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Cochrane - Evidence Based Medicine : Promicanje Cochranea na talijanskom kongresu o dojenju
No full textCharacteristics of ganglion cell complex and retinal nerve fiber layer analysis measured by optical coherence tomography in patients with open-angle glaucoma
No full textCilj istraživanja: Cilj istraživanja bio je usporediti vrijednosti kompleksa ganglijskih stanica (GCC-a) i sloja retinalnih živčanih vlakana (RNFL-a) u skupini bolesnika s glaukomom otvorenog kuta, bolesnika s očnom hipertenzijom i zdravih ispitanika koristeći optičku koherentnu tomografiju (OCT) te istražiti ulogu GCC-a u dijagnostici glaukoma. Ispitanici i postupci: U ovom retrospektivnom i presječnom istraživanju analizirano je 190 očiju podijeljenih u četiri skupine: zdrave oči (N=48), oči s očnom hipertenzijom (N=15), s ranim glaukomom (N=91) i s umjerenim i uznapredovalim glaukomom (N=36). Istraživanje je provedeno u ambulanti za glaukom Klinike za očne bolesti Kliničkog bolničkog centra Split. Debljina GCC-a i RNFL-a dobivena je iz zapisa Cirrus SD-OCT uređaja, parametri vidnog polja iz zapisa Octopus 900 perimetra dok su ostali podatci dobiveni iz bolničkog informatičkog sustava. Rezultati: Statistički značajno sniženje parametara RNFL-a utvrđeno je u svim sektorima osim u temporalnom (P<0,01) u glaukomskim skupinama u odnosu na kontrolnu. Parametri GCC-a također se statistički razlikuju među glaukomskim skupinama i kontrolnom skupinom i to u prosječnoj debljini i svim sektorima (P<0,01). Razlike između očne hipertenzije i zdrave skupine u ovim parametrima nisu značajne. Utvrđena je umjerena do slaba negativna korelacija parametara RNFL-a i GCC-a s funkcionalnim pokazateljima vidnog polja (MD, engl. mean defect i sLV, engl. square root of loss variance), najviše između inferotemporalnog sektora GCC-a i sLV-a (rho=-0,427; P<0,01). Najznačajniji prediktori glaukoma u ovom su istraživanju vertikalni C/D omjer (OR=131,62; 95% CI 16,70-1037,24; P<0,001), sLV (OR=2,76; 95% CI 1,90-4,00; P<0,001) i MD (OR=1,89; 95% CI 1,49-2,39; P<0,001). Najveću dijagnostičku sposobnost pokazao je kombinirani model dobi, spola, prosječne debljine RNFL-a i GCC-a te vertikalnog C/D omjera (AUC=0,80) u odnosu na modele temeljene samo na parametrima GCC-a (AUC=0,77) i RNFL-a (AUC=0,67). Zaključak: Parametri GCC-a i RNFL-a mjereni OCT-om značajno su sniženi u glaukomu te pokazuju negativnu korelaciju s oštećenjem vidnog polja. Parametri GCC-a pokazuju visoku dijagnostičku sposobnost u detekciji glaukoma, ali rezultate dobivene OCT-om treba interpretirati u skladu s anamnezom, oftalmološkim pregledom i perimetrijom.Objectives: The aim of the study was to compare the values of the ganglion cell complex (GCC) and the retinal nerve fiber layer (RNFL) in a group of patients with open-angle glaucoma, ocular hypertension and healthy subjects using optical coherence tomography (OCT) and to investigate the role of GCC in glaucoma diagnosis. Subjects and Methods: In this retrospective and cross-sectional study, 190 eyes were analyzed and divided into four groups: healthy eyes (N=48), eyes with ocular hypertension (N=15), early glaucoma (N=91) and moderate to advanced glaucoma (N=36). The study was conducted at the Glaucoma outpatient clinic of the Department of Ophthalmology, University Hospital of Split. GCC and RNFL thickness were obtained from Cirrus SD-OCT device records, visual field parameters from Octopus 900 perimeter records and other data were retrieved from the hospital information system. Results: A statistically significant reduction in RNFL parameters was observed in all sectors except the temporal sector (P<0.01) in the glaucoma groups compared to the control group. GCC parameters also differed significantly between the glaucoma groups and the control group, both in average thickness and across all sectors (P<0.01). Differences between the ocular hypertension group and