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

{"title":"Prevalence of nonmotor symptoms in patients with Parkinson’s disease in Split-Dalmatia County","authors":"Slaven Lasić, S. Basic, D. Sporiš, G. Džamonja","doi":"10.21857/90836c760y","DOIUrl":"https://doi.org/10.21857/90836c760y","url":null,"abstract":"RAD 547. Medical Sciences 54-55 (2021) : 38-48 www.rad-med.com 38 June 2021 Vol 547 = 54-55 Abstract: Introduction: This study aimed to review the prevalence of NMS in patients with Parkinson’s disease in Split-Dalmatia County and to investigate the effects of other variables on the number and structure of NMS. Materials and Methods: This observational cross-sectional pilot study was conducted at the Department of Neurology, University Hospital of Split. This study lasted from November 2017. to April 2018. and it included 31 patients, hospitalized or treated in the infirmary at the Department of Neurology. By examining medical documentation we acquired necessary demographic and medical information about our subjects. Subjects were then examined and subjected to filling out Parkinson’s disease-specific questionnaires: NMSQuest, Hoehn&Yahr scale, UPDRS, and Schwab&England scale. To analyze given variables we used the Mann-Whitney U test, Kruskal-Wallis test, Spearman’s coefficient of correlation, and ꭓ2 test. Results: On average 12 dwifferent NMS were reported per patient. Most prevalent NMS were reported to be nocturia (67.74%), urinary urgency (61.29%), constipation (61.29%), intense dreams (58.06%), and forgetfulness (58.06%). The least prevalent NMS reported were delusions (6.45%), hallucinations (16.12%), and daytime sleepiness (25.80%). There were neither statistical differences in the total number of NMS nor in demographic variables between men and women. The increased burden of NMS correlated with the disease duration. Prevalence of depression, anxiety, and miscellaneous symptoms rose with the length of disease duration. We established a connection between the number of NMS and the stage of disease according to Hoehn and Yahr. Patients in higher stages of disease (moderate and severe) reported more severe NMS burden than patients in the mild stage of the disease, while patients in the moderate stage had the largest NMS score of all groups. Patients in the mild stage reported urinary, also digestive, and cognitive symptoms, in the moderate stage urinary symptoms, sexual dysfunction, and cardiovascular symptoms were most reported, while in the severe stage of the disease, patients reported cardiovascular symptoms, depression, and anxiety alongside urinary symptoms as most prevalent. Conclusions: Patients are most affected by the autonomic spectrum of NMS, especially urinary symptoms. Duration of the disease and stage of the disease are proven to affect the total number of NMS, while age at onset, current age, and sex have been disproven to have any effect on the total NMS score. Patients in the moderate stage reported the most NMS.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"48 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":"126660669","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":"Essay - Interviews","authors":"M. Pećina, I. Damjanov","doi":"10.21857/yq32oh2l29","DOIUrl":"https://doi.org/10.21857/yq32oh2l29","url":null,"abstract":"","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"83 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":"124995705","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":"What’s the time? – numerical eponyms and brainstem syndromes","authors":"Denis Čerimagić, E. Bilic","doi":"10.21857/yk3jwhxzw9","DOIUrl":"https://doi.org/10.21857/yk3jwhxzw9","url":null,"abstract":": Brainstem syndromes and their eponyms are well known and numerous, but represent only a drop in the ocean of approximately 450 neurological eponyms. Unlike these “human” eponyms dedicated to famous neurologists, “numerical” eponyms that describe various disorders at the anatomical level of the brainstem, are less known and are rarely used in clinical practice. In this short review, we will give an overview of “human” eponyms and present in more detail the “numerical” eponyms related to brainstem syndromes. The availability of sophisticated neuroradiological and other diagnostics methods cannot replace the importance of neurological examination nor diminish the joy of the neurologist when recognizing a set of signs named after an eponym, or to describe a new one. In any case, neurology is a joy and valuable opportunity for lifelong learning, but also for contribution to continuously growing knowledge about the hidden universe in our nervous system.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"118 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":"134542868","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":"Obstructive sleep apnea and type 2 diabetes mellitus","authors":"V. D. Dobrota, V. Lukinović-Škudar, S. Dobrota, L. Filipović-Grčić, I. Prkačin, P. Hrabac, Vanda Vrkić Kirhmajer, S. Soldo","doi":"10.21857/m3v76te87y","DOIUrl":"https://doi.org/10.21857/m3v76te87y","url":null,"abstract":"","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"6 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":"131957702","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":"MoCA test and general anesthesia for a two different surgical techniques","authors":"M. Zura, Tea Pašalić, V. Demarin, Andreja Kulić, Z. Oreskovic, Ivana Vukušić, S. Mihaljevic, S. Morović","doi":"10.21857/m16wjcnkx9","DOIUrl":"https://doi.org/10.21857/m16wjcnkx9","url":null,"abstract":": Introduction Postoperative cognitive dysfunction (POCD) is de fi ned as a new cognitive impairment shown after operation. Many factors may contribute to POCD and has potentially two di ff erent patterns: acute cognitive dysfunction, known as postoperative delirium and a later onset and more persistent POCD. Th e reported incidence vary depending on the group of