Acta clinica Croatica最新文献

{"title":"MASS QUARANTINE EXPERIENCE AFTER UMRAH VISIT.","authors":"Burak Bekgöz, İshak Şan, Eren Usul","doi":"10.20471/acc.2024.63.03-04.05","DOIUrl":"10.20471/acc.2024.63.03-04.05","url":null,"abstract":"<p><p>This study aimed to determine demographic characteristics, COVID-19 positivity rates of the quarantined individuals, and risk factors between those developing and not developing disease symptoms. The individuals who returned from Mecca, Saudi Arabia to Turkey on March 15, 2020 were transported from the airport to the campus of dormitories and quarantined for 14 days. This study included 2941 passengers who returned from Umrah visit to Turkey and were quarantined between March 15, 2020 and April 2, 2020. There were 1828 (62.2%) women. The polymerase chain reaction (PCR) test was positive in 295 (10%) of those in quarantine, 196 (66.4%) of them women. Among the patients with a positive PCR test result, there was no significant difference between women and men in terms of age and comorbidity. Of the 295 COVID-19 patients detected, 37 (12.5%) had symptoms. There was no significant difference between symptomatic individuals and asymptomatic individuals in terms of age, gender, and comorbidity. Quarantining everyone who has come from risky areas ensures that patients are isolated from the community, which can prevent the spread of the disease.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 3-4","pages":"487-493"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231245","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":"PHEOCHROMOCYTOMA CRISIS TREATED WITH URAPIDIL: A CASE REPORT.","authors":"Miro Bakula, Lea Tomašić, Ivana Kokan, Katarina Mucić, Nikolina Marić, Maja Bakula","doi":"10.20471/acc.2024.63.03-04.45","DOIUrl":"10.20471/acc.2024.63.03-04.45","url":null,"abstract":"<p><p>Pheochromocytomas are rare tumors that present with a broad spectrum of symptoms and signs, making differential diagnosis broad. They can cause a pheochromocytoma crisis that manifests with arterial blood pressure oscillations, and subsequent symptoms and signs of catecholamine overproduction. There are many potential triggers of this condition. This report presents a 33-year-old man with an obvious pheochromocytoma crisis that occurred due to beta-blocker application without a concomitant alpha-blocker. The crisis was treated with high doses of urapidil, and once permanent hemodynamic stabilization was achieved, urapidil was replaced with phenoxybenzamine. This report demonstrates that pheochromocytoma crisis can be successfully treated with urapidil but further consideration is needed on the use of urapidil both in pheochromocytoma crisis and preoperative management of pheochromocytoma patients.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 3-4","pages":"816-821"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231307","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 USING TOPICAL ANESTHETIC DURING HIGH-SPEED DIGITAL IMAGING ON PHONATION ASSESSED BY DIGITAL KYMOGRAPHY PARAMETERS.","authors":"Mario Bilić, Juraj Slipac, Lana Kovač Bilić","doi":"10.20471/acc.2024.63.03-04.18","DOIUrl":"10.20471/acc.2024.63.03-04.18","url":null,"abstract":"<p><p>High-speed digital imaging (HSDI) is a contemporary method of the phonation process assessment. It records laryngeal images at a rate of up to 8000 frames <i>per</i> second. Digital kymography (DK) extracts high-speed images sampled at a single point along the vocal folds and enables objective quantification of the vocal fold movements. According to the literature, usage of topical anesthetic (TA) in oral cavity, oropharynx and laryngopharynx prior to examination, in order to reduce pain and discomfort level, is optional but the effect of using TA on the phonation process is not well investigated. The aim of this study was to investigate the effect of using TA during HSDI on DK parameters. We performed a prospective double-blind randomized controlled study on 58 healthy subjects. All subjects were examined on 2 consecutive days using TA and using saline solution (placebo) by the same experienced examiner. DK images, made on the middle of the vocal folds, were obtained from HSDI. Vocal folds were examined across glottal cycles and glottal width and period irregularities, left-right phase asymmetry, and the open, closed, opening and closing quotient were calculated. Our data showed that using TA during HSDI did not induce statistically significant changes of DK parameters in healthy subjects.