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1.
Arch Gynecol Obstet ; 309(6): 2735-2740, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38557832

RESUMEN

INTRODUCTION: Hysterectomy is one of the most common major gynecological surgeries, and it is performed for benign and malignant reasons. Currently, five types of hysterectomies are described: vaginal (VH), abdominal (AH), laparoscopic (LH), robotic, and vNOTES (vaginal natural orifice transluminal endoscopic surgery). This paper compares these two types of surgery in obese patients by analyzing the surgeries performed by our team. MATERIALS AND METHODS: The research was conducted from January 2022 to December 2023 at the Department of Gynecology and Obstetrics of the General Hospital in Zadar. The study included female patients aged 18-75 years with a BMI > 30 kg/m2, regardless of parity, who were operated on for benign pathology. RESULTS: There were 24 patients included in total. One conversion was observed in the TLH group because of excessive bleeding. Median operative time (IQR) was significantly lower in the vNOTES group (p < 0.05) than in the TLH group 35 (10.9) vs 125 (74.0) min. CONCLUSION: The results concerning the duration of surgery, conversion rate, and postoperative bleeding and complications show that vNOTES hysterectomies seem to be feasible for obese patients. Further studies are needed to confirm these observations.


Asunto(s)
Histerectomía , Laparoscopía , Cirugía Endoscópica por Orificios Naturales , Obesidad , Tempo Operativo , Humanos , Femenino , Persona de Mediana Edad , Laparoscopía/estadística & datos numéricos , Laparoscopía/métodos , Obesidad/cirugía , Obesidad/complicaciones , Adulto , Estudios Retrospectivos , Anciano , Histerectomía/métodos , Histerectomía/estadística & datos numéricos , Cirugía Endoscópica por Orificios Naturales/métodos , Adulto Joven , Adolescente , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Hemorragia Posoperatoria/etiología , Hemorragia Posoperatoria/epidemiología , Histerectomía Vaginal/métodos , Histerectomía Vaginal/estadística & datos numéricos , Procedimientos Quirúrgicos Robotizados/estadística & datos numéricos
2.
BMC Cancer ; 19(1): 950, 2019 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-31615453

RESUMEN

BACKGROUND: Strong associations exist between Balkan endemic nephropathy (BEN) and upper urothelial carcinomas (UUCs). However, the common etiology between the two remains unclear and there are no studies to date that visualize UUC risks in Croatia. In Croatia, 14 villages in the southwestern part of Brod-Posavina County are considered endemic for BEN. The aim of this ecological study is to map cancer risks and describe the case distribution of UUCs in Croatia at the county level during 2001-2011. METHODS: A total of 608 incident cases from the Croatian National Cancer Registry were identified. Indirect standardization was employed to compute standardized incidence ratios (SIRs). RESULTS: Counties with SIRs greater than 1 were concentrated around the agricultural region of Slavonia and the coastal region of Dalmatia. However, only Brod-Posavina County and Vukovar-Srijem County had a statistically significant risk of UUC development, where there were 390 and 210% more UUC cases observed than expected, respectively. Only unique to Brod-Posavina County, females were at higher risk (SIR 4.96; 95% CI 3.59-6.34) of developing UUCs than males (SIR 3.03; 95% CI 2.04-4.01) when compared to their Croatian counterparts. Although Brod-Posavina County only made up 3.7% of the total Croatian population (as of 2011), it had the highest frequency of incident UUC cases after the capital City of Zagreb. No elevated cancer risks were noted in the City of Zagreb, even after stratifying by sex. CONCLUSION: Our findings suggest that Brod-Posavina County had the highest cancer risk for UUCs, especially among females, when compared to Croatia as a whole during 2001-2011. Given that a majority of BEN patients develop associated UUCs, concurrent screening programs for UUCs and BEN should be considered not only in endemic areas of BEN but also the surrounding rural areas and amongst at-risk groups such as those undergoing hemodialysis, who frequently develop UUCs, to help clarify BEN-UUC associations by identifying common risk factors while standardizing disease estimates across endemic regions for BEN.


