The Croatian Museum of Medicine and Pharmacy, at the Croatian Academy of Sciences and Arts, is home to the legacy of the Croatian otorhinolaryngologist Ivo Padovan. His legacy became part of the museum property in 2018-2020 by virtue of his wife Ivica Padovan and daughter Adriana Vincenca Padovan. The donated material is a valuable starting point for researching the history of medicine, that is, otorhinolaryngology, through the activities of a prominent representative of this clinical speciality. In this paper, we bring forward a preliminary statement on the content of the legacy, with a special emphasis on the digitised recording of a middle ear surgery from 1954, which was presented as part of the Zagreb event Museum Night, held on January 29, 2021.
{"title":"The memory of heritage: Donation from Ivo Padovan’s legacy preserved at the Croatian Museum of Medicine and Pharmacy of the Croatian Academy of Sciences and Arts","authors":"Silvija Brkić Midžić, Stella Fatović-Frenčić","doi":"10.21857/ygjwrcd30y","DOIUrl":"https://doi.org/10.21857/ygjwrcd30y","url":null,"abstract":"The Croatian Museum of Medicine and Pharmacy, at the Croatian Academy of Sciences and Arts, is home to the legacy of the Croatian otorhinolaryngologist Ivo Padovan. His legacy became part of the museum property in 2018-2020 by virtue of his wife Ivica Padovan and daughter Adriana Vincenca Padovan. The donated material is a valuable starting point for researching the history of medicine, that is, otorhinolaryngology, through the activities of a prominent representative of this clinical speciality. In this paper, we bring forward a preliminary statement on the content of the legacy, with a special emphasis on the digitised recording of a middle ear surgery from 1954, which was presented as part of the Zagreb event Museum Night, held on January 29, 2021.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130607346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Vrdoljak, M. Šapina, Suzana Bitanga, M. Katavić
Atrioventricular (AV) block is defined as a delay or interruption in the transmission of an impulse from the atria to the ventricles due to an anatomical or functional impairment in the conduction system. The conduction disturbance can be transient or permanent. In third degree AV block, also referred to as complete heart block, there is complete dissociation of the atrial and ventricular activity. Atrioventricular block is considered to be “congenital” when it occurs spontaneously in a fetus or young child. In children, the most common cause of permanent acquired complete AV block is surgery for congenital heart disease. Injury to fetal conduction tissues caused by transplacental exposure to maternal autoantibodies related to systemic lupus erythematosus or Sjogren’s syndrome is responsible for 60 to 90 percent of cases of congenital CHB overall1-3. As many as 40 percent of cases of congenital CHB do not present until later in childhood (mean age five to six years). Only rarely do these patients (5 percent) have proven autoimmune etiology. The increased risk of sudden death is associated with the onset of deep bradycardia or ventricular arrhythmia. A routine electrocardiogram is sufficient to diagnose the disease. A 15-year-old girl has been examined at the emergency pediatric outpatient clinic of the University Hospital Centre “Sestre Milosrdnice” for recurrent episodes of presyncope. Physical examination revealed no major deviations other than bradycardia. Her vital signs were within the reference range, with the exception of a pulse of about 44 beats per minute. The electrocardiogram showed atrioventricular dissociation consistent with third degree atrioventricular block. The echocardiogram showed a structurally normal heart except for sinus bradycardia. The girl underwent permanent epicardial pacemaker implantation after which there were no symptoms.
