Acta Clinica Croatica[JOURNAL]
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200 papers
VEIN OF GALEN ANEURYSMAL MALFORMATION IN A NEONATE.
Banjac L, Banjac B
Acta Clin Croat · 2024 Apr · PMID 39959313 · Full text
In this article, we present a neonate with the vein of Galen aneurysmal malformation, a rare blood vessel malformation of the brain, which was clinically manifested by signs of cardiac failure. Cranial ultrasound suspect...
In this article, we present a neonate with the vein of Galen aneurysmal malformation, a rare blood vessel malformation of the brain, which was clinically manifested by signs of cardiac failure. Cranial ultrasound suspected the existence of the vein of Galen aneurysmal malformation, and the diagnosis was confirmed by computed tomography and magnetic resonance imaging. Based on our case, we believe that cranial ultrasound should be included in the screening protocol for neonates with cardiac failure. In addition, we believe that endovascular embolization of the blood vessels that supply the aneurysm is the method of choice in treating the vein of Galen aneurysmal malformation. Treatment of neonates with the vein of Galen aneurysmal malformation is challenging and requires a multidisciplinary approach (neonatologists, cardiologists, neuroradiologists, and neurosurgeons).
EXPOSURE TO ARSENIC IN DRINKING WATER AND RISK OF BLADDER CANCER.
Srećković M, Backović D, Dugandžija T … +4 more , Dragičević I, Nikolić LP, Mulić M, Damnjanović B
Acta Clin Croat · 2024 Apr · PMID 39959312 · Full text
The municipality of Bogatić, part of Mačva District, belongs to the Pannonian Basin, where high concentrations of arsenic in artesian wells were detected. Numerous epidemiological studies have confirmed the association o...
The municipality of Bogatić, part of Mačva District, belongs to the Pannonian Basin, where high concentrations of arsenic in artesian wells were detected. Numerous epidemiological studies have confirmed the association of exposure to arsenic in drinking water and bladder cancer (C67). This retrospective ten-year analysis included age-standardized incidence rates (ASRs) and age-specific incidence rates of C67 in the municipality of Bogatić and rural municipalities of Mačva District. The concentration of arsenic in drinking water was determined at Šabac Public Health Institute (PHI) laboratories in 2015. ASRs were estimated using data from regional cancer registries at Šabac PHI and compared by use of the Mann-Whitney U test. Control population was recruited from an area where there were no artesian wells or hydrogeological conditions that would indicate elevated concentrations of arsenic in drinking water. Arsenic levels in all artesian wells in Bogatić municipality were 1.4 to 41 times higher than the maximum permissible concentration (mean 120 µg/L±165). Female subjects from Bogatić municipality had higher ASRs of C67 compared with the populations in rural municipalities of Mačva District (p<0.01), while the incidence of bladder cancer was by 13% greater than that in central Serbia (standardized incidence ratio, 113; 95% CI 96.97-131.35). Male subjects from Bogatić municipality had higher ASRs of C67 but the difference was not statistically significant (p>0.05). Our analyses suggested that exposure to arsenic in drinking water could triple the risk of bladder cancer. These results support the conclusions of previous studies that there may be an association between higher concentrations of arsenic in drinking water and higher ASRs of bladder cancer in both male and female subjects.
EVALUATION OF PATIENTS WITH COVID-19 IN THE EARLY HYPOXEMIC STAGE AND PATIENTS WITH VIRAL RESPIRATORY TRACT INFECTION IN TERMS OF PULMONARY HYPERTENSION.
Çınaroğlu S, Karakuş K, Keleş H … +1 more , Kaçmaz M
Acta Clin Croat · 2023 Nov · PMID 39310698 · Full text
Arterial hypoxemia occurs in many COVID-19 patients. Hypoxemia is one of the causes of pulmonary hypertension (PH). Main pulmonary artery dilatation and the main pulmonary artery diameter (mPAD) to ascending aorta diamet...
