Croatian Medical Journal最新文献_第6页

Post-COVID lung injury and the need for longitudinal histology. 新冠肺炎后肺损伤与纵向组织学研究的必要性

IF 2.3 4区医学

Croatian Medical Journal Pub Date : 2026-01-05

Barina Khan

引用次数: 0

Pharmacogenomics in the prediction of adverse effects of cardiovascular drugs: the PGx-CardioDrug project. 药物基因组学在心血管药物不良反应预测中的应用：PGx-CardioDrug项目。

IF 2.3 4区医学

Croatian Medical Journal Pub Date : 2026-01-05

Tamara Božina, Lana Ganoci, Livija Šimičević, Majda Vrkić Kirhmajer, Iva Mucalo, Jure Samardžić, Jozefina Palić, Ana Marija Slišković, Vladimir Trkulja

{"title":"Pharmacogenomics in the prediction of adverse effects of cardiovascular drugs: the PGx-CardioDrug project.","authors":"Tamara Božina, Lana Ganoci, Livija Šimičević, Majda Vrkić Kirhmajer, Iva Mucalo, Jure Samardžić, Jozefina Palić, Ana Marija Slišković, Vladimir Trkulja","doi":"","DOIUrl":"","url":null,"abstract":"Although the role of pharmacogenomics (PGx) in personalized pharmacotherapy has been well established, its implementation in clinical practice lags behind. In this article, we present an overview of important achievements in the field of PGx of cardiovascular drugs (CVDs), and identify gaps in the existing research. We also present an outline of the PGx-CardioDrug project (ClinicalTrials.gov: NCT05307718) focused on PGx of three major classes of CVDs: P2Y12 antiplatelets, direct oral anticoagulants (DOACs), and statins. The project intends to evaluate pharmacogenes, concomitant treatments, and their combinations as determinants of adverse drug reactions (ADRs). It is based on a pool of around 1200 consecutive adults who were accrued on the case-control principle defined with respect to the CVDs and ADRs of interest (bleeding related to antiplatelets and DOACs, skeletal muscle or liver toxicity related to statins, inefficiency). Possible perpetrator or victim roles of concomitantly used drugs are assessed using the Lexicomp® Clinical Decision Support System. The assembled data provide a basis for a series of case-control type analyses. Considering the mode of data generation and the nature of the exposures of interest (ie, present before the occurrence of the outcome), potentially observed outcome-exposure associations are likely to be causal, provided that confounding is reasonably controlled. The project enables the development of methods and procedures that better reflect the real-life situation of patients with comorbidities and polytherapy, and might better predict the interactions of multiple drugs and genes that affect the frequency and severity of CVD ADRs.","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 6","pages":"446-455"},"PeriodicalIF":2.3,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12836012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploring pain conceptualization in relation to outcomes in patients with chronic low back pain: a prospective observational study. 探讨疼痛概念化与慢性腰痛患者预后的关系：一项前瞻性观察研究。

