Acta clinica Croatica最新文献

{"title":"A MAN WITH UTERINE LEIOMYOMA AS PART OF PERSISTENT MÜLLERIAN DUCT SYNDROME - A CASE REPORT AND REVIEW OF THE LITERATURE.","authors":"Ivan Novak, Igor Grubišić, Ivan Pezelj, Tihana Regović Džombeta, Ivan Svaguša, Goran Štimac, Monika Ulamec, Božo Krušlin","doi":"10.20471/acc.2024.63.03-04.47","DOIUrl":"10.20471/acc.2024.63.03-04.47","url":null,"abstract":"<p><p>We present a clinical case of a 59-year-old man, father of two children, who complained of irritative voiding of the bladder. An unknown retrovesical structure was detected by ultrasound and computed tomography, and was surgically removed later. Histopathologic analysis reported uterine tissue with a leiomyoma, thus the diagnosis of persistent müllerian duct syndrome (PMDS) was established. It is a rare disorder characterized by the appearance of müllerian derivatives (fallopian tubes, uterus, and upper two-thirds of vagina) in males with normally developed external and internal genitalia. Patients usually present with cryptorchidism and inguinal hernia. Irritative voiding has not yet been described as the main symptom of PMDS. The major complications of the disorder are infertility, testicular tumorigenesis, and malignant transformation of müllerian structures. To the best of our knowledge, in addition to our case, only one case of PMDS with uterine leiomyoma has been described in the literature so far.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 3-4","pages":"828-833"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231105","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}

{"title":"GIANT ATRIAL SEPTAL ANEURYSM WITH THROMBI IN A PATIENT WITH ATRIAL SEPTAL DEFECT AND CEREBRAL ISCHEMIC EVENTS: A CASE REPORT.","authors":"Stanko Biočić, Josip Vincelj, Mario Udovičić, Sandra Jakšić Jurinjak, Jadranka Martinko","doi":"10.20471/acc.2024.63.03-04.44","DOIUrl":"10.20471/acc.2024.63.03-04.44","url":null,"abstract":"<p><p>Atrial septal aneurysm is a congenital abnormality that may occur as an isolated malformation or in combination with other cardiac abnormalities. More than half of the cases of atrial septal aneurysm are associated with an atrial shunt. We present a case with a thrombus at a giant atrial septal aneurysm associated with atrial septal defect and thrombus in the left atrial appendage, detected by transesophageal echocardiography after cerebral ischemic events. To the best of our knowledge, this combination has not been described in the literature so far.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 3-4","pages":"812-815"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231229","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}

{"title":"EVALUATION OF ULTRASOUND AS AN IMAGING MODALITY IN THE ASSESSMENT OF CAROTID ARTERY INVASION IN PATIENTS WITH HEAD AND NECK CANCER.","authors":"Tijana Pandurović, Damir Štimac, Tajana Turk, Siniša Pešić, Vedran Zubčić, Matea Bogović, Nenad Čekić, Luka Šimić","doi":"10.20471/acc.2024.63.03-04.31","DOIUrl":"10.20471/acc.2024.63.03-04.31","url":null,"abstract":"<p><p>Tumor invasion of carotid arteries (CA) is found in 2%-7% of patients with head and neck cancer (HNC). There are no standardized criteria to evaluate the invasion. Tumor invasion of CA is assessed by using computerized tomography (CT) and magnetic resonance imaging. Ultrasound was also used but the method has not become daily routine. The aim of this study was to examine the effect of tumor invasion on CA dynamics and to evaluate the role of ultrasonography in the diagnosis of invasion. The study was conducted on two groups of 22 patients each. The first group consisted of patients with confirmed HNC and CA infiltration, while the second group consisted of patients without any data of HNC. Motion of the CA wall was assessed using ultrasound from which a CA was segmented and then the amount of motion was assessed by optical flow calculation. All patients with a CT-verified CA infiltration had an altered CA motion. The research showed that tumor-infiltrated CA had an altered dynamic when viewed on ultrasound.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 3-4","pages":"701-709"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231240","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}