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 3-4","pages":"595-603"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231234","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":"LYMPHOSCINTIGRAPHY IN LYMPHEDEMA.","authors":"Igor Iskra, Tatjana Bogović Crnčić, Neva Girotto","doi":"10.20471/acc.2024.63.03-04.24","DOIUrl":"10.20471/acc.2024.63.03-04.24","url":null,"abstract":"<p><p>Lymphedema is a chronic, progressive condition caused by impaired lymphatic transport, leading to edema in the lower and/or upper extremities, depending on the underlying cause. The diagnosis is based on clinical examination, ultrasound findings, and imaging tests. Treatment is mostly conservative, usually long-term, and often yielding unsatisfactory results. Recently, surgical options have also become available. Lymphoscintigraphy, a non-invasive and simple nuclear medicine imaging technique, is considered the method of choice in diagnostic workup. It consists of intracutaneous or subcutaneous application of colloidal particles labelled with radioactive technetium-99m and two-dimensional or three-dimensional gamma camera imaging. Lymphoscintigraphy helps differentiate lymphedema from edema of another origin, assess disease severity, and evaluate surgery outcome. However, the procedure is not fully standardized, especially in terms of semiquantitative methods, which are additionally used in disease staging; however, their implementation varies depending on local experience and expertise.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 3-4","pages":"647-655"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231248","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":"TEN-YEAR OUTCOMES AFTER ACUTE STEMI TREATED WITH PRIMARY PCI - THE ROLE OF ACUTE BIOMARKERS AND OTHER PARAMETERS IN PREDICTING CLINICAL SEVERITY AND PROGNOSIS.","authors":"Marko Mornar Jelavić, Zdravko Babić, Dorijan Babić, Diana Balenović, Ronald Lipovšćak, Hrvoje Pintarić","doi":"10.20471/acc.2024.63.03-04.34","DOIUrl":"10.20471/acc.2024.63.03-04.34","url":null,"abstract":"<p><p>This rare prospective study investigated 10-year outcomes of acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), and evaluated the role of acute biomarkers and other parameters in predicting clinical severity and prognosis. We included 250 patients and analyzed their baseline (cardiovascular risk factors), laboratory (maximal CK/TnT, acute inflammatory (white blood cells (WBC), hs-CRP), and liver biomarkers (AST/LDH), glomerular filtration rate (eGFR)) and clinical severity parameters (length of hospital stay, in-hospital complications, coronary angiography, and echocardiography (LVEF)). After hospital discharge, 229 patients were followed-up (2011-2022) and grouped according to the presence of major adverse cardiovascular events (MACE). In the acute phase, WBC, hs-CRP, LDH and AST positively correlated with maximal CK/cTnT and total in-hospital complications, and negatively with LVEF; WBC positively correlated with cardiogenic shock and stent diameter, hs-CRP with cardiac arrest and length of hospital stay, and LDH with stent diameter; total in-hospital complications increased the risk of in-hospital mortality and number of significantly stenosed coronary arteries, risk of heart failure, whereas the length of hospital stay negatively correlated with LVEF (p<0.05 all). During 10-year follow-up, LDH and clinical severity parameters (stenosis of LAD/ACx, multivessel CAD, proximal coronary stenosis, Gensini score, in-hospital complications) increased, while the others (normal eGFR and LVEF) reduced the risk of total MACE (p<0.05). In conclusion, acute biomarkers have a role in predicting clinical severity but they have no role in predicting long-term prognosis (except for LDH). Total in-hospital complications, more severe CAD, systolic dysfunction, and worse kidney function may lead to worse in-hospital and long-term outcomes.