{"title":"Third Degree Atrioventricular Block in Children","authors":"V. Vrdoljak, M. Šapina, Suzana Bitanga, M. Katavić","doi":"10.21857/m3v76t6o3y","DOIUrl":"https://doi.org/10.21857/m3v76t6o3y","url":null,"abstract":"Atrioventricular (AV) block is defined as a delay or interruption in the transmission of an impulse from the atria to the ventricles due to an anatomical or functional impairment in the conduction system. The conduction disturbance can be transient or permanent. In third degree AV block, also referred to as complete heart block, there is complete dissociation of the atrial and ventricular activity. Atrioventricular block is considered to be “congenital” when it occurs spontaneously in a fetus or young child. In children, the most common cause of permanent acquired complete AV block is surgery for congenital heart disease. Injury to fetal conduction tissues caused by transplacental exposure to maternal autoantibodies related to systemic lupus erythematosus or Sjogren’s syndrome is responsible for 60 to 90 percent of cases of congenital CHB overall1-3. As many as 40 percent of cases of congenital CHB do not present until later in childhood (mean age five to six years). Only rarely do these patients (5 percent) have proven autoimmune etiology. The increased risk of sudden death is associated with the onset of deep bradycardia or ventricular arrhythmia. A routine electrocardiogram is sufficient to diagnose the disease. A 15-year-old girl has been examined at the emergency pediatric outpatient clinic of the University Hospital Centre “Sestre Milosrdnice” for recurrent episodes of presyncope. Physical examination revealed no major deviations other than bradycardia. Her vital signs were within the reference range, with the exception of a pulse of about 44 beats per minute. The electrocardiogram showed atrioventricular dissociation consistent with third degree atrioventricular block. The echocardiogram showed a structurally normal heart except for sinus bradycardia. The girl underwent permanent epicardial pacemaker implantation after which there were no symptoms.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116908443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: To examine the proportion of patients with thrombosis or surgical ligation of arteriovenous fistula (AVF) after kidney transplantation (TX) and to explore the time passed after the TX until the loss of AVF function. Patients and methods: The study design was historical cohort study. The study included all 123 patients (57.7 % men, median age 58 years, from 34 to 79) that underwent kidney TX in the University Hospital Centre Osijek during the first 10 years of practicing that kind of surgery in the hospital. The data on AVF function, thrombosis or ligation were undertaken from medical records, along with demographics (age, gender, time after TX). The data were presented descriptively and after statistical analysis that was performed using SPSS (version 17.0). Results: FunctionalAVF immediately prior to TX was found in 78 % of the patients. The AVF was still functional in 39.84 % of all patients for 3 years (median, interquartile range, IQR 0 – 3) after TX. AVF thrombosis happened in 17.89 %, while surgical ligation was performed in 20.33 % of all patients. The most common reason for ligation was increased risk of heart failure (in 75 % of the ligations), followed by aneurysmatic dilatation and arm swelling. Median time after TX to thrombosis or ligation of AVF was 2 years, IQR 0 – 3. Thrombosis or ligations were significantly more frequent in women. The outcome of AVF after kidney TX was not related to the patient’s age. Conclusion: AVF after kidney TX often became nonfunctional, either after spontaneous thrombosis or after surgical ligation, which was required for increased heart failure risk in the majority of the cases.
{"title":"Arteriovenous Fistula After Kidney Transplantation in University Hospital Centre Osijek","authors":"A. Jurić, L. Zibar","doi":"10.21857/yrvgqtkdp9","DOIUrl":"https://doi.org/10.21857/yrvgqtkdp9","url":null,"abstract":"Aims: To examine the proportion of patients with thrombosis or surgical ligation of arteriovenous fistula (AVF) after kidney transplantation (TX) and to explore the time passed after the TX until the loss of AVF function. Patients and methods: The study design was historical cohort study. The study included all 123 patients (57.7 % men, median age 58 years, from 34 to 79) that underwent kidney TX in the University Hospital Centre Osijek during the first 10 years of practicing that kind of surgery in the hospital. The data on AVF function, thrombosis or ligation were undertaken from medical records, along with demographics (age, gender, time after TX). The data were presented descriptively and after statistical analysis that was performed using SPSS (version 17.0). Results: FunctionalAVF immediately prior to TX was found in 78 % of the patients. The AVF was still functional in 39.84 % of all patients for 3 years (median, interquartile range, IQR 0 – 3) after TX. AVF thrombosis happened in 17.89 %, while surgical ligation was performed in 20.33 % of all patients. The most common reason for ligation was increased risk of heart failure (in 75 % of the ligations), followed by aneurysmatic dilatation and arm swelling. Median time after TX to thrombosis or ligation of AVF was 2 years, IQR 0 – 3. Thrombosis or ligations were significantly more frequent in women. The outcome of AVF after kidney TX was not related to the patient’s age. Conclusion: AVF after kidney TX often became nonfunctional, either after spontaneous thrombosis or after surgical ligation, which was required for increased heart failure risk in the majority of the cases.