Asunto(s)
Nefropatía de los Balcanes/epidemiología , Carcinoma de Células Renales/epidemiología , Neoplasias Renales/epidemiología , Sistema de Registros , Neoplasias Ureterales/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Croacia/epidemiología , Enfermedades Endémicas , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Tamizaje Masivo/métodos , Persona de Mediana Edad , Riesgo , Factores Sexuales , Urotelio , Adulto Joven
6.
Croat Med J ; 57(6): 540-547, 2016 Dec 31.
Artículo en Inglés | MEDLINE | ID: mdl-28051278

RESUMEN

AIM: To determine whether apoptosis is more common in previously punctured native veins than in non-punctured native veins among patients who undergo surgical creation of arteriovenous fistula (AVF) for dialysis access. METHODS: Cephalic vein specimens were obtained from January 1, 2013 to December 31, 2014 from 60 patients, 30 with previously punctured native veins and 30 with non-punctured native veins. Before AVF placement, a 1-cm vein segment was excised from distal part of the vein for histological, histochemical, and immunohistochemical analysis. Vein specimens were divided into two portions along the longitudinal axis and stained with hematoxylin and eosin for routine histological evaluation. Immunohistochemical analysis was used to localize Bax, p53, caspase 3, and Bcl-2 expression. RESULTS: The group with previously punctured veins showed significantly increased caspase 3 (P<0.001, two-sided Fisher`s Exact Test) and Bax expression (P=0.002, two-sided Fisher`s Exact Test) and significantly decreased Bcl-2 expression (P<0.001, two-sided Fisher`s Exact Test) compared with the control group. There were no significant differences between the groups in p53 expression (?2=0.071, df=1, P=0.791). Fistula failure was significantly more common in the study group (26.7% vs 6.7%, ?2=4.32, df=1, P=0.038). CONCLUSION: Our study indicates a possible role of venipuncture in apoptosis development and a possible role of apoptosis in fistula failure, but we do not have sufficient evidence to conclude that it represents its main cause.


Asunto(s)
Apoptosis/fisiología , Punciones , Venas/fisiopatología , Apoptosis/inmunología , Derivación Arteriovenosa Quirúrgica , Caspasa 3/biosíntesis , Humanos , Diálisis Renal , Factores de Tiempo
7.
Psychiatr Danub ; 28(1): 73-6, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26938825

RESUMEN

BACKGROUND: During the Croatian War of Independence, 1991-1995, Croatian soldiers were exposed to traumatic and stressful events. Certain number of soldiers who took part in the war, developed depression and posttraumatic stress disorder (PTSD). Stress is one of the etiological factors in the development of myofascial pain (MPS), although the mechanism of these processes is not entirely understood. The aims of this study were to determine the frequency of myofascial pain among Croatian war veterans with depression and PTSD, association between MPS and severity of depression, to describe the most common locations of trigger points in the region of head and neck, and to find out if there is any association in frequency between MPS and endotracheal intubation. SUBJECTS AND METHODS: A total of 101 Croatian war veterans suffering from PTSD and depression participated in the current study. Diagnosis of myofascial pain was based on detailed anamnestic history and careful clinical examination. RESULTS: Our findings showed a high rate of myofascial pain among Croatian war veterans, with occipital region and right temporal region as the most common places of trigger points. Higher severity of depression was accompanied by a higher percentage of subjects with MPS. Finally, there was no significant association between endotracheal intubation and development of MPS among the war veterans. CONCLUSIONS: It can be concluded that the rate of myofascial pain among Croatian war veterans is high and therefore it must be considered in patients with depression and PTSD. Moreover, the severity of depressive symptomatology seems to be related to the presence of myofascial pain.


