Pub Date : 2024-04-01DOI: 10.20471/acc.2024.63.01.21
Marjeta Mišigoj-Duraković, Ljerka Ostojić, Vesna Mijoč, Maroje Sorić, Zdravko Babić, Josip Šimić, Daria Ostojić, Din Duraković
Regular physical activity and maintaining fitness reduce the risk of chronic cardiovascular and metabolic diseases, reduce the risk of exacerbation of existing diseases, maintain physical and mental health, and contribute to healthy and successful aging in the elderly. It is of particular importance during the prolonged COVID-19 pandemic. The aim of this review is to present relevant knowledge about the effects of restrictions and social distancing established with the aim of suppressing the COVID-19 pandemic, on physical activity and mental health of elderly people. During the pandemic, numerous authors have reported a decrease in the share of physically active population and those that used to exercise regularly. The time spent in activity decreases, energy expenditure decreases, and the time spent sedentary increases although the results in all segments related to physical activity are not consistent. Lockdown measures significantly worsen insomnia, sleep quality, feelings of loneliness, anxiety and depression in older people, especially in women. During the restrictive measures caused by the COVID-19 pandemic, physical activity and exercise significantly contribute to the maintenance and improvement of physical and mental health.
{"title":"THE EFFECTS OF RESTRICTIONS DURING THE COVID-19 PANDEMIC ON PHYSICAL ACTIVITY AND MENTAL HEALTH OF THE ELDERLY.","authors":"Marjeta Mišigoj-Duraković, Ljerka Ostojić, Vesna Mijoč, Maroje Sorić, Zdravko Babić, Josip Šimić, Daria Ostojić, Din Duraković","doi":"10.20471/acc.2024.63.01.21","DOIUrl":"10.20471/acc.2024.63.01.21","url":null,"abstract":"<p><p>Regular physical activity and maintaining fitness reduce the risk of chronic cardiovascular and metabolic diseases, reduce the risk of exacerbation of existing diseases, maintain physical and mental health, and contribute to healthy and successful aging in the elderly. It is of particular importance during the prolonged COVID-19 pandemic. The aim of this review is to present relevant knowledge about the effects of restrictions and social distancing established with the aim of suppressing the COVID-19 pandemic, on physical activity and mental health of elderly people. During the pandemic, numerous authors have reported a decrease in the share of physically active population and those that used to exercise regularly. The time spent in activity decreases, energy expenditure decreases, and the time spent sedentary increases although the results in all segments related to physical activity are not consistent. Lockdown measures significantly worsen insomnia, sleep quality, feelings of loneliness, anxiety and depression in older people, especially in women. During the restrictive measures caused by the COVID-19 pandemic, physical activity and exercise significantly contribute to the maintenance and improvement of physical and mental health.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 1","pages":"175-184"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431938","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}
Facing a malignant disease, surgery and creation of an intestinal stoma is a complex process in anyone's life. Adjusting to a new way of life can be complicated, stressful and challenging for patients. With continued education from professional caregivers, the patient and/or family can avoid or mitigate adverse events and improve the quality of life of stoma carriers. The aim of this study was to investigate the quality of life of stoma patients and their relationship with health education in hospital in a qualitative way. The present study included 15 patients of both sexes older than 18 years and living with a stoma for at least one year after surgery. Patients were interviewed using a semi-structured interview, which was recorded. Transcripts were made and analyzed after the interview. A total of 6 women and 9 men aged between 40 and 86 years took part in the study. The results show that patients were very satisfied with health education they received in hospital, but their subjective experience of the quality of life was not satisfactory in all areas analyzed, such as travel and social life. Stoma has an impact on the participants' quality of life. High quality health education of patients by professionals, as well as family and social support play an important role in the lives of stoma patients. These are protective factors that improve the participants' quality of life.