{"title":"SURGICAL METHODS IN THE TREATMENT OF BASAL THUMB ARTHRITIS - FROM ARTHROSCOPY TO ARTHROPLASTY.","authors":"Zoran Sulje, Damir Starčević, Ana Aljinović, Katarina Barbarić Starčević","doi":"10.20471/acc.2024.63.02.16","DOIUrl":"10.20471/acc.2024.63.02.16","url":null,"abstract":"<p><p>The first carpometacarpal joint is the second most common joint affected by degenerative arthritis. The prevalence of the first carpometacarpal joint arthritis increases with age, especially in postmenopausal women. Ligamentous laxity or injury of the first carpometacarpal joint is thought to be the starting point of development of degenerative changes, accompanied with altered biomechanics of the thumb. As the disease progresses, the joint is destroyed and the thumb and hand function are deteriorating. Although many patients, in different stages of disease, experience pain relief with conservative treatment, surgery is often needed. Decision on the type of surgical procedure depends on the age of the patient, functional demands, and stage of the disease. In early stages of the disease, stabilization of the first carpometacarpal joint, extension osteotomy of the first metacarpal and arthroscopic procedures are used. These are joint-preserving procedures, and they slow down progression of the disease and reduce symptoms. In late stages of the disease, joint arthroplasty procedures and first carpometacarpal arthrodesis are performed. In recent years, late stages of the disease can also be treated arthroscopically. This paper describes different surgical methods, their advantages and drawbacks, with respect to different stages of the disease.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"393-402"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655752","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}

{"title":"COMPARISON OF ABBOTT REAL TIME SARS-COV-2 ASSAY AND LIFERIVER NOVEL CORONAVIRUS REAL TIME MULTIPLEX KIT FOR THE RT-PCR BASED DETECTION OF SARS-COV-2 FROM NASOPHARYNGEAL SWABS.","authors":"Jelena Stojčević-Maletić, Iva Barjaktarović, Mirjana Đerić, Velibor Čabarkapa, Vladimir Petrović, Aleksandra Patić, Slobodanka Bogdanović-Vasić","doi":"10.20471/acc.2024.63.02.3","DOIUrl":"10.20471/acc.2024.63.02.3","url":null,"abstract":"<p><p>The objective of this study was to compare performance of two authorized tests, the Abbott Real Time SARS-CoV-2 (ACOV) assay (Abbott Molecular Inc., North Chicago, IL, USA) and Liferiver Novel Coronavirus Real Time Multiplex RT-PCR (Liferiver 2019-nCoV) kit (BioVendor Group, Brno, Czech Republic), and to determine whether the selection of targeted genes has an impact on test specificity. We included 105 nasopharyngeal swabs from adult individuals with symptoms or suspected of coronavirus disease 2019 (COVID-19), aged from 26 to 91 years, previously tested by the ACOV and subsequently tested by the Liferiver 2019-nCoV. In this comparative analysis, we found that the ACOV assay detected more cases of COVID-19 infection than the Liferiver 2019-nCoV assay. The Liferiver 2019-nCoV kit showed a high level of agreement with the ACOV assay. The positive percent agreement was 88.89% (95% confidence intervals (95% CI): 77.42%-100.0%), and the kappa coefficient (kappa) was 0.901 (95% CI: 0.817-0.985). The negative percent agreement was 94.12% (95% CI: 89.74%-98.50%), while 4.76% of SARS-CoV-2 cases were false-negative using the Liferiver test. However, due to the possible false-negative results using the Liferiver 2019-nCOV test, we recommend complete testing with the ACOV assay.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"275-282"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655552","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}