Arterial hypoxemia occurs in many COVID-19 patients. Hypoxemia is one of the causes of pulmonary hypertension (PH). Main pulmonary artery dilatation and the main pulmonary artery diameter (mPAD) to ascending aorta diameter (AAD) ratio of ≥1 are significant findings regarding PH. In this study, COVID-19 patients and non-COVID-19 patients with viral respiratory tract infection were evaluated retrospectively in terms of PH. A total of 124 patients (71 male and 53 female), age range 18-85 years, were included in the study as case group and control group. Thoracic computed tomography (CT) images, blood and biochemical parameters, and demographic information were compared between the case group and control group. The normality of numerical variables was examined with Kolmogorov-Smirnov test and homogeneity of the variances with Levene's test. This is the first study researching the effect of early hypoxemic stage COVID-19 infection on development of PH. As a result, it was specified that COVID-19 infection had no effects on mPAD, whereas it had a positive effect on AAD and thus led to a decrease in the mPAD/AAD ratio. Through these values, which could be easily calculated from thoracic CT images, the changes caused by COVID-19 infection on vessel diameters were put forward.
ASSOCIATION BETWEEN ALLERGIC REACTIONS AND LIP INFLAMMATORY LESIONS (CHEILITIS).
Blagec T, Crnarić I, Homolak D … +3 more , Pondeljak N, Buljan M, Lugović-Mihić L
Acta Clin Croat · 2023 Nov · PMID 39310697 · Full text
The purpose of this study was to examine the possible association between cheilitis and allergic reactions, and to use allergy skin tests to identify the allergens that induce allergic reactions in cheilitis patients (ty...
The purpose of this study was to examine the possible association between cheilitis and allergic reactions, and to use allergy skin tests to identify the allergens that induce allergic reactions in cheilitis patients (type I and type IV). We included 50 patients with recurrent cheilitis (reversible cheilitis) who were dermatologically examined and agreed to undergo allergy skin tests, i.e., patch test and prick test. Additionally, clinical pictures and patient mental stress levels were examined using the Perceived Stress Scale (PSS). Positive prick tests (atopy) were recorded in 84% of patients with cheilitis. The most frequently found allergens were contact allergens (54%) (cobalt chloride, nickel sulfate and thimerosal) and inhalant allergens (46%). The patch test positive subjects who used cosmetic, hygiene, and decorative products were significantly more likely to have swollen and red lips than the patch test negative subjects. Also, low stress levels were recorded less frequently in patients with confirmed allergies than in non-allergic patients. The results indicated a higher incidence of cheilitis in the people prone to allergies (atopics) and confirmed an association between cheilitis and allergies. To our knowledge, this is the first study in patients with cheilitis, which simultaneously analyzed allergies, their clinical features and PSS in the same patients.
ACUTE PAINFUL THYROIDITIS AND THYROTOXICOSIS AFTER PCI - A CASE STUDY.
Kurtić E, Premužić Meštrović I, Marković M … +4 more , Roso V, Obadić V, Stipinović M, Letilović T
Acta Clin Croat · 2023 Nov · PMID 39310696 · Full text
Destructive thyroiditis is a self-limited disease characterized by acute release of preformed thyroid hormones. We present a patient with extremely rare acute painful thyroiditis after percutaneous coronary intervention...
Destructive thyroiditis is a self-limited disease characterized by acute release of preformed thyroid hormones. We present a patient with extremely rare acute painful thyroiditis after percutaneous coronary intervention (PCI) in acute myocardial infarction without ST-elevation. The acute onset of thyroid pain and increase of fT3, fT4 and parameters of inflammation were compatible with acute destructive thyroiditis. Such acute thyroiditis probably resulted from local inflammation induced by a large amount of iodine given to the patient iodinated contrast media used during PCI. Because of the increasing number of patients referred to cardiac catheterization, invasive cardiologists should be aware of the potentially serious thyroid dysfunction that can result from iodinated contrast use. The aim of our paper is, in the light of the patient presented, to discuss the pathophysiology, clinical presentations, therapy and potential preventive measures in patients that develop thyroid dysfunction after PCI.
THE ROLE OF INTERFERON-GAMMA RELEASE ASSAYS IN DIAGNOSIS OF LATENT TUBERCULOSIS INFECTION IN CHILDREN.
