Veterinary medicine - Repository of PHD, master's thesis
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Screening methods for patients with paroxysmal nocturnal hemoglobinuria
No full textParoksizmalna noćna hemoglobinurija (PNH) je rijetka, stečena hematološka bolest uzrokovana mutacijom u PIG-A genu krvotvornih matičnih stanica, što rezultira nedostatkom zaštitnih proteina vezanih GPI sidrom (CD55 i CD59) na staničnoj membrani. Posljedično, dolazi do aktivacije komplementa i intravaskularne hemolize, uz brojne kliničke manifestacije poput anemije, tromboze, bubrežnog oštećenja i različitih nespecifičnih simptoma kao što su bolovi u trbuhu, umor i hemoglobinurija. Dijagnoza se postavlja protočnom citometrijom, zlatnim standardom koji detektira manjak proteina vezanih GPI sidrom na krvnim stanicama. Iako postoje jasne smjernice za testiranje, bolest je često neprepoznata zbog nespecifične kliničke slike. Akronim CATCH (Coombs-negativna anemija, Aplastična anemija, Tromboza, Citopenija, Hemoglobinurija) predložen je kao alat za pravovremeno prepoznavanje sumnjivih pacijenata. Ovaj rad uključuje retrospektivno istraživanje provedeno u Kliničkom bolničkom centru Zagreb na 101 pacijentu testiranom između siječnja i lipnja 2024. godine. Najčešće indikacije za testiranje bile su tromboza, bolesti koštane srži i anemija, a većina je pacijenata bila upućena od hematologa. PNH klon je otkriven kod četiri pacijenta. Svi pacijenti s novootkrivenim PNH klonom su imali aplastičnu anemiju dok niti jedan slučaj nije zabilježen među onima testiranima zbog ostalih indikacija, što ukazuje na moguće nedostatke u selekciji pacijenata. Zaključeno je da se u praksi ne slijede uvijek smjernice za probir, što može dovesti do zakašnjele dijagnoze i povećanog rizika za komplikacije. Pravilno prepoznavanje indikacija, multidisciplinarni pristup i edukacija kliničara ključni su za poboljšanje ishoda oboljelih od PNH.Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired hematological disorder caused by a mutation in the PIG-A gene of hematopoietic stem cells. This mutation results in a deficiency of protective GPI-anchored proteins (CD55 and CD59) on the cell membrane, leading to complement-mediated intravascular hemolysis. Clinical manifestations include anemia, thrombosis, kidney damage, and nonspecific symptoms such as abdominal pain, fatigue, and hemoglobinuria. The gold standard for diagnosis is flow cytometry, which detects the absence of GPI-anchored proteins on blood cells. Despite clear testing guidelines, PNH is often underdiagnosed due to its nonspecific presentation. The acronym CATCH (Coombs-negative anemia, Aplastic anemia, Thrombosis, Cytopenia, Hemoglobinuria) has been proposed as a tool for the early identification of at-risk patients. This study includes a retrospective analysis conducted at the University Hospital Center Zagreb examining 101 patients tested for PNH between January and June 2024. The most common reasons for testing were thrombosis, bone marrow disorders, and anemia, with most referrals coming from hematologists. A PNH clone was identified in four patients, all having aplastic anemia; however, none were from the other screening groups. This highlights potential shortcomings in patient selection. The study concluded that clinical practice does not always adhere to established screening guidelines, which can result in delayed diagnosis and an increased risk of complications. Accurate recognition of indications, a multidisciplinary approach, and improved clinician education are key to improving outcomes for patients with PNH
Association Between Macular Ganglion Cell-Inner Plexiform Layer and Non-Proliferative Retinopathy Without Macular Edema in Type 2 Diabetes via Diabetes Duration and HbA1c Link
No full textBackground/Objectives: This study aimed to evaluate the association between the thickness of the macular ganglion cell-inner plexiform layer (GC-IPL), a marker of retinal neurodegeneration, and diabetic retinopathy (DR), a microvasculopathy, in type 2 diabetic patients (T2DM), and to determine the related risk factors.
Methods: This cross-sectional study included 50 eyes of 25 T2DM with a median age of 64 and a median diabetes duration of 13 years. Complete diabetological, nephrological, and ophthalmological examination was performed, including color fundus photography according to the EURODIAB methodology and optical coherence tomography (OCT) of the macula. Patients with proliferative DR and diabetic macular edema were not included in the study. Data were analyzed using the software package Statistica™ 14.0.1.25 (TIBCO Inc., USA).
