNAL]
Sun
200 papers
COMPARISON OF CT REPORTING SYSTEMS IN PATIENTS UNDERGOING THORAX COMPUTED TOMOGRAPHY FOR COVID-19 PNEUMONIA.
Bozlar U, Sahin HM, Tasci C … +4 more , Karaismailoglu E, Altekin S, Saglam K, Tasar M
Acta Clin Croat · 2024 Dec · PMID 41050228 · Full text
We aimed to compare three commonly used computed tomography (CT) reporting systems for COVID-19, i.e., Radiological Society of North America (RSNA) Consensus, British Society of Thoracic Imaging (BSTI) Guideline, and Dut...
We aimed to compare three commonly used computed tomography (CT) reporting systems for COVID-19, i.e., Radiological Society of North America (RSNA) Consensus, British Society of Thoracic Imaging (BSTI) Guideline, and Dutch Radiological Society Categorical CT Assesment Scheme: COVID-19 Reporting and Data System (CO-RADS). Three thousand thoracic CT scans taken consecutively because of COVID-19 suspicion, diagnosis or follow-up after admission to our hospital between March 2020 and May 2020 were studied. All CT examinations were assigned to the appropriate groups of the aferomentioned CT reporting systems and these systems were compared with each other. Thorax CT imaging did not reveal any findings indicative of infection (RSNA: 40.7%, BTSI: nonapplicable, and CO-RADS: 40.1%) in the vast majority of polymerase chain reaction (PCR) (+) cases in all three reporting systems. The highest number of cases was included in the groups classified as typical/classic/CO-RADS 5 findings in all three reporting systems (RSNA: 213, BSTI: 212, and CO-RADS:101) in COVID-19 diagnosed cases with lung findings. There was no significant difference between PCR (+) and (-) cases with probable COVID-19 infection according to BSTI reporting system and CO-RADS 4 cases (30/23, p=0.381 and 22/19, p=0.245, respectively). In addition, typical thoracic CT findings were observed in RSNA: 70, BSTI: 71, CO-RADS: 71 individuals in all three classifications, but the PCR result was detected negative. When the three reporting systems were compared, we concluded that they did not show distinct advantage to each other and all three ensured that patients were properly classified with similar accuracy.
GIANT ATRIAL SEPTAL ANEURYSM WITH THROMBI IN A PATIENT WITH ATRIAL SEPTAL DEFECT AND CEREBRAL ISCHEMIC EVENTS: A CASE REPORT.
Biočić S, Vincelj J, Udovičić M … +2 more , Jakšić Jurinjak S, Martinko J
Acta Clin Croat · 2024 Dec · PMID 41050227 · Full text
Atrial septal aneurysm is a congenital abnormality that may occur as an isolated malformation or in combination with other cardiac abnormalities. More than half of the cases of atrial septal aneurysm are associated with...
Atrial septal aneurysm is a congenital abnormality that may occur as an isolated malformation or in combination with other cardiac abnormalities. More than half of the cases of atrial septal aneurysm are associated with an atrial shunt. We present a case with a thrombus at a giant atrial septal aneurysm associated with atrial septal defect and thrombus in the left atrial appendage, detected by transesophageal echocardiography after cerebral ischemic events. To the best of our knowledge, this combination has not been described in the literature so far.
SCREENING OF ASYMPTOMATIC COVID-19 CASES FROM THE ASPECT OF VIRUS SPREAD.
Ortatatli M, Kilic Z, Pakdemirli A … +1 more , Kenar L
Acta Clin Croat · 2024 Dec · PMID 41050226 · Full text
The COVID-19 pandemic has hit the entire world. While symptomatic patients can be taken out of the infection chain, asymptomatic cases are very important for the spread of SARS-CoV-2. We investigated the relationship bet...
The COVID-19 pandemic has hit the entire world. While symptomatic patients can be taken out of the infection chain, asymptomatic cases are very important for the spread of SARS-CoV-2. We investigated the relationship between isolating asymptomatic COVID-19 cases with close contacts by identifying and breaking the infection chain. This study included 3 asymptomatic COVID-19 cases identified during screening and 25 close contacts as a result of filiation. Twenty-five people with close contact were classified into groups A (n=8), B (n=6) and C (n=11). On SARS-CoV-2 PCR tests performed in close contacts, all of them were negative on day 0, whereas two group C subjects were positive on day 7. On antibody test applied on day 28, six subjects were positive in group A, two subjects were positive in group B, and one subject was positive in group C. A statistically significant decrease was observed in the number of infected people in the group where asymptomatic cases were identified and removed (p=0.04). It was determined that asymptomatic COVID-19 cases who were not isolated from the community had a 5-fold increased risk of infection. Screening and identification of asymptomatic cases is also essential to augment the effectiveness of quarantine and isolation measures.