Asunto(s)
Depresión/fisiopatología , Síndromes del Dolor Miofascial/fisiopatología , Trastornos por Estrés Postraumático/fisiopatología , Puntos Disparadores/fisiopatología , Veteranos , Adulto , Anciano , Comorbilidad , Croacia/epidemiología , Depresión/epidemiología , Cabeza/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Síndromes del Dolor Miofascial/epidemiología , Cuello/fisiopatología , Trastornos por Estrés Postraumático/epidemiología
8.
Cardiology ; 132(1): 34-44, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26021830

RESUMEN

OBJECTIVES: The aim of this study was to assess the recovery of regional myocardial function of the left-ventricular septal wall and the septal site of the mitral valve (MV) annulus by tissue Doppler imaging (TDI). METHODS: In 63 (32 diabetic and 31 control) patients having off-pump coronary artery bypass grafting (OPCABG), including the left internal mammary artery (LIMA) and the left anterior descending coronary artery (LAD), TDI measurements were performed before operation (baseline), 5 min after LIMA-LAD revascularization (early reperfusion) and after completion of all anastomoses (after revascularization). RESULTS: Compared to the patients with diabetes, the controls had higher peak systolic velocities of the mid septal segments in the early reperfusion measurement (p = 0.002). After revascularization, values of peak systolic strain at the basal (-10.13 vs. -13.36%, p = 0.044) and mid septal segments (-8.25 vs. -12.69%, p = 0.009) were decreased in the diabetic patients compared to the controls. There was no difference between the groups with respect to the velocities acquired at the septal site of the MV annulus. CONCLUSIONS: This study demonstrates an insufficient recovery of regional myocardial function in patients with type II diabetes undergoing OPCABG.


Asunto(s)
Puente de Arteria Coronaria Off-Pump/métodos , Diabetes Mellitus Tipo 2/fisiopatología , Ecocardiografía Doppler/métodos , Anciano , Vasos Coronarios/diagnóstico por imagen , Femenino , Humanos , Masculino , Arterias Mamarias/diagnóstico por imagen , Persona de Mediana Edad , Válvula Mitral/diagnóstico por imagen , Sístole/fisiología
9.
Med Sci Monit ; 20: 191-8, 2014 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-24496387

RESUMEN

BACKGROUND: Vascular access is "the life line" for patients on chronic hemodialysis. The autogenous arteriovenous fistula provides the best access to the circulation because of low complication rate, long-term use, and lower cost, compared to arteriovenous graft and central venous catheter. The primary objective of this prospective study was to investigate the predictive value of vein diameter after intraoperative dilatation with vessel probes on hemodialysis fistula maturation. MATERIAL AND METHODS: Ninety-three fistulas were performed by a single surgeon from February 1, 2006 to January 31, 2009. Intraoperative vein dilatation with vessel probes was attempted in all fistulas. Measurements of the feeding artery diameter, vein diameter and the increased vein diameter after intraoperative dilatation were performed and immediate failure, early patency, early failure, primary patency, and fistula survival outcomes were recorded during 48-month follow-up. RESULTS: Early failure occurred in 20% of fistulas and 70% matured sufficiently for cannulation. Variables with significant impact on the failure to mature by univariate analysis were: body-mass index (P=0.041), artery diameter (P<0.001), vein diameter (P=0.004), and vein diameter after dilatation (P=0.002). However, but multivariate analysis showed that only body-mass index (P=0.038), artery diameter (P=0.001), and the diameter of the vein after dilatation (P=0.018) significantly affected maturation. In a group of 56 (60%) patients with vein diameter before dilatation ≤ 2 mm, among vessel characteristics found by multivariate analysis, only vein diameter after dilatation (P=0.004) significantly affected function. CONCLUSIONS: Artery diameter and vein diameter after intraoperative dilatation with vessel probes were the main predictors of fistula function.