Results: Fifty eyes were divided into two groups: no DR (n = 34) and non-proliferative DR (NPDR) (n = 16). The NPDR group had longer diabetes duration (p = 0.042), higher HbA1c (p = 0.002), lower HDL cholesterol (p = 0.036), and also lower macular GC-IPL thickness (p = 0.027) than those without DR. The correlation between DR and GC-IPL was significantly negative (R = −0.319, p = 0.024). DR was positively related to diabetes duration (p = 0.047) and HbA1c (p = 0.003), while the relation between GC-IPL and diabetes duration (p = 0.042) and HbA1c (p = 0.043) was negative. Binary logistic regression analysis showed that HbA1c (OR = 2.77, p = 0.007) and HDL cholesterol (OR = 0.08, p = 0.031) were the main predictors for DR, whereas the best model for predicting the GC-IPL thickness (R2 = 0.223) obtained from stepwise regression analysis included HDL cholesterol, triglycerides, estimated glomerular filtration rate, and albumin/creatinine ratio. Conclusions: The negative correlation between macular GC-IPL and DR in T2DM indicates the coexistence of two parts, neurodegenerative and microvascular, in one diabetic eye complication, linked by the same well-known risk factors: diabetes duration and HbA1c
European general practitioners’ attitudes towards person-centred care and factors that influence its implementation in everyday practice: The protocol of the cross-sectional PACE GP/FP study in 24 European countries
No full textBackground: Person-centred care (PCC) is a fundamental principle in general practice, emphasising practices tailored to individual patient preferences, needs, and values. Despite the importance of PCC, general practitioners (GPs) face obstacles in effectively implementing it, with associated factors remaining unclear.
Objectives: The PACE GP/FP study aims to explore GPs' attitudes towards PCC and the factors facilitating or hindering its implementation in daily practice across European countries. This paper outlines the PACE GP/FP study protocol.
Methods: The cross-sectional design with data collection via an online survey distribution to GPs in 24 European countries. Study instruments include two validated questionnaires (Perceived Stress Scale (PSS) and Patient Physician Orientation Scale (PPOS)) and additional items covering general information about the doctor and their practice, as well as facilitators and barriers to PCC. These additional items were specifically developed for the study, translated using the forward-backward method, evaluated through cognitive debriefing, and integrated into the REDCap platform to create language and country-specific survey links. The STROBE checklist guides the reporting of the manuscript.
Conclusion: The PACE GP/FP study will provide a comprehensive exploration of GPs' attitudes towards PCC and the factors shaping its practice in Europe. The findings from the PACE GP/FP study will provide evidence for designing future implementation strategies and guide targeted interventions to promote PCC in primary care across Europe
Estimated plasma volume status in COVID-19 patients and its relation to comorbidities and clinical outcomes
No full textBlood plasma is a large reservoir of circulating mediators of inflammation and its expansion has been associated with unfavorable outcomes in patients with inflammatory and cardiovascular diseases. The aim of this study was to determine clinical and prognostic value of estimated plasma volume status (ePVS) in hospitalized patients with COVID-19. We retrospectively investigated 5871 consecutive COVID-19 patient hospitalized in our tertiary-level institution in period 3/2020-6/2021. ePVS was determined using the Strauss-derived Duarte formula and was correlated with clinical characteristics and unwanted outcomes. Median ePVS was 4.77 dl/g with interquartile range 4.11-5.74. Higher ePVS was significantly associated with older age, female sex, higher comorbidity burden, worse functional status, less severe COVID-19 clinical presentation with lower severity and longer duration of symptoms, but more pronounced inflammatory profile with higher C-reactive protein, interleukin-6 and D-dimer levels (P < 0.05 for all analyses). In the multivariate regression analysis U shaped relationship of ePVS with mortality was revealed, present independently of age, sex, COVID-19 severity and comorbidity burden. In addition, higher ePVS was independently associated with higher tendency for mechanical ventilation, intensive care unit treatment, venous thromboembolism, major bleeding and bacteriemia and lower ePVS was independently associated with tendency for arterial thrombotic events. Higher ePVS, indicative of plasma volume expansion and inflammatory cytokine accumulation, may predispose respiratory deterioration and venous thromboembolism, despite less severe initial clinical presentation. Lower ePVS, indicative of hemoconcentration, may predispose arterial thrombotic events. Both may be associated with higher mortality in hospitalized COVID-19 patients
Equivalent: Burnout among Croatian physicians: a cross-sectional national survey
No full textAim To investigate the prevalence of burnout syndrome among physicians of all specialties, including residents and non-specialists, on a national level in Croatia.
