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Sastav crijevne mikrobiote i čimbenici upale u bolesnika s upalnim bolestima crijeva [Gut microbiota composition and inflammatory markers in IBD patients]
Get PDFInflammatory bowel disease (IBD) is a chronic process in the gastrointestinal tract with increasing prevalence that consist of Crohn disease (CD) and ulcerative colitis (UC). The disease is associated with intestinal microbiota composition, immune status and food intake. In this study microbiota composition in intestinal biopsy samples and stool of newly diagnosed IBD patients and non-IBD individuals, as well as inflammatory status from the blood of each participant was investigated. Microbiota composition was determined by the next generation sequencing method while serum biomarkers were detected by specifically tagged antibodies. Results show that the changes in feces and colon microbiota are specific and significant for Crohn's disease (Proteobacteria, Actinobacteria phylum and Dialister genus) and ulcerative colitis (Turibacteraceae, Veillonellaceae, Oxalobacteraceae and Sphingomonadaceae families). These changes in microbiota composition induce activation of certain inflammatory proteins that play a major role in chronic inflammatory response. The most significant differences in a protein level are in CXCL10, IL-6, HGF and IL-17A between CD and control patients and differences observed in CDCP1, FI3L and IL-6 proteins between CD and UC patients. Results of this translational research on newly diagnosed patients could help in better stratification of patients and selection of more suitable therapeutic approaches in the treatment of inflammatory bowel disease
Biomehanička analiza stabilnosti mješovitoga sustava transpedikularnih vijaka i sublaminarnih kukica računalnim modelom konačnih elemenata [Biomechanical stability analysis of transpedicular screws combined with sublaminar hook-rod system using finite element model]
Get PDFIntroduction: Posterior and anterior spinal column reconstruction is the method of choice for stabilization in the treatment of thoracolumbar spine fractures AO A3, B2, B3 and C. This approach is invasive. Our hypothesis is that by augmentation of the posterior stabilization systems with another posterior hook-rod system new stabilization system can be developed whose stiffness approximately equals the stiffness of the combined anterior and posterior stabilization constructs.
Materials and methods: To test our hypothesis, biomechanical analysis was performed. The angles of rotation in each group, as well as the strains on each part of the 3 stabilization constructs, were analyzed separately.
Results: Comparison of the stiffness showed that the combined anterior and posterior stabilization construct was the stiffest, except in the case of lateral bending, where combined posterior stabilization showed to be stiffer. Strain analysis showed that the posterior stabilization construct was significantly unloaded when augmentated with the hook-rod system. A significant concentration of strain was calculated in the cranially placed hooks.
Conclusion: Stiffness analysis showed a comparable stiffness between the tested and proposed stabilization construct Strain analysis showed a luxation tendency in the cranial posted hooks which would most likely lead to a construct failure
Utjecaj prekomjerne tjelesne mase, debljine i visceralne masti na spermiogram i hormonski status [Influence of overweight, obesity and visceral fat on spermiogram and hormonal status]
Get PDFIntroduction: Research results of overweight, obesity and visceral fat impact on spermiogram and hormonal status in men are contradictory. Aim: To investigate influence of overweight, obesity and visceral fat on spermiogram and hormonal status.
Matherials and methods: The study included 127 patients with semen analysis conducted; 66 in the group of interest with abnormal semen analysis and 61 in the control group with normal spermiogram results. Different antropometric measurements are compared between the groups and their impact on semen parameters and relevant hormonal status was investigated. Results: Group of interest had statisticaly significant higher levels of FSH, LH and higher levels of E2 compared to control while levels of total testosteron and SHBG were not significant. There were significant negative correlations of FSH and LH levels and semen quality. Increase of E2 and decreases of testosteron and SHBG in men with larger BMI, waist/hip ratio, visceral fat percantage and rating were significant. There was no negative impact of obesity on semen quality. FSH levels were significantly inversely correlated with semen quality in the whole study population. Conclusion: This study reveals that obesity alters hormonal status in men with no influence on semen quality. In the course of proven negative correlation with semen quality, FSH concentration may serve as an indicator of abnormal spermiogram in clinical practice, with border level ≥3,55 IU/L
Povezanost trihotilomanije i poremećaja nedostatka pažnje s hiperaktivnošću u djece i adolescenata [Correlations between Trichotillomania and Attention Deficit/Hyperactivity Disorder in children and adolescents]
Get PDFThe main goal of this research was to analyse and show the prevalence of ADHD and certain subtypes of this disorder in children and adolescents diagnosed with TTM and the elements which show their connection. Methods: There were 117 participants between the ages of 8 and 17 included in the research. We were comparing three groups with the diagnosis of: TTM (N=38), ADHD (N=40) and OCD (N=39). Diagnoses were determined by the criteria of DSM-IV. We used The Coping Strategies Inventory for Children and Adolescents (SUO), Attention Deficit/Hyperactivity Disorder test (ADHDT),Youth Self Report (YSR). Results: By all three groups of participants there is a high prevalence of psychiatric comorbidity. ADHD is the most prevalent comorbid disorder (n=6) by the participants with TTM. The participants with TTM have a higher quotient of ADHD than those with OCD, more signs and symptoms of impulsivity and attention deficit. The children and adolescents with TTM and ADHD have less combined internalizing problems and lower levels of results on scales which measure anxiety, depression and withdrawal in reference to the participants with OCD. The children and adolescents with TTM and ADHD bite thier nails considerably more often than children and adolescents with OCD. Conclusion: The results of examining the connection of TTM and ADHD indicate the validity of set hypothesis and widen cognitions about TTM as a disorder by which together with internalized problems there is a considerable prevalence of externalized problems. Although the results of this study due to limitations, do not have firm predicative value, they considerably contribute to better understanding and planning the treatment of these disorders. For the time being we can only guess the existence of higher risk for the development of TTM in children and adolescents with ADHD, but the obtained results indicate that this problem should be further researched
Povezanost koncentracije preovulacijskoga i postovulacijskoga progesterona u serumu i ishoda izvantjelesne oplodnje [The relationship between the preovulatory and postovulatory progesterone serum concentration and the outcome of in vitro fertilization]
Get PDFAim: To investigate the influence of elevated preovulatory and postovulatory progesterone (P4) on the outcome of in vitro fertilization.