IF 2.3 4区医学

Croatian Medical Journal Pub Date : 2026-01-05

Iva Lončarić Kelečić, Snježana Schuster

{"title":"Exploring pain conceptualization in relation to outcomes in patients with chronic low back pain: a prospective observational study.","authors":"Iva Lončarić Kelečić, Snježana Schuster","doi":"","DOIUrl":"","url":null,"abstract":"Aim: To examine the relationship between pain conceptualization and treatment outcomes in patients with chronic nonspecific low back pain (CNSLBP) undergoing physiotherapy, and to explore the influence of educational attainment on pain conceptualization.Methods: This prospective observational study enrolled 84 adults (mean age ≈50 years) receiving exercise-based physiotherapy for CNSLBP in an outpatient setting. Outcome measures included pain intensity (Numeric Pain Rating Scale), disability (Roland-Morris Disability Questionnaire), and health-related quality of life (EQ-5D-5L index and EQ-VAS), assessed before and after treatment. Pain conceptualization was measured with the Croatian version of the Concept of Pain Inventory for Adults (COPI-Adult).Results: Significant post-treatment improvements were observed in pain (-2.41), disability (-5.27), EQ-5D-5L index (+0.128), and EQ-VAS (+13.79) (all P<0.001). Higher COPI-Adult scores were weakly and negatively correlated with pain (r = -0.273, P = 0.012) and disability (r = -0.259, P = 0.018), and positively with HRQoL (EQ-5D-5L: r = 0.295; EQ-VAS: r = 0.323). However, pain conceptualization did not significantly moderate the magnitude of outcome changes (all interaction effects P > 0.005). Participants with higher education scored significantly higher on COPI-Adult (P = 0.014; d = 0.55).Conclusions: While pain conceptualization is associated with post-treatment pain, disability, and HRQoL outcomes, it does not predict the degree of improvement after physiotherapy. Educational attainment influences pain conceptualization, which indicates a need for tailored communication strategies in rehabilitation. The Croatian COPI-Adult is a reliable tool for assessing patients' concepts of pain within CNSLBP care.","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 6","pages":"406-418"},"PeriodicalIF":2.3,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12836000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Can medical assistants help improve family medicine practices in Croatia? 医疗助理可以帮助改善克罗地亚的家庭医疗实践吗？

IF 2.1 4区医学

Croatian Medical Journal Pub Date : 2026-01-05

Drago Baković, Vanja Pintarić Japec, Anita Struški, Ino Protrka, Juraj Jug

{"title":"Can medical assistants help improve family medicine practices in Croatia?","authors":"Drago Baković, Vanja Pintarić Japec, Anita Struški, Ino Protrka, Juraj Jug","doi":"","DOIUrl":"","url":null,"abstract":"Aim: To evaluate whether adding a medical assistant (MA) during team substitutions improves workload, access to care, preventive activities, and staff-reported working conditions in Zagreb family medicine practices.Methods: This case-control study involved 60 family medicine practices: 30 with an integrated MA during summer vacation team substitutions and 30 controls. Patient contacts, task distribution, and health care professionals' feedback were assessed. The MAs involved were medical or nursing students in their final years, who undertook non-medical tasks under supervision by health care staff.Results: Teams with an MA demonstrated a significant 10.55% increase in total patient contacts, responded to significantly more patient emails and phone calls, and performed significantly more preventive and chronic disease panels. Furthermore, MAs in these teams resolved up to 39% of consultations without the need for patients to directly contact health personnel. Healthcare professionals in these teams reported improved job satisfaction, reduced work-related stress, and better overall working conditions than the control group.Conclusion: Integrating an MA during team substitutions is a promising strategy for enhancing operational efficiency and improving health care standards in family medicine practices. MAs have the potential to address administrative challenges and promote patient-centered care.","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 6","pages":"429-435"},"PeriodicalIF":2.1,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of miR-145, miR-200c, and miR-21 in distinguishing between hyperplastic and adenomatous colon polyps and colorectal cancer prediction. miR-145、miR-200c和miR-21在区分增生性和腺瘤性结肠息肉以及预测结直肠癌中的作用

IF 2.3 4区医学

Croatian Medical Journal Pub Date : 2025-10-31

Esra Guzel Tanoglu, Alpaslan Tanoglu, Samet Ebinc, Ismail Yılmaz, Muhammed Fevzi Esen

{"title":"The role of miR-145, miR-200c, and miR-21 in distinguishing between hyperplastic and adenomatous colon polyps and colorectal cancer prediction.","authors":"Esra Guzel Tanoglu, Alpaslan Tanoglu, Samet Ebinc, Ismail Yılmaz, Muhammed Fevzi Esen","doi":"","DOIUrl":"","url":null,"abstract":"Aim: To assess whether miRNA expression can be a biomarker for distinguishing between hyperplastic and adenomatous polyps and colon cancer tissues.Methods: The study involved 40 colon adenocarcinoma (CA) tissue samples, 40 low-grade adenomatous (A) polyps, and 40 hyperplastic (HP) polyps. The samples were formalin-fixed and paraffin-embedded. Quantitative real-time polymerase chain reactions were used to determine the expression levels of miR-21, miR-200c, and miR-145.Results: miR-145 expression was significantly lower in the CA than in both the A and HP groups (P=0.012 and P=0.004, respectively) and in the A than in the HP group (P=0.028). miR-200c expression was higher in the CA than in the A (P=0.008) and HP groups (P=0.009), while no difference was observed between the A and HP groups (P=0.624). miR-21 showed a stepwise increase across the groups, with the highest levels in the CA, followed by the A and HP groups (P<0.001 for both CA vs A and CA vs HP; P=0.037 for A vs HP).Conclusion: The study revealed dysregulated expression of miR-145 and miR-21 in colon polyps and cancer tissue, showing that these miRNAs may be used to distinguish between hyperplastic and adenomatous polyps and predict colorectal cancer.","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 5","pages":"345-351"},"PeriodicalIF":2.3,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12623251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The misuse of prescription stimulants: between overdiagnosing and malingering. 滥用处方兴奋剂：在过度诊断和装病之间。