Methods This cross-sectional study, conducted in October 2017, used anonymous online survey based on the Maslach Burnout Inventory Human Services Survey. The Croatian version of the inventory was assessed for acceptability, factorial validity, and reliability. Key dimensions of burnout – emotional exhaustion, depersonalization, and lack of personal accomplishment were assessed. Respondents scoring high for emotional exhaustion or depersonalization were defined as burned-out.
Results The response rate was 18% (2557/14 427). Respondents’ median age was 41 years (range 25-80), and 68% (1737/2557) were women. Good sampling adequacy and scale reliability were confirmed. Factorial validity suggested the presence of three overall factors, and no items were eliminated. Sixty-three percent of physicians were burned-out. High score on emotional exhaustion, depersonalization, and reduced personal accomplishment were found in 58%, 29%, and 52% of respondents, respectively. As many as 16% of the respondents simultaneously experienced high levels of all three burnout dimensions. Multivariate logistic regression analysis revealed that residents and physicians in tertiary or primary care were at an increased risk of burnout, while physicians working in institutes were at a decreased risk.
Conclusion Active national measures are needed to re duce the high prevalence of burnout among Croatian physicians
Association between dynamics of Suppression of Tumorigenicity 2 concentration in serum and ischemic stroke outcome
No full textUvod: Moždani udar (MU) je vodeći uzrok invaliditeta i smrtnosti diljem svijeta. U kliničkoj praksi, prognoza se temelji na kliničkim, neuroslikovnim i laboratorijskim parametrima od kojih niti jedan nije dovoljno osjetljiv i specifičan da omogući ranu prognozu i olakša donošenje terapijskih odluka. Neuroupala je sve više prepoznata kao ključni čimbenik u patofiziologiji ishemijskog MU-a (IMU) pri čemu biljezi poput proteina supresora tumorogenosti 2 (ST2) postaju važni pokazatelji upalnih odgovora koji mogu utjecati na napredovanje oštećenja neurona i ukupni ishod bolesnika.
Cilj: Cilj ovog istraživanja bio je utvrditi može li dinamika otpuštanja upalnog serumskog biljega ST2 predvidjeti ishod IMU-a uz procjenu korisnosti kliničkih, neuroslikovnih i rutinskih laboratorijskih parametara u ishodu IMU-a.
Metode: Provedeno je prospektivno, longitudinalno, opservacijsko istraživanje kod ispitanika s akutnim IMU-om, kod kojih je mjerena koncentracija ST2 i zabilježeni su klinički, neuroslikovni i rutinski laboratorijski parametri, u sedam vremenskih točaka, počevši od prijema (T0), a zatim u uzastopnim 24-satnim intervalima (T1−T6). Nakon 90 dana od početka IMU-a, praćeni su funkcionalni ishod prema modificiranoj Rankinovoj ljestvici (0−2 za dobar i 3−6 za loš ishod) te mortalitet svih uzroka.
Rezultati: U istraživanje je uključeno 20 ispitanika s IMU-om, od kojih je nakon 90 dana 15 imalo loš ishod, a osam je preminulo. Ispitivanje dinamike otpuštanja ST2 pokazalo je najvišu koncentraciju u T1, nakon čega je uslijedio postupni pad. Značajne razlike u koncentracijama ST2 između skupina s dobrim i lošim ishodom, kao i preživjelih i umrlih, nakon 90 dana, pronađene su u većini točaka mjerenja, s najvećom prognostičkom točnošću u T1 (medijan 38 sati) pri vrijednosti >18,9 μg/L. Statistički značajne razlike između istih skupina također su uočene u vrijednostima NIHSS skora (prema engl. National Institutes of Health Stroke Scale), koncentracijama C-reaktivnog proteina (CRP), albumina, vrijednostima PNI-a (prema engl. Prognostic Nutritional Index) i broju trombocita, kao i u volumenu infarkta mozga (VIM).
