Bladder diverticula are defined as an outpouching of the mucosa into the muscle layer of the bladder wall. There is a well-known link between urinary bladder diverticula and tumors arising within the ...diverticula. They are rare with an incidence rate of 0.8%-10%. We report an intradiverticular urothelial carcinoma in a 72-year-old man with a known history of multiple episodes of acute urinary retention and urinary tract infections, followed by transurethral resection of the benign prostatic hyperplasia.
Osteochondritis dissecans (OCD) of the elbow mainly occurs in overhead athletes (OHAs). This narrative review aimed to comprehensively analyze the epidemiological data, etiological factors, clinical ...and imaging features, treatment options, and outcomes of OHAs with the diagnosis of elbow OCD. A literature search was performed in PubMed/MEDLINE, Scopus, and Web of Science. Individuals with elbow OCD were usually 10-17 years of age with incidence and prevalence varying between studies, depending on the sport activity of the patients. The etiology of OCD lesions is multifactorial, and the main causes are believed to be repetitive trauma, the biomechanical disproportion of the articular surfaces, poor capitellar vascular supply, and inflammatory and genetic factors. Athletes usually presented with elbow pain and mechanical symptoms. The mainstay for the diagnosis of elbow OCD is MRI. The treatment of elbow OCD lesions should be conservative in cases of stable lesions, while various types of surgical treatment are suggested in unstable lesions, depending mainly on the size and localization of the lesion. The awareness of medical practitioners and the timely diagnosis of OCD lesions in OHAs are key to favorable outcomes.
Primary Bone Lymphoma of the Scapula Lovaković, Josip; Mandac Smoljanović, Inga; Matković, Andro ...
Hematology reports,
02/2024, Letnik:
16, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Primary bone lymphoma of the scapula is a rare tumor that usually causes local pain. The presented patient suffered for two years from paresthesia, tingling, numbness, and edema of the little and ...ring fingers. The 45-year-old man underwent several radiological and neurological assessments of the palm, elbow, and neck before radiographs revealed a tumor of the left shoulder. Once diffuse large B-cell lymphoma was confirmed, immunochemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and methylprednisolone (R-CHOP) started. The treatment was accompanied by antiviral treatment with lamivudine due to positive hepatitis B virus serology, specifically anti-HBs (hepatitis B surface) antibody, total anti-HBc (hepatitis B core) antibody, and anti-HBe (hepatitis B e antigen) antibody, together with bisphosphonate treatment for the prevention of bone resorption. Once immunochemotherapy was finished, the treatment was supplemented by radiotherapy of the shoulder. After more than three years of remission, the patient had an ischemic stroke manifesting with right-sided hemiparesis. Following physical therapy, the patient is currently in the process of evaluation for thrombophilia, as well as further cardiac assessment due to the positive transcranial Doppler bubble test, setting high suspicion for the presence of patent foramen ovale.
Pseudokidney Sign in Gastric Cancer Ferenc, Thomas; Svetec Dvorski, Jelena; Matković, Andro ...
Diagnostics (Basel),
05/2024, Letnik:
14, Številka:
9
Journal Article
Recenzirano
Odprti dostop
Pseudokidney sign (PKS) is a characteristic sonographic finding of an abnormal mass with a reniform appearance, and a hyperechoic central region surrounded by a hypoechoic area. It has been seldom ...documented in gastric cancer. A 75-year-old male patient presented with a palpable abdominal resistance in the left upper abdominal quadrant and ultrasound evaluation revealed a well-vascularized mass presenting with PKS. Regional lymphadenopathy was also found, and the working diagnosis of gastric cancer was established. The suspected diagnosis was later verified endoscopically and on pathohistological examinations as gastric adenocarcinoma. Computed tomography staging also revealed distant metastases to the lungs, liver, and adrenal glands and abdominal lymphadenopathy. The PKS often indicates gastrointestinal pathology, and it may be seen in benign and malignant conditions due to gastrointestinal wall thickening. Therefore, additional diagnostic examinations are advised for a more definite diagnosis.
