{"title":"INTESTINAL OBSTRUCTION AS A RESULT OF PANCREATIC ECTOPY IN JEJUNUM: A CASE REPORT AND LITERATURE REVIEW.","authors":"Matilda Đolai, Milena Šunjević, Ana Dražin, Predrag Petrović, Slobodan Torbica, Sandra Trivunić Dajko","doi":"10.20471/acc.2024.63.02.18","DOIUrl":"10.20471/acc.2024.63.02.18","url":null,"abstract":"<p><p>Pancreatic heterotopia is a relatively rare condition that implies pancreatic tissue anatomically separated from the main gland, showing no vascular or ductal continuity. It is known to occur in many sites of gastrointestinal tract, with stomach being the most common one. This case is of great interest because ectopic pancreatic tissue in jejunal wall presented as bowel obstruction. The aim of this article is to provide a review of clinical, histopathologic and immunohistochemical features of ectopic pancreatic tissue in jejunum, emphasizing the possible diagnostic pitfalls in gastrointestinal tract, especially in its upper parts. Knowing the most common locations, imaging features and histopathologic criteria, the diagnosis of pancreatic heterotopia could be successfully set preoperatively. Associated complications are various and sometimes difficult to handle, so accurate and precise diagnosis, as well as surgical resection, is often needed.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"413-417"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655790","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}
Maja Žagar, Amar Piknjac, Mirko Soldo, Dubravka Knezović Zlatarić
{"title":"ASSESSMENT OF TOOTH COLOR DIFFERENCE IN DIGITAL PHOTOGRAPHS TAKEN WITH DIFFERENT SMARTPHONES.","authors":"Maja Žagar, Amar Piknjac, Mirko Soldo, Dubravka Knezović Zlatarić","doi":"10.20471/acc.2024.63.02.17","DOIUrl":"10.20471/acc.2024.63.02.17","url":null,"abstract":"<p><p>Digital photography has become an indispensable part of modern medicine and dentistry. In the initial stages, digital single lens reflex cameras were used in medicine and dentistry and were considered the golden standard. In recent years, smartphones have become available and enable adjusting of camera settings. The aim of the study was to examine color accuracy on digital photographs taken with a smartphone and the possibility of applying a simple protocol for shooting digital photographs in daily clinical work. The study was conducted on 45 subjects, and a total of 15 JPEG photographs using three smartphones were taken. Five photographs with different lighting modes were taken with each smartphone and the CIE L*a*b* values were measured. Difference in color (dE) was calculated. The results showed that different lighting conditions and different smartphones did affect color values in this study. The CIE L*a*b* values measured on digital photographs using different smartphones and different illuminations differed significantly (p<0.01). There was significant difference in color between digital photographs in different illuminations and measurements of the natural teeth (p<0.01). Digital photo protocol taken with a smartphone cannot be used as an accurate method for digital determination of tooth color in dentistry.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"403-412"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655853","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}
Dean Girotto, Josip Burić, Hrvoje Šimić, Vjekoslav Tomulić, Tomislav Jakljević, Zvonimir Kvas
{"title":"COMBINED ENDOVASCULAR REPAIR OF AORTA AND REMOVAL OF PENETRATING PEDICLE SCREW AFTER POSTERIOR INSTRUMENTATION: A CASE REPORT AND LITERATURE REVIEW.","authors":"Dean Girotto, Josip Burić, Hrvoje Šimić, Vjekoslav Tomulić, Tomislav Jakljević, Zvonimir Kvas","doi":"10.20471/acc.2024.63.02.20","DOIUrl":"10.20471/acc.2024.63.02.20","url":null,"abstract":"<p><p>Stabilization of spine using transpedicular screws is the most commonly used instrumentation technique among spinal surgeons. The 'free hand' technique is considered relatively safe and can be performed under x-ray control. Vascular injuries with misplaced screws are rare but potentially fatal complications. Injury of thoracoabdominal aorta by malpositioned screw demands a multidisciplinary approach. Injury of vessel wall might demand screw removal and vessel wall repair. Here we present a case of 72-year-old female patient who underwent long segment fixation of thoracolumbar spine. During follow up, computed tomography (CT) scan and afterwards aortography showed a lesion of the posterior aortic wall by malpositioned screw without signs of bleeding. After meticulous preparation, combined endovascular repair with stent-graft and removal of the penetrating screw were performed. Endovascular treatment was performed simultaneously with screw removal. During screw removal, the patient was in lateral decubital position. The patient was discharged on postoperative day 8. Follow up CT aortography 6 months later showed no leak or other changes in the aorta. We found combined endovascular vessel repair with simultaneous screw removal safe and sufficient for this kind of aortic injury. Although lateral decubital position bears limitations, it gives enough space for the operator. Performing intraoperative aortography provides good insight into stent position and possible bleeding after screw removal.