the healthy group in these parameters were not significant. A moderate to weak negative correlation was found between RNFL and GCC parameters and functional visual field indices (MD-mean defect, and sLV-square root of loss variance), with the strongest correlation between the inferotemporal GCC sector and sLV (rho = -0.427; P<0.01). In this study the most significant predictors of glaucoma were the vertical C/D ratio (OR=131.62; 95% CI 16.70-1037.24; P<0.001), sLV (OR=2.76; 95% CI 1.90-4.00; P<0.001), and MD (OR=1.89; 95% CI 1.49-2.39; P<0.001). The highest diagnostic performance was shown by the combined model including age, sex, average RNFL and GCC thickness and vertical C/D ratio (AUC=0.80) compared to models based solely on GCC parameters (AUC= 0.77) or RNFL parameters (AUC= 0.67). Conclusion: GCC and RNFL parameters measured by OCT are significantly reduced in glaucoma and show a negative correlation with visual field damage. GCC parameters demonstrate high diagnostic accuracy in detecting glaucoma; however, OCT results should be interpreted alongside medical history, ophthalmological examination, and perimetry
Analysis of pathohistological findings in abortion samples – A retrospective two-year study
No full textCilj istraživanja: Analizirati patohistološke nalaze pobačaja: usporediti patohistološke nalaze ranih i kasnih pobačaja, ispitati utjecaj dobi trudnice i gestacijskog tjedna trudnoće na patohistološki nalaz pobačenog materijala, istražiti razlikuje li se etiologija ranih od kasnih pobačaja te istražiti etiologiju induciranih pobačaja. Ispitanici i metode: Istraživanje je opservacijsko, retrospektivno. Uzorak koji je ispitivan obuhvaća 91 ženu koje su doživjele pobačaj i čiji su materijali zaprimljeni na analizu na Odjelu patologije Kliničkog zavoda za patologiju, sudsku medicinu i citologiju Kliničkog bolničkog centra Split u razdoblju od 1. siječnja 2023. do 31. prosinca 2024. godine. Podatci su prikupljeni iz središnje elektroničke bolničke evidencije, uneseni u tablicu te je napravljena statistička analiza. Rezultati: Od ukupno 91 analiziranog uzorka, približno 90% slučajeva su bili spontani pobačaji, dok su inducirani pobačaji činili 10%. Nespecifični patohistološki nalazi (decidua, degenerirane resice) prevladali su u ranim pobačajima (13 tjedana), znatno su se češće pojavljivale malformacije ploda, upalne i vaskularne lezije (P = 0,007 i P = 0,031), a ukupna povezanost gestacijske dobi s vrstom nalazišta bila je visoko značajna (P = 0,0004). Nije zabilježena statistički značajna povezanost između dobi trudnice i tipa nalaza (P = 0,1008). Svi inducirani pobačaji sadržavali su jasno definirane fetalne anomalije, najčešće trisomije. Zaključak: Histološki nalazi pobačaja razlikuju se prema gestacijskoj dobi; u ranim pobačajima prevladava decidua, dok su malformacije češće u kasnijim tjednima. Ostali nalazi nisu pokazali statističku značajnost. Gestacijski tjedan ima statistički značajan utjecaj na histološke nalaze, dok dob trudnice nije bila povezana s vrstom nalaza. Rani pobačaji nisu povezani s trisomijama, ali je nalaz mole pokazao statistički značajnu razliku. Nije utvrđena povezanost kasnih pobačaja s infekcijama. Najčešći uzrok induciranih pobačaja bile su kromosomske anomalije, najviše trisomija 21 (Downov sindrom).Objectives: To analyze the histopathological findings of abortions by comparing early and late pregnancy losses, to examine the influence of maternal age and gestational age on the histopathological characteristics of aborted material, to investigate whether the etiology differs between early and late miscarriages, and to explore the etiology of induced abortions. Participants and methods: This study was observational and retrospective. The sample included 91 women who experienced a miscarriage, and whose materials were submitted for analysis at the Department of Pathology, Clinical Institute of Pathology, Forensic Medicine and Cytology