During a routine ultrasound examination of the abdomen, a 60-year-old male patient was diagnosed with mass in the tail of the pancreas. However, computed tomography (CT) suggested that the lesion was ...an intrapancreatic accessory spleen (IPAS). IPAS is a congenital anomaly, which usually does not present with symptoms. IPAS occurs during embryologic splenic development when a portion of the splenic tissue fails to fuse with the main body of the spleen. IPAS does not require treatment, except when it is combined with idiopathic thrombocytopenic purpura. In the present case, the diagnosis of IPAS was confirmed using magnetic resonance imaging (MRI). On CT and MRI, the IPAS had a density and intensity comparable with that of the spleen in all plain and contrast-enhanced phases. Due to comorbidities, the patient refused further evaluation or surgery. The lesion was periodically monitored using CT every 1-2 years. Since the tumour was stable during the 7-year follow-up, it was concluded that it was an IPAS. In patients that cannot undergo surgery, a characteristic location (near the spleen) and imaging features (such as a 'zebra-patterned' enhancement in the arterial phase on CT and high signal intensity on diffusion-weighted imaging sequences on MRI, which is comparative to that of the normal spleen) may allow for a diagnose of IPAS with a high level of certainty. Being aware of this condition could aid a correct diagnosis of IPAS and prevent unnecessary surgery.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Aim: Hemodialysis patients present with signs of chronic systemic inflammation. Periodontitis can also trigger systemic inflammation and thus affect sarcopenia. The aim of the study was to examine ...the presence of sarcopenia and periodontitis in patients on chronic hemodialysis and see whether there is a correlation between them. Methods:The study included 53 patients on hemodialysis. Oral status and routine laboratory parameters, as well as body composition and handgrip strength, were measured. Results: 20.8% of patients had sarcopenia, while 69% had stage 4. periodontitis. No statistically significant correlation was found between sarcopenia and periodontitis, but fat mass (FM%) correlated positively with tooth loss (rho = 0.313, p = 0.027), as well as muscle fat (IMAT) (rho = 0.393, p = 0.005). Percentage of skeletal muscle in relation to body weight (wSMI) correlated negatively with tooth loss (rho = -0.393, p = 0.005), as well as the grip strength of the dominant hand (rho = -0.294, p = 0.043). Conclusion: In this pilot study, the correlation between sarcopenia and periodontitis in patients on HD 'was not determined, but a significant correlation of body composition parameters with tooth loss was found, which should be tested in a larger cohort of patients. Key words: periodontitis, sarcopenia, hemodialysis
Desmoid tumor (DT) is a locally invasive form of fibromatosis, comprising only 0.03% of all tumors. DTs occur more frequently in patients with familial adenomatous polyposis and Gardner's syndrome, ...as intra-abdominal or anterior abdominal wall tumors, whereas sporadic DTs are more likely to be extra-abdominal (only 5% of sporadic DTs are intra-abdominal). There is also an association of DTs with prior trauma, surgery, estrogen exposure and childbirth. Imaging studies, such as computed tomography (CT) and magnetic resonance imaging (MRI) are used for preoperative diagnosis and for the planning of the surgery. Following surgery, CT and MRI are used to detect recurrence and to monitor the tumor's response to radiotherapy or medical therapy for unresectable or recurrent tumors. We herein report a rare case of a sporadic giant intra-abdominal DT in a 28-year-old female patient without any predisposing factors, and highlight the importance of including DT in the differential diagnosis of huge intra-abdominal masses.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Primary squamous cell carcinoma (SCC) of the renal pelvis is a very rare tumor often associated with renal calculi and chronic infections. There are only a few articles in literature which report ...renal pelvis SCC in kidneys treated for renal tuberculosis, diagnosed after nephrectomy. We report the case of SCC in a hydronephrotic kidney previously treated for tuberculosis, diagnosed by ultrasound (US)-guided fine-needle aspiration cytology (FNAC), prior to core biopsy and nephrectomy. Our report highlights the utility of FNAC and the need for a careful search for renal collecting system tumors, in patients previously treated for renal tuberculosis.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract
BACKGROUND AND AIMS
Patients on haemodialysis have signs of chronic systemic inflammation and a higher incidence of sarcopenia. Poor oral health can also trigger systemic inflammation and ...thus affect sarcopenia. The aim of the study was to examine oral health and the presence of sarcopenia in patients on chronic haemodialysis and to determine whether there is a correlation between them.