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"422-430"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655548","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":"EFFECT OF FAMILY SIZE AND PLACE OF RESIDENCE ON SEXUAL ACTIVITY RESUMPTION IN WOMEN AFTER CHILDBIRTH.","authors":"Zorica Knezović Drakšić, Hrvojka Soljačić-Vraneš, Ivka Djaković, Hrvoje Vraneš","doi":"10.20471/acc.2024.63.02.8","DOIUrl":"10.20471/acc.2024.63.02.8","url":null,"abstract":"<p><p>The aim of this study was to assess the effect of social factors such as living in rural <i>versus</i> urban area or in an extended <i>versus</i> nuclear family regarding female sexuality in the postpartum period. In this cross-sectional study 113 women took part. They filled-out a questionnaire that contained sociodemographic questions about their marital status, place of residence, number of family members, and questions about sexual intercourses after giving birth. They were also asked about the frequency, time elapsed until resuming sexual intercourse, and presence of dyspareunia. Time period from giving birth until resuming sexual intercourse was 8 weeks on average. Place of residence (median test: χ<sup>2</sup>(2)=3.3, p>0.05) and number of household members (median test: χ<sup>2</sup>(4)=0.87, p>0.05 for number of household members) had no effect on that time period. There was no significant difference in the frequency of sexual intercourse between women living in urban and rural area (χ<sup>2</sup>-test(1)=0.03, p>0.05). Women in larger families were more sexually active in comparison to women in smaller families (χ<sup>2</sup>-test(2)=9.08, p<0.05). Dyspareunia was reported by 41.3% of study women. Sexuality of women in the postpartum period is liable to social effects. Social support of family members has a greater impact on sexuality in the postpartum period than other social factors such as place of residence. Besides support of close family members, women in that period should have organized social protection and access to information.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"326-331"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655596","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":"POSITIVE CONE MARGINS - A DISADVANTAGE OF THE LARGE LOOP EXCISION OF TRANSFORMATION ZONE TECHNIQUE?","authors":"Dražan Butorac, Bernarda Škrtić, Iva Pitner, Krunoslav Kuna, Ivka Djaković","doi":"10.20471/acc.2024.63.02.5","DOIUrl":"10.20471/acc.2024.63.02.5","url":null,"abstract":"<p><p>The aim was to compare the efficiency of large loop excision of the transformation zone (LLETZ) and cold-knife conization according to the incidence of positive cone margins in histopathologic analysis of the cervical cone. In the study, data obtained from 568 female patients with cone biopsy due to cervical changes during a four-year period (2012-2015) were retrospectively analyzed. Group 1 included patients who were operated on using LLETZ technique and group 2 consisted of patients with cold-knife cone biopsy. LLETZ was a method of choice in 334 (59%) patients, whereas 234 (41%) patients underwent cold-knife cone biopsy. The percentage of positive cone margins was much higher with LLETZ technique, even 39% (131 patients), as compared to 20% with cold-knife cone biopsy. In conclusion, the technique and cone configuration should be individualized, depending on the specifics of the lesion. The transformation zone is not always removed during one LLETZ procedure. High percentage of positive cone margins is not a disadvantage of LLETZ technique because of differences in indications, approach and multiple cutting. The real success of conization can be measured only by the relapse frequency over a long period of time with a high number of patients.