patients studied, the test used, the time of testing and the choice of control group. POCD can only be diagnosed and measured using tests both pre-and postoperative. In our research we use Montreal Cognitive Assessment (MoCA) test. It is a widely used screening assessment for detecting cognitive impairment. Materials and Methods Th e prospective study included 30 patients who were treated at the University Hospital Centre Zagreb. Th ey were anaesthetized for radical prostatectomy using the TIVA technique and divided into two groups: 19 patients who underwent classical surgery and 11 patients who underwent laparoscopic surgery. Th e MoCA test was analysed pre-operatively and 48 hours after surgery. Parametric tests were not used due to deviations of individual distributions from normal, as determined by Shapiro-Wilk tests (p <, 05) and due to the small number of participants. Precise p-values were calculated, except for the Spearman correlation coe ffi cient, which does not use them. Two-way tests and an alpha value of 5% were used. Results Patients who underwent laparoscopic prostatectomy did not have statistically signi fi cantly di ff erent MoCA test results before surgery than those who underwent classical prostatectomy (U = 59.9, z = 1.96, p = .052). After the operation, patients undergoing laparoscopic prostatectomy achieved statistically signi fi cantly higher results (U = 46.0, z = 2.54, p = .011), with a moderate e ff ect (r = .463). Th e results of the MoCA test were statistically signi fi cantly higher after surgery than before surgery (W = 346.5, z = -3.81, p <.001; not in the table), with a strong e ff ect size (r = .696). Th e amount of improvement in MoCA test results was not statistically signi fi cantly di ff erent for laparoscopic and classical prostatectomy (U = 78.0, z = 1.16, p = .268). Conclusion Postoperative values of the MoCA test are higher than the preoperative in both groups-laparoscopic and classical prostatectomy. Th e results of the research can be explained by the fact that anxiety and concern about the upcoming operation a ff ect the results of the examination pre-operatively. Other observed parameters did not a ff ect the MoCA test results.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"73 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":"115924785","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":"Kidney transplantation, brief history and Croatian experience","authors":"T. Hudolin, N. Bašić-Jukić, D. Hauptman, I. Mokos, Jana Lipšinić, I. Jurić, M. Pasini, O. Pavlović, Z. Kastelan","doi":"10.21857/mwo1vcjq4y","DOIUrl":"https://doi.org/10.21857/mwo1vcjq4y","url":null,"abstract":": Kidney transplantation is the treatment of choice for patients with end-stage renal disease. However, it took years and numerous attempts to achieve success, for the kidney to function well and for the patient to survive after the transplantation. Following this breakthrough made by Murray in 1954, the introduction of immunosuppressive therapy and tissue typing has significantly improved this program. Today we have new challenges in maintaining or improving a kidney transplant program, one of which is COVID-19 infection. This review presents the history and current status of kidney transplantation, emphasizing the Croatian Kidney Transplant Program.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"119 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":"122892407","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":"Prevalence of prediabetes and risk factors in the general adult population of Croatia - EH-UH 2 study","authors":"Luka Prgomet, Juraj Skelin, Marija Domislović, Bojan Jelaković","doi":"10.21857/mzvkptl7l9","DOIUrl":"https://doi.org/10.21857/mzvkptl7l9","url":null,"abstract":": Introduction: Prediabetes is a state of elevated blood glucose, but not high enough to be classified as diabetes. The prevalence depends on the criteria used in the definition of prediabetes and on the observed populations. Known risk factors are obesity, age ≥ 45 years, positive family history of type 2 diabetes, insufficient physical activity, arterial hypertension, dyslipidaemia, and positive smoking status. The aim of our study was to determine the prevalence of prediabetes in a randomized, representative sample of the adult population of the Republic of Croatia and to determine the association and predictability of risk factors. Materials and methods: Out of 1219 adult participants who were involved in the scientific research project EHUH-2, 687 met the final criteria. All participants underwent clinical examination. Personal and family history were obtained from the collected data in the questionnaire. The participants were instructed to fast for 12 hours before the blood draw and were given detailed instructions on collecting a 24-hour urine sample. According to the ADA criteria, prediabetes is defined as a fasting glucose value between 5.6, and 6.9 mmol/L. Results: The prevalence of prediabetes in our sample was 11.1%. Predictive factors for prediabetes were older age, male gender, higher body weight, higher body mass index, larger waist circumference, higher systolic and diastolic blood pressure, larger body surface area, a higher percentage of visceral fat, decreased glomerular filtration rate, higher serum uric acid levels, and greater albuminuria (ACR). The final hierarchical regression model, which included body mass index, systolic and diastolic blood pressure, waist circumference, age, gender, eGFR, information on smoking, albuminuria, and urate, was statistically significant (p < ; 0.001; Nagelkerke R2=0,272). Conclusion: Our study is the first in which the prevalence of prediabetes and its association with risk factors were determined in a representative randomized sample of the general adult population of Croatia. While further research is needed, our results shows that in the presence of multiple risk factors for prediabetes, the focus should be on age, systolic blood pressure, and albuminuria as the main predictive factors of prediabetes, especially in individuals with visceral obesity.