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 3-4","pages":"733-744"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231089","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 IMPACT OF ENDODONTIC STATUS ON QUALITY OF LIFE.","authors":"Petra Dijanić, Ana Ivanišević, Silvana Jukić Krmek, Jelena Perica Pavešić, Zoran Karlović, Jurica Matijević","doi":"10.20471/acc.2024.63.03-04.13","DOIUrl":"10.20471/acc.2024.63.03-04.13","url":null,"abstract":"<p><p>The influence of endodontic status on quality of life has not been fully clarified. The aim of this study was to quantify the effect of endodontic status on everyday functioning using the psychometric instrument Oral Impacts on Daily Performances (OIDP) and to correlate endodontic status with quality of life using the OIDP questionnaire. A total of 600 participants were referred to dental radiography for digital orthopantomograms and asked to fill out the OIDP questionnaire. Digital orthopantomograms were analyzed and compared with OIDP results. The correlation between endodontic status and quality of life was tested. The statistical analysis consisted of descriptive statistics, non-parametric statistics, hierarchical multiple regression analysis by enter method, and correlation analysis. The results showed that quality of life was significantly affected by tooth loss (p<0.05). Endodontic treatment on canines and incisors positively correlated with higher OIDP scores, indicating an effect on quality of life (p<0.05). In conclusion, the correlations between variables describing the endodontic status and the quantitative results of the OIDP questionnaire indicate a measurable effect of endodontic disease/health on everyday functioning.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 3-4","pages":"552-559"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231199","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":"RHEOLOGICAL PARAMETERS OF CAROTID CIRCULATION IN METABOLIC SYNDROME WITH OR WITHOUT DIABETES MELLITUS.","authors":"Alen Hajdarević, Dragan Piljić, Fahrudin Šabanović, Dilista Piljić, Farisa Babić, Ajdin Beganović, Juš Kšela","doi":"10.20471/acc.2024.63.03-04.25","DOIUrl":"10.20471/acc.2024.63.03-04.25","url":null,"abstract":"<p><p>The aim of this research was to examine the rheological parameters of carotid arteries and the frequency of abnormal values in patients with metabolic syndrome (MetS) with and without diabetes mellitus (DM). The sample consisted of 90 subjects and was divided into two equal groups. The first group consisted of patients with MetS but without DM, while the second group had both MetS and DM. We used the values of the peak systolic velocity (PSV) as a reference for pathology. The results showed pathological values of PSV in the right internal carotid artery (ICA) in twelve patients in the MetS + DM group. The study found that the incidence of pathological rheological parameters was higher in subjects with MetS + DM as compared to those with only MetS. Subjects with MetS + DM had higher values of maximum acceleration during systole in various carotid arteries. A subject with MetS + DM also showed total flow obstruction in the left and internal carotid artery (ICA) and a severe narrowing of the right ICA, indicating the presence of carotid artery disease. The study also found that nearly two-thirds of subjects with MetS + DM had pathological values of PSV in the right ICA and slightly fewer in the left ICA. Research on French populations has shown similar results. Eleven patients had pathological values in the left ICA. The frequency of the carotid rheological parameters' abnormalities was significantly higher in the MetS with DM patient group. The frequency of abnormalities in the rheological parameters of carotid circulation was significantly higher in patients with MetS and DM (as compared to non-diabetic patients). In our study, pathological changes were generally more susceptible to ICA. This indicates the importance of screening the rheological parameters of subjects with MetS for the prevention and treatment of cerebrovascular disease.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 3-4","pages":"656-661"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231273","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 RECTAL ULTRASOUND IN RECTAL ADENOCARCINOMA STAGING: CAN A SURGEON RELY ON ENDOSCOPIC FINDINGS BEFORE THE SURGERY? - COMPARISON WITH POSTOPERATIVE PATHOLOGICAL DIAGNOSIS.","authors":"Melanija Ražov Radas, Nataša Lisica Šikić","doi":"10.20471/acc.2024.63.03-04.09","DOIUrl":"10.20471/acc.2024.63.03-04.09","url":null,"abstract":"<p><p>Our aim in this study was to demonstrate the usefulness of endoscopic rectal ultra- sound scan (ERUS) in providing information that can help surgeons decide on therapeutic approach and type of surgical procedure in patients with rectal cancer. We compared ERUS findings with postoperative pathological data in 41 patients with endoscopic and pathological (PH) diagnosis of rectal cancer. These patients underwent ERUS examination to determine the extent of the disease and the findings were subsequently compared with postoperative pathological diagnosis. After ERUS examination, there were three patients in group T0, five in group T1, 12 in group T2, 17 in group T3, two in group T4, and two patients had a mucinous metastatic type of cancer. After excluding 15 patients who met the exclusion criteria, we compared ERUS findings of 26 patients with their pathological diagnosis to determine the sensitivity and accuracy of ERUS. The total sensitivity of the ERUS in preoperative staging of the tumor stage T0-T4 was 96%. Accuracy was 89%. This study showed that a surgeon can rely on the findings of ERUS performed by an experienced endoscopist before deciding of type of surgical procedure for T0-T2, and even T3 degree of rectal cancer. T3 rectal cancers are in the \"gray zone\", so both procedures, ERUS and nuclear magnetic resonance imaging (NMR), are needed to decide on the final therapeutic approach. NMR remains the gold standard for staging T4 rectal cancer.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 3-4","pages":"518-522"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231301","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":"COMPLICATED POSTERIOR STERNOCLAVICULAR JOINT DISLOCATION WITH AORTIC ARCH IMPINGEMENT.","authors":"Domagoj Lemac, Ivo Dumić-Čule, Ante Legac, Tomislav Čengic, Igor Nikolić, Igor Čikara, Boris Brkljačić, Gordana Ivanac","doi":"10.20471/acc.2024.63.03-04.43","DOIUrl":"10.20471/acc.2024.63.03-04.43","url":null,"abstract":"<p><p>Posterior sternoclavicular dislocation accompanied by clavicular end fracture is an extremely rare injury according to the available literature. We present a case of a young male with this injury, resulting from a vehicle accident, and additionally complicated by a clavicular bone fragment in the proximity of the aortic arch. An initial X-ray showed no signs of bone trauma, which was, however, revealed on a CT scan. Stable fixation of the fragment and sternoclavicular joint was achieved utilizing a plate and screws. The osteosynthetic material was removed after eight weeks due to the plate breaking. There were no complications in the 5-year follow-up period, and a full range of motion was accomplished. We aimed to emphasize the importance of early diagnosis and appropriate surgical management of complicated posterior sternoclavicular dislocations to avoid life-threatening events.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 3-4","pages":"808-811"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231141","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":"DIAGNOSTIC VALUE OF STIMULATED SERUM THYROGLOBULIN IN THE FOLLOW-UP OF PATIENTS WITH DIFFERENTIATED THYROID CANCER.","authors":"Vlado Wagenhofer, Ivan Mihaljević, Tatjana Kralj, Dubravka Vrdoljak, Tomislav Kizivat","doi":"10.20471/acc.2024.63.03-04.02","DOIUrl":"10.20471/acc.2024.63.03-04.02","url":null,"abstract":"<p><p>The aim was to determine the diagnostic value of stimulated serum thyroglobulin (sTg) for the follow-up of patients with differentiated thyroid cancer (DTC) and to evaluate whether repeated sTg measurement provides additional clinical benefit in detecting persistent or recurrent structural disease if the initial sTg was negative. The retrospective study included 388 consecutive patients with DTC treated and followed-up between 2004 and 2018 at the Clinical Institute of Nuclear Medicine and Radiation Protection, Osijek University Hospital. The negative predictive value (NPV) of the first sTg measured 12 months after the initial treatment was compared with NPV of sTg measured annually during 3 consecutive years of follow-up. The first sTg NPV was 99.5% in the group of low-risk patients and 96.1% in the group of intermediate-risk patients. In both low-and intermediate-risk groups, there were no differences between the first sTg NPV and NPV of sTg measured annually during 3 years of follow-up period. Repeated measurement of the sTg after initially negative result had a limited clinical value for detecting persistent or recurrent structural disease and cannot be recommended in routine follow-up of low and intermediate-risk patients with DTC.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 3-4","pages":"468-474"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231139","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}