To determine patients' knowledge about ionising radiation used in diagnostic imaging and whether they were adequately informed about the procedure they were referred to. A cross-sectional study was ...conducted at the University Hospital Merkur, Zagreb, Croatia during 2019-20. A questionnaire with 14 questions was given to patients in waiting rooms for imaging examinations. Statistical analysis was conducted using the standard software package. Chi-square with Yates correction was used to determine differences in patients' answers between those who received the explanation about the procedure and those who did not. The differences depending on the educational level were also evaluated. The survey was completed by 374 participants (200 women, 174 men) with a mean age of 55.45 ± 15.92 y. Of all patients, 8.63% had no formal education or only finished elementary school, 52.83% had finished high school and 38.55% had a college or a higher degree. The referring physicians informed 63.66% of participants about the radiological exam they were being referred to, and 226 thought that the given explanation was sufficient. Most patients knew that some radiological procedures use ionising radiation. Only 47.37% of respondents correctly identified MRI as a non-ionising method, whereas 37.40% of participants recognised chest X-ray as the modality with the lowest radiation dose. Higher-educated patients had better knowledge of radiological procedures and the potential risks. The study demonstrated suboptimal patients' knowledge about ionising radiation, and additional efforts in their education are needed.
•Chronic liver disease and hepatic osteodystrophy have detrimental impact on bone strength.•Liver transplant candidates showed high prevalence of spinal fragility fractures.•Combination of standard ...X-ray imaging and DXA is needed for adequate bone evaluation in pretransplant period.•Bone specific alkaline phosphatase could be useful for detecting hepatic osteodystrophy in liver transplant candidates.
Existing data on fragility spinal fractures prevalence in liver transplant candidates are scarce and inconsistent. This may be due to other comorbidities, besides hepatic osteodystrophy (HO), that contribute to bone loss and fragility fracture prevalence in chronic liver disease (CLD).
The aim of this study was to investigate the prevalence of spinal thoracic and lumbar fragility fractures among cirrhotic, non-chronic kidney disease (CKD), non-diabetic liver transplant candidates and to explore their relationship with clinical characteristics, laboratory markers and dual-energy x-ray absorptiometry (DXA) results.
This cross-sectional observational study was conducted at Merkur University Hospital, Croatia, between February 2019 and May 2023. Adult patients with liver cirrhosis referred for liver transplantation were included. Patients with acute infection, CKD, diabetes mellitus, malignancies, inflammatory bone diseases and those on corticosteroid or antiresorptive therapy were excluded. Clinical, laboratory and radiological assessment was carried out and patients were accordingly allocated into non-fractured and fractured group for the purpose of statistical analysis.
A total of 90 patients were included in the study. There was 123 fractures, 87 (70.7 %) in the thoracic and 36 (29.3 %) in the lumbar region. Eighty-nine (72.4 %) fractures were grade 1, 31 (25.2 %) were grade 2 and 3 (2.4 %) were grade 3. Patients in the fractured group were significantly older (p < 0.001). No significant differences between fractured and non-fractured group according to laboratory and DXA parameters were noted. Subgroup with lumbar fractures had significantly lower bone mineral density values at L1-L4 region. Statistically significant negative correlation between bone specific alkaline phosphatase (BALP) and hip total BMD (rho = -0.414, p < 0.001) and spine total BMD (rho = -0.258, p = 0.014) values was found.
Present study confirmed detrimental impact of CLD and HO on bone strength. DXA measurement correlated with the presence of lumbar fragility fractures. A combination of standard X-ray imaging and DXA is needed for adequate bone evaluation in pretransplant period and BALP could be useful for detecting HO in CLD. Searching for other risk factors and implementing bone turnover markers and additional imaging techniques for bone loss evaluation in liver transplant candidates is needed.
