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Malignant brain neoplasms incidence and mortality trends in Croatia from 2001 to 2014
Get PDFAim: To analyze the sex-specific incidence and mortality trends of brain malignancies in Croatia from 2001 to 2014. Methods: Incidence and mortality rates per 100 000 population were calculated using data obtained from the Croatian National Cancer Registry and the Croatian Bureau of Statistics. Rates were age-standardized to the European Standard Population, and trends were assessed using joinpoint regression. Results:
In the observed period there were 6634 new brain malignancy cases (52% men) and 5379 deaths due to this diagnosis (52% men). Age-standardized incidence rates ranged from 9.2-11.5 per 100 000 in men and from 7-8.8 per 100 000 in women. Mortality rates ranged from 7.5-8.7 per 100 000 in men and from 5-6.5 in women. Incidence trends in men, mortality in men, and mortality in women were not statistically significant, while a significant trend was observed in incidence in women (annual percent change -1.5; 95% confidence interval -2.3 to -0.6). No joinpoints were observed in any of the joinpoint analyses by sex for incidence and mortality. Age-specific incidence and mortality rates in both sexes indicate a trend shift toward older age. The proportion of morphologically verified cases ranged from 40.2%-62.4% in men and from 38.6%-56.3% in women; the proportion of death-certificate-only cases ranged from 3.3%-9.4% in men and from 3.3%-17.5% in women. Conclusion: Incidence and mortality of brain malignancies in Croatia are among the highest in Europe, while reporting on brain malignancies is still poor. There is a need for improved care of patients with brain malignancies and detailed and accurate data reporting
Utjecaj terapijskoga vježbanja na smanjenje sakroilijakalne disfunkcije u trudnoći [The influence of exercise on reduction of sacroiliac dysfunction in pregnancy]
Get PDFIntroduction: Sacroiliac dysfunction is major pain syndrome in pregnancy. It is caused by specific structure and function of the sacroiliac joints and their adjustment during pregnancy. -----
Aim: To establish the effectiveness of exercise in pregnancy on reducing sacroiliac dysfunction. -----
Materials and methods: Randomised controlled trial has been undertaken in the line of inclusion and exclusion criteria. Study group has conducted four different exercises used in order to stabilize the pelvis performed twice weekly for 20 minutes. The control group was complied with their normal lifestyle. Visual Analog Scale was used to assess the pain intensity while Quebec scale was used for assessment of the degree of disability in everyday activities. -----
Results: Analysis is based on 408 pregnant women included (207 in the study and 201 in control group). Statistical significance was found (p<0.001) in reduction of pain intensity with significantly reduced disability in study group (p<0.001).The results showed a strong positive correlation between decreased/increased pain intensity and degree of disability in the study/control group. -----
Conclusion: Our results supports effectiveness of exercise used in order to stabilize the sacroiliac joints during pregnancy, pointing importance of exercise in management of SID during pregnancy
Utjecaj ugradnje umjetnoga vratnoga intervertebralnoga diska na biomehaniku vratnoga dijela kralježnice [Influence of implementing the artificial cervical intervertebral disc on the biomechanics of the cervical spine]
Get PDFINTRODUCTION: Over the past two decades, cervical disc arthroplasty has become one of the most common methods of treating one-segmental cervical disc herniation. However, the impact of disc arthroplasty on the biomechanics of the cervical spine hasn’t been fully explored yet. -----
AIM: The objective of this study was to investigate the effect of cervical disc arthroplasty on the biomechanics of the cervical spine by comparing the postoperative range of motion of the cervical spine in a cohort that underwent cervical arthroplasty with the preoperative range of motion, and by comparing the postoperative range of motion of the cervical spine in the cohort that had cervical arthroplasty with the range of motion of the cervical spine in the control group. -----
MATERIAL AND METHODS: 50 respondents took part in the research. The cohort consisted of 25 respondents who had their cervical disc replaced with the Discover, an artificial disc device, due to one-segmental cervical disc herniation. The control group consisted of 25 healthy respondents. All members of the cohort had their static and dynamic cervical radiographs taken before the surgery, and 3, 6, 12, and 24 months after the surgery. Members of the control group had their dynamic cervical radiographs taken. Range of motion of the cervical spine, and the range of motion of the operated functional spinal unit was determined by all radiograms in the cohort that underwent cervical arthroplasty, while the range of motion of the cervical spine was determined in the control group. The range of motion of the cervical spine was determined by adding the value of the Cobb angle of the cervical spine in maximum flexion and extension, whereas the range of motion of the operated functional spinal unit was determined by adding the value of the Cobb angle of the operated functional spinal unit in maximum flexion and extension. -----