at the University Hospital Center Split, between January 1, 2023 and December 31, 2024. Data were collected from the central electronic hospital records, entered into a spreadsheet, and analyzed statistically. Results: Out of 91 analyzed cases, approximately 90% were spontaneous abortions, while 10% were induced. Nonspecific histopathological findings (decidua, degenerated villi) predominated in early pregnancy loss (13 weeks), fetal malformations, inflammatory, and vascular lesions appeared significantly more often (P = 0.007 and P = 0.031), and the overall association between gestational age and type of finding was highly significant (P = 0.0004). No statistically significant association was found between maternal age and histopathological findings (P = 0.1008). All induced abortions showed clearly defined fetal anomalies, most commonly trisomies. Conclusion: Histological findings of abortion differ according to gestational age; decidua predominates in early losses, while malformations are more frequent in later weeks. Other findings did not show statistical significance. Gestational age had a statistically significant impact on histological characteristics, whereas maternal age was not associated with the type of findings. Early miscarriages were not linked to trisomies, although the presence of molar pregnancy showed a significant difference. No significant association was found between late pregnancy losses and infections. The most common causes of induced abortions were chromosomal abnormalities, particularly trisomy 21 (Down syndrome)
Procjena učinkovitosti protokola liječenja s Cannabis sativa L. kod osoba s osjetljivom kožom
No full textObjectives: This research aimed to determine whether the cream with hemp extract shows restorative effects on the skin in a human model with sensitive skin and to prove whether its use leads to improvement of skin parameters such as erythema, skin hydration and TEWL. Methods: This study was conducted at the Medical University of Split between May 26 and June 16, 2025, with ethical approval. A total of 21 participants aged 22–35 were recruited, including individuals with and without sensitive skin, determined through a standardized questionnaire. Participants applied a hemp extract cream daily for 3 weeks on the left side of the forehead, while the right side remained untreated as a control. Skin parameters: transepidermal water loss (TEWL), erythema, and hydration, were measured weekly using specialized instruments (Tewameter, Mexameter, and Corneometer). Measurements were taken under controlled temperature and humidity conditions. Statistical analysis involved repeated-measures two-way ANOVA with Bonferroni post hoc testing, with significance set at p < 0.05. Results: TEWL varied significantly over time, suggesting natural or external influences on skin water loss. Although a general upward trend in TEWL was observed in both groups during the second and third weeks no significant differences were found between treated and untreated sides, meaning the cream didn’t have a noticeable effect on the skin barrier. Hydration levels showed a more noticeable response to the treatment, with a significant overall increase and consistently higher values on the treated side, suggesting a beneficial effect of the hemp cream. However, the absence of a significant interaction effect indicates that both sides exhibited a similar trend over time, implying the changes may not be directly associated with the length of treatment. Although some variations in erythema levels were noted throughout the study, the overall differences between the treated and control sides did not reach statistical significance. Having sensitive skin didn’t consistently affect TEWL, hydration, or redness. Conclusion: The hemp extract cream showed no significant effect on transepidermal water loss or erythema. Although skin hydration improved, similar trends on both sides suggest