Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti最新文献

{"title":"A young female adult patient with an ischaemic stroke and patent foramen ovale: a case report and literature review","authors":"I. Đorčeva, A. Arsovska","doi":"10.21857/9e31lh6qwm","DOIUrl":"https://doi.org/10.21857/9e31lh6qwm","url":null,"abstract":"RAD 552. Medical Sciences 58-59 (2022) : 102-110 www.rad-med.com 102 June 2022 Vol 552 = 58-59 Abstract: Strokes in young adults are relatively rare. We present a 36-year old female patient, who came to the urgent neurological outpatient office of the Clinic for neurology due to symptoms presented two hours prior to the examination. The symptoms consisted of inability to move the left arm, partial motor weakness of the left leg, slurred speech and difficulty swallowing. The urgent CT scan result was normal. Despite the fulfilled conditions, thrombolysis was not possible. Brain MRI results revealed a small hypersignal lesion in FLAIR with diffusion restriction on the right, cortically to subcortically, in gyrus praecentralis. The genetic testing for cardiovascular diseases showed that the patient is a homozygote for the mutation C677T (OMIM® 607093.0003) in the gene for methylenetetrahydrofolate reductase (MTHFR) and heterozygote for the mutations eNOS G894T and LTA. The following gene polymorphisms were typed: PAI 5G/4G, HPA1 1b/1a, ACE deletion/insertion, EPCR A4600G A/A, EPCR G4678C C/G and APOE E3/E4. Trans-esophageal echocardiography discovered an aneurysm of the interatrial septum, with a present PFO channel, with a diameter of 6.8 mm. The bubble test was positive, and there were no visible thrombi in the left auricle. The cardiologist recommended closing of the PFO with a device and therapy with acetylsalicylic acid. The cause of the stroke was found and measures for secondary prevention were taken. The patient has returned to her work and private obligations. She upholds neurological consultations regularly and her recovery is closely observed.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123505489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Structural Failures of Aortic Homografts Leading to Emergency Surgery","authors":"T. Tokić, N. Knez, A. Lekić, Mario Pavlek, Lara Lalić Tokić, M. Hrabak, H. Gašparović","doi":"10.21857/y6zolb625m","DOIUrl":"https://doi.org/10.21857/y6zolb625m","url":null,"abstract":"Aortic homografts are composed of aortic roots and variable lengths of the arch and ascending aorta, harvested from donor hearts. Th ey are primarily used in extensive aortic root endocarditis due to its resistance to reinfection. Th ey are, however, prone to structural failure. Redo aortic root surgery is challenging, especially in the setting of aneurysms or pseudoaneurysms (PSAN) lying immediately posterior to the sternum or adhering to it. We present a 43-year-old female with two aortic homograft pseudoaneurysms following her fourth aortic valve and ascending aortic procedure. Th e fi rst PSAN was described as immediately cranial to proximal homograft anastomosis, measuring 21x8 millimeters. It harbored potential for intraoperative rupture because of its proximity to the posterior sternal table. Th e second one was 36x20 millimeters, adjacent to the distal homograft anastomosis. Th e surgical plan entailed institution of peripheral hypothermic cardiopulmonary bypass due to an almost inevitable risk of bleeding from the retrosternal pseudoaneurysm. While the actual sternotomy was uneventful, the PSAN ruptured after sternal retraction. Th e ensuing massive bleeding was expected and was successfully managed during hypothermic circulatory arrest. Th e patient had an unremarkable postoperative course and was discharged home.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121341631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different cytokine expression profiles in metaphyseal and diaphyseal fracture healing may provide new insights in the field of bone regeneration","authors":"Stela Hrkac, Ruđer Novak, Grgur Salai, S. Grazio, T. Vlahovic, L. Grgurević","doi":"10.21857/y6zolb6vzm","DOIUrl":"https://doi.org/10.21857/y6zolb6vzm","url":null,"abstract":"","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129149446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ferroptosis - a link between iron biology, aging and COVID-19?","authors":"Ivana Čepelak, S. Dodig","doi":"10.21857/yk3jwhn429","DOIUrl":"https://doi.org/10.21857/yk3jwhn429","url":null,"abstract":": Severe form of COVID-19 is more common in the elderly and although it may include a variety