ESOPHAGEAL DIAMETER ON HIGH-RESOLUTION COMPUTED TOMOGRAPHY - A POTENTIAL USEFUL MARKER FOR INTERSTITIAL LUNG DISEASE SEVERITY IN PATIENTS WITH SYSTEMIC SCLEROSIS.
Posavec AL, Šalamon L, Huzjan Korunić R … +2 more , Piskač Živković N, Mitrović J
Acta Clin Croat · 2024 Dec · PMID 41050225 · Full text
Patients with systemic sclerosis (SSc) are at an increased risk of developing interstitial lung disease (ILD) and esophageal dysfunction, with frequently present esophageal dilatation. Our study aimed to investigate the...
Patients with systemic sclerosis (SSc) are at an increased risk of developing interstitial lung disease (ILD) and esophageal dysfunction, with frequently present esophageal dilatation. Our study aimed to investigate the relationship between esophageal diameter (ED) analyzed on high-resolution computed tomography (HRCT) with lung function tests and ILD evaluated with Warrick score. Thirty-nine patients with SSc were enrolled in this study. ED and Warrick score were evaluated by HRCT. The relationships between Warrick score, lung function, and ED were analyzed. Multivariate regression analysis was used to determine the effect of individual predictors on SSc-ILD. ILD was present in 25 (64%) patients. ED >10 mm in one or more of the measured locations on HRCT was present in 25 (64%) patients and 19 (76%) of these patients had concurrent ILD. Subjects with esophageal dilatation had a higher Warrick score and lower lung function tests. The measurement of ED was able to predict the presence of ILD in 69% of patients. Results suggest that evaluation of ED during regular HRCT follow-up could be useful in patients with SSc due to the association of esophageal dilatation with worse lung function tests and a more severe form of ILD.
INCIDENCE AND PREVALENCE OF INFLAMMATORY BOWEL DISEASE IN OSIJEK-BARANJA COUNTY, CROATIA, 2000-2014.
Žulj M, Raguž M, Petrović A … +5 more , Kralik K, Juranić B, Mikšić Š, Boban M, Smolić R
Acta Clin Croat · 2024 Dec · PMID 41050224 · Full text
The etiology of inflammatory bowel disease (IBD) is unknown. Data on the incidence and prevalence in different regions can help identify factors relevant to the occurrence of IBD. From 2000 to 2014, 517 patients were new...
The etiology of inflammatory bowel disease (IBD) is unknown. Data on the incidence and prevalence in different regions can help identify factors relevant to the occurrence of IBD. From 2000 to 2014, 517 patients were newly diagnosed with IBD, including 329 (63.6%) patients with ulcerative colitis (UC) and 188 (36.4%) patients with Crohn's disease (CD). The incidence of UC was 71.4/100,000 in the 2000-2010 period and 30.5/100,000 in the 2011-2014 period. The incidence of CD was 37.5/100,000 in the 2000-2010 period and 21/100,000 in the 2011-2014 period. The prevalence of IBD showed an increasing trend during the study period. It increased from 3/100,000 in 2000 to 109.5/100,000 in 2014 for UC, and from 2.5/100000 in 2000 to 63.3 in 2014 for CD. The results from Osijek-Baranja County are consistent with most studies on IBD, except for the distribution by gender and education. There was a statistically significantly higher number of males with CD compared to UC, and patients diagnosed with CD had a significantly higher level of education.
NEW INSIGHTS INTO DEVELOPMENT OF MATERNITY HOSPITALS IN THE REPUBLIC OF CROATIA AFTER WORLD WAR II: OUTPATIENT MATERNITY DEPARTMENT IN KLANJEC, HRVATSKO ZAGORJE, CROATIA.
