Veterinary medicine - Repository of PHD, master's thesis
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Hypnic headache: What does the turtle have to do with it?
No full textHipničke glavobolje (glavobolje koje se javljaju tijekom spavanja) prema Međunarodnoj klasifikaciji glavobolja – 3. izdanje ubrajaju se u primarne glavobolje. Za razliku od ostalih primarnih glavobolja poput migrene, tenzijske i trigeminalne autonomne glavobolje, u kliničkoj praksi često su neprepoznate ili je postavljena pogrešna dijagnoza. Kornjačina glavobolja se javlja nakon jutarnjeg buđenja te ponovnog usnivanja i buđenja. Javlja se kod osoba koje običavaju tijekom spavanja prekriti glavu pokrivačem (odatle potječe analogija s kornjačinim uvlačenjem i izvlačenjem glave ispod oklopa). Iako je u literaturi opisana prije hipničke glavobolje i smatra se njezinim rijetkim podtipom, do danas nije uvrštena u Međunarodnu klasifikaciju glavobolja. U ovom radu prikazujemo pacijenta s dugogodišnjom hipničkom i epizodičnom kornjačinom glavoboljom. Brojne diferencijalnodijagnostičke dileme s kojima smo se susretali zahtijevale su dodatnu kliničku i neuroradiološku obradu. Utvrđivanje vrste glavobolje temelji se na detaljnoj anamnezi i striktnoj primjeni dijagnostičkih kriterija Međunarodne klasifikacije glavobolja. Važnost ispravne dijagnoze značajna je i s terapijskog aspekta jer se farmakoterapija i preventivno liječenje hipničke i kornjačine glavobolje razlikuje od terapije ostalih primarnih glavobolja. S obzirom na to da su u Međunarodnu klasifikaciju glavobolja uvrštena i izuzetno rijetka stanja poput numularne glavobolje i sindroma pekućih usta, mišljenja smo da kornjačina glavobolja zaslužuje uvrštenje u istu.According to the International Classification of Headache Disorders, 3rd edition, hypnic headaches (headaches that occur during sleep) are classified as primary headaches. Unlike other primary headaches, such as migraine, tension, and trigeminal autonomic headaches, they are often unrecognized or misdiagnosed in clinical practice. A turtle headache occurs when you wake up in the morning, fall asleep, and then wake up again. It occurs in people who tend to cover their heads with a blanket during sleep (this is where the analogy with a turtle pulling its head in and out from under its shell comes from). Although it was described in the literature before hypnic headache and is considered its rare subtype, it has not yet been included in the International Classification of Headache Disorders. In this paper, we present a patient with long-term hypnic and turtle headaches. We encountered numerous differential-diagnostic dilemmas that require additional clinical and neuroradiological investigations. Determining the type of headache is based on a detailed history and strict application of the diagnostic criteria of the International Classification of Headache Disorders. The importance of a correct diagnosis is also significant from a therapeutic point of view because the pharmacotherapy and preventive treatment of hypnic and turtle headaches differ from the therapy of other primary headaches. The International Classification of Headache Disorders contains extremely unusual conditions such as nummular headaches and burning mouth syndrome, so we believe that the turtle’s headache deserves to be included in this classification
Moderate SCRIB Expression Levels Correlate with Worse Prognosis in OPSCC Patients Regardless of HPV Status
No full textHead and neck cancers rank as the sixth most prevalent cancers globally. In addition to traditional risk factors such as smoking and alcohol use, human papillomavirus (HPV) infections are becoming a significant causative agent of head and neck cancers, particularly among Western populations. Although HPV offers a significant survival benefit, the search for better biomarkers is still ongoing. In the current study, our objective was to investigate whether the expression levels of three PDZ-domain-containing proteins (SCRIB, NHERF2, and DLG1), known HPV E6 cellular substrates, influence the survival of HNSCC patients treated by primary surgery (n = 48). Samples were derived from oropharyngeal and oral cancers, and HPV presence was confirmed by PCR and p16 staining. Clinical and follow-up information was obtained from the hospital database and the Croatian Cancer registry up to November 2023. Survival was evaluated using the Kaplan–Meier method and Cox proportional hazard regression. The results were corroborated through the reanalysis of a comparable subset of TCGA cancer patients (n = 391). In conclusion, of the three targets studied, only SCRIB levels were found to be an independent predictor of survival in the Cox regression analysis, along with tumor stage. Further studies in a more typical Western population setting are needed since smoking and alcohol consumption are still prominent in the Croatian population, while the strongest association between survival and SCRIB levels was seen in HPV-negative cases
Assessment of NLRP3 inflammasome activation in patients with chronic obstructive pulmonary disease before and after lung transplantation