Asunto(s)
Fístula Arteriovenosa/cirugía , Vasos Sanguíneos/anatomía & histología , Procedimientos Endovasculares/métodos , Diálisis Renal/métodos , Dilatación , Humanos , Estudios Prospectivos , Grado de Desobstrucción Vascular/fisiología
10.
J Stroke Cerebrovasc Dis ; 23(3): e171-6, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24189452

RESUMEN

BACKGROUND: In young individuals, a genetically predisposing hypercoagulability and classic modifying risk factors can act synergistically on the ischemic stroke risk development. The aim of the study was to compare the prevalence of classic vascular risk factors and polymorphisms of the G20210A coagulation factor II (prothrombin), Arg506Glu coagulation factor V Leiden, C677T methylenetetrahydrofolate reductase (MTHFR), and 4G/5G plasminogen activator inhibitor-1 (PAI-1) and the impact of these gene mutations and classic vascular risk factors on the overall stroke risk in individuals aged 55 years or younger. METHODS: The study included 155 stroke patients aged 55 years or younger and 150 control subjects. Stroke prevalence and odds ratio (OR) were assessed for the following parameters: G20210A prothrombin, Arg506Glu factor V Leiden, C677T MTHFR, and 4G/5G PAI-1 polymorphisms; total number of study polymorphisms in a particular subject (genetic sum); and classic vascular risk factors of hypertension, obesity, diabetes mellitus, cigarette smoking, hypercholesterolemia, hypertriglyceridemia, and elevated levels of low-density lipoprotein (LDL) cholesterol and very low-density lipoprotein cholesterol. RESULTS: The prevalence of hypertension (P < .001), smoking (P < .001), decreased HDL cholesterol levels (P < .001), obesity (P = .001), elevated LDL cholesterol (P = .036), C677T MTHFR polymorphism (P < .001), and genetic sum was significantly higher in the group of stroke patients. The following parameters were found to act as independent risk factors for ischemic stroke: decreased HDL cholesterol level (P < .001; OR 4.618; 95% confidence interval [CI] 2.381-8.957); hypertension (P = .001; OR 2.839; 95% CI 1.519-5.305); obesity (P = .040; OR 2.148; 95% CI 1.036-4.457); smoking (P = .001; OR 2.502; 95% CI 1.436-4.359); and genetic sum as a continuous variable (P < .01; OR 2.307; 95% CI 1.638-3.250). CONCLUSIONS: Gene mutations of the procoagulable and proatherosclerotic factors investigated exerted a synergistic action in the development of overall risk of ischemic stroke in young and middle-aged individuals.


Asunto(s)
Coagulación Sanguínea/genética , Isquemia Encefálica/genética , Metilenotetrahidrofolato Reductasa (NADPH2)/genética , Mutación , Accidente Cerebrovascular/genética , Trombofilia/genética , Adulto , Factores de Edad , Isquemia Encefálica/sangre , Isquemia Encefálica/epidemiología , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Croacia/epidemiología , Factor V/genética , Femenino , Predisposición Genética a la Enfermedad , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Fenotipo , Inhibidor 1 de Activador Plasminogénico/genética , Prevalencia , Estudios Prospectivos , Protrombina/genética , Factores de Riesgo , Accidente Cerebrovascular/sangre , Accidente Cerebrovascular/epidemiología , Trombofilia/sangre , Trombofilia/complicaciones , Trombofilia/epidemiología
11.
Coll Antropol ; 38(1): 155-9, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24851611