Šegović M, Mihatov Štefanović I, Pavić I
Acta Clin Croat · 2023 Nov · PMID 39310695 · Full text
Despite numerous published papers, diagnosis of latent tuberculosis infection (LTBI) in children is still an undefined area. The importance of this topic lies in the fact that one third of the world's population is infec...
Despite numerous published papers, diagnosis of latent tuberculosis infection (LTBI) in children is still an undefined area. The importance of this topic lies in the fact that one third of the world's population is infected with . The majority of infected individuals are LTBI cases which make a reservoir for future active tuberculosis (TB) patients. The gold standard for LTBI detection is still undetermined and this is due to the effect of various confounding factors on existing diagnostic tests. Until a decade or so ago, throughout the last century, tuberculin skin test (TST) was the only diagnostic test for LTBI. Due to scientific advances, new assays, interferon-gamma release assays (IGRAs) were discovered recently. The sensitivities of IGRAs are a bit better than those of TST, while great progress has been made in increasing the specificity of IGRA relative to TST. Nevertheless, in the diagnosis of LTBI in children, TST still has some advantages. However, generations of IGRAs have brought many diagnostic advantages that are emphasized in this review. In a difficult procedure of diagnosing LTBI in children, performance of IGRA could be the key factor in making decision whether to use preventive therapy or not.
ISOLATED ABDUCENS NERVE PALSY AFTER LUMBAR PUNCTURE - A CASE REPORT.
Grbić N, Zavoreo I, Bašić Kes V
Acta Clin Croat · 2023 Nov · PMID 39310694 · Full text
Isolated abducens nerve palsy following lumbar puncture is a rare complication. In scientific literature, it has been mostly described after performing spinal anesthesia in anesthesiology literature rather than in neurol...
Isolated abducens nerve palsy following lumbar puncture is a rare complication. In scientific literature, it has been mostly described after performing spinal anesthesia in anesthesiology literature rather than in neurological literature. Isolated abducens nerve palsy usually occurs from one to three weeks after performing lumbar puncture and it is important to connect it with this procedure and exclude other possible etiologies. The actual incidence of this complication is unknown. We describe a 32-year-old male patient who presented with unspecific headache attributed to cavernous malformation and two developmental venous anomalies. While searching for headache etiology, lumbar puncture was performed. Two days after lumbar puncture, the patient presented with isolated abducens palsy of the right eye. Our planned diagnostic evaluation included measuring intracranial pressure by noninvasive optic sheath nerve sonography and repeating brain magnetic resonance imaging. We also planned to treat the patient with epidural blood patch, which is usually successful when performed as soon as the diagnosis is established. Unfortunately, our patient refused diagnostic and therapeutic proposal, so it was impossible to know final outcome. In conclusion, we want to highlight these complications, especially to young doctors and specialists who might see it rarely.
PHARMACOVIGILANCE IN SERBIA: A TEN-YEAR PHARMACOEPIDEMIOLOGIC ANALYSIS.
Živanović D, Mijatović Jovin V, Javorac J … +6 more , Samojlik I, Rašković A, Jevtić M, Stojkov S, Jovanović Lješković N, Perković Vukčević N
Acta Clin Croat · 2023 Nov · PMID 39310693 · Full text
Pharmacovigilance as a science and group of activities related to detection, collection, analysis, understanding and prevention of adverse drug reactions (ADRs) is an essential activity in the regulatory system of drugs...
Pharmacovigilance as a science and group of activities related to detection, collection, analysis, understanding and prevention of adverse drug reactions (ADRs) is an essential activity in the regulatory system of drugs of any country. Defining increased patient safety as the main purpose of ADR reporting, a well-designed national pharmacovigilance system achieves its ultimate goal, i.e., protection of public health. In organizational and technical terms, the Republic of Serbia has a well-developed system of pharmacovigilance, created on the basis of a proven reliable system of the former SFR Yugoslavia, and carried out by the National Agency for Medicines and Medical Devices of Serbia (ALIMS), which conducts all organized activities aimed at strengthening the national system of ADR monitoring and reporting. Unlike the neighboring Croatia and Montenegro with similar pharmacovigilance systems, Serbia has only recently approached the WHO standard of 200 reports million inhabitants despite a significant increase of 180 ADR reports million inhabitants in 2019 (1251 in total). Considering this, our study aimed to provide a critical insight into the practice of pharmacovigilance in Serbia by pharmacoepidemiologic analysis of a ten-year period of ADR monitoring and reporting activities.