Fureš R, Stanojević M, Stanić Ž … +8 more , Fureš D, Ćosić V, Fureš Ž, Malinac Malojčić S, Gredičak M, Hrgović Z, Ivkošić IE, Mikelin N
Acta Clin Croat · 2024 Dec · PMID 41050223 · Full text
In the area of today's Krapina-Zagorje County, after World War II, there were three outpatient maternity departments (OMD) in Krapina, Klanjec and Pregrada, making a considerable step forward in public health improvement...
In the area of today's Krapina-Zagorje County, after World War II, there were three outpatient maternity departments (OMD) in Krapina, Klanjec and Pregrada, making a considerable step forward in public health improvement. The first and biggest OMD was located in the Klanjec Public Health Center. In parallel with establishment of the maternity hospital (MH) in Zabok, all OMDs throughout today's Krapina-Zagorje County were closed. The aim of our research was to present the activities of Klanjec OMD (KOMD) and show its impact on perinatal health. Data on KOMD activities were obtained from the Birth Registry. Major obstetric procedures, including delivery by cesarean section, were not performed in KOMD. Based on the above, numerous transports of women in labor and postpartum transports were organized to maternity wards in large centers. The most common cause for transport were transports during childbirth caused by prolonged labor. In conclusion, organization of OMD in the area of today's Krapina-Zagorje County significantly improved perinatal care in the 1950s. It was followed by gradual closure of OMD which could not meet the newly set spatial, material and personnel demands, along with the establishment of maternity hospitals in general and university hospitals. The trend of perinatal and maternal mortality reduction in the Zagorje region that began with the establishment of inpatient maternity department at the Zabok Hospital continues to this day.
EFFECT OF UNCOMPLICATED ULTRASOUND PHACOEMULSIFICATION CATARACT SURGERY ON CENTRAL MACULAR THICKNESS CHANGES IN THE EARLY POSTOPERATIVE PERIOD IN DIABETIC PATIENTS.
Pivić-Kovačević I, Matić S, Barać J … +3 more , Jelić Vuković M, Benašić T, Salinger Ž
Acta Clin Croat · 2024 Dec · PMID 41050222 · Full text
The aim of this prospective study was to determine changes in central macular thickness in the early postoperative period after uncomplicated phacoemulsification cataract surgery in diabetic patients using spectral domai...
The aim of this prospective study was to determine changes in central macular thickness in the early postoperative period after uncomplicated phacoemulsification cataract surgery in diabetic patients using spectral domain optical coherence tomography (SD-OCT). Uncomplicated ultrasound phacoemulsification cataract surgery causes minimal changes of retinal layer thickness, which may result in subclinical cystoid macular edema development. This prospective study included 55 patients divided into two groups. Group 1 included diabetic patients with cataract, and group 2 included patients with cataract and without diabetes. All patients underwent uncomplicated ultrasound phacoemulsification cataract surgery at the Department of Ophthalmology, University Hospital Osijek in the period from November 2017 to January 2018. Patients were followed-up for one month after surgery. At each examination, OCT recording of the eye undergoing cataract surgery was performed. A statistically significant difference in central macular thickness in the diabetic group and control group (p=0.0005 both) was confirmed preoperatively and one month after cataract surgery. A statistically significant difference in central macular thickness was confirmed in diabetic group (p=0.006), as well as in the control group of patients (p=0.01) seven days and one month after cataract surgery. There was no statistically significant difference in macular thickness changes between the diabetic and control group of patients preoperatively (p=0.618), seven days (p=0.6848) or one month after cataract surgery (p=1). The effect of HbA1c on macular thickness change in diabetic patients was not statistically significant. The mean HbA1c in diabetic patients was 7.24±1.34%. There was no statistically significant difference in the effect of cumulative dissipated energy on macular thickness change in either group. This study confirmed a statistically significant correlation of the effect of fluid volume consumption on macular thickness changes in diabetic patients. There was no statistically significant effect of fluid volume consumption on macular thickness change in the control group of patients. Uncomplicated ultrasound phacoemulsification cataract surgery caused changes in cen-tral macular thickness in the early postoperative period in both patient groups. Changes in central macular thickness in the observed period were not manifested with clinically significant macular edema or by a more significant decrease in visual acuity. All patients had significant improvement in visual acuity seven days and one month after cataract surgery.
THE EFFECT OF ANESTHESIA ON POSTOPERATIVE COGNITIVE DYSFUNCTION.