METHOD
This study included 100 patients on chronic haemodialysis at the Clinical University Hospital `Sestre Milosrdnice’ in Zagreb, who underwent oral status, routine laboratory measurements, bioimpedance analysis of body composition and measurement of hand grip strength.
RESULTS
Of the total number of participants (N = 100), 28.0% had sarcopenia. The majority of participants were male (61.0%). Poor oral hygiene was recorded in as many as 39.0% of participants, while 46.0% had their last visit to the dentist several years ago. It is interesting to note that 64.3% of patients with confirmed sarcopenia were last examined by a dentist several years ago, while in those without sarcopenia the proportion was 38.9%. The median total number of erupted teeth in all patients was 12.0 (7.0–23.0). A positive correlation of the total number of erupted teeth and erupted premolars with sarcopenia was confirmed.
CRP was significantly elevated in patients with sarcopenia (P = 0.035), in contrast to those without sarcopenia (3.45 versus 2.70). A total of 51% of patients had increased calculus formation, 49% had oral candidiasis and 38% periodontitis, with as many as 24% of petechiae on the mucosa and 22% of dental caries. A total of 8% of patients had an ammonia breath and 4% had a metallic taste in their mouth. Of all the examined signs and symptoms of oral health, significant differences were observed only in the incidence of dental caries, which was significantly more common in the group that did not have sarcopenia (P = 0.031). However, it should be noted that in patients with sarcopenia, total edentulousness was present in 17.9% as opposed to 9.7% in patients who did not have sarcopenia, i.e. 12% of the total number of participants had total edentulousness. Moreover, in 21% of patients with sarcopenia, a complete denture was present in combination with a partial denture, while that was the case in only 9.7% of patients without sarcopenia.
CONCLUSION
This study confirmed poorer oral health in haemodialysis patients who had sarcopenia. Therefore, intervention studies are needed to improve oral health of patients on HD, which could possibly influence the incidence and severity of sarcopenia.
Humani papiloma virusi (HPV) su mali, epitelotropni DNK virusi. Dosadašnji podatci ukazuju na postojanje više od dvjesto genotipova virusa, od kojih oko četrdeset uzrokuje infekcije genitalnog ...područja. S obzirom na onkogeni potencijal, razlikujemo genotipove visokog (HPV 16, HPV 18, itd.) i genotipove niskog rizika (HPV 6, HPV 11, itd.). Genitalni HPV najčešće se prenosi kontaktom s inficiranom kožom ili sluznicom. Ostali načini prijenosa uključuju neizravni kontakt s kontaminiranim predmetima te autoinokulaciju. HPV uzrokuje različite
promjene genitalne regije poput kondiloma, intraepitelnih neoplazija i invazivnih karcinoma cerviksa, vulve, penisa ili anusa. Također, HPV može prouzročiti lezije u područjima izvan genitalne regije kao što su usna šupljina, ždrijelo, grlo i jednjak. Ne postoji suglasnost vezana uz prevalenciju HPV-a tijekom trudnoće, pa ona varira u različitim zemljama između 5,5% i 65%. Vertikalni prijenos HPV-a označava mogućnost prijenosa HPV-a s majke na dijete tijekom trudnoće. Do perikonceptualnog prijenosa HPV DNA dolazi u vrijeme fertilizacije, dok se antenatalni prijenos događa isključivo za vrijeme trudnoće. No, većina HPV infekcija novorođenčadi nastaje perinatalnim prijenosom tijekom porođaja. Incidencija anogenitalnih kondiloma u trudnoći iznosi između 11,6% i 28,2%. Oni predstavljaju rizik od kontaminacije novorođenčeta HPV-om tijekom porođaja. Porastom učestalosti pojavljivanja anogenitalnih kondiloma u odraslih uočen je i usporedni porast incidencije anogenitalnih kondiloma u djece. HPV u djece može uzrokovati i rekurentnu respiratornu papilomatozu koju karakterizira nastajanje multiplih papiloma glasnica. Rijetko dolazi do totalne opstrukcije dišnog puta ili progresije u karcinom.