IF 2.3 4区医学

Croatian Medical Journal Pub Date : 2025-10-31

Ivana Todorić Laidlaw, Sandra Caratan, Marija Štracak

引用次数: 0

The onset inflammatory parameters and the Cobb angle in adolescent idiopathic scoliosis: a case-control study. 青少年特发性脊柱侧凸的发病炎症参数和Cobb角：一项病例对照研究。

IF 2.3 4区医学

Croatian Medical Journal Pub Date : 2025-10-31

Gülseren Demir Karakılıç, Esra Şahingöz Bakırcı

{"title":"The onset inflammatory parameters and the Cobb angle in adolescent idiopathic scoliosis: a case-control study.","authors":"Gülseren Demir Karakılıç, Esra Şahingöz Bakırcı","doi":"","DOIUrl":"","url":null,"abstract":"Aim: To investigate the association between early inflammatory markers: neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), and C-reactive protein/albumin ratio (CAR) and the Cobb angle in adolescent idiopathic scoliosis (AIS).Methods: This multicenter case-control study (2017-2024) enrolled 419 patients with AIS (Cobb angle >10°) and 381 age- and sex-matched controls (Cobb angle 0°). We collected demographic data, curve characteristics, and laboratory parameters (white blood cells [WBC], NLR, MLR, PLR, and CAR) at the time of initial diagnosis, before treatment initiation or infection. The Cobb angle was measured by two independent radiologists blinded to clinical data.Results: Compared with controls, AIS patients had significantly higher WBC, neutrophil, lymphocyte, and monocyte counts, CRP, NLR, and CAR, and lower platelets, PLR, and calcium levels (all P<0.05). CAR and NLR values increased with greater Cobb angle. In contrast, mean platelet volume did not differ between the groups.Conclusion: This is the first study to evaluate CAR in AIS, demonstrating its significant association with the Cobb angle, alongside NLR and MLR. As inexpensive and readily available markers, CAR and NLR may help in diagnosing AIS, but their role in risk stratification and disease monitoring requires confirmation in future prospective studies.","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 5","pages":"352-359"},"PeriodicalIF":2.3,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12623253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The impact of Croatia's 2013 Primary Care Payment Reform: an exploratory case study of a rural family practitioner group practice. 克罗地亚2013年初级保健支付改革的影响：一个农村家庭医生群体实践的探索性案例研究。

IF 2.3 4区医学

Croatian Medical Journal Pub Date : 2025-10-31

Tatjana Prenđa Trupec, Milena Pavlova, Tetiana Chernysh, Wim Groot

引用次数: 0

The ejaculate obtained on the morning of microdissection testicular sperm extraction (m-TESE) or m-TESE itself in repeated intracytoplasmic sperm injection failure due to severe male infertility? A retrospective study. 是显微解剖睾丸精子提取术（m-TESE）早晨获得的射精，还是重度男性不育症反复胞浆内单精子注射失败的m-TESE本身？回顾性研究。

IF 2.3 4区医学

Croatian Medical Journal Pub Date : 2025-10-31

Sule Atalay Mert, Mustafa Ozturk, Tugba Kinay, Ulaş Fidan, Ozhan Ozdemir, Turgay Ebiloglu, Cem Korkmaz, Seyit Temel Ceyhan