Bilić M, Lukšić M, Miklić Bublić M … +3 more , Orešković Z, Mijatović D, Vrbanović Mijatović V
Acta Clin Croat · 2024 Dec · PMID 41050221 · Full text
Postoperative cognitive dysfunction (POCD) is a newly developed cognitive function deficit after surgery. The aim of the study was to determine the incidence of POCD after anesthesia and possible risk factors. A prospect...
Postoperative cognitive dysfunction (POCD) is a newly developed cognitive function deficit after surgery. The aim of the study was to determine the incidence of POCD after anesthesia and possible risk factors. A prospective study was conducted on 90 patients scheduled for elective surgery under general (60 patients) or regional (30 patients) anesthesia. Each patient completed the Montreal cognitive assessment (MoCa) test the day before and the day after surgery. Data on comorbidities, previous COVID-19 infection, demographic and anesthesia related data were also collected. The day after surgery, POCD defined according to the 2 scores rule was present in 38 (42.2%) patients. A lower level of education (p=0.023), previous COVID-19 infection (p=0.032), higher Charlson comorbidity index (CCI) (p=0.014), and general anesthesia (p=0.035) were identified as risk factors, whereas a statistically significant negative correlation with preoperative (p=0.001) and postoperative result (p=0.001) was proven for age. The results indicated that a significant proportion of patients after general or regional anesthesia developed POCD depending on patient education, CCI, COVID-19 infection, and type of anesthesia. It was also shown that older age correlated with poorer MoCa test result independently of anesthesia. These factors can be identified before the procedure under anesthesia, thus offering the possibility of adjusting anesthesia and postoperative care in patients at risk of developing POCD.
ETIOLOGY OF URINARY TRACT INFECTIONS IN NEONATES AND BACTERIAL RESISTANCE IN CROATIA.
Potkonjak AM, Terzić I, Lovrić M … +8 more , Gall V, Soljačić Vraneš H, Milošević D, Tučkar N, Vujić G, Košec V, Budimir A, Filipović-Grčić B
Acta Clin Croat · 2024 Dec · PMID 41050220 · Full text
Urinary tract infection (UTI) occurs in approximately 15% of full-term neonates and 8% of those born before 37 weeks of gestation. Severe UTI can lead to sepsis or long-term complications such as renal scarring and hyper...
Urinary tract infection (UTI) occurs in approximately 15% of full-term neonates and 8% of those born before 37 weeks of gestation. Severe UTI can lead to sepsis or long-term complications such as renal scarring and hypertension. Given the rising concern of bacterial resistance to antibiotics, this research aimed to examine the epidemiology of neonatal UTI, most common antibiotic prescription patterns, as well as resistance of the causative agents in Croatia. This retrospective multicenter analysis was focused on neonates born in 2005 and 2015. Of the 103 bacterial UTI cases, 78.6% affected term neonates. Male neonates constituted 62.1% of the study population. Eutrophic neonates accounted for 87.4%, and hospital-acquired infections were prevalent in 47.6% of cases. The main causative pathogens were (60.2%) and (28.2%). Most commonly prescribed empirical antibiotics included ceftriaxone (31.1%) and the ampicillin-gentamicin combination (10.7%). In 2005, 72.7% of isolates were sensitive to empirical therapy. In 2015, sensitivity to empirical antibiotic therapy was observed in 75.6% of cases. In this study, frequently exhibited antibiotic resistance to ampicillin, amoxicillin, trimethoprim-sulfamethoxazole, and gentamicin. For UTIs attributed to , the prevailing bacterial resistance was observed against gentamicin, ceftibuten, ampicillin, cefazolin, and piperacillin. The predominance of as the most common pathogen causing UTI was consistent with global trends. Founded on continuous differences in bacterial resistance, this study can serve as a basis for comprehending local resistance patterns of pathogens causing neonatal UTI, highlighting the need of additional prospective research.
CORRELATION BETWEEN VISUAL FIELD SENSITIVITY AND RETINAL NERVE FIBER LAYER THICKNESS IN UNILATERAL EXFOLIATION SYNDROME.
Šimić Prskalo M, Prskalo Z, Tomić Ž … +1 more , Tomić T
Acta Clin Croat · 2024 Dec · PMID 41050219 · Full text
This study aimed to evaluate retinal nerve fiber layer thickness in exfoliation syndrome (XFS), present unilaterally, using optical coherence tomography (OCT). This prospective study included 90 examinees with unilateral...