{"title":"QUALITY OF LIFE OF OSTOMATES - A QUALITATIVE STUDY.","authors":"Vanja Vasiljev, Marina Haring, Denis Juraga, Darko Roviš, Aleksandar Racz, Tomislav Rukavina","doi":"10.20471/acc.2024.63.01.4","DOIUrl":"10.20471/acc.2024.63.01.4","url":null,"abstract":"<p><p>Facing a malignant disease, surgery and creation of an intestinal stoma is a complex process in anyone's life. Adjusting to a new way of life can be complicated, stressful and challenging for patients. With continued education from professional caregivers, the patient and/or family can avoid or mitigate adverse events and improve the quality of life of stoma carriers. The aim of this study was to investigate the quality of life of stoma patients and their relationship with health education in hospital in a qualitative way. The present study included 15 patients of both sexes older than 18 years and living with a stoma for at least one year after surgery. Patients were interviewed using a semi-structured interview, which was recorded. Transcripts were made and analyzed after the interview. A total of 6 women and 9 men aged between 40 and 86 years took part in the study. The results show that patients were very satisfied with health education they received in hospital, but their subjective experience of the quality of life was not satisfactory in all areas analyzed, such as travel and social life. Stoma has an impact on the participants' quality of life. High quality health education of patients by professionals, as well as family and social support play an important role in the lives of stoma patients. These are protective factors that improve the participants' quality of life.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 1","pages":"29-35"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431858","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}
Pub Date : 2024-04-01DOI: 10.20471/acc.2024.63.01.17
Nikola Krmek, László Környei, Ivana Kralik, Diana Delić-Brkljačić, Milan Milošević, Mirta Rode, Flóra Kocsis, Vjekoslav Radeljić
Since the introduction of 3D mapping systems, the use of x-rays in electrophysiology procedures has significantly decreased. The goal of this study was to analyze the frequency of x-ray use in pediatric electrophysiology in relation to age or body mass, indication for the procedure, and arrhythmia substrate. This retrospective, cross-sectional study included all pediatric procedures in two centers, Gottsegen Cardiovascular Center, Budapest, Hungary and Sestre milosrdnice University Hospital Center, Zagreb, Croatia. Patient data included weight, age, sex, presence of structural heart disease, indication for the electrophysiology study, arrhythmia substrate, and x-ray use. A total of 914 participants were analyzed, mean age 13.25 years and mean mass 53.20 kg. Of all procedures, 62.04% were performed without and 37.96% with fluoroscopy. There were no statistically significant differences in the frequency of x-ray use when comparing the groups by sex (p=0.181), age (p=0.380) or mass (p=0.120). Left-sided accessory pathways required x-ray use most frequently, whereas unknown substrates and of the known substrates atrioventricular nodal reentry tachycardia required it least frequently (p<0.001). Younger or smaller children were not irradiated more frequently during electrophysiology procedures performed with 3D mapping systems. In conclusion, there is no reason to postpone the procedure based on radiation frequency use.
{"title":"SHOULD PATIENT AGE AND BODY MASS BE TAKEN IN CONSIDERATION WHEN ZERO FLUORO ABLATION IS SCHEDULED?","authors":"Nikola Krmek, László Környei, Ivana Kralik, Diana Delić-Brkljačić, Milan Milošević, Mirta Rode, Flóra Kocsis, Vjekoslav Radeljić","doi":"10.20471/acc.2024.63.01.17","DOIUrl":"10.20471/acc.2024.63.01.17","url":null,"abstract":"<p><p>Since the introduction of 3D mapping systems, the use of x-rays in electrophysiology procedures has significantly decreased. The goal of this study was to analyze the frequency of x-ray use in pediatric electrophysiology in relation to age or body mass, indication for the procedure, and arrhythmia substrate. This retrospective, cross-sectional study included all pediatric procedures in two centers, Gottsegen Cardiovascular Center, Budapest, Hungary and Sestre milosrdnice University Hospital Center, Zagreb, Croatia. Patient data included weight, age, sex, presence of structural heart disease, indication for the electrophysiology study, arrhythmia substrate, and x-ray use. A total of 914 participants were analyzed, mean age 13.25 years and mean mass 53.20 kg. Of all procedures, 62.04% were performed without and 37.96% with fluoroscopy. There were no statistically significant differences in the frequency of x-ray use when comparing the groups by sex (p=0.181), age (p=0.380) or mass (p=0.120). Left-sided accessory pathways required x-ray use most frequently, whereas unknown substrates and of the known substrates atrioventricular nodal reentry tachycardia required it least frequently (p<0.001). Younger or smaller children were not irradiated more frequently during electrophysiology procedures performed with 3D mapping systems. In conclusion, there is no reason to postpone the procedure based on radiation frequency use.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 1","pages":"142-148"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431871","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}
Pub Date : 2024-04-01DOI: 10.20471/acc.2024.63.01.23
Danko Müller, Naranđa Aljinović Ratković, Igor Blivajs, Dalibor Franćeski, Karolina Krstanac, Sven Seiwerth
Fibrous dysplasia is a benign fibro-osseous lesion which rarely undergoes malignant transformation, frequently after radiotherapy. Osteosarcoma is the most common malignancy arising in fibrous dysplasia. We report a case of 67-year-old female patient with osteosarcoma developing in long lasting fibrous dysplasia without prior radiation. The patient underwent surgery with postoperative chemotherapy. She developed two relapses over the course of four years after the initial therapy. With this case, we want to underline the importance of noticing any significant change in the otherwise unremarkable course in patients with fibrous dysplasia.
