Acta clinica Croatica最新文献

{"title":"DISTAL FEMUR AND PROXIMAL TIBIA MORPHOMETRY AFTER TOTAL KNEE ARTHROPLASTY: 3D CT ANALYSIS IN OA <i>VERSUS</i> NORMAL KNEES.","authors":"Sayed Abdulla Jami, Mohammad Khaleel Sallam Ma'aitah","doi":"10.20471/acc.2025.64.01.16","DOIUrl":"10.20471/acc.2025.64.01.16","url":null,"abstract":"<p><p>There is a paucity of data concerning morphological differences in the resected distal femur and proximal tibia between osteoarthritis (OA) and normal knees. The objective of this study was to determine if morphometric differences existed in the resected distal femur and proximal tibia surface between OA and normal knees in the Chinese population. Ninety-eight OA knees and 96 normal ones taken from the Chinese population were measured by computed tomography for femoral mediolateral (fML), medial anteroposterior (fMAP), lateral anteroposterior (fLAP), medial condylar width (fMCW), lateral condylar width (fLCW) and tibial mediolateral (tML), middle anteroposterior (tAP), medial anteroposterior (tMAP), and lateral anteroposterior (tLAP) dimensions to determine morphological differences between OA and normal knees. The mean tMAP and fMCW dimensions were 50.2±3.3 mm and 28.7±2.3 mm for OA, and 48.8±3.8 mm and 27.1±2.2 mm for normal knees, respectively. There were significant differences between OA and normal knees concerning tMAP and fMCW dimensions (p<0.05). The study revealed morphological differences in tMAP and fMCW between the OA and normal knee groups, which may provide guidelines for designing better knee implants that are more size-matching for OA knees.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"64 1","pages":"150-155"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666751","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 INTRADIALYTIC THERAPEUTIC EXERCISES AND ELECTRICAL STIMULATION ON LEG FUNCTIONAL ABILITY, DIALYSIS EFFICACY AND INTRADIALYTIC HYPOTENSION IN PATIENTS ON CHRONIC HEMODIALYSIS.","authors":"Petra Kovačević Totić, Karmela Altabas, Vanja Ivković, Velimir Altabas, Siniša Šefer, Karla Kovačević Čorak, Simeon Grazio","doi":"10.20471/acc.2025.64.01.04","DOIUrl":"10.20471/acc.2025.64.01.04","url":null,"abstract":"<p><p>Chronic inflammation and protein energy malnutrition in patients on hemodialysis lead to decrease in muscle mass and impaired functional ability. Our goal was to evaluate the effect of a combination of electrical stimulation (ES) with intradialytic therapeutic exercises on dialysis efficacy, ar- terial blood pressure, and functional ability of lower extremities. The study involved 35 patients who were on chronic hemodialysis. The study consisted of two phases. During the first month, no intervention was performed. It was followed by a therapeutic program combining intradialytic resistance exercises with ES on quadriceps muscle, which was performed 3 times a week for 3 months. Functional tests for lower extremity and body composition analysis were obtained at baseline and at the end of the study. Arterial pressure, dialysis efficacy and laboratory parameters were monitored. Functional tests showed significant improvement after the intervention. A significant positive correlation was found in patients who had shown improvement in functional tests, with less intradialytic episodes of hypotension and improvement in dialysis efficacy. This study found a positive effect of combining resistance exercises and ES on dialysis efficacy and functional ability of lower extremities in patients on chronic hemodialysis.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"64 1","pages":"38-45"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666722","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":"CHANGES IN SALIVARY PROTEOME WITH REGARD TO PAIN-RELATED PROTEINS FOLLOWING FIXED ORTHODONTIC APPLIANCE PLACEMENT.","authors":"Iva Jelić, Ruđer Novak, Stela Hrkač, Grgur Salai, Marko Močibob, Lovorka Grgurević","doi":"10.20471/acc.2025.64.01.11","DOIUrl":"10.20471/acc.2025.64.01.11","url":null,"abstract":"<p><p>Orthodontic tooth movement relies on the application of force that drives bone resorption and formation. As saliva reflects these processes and harbors proteins of diagnostic and prognostic value, we studied these changes in patients with malocclusion. This study sampled the proteomes and evaluated the intensity of experienced pain related to the apparatus placement in ten male patients with malocclusion on day 0, 30 and 60 of orthodontic therapy. A prospective shotgun proteomic pilot study identified 947 proteins, and demonstrated a shift in the salivary proteome during orthodontic