This study aimed to evaluate retinal nerve fiber layer thickness in exfoliation syndrome (XFS), present unilaterally, using optical coherence tomography (OCT). This prospective study included 90 examinees with unilateral syndrome. However, examinees with higher intraocular pressure or findings implicative of glaucoma were excluded from the study, as well as examinees with optic nerve changes. In individuals with unilateral XFS, OCT findings were compared between the two groups: the affected eye group and the fellow eye group. The study results show that the average thinning of the retinal nerve fiber layer, especially in the inferior and superior quadrants, has not resulted in visual field defects in examinees with unilateral XFS. In the group of eyes without XFS, 85.55% exhibited reference inferior quadrant thickness values, and 91.11% exhibited reference superior quadrant thickness values. In the group of eyes with manifest XFS, 82.22% exhibited reference inferior quadrant thickness values, and 88.88% exhibited reference superior quadrant thickness values. Most examinees in both groups had normal average retinal nerve fiber layer (RNFL) thickness (72.22%). In examinees with clinically unilateral XFS, RNFL thinning occurs in both eyes before XFS becomes bilateral and before hypertensive intraocular pressure can be measured.
SKIN SURFACE TEMPERATURE CHANGES BEFORE AND AFTER MEDIAN NERVE DECOMPRESSION IN CARPAL TUNNEL SYNDROME.
Pavljak L, Bulić K, Mrak M … +1 more , Antabak A
Acta Clin Croat · 2024 Dec · PMID 41050218 · Full text
Carpal tunnel syndrome is the most common upper extremity compression neuropathy caused by compression of the median nerve at the wrist. Along with motor and sensory fibers, sympathetic fibers also pass through the media...
Carpal tunnel syndrome is the most common upper extremity compression neuropathy caused by compression of the median nerve at the wrist. Along with motor and sensory fibers, sympathetic fibers also pass through the median nerve, playing an important role in the regulation of blood flow to the skin which interacts between the body interior and its environment. The aim of this study was to examine the preand postoperative correlation between skin temperature changes in the area innervated by compressed median nerve compared to the skin areas innervated by radial and ulnar nerve and median nerve of the unaffected hand. The study included 16 patients with carpal tunnel syndrome with an indication for open carpal tunnel decompression. Skin temperature was measured preoperatively, at 2-week, 2and 6-month follow-ups on the areas innervated by median, ulnar and radial nerve of the affected hand and median nerve of the non-affected hand. On the affected hand, median nerve innervated skin temperature showed maximum increase at 2-month follow-up before decreasing to a level higher than preoperatively. Radial nerve innervated skin temperature was lower than the preoperative value at 2-week follow-up, increasing to higher levels afterwards. Ulnar nerve temperature followed the curve of the median nerve innervated skin at all follow-ups. Unaffected median nerve innervated skin temperature increased at all follow-ups compared to the preoperative values. In conclusion, two or even five additional measurements should be made after at least one year. The results should be correlated with clinical and electromyoneurography recovery.
ACOUSTIC RHINOMETRY STUDY IN PATIENTS WITH ALLERGIC RHINITIS.
Vlaykov A
Acta Clin Croat · 2024 Dec · PMID 41050217 · Full text
Acoustic rhinometry is a non-invasive technique that requires minimal cooperation from patients compared to other diagnostic methods. This technique can be used even in children under 3 years of age, which makes it widel...
Acoustic rhinometry is a non-invasive technique that requires minimal cooperation from patients compared to other diagnostic methods. This technique can be used even in children under 3 years of age, which makes it widely applicable in the practice of rhinologists. The aim of this research was to study nasal patency and nasal volume in patients with persistent allergic rhinitis (PAR) and intermittent allergic rhinitis (IAR) using acoustic rhinometry and to compare the degree of swelling of the nasal mucosa in patients with different forms of the disease. The study was conducted on the territory of the University Hospital "Prof. Dr. St. Kirkovich" (Stara Zagora, Bulgaria), where 139 participants (111 with allergic rhinosinusitis [AR] and 28 controls), aged 19 to 84 years, were examined. To compare the results, an acoustic rhinometry study was performed on the participants and the control group. The main indicators considered were the volume of the nasal cavity, the minimum cross-section area of the left and right halves, as well as the distance from the nasal entrance where it is located. To check the reactivity of the nasal mucosa, the same test was repeated after using a nasal decongestant. Increased nasal mucosal swelling in patients with IAR than those with PAR has been found. More manifested nasal congestion is observed in patients with IAR, probably because pollen has a stronger immunological stimulus and causes more manifested expression of symptoms than allergens provoking year-round forms of AR. A severely reduced reactive response to nasal decongestants has been demonstrated in participants with persistent AR.