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"195 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122597898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Many years scientist try to explore the connection between air pollution and its influence on human health and after numerous conducted researches they came up with the clear evidence that air pollution has a significant impact on overall health and especially on stroke. In the Global Burden of Disease Study, it has emerged as a significant contributor to the global stroke burden, especially in lowand middle-income countries. Furthermore, these and some other researches have suggested a closer link between air pollution and ischemic stroke, due to huge diversity of the results of numerous other studies, for drawing definitive conclusions, further research is still needed. Due to the complexity of stroke with its types and subtypes, the results of their reaction to air pollution differ. Some studies have shown the link between cardioembolic stroke and AP, others with SAH but not with intracerebral haemorrhage. There was a suggestion that nitrogen dioxide exposure might be associated with stroke caused by small vessel disease, while other studies are not reporting any association of AP and the risk of ischemic stroke. In some studies, AP was more affecting young adults and in some, it was more pronounced in women. Some studies reported a more clear link between AP and recent stroke in patients with other risk factors like diabetes and previous stroke. Studies have varied by the concentration and types of pollutants studied, which vary geographically, as well as by duration to AP exposure being shortor long-term, and in some studies being present only during warm seasons. Regulations have improved air quality in many countries in Europe and the United States, resulting in greater life expectancy, which highlights the continued importance of further efforts in that direction.
{"title":"Air Pollution: a New Risk Factor for Developing Stroke","authors":"V. Demarin, S. Morović, F. Đerke","doi":"10.21857/mzvkptz3n9","DOIUrl":"https://doi.org/10.21857/mzvkptz3n9","url":null,"abstract":"Many years scientist try to explore the connection between air pollution and its influence on human health and after numerous conducted researches they came up with the clear evidence that air pollution has a significant impact on overall health and especially on stroke. In the Global Burden of Disease Study, it has emerged as a significant contributor to the global stroke burden, especially in lowand middle-income countries. Furthermore, these and some other researches have suggested a closer link between air pollution and ischemic stroke, due to huge diversity of the results of numerous other studies, for drawing definitive conclusions, further research is still needed. Due to the complexity of stroke with its types and subtypes, the results of their reaction to air pollution differ. Some studies have shown the link between cardioembolic stroke and AP, others with SAH but not with intracerebral haemorrhage. There was a suggestion that nitrogen dioxide exposure might be associated with stroke caused by small vessel disease, while other studies are not reporting any association of AP and the risk of ischemic stroke. In some studies, AP was more affecting young adults and in some, it was more pronounced in women. Some studies reported a more clear link between AP and recent stroke in patients with other risk factors like diabetes and previous stroke. Studies have varied by the concentration and types of pollutants studied, which vary geographically, as well as by duration to AP exposure being shortor long-term, and in some studies being present only during warm seasons. Regulations have improved air quality in many countries in Europe and the United States, resulting in greater life expectancy, which highlights the continued importance of further efforts in that direction.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116733070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Resistance of Human Immunodeficiency Virus (HIV) to antiretroviral drugs is an important limitation in achieving complete suppression of viral replication and therefore represents an important clinical issue. It refers especially to therapy-naive individuals infected with resistant HIV strains, e.g. individuals with transmitted drug resistance (TDR). Transmitted drug resistance mutations (TDRMs) are clinically relevant and may reduce the efficacy of antiretroviral therapy. In this paper, we report the first case of HIV-1 transmitted triple-class drug resistance in Croatia. The aim of this study was to characterize drug resistance patterns and TDRMs in the newly diagnosed, treatment-naive HIV-1 patient with such a complex resistance pattern. Sanger sequencing (SS) of the sample showed four reverse transcriptase inhibitor (RTI) resistance mutations (E44D, T215E, K103N, L100I) affecting two drug classes and two protease inhibitor resistance mutations (V32I, I47V). To characterize HIV-1 minority drug resistance variants below the detection limit of SS, deep sequencing (DS) analysis was performed. DS analysis identified the same triple class resistance pattern that was identified by SS with addition of several other RTI mutations. The patient described in this report is the first patient with HIV-1 triple-class resistance in Croatia and further studies will be directed toward analysing possible local onward transmission of this resistant virus.
