Influence of various factors on functional dyspepsia.

Aim of the research is to establish the prevalence of dyspepsia in Osjecko-baranjska County, to establish its specific characteristics and to determine the effect of demographic, anthropometric, and socioeconomic factors. It is a cross-sectional and case control study conducted in 2010 on systematic sample of 900 subjects between 20 and 69 years of age. Every subject was sent an invitation letter and a Rome III diagnostic questionnaire for one of the disorders. A scoring algorithm was used to confirm or exclude the diagnosis of functional dyspepsia (FD). The chi-square test, t-test and logistic regression were used for analysis.Prevalence of dyspepsia was recorded in 16, 56%, of subjects. There is no statistically significant difference in prevalence of dyspepsia male and female. The prevalence of dyspepsia increases with age. Correlation with the place of birth was proven. There is no correlation between the current place of residence (rural area and town) and dyspepsia. There is a correlation with marital status. Correlation between stool forms was proven. There were a greater number of subjects that had at least one alarm symptom or some of the psychosocial factors and they often suffered from a chronic disease. The risk for dyspepsia increases with age, body mass index (BMI), and poorer health. Logistic regression showed the following as statistically significant for dyspepsia: place of birth and self-assessment of one's health. FD presents a significant health problem. Rome III survey questionnaire proved to be an acceptable method for diagnosing this functional disorder in clinical-consilliary and primary health care for persons showing signs of alarm and needing further diagnostic treatment.

Asymptomatic dissecting intimal lesions of common carotid arteries after carotid endarterectomy.

PURPOSE: Carotid endarterectomy is a standard treatment for symptomatic high-degree internal carotid artery stenosis. The aim of this article is to present possible intimal lesions after carotid endarterectomy. These lesions could be manifested as intimal flaps, intimal steps or dissections with or without occlusion or stenosis of the artery. METHODS: The evaluation of the frequency and characteristics of the asymptomatic dissecting intimal lesions of the common carotid arteries was performed in a sample of 100 patients who underwent endarterectomy for symptomatic high-grade stenosis of the internal carotid artery. RESULTS: We found five patients with asymptomatic dissecting intimal lesions of the common carotid arteries. CONCLUSION: The most common causes of these intimal lesions were shunting and prolongation of the clamping time. Routine carotid ultrasound follow-up exams are necessary because of the potential need for a change in the antithrombotic therapy or due to a need to perform an endovascular treatment.

Bilateral synchronous breast cancer.

We report a rare case of synchronous bilateral breast cancer in 79-year-old female patient treated at our hospital. The tumors were discovered one year ago after a complete clinical and radiological (mammography, US) examination with cytopunction of tumor masses. Results came back and showed carcinomas of both breasts. Patient underwent surgical re moval of the both breasts with bilateral axillary lymphadenectomy. Later histological examination confirmed earlier diagnosis of invasive ductal carcinoma in both breasts in a G3 stage. After surgical removal of the tumors patient was also treated with radiotherapy. One year after bilateral mastectomy and axillary lymphadenectomy, clinical and radiological examination that included mammography and ultrasound of breast with tumor marker C15-3 which was 2.8, we did not found recurrence of the tumor.

Blunt trauma of thorax with subclavian and axillary artery lesion--case report.