{"title":"OSTEOSARCOMA IN A PATIENT WITH CRANIAL FIBROUS DYSPLASIA: A CASE REPORT.","authors":"Danko Müller, Naranđa Aljinović Ratković, Igor Blivajs, Dalibor Franćeski, Karolina Krstanac, Sven Seiwerth","doi":"10.20471/acc.2024.63.01.23","DOIUrl":"10.20471/acc.2024.63.01.23","url":null,"abstract":"<p><p>Fibrous dysplasia is a benign fibro-osseous lesion which rarely undergoes malignant transformation, frequently after radiotherapy. Osteosarcoma is the most common malignancy arising in fibrous dysplasia. We report a case of 67-year-old female patient with osteosarcoma developing in long lasting fibrous dysplasia without prior radiation. The patient underwent surgery with postoperative chemotherapy. She developed two relapses over the course of four years after the initial therapy. With this case, we want to underline the importance of noticing any significant change in the otherwise unremarkable course in patients with fibrous dysplasia.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 1","pages":"191-196"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431922","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}
Pub Date : 2024-04-01DOI: 10.20471/acc.2024.63.01.15
Slobodan P Pantelinac, Dušica S Simić-Panić, Gordana V Devečerski, Snežana T Tomašević Todorović
Microdiscectomy is one of the surgical methods for the treatment of herniated intervertebral disc in patients with low back pain. The aim of the research was to evaluate the presence of psychological and cognitive-behavioral factors, including anxiety, fears and fear-avoidance beliefs of physical activity and work and their correlation with the pain and functional disability in patients after lumbar microdiscectomy and subsequent physical therapy. The research was performed on 198 patients (95 men and 103 women), mean age 50.20±10.26 years. The following questionnaires were used in the study: Spielberger Anxiety Inventory-State and Trait; Fear-Avoidance Beliefs Questionnaire (Physical activity and Work); for intensity of pain, visual analog scale and Oswestry Low Back Pain Disability Questionnaire. These assessments were carried out after microdiscectomy, as follows: just before rehabilitation treatment, and 1, 3 and 6 months after microdiscectomy. The pain and functional disability had significant correlations with the following factors: anxiety-state (p<0.01), anxiety-trait (p<0.01), fear/avoidance beliefs - physical activity (p<0.01) and fear/avoidance beliefs - work (p<0.01). The pain and functional disability in patients after lumbar microdiscectomy showed significant correlation with anxiety, fears and fear-avoidance beliefs. The mentioned psychological and cognitive-behavioral factors can predict the degree of functional recovery and indicate additional therapy after lumbar microdiscectomy.
