Croatian Medical Journal最新文献

Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily affects the respiratory system, neurological symptoms were reported both during acute and post-acute COVID-19. Notably, patients with no history of epilepsy or other neurological conditions developed new-onset refractory status epilepticus (NORSE) weeks, months, or even up to a year following the viral infection. While NORSE is uncommon, it carries a high mortality rate and can result in permanent epilepsy. Therefore, clinicians should consider the possibility of death or epilepsy development when treating individuals with NORSE who have recently contracted SARS-CoV-2. This article compiles comprehensive information on the mechanisms of epileptogenesis linked to SARS-CoV-2, the diagnosis of NORSE syndrome, its treatment options, and associated outcomes. Our aim was to enhance physicians' understanding of the virus's pathogenesis and increase the awareness of NORSE.

Aim: To ascertain whether Croatian respondents' knowledge on pain aligns with modern pain science, and determine the measurement properties of the Croatian version of the Concept of Pain Inventory for Adults (COPI-Adult).

Methods: A cross-sectional, online survey was used to collect the respondents' sociodemographic, clinical, and COPI-Adult (CRO) data (n = 509). A Pearson correlation coefficient test was used to assess the correlations between sociodemographic, clinical, and COPI-Adult (CRO) data. Confirmatory factor analysis and Cronbach's coefficient, based on classical test theory, were used to determine the measurement properties of the questionnaire.

Results: The average COPI-Adult (CRO) score was 35.91 ± 5.8 out of 52 and it was similar in respondents with (36.52±6.01) and without (35.36±5.57) formal medical/health care education. Respondents exhibited a reductionist understanding of pain as a result of structural damage. Higher COPI-Adult scores were very weakly correlated with formal medical/health care education, younger age, lower pain intensity, higher pain knowledge self-assessment, and higher education level. Formal medical education significantly moderately correlated with pain knowledge self-assessment (r=-0.425; P<0.001). One-factor COPI-Adult (CRO) model revealed significant factor loadings of each item (P<0.001) and good internal consistency (Cronbach α=0.803).

Conclusions: Croatian respondents' concept of pain aligns with their objective knowledge, but only partially with modern pain science. This indicates the need to bridge the gap between traditional and contemporary understandings of pain in the Croatian population. One-factor COPI-Adult (CRO) inventory serves as the first questionnaire for assessing the concept of pain among Croatian adults.

It is generally accepted that intraocular pressure (IOP) depends on the rate of aqueous humor production, system outflow resistance, and episcleral venous pressure. Therefore, control IOP values are expected to be within the strict and predictable limits in specific animal species, and there should be no vast differences between species. However, in the literature the control IOP values significantly vary (from potentially "hypotensive" to "hypertensive") within the same species, and especially between species depending on the measurement technique, head position in relation to the rest of the body, circadian rhythm, age, and topical and systemic drugs (anesthetics) applied. These variations make it difficult to compare different therapeutic approaches for intraocular hypertension, investigate the correlation between IOP and intracranial pressure, and determine target IOP values in glaucoma research. We recommend that different IOP physiology and pathophysiology studies take into account all the mentioned factors when describing IOP measurement methodology.

Aim: To assess the behavioral correlates of health literacy (HL) among university students of health sciences in Kosovo, irrespective of their sociodemographic characteristics.

Methods: This cross-sectional study, carried out in Kosovo in 2024, enrolled 470 students of health sciences from the universities of Prishtina and Gjakova (86% women; mean age: 20.7±2.7 years; response rate: 70%). We gathered HL data with the European Health Literacy Survey Questionnaire, as well as information on behavioral characteristics and sociodemographic factors. General linear model and binary logistic regression were used to assess the independent behavioral correlates of HL.

Results: In multivariable-adjusted general linear models controlling for all sociodemographic factors and behavioral characteristics, lower HL scores were positively associated with alcohol consumption (36 vs 38 in non-drinkers, P=0.024), low levels of physical exercise (36 vs 39 among students with high level of physical activity, P<0.001), obesity (35 vs 39 among normal-weight individuals, P=0.011), and a poorer health status (36 vs 37 among students with a better self-rated health status, P=0.031). Furthermore, fully adjusted logistic regression models revealed a positive and strong relationship of "inadequate and/or problematic HL" (scores: 0-33) with physical inactivity (OR=7.6, 95%CI=1.8-31.9) and especially obesity (OR=21.4, 95%CI=3.8-119.8).

Conclusions: Students with low HL may be more likely to engage in behaviors detrimental to health. There is need to enhance HL among future health professionals.

Aim: To determine age and gender patterns of alcohol use among Croatian pupils and assess whether alcohol use was associated with factors related to school, peers, family, and the COVID-19 pandemic.