ANALYSIS OF TIME, PLACE AND METHOD OF SUICIDE IN THE AREA OF BJELOVAR-BILOGORA COUNTY IN THE 1988-2017 PERIOD.
Jelašić I, Čatipović V
Acta Clin Croat · 2023 Nov · PMID 39310692 · Full text
The aim of the study was to analyze changes in the number of suicides associated with seasonal variables, calendar month, time of day variable location and method of suicide. Data were obtained from the Analytical Polic...
The aim of the study was to analyze changes in the number of suicides associated with seasonal variables, calendar month, time of day variable location and method of suicide. Data were obtained from the Analytical Police Department of Bjelovar-Bilogora County for the 1988-2017 period. The process of Croatian application process into the European Union, accompanied by economic and social changes, was a significant socioeconomic event, which divided the analyzed period into two parts. Significant changes in the impact of the analyzed variables on the suicides committed in the two observed periods were tested with the χ-test and Fisher exact test. Consistency of the results, as well as absence of the impact of significant changes would show less susceptibility of the covariate variable to the effect of socioeconomic factors. In the case of time of day and location of the suicides, there was no significant difference when comparing results between the 1988-2004 and 2005-2017 periods; however, a statistically significant difference was confirmed when considering the month of suicide (February) and season (winter, borderline result for autumn). Statistically, the most significant changes were found in the methods of suicide. The two observed periods differed in the mean suicide rate.
PLANNING TO 'NEW NORMAL' DURING COVID-19 PANDEMIC AT GENERAL SURGERY DEPARTMENT: A TURKEY EXPERIENCE.
Ekici MF, Yıldırım AC, Zeren S … +3 more , Yaylak F, Arık Ö, Algın MC
Acta Clin Croat · 2023 Nov · PMID 39310691 · Full text
Planning of non-postponable treatments for cancer, trauma, emergency diseases, and follow-up and treatment of chronic diseases are inevitable for the ongoing pandemic and future pandemics. In this study, we evaluated the...
Planning of non-postponable treatments for cancer, trauma, emergency diseases, and follow-up and treatment of chronic diseases are inevitable for the ongoing pandemic and future pandemics. In this study, we evaluated the capacity of surgical applications and treatments made to the surgery department in the first 3 months of the onset of the COVID-19 pandemic. A retrospective cohort study was performed from March 12, 2020 to June 1, 2020. COVID-19 negative general surgery patients were included. Demographics, diagnosis and management were recorded, as well as bed turnover and length of stay in the hospital. Similar data were collected on patients admitted during the same period in 2019 and 2018 to allow for comparison. A total of 1764 operations were included. There was a reduction in surgeries when comparing 2020 with 2019 and 2018 (164 713 and 890); however, there was no difference in the length of stay in the hospital (4.12 4.37 and 4.07 days, p=0.626). During 2020, appendectomies decreased (53 102 and 100, p=0.013). There was no difference in the number of emergency oncologic surgeries during 2020 as compared with 2019 and 2018 (16 8 and 13, p=0.149). In conclusion, COVID-19 significantly impacted the number of admissions to general surgery. However, cancer and emergency operations continued to be required, thus provisions need to be made to enable planning these interventions.
ALTERNATING HYPOTHYROIDISM AND HYPERTHYROIDISM IN AN ADOLESCENT BOY - DO WE ALWAYS UNDERSTAND WHAT DRIVES THE SWITCH?