RESULTS: Our cervical biomechanical research has shown that the range of motion of the cervical spine and the range of motion of the operated functional spinal unit increase after the Discover artificial cervical disc arthroplasty, and that one year after surgery there is no statistically significant difference between the average value of the range of motion of the cervical spine in the cohort and the control group. In addition, the research has shown that the same properties are retained two years after surgery. No cases of heterotopic ossification or signs of adjacent segment disease were found in the group of patients who underwent the Discover artificial cervical disc arthroplasty at two years post-surgery
Procjena debljine lipidnoga sloja mjerenjem pucanja suznoga filma ručnim instrumentom [Non-invasive tear break-up time measurement using handheld lipid layer thickness assessment tool]
Get PDFAim: To determine feasibility and reliability of non-invasive tear break- up time (NIBUT) assessment using handheld tear lipid layer thickness assessment tool, and to compare it with standard tear break-up time (TBUT) test. ----- Methods: 108 patients were enrolled, 56 with and 52 without dry eye symptoms. Schein questionnaire was used order to determine the severity of dry eye symptoms. Ocular signs were assessed by NIBUT, TBUT, lipid layer thickness measurement, Lid-Parallel Conjunctival Folds, conjunctival hyperemia and corneal staining. ----- Results: Mean NIBUT and TBUT values were significantly shorter in dry eye symptoms group than in control group. NIBUT showed great correlation with TBUT as well as with other dry eye ocular signs and symptoms. Cutoff value to distinguish patients with symptoms of dry eye from control group was 12 seconds for NIBUT and 10 seconds for TBUT, with NIBUT having significantly higher sensitivity, specificity, area under the receiver operating characteristic curve, and repeatability. NIBUT was stronger connected and more consistent with dry eye than TBUT. Finally, it was better predictor and indicator of dry eye. ----- Conclusion: NIBUT measured by handheld instrument is simple, accessible, practical and, most of all, accurate and reliable method, superior than TBUT in dry eye diagnostics
Prognostičko značenje izraženosti Fas, FasL i c-FLIP u klasičnom Hodgkinovom limfomu
Get PDFHodgkin/Reed Sternberg cell is a cell of lymphocyte B origin and due to its complex interactions
with its microenvironment, is responsible for biological and clinical manifestations of Hodgkin
lymphoma. HRS cells usually lack B-cell receptor (BcR). Normal lymph node cells without BcR
undergo Fas (CD95)-mediated apoptosis. Mechanisms of HRS cell survival, although explored,
have not been truly elucidated yet. It is believed that c-FLIP mediates resistance of HRS to Fasmediated
apoptosis. Correlation between immunohistochemical expression of apoptosis markers
and clinical and laboratory parameters integrated in standardized prognostic indexes
(EORTC/GHSG/IPS) in our study cohort showed for the first time that patients with stronger c-
FLIP expression had significantly more lymphopenias. Also, expression of c-FLIP showed
strong correlation to nodular sclerosis subtype, which is the most common histologic type of
Hodgkin lymphoma. C-FLIP expression did not correlate with unfavourable prognosis according
to GHSG, EORTC and IPS. There were significantlly less patients with unfavourable IPS score
in group of patients with stronger FasL expression. Also, patients with stronger FasL expression
had significantly less anemia compared to those without it. Comparison of Fas, FasL and c-FLIP
expression with other clinical and laboratory parameters did not show any statistically significant
correlations. Expression of any of these proteins did not show influence on overall survival or
time to disease progression in our study cohort
Incidence, management, and outcomes of autoimmune nephropathies following alemtuzumab treatment in patients with multiple sclerosis
Get PDFBackground: Autoimmune disorders including nephropathies have been reported more frequently in alemtuzumab-treated multiple sclerosis (MS) patients than in the general population.
----- Objective: Describe instances of autoimmune nephropathy in alemtuzumab-treated MS patients.
----- Methods: Cases were identified from safety monitoring within the alemtuzumab relapsing-remitting multiple sclerosis (RRMS) clinical development program (CDP) or post-marketing, or following off-label use.
----- Results: As of 16 June 2017, 16 autoimmune nephropathies have occurred following alemtuzumab treatment for MS. The incidence of autoimmune nephropathies was 0.34% within the CDP (5/1485 patients). The five CDP cases (one of anti-glomerular basement membrane (anti-GBM) disease, two of membranous glomerulonephropathy, and two of serum anti-GBM antibody without typical anti-GBM disease) were identified early, responded to conventional therapy (where needed), and had favorable outcomes. Three of 11 cases outside the CDP occurred following off-label alemtuzumab use prior to approval for RRMS and were all anti-GBM disease. Diagnosis was delayed in one of these three cases and another did not receive appropriate treatment; all three cases resulted in end-stage renal failure. All anti-GBM disease cases with documented urinalysis demonstrated prior microscopic hematuria.