{"title":"ARE COVID-19 PNEUMONIA FINDINGS DIFFERENT BETWEEN COMORBID AND NON-COMORBID PATIENTS? THE HIGH RESOLUTION COMPUTED TOMOGRAPHY FEATURES OF THE 108 FOLLOW-UP PATIENTS.","authors":"Ayşe Özlem Balık, Buket Yagci, Recep Balik, Ulaş Yalim Uncu","doi":"10.20471/acc.2024.63.02.2","DOIUrl":"10.20471/acc.2024.63.02.2","url":null,"abstract":"<p><p>The aim was to compare the computed tomography (CT) semi-quantitative severity scoring (CT-SS) system assessments of COVID-19 pneumonia on initial and follow-up examinations according to the presence of comorbidities. Of the 278 real-time reverse transcription-polymerase chain reaction positive patients, 108 with a follow-up CT scan were evaluated. Then, all CT images were independently reviewed for CT-SS analysis by two reviewers. Reviewers were unaware of the patient laboratory and clinical findings. A quarter of patients had negative findings on their initial CTs. Sixty-one (56.4%) patients showed progression. Disease progression was more frequently observed in patients with type 2 diabetes mellitus (DM) and malignancies (p=0.044 and p=0.019, respectively). Follow-up CTs of patients with comorbidities, especially those with cardiovascular disease (56.4%) and type 2 DM (70.0%), demonstrated an increased frequency of diffuse involvement. The white lung sign was more frequently observed in patients with malignancies (60.0%). In this study, COVID-19 patients with comorbidity showed a higher rate of disease progression than those without comorbidity. Patients with comorbidities more frequently had severe CT findings with high CT-SS. These findings may serve as a guide in the COVID-19 pneumonia follow-up and treatment.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"260-274"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655850","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}

{"title":"COMPUTED TOMOGRAPHY SCORING SCALES AS EARLY OUTCOME PREDICTORS IN PATIENTS WITH TRAUMATIC BRAIN INJURY: WHICH ONE TO USE?","authors":"Jagoš Golubović, Petar Vuleković, Djula Djilvesi, Nenad Krajčinović, Igor Horvat, Bojan Jelača, Filip Pajičić, Nebojša Lasica, Srđan Stošić, Ante Rotim, Lukas Rasulić","doi":"10.20471/acc.2024.63.02.11","DOIUrl":"10.20471/acc.2024.63.02.11","url":null,"abstract":"<p><p>Computed tomography (CT) is an essential tool in diagnosing and treating traumatic brain injury (TBI). Marshall CT classification, Rotterdam and Helsinki CT scores were consecutively developed as prediction outcome scales by computing TBI CT abnormalities. None of them classifies the pathological CT findings in the same manner. We aimed to determine which one is most accurate and has the best grading discriminatory power in determining early outcome. All TBI patients treated at a single center in a one-year period having undergone a CT scan on admission were retrospectively included. After calculation of all three scores, comparison among scale performances, as well as their accuracy in predicting patient 6-month outcome by the Glasgow Outcome Scale (GOS) was made. We used the Receiver Operating Characteristic curves to analyze correlation between all scales and early outcome. We calculated the area under the curve (AUC) to determine the power of each system while paired samples T-test was used to determine correlation among the scales. Mann-Whitney U test was performed to determine difference in outcome groups. A total of 1006 patients were included in final analysis. The mean patient age at presentation was 55.6 (±20.1) years, overall mortality was 6.4%, mean GOS was 3.00 (±1.4), and mean Glasgow Coma Score (GCS) was 13.9 (±0.2). Mortality was higher among patients with lower scores (p<0.01 all). The AUCs indicated that all scoring systems had a similarly high discriminative power in predicting early unfavorable outcome (Marshall AUC 0.86 <i>vs</i>. Rotterdam AUC 0.82 <i>vs</i>. Helsinki AUC 0.84). High correlation was found between Marshall and Rotterdam grading, r = 0.78, and moderate correlation between the other two pairs (Marshall <i>vs</i>. Helsinki, r=0.62, and Rotterdam <i>vs</i>. Helsinki, r=0.51). Additionally, low GCS and high injury severity score (ISS) could be identified as strong predictors of early death and poor outcome. In conclusion, all classification systems demonstrated a similar, strong predictive power for early outcome, but even greater discrimination results could be obtained if GCS and ISS were incorporated in the calculation. Helsinki CT score was least predictable of all three, and had the lowest correlation with the other two. Although Marshall CT classification was the oldest and simplest, it had at least the same prediction power as the newer scoring scales and should remain in use. Therefore, for prognostic purposes, this study recommends using one individual scale in clinical application to get the best possible prediction for TBI.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"351-357"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655554","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}