{"title":"Triple Class HIV-1 Drug Resistance in Croatia: the First Report","authors":"A. Planinić, Maja Oroz, S. Z. Lepej","doi":"10.21857/m16wjc6l69","DOIUrl":"https://doi.org/10.21857/m16wjc6l69","url":null,"abstract":"Resistance of Human Immunodeficiency Virus (HIV) to antiretroviral drugs is an important limitation in achieving complete suppression of viral replication and therefore represents an important clinical issue. It refers especially to therapy-naive individuals infected with resistant HIV strains, e.g. individuals with transmitted drug resistance (TDR). Transmitted drug resistance mutations (TDRMs) are clinically relevant and may reduce the efficacy of antiretroviral therapy. In this paper, we report the first case of HIV-1 transmitted triple-class drug resistance in Croatia. The aim of this study was to characterize drug resistance patterns and TDRMs in the newly diagnosed, treatment-naive HIV-1 patient with such a complex resistance pattern. Sanger sequencing (SS) of the sample showed four reverse transcriptase inhibitor (RTI) resistance mutations (E44D, T215E, K103N, L100I) affecting two drug classes and two protease inhibitor resistance mutations (V32I, I47V). To characterize HIV-1 minority drug resistance variants below the detection limit of SS, deep sequencing (DS) analysis was performed. DS analysis identified the same triple class resistance pattern that was identified by SS with addition of several other RTI mutations. The patient described in this report is the first patient with HIV-1 triple-class resistance in Croatia and further studies will be directed toward analysing possible local onward transmission of this resistant virus.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122185314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Borić, M. Pećina, Maja Mirković, Tatjana Cicvara-pećina, D. Matoković, M. Plečko, I. Dumić-Čule
Sesamoid bones play an essential role in first metatarsophalangeal (MTP) joint biomechanics, together with other articular surfaces, joint capsule, plantar fascia, ligaments and tendons. They are prone to different acute and chronic injuries, such as acute fracture, stress fractures, chondromalacia, avascular necrosis, bursitis degenerative changes, inflammation etc., all of which clinically manifest as a painful condition and are often diagnosed under a broad term called sesamoiditis. The mechanism of injury is most commonly associated with overuse of the anterior part of the sole of the foot accompanied by excessive dorsiflexion of the great toe. Sesamoiditis presents with pain and localized swelling in the projection of the tibial sesamoid bone, which is affected more frequently than the fibular one. Diagnostic radiology plays a key role in determination of etiology of the disease, as well as in planning of it’s treatment. Typical radiological examination includes weight-bearing dorsoplantar, lateral, oblique medial and oblique lateral radiographs of the foot, together with a direct axial radiograph of sesamoid bones. Computerized tomography is used for distinction of acute fractures and early stage of stress fractures from other pathological conditions. Magnetic resonance imaging allows differentiation between bony pathology and soft tissue conditions. Sesamoiditis management is primarily conservative and it depends on duration and severity of the condition. Orthotic insoles customized according to pedobarographic findings may be useful for solving biomechanical deformities that could have led to development of sesamoiditis. Specific pads placed under the first MTP joint in order to prevent the great toe from dorsiflexion proved to be a very effective conservative treatment option. Surgical treatment is considered if conservative methods fail to provide sufficient management of the