{"title":"ANXIETY, FEARS AND FEAR-AVOIDANCE BELIEFS AND THERAPEUTIC OUTCOME AFTER LUMBAR MICRODISCECTOMY.","authors":"Slobodan P Pantelinac, Dušica S Simić-Panić, Gordana V Devečerski, Snežana T Tomašević Todorović","doi":"10.20471/acc.2024.63.01.15","DOIUrl":"10.20471/acc.2024.63.01.15","url":null,"abstract":"<p><p>Microdiscectomy is one of the surgical methods for the treatment of herniated intervertebral disc in patients with low back pain. The aim of the research was to evaluate the presence of psychological and cognitive-behavioral factors, including anxiety, fears and fear-avoidance beliefs of physical activity and work and their correlation with the pain and functional disability in patients after lumbar microdiscectomy and subsequent physical therapy. The research was performed on 198 patients (95 men and 103 women), mean age 50.20±10.26 years. The following questionnaires were used in the study: Spielberger Anxiety Inventory-State and Trait; Fear-Avoidance Beliefs Questionnaire (Physical activity and Work); for intensity of pain, visual analog scale and Oswestry Low Back Pain Disability Questionnaire. These assessments were carried out after microdiscectomy, as follows: just before rehabilitation treatment, and 1, 3 and 6 months after microdiscectomy. The pain and functional disability had significant correlations with the following factors: anxiety-state (p<0.01), anxiety-trait (p<0.01), fear/avoidance beliefs - physical activity (p<0.01) and fear/avoidance beliefs - work (p<0.01). The pain and functional disability in patients after lumbar microdiscectomy showed significant correlation with anxiety, fears and fear-avoidance beliefs. The mentioned psychological and cognitive-behavioral factors can predict the degree of functional recovery and indicate additional therapy after lumbar microdiscectomy.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 1","pages":"123-133"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432185","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}
Congenital muscular torticollis (CMT) is one of the most common congenital musculoskeletal deformities, and is defined as tilted head position with hypertonic sternocleidomastoid muscle and limited cervical spine mobility. Incidences up to 16% have been recorded, more often in male children. Clinical features are characterized by an inclined position of the head on the diseased side and a gaze directed towards the healthy side, deformities such as plagiocephaly, and various complications. In order to prevent this, it is recommended to screen all infants up to four months of age. Diagnosis is usually made through history and physical examination. CMT treatment is carried out conservatively, and the habilitation program is created individually, depending on the degree of CMT. The habilitation program includes neck stretching exercises, neck muscle strengthening exercises, motor activities that encourage a symmetrical movement pattern, adaptation to the environment, and education and support of parents or guardians to ensure a daily, intensive home program. Early treatment is one of the main prognostic factors on which the outcome and duration of treatment depend. As this is the only prognostic factor that we can act on, our goal is to speed up the diagnosis and therapy implementation until the cure.
{"title":"DIAGNOSIS AND HABILITATION OF CONGENITAL MUSCULAR TORTICOLLIS: A NARRATIVE REVIEW.","authors":"Valentina Matijević, Danijel Mikulić, Danijela Rašić Markota, Asija Rota Čeprnja, Goranka Radmilović","doi":"10.20471/acc.2024.63.01.19","DOIUrl":"10.20471/acc.2024.63.01.19","url":null,"abstract":"<p><p>Congenital muscular torticollis (CMT) is one of the most common congenital musculoskeletal deformities, and is defined as tilted head position with hypertonic sternocleidomastoid muscle and limited cervical spine mobility. Incidences up to 16% have been recorded, more often in male children. Clinical features are characterized by an inclined position of the head on the diseased side and a gaze directed towards the healthy side, deformities such as plagiocephaly, and various complications. In order to prevent this, it is recommended to screen all infants up to four months of age. Diagnosis is usually made through history and physical examination. CMT treatment is carried out conservatively, and the habilitation program is created individually, depending on the degree of CMT. The habilitation program includes neck stretching exercises, neck muscle strengthening exercises, motor activities that encourage a symmetrical movement pattern, adaptation to the environment, and education and support of parents or guardians to ensure a daily, intensive home program. Early treatment is one of the main prognostic factors on which the outcome and duration of treatment depend. As this is the only prognostic factor that we can act on, our goal is to speed up the diagnosis and therapy implementation until the cure.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 1","pages":"157-164"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432264","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}
Pub Date : 2024-04-01DOI: 10.20471/acc.2024.63.01.7
Marijana Srećković, Dušan Backović, Tihomir Dugandžija, Igor Dragičević, Ljubica Pajić Nikolić, Maida Mulić, Bojan Damnjanović
The municipality of Bogatić, part of Mačva District, belongs to the Pannonian Basin, where high concentrations of arsenic in artesian wells were detected. Numerous epidemiological studies have confirmed the association of exposure to arsenic in drinking water and bladder cancer (C67). This retrospective ten-year analysis included age-standardized incidence rates (ASRs) and age-specific incidence rates of C67 in the municipality of Bogatić and rural municipalities of Mačva District. The concentration of arsenic in drinking water was determined at Šabac Public Health Institute (PHI) laboratories in 2015. ASRs were estimated using data from regional cancer registries at Šabac PHI and compared by use of the Mann-Whitney U test. Control population was recruited from an area where there were no artesian wells or hydrogeological conditions that would indicate elevated concentrations of arsenic in drinking water. Arsenic levels in all artesian wells in Bogatić municipality were 1.4 to 41 times higher than the maximum permissible concentration (mean 120 µg/L±165). Female subjects from Bogatić municipality had higher ASRs of C67 compared with the populations in rural municipalities of Mačva District (p<0.01), while the incidence of bladder cancer was by 13% greater than that in central Serbia (standardized incidence ratio, 113; 95% CI 96.97-131.35). Male subjects from Bogatić municipality had higher ASRs of C67 but the difference was not statistically significant (p>0.05). Our analyses suggested that exposure to arsenic in drinking water could triple the risk of bladder cancer. These results support the conclusions of previous studies that there may be an association between higher concentrations of arsenic in drinking water and higher ASRs of bladder cancer in both male and female subjects.