We report a rare case of blunt trauma of the axillary artery in a 20-year-old man who was injured as a motorcycle rider and received severe body injuries. Injuries included severe trauma of the left lower leg with contusion and extensive soft tissue and bone trauma of these regions with poor general condition and with the presence of clinical signs of traumatic shock. Upon arrival, we found that in addition to earlier clearly visible trauma to the leg, there was a hematoma of the medial side of the left supraclavicular region and the absence of the radial artery pulse with paralysis of the left arm. Given the clinical findings, emergency radiological examination was made to the patient (X-ray, US, CDFI, MSCT-angiography) and we found out that there was trauma of axillary artery with clear signs of thrombosis of extra thoracic part of subclavian artery due to its transition into the axillary artery. After hemodynamic stabilization, above knee amputation of the left leg was performed and emergency exploration of earlier mentioned arteries. Bypass of the damaged arteries with synthetic graft 6 mm in diameter was made. Control MSCT angiography showed normal flow in the arterial tree of the whole left hand and the MRI of the cervical spine and shoulder girdle did not found lesions of the brachial plexus. SSEP demonstrated the absence of pulses on the left hand. Patient on regular check-ups showed normal general condition, with adequate passable graft and pronounced paralysis on the left hand. In the process of rehabilitation physiotherapy was also included. Blunt trauma to the axillary artery is an extremely rare example of trauma of blood vessels which makes only 0.03% of all vascular injuries.

Demographic, anthropometric and socioeconomic characteristics of functional constipation in Eastern Croatia.

Aim of the research is to establish the prevalence of constipation in Osjecko-baranjska County, to establish its specific characteristics and to determine the effect of demographic, anthropometric and socioeconomic factors. It is a cross-sectional study conducted in 2010. on systematic sample of 900 subjects between 20 and 69 years of age. Every subject was sent an invitation letter and a Rome III diagnostic questionnaire for one of the disorders. A scoring algorithm was used to confirm or exclude the diagnosis of functional constipation. The chi-square test (chi2 test), t-test and logistic regression were used for analysis. The prevalence of constipation in our study was 22.19%, which is higher than the prevalence in most other countries, where it ranges from 5% to 18%. In our study statistically significant variables were: place of current residence (urban), education level (high school), marital status (divorced people), a larger number of household members and a lower health status by self-assessment. According to t-test persons with constipation on average are older, have higher average BMI and lower average grade valued financial status of households and their health. There were a greater number of subjects that had at least one alarm symptom or some of the psychosocial factors and they often suffered from a chronic disease. Functional constipation presents a significant health problem. Rome III survey questionnaire proved to be an acceptable method for diagnosing this functional disorder in clinical-consilliary and primary health care, and for persons showing signs of alarm and needing further diagnostic treatment.

[Delirium assessment scoring scales]. / Bodovne ljestvice za procjenu delirija.

Delirium is a significant psychiatric disorder in intensive care units that has negative impact on morbidity and mortality of intensive care patients. Subjective clinical assessment of patients by non-psychiatric health professionals in intensive care units is not sufficient for detection and measurement of delirium. Therefore, different scoring scales for delirium assessment have been developed. This paper reviews the characteristics of commonly used scoring scales for assessment of delirium in intensive care units: the Confusion Assessment Method-Intensive Care Unit (CAM-ICU), the Intensive Care Delirium Screening Checklist (ICD-SC), the Nursing Delirium Screening Scale (Nu-DESC) and the Detecting Delirium Scale (DDS). Routine implementation of objective scoring scales is not widespread. Evidence suggests that objective assessment of delirium contributes to its early detection in intensive care and initiation of appropriate treatment. It is therefore advisable to make additional educational effort to provide an objective scoring scale for the assessment of delirium, such as CAM-ICU, to be routinely used in intensive care units.

Clinical and anorectal motility features in chronically constipated children.

Constipation is a common problem in children. It can be a symptom of functional disorder in majority of cases, but sometimes a serious organic disease is a cause of constipation. Anorectal manometry plays an important role in the diagnostic procedure. It can be presumed that some values of manometric parameters could be very useful in treatment plan. The aim of this study was to confirm or exclude such limits in manometric finding, to make a plan of the therapy more accurate. Therefore the group of 81 constipated children was investigated. There were 58 patients suffering from functional constipation and 23 with organic disorders. The age of the patients was 3 to 15 years. Scoring system was applied to estimate severity of constipation and anorectal manometry was performed. Our results did not show significant correlation between clinical symptoms and signs and the values that we obtained using anorectal manometry. But, we recommend anorectal manometry because it is a safe method and contributes to clarify the diagnosis, which is very important for treatment plan.