RESUMEN

Endemic nephropathy is a chronic tubulointerstitial disease characterized by early damage to the proximal tubule, with low-molecular weight proteinuria being an important hallmark and possible tool for early diagnosis. The aim of this retrospective cohort study was to assess the risk of developing endemic nephropathy in subjects with proteinuria from the endemic region in Croatia. The cohort study included subjects with proteinuria determined by the sulfosalicylic acid method (after 1988 with strip method), involved in the field survey conducted in the Croatian endemic village of Kaniza in 1975 and followed up until 1997. Subjects with endemic nephropathy established at the first visit and patients that failed to present for follow up visits after 1975. were excluded. In the field survey group that consisted of 624 subjects (286 male and 338 female), proteinuria was established in 157 subjects. Upon the application of exclusion and inclusion criteria, the study cohort included 111 of 157 subjects. The mean follow up was 7.26 years (95% confidence interval 4.06-10.46 years). During the follow up period, 19 (17%) subjects with initial proteinuria developed endemic nephropathy. The incidence density of endemic nephropathy among subjects with proteinuria was 1.3 per 100 persons/year. Estimated risk was 0.0137 (confidence interval 0.0087-0.0214) per year of exposure. The presence of proteinuria determined by the sulfosalicylic acid or test strip in subjects from the endemic village indicated that endemic nephropathy would develop in 1.3 of 100 subjects with proteinuria per year.


Asunto(s)
Nefropatía de los Balcanes/epidemiología , Proteinuria/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Croacia/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Adulto Joven
12.
Front Med (Lausanne) ; 11: 1405743, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38882670

RESUMEN

Purpose: Myopia is a major global health issue, especially among children and adolescents. Understanding its traits and progression is vital for proper management and prevention. This study aimed to fill a gap in research by analyzing demographic and refractive data concerning myopia among children and adolescents in Croatia, with the goal of providing insights into myopia prevalence, progression rates, and associated risk factors within the Croatian population. Design: This retrospective study utilized a comprehensive dataset from pediatric ophthalmology clinics at the University Eye Department, University Hospital "Sveti Duh," Zagreb, Croatia. The dataset included electronic medical records spanning from January 2008 to July 2023, encompassing demographic and refractive data. Methods: Data analysis focused on individuals aged 4 to 18 years who were diagnosed with primary myopia and/or compound myopic astigmatism. Ophthalmic examinations, including visual acuity tests, cycloplegic refraction, and assessments for eye comorbidities, were conducted by experienced pediatric ophthalmologists. Statistical analysis, including t-tests, survival analysis, and logistic regression, was performed to assess myopia prevalence, progression rates, and associated factors. These analyses were adjusted for covariates such as age, parental myopia, and gender. Results: The study included 895 individuals, 51 premyopes, 813 low myopes, and 31 high myopes. The average age of diagnosis was 11.37 ± 3.59 years for premyopes, 11.18 ± 3.53 years for low myopes, and 11.44 ± 4.35 years for high myopes. The fastest progression occurred in 2021 and 2022, -0.5 ± 0.12 D/y for premyopes and - 0.45 ± 0.1 D/y for low myopes. Premyopic progression to low myopia was associated with age 7-9 years (HR 2.42, 1.53 to 3.21) and both parents being myopic (HR 920.27. 850.16 to 950.53). Low myopic individuals with both myopic parents displayed the fastest 11-24 months after first visit progression rates, -0.69 (-0.52 to -0.87) D/y, while the 7-9 age group demonstrated -0.36 (-0.24 to -0.45) D/y. Low myopes aged 7-9 years with baseline SE between -6 D and -4 D were more strongly associated with ≤ - 0.5 D progression (OR = 2.0, 95% CI -1.00 to 2.39). Conclusion: This study highlights the importance of environmental factors, genetics, and age in addressing myopia progression among Croatian youth, urging further research for effective local intervention strategies.

13.
Lijec Vjesn ; 135(11-12): 310-5, 2013.
Artículo en Croata | MEDLINE | ID: mdl-24490331

RESUMEN

A growing interest of general population to seek health information on the Internet and a growing body of health websites have been well documented in the recent health literature. Moreover, the Internet has become a popular mode of communication between healthcare providers and patients. This has resulted in many efforts to set specific quality guidelines for development of information for patients on the Internet, including different aspects of access to health information. This paper presents results of a study that explored the structure of information sources of surgical patients. Analysis of patient profiles shows that older patients rarely sought surgical information on the Internet, and mostly relied on communication with their doctors. This paper discusses various options of how to make this medium more attractive to patients and how to use the rich experience of the older patient generations to improve the quality of doctor-patient communication.