La Grasta Sabolić L, Požgaj Šepec M, Stipančić G
Acta Clin Croat · 2023 Nov · PMID 39310690 · Full text
Alternating hypothyroidism and hyperthyroidism is a rare phenomenon, especially among pediatric patients. It is usually related to simultaneous, unbalanced presence of stimulating and blocking thyroid stimulating hormone...
Alternating hypothyroidism and hyperthyroidism is a rare phenomenon, especially among pediatric patients. It is usually related to simultaneous, unbalanced presence of stimulating and blocking thyroid stimulating hormone receptor antibodies (TRAbs). Herein we describe thyroid stimulating hormone (TSH) and thyroid hormone fluctuations in an adolescent boy with negative TRAbs. A 12-year-old healthy boy exhibited alternating thyroid function, with several switches between hypothyroidism and hyperthyroidism during almost six years of follow-up. He had persistently elevated thyroid peroxidase antibodies, while TRAbs were repetitively negative. Due to a mild clinical presentation, most of the time he did not require any medication. This case contributes to the spectrum of alternating hypothyroidism and hyperthyroidism in the pediatric age and raises the question of mechanisms involved in fluctuating thyroid function. Therapeutic decisions should be individualized and guided by clinical manifestations and thyroid function tests, irrespective of the underlying pathophysiology.
GLUCOSE AND SODIUM LEVELS AS DISEASE OUTCOME PREDICTORS IN CRITICALLY ILL PATIENTS.
Dragila Ž, Dorokazi A, Mihić D … +3 more , Loinjak D, Šram M, Bačun T
Acta Clin Croat · 2023 Nov · PMID 39310689 · Full text
The main aim of this study was to examine the association of glucose and sodium level with diagnosis and disease outcome of critically ill patients. Glucose and sodium concentrations of 283 patients admitted in critical...
The main aim of this study was to examine the association of glucose and sodium level with diagnosis and disease outcome of critically ill patients. Glucose and sodium concentrations of 283 patients admitted in critical condition to the Intensive Care Unit of the Department of Internal Medicine in a period from November 1, 2015 to February 28, 2017 were reviewed. The most common diagnoses in critically ill patients were acute kidney injury (26.1%) and sepsis (including septic shock, 22.3%). Significantly lower glucose concentration was observed in patients with acute kidney injury (p=0.02), whereas patients in sepsis and septic shock had a significantly higher sodium concentration (p=0.04). Higher glucose level was related to higher mortality rate (p=0.001). On the other hand, sodium level was not significantly associated with survival. Higher mortality, as well as higher glucose concentration were more common in patients older than 65 years (p<0.001). Study results showed significantly lower glucose concentrations in patients with acute kidney injury, whereas in patients older than 65, glucose concentration was significantly higher. Patients in sepsis and septic shock had significantly higher sodium concentrations. Higher concentration of glucose was connected with higher mortality in the elderly, whereas sodium concentration did not show connection with mortality.
THE EFFECT OF EDUCATION AND EMPLOYMENT ON SEXUAL ACTIVITY AFTER CHILDBIRTH.
Potkonjak AM, Vraneš H, Djaković I … +1 more , Soljačić Vraneš H
Acta Clin Croat · 2023 Nov · PMID 39310688 · Full text
The aim of the study was to explore the relationship between educational level, employment status and sexual activity after delivery. The study was conducted on 286 women with experience of vaginal delivery who completed...
The aim of the study was to explore the relationship between educational level, employment status and sexual activity after delivery. The study was conducted on 286 women with experience of vaginal delivery who completed the questionnaire about age, education, employment, and health status for themselves and partners. Time of the first intercourse and its frequency in the first year after childbirth was observed. Relationship between the variables observed was explored by using multiple linear regression. The mean pregnancy duration was 39 weeks. The mean age of participants was 29.9 (16 to 44) years. Most women had high education (n=170, 59.4%), 114 (39.9%) had secondary, and 2 (0.7%) had primary educational level. Although there were significant differences in the time of the first intercourse and maternal educational level (p=0.013872), partner's employment status (p=0.007403) and maternal age (p= 0.01107), as well as differences in the frequency of intercourse in the first year following delivery and partner's educational level (p=0.016929), multiple correlation coefficients indicated a very weak correlation. According to study results, the correlation of educational level, employment status and sexual activity after childbirth is weak.