DIAGNOSTIC VALUE OF STIMULATED SERUM THYROGLOBULIN IN THE FOLLOW-UP OF PATIENTS WITH DIFFERENTIATED THYROID CANCER.
Wagenhofer V, Mihaljević I, Kralj T … +2 more , Vrdoljak D, Kizivat T
Acta Clin Croat · 2024 Dec · PMID 41050216 · Full text
The aim was to determine the diagnostic value of stimulated serum thyroglobulin (sTg) for the follow-up of patients with differentiated thyroid cancer (DTC) and to evaluate whether repeated sTg measurement provides addit...
The aim was to determine the diagnostic value of stimulated serum thyroglobulin (sTg) for the follow-up of patients with differentiated thyroid cancer (DTC) and to evaluate whether repeated sTg measurement provides additional clinical benefit in detecting persistent or recurrent structural disease if the initial sTg was negative. The retrospective study included 388 consecutive patients with DTC treated and followed-up between 2004 and 2018 at the Clinical Institute of Nuclear Medicine and Radiation Protection, Osijek University Hospital. The negative predictive value (NPV) of the first sTg measured 12 months after the initial treatment was compared with NPV of sTg measured annually during 3 consecutive years of follow-up. The first sTg NPV was 99.5% in the group of low-risk patients and 96.1% in the group of intermediate-risk patients. In both low-and intermediate-risk groups, there were no differences between the first sTg NPV and NPV of sTg measured annually during 3 years of follow-up period. Repeated measurement of the sTg after initially negative result had a limited clinical value for detecting persistent or recurrent structural disease and cannot be recommended in routine follow-up of low and intermediate-risk patients with DTC.
INTESTINAL OBSTRUCTION AS A RESULT OF PANCREATIC ECTOPY IN JEJUNUM: A CASE REPORT AND LITERATURE REVIEW.
Đolai M, Šunjević M, Dražin A … +3 more , Petrović P, Torbica S, Trivunić Dajko S
Acta Clin Croat · 2024 Oct · PMID 40104243 · Full text
Pancreatic heterotopia is a relatively rare condition that implies pancreatic tissue anatomically separated from the main gland, showing no vascular or ductal continuity. It is known to occur in many sites of gastrointes...
Pancreatic heterotopia is a relatively rare condition that implies pancreatic tissue anatomically separated from the main gland, showing no vascular or ductal continuity. It is known to occur in many sites of gastrointestinal tract, with stomach being the most common one. This case is of great interest because ectopic pancreatic tissue in jejunal wall presented as bowel obstruction. The aim of this article is to provide a review of clinical, histopathologic and immunohistochemical features of ectopic pancreatic tissue in jejunum, emphasizing the possible diagnostic pitfalls in gastrointestinal tract, especially in its upper parts. Knowing the most common locations, imaging features and histopathologic criteria, the diagnosis of pancreatic heterotopia could be successfully set preoperatively. Associated complications are various and sometimes difficult to handle, so accurate and precise diagnosis, as well as surgical resection, is often needed.
IMPACT OF BODY MASS INDEX ON FUNCTIONAL RECOVERY AFTER TOTAL KNEE REPLACEMENT.
Mešanović M, Vučković M, Schuster S
Acta Clin Croat · 2024 Oct · PMID 40104242 · Full text
The aim of this study was to determine whether body mass index and age had an impact on functional recovery two years after total knee replacement. The research was conducted at the Lovran Hospital of Orthopedics and Tra...