{"title":"Hallux Sesamoiditis - Radiological Diagnostics and Conservative Management","authors":"I. Borić, M. Pećina, Maja Mirković, Tatjana Cicvara-pećina, D. Matoković, M. Plečko, I. Dumić-Čule","doi":"10.21857/m8vqrtzxg9","DOIUrl":"https://doi.org/10.21857/m8vqrtzxg9","url":null,"abstract":"Sesamoid bones play an essential role in first metatarsophalangeal (MTP) joint biomechanics, together with other articular surfaces, joint capsule, plantar fascia, ligaments and tendons. They are prone to different acute and chronic injuries, such as acute fracture, stress fractures, chondromalacia, avascular necrosis, bursitis degenerative changes, inflammation etc., all of which clinically manifest as a painful condition and are often diagnosed under a broad term called sesamoiditis. The mechanism of injury is most commonly associated with overuse of the anterior part of the sole of the foot accompanied by excessive dorsiflexion of the great toe. Sesamoiditis presents with pain and localized swelling in the projection of the tibial sesamoid bone, which is affected more frequently than the fibular one. Diagnostic radiology plays a key role in determination of etiology of the disease, as well as in planning of it’s treatment. Typical radiological examination includes weight-bearing dorsoplantar, lateral, oblique medial and oblique lateral radiographs of the foot, together with a direct axial radiograph of sesamoid bones. Computerized tomography is used for distinction of acute fractures and early stage of stress fractures from other pathological conditions. Magnetic resonance imaging allows differentiation between bony pathology and soft tissue conditions. Sesamoiditis management is primarily conservative and it depends on duration and severity of the condition. Orthotic insoles customized according to pedobarographic findings may be useful for solving biomechanical deformities that could have led to development of sesamoiditis. Specific pads placed under the first MTP joint in order to prevent the great toe from dorsiflexion proved to be a very effective conservative treatment option. Surgical treatment is considered if conservative methods fail to provide sufficient management of the","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120950519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Astaxanthin is a carotenoid that is present in high quantities in the meat of fish like salmon and the shells of shrimp and crab. It exhibits free radical scavenging antioxidant activity when consumed dietarily. Astaxanthin is absorbed by the small intestine before exerting its antioxidant effect; however, a portion of dietary intake remains unabsorbed in the digestive tract and reaches the large intestines . We hypothesized that astaxanthin may exert its antioxidant action in the large intestine to influence the gut microbiota. In this review we introduce the results of two studies of astaxanthin. Firstly, a clinical trial targeting post-menopausal women screened for high oxidative stress burden. Astaxanthin was administered orally for eight weeks in order to examine its effects and safety, and subjects were surveyed for any changes in subjective symptoms. Secondly, in a mouse model, real time PCR (polymerase chain reaction) was used to examine the ability of astaxanthin to prevent changes in the enteric flora induced by a high-fat diet. When fat intake increases due to changes in diet, the equilibrium between the various species that constitute the intestinal flora is altered. As a result, degenerative changes in lifestyle-related disease and aging of the host are promoted. Here we find that the intake of astaxanthin was able to inhibit these changes in the gut microbiota of mice induced by a high-fat diet. Even in humans, it is highly probably that the unabsorbed astaxanthin that remains in the intestinal tract exerts a positive effect against disturbance of the intestinal flora caused by a high-fat diet.