natural factors may have contributed. No notable differences were found between participants with sensitive and normal skin.Ciljevi: Cilj ovog istraživanja bio je utvrditi pokazuje li krema s ekstraktom konoplje obnavljajuće učinke na kožu kod osoba s osjetljivom kožom te dokazati poboljšava li njena primjena kožne parametre poput eritema, hidratacije kože i transepidermalnog gubitka vode (TEWL). Metode: Istraživanje je provedeno na Medicinskom fakultetu Sveučilišta u Splitu u razdoblju od 26. svibnja do 16. lipnja 2025. godine, uz odobrenje etikog povjerenstva. Ukupno je sudjelovala 21 osoba u dobi od 22 do 35 godina, uključujući osobe s osjetljivom i normalnom kožom, određene putem standardiziranog upitnika. Sudionici su svakodnevno tijekom 3 tjedna nanosili kremu s ekstraktom konoplje na lijevu stranu čela, dok je desna strana ostala netretirana kao kontrola. Kožni parametri – transepidermalni gubitak vode (TEWL), eritem i hidratacija – mjerili su se tjedno pomoću specijaliziranih instrumenata (Tewameter, Mexameter i Corneometer). Mjerenja su se provodila u kontroliranim uvjetima temperature i vlage. Statistička analiza uključivala je dvosmjernu ponovljenu ANOVA analizu s Bonferroni post hoc testom, pri čemu je razina značajnosti postavljena na p < 0.05. Rezultati: Vrijednosti TEWL-a značajno su varirale kroz vrijeme, što upućuje na moguće prirodne ili vanjske utjecaje na gubitak vode iz kože. Iako je u drugom i trećem tjednu zabilježen porast TEWL-a u obje skupine, nisu uočene značajne razlike između tretirane i netretirane strane, što znači da krema nije imala vidljiv učinak na funkciju kožne barijere. Hidratacija kože pokazala je izraženiji odgovor na tretman, s općim povećanjem i stalno višim vrijednostima na tretiranoj strani, što sugerira pozitivan učinak kreme s konopljom. Ipak, zbog izostanka značajne interakcije terapije i vremena, pretpostavlja se da su promjene bile djelomično posljedica prirodnih faktora. Premda su zabilježene određene promjene u razinama eritema, razlike između tretirane i kontrolne strane nisu bile statistički značajne. Prisutnost osjetljive kože nije dosljedno utjecala na TEWL, hidrataciju niti crvenilo. Zaključak: Krema s ekstraktom konoplje nije pokazala značajan učinak na transepidermalni gubitak vode niti na eritem. Iako je došlo do poboljšanja hidratacije kože, slični obrasci na obje strane sugeriraju da su prirodni čimbenici mogli pridonijeti tim promjenama. Nisu zabilježene značajne razlike između osoba s osjetljivom i normalnom kožom
Projekt.exe : Okrugli stol: Je li dr. Google i vaš kućni liječnik?
No full textU sklopu projekta „Provjera točnosti informacija o zdravlju” 5. veljače na Medicinskom fakultetu u Splitu održan je okrugli stol „Je li dr. Google i vaš kućni liječnik?”. Sudjelovali su zdravstveni djelatnici, znanstvenici, predstavnici pacijenata i ostali građani
Tumors of the major salivary glands surgically treated at the Clinic for ear, nose, and throat diseases with head and neck surgery: a five-year retrospective study
No full textCilj istraživanja: Ciljevi ovog istraživanja bili su odrediti incidenciju benignih i malignih tumora velikih žlijezda slinovnica u Splitsko-dalmatinskoj županiji, utvrditi učestalost malignih tumora s obzirom na benigne, učestalost tumora s obzirom na dob, spol i rizične čimbenike te odrediti uspješnost kirurškog liječenja i pojave recidiva. Ispitanici i postupci: Istraživanje je provedeno na bolesnicima s tumorima velikih žlijezda slinovnica koji su u periodu od 1. siječnja 2020. do 1. siječnja 2025. operirani u Klinici za bolesti uha, nosa i grla s kirurgijom glave i vrata Kliničkog bolničkog centra Split. Podatci su prikupljani iz operacijskih protokola i povijesti bolesti, kako bi se analizirali i tablično prikazali rezultati. Rezultati: Incidencija neoplazmi slinovnica u Splitsko-dalmatinskoj županiji u petogodišnjem periodu iznosi 8,79/100 000 stanovnika. Izračunati su medijan dobi i