therapy. Gene enrichment analysis revealed hemostasis, but also platelet activation, signaling, aggregation and degranulation as prominent processes occurring 30 days post appliance placement, while proteins related to antimicrobial resistance were detected throughout the observed tooth movement period. Our research indicated an increased expression of proteins related to the immune and protective response to foreign bodies and pathogens, cellular and tissue injury, and biomechanical stimuli associated to bone remodeling. While a direct linkage between the alteration of the proteomic profile and the direction of painful perception was not identified, all results suggest a well-coordinated yet complex occurrence involving a multitude of biologically active signaling pathways and molecules.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"64 1","pages":"102-109"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666774","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":"CONTEMPORARY CONCEPTS AND SURGICAL TECHNIQUES IN FACIAL REANIMATION: A SCOPING REVIEW.","authors":"Alan Pegan, Darko Solter, Davor Vagić, Andro Košec","doi":"10.20471/acc.2025.64.01.14","DOIUrl":"10.20471/acc.2025.64.01.14","url":null,"abstract":"<p><p>Paralysis of the facial nerve represents an exceptional functional, social and cos- metic problem for the patient. Loss of function directly leads to the inability to protect the eyes, as well as oral competence, while indirectly affecting breathing and verbal communication. Patients often encounter social stigmatization and isolation, which is direct consequence of the loss of mimic function and disfiguration that is necessary for everyday nonverbal communication. Thus, the quality of life is strongly impaired, and patients are prone to developing depression. The primary goal of reanimation is establishment of facial tone at rest, mimic function, and symmetry. The method of choice is directly dependent on the time elapsed from the onset of paralysis. Facial reanimation methods can be divided into static and dynamic. In reanimation procedures, we usually divide the face into thirds. Procedures for reanimation of the upper third of the face include oculoplastic procedures, which are divided according to the place of intervention into procedures aimed at the eyebrow, upper and lower eyelid. Static methods predominate here, i.e., endoscopic eyebrow lifting, tightening of the upper eyelid, and tightening of the lower eyelid. Procedures for reanimation of the lower third of the face are mainly based on restoring oral competence and smile, therefore the method of choice is dynamic reanimation. Direct repair of the nerve either by direct anastomosis or interposition provides the best results. In the absence of the proximal part of the facial nerve, and functional distal branches, local motor nerves and/or cross facial nerve graft (CFNG) are used as a source. In the case of long-term paralysis of the facial nerve (>2 years), muscle tissues are used in reanimation using local or innervated free flaps. Of the local muscle flaps, we most often use the minimally invasive temporalis tendon transfer (MIT3) method. The gracilis free flap is most often used in younger patients who desire to achieve a more accentuated smile, and the procedure can be performed in one or two acts. Reanimation of the face is an often neglected but extremely important procedure that should provide the patient with partial function resumption while significantly improving the quality of life.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"64 1","pages":"130-140"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666771","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":"FACTORS ASSOCIATED WITH COVID-19 RELATED DEATH IN 2020 IN CROATIA: A NATIONWIDE OBSERVATIONAL COHORT STUDY.","authors":"Sanja Musić Milanović, Tin Orešković, Helena Križan, Adriana Vince","doi":"10.20471/acc.2025.64.01.08","DOIUrl":"10.20471/acc.2025.64.01.08","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) has had a global effect on mortality. Many attempts were made to identify those at the highest risk of death if infected with SARS-CoV-2, yet the relative importance and global generalizability of individual risk factors remain unclear. At the Croatian Institute of Public Health, electronic health data from multiple databases were combined to examine factors associated with COVID-19 related death. Data on 212 615 patients confir med to have COVID-19 by a positive RT-PCR in 2020 were pseudonymously linked to hospital records and 16 150 hospitalized patients were