{"title":"High-fat Diet Induced Dysbiosis & Amelioration by Astaxanthin","authors":"Kyle Haasbroek, Wakako Takabe, M. Yagi, Y. Yonei","doi":"10.21857/9xn31crexy","DOIUrl":"https://doi.org/10.21857/9xn31crexy","url":null,"abstract":"Astaxanthin is a carotenoid that is present in high quantities in the meat of fish like salmon and the shells of shrimp and crab. It exhibits free radical scavenging antioxidant activity when consumed dietarily. Astaxanthin is absorbed by the small intestine before exerting its antioxidant effect; however, a portion of dietary intake remains unabsorbed in the digestive tract and reaches the large intestines . We hypothesized that astaxanthin may exert its antioxidant action in the large intestine to influence the gut microbiota. In this review we introduce the results of two studies of astaxanthin. Firstly, a clinical trial targeting post-menopausal women screened for high oxidative stress burden. Astaxanthin was administered orally for eight weeks in order to examine its effects and safety, and subjects were surveyed for any changes in subjective symptoms. Secondly, in a mouse model, real time PCR (polymerase chain reaction) was used to examine the ability of astaxanthin to prevent changes in the enteric flora induced by a high-fat diet. When fat intake increases due to changes in diet, the equilibrium between the various species that constitute the intestinal flora is altered. As a result, degenerative changes in lifestyle-related disease and aging of the host are promoted. Here we find that the intake of astaxanthin was able to inhibit these changes in the gut microbiota of mice induced by a high-fat diet. Even in humans, it is highly probably that the unabsorbed astaxanthin that remains in the intestinal tract exerts a positive effect against disturbance of the intestinal flora caused by a high-fat diet.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129200456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: The aim of our study was to determine the association between body position during sleep and OSA severity in patients with newly diagnosed OSA after full-length polysomnography. Subjects and Methods: We conducted a cross-sectional and clinical study involving 414 subjects (281 men and 133 women) older than 18 whose median age was 55 years. In 2017, subjects came to the Center for Sleep Medicine at UHC Split and the Split School of Medicine and their dana was taken from the archives of the same center. All patients did a full-night polysomnography after which the severity of OSA was estimated with the help of AHI in accordance with the OSA diagnosis guidelines prescribed by the American Academy of Sleep Medicine (AASM) and European Sleep Research Society (ESRS). Excessive daily sleepiness has been estimated by the Epworth Sleepiness Scale (ESS). Results: Statistical analysis showed that patients had spent more time on the back (189.9±118.4min) than on the left (113.3±90.9min) or right side (80.6±90.6min) during sleep and had the most sleep apneas on their back (AHI = 31.1±31.9). Patients with diagnosed OSA (AHI≥5) also had higher AHI values on the back (39.1±31.9) than on the left (23.8±25.2) or right side (18.5±25.6) during sleep. Patients with diagnosed OSA in comparison to patients without OSA diagnosis had statistically significantly higher BMI (29.5±4.6kg/m2 vs. 25.3±4.1kg/m2, P<0.001) and neck circumference (42.0±4.4cm vs 37.4±3.9cm, P<0.001). Overall, considering the whole sample, men were taller (180.8±7.4cm than 165.9±6.7cm, P<0.001), had higher BMI (29.4±4.5kg/m2 compared to 26.8±4.9kg/m2, P<0.001 ) and bigger neck circumference (43.2±3.5cm vs. 36.2±3.4cm, P=0.002), as well as a larger ESS sum (7.6±4.7 compared to 6.3±4.8, P=0.021). Using the Pearson Correlation Coefficient, we showed a negative correlation of AHI with sleep time on the right side (r=-0.178, P=0.005) in OSA patients, while positive correlation was found in sleep on the left side (r=0.003, P=0.959) and back (r=0.183, P=0.002). Conclusion: Our research showed that patients sleep the most time n their back and that AHI ist the highest in that sleep position in comparison to other sleep position which worsens sleep quality in the