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"300-305"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655830","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":"THE EFFECT OF URIC ACID LEVEL ON THE SEVERITY OF COVID-19.","authors":"Kubra Aydin Bahat","doi":"10.20471/acc.2024.63.02.1","DOIUrl":"10.20471/acc.2024.63.02.1","url":null,"abstract":"<p><p>Epidemiological and clinical features of COVID-19 have been reported, but risk factors need to be determined to predict the course of the disease. In our study, we aimed to determine the effect of uric acid level on the severity of the disease. COVID-19 patients who received inpatient treatment between March 11, 2020 and May 30, 2020, and whose uric acid level was measured were included in the study. Demographic characteristics, comorbidities, symptoms, clinical course, laboratory parameters, and treatments were recorded. The study included 83 patients, of these 43 (52%) were males. The mean age was 59±17.1 years. The mean uric acid and albumin levels of the patients who needed oxygen were lower than in those who did not need oxygen (p=0.471 and p=0.057, respectively). There was a significant relationship between the presence of hypouricemia and mortality (p=0.019). In addition, the mean uric acid levels of patients who needed intensive care or died were lower than the mean uric acid levels of patients who did not need intensive care or who lived (p=0.665 and p=0.241, respectively). Oxygen need, intensive care need, and low uric acid level were found to be associated with increased length of hospital stay (p=0.00, p=0.001, p=0.012, and r=-0.276, respectively). Our study results suggest that uric acid levels may be associated with disease severity in the course of COVID-19.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"251-259"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655772","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":"ORAL HEALTH STATUS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE.","authors":"Filip Doder, Lara Vranić, Luka Šimunović","doi":"10.20471/acc.2024.63.02.14","DOIUrl":"10.20471/acc.2024.63.02.14","url":null,"abstract":"<p><p>The aim is to point to oral health status in patients suffering from chronic obstructive pulmonary disease (COPD). The study included 106 patients diagnosed with COPD who were treated at the Special Hospital for Pulmonary Diseases, Zagreb, Croatia. The World Health Organization questionnaire for oral health in adults was used as a validated measure to assess oral health. Results were compared based on the severity of the disease according to the GOLD classification, long term oxygen therapy, and their smoking habits. Most patients (61.3%) had less than 10 teeth. Also, 82.2% of the patients had problems with their oral health in the previous year. More than half of the patients (55.7%) ranked the status of their oral cavity and teeth as average or worse, whereas 58.5% of the patients ranked their gingival status as good or better. Also, 55.7% of the patients brushed their teeth once a day or less, which was more pronounced in men. The same percentage of the patients did not know whether their toothpaste contained fluoride. Sixty-seven percent of the patients were former smokers, while the rest were active smokers. Smokers reported more frequent feeling of shame and tension because of the appearance of their teeth in relation to non-smokers. Patients with advanced stages of COPD are more likely to report problems with eating and chewing food compared to patients with less advanced stages of the disease. According to the results, further systematic education of COPD patients is crucial in promoting the importance of oral health.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"376-383"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655795","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":"ARTERIOVENOUS FISTULA FOR HEMODIALYSIS IN RELATION TO THE TIMING OF CREATION: ANALYSIS OF KEY FACTORS.","authors":"Radojica V Stolić, Mirjana Pajčin, Vekoslav Mitrović, Nataša D Zdravković, Saša Sovtić, Snežana Marković-Jovanović, Slavica Pajović, Kristina Bulatović, Branka Mitić, Dragiša Rašić","doi":"10.20471/acc.2024.63.02.13","DOIUrl":"10.20471/acc.2024.63.02.13","url":null,"abstract":"<p><p>Timely creation of an arteriovenous fistula is not always feasible. The aim was to determine the key factors for functionality and maturation of arteriovenous fistulas in relation to timing of its creation. The research was conducted at the Department of Nephrology and Dialysis, Kragujevac University Clinical Center, Kragujevac, Serbia, in patients who had had a fistula surgically created over a period of fifteen years. A total of 1089 patients were registered. All clinical and biochemical parameters that were of interest for this study were analyzed. The group of patients with fistulas created before the start of hemodialysis was statistically different from the group of patients whose fistulas were created after the start of hemodialysis according to vein lumen (p=0.005), systolic blood pressure (p<0.001), total cholesterol (p<0.001), HDL cholesterol (p=0.008) and LDL cholesterol (p<0.001). Predictive parameters of the initial dysfunction were vein diameter (p=0.004), cholesterol (p=0.008) and LDL cholesterol (p=0.033), while the maturation parameter was systolic blood pressure (p=0.042). In conclusion, predictive parameters of initial fistula dysfunction are vein diameter, cholesterol and LDL cholesterol, while systolic blood pressure is most important for maturation.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"368-375"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655851","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}