Zaključak: Rezultati istraživanja potvrdili su značaj dinamike ST2 u ishodu IMU-a, otvarajući mogućnost ispitivanja njegove kliničke primjene osobito u ranim fazama IMU-a, gdje bi ST2 kao biljeg mogao značajno unaprijediti skrb bolesnika. Od kliničkih parametara, NIHSS skor, VIM, a dijelom i PNI, pokazali su se dobrima za prognozu ishoda. Rutinski laboratorijski testovi, osim CRP-a, nisu se pokazali korisnima u praćenju dinamike niti u prognozi ishoda.Introduction: Stroke is a leading cause of disability and mortality worldwide, with significant public health consequences. In clinical practice, prognosis relies on clinical, neuroimaging, and laboratory parameters, none of which are sufficiently sensitive or specific to enable early prognosis and facilitate treatment decisions. The pathophysiology of ischemic stroke (IS) increasingly recognizes neuroinflammation as a key factor, and biomarkers like suppression of tumorigenicity 2 (ST2) are emerging as important indicators of inflammatory responses that may influence the progression of neuronal damage and overall patient outcomes.
Aim: This study aimed to determine whether the dynamics of the release of the inflammatory serological biomarker ST2 could predict IS outcome, alongside of assessing the usefulness of clinical, neuroimaging, and routine laboratory parameters in predicting IS outcomes.
Methods: A prospective, longitudinal, observational study was conducted involving patients with acute IS. ST2 concentrations and clinical, neuroimaging, and routine laboratory parameters were measured at seven time points, starting at admission (T0), followed by consecutive 24-hour intervals (T1−T6). After 90 days from the onset of IS, functional outcomes were assessed using the modified Rankin Scale (0−2 for good outcome and 3−6 for poor outcome), along with all-cause mortality.
Results: The study included a total of 20 IS patients. After 90 days, 15 patients had poor outcomes, and eight patients died. The analysis of ST2 release dynamics showed the highest concentration at T1, followed by a gradual decline. Significant differences in ST2 concentrations between the groups with good and poor outcomes and between survivors and deceased were found in most measurement points, with the highest prognostic accuracy at T1 (median 38 hours) at a cutoff value of >18.9 μg/L. Additionally, statistically significant differences between the same groups were observed in National Institutes of Health Stroke Scale (NIHSS), C-reactive protein (CRP) and albumin concentrations, prognostic nutritional index (PNI), platelet counts, and infarct volume (IV).
Conclusion: The study's findings confirmed the importance of ST2 dynamics in the outcome of IS, opening avenues for exploring its clinical application, particularly in the early stages of IS, where ST2 as a biomarker could significantly enhance patient care. Among clinical parameters, NIHSS, IV and, to a lesser extent, PNI proved effective for outcome prediction. At
the same time, routine laboratory tests, except for CRP, did not show usefulness in monitoring dynamics or predicting outcomes
Von Willebrand factor and Factor VIII in chronic Graft-versus-Host Disease
No full textKronična bolest presatka protiv primatelja (cGvHD) kasna je komplikacija alogenične transplantacije krvotvornih matičnih stanica (alo-PKMS) koju karakterizira imuna disregulacija. U svakodnevnoj kliničkoj praksi istaknuta je potreba za neinvazivnim i lako dostupnim biomarkerom koji bi pouzdano pokazivao aktivnost bolesti i pomogao u modulaciji terapijske strategije. Von Willebrandov faktor (VWF) i faktor VIII (FVIII) su koagulacijski faktori koji djeluju kao upalni markeri koji mogu odražavati i endotelnu aktivaciju, inače poznati etiopatogenetski čimbenik nastanka cGvHD-a. Njihov biomarkerski potencijal u procjeni aktivnosti bolesti opisivan je ranije u autoimunim bolestima koje klinički nalikuju cGvHD-u. Rezultati naše studije pokazali su kako su razine VWF i FVIII značajno više kod bolesnika oboljelih od cGvHD-a u odnosu na kontrole koji nisu razvili cGvHD (VWF:Ag 268,2% vs 191,9%, p=0,003; VWF:RCo 261,8% vs 178,2%, p= 0,003; FVIII 2,17 vs 1,82, p=0,006). Daljnom analizom pokazano je kako su razine VWF:Ag iznad 246,3% i VWF:RCo iznad 271,4% u inicijalnoj fazi bolesti dijagnostički pokazatelj pojave cGvHD-a visoke specifičnosti (92,3%) i dobre osjetljivosti (67,5%). Pokazano je i da su razine faktora povezane s postojanjem manifestacija cGvHD u jetri, ustima i gastrointestinalnom traktu. Ovim longitudinalnim istraživanjem po prvi