No full textThe interplay between purinergic receptors as well as pattern recognition receptors like Toll-like receptors (TLRs) and NOD-, LRR-, and pyrin domain-containing protein 3 (NLRP3) might have a role in the pathogenesis of chronic obstructive pulmonary disease (COPD). The aim of this study was to determine and compare the concentrations of the damage-associated molecular patterns (DAMPs) heat shock protein 70 (Hsp70) and adenosine triphosphate (ATP), and gene expression of their respective receptors as well as NLRP3 inflammasome-related molecules in the peripheral blood of patients with end-stage COPD before and 1 year after lung transplantation (LT). Lung function was assessed by spirometry and diffusion capacity for carbon monoxide (DLCO). Quantitative polymerase chain reaction (qPCR) was applied for detection of TLR2, TLR4, P2X7R, P2Y2R, IL1B, CASP1, and NLRP3 expression. High-sensitivity ELISA kits were used for extracellular (e) Hsp70 and IL-1β, and luminescence assay for eATP measurements. Concentrations of eHsp70 and eATP as well as IL-1β were significantly increased in the plasma of end-stage COPD patients and significantly decreased after LT. In addition, TLR4, P2Y2R, IL1B, CASP1, and NLRP3 expression was up-regulated in COPD patients before LT, while it was significantly suppressed after LT. In conclusion, it could be assumed that NLRP3 inflammasome is activated in the peripheral blood of end-stage COPD patients and that eHsp70 and eATP could be responsible for its activation through triggering their receptors. On the other hand, previously enhanced pro-inflammatory reactions seem to be suppressed to the healthy population levels in lung recipients without allograft rejection
Utjecaj poslijeoperacijske gustoće na zakrivljenost rožnice nakon procedure rožnične metode kros linkinga
No full textPurpose: This thesis aims to determine if there is a predictable and accountable correlation between preoperative and early postoperative corneal tomography measures and the visual acuity outcome one year after the corneal cross-linking procedure.
Methods and Materials: A prospective study was performed on 101 keratoconus eyes, treated with a corneal cross-linking procedure per the standard Dresden protocol and followed up to one year postoperatively. The data was explored to determine the significance of correlations between tomography parameters and CDVA during the follow-up period.
Results: A medium-strong significant correlation exists between the K max at 12 months and COD in 7 analysed regions at one month, for R=0.42, Durbin Watson =1.744. The 0-2mm anterior region has the highest positive correlation to K max at one month. The predictability of the CDVA at one year, using only objective parameters, is 60.4%, and after CDVA at preoperative added, it rises to 72.29%
Conclusion: CDVA at one year can be predicted with the highest probability using objective preoperative parameters derived by Pentacam in combination with CDVA at preoperative.Cilj: Cilj disertacije je utvrditi postoji li korelacija predvidljivosti i primjenjivosti između mjerenja prijeoperacijske i rane poslijeoperaciske rožnične tomografije i utjecaj na vidne oštrine godinu dana nakon postupka rožničnog kros linkinga.
Materijali i Metode: Prospektivna studija provedena na 101 oku sa keratokonusom, tretiranim kros linkingom, prema standardnom Drezdenskom protokolu i praćenih godinu dana nakon operativnog zahvata. Podatci praćenja su analizirani kako bi se odredila korelacija između parametra tomografije i korigirane vidne oštrine na daljinu tijekom razdoblja praćenja.
Rezultati: Srednje jaka značajna korelacija postoji između K max nakon 12 mjeseci i rožnične gustoće u sedam analiziranih regija, mjesec dana nakon operacijskog zahvata, za R+0.42, Durbin Watson +1.744. Regija 0-2mm prednja površina, mjesec dana nakon operacijskog zahvata ima najsnažniju pozitivnu korelaciju sa K max. Predvidljivost korigirane vidne oštrine na daljinu nakon godinu dana, korišćenjem samo objektivnih tomografskih parametra iznosi 60.4%, dok nakon dodavanja prijeoperacijske korigirane vidne oštrine, penje se na 72.29%.
Zaključak: Korigirana vidna oštrina na daljinu nakon godinu dana može se predvidjeti sa najvećom vjerovatnoćom korišćenjem objektivnih prijeoperaciskih parametara dobivenih Pentakamom u kombinaciji sa korigiranom vidnom oštrinom prije operacijskog zahvata
The Mutographs biorepository: A unique genomic resource to study cancer around the world
No full textLarge-scale biorepositories and databases are essential to generate equitable, effective, and sustainable advances in cancer prevention, early detection, cancer therapy, cancer care, and surveillance. The Mutographs project has created a large genomic dataset and biorepository of over 7,800 cancer cases from 30 countries across five continents with extensive demographic, lifestyle, environmental, and clinical information. Whole-genome sequencing is being finalized for over 4,000 cases, with the primary goal of understanding the causes of cancer at eight anatomic sites. Genomic, exposure, and clinical data will be publicly available through the International Cancer Genome Consortium Accelerating Research in Genomic Oncology platform. The Mutographs sample and metadata biorepository constitutes a legacy resource for new projects and collaborations aiming to increase our current research efforts in cancer genomic epidemiology globally
Are treatment options used for adult-onset type 2 diabetes mellitus (equally) available and effective for children and adolescents?