of extrapulmonary manifestations, respiratory dysfunction is primarily present, which includes iron dyshomeostasis. The aging process is characterized by a chronic pro-inflammatory condition of a milder type, and COVID-19 by strong acute inflammation, both resulting in changes in iron metabolism. A new, iron-dependent form of programmed cell death, ferroptosis, is associated with iron dyshomeostasis. The main features of ferroptosis include intracellular iron overload, inhibition of the cellular GSH / GPX4 system, and accumulation of lipid reactive compounds. Clinical manifestations of COVID-19 and changes during aging include GSH depletion, GPX4 inactivation, changes in iron metabolism markers as well as markers of enhanced lipid peroxidation. There is therefore a possibility that SARS-CoV-2 may cause feroptotic death of lung cells but also cells of other organs. This review considers the molecular mechanisms of ferroptosis, their relationship to the aging process and the pathogenesis of COVID-19, and the consideration of ferroptosis as a factor linking aging and the pathogenesis of COVID-19.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130821594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cooperation in the Field of Public Health and Medicine: Instances of Expert and Knowledge Mobility between Vienna, Zagreb and the Far East","authors":"Ž. Dugac","doi":"10.21857/y7v64t56ny","DOIUrl":"https://doi.org/10.21857/y7v64t56ny","url":null,"abstract":"","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132675680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bulgarian mutation spectrum in Cadasil: Our experience","authors":"I. Tourtourikov, T. Kadiyska, V. Mitev, A. Todorova, E. Titianova","doi":"10.21857/yrvgqtezr9","DOIUrl":"https://doi.org/10.21857/yrvgqtezr9","url":null,"abstract":"Introduction Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CA-DASIL, OMIM 125310), is a hereditary autosomal dominant disease, caused by mutations in the NOTCH3 gene. The aim of this study was to describe our experience with the molecular diagnostics of CADASIL in a group of Bulgarian patients in the period of 2015-2020. Materials and Methods Screening for germline mutations was performed by Sanger sequencing of the NOTCH3 gene in eleven subjects provided written and signed informed consent forms. Mutation negative patients were further subjected to multiplex ligation-dependent probe amplification (MLPA) to detect deletions/ duplications in the NOTCH3 gene. Results We present eleven Bulgarian patients (3 males and 9 females, median age 49.7 years) exhibiting clinical symptoms of possible CADASIL, referred to our laboratory for genetic testing of the NOTCH3 gene in the period of 2015-2020. Sequencing revealed missense mutations in five patients (one male and four females) following the typical pattern of cysteine-altering mutations in CADASIL. Four of the mutations have been previously described in the literature. One patient presented with a novel mutation, classified as “likely pathogenic” by the criteria of the ACMG. No large deletions or duplications were detected by the use of MLPA analysis.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132856956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genuine and cross-reactive allergenic molecules of birch and hazel","authors":"S. Dodig","doi":"10.21857/yl4okfle19","DOIUrl":"https://doi.org/10.21857/yl4okfle19","url":null,"abstract":": Birch and hazel pollen are the most common causes of allergic diseases that occur during the spring season. For decades, the method of quantitative determination of specific IgE (sIgE) against allergen extracts has been used in the laboratory diagnosis of allergies. In recent years, there has been the possibility of determining sIgE by individual allergenic molecules, either native or recombinant. This method, known as Component Resolved Diagnosis (CRD), has made it possible to identify major and cross-reactive allergenic molecules. Genuine allergenic molecules in birch (Bet v 1), hazel (Cor a 1) and hazelnut (Cor a 8, 9, 11, 14) are responsible for allergic reactions in most patients. Moreover, they cause a severe clinical picture in patients with hypersensitivity, in contrast to cross-reactive molecules, eg. Bet v 1 homologues in vegetables (celery, soy) and fruits (apple, cherry, pear), or Bet v 2 homologues in vegetables (celery, carrot) and fruits (muskmelon, peach, banana), that cause milder symptoms. In the diagnostic context, future research will make it possible to determine the diagnostic significance of the detection of individual allergen molecules responsible for allergy symptoms in each individual patient. The application of bioinformatics will certainly help in the interpretation of the findings, especially in cases when multiplex assays are applied. Particular progress is also expected in the application of allergen molecules to allergen-specific immunotherapy.