Asunto(s)
Cirugía General , Difusión de la Información/métodos , Internet , Adulto , Anciano , Femenino , Cirugía General/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
14.
World J Psychiatry ; 13(6): 376-385, 2023 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-37383282

RESUMEN

BACKGROUND: Studies have demonstrated that patients who have experienced acute coronary syndrome (ACS) have an increased risk of developing posttraumatic stress disorder (PTSD) and experiencing worse survival outcomes than those who do not develop PTSD. Nevertheless, the prevalence rates of PTSD following ACS vary widely across studies, and it is noteworthy that in most cases, the diagnosis of PTSD was based on self-report symptom questionnaires, rather than being established by psychiatrists. Additionally, the individual characteristics of patients who develop PTSD after ACS can differ widely, making it difficult to identify any consistent patterns or predictors of the disorder. AIM: To investigate the prevalence of PTSD among a large sample of patients undergoing cardiac rehabilitation (CR) after ACS, as well as their characteristics in comparison to a control group. METHODS: The participants of this study are patients who have experienced ACS with or without undergoing percutaneous coronary intervention and are enrolled in a 3-wk CR program at the largest CR center in Croatia, the Special Hospital for Medical Rehabilitation Krapinske Toplice. Patient recruitment for the study took place over the course of one year, from January 1, 2022, to December 31, 2022, with a total of 504 participants. The expected average follow-up period for patients included in the study is about 18 mo, and currently ongoing. Using self-assessment questionnaire for PTSD criteria and clinical psychiatric interview, a group of patients with a PTSD diagnosis was identified. From the participants who do not have a PTSD diagnosis, patients who would match those with a PTSD diagnosis in terms of relevant clinical and medical stratification variables and during the same rehabilitation period were selected to enable comparability of the two groups. RESULTS: A total of 507 patients who were enrolled in the CR program were approached to participate in the study. Three patients declined to participate in the study. The screening PTSD Checklist-Civilian Version questionnaire was completed by 504 patients. Out of the total sample of 504 patients, 74.2% were men (n = 374) and 25.8% were women (n = 130). The mean age of all participants was 56.7 years (55.8 for men and 59.1 for women). Among the 504 participants who completed the screening questionnaire, 80 met the cutoff criteria for the PTSD and qualified for further evaluation (15.9%). All 80 patients agreed to a psychiatric interview. Among them, 51 patients (10.1%) were diagnosed with clinical PTSD by a psychiatrist according to Diagnostic and Statistical Manual of Mental Disorders criteria. Among the variables analyzed, there was a noticeable difference in the percentage of theoretical maximum achieved on exercise testing between the PTSD and non-PTSD groups. Non-PTSD group achieved a significantly higher percentage of their maximum compared to the PTSD group (P = 0.035). CONCLUSION: The preliminary results of the study indicate that a significant proportion of patients with PTSD induced by ACS are not receiving adequate treatment. Furthermore, the data suggest that these patients may exhibit reduced physical activity levels, which could be one of the possible underlying mechanisms in observed poor cardiovascular outcomes in this population. Identifying cardiac biomarkers is crucial for identifying patients at risk of developing PTSD and may derive benefits from personalized interventions based on the principles of precision medicine in multidisciplinary CR programs.