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"55 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":"121519603","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":"Disease-modifying therapy for multiple sclerosis in Slovenia: analysis of 20 years of treatment","authors":"U. Rot, Gregor Brecl-Jakob, Saša Šega-Jazbec, Alenka Horvat-Ledinek","doi":"10.21857/mjrl3ug069","DOIUrl":"https://doi.org/10.21857/mjrl3ug069","url":null,"abstract":"RAD 552. Medical Sciences 58-59 (2022) : 28-34 www.rad-med.com 28 June 2022 Vol 552 = 58-59 Abstract Introduction: Disease-modifying therapy (DMT) dramatically influenced the management of relapsing-remitting multiple sclerosis (RRMS). Novel medicines have been developing constantly and therapeutic strategy has changed. We aimed to analyse the development of DMT for MS in Slovenia with a special emphasis on contemporary approaches to the patient management. Materials and Methods: Prescriptions of all DMT in Slovenia from 2001-2021 were analysed as well as referrals to the Committee for MS DMT the Centre for MS in Ljubljana in the last three years (2019-2021). Results: Altogether approximately 360 patients were on DMT in 2001 and 1839 in 2021. The total number of patients on injectable therapies decreased through time while the number of patients on oral therapies increased. Dimethyl fumarate is currently the most frequently used medicine with 505 patients on the drug in 2021. The number of patients on potent medications increased from 28 (3%) in 2012 to 763 (41%) in 2021. Highly active medicines represented 52%, 62% and 69% of all DMT approvals in 2019, 2020 and 2021, respectively. Conclusions: The number of treated MS patients has been increasing steadily in Slovenia as well as the number of patients on potent DMT which proves that neurologists follow the modern concept of MS treatment.","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":"121110535","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":"Cumulated injuries in junior female figure skater caused by detraining in COVID-19 lockdown","authors":"Tena Šimunjak, S. Dubravčić-Šimunjak, Petra Hodak, Sarah Filipović, Katarina Ivanković, Boris Šimunjak","doi":"10.21857/mzvkptq8q9","DOIUrl":"https://doi.org/10.21857/mzvkptq8q9","url":null,"abstract":": As the SARS-CoV-2 virus started its fulminate spread, due to strict epidemiological measures, athletes were transferred to unsupervised online training. This resulted in injury increase occurrence in elite sport. Some of many reasons for this are detraining process linked with reversible decrease in muscle mass and increase in body fat content. We present the unique case of the 13-year-old healthy, junior female figure skater who suffered from multiple injuries associated with unsupervised training and detraining during COVID-19 lockdown. This case reports injuries described in elite athletes’ population, but never reported cumulatively in three months’ time period. Healthy elite athlete with magnetic resonance imaging was diagnosed with a stress fracture of the second and stress reaction of the fourth metatarsal bone, which occurred during online unsupervised training. The same patient also suffered from lumbar discus protrusion on L4-L5 segment and discus bulging sign on L3-L4 and L5-S1 segments, which occurred after lockdown period, in immediate return to sport. Individual rehabilitation program, which included different modalities of physical therapy during which special attention was given to strengthening, stretching, proprioceptive and dynamic neuromuscular stabilization exercises, resulted in safe and pain free return to sport. A multi-faced controlled exercise program should be considered as part of successful rehabilitation program in elite sport. As part of injury prevention program, we suggest that sporting federations in collaboration with medical and sport experts develop and implement different and convenient sport-specific guidelines to prevent a rapid increase of injuries in different sport disciplines.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"3 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":"117042133","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":"A practical approach to patient with Young-onset dementia","authors":"M. Boban","doi":"10.21857/mwo1vcjl7y","DOIUrl":"https://doi.org/10.21857/mwo1vcjl7y","url":null,"abstract":"RAD 547. Medical Sciences 54-55 (2021) : 86-92 www.rad-med.com 86 June 2021 Vol 547 = 54-55 Abstract: “Young-onset dementia” (YOD) includes clinical presentations of dementia with the onset before age of 65. There are several important clinical differences between much more frequent late onset dementia (LOD) and YOD syndromes. First, YOD has much wider range of different aetiologies comparing to LOD. Among all possible aetiologies, treatable/potentially reversible causes are much more common in YOD then in LOD. There is also significantly higher prevalence of inherited dementias in younger age-groups. Furthermore, atypical cognitive (non-amnestic) presentations of common degenerative dementias (e. g. Alzheimer’s disease) are more frequent in YOD. Therefore, routine cognitive evaluation using standard screening tests (e.g. MMSE) may be insufficient. YOD is more often accompanied by neurological and systemic features (dementia plus syndromes) and the identification of these features can aid the diagnosis. Based on these specificities of YOD, diagnostic approach is always challenging. Therefore, a thorough neurocognitive assessment and a structured and rational diagnostic approach is mandatory to ensure early diagnosis and treatment.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"63 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":"122186879","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}