目的:我们研究的目的是确定新诊断为OSA的患者在睡眠时体位与OSA严重程度之间的关系。对象和方法:我们进行了一项横断面和临床研究，涉及414名年龄大于18岁，中位年龄为55岁的受试者(281名男性和133名女性)。2017年，受试者来到UHC斯普利特和斯普利特医学院的睡眠医学中心，他们的dana来自同一中心的档案。所有患者均进行通宵多导睡眠图检查，并根据美国睡眠医学会(AASM)和欧洲睡眠研究学会(ESRS)制定的OSA诊断指南，借助AHI评估OSA的严重程度。爱普沃斯嗜睡量表(ESS)对每日过度嗜睡进行了评估。结果:统计分析显示，患者睡眠时仰卧时间(189.9±118.4min)多于左侧仰卧时间(113.3±90.9min)和右侧仰卧时间(80.6±90.6min)，睡眠呼吸暂停以仰卧时间最多(AHI = 31.1±31.9)。诊断为OSA (AHI≥5)的患者睡眠时背部AHI值(39.1±31.9)高于左侧(23.8±25.2)或右侧(18.5±25.6)。诊断为OSA的患者BMI(29.5±4.6kg/m2 vs. 25.3±4.1kg/m2, P<0.001)和颈围(42.0±4.4cm vs. 37.4±3.9cm, P<0.001)高于未诊断为OSA的患者。总体而言，从整个样本来看，男性身高更高(180.8±7.4cm比165.9±6.7cm, P<0.001)， BMI更高(29.4±4.5kg/m2比26.8±4.9kg/m2, P<0.001)，颈围更大(43.2±3.5cm比36.2±3.4cm, P=0.002)， ESS总分更高(7.6±4.7比6.3±4.8,P=0.021)。运用Pearson相关系数，我们发现OSA患者的AHI与右侧睡眠时间呈负相关(r=-0.178, P=0.005)，而左侧睡眠时间(r=0.003, P=0.959)和背部睡眠时间(r=0.183, P=0.002)呈正相关。结论:我们的研究表明，与其他睡姿相比，患者仰卧的睡眠时间最长，AHI最高，而其他睡姿会使睡眠质量恶化
{"title":"Connection Between Body Position During Sleep and Findings from Full-Night Polysomnography in Patients with Obstructive Sleep Apnea","authors":"Alen Juginović, R. Pecotić","doi":"10.21857/ydkx2crgw9","DOIUrl":"https://doi.org/10.21857/ydkx2crgw9","url":null,"abstract":"Aim: The aim of our study was to determine the association between body position during sleep and OSA severity in patients with newly diagnosed OSA after full-length polysomnography. Subjects and Methods: We conducted a cross-sectional and clinical study involving 414 subjects (281 men and 133 women) older than 18 whose median age was 55 years. In 2017, subjects came to the Center for Sleep Medicine at UHC Split and the Split School of Medicine and their dana was taken from the archives of the same center. All patients did a full-night polysomnography after which the severity of OSA was estimated with the help of AHI in accordance with the OSA diagnosis guidelines prescribed by the American Academy of Sleep Medicine (AASM) and European Sleep Research Society (ESRS). Excessive daily sleepiness has been estimated by the Epworth Sleepiness Scale (ESS). Results: Statistical analysis showed that patients had spent more time on the back (189.9±118.4min) than on the left (113.3±90.9min) or right side (80.6±90.6min) during sleep and had the most sleep apneas on their back (AHI = 31.1±31.9). Patients with diagnosed OSA (AHI≥5) also had higher AHI values on the back (39.1±31.9) than on the left (23.8±25.2) or right side (18.5±25.6) during sleep. Patients with diagnosed OSA in comparison to patients without OSA diagnosis had statistically significantly higher BMI (29.5±4.6kg/m2 vs. 25.3±4.1kg/m2, P<0.001) and neck circumference (42.0±4.4cm vs 37.4±3.9cm, P<0.001). Overall, considering the whole sample, men were taller (180.8±7.4cm than 165.9±6.7cm, P<0.001), had higher BMI (29.4±4.5kg/m2 compared to 26.8±4.9kg/m2, P<0.001 ) and bigger neck circumference (43.2±3.5cm vs. 36.2±3.4cm, P=0.002), as well as a larger ESS sum (7.6±4.7 compared to 6.3±4.8, P=0.021). Using the Pearson Correlation Coefficient, we showed a negative correlation of AHI with sleep time on the right side (r=-0.178, P=0.005) in OSA patients, while positive correlation was found in sleep on the left side (r=0.003, P=0.959) and back (r=0.183, P=0.002). Conclusion: Our research showed that patients sleep the most time n their back and that AHI ist the highest in that sleep position in comparison to other sleep position which worsens sleep quality in the","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117039763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Inguinal Hernia Containing an Incarcerated Ureter of a Transplanted Kidney","authors":"L. Filipović-Grčić, Neva Coce","doi":"10.21857/yk3jwhrq39","DOIUrl":"https://doi.org/10.21857/yk3jwhrq39","url":null,"abstract":"","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126536850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iva Mucalo, Andrea Brajković, Ivona Jukić, Danijela Jonjić, Dagmar Radin, A. Balenović, Djenane Ramalho de Oliveira