IQR: 62 (50,25-70). Najviše bolesnika bilo je u dobnoj skupini 60-79 godina (51,08%). Od ukupno 186 tumora, 163 su bili benigni, a 23 maligni. Nije bilo značajne razlike među pojavnosti tumora u žena i muškaraca (1,35:1). Čak 91,94% ih se pojavilo u parotidi, a ostali u submandibularnoj žlijezdi. Najčešći tumor bio je Warthin (47,85%). Među njima je bilo 69,66% pušača. Srednja dob bolesnika s Warthinovim tumorom bila je 64, a kod bolesnika s pleomorfnim adenomom 53. Navedeni tumori su u 23,6%, odnosno 3,33% slučajeva bili bilateralni. Limfni čvorovi bili su pozitivni u 50% malignih high grade tumora, a presadnice su se pojavile u 8,33% low grade i 20% high grade tumora. Najčešća operacijska tehnika bila je superficijalna parotidektomija (68,82%). Komplikacije su uslijedile nakon 56 operacija, a najčešće su bile pareza grane facijalisa (16,13%) i salivarna fistula (5,38%). Najviše recidiva imali su bolesnici s Warthinovim tumorom. Zaključak: Incidencija tumora velikih slinovnica u Splitsko-dalmatinskoj županiji veća je nego u svijetu, s najčešćom pojavom u sedmom i osmom desetljeću života. Većinski su smješteni u parotidi, a Warthinov tumor koji je povezan s pušenjem dominira među podtipovima. Omjer benignih i malignih tumora, spolne razlike te proširenost bolesti usklađeni su sa svjetskim podacima. Primjena kirurških tehnika i učestalost poslijeoperacijskih komplikacija odgovaraju očekivanjima, a najčešći recidivi su kod Warthinovog tumora i pleomorfnog adenoma.Objectives: The aims of this study were to determine the incidence of benign and malignant tumors of the major salivary glands in the Split-Dalmatia County, to establish the frequency of malignant tumors relative to benign ones, the occurrence of tumors according to age, sex, and risk factors, and to assess the success of surgical treatment and the occurrence of recurrences. Subjects and methods: The study was conducted on patients with tumors of the major salivary glands who underwent surgery at the Clinic for Ear, Nose, and Throat Diseases with Head and Neck Surgery, University Hospital of Split, between January 1, 2020, and January 1, 2025. Data were collected from surgical protocols and medical records to analyze and present the results in tables. Results: The incidence of salivary gland neoplasms in Split-Dalmatia County over the five-year period was 8.79 per 100,000 inhabitants. The median age and interquartile range (IQR) were 62 (50.25–70) years. Most patients were aged 60–79 years (51.08%). Of a total of 186 tumors, 163 were benign and 23 malignant. There was no significant difference in tumor incidence between women and men (1.35:1). A total of 91.94% of tumors occurred in the parotid gland, with the remainder in the submandibular gland. The most common tumor was Warthin’s tumor (47.85%), among which 69.66% were smokers. The median age of patients with Warthin’s tumor was 64, and 53 for those with pleomorphic adenoma. These tumors were bilateral in 23.6% and 3.33% of cases, respectively. Lymph nodes were positive in 50% of malignant high-grade tumors, and metastases appeared in 8.33% of low-grade and 20% of high-grade tumors. The most common surgical technique was superficial parotidectomy (68.82%). Complications occurred after 56 surgeries, most commonly facial nerve branch paresis (16.13%) and salivary fistula (5.38%). The highest recurrence rates were observed in patients with Warthin’s tumor. Conclusion: The incidence of major salivary gland tumors in Split-Dalmatia County is higher than worldwide rates, with the highest occurrence in the seventh and eighth decades of life. The majority are located in the parotid gland, with Warthin’s tumor—associated with smoking—being the dominant subtype. The ratio of benign to malignant tumors, sex differences, and disease spread are consistent with global data. The application of surgical techniques and the frequency of postoperative complications meet expectations, with the most frequent recurrences in Warthin’s tumor and pleomorphic adenoma
