{"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}
{"title":"CROATIAN GUIDELINES FOR SPECIFIC PREVENTIVE TREATMENT OF MIGRAINE WITH MONOCLONAL ANTIBODIES TARGETING CALCITONIN GENE-RELATED PEPTIDE (CGRP) (EPTINEZUMAB, FREMANEZUMAB, AND GALCANEZUMAB) OR THE CGRP RECEPTOR (ERENUMAB).","authors":"Davor Jančuljak, Damir Petravić, Darija Mahović Lakušić, Arijana Lovrenčić-Huzjan, Koraljka Bačić Baronica, Marijana Bosnar Puretić, Zlatko Hucika, Marina Titlić, Zvonimir Popović, Zoran Tomić, Maristela Stojić, Vanja Bašić Kes","doi":"10.20471/acc.2024.63.02.22","DOIUrl":"10.20471/acc.2024.63.02.22","url":null,"abstract":"<p><p>Calcitonin gene-related peptide (CGRP) plays a key role in the pathophysiology of migraine, acting on CGRP receptors in the trigeminovascular system, causing neurogenic inflammation and vasodilation, and promoting nociception. Four specific monoclonal antibodies targeting CGRP are available for prevention of episodic and chronic migraine in adults with at least four migraine days <i>per</i> month. The aim of these guidelines is to provide evidence-based recommendations for the use of monoclonal antibodies targeting CGRP in migraine prevention in Croatia. The questions were formulated using the Patients, Intervention, Comparison, Outcome (PICO) criteria, with evidence-based answers. To assess the quality of scientific evidence, a review of the literature available in PubMed was performed. Relevant studies were reviewed by the Expert Group of the Headache Section of the Croatian Neurological Society, and served as the basis for formulating the recommendations outlined in these guidelines. We found high quality evidence for good safety and efficacy of anti-CGRP monoclonal antibodies in the preventive treatment of episodic and chronic migraine. These medications may be considered as first-line prophylactic therapy depending on the patient's history, concomitant diseases, and disease burden. Further real-world studies are needed to elucidate other aspects of their application.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"436-450"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655567","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":"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":"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":"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}
Hamide Zengin, Aslı Akdeniz Kudubes, Gülcin Ozalp Gerceker
{"title":"TURKISH VALIDITY AND RELIABILITY STUDY OF A SYMPTOM SCREENING TOOL (MINI-SSPedi) IN 4-7-YEAR-OLD CHILDREN RECEIVING CANCER TREATMENT.","authors":"Hamide Zengin, Aslı Akdeniz Kudubes, Gülcin Ozalp Gerceker","doi":"10.20471/acc.2024.63.02.10","DOIUrl":"10.20471/acc.2024.63.02.10","url":null,"abstract":"<p><p>This research was carried out to adapt the Symptom Screening in Pediatrics Tool for Turkish children with cancer aged 4-7 years, and to evaluate its validity and reliability. This study, which was descriptive and methodological, was conducted on 159 children receiving cancer treatments between June 2021 and December 2021. Data collection tools included a socio-demographic form and the Symptom Screening in Pediatrics Tool for children aged 4-7 years (mini-SSPedi). Data were analyzed using Cronbach's alpha, factor analysis, and item-total score analysis. There were 15 items on the mini-SSPedi, and it had one dimension. The results of the exploratory factor analysis indicated that total factor loading was >0.30 and that the Kaiser-Meyer-Olkin value was 0.831. The confirmatory factor analysis indicated that the fit indices were χ<sup>2</sup>/sd: 1.739 (p=0.000), GFI 0.895, CFI 0.919, TLI 0.897, RMSEA 0.068 and SRMR 0.064. Cronbach's alpha coefficient of the total scale was 0.846. The correlation between the items and total scale score ranged between 0.411 and 0.749. The mini-SSPedi was found to be a valid and reliable scale for the Turkish sample. The mini-SSPedi can contribute to determination of symptom screening in children with cancer aged 4-7 years.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"340-350"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655807","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}
Karolina Lice, Ana Matić Škorić, Jelena Kuvač Kraljević
{"title":"WORD PROCESSING ABILITIES IN SUBJECTS AFTER STROKE OR TRAUMATIC BRAIN INJURY.","authors":"Karolina Lice, Ana Matić Škorić, Jelena Kuvač Kraljević","doi":"10.20471/acc.2024.63.02.4","DOIUrl":"10.20471/acc.2024.63.02.4","url":null,"abstract":"<p><p>Acquired language disorder is a common consequence of stroke and traumatic brain injury (TBI). Following the logogen model, this study investigated word processing abilities of post-stroke and post-TBI patients. Within- and between-group differences in word comprehension, naming, and reading were observed, as well as predominant errors in performance. Twenty-two post-stroke and 22 post-TBI patients were tested using tasks from the Comprehensive Aphasia Test-HR (CAT-HR). Post-TBI patients outperformed post-stroke patients in naming and reading. Both groups exhibited neologisms, phonological, semantic and unrelated errors, although in different proportions. In word comprehension and naming, post-TBI patients primarily exhibited semantic errors, whereas post-stroke patients had equally distributed phonological and semantic errors. In reading, both groups predominantly produced phonological errors. Error distribution differed only in naming, with post-TBI patients exhibiting more semantic errors than post-stroke patients. Therefore, performance in naming differentiated these groups most. Although error analysis is rather insightful, one cannot expect a particular profile of language disturbances in post-stroke and post-TBI patients. The findings obtained bear concrete clinical implications, especially those related to the role and meaning of the errors produced by the patient to determine the exact location of the processing deficits.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 2","pages":"283-299"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655854","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}