15.
Croat Med J ; 53(3): 278-84, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22661142

RESUMEN

AIM: To assess perceptions, knowledge, and awareness of cardiovascular disease (CVD) risk factors among medical students (freshmen and graduating students). METHODS: A descriptive cross-sectional survey based on an anonymous self-administered questionnaire was conducted in 2008 on 443 medical students - 228 freshmen on their enrollment day and 214 students on the day of their final exam at the University of Zagreb School of Medicine, Croatia. RESULTS: The perception and knowledge of some CVD risk factors, eg, dyslipidemia, arterial hypertension, and metabolic syndrome as well as of lipid-lowering therapy important for CVD prevention was significantly better among graduating students but was still not sufficient. Only 66% of graduating students reported that they would prescribe lipid-lowering therapy to high risk patients. Disappointingly, many graduating students were smoking (30.4%) and had low-awareness of obesity as an important CVD risk factor. CONCLUSION: These results suggest an urgent need to improve medical students' knowledge of obesity and low physical activity as important CVD risk factors and of the methods for increasing low high-density lipoprotein-cholesterol and for smoking cessation. All this provides a rationale for modifying the university core curriculum to include more information concerning these issues.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Percepción , Estudiantes de Medicina , Distribución de Chi-Cuadrado , Croacia , Estudios Transversales , Curriculum , Evaluación Educacional/métodos , Escolaridad , Femenino , Humanos , Masculino , Factores de Riesgo , Estadística como Asunto , Encuestas y Cuestionarios
16.
J Clin Med ; 11(5)2022 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-35268375

RESUMEN

Testicular torsion potentially leads to acute scrotum and testicle loss, and requires prompt surgical intervention to restore testicular blood flow, despite the paradoxical negative effect of reperfusion. While no drug is yet approved for this condition, antioxidants are promising candidates. This study aimed to determine astaxanthin's (ASX), a potent antioxidant, effect on rat testicular torsion-detorsion injury. Thirty-two prepubertal male Fischer rats were divided into four groups. Group 1 underwent sham surgery. In group 2, the right testis was twisted at 720° for 90 min. After 90 min of reperfusion, the testis was removed. ASX was administered intraperitoneally at the time of detorsion (group 3) and 45 min after detorsion (group 4). Quantification of caspase-3 positive cells and oxidative stress markers detection were determined immunohistochemically, while the malondialdehyde (MDA) value, superoxide dismutase (SOD), and glutathione peroxidase (GPx) activities were determined by colorimetric assays. The number of apoptotic caspase-3 positive cells and the MDA value were lower in group 4 compared to group 2. A significant increase in the SOD and GPx activity was observed in group 4 compared to groups 2 and 3. We conclude that ASX has a favorable effect on testicular ischemia-reperfusion injury in rats.

17.
Diagnostics (Basel) ; 12(4)2022 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-35453913

RESUMEN

Background: Indolent nature but a high incidence of differentiated thyroid cancer (DTC) remains a challenge for optimizing patient care. Therefore, prognostic factors present valuable information for determining an adequate clinical approach. Methods: This study assessed prognostic features of 1167 papillary (PTC) and 215 follicular (FTC) thyroid cancer patients that had undergone surgery between 1962 and 2012, and were followed-up up to 50 years in a single institution, till April 2020. Age, gender, tumor size, presence of local and distant metastases at presentation, extrathyroidal extension, disease recurrence, and cancer-specific survival were evaluated. Results: In multivariate analysis, factors affecting the worse outcome were age (p = 0.005), tumor size (p = 0.006), and distant metastases (p = 0.001) in PTC, while extrathyroidal extension (p < 0.001), neck recurrence (p = 0.002), and distant metastases (p < 0.001) in FTC patients. Loco-regional recurrence rate was 6% for PTC and 4.7% for FTC patients, while distant metastases were detected in 4.2% PTC and 14.4% of FTC patients. The 10-year cancer-specific survival rates for PTC and FTC were 98.6% and 89.8%, respectively (p < 0.001). Conclusions: Negative prognostic factors, besides distant metastases, were older age and greater tumor size in PTC, and extrathyroidal extension and neck recurrence in FTC patients. The recurrence and mortality rates were very low.