Maša Malenica, Tena Trbojević, Stjepan Herceg, Monika Kukuruzović, Iva Šeparović, Nina Rotim, Krešimir Rotim
{"title":"GIGANTISM AND ACROMEGALY THROUGH HISTORY.","authors":"Maša Malenica, Tena Trbojević, Stjepan Herceg, Monika Kukuruzović, Iva Šeparović, Nina Rotim, Krešimir Rotim","doi":"10.20471/acc.2024.63.02.15","DOIUrl":"10.20471/acc.2024.63.02.15","url":null,"abstract":"<p><p>Giants and acromegalists have long captured attention, and they were often almost mythical creatures of great strength and power. Due to their expressive appearance, they were recorded in myths and works of art much earlier than they were of interest to medical practitioners. The first recognition was made by a Dutch physician Johannes Wier in 1567, but the first description and appellation originated by Pierre Marie in 1886. Involvement and interest from neurosurgeons followed, and in 1907, Hermann Schloffer performed the first transsphenoidal surgery in a patient with pituitary adenoma. In 1909, Harvey Cushing linked removal of the enlarged pituitary gland to regression of acromegaly and considered 'growth hormone' a pathophysiological trigger. Knowledge of acromegaly has been enhanced by the discovery of growth hormone (GH) and insulin-like growth factor (IGF-I) and evidence for an association between GH hypersecretion and elevated circulating IGF-I with the clinical phenotype. After 1970, pharmacotherapy (dopamine agonists, somatostatin analogs and GH receptor blockers) was introduced. Despite advances in drug therapy and radiotherapy, surgical treatment still provides optimal results (first-line treatment) after more than a century of attempts. In this paper, we present gigantism and acromegaly over time, important turning points from its recognition to the current insights and fundamental approach reminding us of the immense prosperity of medicine and science. The development of basic sciences and clinical endocrinology will enable progress and improvement of comprehension in the pathogenesis and diagnostics, as well as curative modalities.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"384-392"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655632","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}
Goran Lakičević, Bruno Splavski, Sandra Lakičević, Krešimir Rotim
{"title":"PATIENT-REPORTED SURVEY TO ASSESS CLINICAL STATUS AND SURGICAL OUTCOME AFTER ANTERIOR CERVICAL DISCECTOMY AND FUSION USING AN ALLOGRAFT WITH A FIXED ANGLE OF INCLINATION.","authors":"Goran Lakičević, Bruno Splavski, Sandra Lakičević, Krešimir Rotim","doi":"10.20471/acc.2024.63.02.12","DOIUrl":"10.20471/acc.2024.63.02.12","url":null,"abstract":"<p><p>Degenerative cervical disc disease can be surgically treated by various procedures, one of which is anterior cervical discectomy and fusion (ACDF). It is used to stabilize the spine and decompress neural structures of the spinal canal. However, measuring its impact on postoperative clinical status and surgical outcome is difficult. That is the reason why patient-reported surveys are commonly used to assess clinical status and surgical outcomes. To evaluate the surgical outcomes of ACDF with an allograft with a fixed angle of inclination at one cervical level, we conducted a prospective study on 60 patients over one year. We used a structured patient-reported survey based on the visual analog scale (VAS), Oswestry Disability Index (ODI), and Odom questionnaire. Most patients experienced significant reduction in pain intensity in their arms and neck after undergoing ACDF with a carbon wedged-shaped allograft with a fixed inclination angle of 7º. This improvement was equally represented across all age groups and levels of the cervical spine operated on. Most patients also experienced a decrease in postoperative disability, as measured by the ODI, regardless of their age or the level of the cervical spine operated on. The majority of them rated their outcomes as either excellent or good, which was true across all age groups and levels of the cervical spine. In conclusion, patient-reported clinical status and outcome surveys are valuable and easy-to-perform tools for evaluating the quality of life of patients suffering from degenerative cervical disc disease after ACDF with a carbon cage having a fixed inclination angle.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"358-367"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655801","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}