No full textYouth-onset type 2 diabetes mellitus (T2DM), influenced by an increase in obesity, is a rising problem worldwide. Pathophysiological mechanisms of this early-onset T2DM include both peripheral and hepatic insulin resistance, along with increased hepatic fasting glucose production accompanied by inadequate first and second-phase insulin secretion. Moreover, the incretin effect is reduced. The initial presentation of type 2 diabetes can be dramatic and symptoms may overlap with those of type 1 diabetes mellitus. Therefore, immediate therapy should address hyperglycemia and associated metabolic derangements irrespective of ultimate diabetes type, while further therapy adjustments are prone to patients’ phenotype. New agents with proven glycemic and beyond glycemia benefits, such as Glucagon-like polypeptide 1 receptor agonists and Sodium-glucose cotransporter-2 inhibitors, used in the adult population of T2DM patients, might become increasingly important in the treatment armamentarium. Moreover, metabolic surgery is an option for markedly obese (body mass index > 35 kg/m2) children and adolescents suffering from T2DM who have uncontrolled glycemia and/or serious comorbidities when lifestyle and pharmacologic interventions fail. In this mini-review, we will discuss the potential of treatment options considering new data available from randomized control trials, including individuals with adult-onset type diabetes mellitus
Antibiotics Prescribing Pattern and Quality of Prescribing in Croatian Dental Practices—5-Year National Study
No full textPurpose: Antibiotic resistance is one of the biggest threats to global health today. The aim of this study was to analyze antibiotic prescribing patterns and quality of prescribing in Croatian dental practices over a 5-year period.
Methods: This is a retrospective observational study based on the analysis of the electronic prescriptions (medicines in ATC groups J01 and P01) from dental practices in Croatia prescribed from 1 January 2015 to 31 December 2019. Prescriptions were retrieved from the Croatian Health Insurance Fund (HZZO). The analyses included the number of prescriptions, type and quantity of prescribed drugs, indication, and the patient’s and prescriber’s characteristics.
Results: The consumption increased from 1.98 DID in 2015, to 2.10 DID in 2019. The most prescribed antibiotic was Amoxicillin with clavulanic acid followed by Amoxicillin, Clindamycin, Metronidazole and Cefalexin. The analyses showed that 29.79% of antibiotics were not prescribed in accordance with the contemporary guidelines for the proper use of antibiotics. Additionally, 22% of antibiotics were prescribed in inconclusive indications.
Conclusion: The research showed an increase in antibiotic consumption over five years along with unnecessary prescribing of antibiotics in cases with no indications for its use. The development of national guidelines for antibiotic use is necessary
The influenza landscape and vaccination coverage in older adults during the SARS-Cov-2 pandemic: data from Several European Countries and Israel
No full textIntroduction: The Raise Awareness of Influenza Strategies in Europe (RAISE) group gathered information about the healthcare burden of influenza (hospitalizations, intensive care unit [ICU] admissions, and excess deaths), surveillance systems, and the vaccine coverage rate (VCR) in older adults in 18 European countries and Israel.
Areas covered: Published medical literature and official medical documentation on the influenza disease burden in the participating countries were reviewed from 2010/11 until the 2022/23 influenza seasons. Information on the framework for monitoring the disease burden and the provision for ensuring older adults had access to vaccination in their respective countries was provided. Data on influenza VCR in older adults were collected for the 2019/20 to 2022/23 influenza seasons. Data are reported descriptively.
Expert opinion: Influenza presents a significant healthcare burden in older adults. Reporting outcomes across participating countries is heterogeneous, highlighting the need for standardized approaches. Although older adults receive free influenza vaccination, vaccine uptake is highly variable among countries. Moreover, hospitalization rates remain high even in countries reporting a high VCR. Increased awareness and education on the burden of disease and the broader use of improved influenza vaccines for older adults may help reduce the disease burden on this population
Statement of the ASPHER Task Force on War and Public Health on the Conflict in Israel/Palestine
No full textSalivary Interleukin-13 and Transforming Growth Factor Beta as Potential Biomarkers of Cancer Cachexia
No full textCancer cachexia is a syndrome characterized by weight and muscle loss and functional impairment, strongly influencing survival in cancer patients. In this study, we aimed to establish the role of saliva cytokine measurement in cancer cachexia investigation and define two potential independent salivary biomarkers of the condition.
Methods: serum and saliva specimens were obtained from 78 patients. Forty-six patients were non-cachectic, and 32 patients were cachectic (per SCRINIO group criteria), all with metastatic solid tumors. Commercial ELISA kits were used to determine the salivary and serum concentrations of interleukin 13 (IL-13) and transforming growth factor beta (TGF-β) in two patient groups and healthy controls. Laboratory values were obtained from the hospital information system, and weight and height were measured at the time of sampling.
Results: A statistically significant difference was observed between the groups in saliva IL-13 concentrations but no difference in serum concentrations. Statistically significant differences were also observed between the groups in saliva and serum concentrations of TGF-β. Logistic regression analysis has identified salivary IL-13 and TGF-β as independent factors for cancer cachexia.
Conclusions: We demonstrated saliva as a valuable specimen for cachexia investigation and established IL-13 and TGF-β as potential cancer cachexia biomarkers. Further research is needed to evaluate these findings