Acta clinica Croatica最新文献

The purpose of this study was to examine the possible association between cheilitis and allergic reactions, and to use allergy skin tests to identify the allergens that induce allergic reactions in cheilitis patients (type I and type IV). We included 50 patients with recurrent cheilitis (reversible cheilitis) who were dermatologically examined and agreed to undergo allergy skin tests, i.e., patch test and prick test. Additionally, clinical pictures and patient mental stress levels were examined using the Perceived Stress Scale (PSS). Positive prick tests (atopy) were recorded in 84% of patients with cheilitis. The most frequently found allergens were contact allergens (54%) (cobalt chloride, nickel sulfate and thimerosal) and inhalant allergens (46%). The patch test positive subjects who used cosmetic, hygiene, and decorative products were significantly more likely to have swollen and red lips than the patch test negative subjects. Also, low stress levels were recorded less frequently in patients with confirmed allergies than in non-allergic patients. The results indicated a higher incidence of cheilitis in the people prone to allergies (atopics) and confirmed an association between cheilitis and allergies. To our knowledge, this is the first study in patients with cheilitis, which simultaneously analyzed allergies, their clinical features and PSS in the same patients.

The aim of the study was to analyze changes in the number of suicides associated with seasonal variables, calendar month, time of day versus variable location and method of suicide. Data were obtained from the Analytical Police Department of Bjelovar-Bilogora County for the 1988-2017 period. The process of Croatian application process into the European Union, accompanied by economic and social changes, was a significant socioeconomic event, which divided the analyzed period into two parts. Significant changes in the impact of the analyzed variables on the suicides committed in the two observed periods were tested with the χ²-test and Fisher exact test. Consistency of the results, as well as absence of the impact of significant changes would show less susceptibility of the covariate variable to the effect of socioeconomic factors. In the case of time of day and location of the suicides, there was no significant difference when comparing results between the 1988-2004 and 2005-2017 periods; however, a statistically significant difference was confirmed when considering the month of suicide (February) and season (winter, borderline result for autumn). Statistically, the most significant changes were found in the methods of suicide. The two observed periods differed in the mean suicide rate.

Arterial hypoxemia occurs in many COVID-19 patients. Hypoxemia is one of the causes of pulmonary hypertension (PH). Main pulmonary artery dilatation and the main pulmonary artery diameter (mPAD) to ascending aorta diameter (AAD) ratio of ≥1 are significant findings regarding PH. In this study, COVID-19 patients and non-COVID-19 patients with viral respiratory tract infection were evaluated retrospectively in terms of PH. A total of 124 patients (71 male and 53 female), age range 18-85 years, were included in the study as case group and control group. Thoracic computed tomography (CT) images, blood and biochemical parameters, and demographic information were compared between the case group and control group. The normality of numerical variables was examined with Kolmogorov-Smirnov test and homogeneity of the variances with Levene's test. This is the first study researching the effect of early hypoxemic stage COVID-19 infection on development of PH. As a result, it was specified that COVID-19 infection had no effects on mPAD, whereas it had a positive effect on AAD and thus led to a decrease in the mPAD/AAD ratio. Through these values, which could be easily calculated from thoracic CT images, the changes caused by COVID-19 infection on vessel diameters were put forward.

The main aim of this study was to examine the association of glucose and sodium level with diagnosis and disease outcome of critically ill patients. Glucose and sodium concentrations of 283 patients admitted in critical condition to the Intensive Care Unit of the Department of Internal Medicine in a period from November 1, 2015 to February 28, 2017 were reviewed. The most common diagnoses in critically ill patients were acute kidney injury (26.1%) and sepsis (including septic shock, 22.3%). Significantly lower glucose concentration was observed in patients with acute kidney injury (p=0.02), whereas patients in sepsis and septic shock had a significantly higher sodium concentration (p=0.04). Higher glucose level was related to higher mortality rate (p=0.001). On the other hand, sodium level was not significantly associated with survival. Higher mortality, as well as higher glucose concentration were more common in patients older than 65 years (p<0.001). Study results showed significantly lower glucose concentrations in patients with acute kidney injury, whereas in patients older than 65, glucose concentration was significantly higher. Patients in sepsis and septic shock had significantly higher sodium concentrations. Higher concentration of glucose was connected with higher mortality in the elderly, whereas sodium concentration did not show connection with mortality.

The aim of this cross-sectional study was to determine the signs of biofilm in the maxillary sinus of patients with antrochoanal polyps (ACP), and status of the mucosa on which the biofilm occurred. Mucosal samples from maxillary sinus in 40 ACP patients who underwent endoscopic sinus surgery were analyzed histopathologically and by scanning electron microscopy. Results were compared with maxillary mucosa samples of 40 patients without endoscopic and radiological signs of sinus disease. The existence of biofilm and its relation to the degree of histopathological changes according to Terrier classification of chronic mucosal inflammation of maxillary sinus were statistically analyzed. Biofilm was detected in 23 of 40 (57.5%) ACP patients; the incidence was significantly lower in the control group (2/40, 5%). Biofilm was not found in type 1 mucosa according to Terrier classification. In conclusion, biofilm showed a significant incidence in the maxillary sinus mucosa of ACP patients (57.5%). Occasionally, biofilm can be found in patients with no signs of sinus disease, but not on histologically normal mucosa. Results of this study support the theory that biofilm formation does not represent the initial stage of the inflammatory process.