DOES THE PRESENCE OF CHRONIC LYMPHOCYTIC THYROIDITIS AFFECT DIAGNOSTIC VALUE OF FINE NEEDLE ASPIRATION BIOPSY IN BETHESDA CATEGORY III NODULES?
Pedük Ş, Koçer B
Acta Clin Croat · 2023 Nov · PMID 39310687 · Full text
This study aimed to determine the relationship between the presence of Hashimoto's thyroiditis (HT) and malignancy rates with prognostic factors in thyroid nodules diagnosed as Bethesda category III, and to examine the e...
This study aimed to determine the relationship between the presence of Hashimoto's thyroiditis (HT) and malignancy rates with prognostic factors in thyroid nodules diagnosed as Bethesda category III, and to examine the effect of HT on diagnostic value of fine-needle aspiration biopsy (FNAB). Demographic information, preoperative examination, and final pathological evaluation of patients with Bethesda category III (AUS-FLUS) nodules who had been operated on in our department over the last 6 years were analyzed. Statistical analyses were performed using the Student's t-test, Mann-Whitney U test and χ-test and logistic regression analysis using SPSS version 22 software. The malignancy rate on final pathology of 159 patients was 24.5%. Malignancy rates were found to be higher in patients with HT coexistence (30.7% 21.5%, p=0.20). Poor prognostic factors such as multifocality, number of metastatic lymph nodes (p=0.04), and extrathyroidal extension were more common in patients with cancer in the pathology specimen who were in the non-HT group. It cannot be said that HT decreases diagnostic value of FNAB in lesions diagnosed with AUS-FLUS. The lower incidence of poor prognostic factors in the HT group may be attributed to cytotoxic cell dominance in tumor immunity.
STUDY HYPOTHESIS: AGE, GENDER, PRESENCE OF DIABETES MELLITUS OR HYPERTENSION, AND ANTI-HYPERTENSIVE DRUGS ARE INDEPENDENT RISK FACTORS FOR COVID-19 MORTALITY.
Karandere F, Kocoglu H, Korkusuz R … +3 more , Erismis B, Hursitoglu M, Kart KY
Acta Clin Croat · 2023 Nov · PMID 39310686 · Full text
We aimed to investigate the effects of comorbid diseases and antihypertensive drugs on the clinical outcome of hospitalized patients with COVID-19 infection. A total of 1045 patients whose data could be gathered and conf...
We aimed to investigate the effects of comorbid diseases and antihypertensive drugs on the clinical outcome of hospitalized patients with COVID-19 infection. A total of 1045 patients whose data could be gathered and confirmed from both hospital files and Turkish National Health Network records were retrospectively screened, and 264 of 1045 patients were excluded because of having more than one comorbid disease. The study population consisted of a total of 781 patients, of which 482 had no comorbid disease, while the remaining 299 patients had only one comorbid disease. The mortality risk was 7.532 times higher in those over 65 years of age compared to cases younger than 30 years (OR: 7.532; 95% CI: 1.733-32.730); the risk of mortality in men was 2.131 times higher than in women (OR: 2.131; 95% CI: 1.230-3.693); and presence of diabetes mellitus (DM) increased mortality risk 2.784 times (OR: 2.784; 95% CI: 1.288-6.019). While hypertension was not found to be an independent risk factor for COVID-19 mortality, age, gender, and presence of DM were independent risk factors for COVID-19 mortality. There was no association between antihypertensive drugs and mortality. Accordingly, age (>65 years), gender (male), and presence of DM were independent risk factors for COVID-19 mortality, whereas hypertension and use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and their combinations with other antihypertensive drugs were not risk factors for COVID-19 mortality.
BIOFILM AND HISTOPATHOLOGICAL GRADING OF MAXILLARY SINUS MUCOSA IN PATIENTS WITH ANTROCHOANAL POLYPS.