identified. Apart from older age and male sex, major factors associated with an increased rate of mortality among patients hospitalized with COVID-19 were cardiovascular diseases (adjusted HR: 1.20; 95% CI 1.12-1.28); diabetes (adjusted HR: 1.17; 95% CI 1.09-1.25); and chronic lower respiratory diseases (adjusted HR: 1.10; 95% CI 1.02-1.18). This Croatian study used primary care and hospital data to establish factors associated with COVID-19 related death among patients hospitalized with COVID-19. The results of this study provide rigorous evaluation of the previously defined risk factors and offer guidance for further studies that will create prognostic models based on empirical data from 2020.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"64 1","pages":"68-79"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666717","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":"TELEDERMATOLOGY AS A TRIAGE METHOD DURING THE COVID-19 PANDEMIC AND EARTHQUAKE AFTERMATH IN ZAGREB.","authors":"Vedrana Bulat, Mirna Šitum, Nika Filipović, Marija Delaš Aždajić, Iva Crnarić","doi":"10.20471/acc.2025.64.01.05","DOIUrl":"10.20471/acc.2025.64.01.05","url":null,"abstract":"<p><p>The COVID-19 pandemic has put a tremendous burden on the medical community and brought a great number of accompanying issues, as well as other closely associated diseases. The response to this public health and medical challenge was outstanding. However, dealing with the COVID-19 pandemic and various issues brought on by the earthquake was successfully facilitated by the use of teledermatology. This innovative technology enabled dermatovenereologists to stay in continuous touch with their patients and provide much needed care and assistance in difficult circumstances caused by several crises.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"64 1","pages":"47-49"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666789","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":"VITAMIN D IN PATIENTS WITH INFLAMMATORY SKIN DISEASES.","authors":"Liborija Lugović-Mihić, Maja Tolušić Levak, Sara Špičić, Vedrana Bulat, Ana Brkić, Ana Šešerko","doi":"10.20471/acc.2025.64.01.13","DOIUrl":"10.20471/acc.2025.64.01.13","url":null,"abstract":"<p><p>In search for the ways to cure and improve skin condition of patients with inflammatory skin diseases, vitamin D supplementation has been shown to be useful, primarily due to its effects on a number of skin functions, e.g., keratinocyte proliferation, differentiation and apoptosis, maintenance of the epidermal barrier, and regulation of immune processes in the skin, among others. Vitamin D is essential for good general health and healthy skin, but deficiency can occur due to various factors that result in increased time spent indoors and limited sunlight exposure, such as geography (place of residence) and genetic factors. Although some results are inconsistent, previous research indicates that multiple inflammatory skin diseases can be affected by vitamin D deficiency, particularly atopic dermatitis, but also other inflammatory skin diseases. There is also evidence for an association between vitamin D deficiency and the risk of worsening of skin diseases such as psoriasis, chronic urticaria, contact dermatitis, etc. For these and several other inflammatory skin diseases, most research suggests that patients benefit from vitamin D supplementation.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"64 1","pages":"118-128"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666419","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":"SIMULTANEOUS PULMONARY EMBOLISM WITH CARDIAC TAMPONADE AND REPETITIVE ISCHEMIC STROKE AS VASCULAR COMPLICATIONS OF LUNG CANCER: A CASE REPORT AND SYSTEMATIC LITERATURE REVIEW.","authors":"Nikola Kos, Mislav Vrsalović","doi":"10.20471/acc.2025.64.01.19","DOIUrl":"10.20471/acc.2025.64.01.19","url":null,"abstract":"<p><p>It is known that patients with lung cancer have a considerably higher incidence of cardiovascular complications that lead to venous or arterial events, and malignant pericardial effusion can often be observed due to pericardial metastases. Simultaneous occurrence of cardiac tamponade and venous thromboembolism almost always happens in patients with lung malignancy. Our case report describes a patient with concurrent pulmonary embolism and cardiac tamponade as the initial manifestation of lung cancer, which, apart from pericardiocentesis and symptomatic therapy, was treated at long term with a direct oral anticoagulant (apixaban). Therapy was well tolerated by the patient and there were no bleeding