Acta clinica Croatica最新文献

The aim was to evaluate the effects of educated labor attendant (ELA) to pregnant women on the delivery process, mother's delivery satisfaction, and postpartum parenting behavior. Study women were divided into two groups depending on whether an ELA was present during labor or not. Obstetric and neonatal outcomes, Postpartum Parenting Behavior Scale (PPBS), Labor Agentry Scale, and labor satisfaction rate were evaluated and compared in the intervention and control groups. A total of 252 pregnant women, 126 in each group, were included in the study. The rate of cesarean section, the need of systemic analgesic application and pain measurements were significantly lower in the study group compared to the control group (p=0.01, p<0.001 and p<0.001, respectively). The mean PPBS and Labor Agentry Scale scores were significantly higher in the study group compared to the control group (p<0.001). ELA accompanying pregnant women help them overcome their labor fear in every stage of delivery, and decrease the rate of cesarean section.

The results of existing studies on the range of motion in the knee joint rotation are contradictory. The best method for measuring knee rotation has not yet been found. The purpose of this study was to investigate the repeatability and reliability of knee joint rotational laxity measurement using two magnetic goniometers. Thirty healthy subjects (15 males and 15 females) aged between 20 and 32 years participated in the study. Internal and external rotation of the left and right knee joints were measured with double goniometry in the sitting position with 90° flexion of the knee. There was no statistically significant difference in measurements between first and second session. The intraclass correlation coefficient (ICC) for repeatability ranged from 0.812 to 0.858 and for reliability from 0.655 to 0.837. Within-subject coefficient of variation was less than 10%, standard error of measurement was between 1.4^o and 2.0^o, minimal detectable change was between 2.5^o and 3.8^o. The measured values of internal and external rotation did not completely agree with those reported by other authors. The ICC values indicated good to very good repeatability and reliability of the double goniometry measurement of rotational knee laxity. Technical improvements will be required before translation into clinical practice.

Exercise causes considerable changes in the number and function of immune cells and hormones in circulation. The aim of this study was to assess the impact of training regime on immune and inflammatory markers and parameters of complete blood count, thyroid function and tumor markers, immediately after intense, mostly anaerobic training in elite karate athletes. There are no similar studies that would determine changes in the concentration of tumor markers immediately after intense exercise. Study population included seven elite trained athletes, members of the Croatian National Karate Kata female team and Kata male team. Our data provided evidence that the white blood cell and segmented neutrophil granulocyte counts were significantly decreased and lymphocytes significantly increased with no major changes in interleukin-6 immediately after anaerobic exercise. We also noticed a strong increase of thyrotropin and no significant change in the levels of tumor markers. It was concluded that immune response and thyroid hormone status were in correlation with exercise duration and intensity. According to our results, a larger study is needed to define the impact of training and interrelation between sports and laboratory medicine as a perfect combination in terms of discovering new mechanisms and biochemical strategies in training of elite athletes.

This study aimed to determine which treatment methods university students use to relieve menstrual pain. The study was conducted in April 2021 and included 861 female students at the University of Zagreb. Data were collected through an anonymous online questionnaire containing 22 questions regarding menstrual characteristics and pain management. The study found that 366 (42.5%) students asked advice from a healthcare professional regarding primary dysmenorrhea and pain management. Pharmacological methods were used by 780 (90.6%) and non-pharmacological methods by 648 (75.3%) students. Most commonly, students were advised to use these methods by their families (73.8% and 64.5%, respectively). The most common drug used to treat painful menstruation was ibuprofen (84.7%). Local application of heat (78.7%) and taking an antalgic position (75.2%) were the most common alternative methods for relieving pain. Students who perceived their pain to be more severe were usually more likely to seek advice from a health worker and use both pharmacological and non-pharmacological methods in pain management. Our study found that Croatian students were more likely to self-medicate than to seek advice from a health professional regarding painful menstruation. They use both pharmacological and non-pharmacological methods.

The SYNTAX Score II (SS II) is a clinical tool that allows individualized prediction of mortality in patients with multivessel coronary artery disease (CAD) treated with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The aim was to examine whether lipid profile, uric acid and diabetes had a positive correlation with higher values of SS II. The study included 72 CAD patients. An online calculator was used to calculate SS II. Statistical tests (Mann Whitney U test and Shapiro-Wilk test) were used to assess correlations and differences in lipid profile, uric acid and diabetes status according to SS II values. There was a significant positive correlation between the proportion of patients with HDL levels above the reference values and SS II PCI. Patients with lower LDL values had significantly increased values of SS II CABG, but not SS II PCI. There was no significant correlation of total cholesterol and triglycerides with SS II PCI or SS II CABG. Patients with hyperuricemia had significantly higher SS II PCI but not SS II CABG. People with diabetes had significantly increased SS II PCI but not SS II CABG compared to non-diabetic patients. In conclusion, SS II is associated with some of the classic risk factors for atherosclerosis (uric acid, diabetes), whereas in our patient cohort there was a surprising correlation of SS II with high HDL levels and low LDL levels.