{"title":"The ejaculate obtained on the morning of microdissection testicular sperm extraction (m-TESE) or m-TESE itself in repeated intracytoplasmic sperm injection failure due to severe male infertility? A retrospective study.","authors":"Sule Atalay Mert, Mustafa Ozturk, Tugba Kinay, Ulaş Fidan, Ozhan Ozdemir, Turgay Ebiloglu, Cem Korkmaz, Seyit Temel Ceyhan","doi":"","DOIUrl":"","url":null,"abstract":"Aim: To compare intracytoplasmic sperm injection (ICSI) outcomes between oligoasthenoteratozoospermic (OAT) men with recurrent assisted reproductive technology (ART) failures who underwent ICSI using sperm from the ejaculate on the day of a planned microdissection testicular sperm extraction (m-TESE) vs sperm obtained via m-TESE.Methods: We reviewed the outcomes of men who underwent ICSI using either ejaculate or m-TESE due to OAT and recurrent ART failure at the Department of Reproductive Endocrinology, Gülhane Training and Research Hospital, between November 2016 and January 2024. The study enrolled 172 men: 66 men in the ejaculate group and 106 in the m-TESE group. All patients had fewer sperm parameters in two subsequent semen analyses.Results: The groups did not significantly differ in terms of female (P=0.631) or male (P=0.655) age. Sperm was obtained from 76/106 men in the m-TESE group (69.81%). The embryo transfer rate on day three was significantly higher in the m-TESE group (32.2% vs 8.3%; P=0.003), whereas, on day five, it was significantly higher in the ejaculate group (61.7% vs 37.9%; P=0.015). The ejaculate group had significantly higher overall pregnancy rates (59.1% vs 33%; P=0.001) and overall live birth rates (37.9% vs 22.6%; P=0.031).Conclusion: In recurrent ICSI failure, the reproductive success of ejaculate was higher than that of m-TESE. If it contains motile spermatozoa, the ejaculate before m-TESE could be considered even in severe OAT patients with two or more ART/ICSI failures.","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 5","pages":"367-375"},"PeriodicalIF":2.3,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12623257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Personality traits and medical specialty preference among medical students and graduates: a scoping review. 医学生和毕业生的人格特征与医学专业偏好：一项范围综述。

IF 2.3 4区医学

Croatian Medical Journal Pub Date : 2025-10-31

Antonia Peroš, Nensi Bralić, Ivan Buljan

{"title":"Personality traits and medical specialty preference among medical students and graduates: a scoping review.","authors":"Antonia Peroš, Nensi Bralić, Ivan Buljan","doi":"","DOIUrl":"","url":null,"abstract":"Aim: To review the available research on the association between personality traits and specialty choice.Methods: A systematic search of MEDLINE, ERIC, Scopus, PsycINFO, and Web of Science was performed in June 2022 and updated on August 18, 2025. Studies were eligible if they examined the association between personality traits and specialty choice among medical students and graduates using validated psychological tests. The protocol was registered at the Open Science Framework (https://osf.io/su6md). Screening, eligibility assessment, and data extraction were performed independently by two reviewers.Results: A total of 9212 articles were retrieved, of which 61 met the inclusion criteria. Considerable heterogeneity in study design, instruments used, and outcomes assessed precluded quantitative synthesis. Most studies indicated associations between personality traits and specialty choice, although findings were inconsistent. Surgery was the most frequently assessed specialty, with several studies reporting higher impulsivity, higher extraversion, higher openness to new experiences, and a lower desire to work with people among students choosing surgery. Psychiatry, internal medicine, and family medicine were also frequently examined, but associations varied across studies. Methodological limitations were common, including reliance on cross-sectional designs, inconsistent measurement tools, and underreporting of psychometric properties.Conclusion: Evidence suggests a relationship between personality traits and specialty choice; however, this evidence remains weak due to methodological shortcomings. Future studies should apply standardized measurements for both personality traits and specialty choice, with larger and more diverse samples.","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 5","pages":"321-333"},"PeriodicalIF":2.3,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12631570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0