----- Conclusion: Close monitoring of alemtuzumab-treated MS patients facilitates diagnosis and treatment early in the nephropathy course when preservation of renal function is more likely
Copresentation of BMP-6 and RGD ligands enhances cell adhesion and BMP-mediated signaling
Get PDFWe report on the covalent immobilization of bone morphogenetic protein 6 (BMP-6) and its co-presentation with integrin ligands on a nanopatterned platform to study cell adhesion and signaling responses which regulate the transdifferentiation of myoblasts into osteogenic cells. To immobilize BMP-6, the heterobifunctional linker MU-NHS is coupled to amine residues of the growth factor; this prevents its internalization while ensuring that its biological activity is maintained. Additionally, to allow cells to adhere to such platform and study signaling events arising from the contact to the surface, we used click-chemistry to immobilize cyclic-RGD carrying an azido group reacting with PEG-alkyne spacers via copper-catalyzed 1,3-dipolar cycloaddition. We show that the copresentation of BMP-6 and RGD favors focal adhesion formation and promotes Smad 1/5/8 phosphorylation. When presented in low amounts, BMP-6 added to culture media of cells adhering to the RGD ligands is less effective than BMP-6 immobilized on the surfaces in inducing Smad complex activation and in inhibiting myotube formation. Our results suggest that a local control of ligand density and cell signaling is crucial for modulating cell response
Unnecessary prescribing of antibiotics to healthy/asymptomatic school-age carriers of potentially pathogenic bacteria
Get PDFObjectives: To re-draw attention to the unnecessary prescribing of antibiotics.
----- Methods: We monitored nasopharyngeal colonization by 3 potentially pathogenic bacteria, Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae type b in 81 children between the ages of 6 and 7 years who attended the same primary school. The children's health status was also monitored, without using antimicrobial treatment for healthy/asymptomatic carriers. Nasopharyngeal swabs were collected on 6 occasions during autumn months, from mid-September to mid-December 2016. The children who fell ill during the study were treated at the Ear, Nose and Throat Clinic, Sisters of Mercy University Hospital Center, Zagreb, Croatia.
----- Results: Four hundred and sixty-three nasopharyngeal swabs were collected. Each child had at least one positive swab result. Bacterial colonization with Streptococcus pyogenes had the highest colonization rate. During the study, 83% of the children were healthy/asymptomatic carriers with no clinical signs of disease, while 17% became ill. The statistical results showed that the increase in all examined bacteria was statistically significant.
----- Conclusions: Our study results showed that positive bacterial findings in nasopharyngeal swabs from clinically healthy carriers were not an indication for antibiotic therapy
Pulse wave velocity as a measure of arterial stiffness in patients with familial hypercholesterolemia: a systematic review and meta-analysis
Get PDFIntroduction: The aim of this meta-analysis was to establish whether vascular pulse wave velocity (PWV) as a measure of arterial stiffness is changed in patients with familial hypercholesterolemia (FH). -----
Material and methods: Studies comparing PWV between patients with FH and controls were searched in PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases (up to November 26, 2017). A meta-analysis was conducted using Comprehensive Meta-Analysis V2 software. A random-effects model (using the DerSimonian-Laird method) and the generic inverse variance method were used to compensate for the heterogeneity of studies concerning demographic characteristics and differences in the studies' design. -----
Results: This meta-analysis of 8 studies involving 317 patients with FH and 244 non-FH individuals did not suggest a significantly altered PWV in FH patients versus controls (weighted mean difference (WMD): 0.17 m/s, 95% confidence interval (CI): -0.31, 0.65, p = 0.489; I 2 = 80.15%). The result was robust in the sensitivity analysis and its significance was not influenced after omitting each of the included studies from the meta-analysis. Subanalysis of 6 of these studies which had data on intima-media thickness (IMT) indicated an increased IMT in FH patients when compared with controls (WMD = 0.03 mm, 95% CI: 0.003, 0.06, p = 0.034; I 2 = 48.95%). However, the effect size was sensitive to some of the included studies. -----
Conclusions: This meta-analysis suggests that FH patients do not have significantly altered PWV when compared with normocholesterolemic individuals. However, a subanalysis of studies in which IMT was measured indicated that IMT is increased in FH patients compared with controls