The intraocular pressure (IOP) ranges of premature newborns are not the same as those in full-term newborns and adult population. The exact ranges and causes, however, differ depending on the measurement techniques used and analysis. Our study aimed to summarize and analyze available information in the up-to-date literature concerning IOP values in premature newborns. We performed a systematic literature review with meta-analysis. Our research showed the mean IOP in premature newborns to range from 10 to 29 mmHg according to different authors, and its mean values were higher in premature compared to full-term newborns. The most commonly analyzed factor that probably affected IOP measurement was central corneal thickness. Longitudinal studies showed that IOP and central corneal thickness declined with maturation of the newborn and both factors were probably correlated. Additional studies with larger sample sizes and better differentiated sample groups need to be performed.

One of the most common diseases in vascular surgery is peripheral arterial disease, the last stage of which is critical limb ischemia. It is characterized by rest pain or tissue loss. In most cases, after revascularization, and due to gangrenous changes, it is necessary to perform amputation of a part of the lower limb. After amputation, the wound is bandaged with dressings. In conducting this pilot study, some patients were bandaged with platelet rich fibrin (PRF) in combination with dressings, while the others were treated only with dressings. PRF is a biologic material that is received from blood of the patient. All patients included in the trial had at least 2 out of 3 traversable blood vessels in the lower leg before treatment and underwent femoropopliteal bridging with prosthesis. Patients treated with PRF after revascularization had an average of 5 weeks of wound healing, in contrast to patients treated only with dressings, whose mean wound healing was 8.5 weeks and a proportion of these patients ended up with an extended amputation level. After the study, it is concluded that this type of treatment can be safely used in the treatment of vascular pathology.

The aim of the study was to examine the levels and relationships of self-compassion, mindfulness, coping with stress, anxiety, depression, and perceived stress in pregnant women. The study involved 153 pregnant women (6⁺⁰-7⁺⁶) who completed a questionnaire of socio-demographic data, Self-Compassion Scale, Mindful Attention Awareness Scale, Coping Orientation to Problems Experienced, Beck Anxiety Inventory, Depression Questionnaire of the Center for Epidemiological Research and Perceived Stress Scale. Subjects with higher levels of self-compassion and mindfulness had lower levels of anxiety (r=-0.44, p<0.01), (r=-0.53, p<0.01), depression (r=-0.45, p<0.01), (r=-0.51, p<0.01), and stress (r=-0.53, p<0.01), (r=-0.45, p<0.01). Significantly higher levels of anxiety (r=0.19, p<0.05), depression (r=0.23, p<0.01), and stress symptoms (r=0.26, p<0.01) were experienced by subjects who used avoidance-focused coping. Self-compassion and mindfulness were negative predictors of anxiety (β=-0.26, p<0.001), (β=-0.42, p<0.001), depression (β=-0.35, p<0.001), (β=-0.37, p<0.001) and stress (β=-0.40, p<0.001), (β=-0.25, p<0.01). Problem-focused coping had a positive contribution to depression (β=0.15, p<0.05). Avoidance showed a tendency toward a positive effect on stress (β=0.13, p=0.06). The results indicate a significant role of self-compassion and mindfulness in predicting symptoms of anxiety, depression and stress in pregnant women in early pregnancy as a focus of non-pharmacological interventions aimed at early prevention of mental disorders.

Thyroid cancers are frequently seen tumors and surgery is the gold standard in treatment. An 80-year-old female patient presented to our department with right side neck swelling and shortness of breath. Her history revealed that she had undergone a near-total thyroidectomy 10 years before due to papillary thyroid carcinoma and she had a growing swelling in her neck in the last 2 years. A hard mass involving the whole right side of her neck was found on physical examination. Tomography showed a mass on the right side of the neck approximately 10x12 cm in size with heterogeneous density, which was pushing the trachea to the left. Fine needle aspiration biopsy findings suggested undifferentiated malignant tumor, i.e., anaplastic thyroid carcinoma were obtained while her distant organ scans were normal. The patient was operated under general anesthesia; she underwent completion total thyroidectomy and radical neck dissection. As a result of the histopathologic examination, she was diagnosed with anaplastic thyroid carcinoma. The patient received radioactive I-131 therapy and no problems were found at her 3-month follow up examination. In conclusion, when surgical near-total thyroidectomy is performed in patients with papillary thyroid carcinoma, a new malignancy may develop in the residual thyroid tissue even after many years. In such cases, completion total thyroidectomy and adjuvant multimodal treatment methods should be preferred.

Ameloblastic carcinoma is a rare malignant epithelial tumor, mostly affecting the mandible. Maxillary ameloblastic carcinoma is even more uncommon and its clear cell variant has been exceedingly rarely described. Because clear cell lesions of jaw bones are both rare and diagnostically challenging, the incidence of the tumor, as well as the criteria for classification are not precisely defined. Differential diagnosis includes a variety of benign or malignant tumors of odontogenic and salivary gland origin, as well as metastatic tumors. Diagnostic dilemma extends to therapeutic approach. Treatment modalities are still debated. The present case report discusses the clinical and histologic differential diagnosis of clear cell variant of an aggressive maxillary ameloblastic carcinoma which was successfully treated with preoperative radiation therapy, followed by surgical excision of the residual lesion and reconstruction of the maxilla.