Poje G, Bilić M, Dawidowsky K … +1 more , Kovač Bilić L
Acta Clin Croat · 2023 Nov · PMID 39310685 · Full text
The aim of this cross-sectional study was to determine the signs of biofilm in the maxillary sinus of patients with antrochoanal polyps (ACP), and status of the mucosa on which the biofilm occurred. Mucosal samples from...
The aim of this cross-sectional study was to determine the signs of biofilm in the maxillary sinus of patients with antrochoanal polyps (ACP), and status of the mucosa on which the biofilm occurred. Mucosal samples from maxillary sinus in 40 ACP patients who underwent endoscopic sinus surgery were analyzed histopathologically and by scanning electron microscopy. Results were compared with maxillary mucosa samples of 40 patients without endoscopic and radiological signs of sinus disease. The existence of biofilm and its relation to the degree of histopathological changes according to Terrier classification of chronic mucosal inflammation of maxillary sinus were statistically analyzed. Biofilm was detected in 23 of 40 (57.5%) ACP patients; the incidence was significantly lower in the control group (2/40, 5%). Biofilm was not found in type 1 mucosa according to Terrier classification. In conclusion, biofilm showed a significant incidence in the maxillary sinus mucosa of ACP patients (57.5%). Occasionally, biofilm can be found in patients with no signs of sinus disease, but not on histologically normal mucosa. Results of this study support the theory that biofilm formation does not represent the initial stage of the inflammatory process.
CLINICAL AND SURGICAL CHARACTERISTICS OF POSTERIOR FOSSA TUMORS IN ADULTS - SINGLE-CENTER EXPERIENCE OF SURGICAL MANAGEMENT.
Janković D, Ahmetspahić A, Splavski B … +4 more , Schmidt L, Rotim K, Tomasović S, Arnautović K
Acta Clin Croat · 2023 Nov · PMID 39310684 · Full text
In contrast to tumors in children, between 6% and 20% of all brain tumors in adults arise solitary in the posterior cranial fossa. Given their rarity in adults, as well as the importance and complexity of their treatment...
In contrast to tumors in children, between 6% and 20% of all brain tumors in adults arise solitary in the posterior cranial fossa. Given their rarity in adults, as well as the importance and complexity of their treatment, this paper reviews and discusses the clinical and surgical characteristics of such tumors. In a retrospective single-institution observational study, adult patients with posterior fossa tumors treated surgically over a ten-year period were analyzed. The characteristics observed were age and gender distribution, clinical symptoms, histopathologic tumor type, tumor size, location and extent of surgical resection, tumor recurrence and postoperative complications, as well as surgical outcome. Sixty-six patients who underwent surgical treatment were diagnosed with a tumor in the posterior fossa. The mean age was 63 years, and patients were evenly distributed by gender. The most common histopathologic type was metastatic tumor (59.1%), whereas meningioma was the most common primary brain tumor (16.6%) recorded. Most patients presented with vegetative and cerebellar symptoms in general and cranial nerve palsy, especially in the occurrence of vestibular schwannoma. In conclusion, posterior fossa tumors grow in a confined space and therefore may directly threaten vital centers in their immediate vicinity. Thus, it is crucial to schedule an appropriate surgical intervention as soon as possible, as it can significantly improve treatment outcome and prognosis of the disease. If possible, meticulous total tumor resection should be the treatment of choice. In the case of hydrocephalus, a ventriculoperitoneal shunt should be considered as an alternative surgical option after tumor resection.
ANAL CANCER IN A RENAL TRANSPLANT RECIPIENT: A CASE REPORT AND LITERATURE REVIEW.
Mokos M, Ćorić M, Silovski H … +1 more , Bašić-Jukić N
Acta Clin Croat · 2023 Nov · PMID 39310683 · Full text
Anal carcinoma is a rare tumor in the general population accounting for 1%-2% of all malignancies. Most anal cancers are squamous cell carcinomas. Human papillomavirus and immunosuppression are the main risk factors for...