The objective of this study was to establish physiological loads elite basketball referees sustain during competitive games. Thirty-one referees (age: 33.35 ± 5.17 years, body mass: 88.04 ± 7.47 kg, ...height: 186.37 ± 5.40 cm), all classified as A-list referees of the 1st Croatian Basketball League, were subjected to progressive spiroergometric testing on the treadmill in order to determine the anaerobic threshold (V-slope method). The referees were monitored electrocardiographically for the establishment of physiological load during competitive games. Their heart rate (HR) was measured during the games using a POLAR RS400 cardiotachometer. The level of physiological load was determined according to individual work intensity zones that had been determined using laboratory testing for each subject separately. The lowest intensity zone of load was below 79% of HR at the ventilatory threshold, the following zone included HRs between 80 and 89% of HR at the ventilatory threshold, then between 90 and 100% of HR at the ventilatory threshold, whereas the highest zone was above the HR at the ventilatory threshold. The time each subject spent in a particular intensity zone was determined and expressed as a percentage of the total game time. The average HR during a game was 131.52 ± 9.10 bpm, that is, 77.34 + or - 6.05% of the HR at the anaerobic threshold. It was established that the referees spent 50% of the total game time in zones of high aerobic load (extensive and intensive aerobic zone), whereas if we only examine the time during the quarters, then this percentage amounts up to 60%. The referees spent only 1-2% of the total game time in the anaerobic energetic process load zone. There were no significant differences between younger and older referees in physiological load they sustain during the games. These findings indicate basketball referees must possess a high aerobic capacity to withstand physiological load during a basketball game. Key words: heart rate, aerobic capacity, anaerobic threshold
Celotno besedilo
Dostopno za:
DOBA, FSPLJ, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The main objective of this research was to determine whether progressive physiological load affects changes in certain kinematic parameters while performing jump shots in basketball. This study ...primarily examined the effect of fatigue on changes in angular velocities of joints of the lower and upper extremities, however, the relationship of the mentioned parameters in terms of the ultimate outcome, i.e. the duration of the shot, as well as the precision of the shot were likewise studied. The research included one examinee who is a member of the Croatian U18 Men's National Team. The study incorporated a precisely determined protocol according to which the following parameters were determined: angles of the knee and hip joint at the moment of receiving the ball, maximum and average angular velocity in the ankle, knee, hip, shoulder, elbow and wrist joint, height at the moment of releasing the ball, duration of the shot, angle at which the ball enters the basket and shooting percentage. The obtained results indicate certain differences in angular velocities of the upper and lower extremities, as well as in the height at the moment of releasing the ball under the influence of progressive fatigue. Kinematic parameters affecting the ball (duration of the shot and the angle at which the ball enters the basket) demonstrated no significant variations, however there was a significant change of the shooting percentage.
Alpine skiers should physically prepare for skiing due to the specific body movements it requires. As balance is essential for the success of competitive alpine skiers, we investigated its importance ...during preparation for alpine skiing in recreational skiers. We included 24 male participants; twelve recreational skiers just after 10 days of alpine skiing, and twelve alpine ski novices. All participants were tested with two balance tests (BAL40 and GYKO). Participants of the two groups did not differ significantly in the results of the BAL40 standard balance test. In contrast, we found significant differences in four out of six variables measured with the GYKO test performed on BOSU trainer during the two-feet stand. Participants specifically differed in the variables overall average body tilt (p=0.02), overall average deviation of body tilt (p=0.00), overall medio-lateral average body tilt (p=0.01), and overall medio-lateral average deviation of body tilt (0.00). Average results were lower for participants of the group of recreational skiers than for participants of the novice alpine ski group, suggesting that balance is important for recreational skiers, either as an acquired trait during skiing, or the result of conditioning training in the preparation period for skiing. According to the results, we would advise recreational skiers as well as people planning to be involved in alpine skiing as a new recreational activity to include balance exercises in the preparation period.
We conducted a longitudinal study to examine changes in the respiratory exchange ratio (RER) during progressively increasing body exertion in children and adolescents of female sex. In this analysis ...we only included 23 examinees for which we had all yearly measurements from examinee's age 9 years until 18 years of age. The data were analyzed according to the chronological and biological age. According to both criteria, the highest RER values were recorded at moments of maximum exertion and they did not increase with age. We found the highest RER values were in the year of the menarche. We interpret these results as related to the effect of estrogen. The beginning of sexual development involves a gradual increase in estrogen plasma concentrations. At one point serum levels of estrogen reach a level high, enough to allow for maximum RER values, i.e. causing the optimum anaerobic capacity of the examinee. This threshold estrogen value varies between individuals.