Methods: Data were collected from the 2022 Health Behavior in School-aged Children cross-sectional study conducted in Croatia involving 5338 pupils. Pearson χ2 test and multivariate logistic regression were performed.

Results: At the age of 11, boys were drinking alcohol more than girls (P<0.001), while 13- and 15-year-old girls aligned with boys. Lifetime alcohol use was positively associated with schoolwork pressure in 11-year-old girls (OR 3.28, CI 1.36-7.75) and boys (OR 1.87, CI 1.03-3.37). The COVID-19 pandemic negatively affected mental health in 13- (OR 2.21, 1.56-3.13) and 15-year-old girls (OR 1.50, CI 1.01-2.23), and life in 15-year-old boys (OR 1.83, 1.03-3.27). Recent alcohol use was positively associated with hospitalization of a close family member for COVID-19 in 11-year-old girls (OR 2.35, 1.05-5.28), low peer support in 13-year-old boys (OR 1.49, 1.01-2.20), difficult communication with father in 15-year-old girls (OR 1.49,1.05-2.12), negative COVID-19 impact on mental health in 13-year-old girls (OR 1.67,1.13-2.47), and negative COVID-19 impact on life in 15-year-old boys (OR 1.79, 1.08-2.98). Lifetime drunkenness was positively associated with negative COVID-19 impact on mental health in 13- (OR, 2.03,1.28-3.21) and 15-year-old girls (OR 2.12, 1.49-3.01), and with positive or neutral COVID-19 impact on life in 15-year-old girls (OR 0.65, 0.43-0.97).

Conclusion: Preventive activities should offer support systems to minimize the negative COVID-19 impact, with special attention to girls' needs.

Aim: To investigate histopathological changes in the lung tissue of long-COVID patients.

Methods: In this cross-sectional study, transbronchial lung biopsy was performed in long-COVID patients with persisting symptoms and radiological abnormalities. Histopathologic analyses were performed by using hematoxylin-eosin, Martius, Scarlet and Blue, Movat's, thyroid transcription factor 1, CD34, and CD68 staining.

Results: Adequate biopsy samples were obtained from 29/32 patients. The median (Q1-Q3) time from disease onset to biopsy was 13 (9-20) weeks. We observed several histopathologic patterns: DAD with vascular abnormalities (VA) (n=8); VA with inflammatory pattern (n=4); inflammatory pattern (n=13), and fibrotic pattern (n=4). VA included capillary thrombi, dilated venules, and dissection of small pulmonary arteries. DAD with VA was detected up to the 9th week from the onset of disease; inflammatory pattern from the 8th to 28th week (4 patients with this pattern biopsied in the 11th-13th week had accompanying VA); and a predominantly fibrotic pattern was found at weeks 8, 10, 48, and 49.

Conclusion: Our study observed a slow recovery of lung tissue with long-lasting DAD and VA, likely followed by interstitial inflammation or focal fibrosis. These findings might be the underlying cause of the slow recovery of long-COVID patients.

Aim: To evaluate outcomes after percutaneous coronary intervention (PCI) in patients with cancer and atrial fibrillation (AF).

Methods: Data of all adult discharges undergoing PCI between October 2015 and December 2018 were obtained from the National Inpatient Sample (NIS) database. Adjusted odds ratios (aOR) of adverse complications were calculated using binominal logistic regression.

Results: 1387320 patients were detected, out of which 15.4% had AF but no cancer, 1.9% had cancer but no AF, and 0.6% had both cancer and AF. Compared with cancer patients without AF, those with AF had a greater aOR of mortality (aOR 1.20, 95%CI 1.08-1.33), major adverse cardiac and cerebrovascular events (MACCE) (aOR 1.18, 95%CI 1.07-1.29), and bleeding (aOR 1.23, 95%CI 1.08-1.39). However, the risk of ischemic stroke was similar between the two groups. Patients with solid cancer and AF had a higher aOR for all outcomes, including mortality (aOR 1.28, 95%CI 1.09-1.50), MACCE (aOR 1.37, 95%CI 1.19-1.57), ischemic stroke (aOR 1.48, 95%CI 1.10-1.99), and bleeding (aOR 1.66, 95%CI 1.39-1.98) compared with the solid cancer group without AF. In patients with hematological cancer, AF was associated only with significantly increased risk of mortality (aOR 1.40, 95%CI 1.16-1.70) and MACCE (aOR 1.26, 95%CI 1.06-1.49).

Conclusions: The presence of AF in solid cancer patients increases the risk of mortality, MACCE, stroke, and major bleeding, while in the setting of hematological cancer it is only associated with a higher risk of mortality and MACCE.