18.
Epilepsy Behav ; 20(4): 686-90, 2011 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21402499

RESUMEN

The aim of the survey was to estimate the prevalence rate of epilepsy, as well as seizure types, frequency, etiology, and comorbidity, by gender, age, and socioeconomic status among people with epilepsy in the Croatian county of Sibenik-Knin. The survey revealed that of 112,871 inhabitants, 1228 were identified as having active epilepsy. The crude prevalence rate for Sibenik-Knin County was 10.9 per 1000 inhabitants. Prevalence rates (per 1000) by age and gender were: 6.9 (ages 0-19); 10.6 (ages 20-59); 15.1 (ages 60+), 10.1 (females), and 11.7 (males). A significant number of subjects had different comorbid disorders. Although the literature suggests that Dalmatia is a region with a low prevalence of epilepsy, our results showed that Sibenik-Knin County has a higher prevalence of epilepsy than expected for European populations. The most common comorbid disorders, such as mental retardation, psychotic episodes, and substance addiction, highly influence socioeconomic status and quality of life.


Asunto(s)
Recolección de Datos , Epilepsia/epidemiología , Epilepsia/psicología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Croacia/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Prevalencia , Calidad de Vida , Estudios Retrospectivos , Factores Sexuales , Adulto Joven
19.
Coll Antropol ; 35(3): 775-9, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22053555

RESUMEN

Ovarian cancer is the leading cause of mortality among gynecological cancers. The aim of the study was to form the decision rules for distinguishing benign from malignant ovary lesions. The research was conducted on 201 women with ovary tumor. Commonly used specific markers for ovarian cancer (biochemical marker Ca 125, ultrasound and vascular markers) were used. The significant difference in the presence of an ultrasound and vascular markers between benign and malignant ovary changes along with the significantly different level of Ca 125 is confirmed. To a specific marker certain score number was appointed and the scoring system was formed. The incidence of benign/malignant ovary changes was observed in the researched group regarding anthropometric parameters (age, marital and menopausal status and number of deliveries). There is also significant difference in the incidence of benign/malignant ovary tumor regarding these parameters. Based on combination of the scoring system and anthropometric parameters the decision rules for distinguishing benign from malignant ovary tumors were formed. The logistic regression method was used. We proved that this method has higher accuracy in prediction of malignancy in women with ovary tumors than using morphological, Doppler or anthropometric parameters separately.


Asunto(s)
Neoplasias Ováricas/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antígeno Ca-125/sangre , Femenino , Humanos , Modelos Logísticos , Menopausia , Persona de Mediana Edad , Neoplasias Ováricas/sangre
20.
Prev Med ; 51(6): 494-6, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20951724

RESUMEN

OBJECTIVE: Since there are almost no data about the perceptions and attitudes of the general public concerning risk factors for cardiovascular diseases (CVD) this survey was performed. METHOD: Face-to-face interviews were conducted based upon a questionnaire with 883 members of the general population from different parts of Croatia in October-November 2008. RESULTS: 36.1% of them correctly identified CVD as the leading cause of death but the most feared disease was cancer (40.0%). CVD was on the second place with only 21.6%. 30.9% was aware that elevated LDL-cholesterol increases CVD risk but 49.0% knew that high HDL-cholesterol is beneficial. 43.3% knew their total cholesterol (TC) value and 74.4% knew their blood pressure (BP). 30.9% knew what their target TC should be and 33.9% knew what their target BP should be. The knowledge about TC and BP target values was positively associated with higher educational level. 53.2% of the general public reported that they have never discussed any CVD risk factor with their physician. CONCLUSION: These data suggest insufficient awareness of CVD risk factors in general population and a need for improved promotion of CVD prevention. To achieve this people and physicians should be motivated by the health authorities and/or insurance companies.


Asunto(s)
Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/psicología , Conocimientos, Actitudes y Práctica en Salud , Adulto , Croacia , Estudios Transversales , Femenino , Humanos , Entrevistas como Asunto , Masculino , Factores de Riesgo
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