put je pokazano kako su razine VWF i FVIII povišene dugo nakon postavljanja dijagnoze cGvHD-a i da su povezane s aktivnošću bolesti. Navedeni rezultati ukazuju na moguću dugotrajnu ulogu endotela u aloimunom odgovoru povezanim s cGvHD-om čime se dodatno ističe potreba za bazičnim istraživanjima koji bi dodatno objasnili biologiju bolesti. Potrebno je provesti dodatna istraživanja biomarkerskog potencijala VWF kao dijagnostičkog sredstva u predmanifestnoj fazi bolesti te u procjeni odgovora na terapiju čime bi se mogla omogućiti ranija terapijska intervencija i smanjenje nastanka ireverzibilih i teških sekvela bolesti.Chronic Graft-versus-Host Disease (cGvHD) is a late complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) characterized by immune dysregulation. In clinical practice, there is a critical need for a non-invasive and easily accessible biomarker that can reliably indicate disease activity and assist in tailoring therapeutic strategies. Von Willebrand factor (VWF) and factor VIII (FVIII) are coagulation factors that function as inflammatory markers and can reflect endothelial activation, a known etiopathogenetic factor in the development of cGvHD. Their biomarker potential in assessing disease activity has been previously described in autoimmune diseases that clinically resemble cGvHD. Our study results showed that VWF and FVIII levels were significantly higher in patients with cGvHD compared to controls who did not develop cGvHD (VWF 268.2% vs 191.9%, p=0.003; VWF 261.8% vs 178.2%, p=0.003; FVIII 2.17 vs 1.82, p=0.006). Further analysis revealed that VWF levels above 246.3% and VWF levels above 271.4% in the initial phase of the disease are diagnostic indicators of cGvHD with high specificity (92.3%) and good sensitivity (67.5%). It was also shown that these factor levels are associated with the presence of cGvHD manifestations in the liver, mouth, and gastrointestinal tract. This longitudinal study demonstrated for the first time that VWF and FVIII levels remain elevated long after the diagnosis of cGvHD and correlate with ongoing disease activity. These findings suggest a possible long-term role of the endothelium in the alloimmune response related to cGvHD, highlighting the need for basic research to further explain the biology of the disease. Additional studies are needed to investigate the biomarker potential of VWF as a diagnostic tool in the pre-manifestation phase of the disease and in assessing response to therapy, which could enable earlier therapeutic intervention and reduce the occurrence of irreversible and severe disease sequelae
Multiparametric Assessment of Right Ventricular Dysfunction in Heart Failure: An Analysis From PARAGON‐HF
No full textBackground: This study aims to characterize right ventricular dysfunction (RVD) in heart failure (HF) with preserved ejection fraction and understand the cumulative prognostic value of abnormal RV echocardiographic parameters in HF with preserved ejection fraction.
Methods and results: Data from 809 patients in the PARAGON-HF (Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor With Angiotensin-Receptor Blocker Global Outcomes in HF With Preserved Ejection Fraction) echocardiographic substudy (55% women, mean age 74±8 years) were analyzed. Correlates of RVD (defined as tricuspid annular plane systolic excursion <1.7 cm, fractional area change <35% or absolute RV free wall longitudinal strain <20%) were identified using multivariable logistic regression models. We further assessed the prognostic value of the number of abnormal RV parameters (0, 1, ≥2) on total HF hospitalizations (HFH) and cardiovascular death, total HFH, first HFH or cardiovascular death, all-cause death, and cardiovascular death. RVD was identified in 461 (57%) patients. Correlates of RVD included older age, higher heart rate, atrial fibrillation/flutter, greater left ventricle wall thickness, higher N-terminal pro-B-type natriuretic peptide levels, lower systolic blood pressure, and lower left ventricle absolute global longitudinal strain. These results were consistent across sexes, except atrial fibrillation/flutter and LV wall thickness, which were associated with a higher risk of RVD in men but not in women. Participants with ≥2 abnormal RV parameters had a significantly higher adjusted risk of total HFH and cardiovascular death (rate ratio, 2.13 [95% CI, 1.13-4.01]), first HFH or cardiovascular death, all-cause death, and cardiovascular death. Conversely, an isolated abnormal RV parameter was not associated with a worse outcome.
