Young stroke patient with patent foramen ovale and intracranial stenosis-a case report.

The prevalence of patent foramen ovale is approximately 20% in the global population. In patients under the age of 55 years, it has been proven as a cause of acute ischemic embolic stroke of otherwise undetermined source. We present a case of a 25-year-old patient who experienced an acute stroke of dominant hemisphere due to internal carotid artery occlusion.The patient underwent mechanical thrombectomy, followed by acute intracranial stenting due to persistent subocclusion of internal carotid artery. Further diagnostic investigations revealed a significant patent foramen ovale. During subsequent follow-up periods, the patient encountered multiple transient ischemic attacks despite receiving antithrombotic therapy. The indicated angiography examination revealed in-stent stenosis and thrombosis, which were resolved after optimal medical treatment. Following patent foramen ovale closure, the patient remained free from further neurological events during the subsequent two-year follow-up periods. This case emphasizes the necessity of comprehensive diagnostic evaluations in young individuals with stroke and underscores the importance of prudent slection of medical therapies.

Effects of Electromyographic Biofeedback on Functional Recovery of Patients Two Months after Total Knee Arthroplasty: A Randomized Controlled Trial.

The incidence of total knee arthroplasty (TKA) is steadily increasing worldwide. Therefore, it is crucial to develop efficient rehabilitation protocols and investigate the innovations in medical technology, which could improve rehabilitation outcomes. The aim of the study was to investigate the effect of adding electromyographic biofeedback (EMG-BF) to the conventional program of rehabilitation after TKA on quality of life, intensity of pain, and functional performance. The study was designed as a randomized controlled trial. A total of 131 patients were randomly assigned to two groups: an experimental group (n = 67; median age 70 (IQR 10)), and a control group (n = 64; median age 69 (IQR 9)). Both groups participated in an inpatient program of 21 days of rehabilitation, including land-based and aquatic exercise therapy, electrotherapy, and education. In the experimental group, a portion of land-based exercise therapy was supplemented by EMG-BF. A numeric rating scale (NRS), Knee Injury and Osteoarthritis Outcome Score (KOOS), use of mobility aids, 30 s chair stand test (CST), and timed up and go (TUG) test were used to measure outcomes. Both groups improved their functional abilities from day 1 to day 21 of rehabilitation. A higher proportion of participants did not use a walking aid (p < 0.002), and their NRS, KOOS, 30 s CST and TUG scores improved (p < 0.001). There were no significant differences between the groups in the outcomes. EMG-BF did not provide additional benefits to the conventional rehabilitation after TKA.

Clinical Evaluation of Two Non-Invasive Genetic Tests for Detection and Monitoring of Urothelial Carcinoma: Validation of UroVysion and Xpert Bladder Cancer Detection Test.

A variety of commercially available urinary molecular markers have been introduced for detecting and monitoring urothelial carcinoma (UC). We prospectively evaluated the UroVysionTM Bladder Cancer Kit (FISH) and the Xpert® Bladder Cancer Detection (Xpert) test. Both tests were performed on voided urine samples after negative cystoscopy and negative abdominal ultrasound (US) and/or negative computed tomography urography (CTU). Urine specimens from 156 patients diagnosed with hematuria and suspected of having UC and 48 patients followed up after treatment of UC were analyzed using FISH and Xpert. Among 204 patients, 20 had UC, 11 located in the bladder, six in the ureter, and three in the renal pelvis. FISH had an overall sensitivity (SN) of 78%, a specificity (SP) of 93%, and a negative predictive value (NPV) of 96%. Xpert had an overall SN of 90%, an SP of 85%, and an NPV of 98%. Both tests had high SN, SP, and NPV. The SP of FISH was significantly higher. By using FISH and Xpert in addition to cystoscopy, renal and bladder US, and/or CTU in the diagnostic workup of patients with hematuria and follow-up after transurethral resection of the bladder (TURB), a substantial number of patients (10%) otherwise missed were discovered to have UC.

Mental Health and Physical Activity in Health-Related University Students during the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic led to increased negative emotional states among students. Physical activity is known to have positive impacts on mental health and well-being. However, due to the closure of gyms and other recreational facilities as a restrictive measure, students' physical activity levels may decrease. This cross-sectional study aimed to determine the prevalence of depression, anxiety, and stress symptoms and physical activity among health-related students during the second partial COVID-19 lockdown. The study included 823 students from the Faculty of Dental Medicine and Health of the University of Osijek in Croatia. The Depression Anxiety Stress Scale-21 (DASS-21) and the Godin-Shephard Leisure Time Questionnaire for Physical Activity (GSLTPAQ) questionnaires were used to assess the prevalence of depression, anxiety, and stress symptoms as well as physical activity. Two-thirds (59.2%) of students in health-related fields were insufficiently active, while the prevalence of depression (50.8%), anxiety (50.9%), and stress (49.9%) symptoms were high. Also, female respondents had significantly higher levels of depression, anxiety, and stress than their male counterparts. Graduate students had higher levels of all three negative emotional states, but only anxiety levels were significant. This study shows that students in health-related fields had reduced physical activity and a high prevalence of negative emotional conditions (depression, anxiety, and stress) during the second partial lockdown. The resulting symptoms were mostly of mild intensity; however, we consider this a significant mental health issue during the COVID-19 pandemic. Hence, it is crucial to control and support students' mental health, especially in more affected female individuals, in order to reduce the pandemic's negative impact.

Evidencing the Influence of the COVID-19 Pandemic and Imposed Lockdown Measures on Fitness Status in Adolescents: A Preliminary Report.