Cilj: Bolesnici na hemodijalizi imaju prisutne znakove kronične sistemne upale. Parodontitis također može potaknuti
sistemnu upalu i na taj način utjecati na sarkopeniju. Cilj istraživanja bio je ...ispitati prisutnost sarkopenije i parodontitisa u
bolesnika na kroničnoj hemodijalizi te istražili postoji li njihova povezanost. Metode: U studiju su uključena 53 bolesnika koji
su na hemodijalizi te im je učinjen oralni status, procjena stupnja parodontitisa, rutinska laboratorijska obrada, mjerenje
sastava
tijela i procjena snage stiska šake. Rezultati: Od ukupnog broja ispitanika 20,8 % je imalo sarkopeniju, dok je 69 %
imalo 4. stadij parodontitisa. Nije pronađena statistički značajna povezanost između sarkopenije i parodontitisa (Z= -0,401,
p=0,689), no utvrđena je pozitivna povezanost postotka masti u tijelu (FM%) s gubitkom zubi (rho= 0,313, p= 0,027), kao i
intramuskularnog masnog tkiva s gubitkom zubi (IMAT) (rho=0,393, p=0,005). Postotak skeletnih mišića u odnosu na
tjelesnu
težinu (wSMI) korelira negativno s gubitkom zubi (rho= -0,393, p=0,005), isto kao i snaga stiska šake desne ruke
(rho= -0,294, p= 0,043). Zaključak: Ovim pilot istraživanjem nismo utvrdili povezanost sarkopenije i parodontitisa kod ove
skupine bolesnika, no otkrili smo značajnu povezanost parametara sastava tijela s brojem ispalih zubi, što bi dodatno trebalo
ispitati na većem broju ispitanika.
Uvod. Zaštitna oprema postala je globalno korištena
za zaštitu od respiratornih infekcija kod zdravstvenih
radnika i bolesnih pacijenata. S pojavom virusa SARSCoV-
2 i globalnom pandemijom, uloga ...zaštitnih maski
u smanjenju prijenosa novog virusa postala je predmetom
mnogih istraživanja. Iako zaštitna maska ima
važnu ulogu u smanjenju prijenosa infekcija, njezino
nošenje ima i određene neželjene učinke.
Cilj. Prikazati učinkovitost različitih vrsta zaštitnih
maski u smanjenju prijenosa virusa SARS-CoV-2, kao
i usporedbu neželjenih učinaka pri nošenju zaštitnih
maski.
Metode. Analiza teme o učinkovitosti zaštitnih maski
uključivala je preglede radova na tražilici Google
te baza podataka Medline (putem PubMeda) i Hrčak.
U analizu su uključeni znanstveni radovi s kliničkim
ispitivanjima ili pregledni radovi, na engleskom i hrvatskom
jeziku, bez obzira na metodologiju, objavljeni
od 2020. Uključeni radovi sadrže teme kao što
su medicinske maske, respiratori, platnene maske i
njihovi materijali, učinkovitost i važnost korištenja te
neželjeni učinci nošenja zaštitnih maski. Pronađeno
je 2110 članaka, originalnih i preglednih radova, od
kojih je nakon detaljnog čitanja i analize više autora
odabrano 11 koji zadovoljavaju uključujuće kriterije
za potrebe ovog preglednog rada.
Rezultati. Razlikuju se filtarske polumaske s ventilima
ili bez njih, kirurške maske te higijenske ili platnene
maske. Kirurška maska može biti bolja zaštita
od platnene maske, iako to može ovisiti o slojevima i
materijalu od kojeg je maska izrađena. Maske respira-tori nešto su učinkovitije od kirurških maski, no razlika
se pokazala neznatnom. Najčešći su neželjeni učinci
pri dugotrajnom nošenju maski pojačana produkcija
sputuma, kašalj, dispneja, otežana komunikacija, nedostatak
bliskosti i osjećaj nesigurnosti.
Zaključak. Maska za lice štiti od infekcija i povezuje
se sa smanjenim rizikom od infekcije. Navika nošenja
maske i pravilan način nošenja pokazali su se važnim
čimbenikom za smanjenje rizika od infekcije.
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