Due to an increase in the prevalence of chronic diseases, medication use and their cost is rising rapidly. This scenario render chronic patients at an increased risk of experiencing drug therapy problems, subsequently leading to unfavourable clinical and economic outcomes. Thus, to ensure patients’ optimal medication use and improve their clinical outcomes, a comprehensive and systematic management of medications is deemed crucial. Hence, Comprehensive Medication Management (CMM) services offered by trained pharmacists can fill this gap by decreasing the unnecessary and often harmful use of medicines and consequent resulting complications. Collaborative practice between pharmacists and general practitioners, together with patients’ active participation in the definition of treatment regimens, plays an important role in the effectiveness of CMM services. CMM services is defined as the standard of care that ensures each patient’s medications (prescription, non-prescription, alternative, traditional, vitamins, or nutritional supplements) are individually assessed to determine that each medication is appropriate for the patient, effective for the medical condition, safe given the comorbidities and other medications taken, and that the patient is able to take them as intended. It includes an individualized care plan that achieves the intended goals of therapy with appropriate follow-up to determine actual patient outcomes. Apart from the USA, several countries (e.g. Australia, Canada and Brazil) have managed to integrate CMM services into their existing health care system at the primary care level. However, in Europe, in spite of the widespread recognition of the need for medication management services, initiation and implementation of CMM services are lagging behind. Hence, for CMM services to become a reality in Europe and elsewhere, numerous prerequisites need to be accomplished, including policies and legal regulations supporting the provision of CMM services on a much larger scale, clearly defined and standardized professional practice and common language shared among the pharmacists, and well trained and experienced practitioners providing full-time, direct patient care.
{"title":"Comprehensive Medication Management Services as a Solution to Medication Mismanagement: A European Perspective","authors":"Iva Mucalo, Andrea Brajković, Ivona Jukić, Danijela Jonjić, Dagmar Radin, A. Balenović, Djenane Ramalho de Oliveira","doi":"10.21857/90836cwv2y","DOIUrl":"https://doi.org/10.21857/90836cwv2y","url":null,"abstract":"Due to an increase in the prevalence of chronic diseases, medication use and their cost is rising rapidly. This scenario render chronic patients at an increased risk of experiencing drug therapy problems, subsequently leading to unfavourable clinical and economic outcomes. Thus, to ensure patients’ optimal medication use and improve their clinical outcomes, a comprehensive and systematic management of medications is deemed crucial. Hence, Comprehensive Medication Management (CMM) services offered by trained pharmacists can fill this gap by decreasing the unnecessary and often harmful use of medicines and consequent resulting complications. Collaborative practice between pharmacists and general practitioners, together with patients’ active participation in the definition of treatment regimens, plays an important role in the effectiveness of CMM services. CMM services is defined as the standard of care that ensures each patient’s medications (prescription, non-prescription, alternative, traditional, vitamins, or nutritional supplements) are individually assessed to determine that each medication is appropriate for the patient, effective for the medical condition, safe given the comorbidities and other medications taken, and that the patient is able to take them as intended. It includes an individualized care plan that achieves the intended goals of therapy with appropriate follow-up to determine actual patient outcomes. Apart from the USA, several countries (e.g. Australia, Canada and Brazil) have managed to integrate CMM services into their existing health care system at the primary care level. However, in Europe, in spite of the widespread recognition of the need for medication management services, initiation and implementation of CMM services are lagging behind. Hence, for CMM services to become a reality in Europe and elsewhere, numerous prerequisites need to be accomplished, including policies and legal regulations supporting the provision of CMM services on a much larger scale, clearly defined and standardized professional practice and common language shared among the pharmacists, and well trained and experienced practitioners providing full-time, direct patient care.","PeriodicalId":195938,"journal":{"name":"Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126471482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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