complications related to primary disease and anticoagulant treatment. The course of the disease was complicated by repetitive strokes, which were treated with mechanical thrombectomy. Because of this scenario, a systematic review of the literature was conducted, listing all available case reports of patients with the simultaneous occurrence of cardiac tamponade and pulmonary embolism. In all patients, the underlying condition was lung malignancy, often as the first manifestation of the disease. This is a relatively rare event, and the approach to long-term treatment varied from case to case in the absence of valid guidelines. Our case demonstrated that, in the light of new studies and guidelines, apixaban represented a safe and effective treatment option even in patients at a high risk of bleeding.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"64 1","pages":"166-172"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666706","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":"LASER SURGERY FOR PILONIDAL DISEASE - A NOVEL MINIMALLY INVASIVE PROCEDURE.","authors":"Tihomir Grgić, Dora Grgić, Mirna Žulec, Fran Rašić, Zvonimir Zadro, Karlo Golubić, Kristina Šemanjski","doi":"10.20471/acc.2025.64.01.17","DOIUrl":"10.20471/acc.2025.64.01.17","url":null,"abstract":"<p><p>Pilonidal disease (PD) is a common inflammatory disease of the gluteal region with an incidence of 26/100000 and usually occurs in young males (15-30 years old). The etiology of pilonidal disease is unclear, but literature describes a wide range of factors such as keratin plugs, foreign substance reaction related to hairs, as well as dermatopathy and debris in hair follicles in the natal cleft. PD and also its classic treatment can cause discomfort and very much deteriorate the patient's quality of life. There are many possibilities (conservative or surgical) in the treatment of pilonidal disease, but there is no gold standard. In the acute phase (abscess), surgical incision with pus evacuation and antibiotic therapy is enough. In the chronic phase, there are many possibilities like phenol treatment, surgical excision with lay open and secondary wound healing. There are many reconstructive techniques such as Karydakis, V-Y flap or Limberg flap. A recently minimally invasive technique such as endoscopic surgical procedure or filling pilonidal tract with fibrin glue or phenol have been introduced. We present our experience with laser treatment (Biolitec, Germany) of pilonidal sinus disease.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"64 1","pages":"157-161"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666747","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":"DIFFERENCES BETWEEN AQUEOUS HUMOR AND SERUM CONCENTRATIONS OF BDNF AND PPARG GENETIC VARIANTS IN GLAUCOMA PATIENTS.","authors":"Tena Križ, Mia Zorić Geber, Ana Merkler Šorgić, Ana Kozmar, Katia Novak-Lauš, Zoran Vatavuk, Jadranka Sertić","doi":"10.20471/acc.2025.64.01.15","DOIUrl":"10.20471/acc.2025.64.01.15","url":null,"abstract":"<p><p>Brain-derived neurotrophic factor (BDNF) is essential for neuronal development, differentiation and survival, and aberrant BDNF expression in retina is associated with glaucoma. Peroxisome proliferator-activated receptor gamma (PPAR-γ) in retinal pigment epithelium plays a significant role in ocular pathophysiology. <i>PPARG</i> c.34C>G (rs1801282) (p.Pro12Ala) modulates transcriptional activity. This study aimed to determine whether BDNF in aqueous humor and serum could be used as a biomarker for primary open angle glaucoma (POAG) and to examine differences between <i>PPARG</i> genotype and BDNF concentrations in aqueous humor and serum in POAG patients. The study included 140 POAG patients and 87 non-glaucoma controls. BDNF concentrations were measured by ELISA methods and <i>PPARG</i> genotype was determined by PCR-RFLP. BDNF concentrations in aqueous humor were significantly higher in POAG patients compared to controls (p=0.001). A significant difference in aqueous humor BDNF concentration was observed between early and moderate (p=0.008) and early and advanced stages of POAG (p=0.022). There was no significant difference between BDNF concentration in aqueous humor and PPARG genotype in POAG patients (p=0.184). BDNF in aqueous humor may serve as a dynamic biomarker for POAG. No significant differences were found between <i>PPARG</i> genotypes and BDNF concentrations.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"64 1","pages":"142-149"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666730","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}