Materials and methods: This is a prospectice cohort study which included 400 patients (300 in the control group and 100 in the group with elevated preovulatory P4 – 85 normal responders and 15 high responders). The IVF outcome among patients with normal preovulatory P4 as compared to the patients with elevated preovulatory P4, the IVF outcome among normal and high responders, the influence of the embryo transfer type (BET or FET) among patients with elevated preovulatory P4 on the outcome of IVF procedures and the influence of postovulatory P4 on the IVF outcome have been investigated in this study.
Results: Positive IVF outcome has been recorded in about one third of all the performed procedures in the control and the study group, with slightly better outcome with elevated preovulatory P4. Better outcome with FET among normal responders and a discretely better outcome with BET among high responders has been recorded. Better IVF outcome has been recorded with P4 on the 5th day >425,7 nmol/L among all the patients and with P4 on the 5th day >384,6 nmol/L among patients with elevated preovulatory P4.
Conclusion: Elevated preovulatory P4 has a slightly protective effect on IVF outcome while the P4 on the 5th day >425,7 nmol/L could be a potential marker for the success of the IVF procedures among all the patients and with P4 on the 5th day >384,6 nmol/L among patients with elevated preovulatory P4
Odnos specifične i nespecifične nosne hiperreaktivnosti u bolesnika sa sezonskim alergijskim rinitisom [Relationship between specific and nonspecific nasal hyperreactivity in patients with seasonal allergic rhinitis]
Get PDFThis study is based on the hypothesis that the intensity of non-specific nasal hyperreactivity correlates with the intensity of specific nasal hyperreactivity and the intensity of early and late phase allergic cellular reaction in patients with seasonal allergic rhinitis. It included 30 patients of both sexes, aged 18 to 65, with monoallergy to grass or ambrosia pollen. Ten patients with non-alergic rhinitis were included as a control group. An out-of-allergy-season, provocation test with a specific allergen was administered to the patients’ nasal mucosa, followed by histamine and hypertonic solutions with a 24 and 72 hour delay, respectively. The subjective intensity of nasal and ocular symptoms was recorded. Nasal patency was evaluated through acoustic rhinometry, and tryptase, eosinophillic cationic protein and substance P concentrati-ons were measured in nasal secretions and tears before and after provocation. A statistically significant correlation in immediate subjective response and tryptase le-vels after allergen and histamine provocation was noted. In addition, eosinophillic cationic protein levels correlated with subjective response 24 hours after allergen exposure. These correlations were not observed after hypertonic fluid provocation. The subjective response to allergen and histamine provocation showed a stronger correlation with mast cell degranulation than eosinophillic activation in patients with seasonal allergic rhinitis. Cellular inflammatory response seems to have a stronger correlation to subjective symptoms scores than neurogenic inflammation
Vrijednost određivanja vaskularnoga endotelnoga čimbenika rasta u serumu i bazičnoga čimbenika rasta fibroblasta u urinu u djece s hemangiomima [Importance of determining vascular endothelial growth factor in serum and basic fibroblast growth factor in urine in children with hemangiomas]
Get PDFObjective: The aim of this study is to investigate the importance of determining VEGF
in serum and bFGF in urine in various stages of growth of hemangiomas in children.
Patients and methods: This is a prospective study of research pairs (case-control
study), which includes fifty patients (N = 50) with hemangiomas in the stage of
proliferation and fifty patients (N = 50) with hemangiomas in the involution phase and
hundred healthy patients (N = 100) as a control group of comparable age and sex of
the patient group. Immunoassay (ELISA) is determined by the value of VEGF and
bFGF in serum and urine in the proliferative phase of hemangioma growth and
involution phase of the hemangioma. The results were compared with the results of a
control children group of comparable age and sex, and other clinical indicators.