The aim of this study was to determine whether body mass index and age had an impact on functional recovery two years after total knee replacement. The research was conducted at the Lovran Hospital of Orthopedics and Traumatology, School of Medicine, University of Rijeka, Croatia. Study sample included patients who underwent total knee replacement surgery with median parapatellar approach in 2019. Morphological measurements, knee range of motion and WOMAC questionnaire score were examined before and two years after surgery. Descriptive statistics was used for gender, age and body mass index, and inferential statistics was employed to check the correlation of recovery measured by changes in the WOMAC score and change in the range of motion results with age and body mass index. According to study results, male and female patients did not differ in body mass index (t=1.184; p>0.05). There was no statistically significant correlation of functional recovery of the patients with age (p=0.556), or between body mass index and differences in the range of motion (p=0.927) from flexion to extension. The study indicated that knee arthroplasty and thus the impact on functional recovery had an equally good effect regardless of age. In patients who had flexion contracture before surgery, the surgery improved motion amplitude.
SURGICAL METHODS IN THE TREATMENT OF BASAL THUMB ARTHRITIS - FROM ARTHROSCOPY TO ARTHROPLASTY.
Sulje Z, Starčević D, Aljinović A … +1 more , Barbarić Starčević K
Acta Clin Croat · 2024 Oct · PMID 40104241 · Full text
The first carpometacarpal joint is the second most common joint affected by degenerative arthritis. The prevalence of the first carpometacarpal joint arthritis increases with age, especially in postmenopausal women. Liga...
The first carpometacarpal joint is the second most common joint affected by degenerative arthritis. The prevalence of the first carpometacarpal joint arthritis increases with age, especially in postmenopausal women. Ligamentous laxity or injury of the first carpometacarpal joint is thought to be the starting point of development of degenerative changes, accompanied with altered biomechanics of the thumb. As the disease progresses, the joint is destroyed and the thumb and hand function are deteriorating. Although many patients, in different stages of disease, experience pain relief with conservative treatment, surgery is often needed. Decision on the type of surgical procedure depends on the age of the patient, functional demands, and stage of the disease. In early stages of the disease, stabilization of the first carpometacarpal joint, extension osteotomy of the first metacarpal and arthroscopic procedures are used. These are joint-preserving procedures, and they slow down progression of the disease and reduce symptoms. In late stages of the disease, joint arthroplasty procedures and first carpometacarpal arthrodesis are performed. In recent years, late stages of the disease can also be treated arthroscopically. This paper describes different surgical methods, their advantages and drawbacks, with respect to different stages of the disease.
POSITIVE CONE MARGINS - A DISADVANTAGE OF THE LARGE LOOP EXCISION OF TRANSFORMATION ZONE TECHNIQUE?
Butorac D, Škrtić B, Pitner I … +2 more , Kuna K, Djaković I
Acta Clin Croat · 2024 Oct · PMID 40104240 · Full text
The aim was to compare the efficiency of large loop excision of the transformation zone (LLETZ) and cold-knife conization according to the incidence of positive cone margins in histopathologic analysis of the cervical co...
The aim was to compare the efficiency of large loop excision of the transformation zone (LLETZ) and cold-knife conization according to the incidence of positive cone margins in histopathologic analysis of the cervical cone. In the study, data obtained from 568 female patients with cone biopsy due to cervical changes during a four-year period (2012-2015) were retrospectively analyzed. Group 1 included patients who were operated on using LLETZ technique and group 2 consisted of patients with cold-knife cone biopsy. LLETZ was a method of choice in 334 (59%) patients, whereas 234 (41%) patients underwent cold-knife cone biopsy. The percentage of positive cone margins was much higher with LLETZ technique, even 39% (131 patients), as compared to 20% with cold-knife cone biopsy. In conclusion, the technique and cone configuration should be individualized, depending on the specifics of the lesion. The transformation zone is not always removed during one LLETZ procedure. High percentage of positive cone margins is not a disadvantage of LLETZ technique because of differences in indications, approach and multiple cutting. The real success of conization can be measured only by the relapse frequency over a long period of time with a high number of patients.
THE EFFECT OF URIC ACID LEVEL ON THE SEVERITY OF COVID-19.
Aydin Bahat K
Acta Clin Croat · 2024 Oct · PMID 40104239 · Full text
Epidemiological and clinical features of COVID-19 have been reported, but risk factors need to be determined to predict the course of the disease. In our study, we aimed to determine the effect of uric acid level on the...