Analysis of surgically treated patients with medullary thyroid carcinoma at the Department of Ear, Nose and Throat with Head and Neck Surgery of the University Hospital of Split, from 2009 to 2024
No full textCilj istraživanja: Prikazati epidemiološke i kliničke karakteristike kirurški zbrinutih bolesnika oboljelih od medularnog karcinoma štitnjače (MTC) u Klinici za bolesti uha, nosa i grla s kirurgijom glave i vrata Kliničkog bolničkog centra (KBC) Split u razdoblju od 2009. do 2024. godine. Analizirati dobnu i spolnu raspodjelu, opseg kirurških zahvata te ishod liječenja bolesnika kojima je opseg kirurškog zahvata određen na temelju prijeoperacijskih vrijednosti kalcitonina (Ctn) u serumu. Ispitanici i metode: U retrospektivno kohortno istraživanje uključeno je 36 bolesnika s potvrđenom dijagnozom MTC-a, kirurški zbrinutih u KBC-u Split u razdoblju od 1. siječnja 2009. do 31. prosinca 2024.godine. Podatci su prikupljeni iz medicinske dokumentacije, registara kirurških zahvata i Bolničkog informacijskog sustava. Analizirani su podatci o dobi, spolu, opsegu kirurških zahvata te prijeoperacijskim i poslijeoperacijskim vrijednostima Ctn-a. Rezultati: U razdoblju od 2009. do 2024. godine u KBC-u Split kirurški je zbrinuto 36 bolesnika s MTC-om, potvrđujući nisku i stabilnu incidenciju s blagim trendom pada. Dob ispitanika pri operaciji bila je u rasponu od 37 do 84 godine, s medijanom od 62 godine, a omjer žena i muškaraca bio je 3:1 u korist žena. Analiza prijeoperacijskih vrijednosti Ctn-a u serumu bila je dostupna za 19 bolesnika i pokazala je statistički značajnu povezanost viših vrijednosti Ctn-a (>200 pg/mL) s opsežnijim kirurškim zahvatima (P=0,016). Poslijeoperacijske vrijednosti Ctn-a bile su statistički značajno niže u odnosu na prijeoperacijske (P200 pg/mL) and more extensive surgical procedures (P=0.016). Postoperative Ctn levels were significantly lower compared to preoperative values (P<0.001), indicating successful surgical treatment. Although postoperative Ctn data were available for a smaller subset of patients (n=10), the importance of monitoring Ctn in the postoperative period was emphasized. No statistically significant correlation was found between patient age and Ctn levels or the extent of surgery. Conclusions: The incidence of MTC at the University Hospital of Split is low and stable, with a slight decreasing trend. The disease is more prevalent in women, with a female to male ratio of 3:1. Higher preoperative serum Ctn levels are associated with more extensive surgical interventions, and tailoring the surgical extent according to these values contributes to achieving biochemical remission. Preoperative Ctn levels proved to be a reliable guide for surgical planning. Patient age did not significantly influence serum Ctn levels or the extent of surgery
Inovacije : AI u medicini: budućnost koja je već počela: razgovor s dr. sc. Josipom Vrdoljakom
No full textNovel sternal closure technique in minimally invasive aortic valve replacement
No full textCilj istraživanja: Cilj ovog istraživanja bio je prikazati novu tehniku zatvaranja prsne kosti kod bolesnika podvrgnutih minimalno invazivnoj zamjeni aortnog zaliska. Središnja hipoteza bila je da bolesnici kod kojih je prsna kost zatvorena kombinacijom STERN FIX karbonskih kopči i sternalnih žica imaju bolju poslijeoperacijsku stabilnost i manju incidenciju infekcija u odnosu na zatvaranje isključivo sternalnim žicama. Ispitanici i metode: Retrospektivna opservacijska studija provedena je u Zavodu za kardiokirurgiju Kliničkog bolničkog centra (KBC-a) Split i obuhvatila je sve bolesnike kod kojih je u razdoblju od 1. srpnja 2024. do 1. srpnja 2025. učinjena minimalno invazivna zamjena aortnog zaliska. Svim bolesnicima zatvaranje prsne kosti učinjeno je kombinacijom sternalnih žica i STERN FIX kopči. Prikupljeni su prijeoperacijski, intraoperacijski