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116969416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State-of-the-art of the Bone Morphogenetic Protein research field: 13th International BMP Conference, Dubrovnik 2022","authors":"Nikola Štoković, Natalia Ivanjko, Ivona Matić Jelić, Marina Milešević, Viktorija Rumenovic, Valentina Blažević, Lucija Rogina, Ivančica Bastalić, I. Erjavec, Tatjana Bordukalo Nikšić, Vera Kufner, Dora Adanić, M. Perić, M. Pećina, T. Kuber Sampath, S. Vukicevic","doi":"10.21857/ypn4ocd309","DOIUrl":"https://doi.org/10.21857/ypn4ocd309","url":null,"abstract":"","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115709585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated arterial stiffness and cardiovascular risk in chronic kidney disease – a study protocol","authors":"Marija Domislović, Ivan Brzić, D. Radunović, V. Prelevic, B. Jelaković","doi":"10.21857/yvjrdcvx1y","DOIUrl":"https://doi.org/10.21857/yvjrdcvx1y","url":null,"abstract":"","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127579491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute encephalitis caused by Streptococcus pneumoniae: case report and review of the literature","authors":"A. Arsovska, I. Đorčeva, Ivana Jacheva, Snezhana Gjorgieva","doi":"10.21857/mzvkptl2p9","DOIUrl":"https://doi.org/10.21857/mzvkptl2p9","url":null,"abstract":"RAD 552. Medical Sciences 58-59 (2022) : 96-101 www.rad-med.com 96 June 2022 Vol 552 = 58-59 Abstract: Introduction: Streptococcus pneumoniae (pneumococcus), is a Gram-positive, spherical bacteria, member of the genus Streptococcus. It resides asymptomatically in healthy carriers typically colonizing the respiratory tract, sinuses, and nasal cavity. However, in susceptible individuals with weaker immune systems, pneumococcus may become pathogenic and spread to other locations causing cardiorespiratory and bone diseases as well as meningitis. Encephalitis and brain abscesses caused by Streptococcus pneumoniae are rare entities and they account for less than 1% of all bacterial brain abscesses. Purpose: We aim to present a case report of an acute encephalitis in a 16 years old female patient caused by Streptococcus pneumoniae, with review of the literature. Case Report: A 16 years old, right-handed female, was hospitalized at the clinic due to impaired consciousness (coma) and decerebrate posturing. The symptoms started the previous days with vomiting, drowsiness, subfebrile temperature and were originally perceived as food poisoning. Laboratory blood analysis were normal at the beginning and despite supportive therapy, deterioration of the clinical condition occurred, followed by confusion, muscle weakness and collapse. These symptoms were initially addressed as a functional neurological symptom disorder and the patient was referred to a psychiatrist. However, the patient’s condition got worse, with febrile symptoms, while the control laboratory blood examination showed signs of infectious syndrome. The patient was seen by infectologist and COVID-19 test was performed, with negative result. The analysis of CSF found bacterial infiltration, while the PCR test isolated Streptococcus pneumoniae. MRI of the brain (native and with contrast) showed bilateral multiple microabscesses, predominantly in the frontal and parietal regions. After the diagnosis was confirmed, the patient was treated promptly with antiedematous, antibiotic, neuroprotective and other symptomatic therapy for a period of 2 months. Her condition gradually improved completely, with amelioration of the state of consciousness and muscle weakness as well. Control laboratory blood analysis and CSF examination showed improvement as well, while the MRI of the brain displayed reduction of the previously described lesions and edema. Conclusion: The atypical clinical picture may sometimes mislead the treating physician. Cases with encephalitis caused by Streptococcus pneumoniae have been rarely described in the literature, however, early recognition and adequate treatment are crucial for the positive outcome.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123289417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}