Epidemiological and clinical features of COVID-19 have been reported, but risk factors need to be determined to predict the course of the disease. In our study, we aimed to determine the effect of uric acid level on the severity of the disease. COVID-19 patients who received inpatient treatment between March 11, 2020 and May 30, 2020, and whose uric acid level was measured were included in the study. Demographic characteristics, comorbidities, symptoms, clinical course, laboratory parameters, and treatments were recorded. The study included 83 patients, of these 43 (52%) were males. The mean age was 59±17.1 years. The mean uric acid and albumin levels of the patients who needed oxygen were lower than in those who did not need oxygen (p=0.471 and p=0.057, respectively). There was a significant relationship between the presence of hypouricemia and mortality (p=0.019). In addition, the mean uric acid levels of patients who needed intensive care or died were lower than the mean uric acid levels of patients who did not need intensive care or who lived (p=0.665 and p=0.241, respectively). Oxygen need, intensive care need, and low uric acid level were found to be associated with increased length of hospital stay (p=0.00, p=0.001, p=0.012, and r=-0.276, respectively). Our study results suggest that uric acid levels may be associated with disease severity in the course of COVID-19.
THE PREVALENCE OF ORTHOREXIA NERVOSA AMONG GYM PARTICIPANTS FROM CROATIA: AN OBSERVATIONAL STUDY.
Ružman E, Žaja O, Karuza J … +1 more , Banjari I
Acta Clin Croat · 2024 Oct · PMID 40104238 · Full text
Orthorexia nervosa (ON) is pathological obsession and preoccupation with 'healthy' and 'clean' eating, which is more pronounced in specific population groups such as fitness enthusiasts. The aim of this observational stu...
Orthorexia nervosa (ON) is pathological obsession and preoccupation with 'healthy' and 'clean' eating, which is more pronounced in specific population groups such as fitness enthusiasts. The aim of this observational study was to determine the prevalence and characteristics of ON symptoms among gym attendees in Croatia based on ORTHO-15 questionnaire. A number of individual characteristics were considered too, from eating habits, anthropometry, personality traits, psychophysical state, to the presence of irritable bowel syndrome symptoms. Out of 126 participants who completed the questionnaire, 99 were analyzed (female 68.7% and male 31.3%, median age 24 years). Based on the traditional criterion (ORTHO-15 score <40), the prevalence of ON was 77.8% and 33.3% according to the modified criterion (ORTHO-15 <35). Women were two times more likely to have high ON tendency in comparison to men (39.7% . 19.4%, p=0.037). Participants with high ON tendency avoided a wide variety of foods, especially sugar, processed food and gluten, and did not skip meals. There were no significant differences in orthorexic tendencies according to nutritional status, personality traits, psychophysical state, or irritable bowel symptoms. For gym attendees in Croatia, being a woman and dietary restrictions were identified as independent risk factors for ON.
ORAL HEALTH STATUS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE.
Doder F, Vranić L, Šimunović L
Acta Clin Croat · 2024 Oct · PMID 40104237 · Full text
The aim is to point to oral health status in patients suffering from chronic obstructive pulmonary disease (COPD). The study included 106 patients diagnosed with COPD who were treated at the Special Hospital for Pulmonar...
The aim is to point to oral health status in patients suffering from chronic obstructive pulmonary disease (COPD). The study included 106 patients diagnosed with COPD who were treated at the Special Hospital for Pulmonary Diseases, Zagreb, Croatia. The World Health Organization questionnaire for oral health in adults was used as a validated measure to assess oral health. Results were compared based on the severity of the disease according to the GOLD classification, long term oxygen therapy, and their smoking habits. Most patients (61.3%) had less than 10 teeth. Also, 82.2% of the patients had problems with their oral health in the previous year. More than half of the patients (55.7%) ranked the status of their oral cavity and teeth as average or worse, whereas 58.5% of the patients ranked their gingival status as good or better. Also, 55.7% of the patients brushed their teeth once a day or less, which was more pronounced in men. The same percentage of the patients did not know whether their toothpaste contained fluoride. Sixty-seven percent of the patients were former smokers, while the rest were active smokers. Smokers reported more frequent feeling of shame and tension because of the appearance of their teeth in relation to non-smokers. Patients with advanced stages of COPD are more likely to report problems with eating and chewing food compared to patients with less advanced stages of the disease. According to the results, further systematic education of COPD patients is crucial in promoting the importance of oral health.
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