i poslijeoperacijski parametri. Izvor podataka su arhiva elektronskih podataka iz Informacijskog Bolničkog Sustava, pisani protokol operacijskih zahvata te pismohrana povijesti bolesti. Rezultati: U istraživanje je uključeno 11 bolesnika (prosječna dob 69 godina), od kojih je 55% bilo ženskog spola. Medijan EuroSCORE II iznosio je 1,6%, što ukazuje na nizak operativni rizik. Nije zabilježena niti jedna duboka infekcija sternuma. Medijan vremena izvantjelesne cirkulacije i ishemije srca iznosili su 75 i 43 minute. Niti jedan bolesnik nije zahtijevao konverziju u potpunu sternotomiju. Poslijeperacijske vrijednosti troponina T i vrijeme mehaničke ventilacije bile su unutar očekivanih granica, a niti jedan bolesnik nije razvio poslijeoperacijsku fibrilaciju atrija. U ranom poslijeoperacijskom razdoblju nije bilo rehospitalizacija ni reoperacija. Zaključci: Minimalno invazivna zamjena aortnog zaliska u KBC-u Split pokazala se kao tehnički izvediva i sigurna procedura s dobrim operativnim ishodima i bez većih komplikacija. Hibridna tehnika zatvaranja sternuma korištenjem STERN FIX kopči i sternalnih žica pokazala je zadovoljavajuću mehaničku stabilnost i učinkovitost u sprječavanju ozbiljnih infekcija. Potrebna su daljnja istraživanja na većem broju ispitanika radi potvrde rezultata i optimizacije tehnike zatvaranja.Objectives: The aim of this study was to present a novel sternal closure technique in patients undergoing minimally invasive aortic valve replacement. The central hypothesis was that patients whose sternum was closed using a combination of STERN FIX carbon clips and sternal wires would have improved postoperative stability and a lower incidence of infections compared to those closed with sternal wires alone. Patients and Methods: This was a retrospective observational study conducted at the Department of Cardiac Surgery, University Hospital of Split, including all patients who underwent minimally invasive aortic valve replacement between July 1st, 2024, and July 1st, 2025. In all patients, sternal closure was performed using a combination of sternal wires and STERN FIX clips. Preoperative, intraoperative, and postoperative parameters were collected. Data sources included the electronic medical records from the Hospital Information System, written operative reports and archived patient medical histories. Results: The study included 11 patients (mean age 69 years), 55% of whom were female. The median EuroSCORE II was 1.6%, indicating a low operative risk. No deep sternal wound infections were recorded . The median cardiopulmonary bypass (CPB) time and aortic crossclamp (XCT) time were 75 and 43 minutes, respectively. No patient required conversion to full sternotomy. Postoperative troponin T levels and mechanical ventilation times were within expected ranges and no cases of atrial fibrillation were observed. There were no hospital readmissions or reoperations in the early postoperative period. Conclusions: Minimally invasive aortic valve replacement at the Unitveristy Hosptal of Split is feasible and safe, with good operative outcomes and no major complications. The hybrid sternal closure technique using STERN FIX and sternal wires demonstrated promising mechanical stability and infection control, although superficial wound infections were more frequent than in comparative literature. Further studies on larger samples are necessary to validate these findings and optimize closure techniques
Extrahepatic activity of glucuronidation system