{"title":"EXPOSURE TO ARSENIC IN DRINKING WATER AND RISK OF BLADDER CANCER.","authors":"Marijana Srećković, Dušan Backović, Tihomir Dugandžija, Igor Dragičević, Ljubica Pajić Nikolić, Maida Mulić, Bojan Damnjanović","doi":"10.20471/acc.2024.63.01.7","DOIUrl":"10.20471/acc.2024.63.01.7","url":null,"abstract":"<p><p>The municipality of Bogatić, part of Mačva District, belongs to the Pannonian Basin, where high concentrations of arsenic in artesian wells were detected. Numerous epidemiological studies have confirmed the association of exposure to arsenic in drinking water and bladder cancer (C67). This retrospective ten-year analysis included age-standardized incidence rates (ASRs) and age-specific incidence rates of C67 in the municipality of Bogatić and rural municipalities of Mačva District. The concentration of arsenic in drinking water was determined at Šabac Public Health Institute (PHI) laboratories in 2015. ASRs were estimated using data from regional cancer registries at Šabac PHI and compared by use of the Mann-Whitney U test. Control population was recruited from an area where there were no artesian wells or hydrogeological conditions that would indicate elevated concentrations of arsenic in drinking water. Arsenic levels in all artesian wells in Bogatić municipality were 1.4 to 41 times higher than the maximum permissible concentration (mean 120 µg/L±165). Female subjects from Bogatić municipality had higher ASRs of C67 compared with the populations in rural municipalities of Mačva District (p<0.01), while the incidence of bladder cancer was by 13% greater than that in central Serbia (standardized incidence ratio, 113; 95% CI 96.97-131.35). Male subjects from Bogatić municipality had higher ASRs of C67 but the difference was not statistically significant (p>0.05). Our analyses suggested that exposure to arsenic in drinking water could triple the risk of bladder cancer. These results support the conclusions of previous studies that there may be an association between higher concentrations of arsenic in drinking water and higher ASRs of bladder cancer in both male and female subjects.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"63 1","pages":"55-64"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432270","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}
Pub Date : 2023-12-01DOI: 10.20471/acc.2023.62.04.5
Tjaša Ivošević, Biljana Miličić, Aleksandar Trivić, Bojana Bukurov, Nenad Arsović, Nikola Slijepčević, Hristina Ugrinović, Nemanja Radivojević, Nevena Kalezić
Intraoperative hypertension (IOHTA) during neck surgery is undesirable because this type of surgery has a propensity to bleed profoundly even in normotensive anesthesia. The purpose of our study was to detect predictors of IOHTA in patients undergoing neck surgery. This single center retrospective study included 880 adult patients who underwent neck surgery under general anesthesia. The impact of gender, age, comorbidity, difficult tracheal intubation, anesthesia duration, and induced hypotension on IOHTA was studied. IOHTA was present in 57 (6.7%) patients. The highest incidence of IOHTA was recorded in patients with ASA 4 status and those with Cormack-Lehane grade 4,: (22.2% and 21.4%, respectively). Significantly more patients with hypertension, hyperlipoproteinemia and ventricular extrasystoles had IOHTA compared with patients without these comorbidities. Statistically significant predictors of IOHTA were age (OR 1.438; 95% CI 1.144-1.808; p=0.002), cardiac arrhythmia (OR 1.702; 95% CI 1.129-2.566; p=0.011), Cormack-Lehane grade (OR 1.407; 95% CI 1.054-1.878; p=0.020), and duration of anesthesia (OR 1.005; 95% CI 1.001-1.008; p=0.005). The risk of IOHTA occurrence was lower in patients with induced hypotension (OR 0.024; 95% CI 0.003-0.185; p=0.000). During neck surgery, special attention is needed in patients of older age, those with cardiac arrhythmia, difficult intubation, and longer anesthesia duration because they are at risk of IOHTA.