Anal carcinoma is a rare tumor in the general population accounting for 1%-2% of all malignancies. Most anal cancers are squamous cell carcinomas. Human papillomavirus and immunosuppression are the main risk factors for developing anal squamous cell carcinoma. Therefore, the incidence rate of anal squamous cell carcinoma is significantly higher in renal transplant recipients than in the general population. We present a patient who developed anal cancer nine years after renal transplantation. Since there was a significant diagnostic delay in our patient, we would like to emphasize the importance of regular screening for anal cancer in renal transplant recipients.
VALIDATION OF THE QUALITY OF RECOVERY-40 QUESTIONNAIRE ADAPTED FOR CROATIAN POPULATION.
Sulen N, Šimurina T, Milošević M … +2 more , Župčić M, Mraović B
Acta Clin Croat · 2023 Nov · PMID 39310682 · Full text
Quality of recovery after anesthesia is an important indicator of patient postoperative outcomes. Quality of Recovery-40 (QoR-40) is a validated and widely used multidimensional 40-item questionnaire that measures postop...
Quality of recovery after anesthesia is an important indicator of patient postoperative outcomes. Quality of Recovery-40 (QoR-40) is a validated and widely used multidimensional 40-item questionnaire that measures postoperative quality of recovery. The aim of this study was to perform translation and psychometric validation of the Croatian version of QoR-40, which included validity, reliability, responsiveness, and clinical acceptability. The QoR-40 and Short Form-36 (SF-36) questionnaires were administered to patients undergoing general anesthesia for elective surgery on the day before surgery and on postoperative day 3. The quality of recovery was also assessed with visual analog scale (VAS) 0-100. Of 192 enrolled patients, 162 completed the study protocol. Convergent validity assessed by Pearson correlation (r) between the QoR-40 and VAS scores was 0.68 (p<0.001). There were moderate correlations of QoR-40 with SF-36 Physical component scale (r=0.521; p<0.001) and with SF-36 Mental component scale (r=0.580; p<0.001). Construct validity was supported by negative correlation with the length of hospital stay (r=-0.21; p=0.007) and significant difference in total postoperative QoR-40 scores between patients with and without postoperative complications (p<0.001). Internal consistency of the global QoR-40 was high (Cronbach's α=0.93) and of the QoR-40 dimensions it was moderate to high (≥0.714). Split-half coefficient was 0.87, Cohen's effect size was 0.81, and standardized response mean was 0.762. Our translated QoR-40 is a valid, reliable and comprehensive questionnaire for measuring quality of postoperative recovery across surgery spectrum in Croatian population with psychometric properties similar to the original version.
DOES GALLIC ACID HAVE A POTENTIAL REMEDIAL EFFECT IN EXPERIMENTAL CORROSIVE BURN INJURY TO THE ESOPHAGUS?
Basuguy E, Ozkorkmaz EG
Acta Clin Croat · 2023 Nov · PMID 39310681 · Full text
Gallic acid, acting as an antioxidant, anti-precipitant and cytoprotective agent, was used as a possible remedial natural component for treating experimentally induced esophageal burn. Wistar rats (n=24) were divided int...
Gallic acid, acting as an antioxidant, anti-precipitant and cytoprotective agent, was used as a possible remedial natural component for treating experimentally induced esophageal burn. Wistar rats (n=24) were divided into three groups. Control group was given 1 mL 0.9% NaCl. Experimental esophageal burn was induced with 1 mL 40% NaOH application to the esophagus in groups 2 and 3. Gallic acid® (20 mg/kg) was administered to the treated group oral gavage for 10 days. Removed tissues were fixed and paraffin blocks were prepared. Histopathological examination was performed after the sections had been stained with hematoxylin-eosin. Tumor necrosis factor alpha and caspase-3 antibodies were used on immunohistochemical analysis. In the esophageal burn group, necrosis, degeneration and numerous apoptotic cells, as well as intense inflammatory cell infiltration and fibrosis in the muscle layer were observed under light microscope. In the treated group, remodeling of epithelial cells with marked reduction in the connective tissue collagen content was observed, as well as marked reduction in the volume of collagen and abundance of inflammatory cells in blood vessels. Gallic acid treatment may help heal esophageal burns and prevent complications.
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