No full textCILJ: Primarni cilj ovog istraživanja bio je usporediti izražaj glukuronidacijskog sustava u staničnim linijama jetrenog, bubrežnog i crijevnog podrijetla, odnosno u stanicama HepG2, HEK 293 i Caco-2. Osim toga, istražili smo utjecaj izloženosti ovih staničnih linija ksenobiotiku BBN na ekspresiju sustava UGT. MATERIJALI I METODE: U istraživanju su korištene tri stanične linije: HepG2 (jetrene stanice), HEK 293 (bubrežne stanice) i Caco-2 (crijevne stanice). Stanice su uzgajane u standardnim uvjetima i tretirane kancerogenim ksenobiotikom BBN. Ekspresija UGT1A gena analizirana je metodom kvantitativnog PCR-a (qPCR), dok je razina UGT proteina određena metodom western blot. Za statističku obradu podataka korišteni su Shapiro-Wilkov test, jednosmjera ANOVA s post-hoc Tukey testom i nespareni t-test. REZULTATI: Rezultati qPCR analize pokazali su da je konstitutivna ekspresija gena UGT1A najviša u Caco-2 stanicama, a najniža u HEK 293, uz statistički značajne razlike među svim staničnim linijama (P < 0,001). Denzitometrijskom analizom western blot-a utvrđeno je da razlike u bazalnoj razini UGT proteina nisu bile statistički značajne, iako je izražaj bio najviši u Caco-2 stanicama. Nakon tretmana BBN-om, u svim staničnim linijama zabilježen je porast izražaja UGT1A gena, ali je statistički značajan bio samo u Caco-2 stanicama (P < 0,05). S druge strane, količina UGT proteina nakon izlaganja BBN-u smanjila se u HepG2 i Caco-2, a porasla u HEK 293 stanicama, no nijedna promjena nije bila statistički značajna. Najniža P-vrijednost zabilježena je u HepG2 stanicama (P = 0,126). ZAKLJUČAK: Prema rezultatima dobivenim u ovom diplomskom radu, utvrđeno je nekoliko ključnih nalaza. Najviši izražaj gena UGT1A zabilježen je u stanicama crijevnog podrijetla. Nakon izlaganja staničnih linija ksenobiotiku BBN, porast izražaja tog gena posebno je uočen u Caco-2 stanicama, dok je u ostalim staničnim linijama primijećen trend porasta. S druge strane, količina enzima UGT nije se značajno razlikovala među ispitivanim staničnim linijama. Također, nakon izlaganja BBN-u nije došlo do promjene u količini enzima UGT, iako je u stanicama bubrežnog podrijetla uočen trend porasta.OBJECTIVES: The main objective of this study was to compare the expression of the glucuronidation system in cell lines of hepatic, renal and intestinal origin, specifically in HepG2, HEK 293 and Caco-2 cells. In addition, we examined whether exposure of these cell lines to the xenobiotic BBN influences the expression of the UGT system. MATERIALS AND METHODS: This study used three cell lines: HepG2 (hepatic), HEK 293 (renal), and Caco-2 (intestinal). Cells were cultured under standard conditions and treated with the carcinogenic xenobiotic BBN. UGT1A gene expression was analyzed using quantitative PCR (qPCR) and UGT protein levels were measured by western blot. Statistical analyses included the Shapiro-Wilk test, one-way ANOVA with Tukey post-hoc test and unpaired t-test. RESULTS: qPCR analysis showed that the constitutive expression of the UGT1A gene was highest in Caco-2 cells and lowest in HEK 293, with statistically significant differences among all tested cell lines (P < 0.001). Densitometric analysis of western blot results revealed no statistically significant differences in baseline UGT protein levels, although expression was highest in Caco-2 cells. Following BBN treatment, an increase in UGT1A gene expression was observed in all cell lines, reaching statistical significance only in Caco-2 cells (P < 0.05). In contrast, UGT protein levels decreased in HepG2 and Caco-2 cells and increased in HEK 293 cells, but none of these changes were statistically significant. The lowest P-value was recorded in HepG2 cells (P = 0.126). CONCLUSION: Based on the results obtained in this thesis, several key findings were observed. The highest expression of the UGT1A gene was detected in cells of intestinal origin. Following exposure of the cell lines to the xenobiotic BBN, an increase in the expression of this gene was observed in Caco-2 cells, while a trend of increased expression was noted in other cell lines. On the other hand, the amount of UGT enzyme did not differ significantly among the tested cell lines. Additionally, exposure to BBN did not change the amount of UGT enzyme, although a trend of increase was observed in cells of renal origin