The aim of this study was to present the results and to explore the success of combined screening at the Split University Hospital Center. A cross-sectional retrospective study was performed, including all pregnant women who underwent combined screening at the Split University Hospital Center from 2011 to 2017. Data were collected from the hospital archives. During the research period, a total of 6898 pregnant women underwent combined screening. With the high risk cut-off value set at 1:250, the sensitivity of combined screening was 81.0% and specificity 96.8% (AUC 0.929, 95% CI 0.859-1.000; p<0.001). The mean value of a priori risk of Down syndrome based on age was higher than the one calculated by combined screening (1:487.57 vs. 1:13216.9; p<0.001). The number of women who were a priori at a high risk of Down syndrome was significantly higher than the number of those at a high risk based on combined screening results (1457 vs. 239; p<0.001). With the increase in women's age, a statistically significant increase was detected in the mean value of a priori risk of Down syndrome, as well as in the risk based on combined screening results (p<0.001). Combined screening detected a high risk in 8.09% (118/1457) of pregnant women a priori at a high risk of Down syndrome, as well as in 2.22% (121/5441) of pregnant women a priori at a low risk of it. Thus, combined screening placed 121 pregnant women a priori at a low risk in the high-risk group. Down syndrome was subsequently confirmed in 17 (14.05%) women. Analysis of the combined screening results confirmed the validity of using the said fetal Down syndrome screening method in the study population of pregnant women.

We aimed to investigate the effects of comorbid diseases and antihypertensive drugs on the clinical outcome of hospitalized patients with COVID-19 infection. A total of 1045 patients whose data could be gathered and confirmed from both hospital files and Turkish National Health Network records were retrospectively screened, and 264 of 1045 patients were excluded because of having more than one comorbid disease. The study population consisted of a total of 781 patients, of which 482 had no comorbid disease, while the remaining 299 patients had only one comorbid disease. The mortality risk was 7.532 times higher in those over 65 years of age compared to cases younger than 30 years (OR: 7.532; 95% CI: 1.733-32.730); the risk of mortality in men was 2.131 times higher than in women (OR: 2.131; 95% CI: 1.230-3.693); and presence of diabetes mellitus (DM) increased mortality risk 2.784 times (OR: 2.784; 95% CI: 1.288-6.019). While hypertension was not found to be an independent risk factor for COVID-19 mortality, age, gender, and presence of DM were independent risk factors for COVID-19 mortality. There was no association between antihypertensive drugs and mortality. Accordingly, age (>65 years), gender (male), and presence of DM were independent risk factors for COVID-19 mortality, whereas hypertension and use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and their combinations with other antihypertensive drugs were not risk factors for COVID-19 mortality.

Destructive thyroiditis is a self-limited disease characterized by acute release of preformed thyroid hormones. We present a patient with extremely rare acute painful thyroiditis after percutaneous coronary intervention (PCI) in acute myocardial infarction without ST-elevation. The acute onset of thyroid pain and increase of fT3, fT4 and parameters of inflammation were compatible with acute destructive thyroiditis. Such acute thyroiditis probably resulted from local inflammation induced by a large amount of iodine given to the patient via iodinated contrast media used during PCI. Because of the increasing number of patients referred to cardiac catheterization, invasive cardiologists should be aware of the potentially serious thyroid dysfunction that can result from iodinated contrast use. The aim of our paper is, in the light of the patient presented, to discuss the pathophysiology, clinical presentations, therapy and potential preventive measures in patients that develop thyroid dysfunction after PCI.

Gallic acid, acting as an antioxidant, anti-precipitant and cytoprotective agent, was used as a possible remedial natural component for treating experimentally induced esophageal burn. Wistar rats (n=24) were divided into three groups. Control group was given 1 mL 0.9% NaCl. Experimental esophageal burn was induced with 1 mL 40% NaOH application to the esophagus in groups 2 and 3. Gallic acid® (20 mg/kg) was administered to the treated group via oral gavage for 10 days. Removed tissues were fixed and paraffin blocks were prepared. Histopathological examination was performed after the sections had been stained with hematoxylin-eosin. Tumor necrosis factor alpha and caspase-3 antibodies were used on immunohistochemical analysis. In the esophageal burn group, necrosis, degeneration and numerous apoptotic cells, as well as intense inflammatory cell infiltration and fibrosis in the muscle layer were observed under light microscope. In the treated group, remodeling of epithelial cells with marked reduction in the connective tissue collagen content was observed, as well as marked reduction in the volume of collagen and abundance of inflammatory cells in blood vessels. Gallic acid treatment may help heal esophageal burns and prevent complications.

Planning of non-postponable treatments for cancer, trauma, emergency diseases, and follow-up and treatment of chronic diseases are inevitable for the ongoing pandemic and future pandemics. In this study, we evaluated the capacity of surgical applications and treatments made to the surgery department in the first 3 months of the onset of the COVID-19 pandemic. A retrospective cohort study was performed from March 12, 2020 to June 1, 2020. COVID-19 negative general surgery patients were included. Demographics, diagnosis and management were recorded, as well as bed turnover and length of stay in the hospital. Similar data were collected on patients admitted during the same period in 2019 and 2018 to allow for comparison. A total of 1764 operations were included. There was a reduction in surgeries when comparing 2020 with 2019 and 2018 (164 vs. 713 and 890); however, there was no difference in the length of stay in the hospital (4.12 vs. 4.37 and 4.07 days, p=0.626). During 2020, appendectomies decreased (53 vs. 102 and 100, p=0.013). There was no difference in the number of emergency oncologic surgeries during 2020 as compared with 2019 and 2018 (16 vs. 8 and 13, p=0.149). In conclusion, COVID-19 significantly impacted the number of admissions to general surgery. However, cancer and emergency operations continued to be required, thus provisions need to be made to enable planning these interventions.