{"title":"ENDOSCOPIC TREATMENT OF INTRALUMINAL DUODENAL DIVERTICULUM: A CASE REPORT.","authors":"Ivan Budimir, Filip Babić, Vedran Tomašić, Petra Ćaćić, Ivana Bešlić, Pierre Henri Deprez","doi":"10.20471/acc.2024.63.02.19","DOIUrl":"10.20471/acc.2024.63.02.19","url":null,"abstract":"<p><p>Intraluminal duodenal diverticulum is a rare entity that may cause recurrent pancreatitis. We report a case of a 36-year-old female admitted with etiologically unclear, recurrent pancreatitis. Radiographic study and endoscopy revealed a sac-like structure of the second portion of the duodenum near the minor duodenal papilla. Endoscopic diverticulotomy was successfully performed. No complications were observed and the patient was discharged home a day later. After 62-month follow-up, the patient was active and without symptoms. To our knowledge, this is the first reported case of recurrent pancreatitis caused by intraluminal duodenal diverticulum near the minor duodenal papilla, treated with endoscopic diverticulotomy performed from the apex to the base of the diverticulum.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"418-421"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655621","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}

{"title":"IMPACT OF BODY MASS INDEX ON FUNCTIONAL RECOVERY AFTER TOTAL KNEE REPLACEMENT.","authors":"Mirhada Mešanović, Mirela Vučković, Snježana Schuster","doi":"10.20471/acc.2024.63.02.9","DOIUrl":"10.20471/acc.2024.63.02.9","url":null,"abstract":"<p><p>The aim of this study was to determine whether body mass index and age had an impact on functional recovery two years after total knee replacement. The research was conducted at the Lovran Hospital of Orthopedics and Traumatology, School of Medicine, University of Rijeka, Croatia. Study sample included patients who underwent total knee replacement surgery with median parapatellar approach in 2019. Morphological measurements, knee range of motion and WOMAC questionnaire score were examined before and two years after surgery. Descriptive statistics was used for gender, age and body mass index, and inferential statistics was employed to check the correlation of recovery measured by changes in the WOMAC score and change in the range of motion results with age and body mass index. According to study results, male and female patients did not differ in body mass index (t=1.184; p>0.05). There was no statistically significant correlation of functional recovery of the patients with age (p=0.556), or between body mass index and differences in the range of motion (p=0.927) from flexion to extension. The study indicated that knee arthroplasty and thus the impact on functional recovery had an equally good effect regardless of age. In patients who had flexion contracture before surgery, the surgery improved motion amplitude.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"332-339"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655785","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}

{"title":"COCAINE-INDUCED MIDLINE DESTRUCTIVE LESIONS.","authors":"Hanna Pašić, Branka Vidrih, Iva Šarac, Nina Rotim, Ana Hrkać Pustahija, Branko Malojčić, Ivana Karla Franić, Ivona Radmanović, Maja Živković, Stjepan Jurić, Jelena Šarić-Jurić, Marija Bošnjak Pašić","doi":"10.20471/acc.2024.63.02.21","DOIUrl":"10.20471/acc.2024.63.02.21","url":null,"abstract":"<p><p>Prolonged cocaine inhalation can cause destruction of nasal mucosa and ethmoid sinuses and palate perforation, thus inducing cocaine-induced midline destructive lesions (CIMDL) that affect only a limited number of predisposed patients. CIMDL are an autoimmune necrotizing inflammatory phenomenon associated with the presence of atypical antineutrophil cytoplasmic antibody (ANCA). Patients complain of epistaxis, nasal obstruction, hyposmia, sinus infections, and facial pain. Protocol for the CIMDL diagnosis includes medical history, clinical examination, magnetic resonance imaging, laboratory tests, immunology and serology tests, and chest x-ray. A 68-year-old man presented with a brain extension mimicking an ischemic-like lesion with surrounding edema. A diagnosis of CIMDL was made in the light of the patient's medical history, imaging studies, and laboratory testing including pANCA positivity which seems to promote disease phenotype.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"431-435"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655542","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}