Results: Comparison of VEGF serum and bFGF values in urine between phase of
proliferation and involution in the group of patients with IH did not show statistically
significant differences. The control group had significantly higher VEGF values
measured in the proliferation phase IH (P = 0.009). Likewise, the control group had
significantly higher values of VEGF, measured in the involution phase IH (P = 0.019).
Significantly more subjects in the control group had bFGF values in urine ≥ 0.31 (the
lowest value found on the device) measured in the proliferation phase IH (24.0%
versus 4.0%; P = 0.008). The level of bFGF in urine in the involution phase IH
compared to the examined and control group did not show statistically significant
difference (P = 0.617).
Conclusion: Although IH is thought to be a result of disregulation of angiogenesis and
vasculogenesis under the influence of angiogenic factors, notably VEGF and bFGF,
this research has not demostrated that VEGF serum values and bFGF in urine in the
proliferation phase of hemangioma are higher compared to the involution phase
Vrednovanje određivanja ukupnih i fosforiliranih tau proteina u likvoru radi razlikovanja Alzheimerove bolesti i vaskularne demencije [Evaluation of measurement of total and phosphorylated tau proteins in cerebrospinal fluid for differentiation of Alzheimer's disease and vascular dementia]
Get PDFDementia is a major public health problem worldwide. The most common primary cause of dementia is Alzheimer's disease (AD) followed by vascular dementia (VaD). AD and VaD are often difficult to distinguish in their early stages in clinical practice. Because VaD can be prevented by acting on risk factors and new medications have emerged that could slow down the progression of AD, early accurate diagnosis is crucial. Available clinical criteria have not shown sufficient sensitivity and specificity in differentiatiating of AD and VaD, and better biological markers are needed. The aim of this study was to evaluate cerebrospinal fluid (CSF) levels of total tau protein, tau phosphorylated at threonine 181 (p-tau181), serine 199 (p-tau199), and threonine 231 (p-tau231) for their use in the early differentiation of AD and VaD. The study included 152 patients with AD (Mini-Mental State Examination, MMSE 15-26), 28 patients with VaD, four patients with "mixed dementia" (VaD + AD) and 18 healthy controls. The diagnostic accuracy of all investigated biomarkers showed that they may differentiate patients with AD and VaD from healthy control subjects. However none could differentiate patients with AD from patients with VaD. Only the compund factor score (FS) of p-tau231 and MMSE distinguished the patients with AD from those with VaD with statistical significance (p < 0.05), with a sensitivity higher than 75%. These data indicate that FS of p-tau231 and MMSE scores has a strong potential to provide early stage distinction between AD and VaD
Clinical recommendations for diagnosis, treatment and monitoring of patients with gastric cancer [Clinical recommendations diagnosis, treatment and monitoring of patients with gastric cancer]
Get PDFAlthough the incidence of the most frequent malignant gastric tumour, adenocarcinoma, has been decreasing,
during the last decades the incidence of proximal localizations of gastric cancer as well as esophagogastric cancer
has been increasing. Due to the late detection of initially advanced disease the outcomes of treatment for the patients
are unsatisfactory. Diagnosis is set by tumour biopsy during endoscopy. The basis of treatment of locoregional disease
is surgery in combination with perioperative chemotherapy. Alternatively, if no preoperative chemotherapy is administered,
adjuvant chemoradiotherapy or chemotherapy should be performed. Metastatic disease is treated with palliative
chemotherapy and best supportive care. Treatment decisions should be individualized according to patients’ characteristics
and made after multidisciplinary team discussion. The following text presents the clinical guidelines in order to
standardize the diagnostic procedures, treatment and monitoring of patients with gastric cancers in the Republic of
Croatia
Opstrukcija tankog crijeva stranim tijelom u bolesnika s Crohnovom bolesti [Foreign body as a cause of small bowel obstruction in patient with Crohn's disease]
Get PDFForeign body in digestive tract is a rare cause of intestinal obstruction. Most foreign bodies pass digestive
tract spontaneously. Endoscopic intervention will be needed in approximately 10-20%, and surgical intervention in less
than 1% of cases. People with increased risk of foreign body obstruction are those with previous abdominal operation,
hernia, tumor, Crohn’s disease or congenital intestinal malformations. In this paper we have presented a patient with
Crohn’s disease and stenosis of terminal ileum with prestenotic dilatation hospitalized due to bowel obstruction caused
by foreign body in terminal ileum. Surgicaly removed foreign body was peach pit stuck in the ileocaecal valve. Except
of the most common causes of small bowel obstruction, it is necessary to bear in mind the rare causes of obstruction and
consider them in differential diagnosis, especially in patients with Crohn’s disease, due to timely intervention and
lowering the possibility of developing complications such as perforation, bleeding or fi stula formation