{"title":"PREDICTORS OF INTRAOPERATIVE HYPERTENSION IN NECK SURGERY: A SINGLE CENTER RETROSPECTIVE STUDY.","authors":"Tjaša Ivošević, Biljana Miličić, Aleksandar Trivić, Bojana Bukurov, Nenad Arsović, Nikola Slijepčević, Hristina Ugrinović, Nemanja Radivojević, Nevena Kalezić","doi":"10.20471/acc.2023.62.04.5","DOIUrl":"10.20471/acc.2023.62.04.5","url":null,"abstract":"<p><p>Intraoperative hypertension (IOHTA) during neck surgery is undesirable because this type of surgery has a propensity to bleed profoundly even in normotensive anesthesia. The purpose of our study was to detect predictors of IOHTA in patients undergoing neck surgery. This single center retrospective study included 880 adult patients who underwent neck surgery under general anesthesia. The impact of gender, age, comorbidity, difficult tracheal intubation, anesthesia duration, and induced hypotension on IOHTA was studied. IOHTA was present in 57 (6.7%) patients. The highest incidence of IOHTA was recorded in patients with ASA 4 status and those with Cormack-Lehane grade 4,: (22.2% and 21.4%, respectively). Significantly more patients with hypertension, hyperlipoproteinemia and ventricular extrasystoles had IOHTA compared with patients without these comorbidities. Statistically significant predictors of IOHTA were age (OR 1.438; 95% CI 1.144-1.808; p=0.002), cardiac arrhythmia (OR 1.702; 95% CI 1.129-2.566; p=0.011), Cormack-Lehane grade (OR 1.407; 95% CI 1.054-1.878; p=0.020), and duration of anesthesia (OR 1.005; 95% CI 1.001-1.008; p=0.005). The risk of IOHTA occurrence was lower in patients with induced hypotension (OR 0.024; 95% CI 0.003-0.185; p=0.000). During neck surgery, special attention is needed in patients of older age, those with cardiac arrhythmia, difficult intubation, and longer anesthesia duration because they are at risk of IOHTA.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"62 4","pages":"615-622"},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045382","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}
Pub Date : 2023-12-01DOI: 10.20471/acc.2023.62.04.18
Ljiljana Smiljanić Tomičević, Marko Barešić, Miroslav Mayer, Branimir Anić
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that most commonly affects the young, working, female population. Musculoskeletal manifestations are one of the most prevalent and presenting features in SLE. Arthralgia, myalgia, non-erosive arthritis, myositis but also tenosynovitis and enthesitis are present in more than 90% of SLE patients. Although not considered very severe SLE manifestations, they significantly affect the patient's quality of life and daily functioning. Clinical assessment of joints, tendons, entheses, and muscles is still the gold diagnostic standard. There are many radiological imaging methods, i.e., classic radiograms, ultrasound, bone scintigraphy, and magnetic resonance imaging that provide morphological information regarding damage and activity of musculoskeletal diseases in SLE and other rheumatic diseases. Musculoskeletal ultrasound stands out as an accessible and affordable method. Recognizing musculoskeletal manifestations may help establish an early diagnosis of SLE and assess disease activity, thus leading to early initiation of treatment and preventing chronic and irreversible changes with a beneficial effect on the quality of life.