Conclusions: RV measures may underestimate the burden of RVD in HF with preserved ejection fraction when considered in isolation. Clinicians should consider multiple dimensions to comprehensively assess RV function in patients with HF with preserved ejection fraction
The influence of prior statin therapy on the course and outcome of acute diverticulitis
No full textLijekovi iz skupine statina putem inhibicije enzima HMG-CoA-reduktaze smanjuju razinu kolesterola u krvi. Kroz nekoliko godina njihove široke primjene otkriveni su dodatni pleiotropni učinci statina. Pokazalo se da statini posjeduju antiupalna, antioksidativna, antiagregacijska i antiproliferacijska svojstva. Glavni cilj ovog istraživanja bio je utvrditi utjecaj navedenih svojstava na ishod i tijek akutnog divertikulitisa.
U provedenoj studiji retrospektivno je promatrano 120 pacijenata koji su u razdoblju od 1. siječnja 2023. do 1. siječnja 2024. obrađeni na OHBP-u Kliničkog bolničkog centra Zagreb radi epizode akutnog divertikulitisa. Pacijenti sa statinima i pacijenti bez statina u terapiji upareni su prema rezultatima sklonosti (engl. propensity score) te su definirani pokazatelji težine bolesti (vrijednosti CRP-a, leukocita, postotak hospitaliziranih, trajanje hospitalizacije).
Pronađena je korelacija između terapije statinima i navedenih pokazatelja težine bolesti. Razina CRP-a, leukocita i postotak hospitaliziranih pacijenata ukazivali su na blaži tijek bolesti u pacijenata na terapiji statinima, dok je trajanje hospitalizacije bilo podjednako u obje skupine pacijenata.
Laboratorijski pokazatelji zajedno s postotkom hospitaliziranih pacijenata ukazali su na pozitivan učinak terapije statinima na ishod i tijek akutnog divertikulitisa. Ti su rezultati u skladu s rezultatima drugih studija koje su proučavale učinak statina na druge upalne bolesti. Eventualna praktična primjena dokazanoga ponajprije se treba razmotriti u određenoj populaciji bolesnika s učestalim recidivima bolesti, kao i u pacijenata s teškom epizodom akutnog divertikulitisa u anamnezi.
Buduće prospektivne studije s velikim brojem pacijenata i jasno definiranim ishodima bolesti upotpuniti će rezultate ovog istraživanja i jasnije definirati potencijalnu praktičnu primjenu dokazanog.Drugs from the statin group reduce blood cholesterol levels by inhibiting the enzyme HMG-CoA reductase. Over several years of widespread use, additional pleiotropic effects of statins have been discovered. Statins possess anti-inflammatory, antioxidant, anti-aggregatory, and anti-proliferative properties. The main aim of this study was to determine the impact of these properties on the outcome and course of acute diverticulitis.
In the conducted study, 120 patients who were treated at the Emergency Department of the Clinical Hospital Center Zagreb for an episode of acute diverticulitis between 1st of January, 2023 and 1st of January, 2024 were retrospectively observed. Patients on statins and patients without statins in their therapy were matched based on propensity scores, and indicators of disease severity (CRP values, leukocyte count, percentage of hospitalized patients, duration of hospitalization) were defined.
A correlation was found between statin therapy and the aforementioned indicators of disease severity. CRP levels, leukocyte count, and the percentage of hospitalized patients indicated a milder course of the disease in patients on statin therapy, while the duration of hospitalization was the same in both groups of patients.
Laboratory indicators along with the percentage of hospitalized patients indicated a positive effect of statin therapy on the outcome and course of acute diverticulitis. These results are consistent with the results of other studies that have examined the effect of statins on other inflammatory diseases. The potential practical application of the findings should primarily be considered in a specific population of patients with frequent recurrences of the disease, as well as those with a severe episode of acute diverticulitis in their history.
Future prospective studies with a larger number of patients and clearly defined disease outcomes will complement the results of this study and more clearly define the potential practical application of the finding