It was established that the COVID-19 pandemic resulted in decreased physical activity levels, potentially leading to reduced physical fitness. The aim of this research was to investigate the impact of the COVID-19 lockdown on fitness indices in adolescents. We observed high school adolescents (33% girls; aged 15-17 years) divided into two cohorts. The first cohort (control; n = 48) included adolescents who were in school during the 2018/2019 year, while the second cohort (lockdown; n = 66) was observed during the school year 2019/2020 when COVID-19 lockdown measures were imposed. Variables included body height, body mass, BMI, sit-ups, and the 600 m dash. Both cohorts were tested at the beginning and at the end of the observed school years. A factorial analysis of variance for repeated measurements evidenced an improvement in sit-ups and the 600 m dash in the control, and a decrease of the same capacities in the lockdown cohort. In the lockdown cohort, a decrease in muscular fitness was more evident in boys than in girls. No differential changes between cohorts were evidenced in anthropometrics. Results suggest that the COVID-19 lockdown negatively influenced muscular fitness status in adolescents, especially in boys.

Pre-Planned and Non-Planned Agility in Patients Ongoing Rehabilitation after Knee Surgery: Design, Reliability and Validity of the Newly Developed Testing Protocols.

BACKGROUND: Due to its association with the risk of falling and consequent injury, the importance of agility is widely recognized, but no study so far has examined the different facets of agility in an untrained/clinical population. The aim of this study was to evaluate the reliability, validity, and correlates of newly developed tests of non-planned agility (NPA) and pre-planned agility (PPA) in an untrained/clinical sample. METHODS: The sample comprised 38 participants older than 40 years (22 females, age: 56.1 ± 17.3 years, height: 170.4 ± 10.8 cm, mass: 82.54 ± 14.79 kg) who were involved in a rehabilitation program following total knee arthroplasty and knee arthroscopy. Variables included age, gender, type of surgery, history of fall, anthropometrics/body composition, and newly developed tests of NPA and PPA. RESULTS: The results showed the high inter-testing- (ICC > 0.95, CV < 9%), and intra-testing-reliability (ICC > 0.96, CV < 9) of the newly developed tests. PPA and NPA were found to be valid in differentiation between age groups (>50 yrs. vs. <50 yrs.), and genders, with better performance in younger participants and males. Only NPA differentiated participants according to type of surgery, with better performance in those who had arthroscopic surgery, than those who had total knee arthroplasty. No differences in NPA and PPA were established between groups based on fall-history. In females, the body mass (Pearson's r = 0.58 and 0.59, p < 0.001) and body fatness (Pearson's r = 0.64 and 0.66, p < 0.001) were negatively correlated, while the lean body mass (Pearson's r = 0.70 and 0.68, p < 0.001) was positively correlated with PPA and NPA. The NPA and PPA were highly correlated (Pearson's r = 0.98, p < 0.001). CONCLUSIONS: We found that the proposed tests are reliable when evaluating agility characteristics in an untrained/clinical population after knee arthroplasty/arthroscopy. Further evaluation of the specific validity of the proposed tests in other specific subsamples is warranted.

[Anxiety and depression in oncology patients in the Mostar University Clinical Hospital]. / Anksioznost i depresivnost kod onkoloskih bolesnika u Sveucilisnoj Klinickoj Bolnici Mostar.

OBJECTIVE: To determine the degree of anxiety and depression in patients hospitalized at the Department of Oncology of the Mostar University Clinical Hospital and the relationship between the degree of anxiety and depression, sex, marital status, age, and education of the patients. PATIENTS AND METHODS: The study included 160 patients who were divided into two groups: a test and a control group. A patient from the test group was assigned a patient from the control group according to his/her age, gender, education level and marital status. The study population consisted of 80 patients who were treated at the Department of Oncology of the Mostar University Clinical Hospital from January 1, 2010 to March 31, 2010. The control group consisted of 80 patients who were admitted via the Family Medicine Office of the Mostar Community Health Center from March 1, 2010 to March 31, 2010. The Beck's Anxiety and Depression scale was used. The appropriate statistical methods were used to test the collected data. RESULTS: Patients hospitalized at the Department of Oncology had a greater degree of depression than the control group (exact test, P<0.001). A significant difference in the level of anxiety between the test and control groups was not found (exact test, P=0.143). A mild degree of anxiety was found in the cancer patients older than 60 and a high level of anxiety in the group aged 25-40 (exact test, P<0.001) and in highly educated patients (exact test, P=0.024). The research showed that the cancer patients from the younger age group had higher levels of depression (exact test, P<0.001). By comparing the degree of anxiety to the age in the control group, statistically significant difference was not found, so the highest level of anxiety was found in the patients aged between 41 and 60 (exact test, P<0.001). It was determined that a higher percentage of women (exact test, P=0.034) and patients over 60 years old (exact test, P=0.006) in the control group were more depressed. CONCLUSION: Although a statistically higher level of depression was determined for the test group patients, a statistically significant difference in the levels of anxiety between test and control groups was not found.

Recent developments in capillary electrokinetic chromatography with replaceable charged pseudostationary phases or additives.

Although electrochromatography in packed beds or monolithic columns has gained enormous interest, techniques based on charged pseudostationary phases like micelles are of high practical importance in electrically driven separation science. However, nonmicellar alternatives, e.g., using charged soluble polymers or smaller additives are still attractive, as they allow high concentrations of organic solvents, and their application is not limited by the critical micellar concentration. This review discusses the developments in the field of electrokinetic chromatography with these additives in the last three years, covering ionic polymeric pseudostationary phases, dendrimers and so-called micelle polymers, but also small molecules which implement separation selectivity due to their specific interaction with the analytes.