{"title":"MUSCULOSKELETAL MANIFESTATIONS OF SYSTEMIC LUPUS ERYTHEMATOSUS.","authors":"Ljiljana Smiljanić Tomičević, Marko Barešić, Miroslav Mayer, Branimir Anić","doi":"10.20471/acc.2023.62.04.18","DOIUrl":"10.20471/acc.2023.62.04.18","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that most commonly affects the young, working, female population. Musculoskeletal manifestations are one of the most prevalent and presenting features in SLE. Arthralgia, myalgia, non-erosive arthritis, myositis but also tenosynovitis and enthesitis are present in more than 90% of SLE patients. Although not considered very severe SLE manifestations, they significantly affect the patient's quality of life and daily functioning. Clinical assessment of joints, tendons, entheses, and muscles is still the gold diagnostic standard. There are many radiological imaging methods, i.e., classic radiograms, ultrasound, bone scintigraphy, and magnetic resonance imaging that provide morphological information regarding damage and activity of musculoskeletal diseases in SLE and other rheumatic diseases. Musculoskeletal ultrasound stands out as an accessible and affordable method. Recognizing musculoskeletal manifestations may help establish an early diagnosis of SLE and assess disease activity, thus leading to early initiation of treatment and preventing chronic and irreversible changes with a beneficial effect on the quality of life.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"62 4","pages":"714-723"},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045376","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}
Pub Date : 2023-12-01DOI: 10.20471/acc.2023.62.04.1
Rozita Gulić, Andrej Šribar, Davor Vagić
The aim was to measure sphenoid sinus volume on the basis of computed tomography data post processing and to investigate the possible relationship with age, gender and mastoid pneumatization. Sphenoid sinus volume was measured using the semi-automatic post processing algorithm of MSCT DICOM datasets of 66 patients. There were 35 female and 31 male subjects. Median age was 54 (range 17-84) years. Datasets were selected retrospectively from computer archives of our hospital radiology department. Subjects with healthy sphenoid sinuses were included. Relationship of total sphenoid volume with age, gender and mastoid pneumatization was analyzed. Data acquisition was performed using Siemens Somatom Emotion scanner. Measurements were performed using volumetric module of Syngo 2006G software. Virtual endoscopy and three-dimensional volume rendering were also performed. Median sphenoid total volume (left and right together) was 10.12 cm3. Median volume of the right mastoid was 4.86 cm3 and 5.31 cm3 on the left side. We found a significant positive correlation between total sphenoid volume and both left and right mastoid pneumatization (Spearman ρ=0.528, p<0.001 and ρ=0.450, p<0.001, respectively). Sphenoid volume was positively correlated with age, but without statistical significance (ρ=0.186; p=0.136). Sphenoid volumes were larger in males than in females, but mastoid air cells showed no gender difference. In conclusion, volumetric measurements of paranasal sinuses may be accurately performed on the basis of MSCT data post processing. Sphenoid volume was positively correlated with mastoid pneumatization and age. Virtual endoscopy and 3D volume rendering may accurately display anatomic structures of sphenoid sinuses.
{"title":"RELATIONSHIP OF MASTOID PNEUMATIZATION AND AGE WITH COMPUTED TOMOGRAPHY MEASURED SPHENOID SINUS VOLUME.","authors":"Rozita Gulić, Andrej Šribar, Davor Vagić","doi":"10.20471/acc.2023.62.04.1","DOIUrl":"10.20471/acc.2023.62.04.1","url":null,"abstract":"<p><p>The aim was to measure sphenoid sinus volume on the basis of computed tomography data post processing and to investigate the possible relationship with age, gender and mastoid pneumatization. Sphenoid sinus volume was measured using the semi-automatic post processing algorithm of MSCT DICOM datasets of 66 patients. There were 35 female and 31 male subjects. Median age was 54 (range 17-84) years. Datasets were selected retrospectively from computer archives of our hospital radiology department. Subjects with healthy sphenoid sinuses were included. Relationship of total sphenoid volume with age, gender and mastoid pneumatization was analyzed. Data acquisition was performed using Siemens Somatom Emotion scanner. Measurements were performed using volumetric module of Syngo 2006G software. Virtual endoscopy and three-dimensional volume rendering were also performed. Median sphenoid total volume (left and right together) was 10.12 cm<sup>3</sup>. Median volume of the right mastoid was 4.86 cm<sup>3</sup> and 5.31 cm<sup>3</sup> on the left side. We found a significant positive correlation between total sphenoid volume and both left and right mastoid pneumatization (Spearman ρ=0.528, p<0.001 and ρ=0.450, p<0.001, respectively). Sphenoid volume was positively correlated with age, but without statistical significance (ρ=0.186; p=0.136). Sphenoid volumes were larger in males than in females, but mastoid air cells showed no gender difference. In conclusion, volumetric measurements of paranasal sinuses may be accurately performed on the basis of MSCT data post processing. Sphenoid volume was positively correlated with mastoid pneumatization and age. Virtual endoscopy and 3D volume rendering may accurately display anatomic structures of sphenoid sinuses.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"62 4","pages":"577-584"},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045344","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}