: Increased osteopontin (OPN) concentrations in the plasma of patients with head and neck squamous cancer (HNSCC) have diagnostic significance, and it can indicate more aggressive biological behavior ...of cancer. The aim of this study was to determine OPN levels in patients with HNSCC of different primary locations and to assess its prognostic significance in metastasis development.
: This cohort study included 45 patients (41 male and 4 female patients) with HNSCC with different primary localization of head and neck. All patients underwent surgery-neck dissection. All patients were categorized according to the histological findings of the resected material and tumor-node-metastasis (TNM) classification system. After surgery, N categories were determined on the basis of histological features of resected material.
: The histological findings of our patients showed: N0 in 11 patients, N1 in 8 patients, N2a in 4 patients, N2b in 14 patients and N2c in 8 patients. Plasma OPN values in all study participants ranged from 2.24 to 109.10 ng/mL. OPN levels in plasma of patients with negative nodes compared to the group of patients with positive nodes in the neck differed significantly (16.89 ng/mL to 34.08 ng/mL, respectively;
= 0.03). There were significantly lower OPN plasma levels in the group of subjects with histologically positive one lymph node in the neck (N1) compared to the group of patients with N2b histologically positive findings of resected neck material (10.4 ng/mL to 43.9 ng/mL, respectively;
= 0.02).
: The results have shown that growing N degrees of positive neck nodes classification were accompanied by growing values of plasma osteopontin. Osteopontin might be important for the development of neck metastases.
An overview of the negative effects of the COVID-19 pandemic on the mariculture industry of the republic of Croatia is provided. An initial online survey was circulated early after the onset of the ...pandemic and a follow-up field survey was performed a year into the pandemic. The surveyed companies varied in size (micro to medium enterprises), location (north, central and southern coast) and cultured organism (European flat oyster, Mediterranean mussel, European sea bass, Gilthead sea bream and/or Bluefin tuna) and were asked questions on the subject of economic and job losses, aquaculture supply chain processes and implemented or proposed measures for mitigation of negative effects. Results from the online survey showed higher economic loss than job loss, but companies reported increased job loss in the period leading to the field survey. Most companies reported reductions in sales and avenues of procurement, which, in addition to direct stressors, indirectly affected business processes. Micro enterprises fared well due to their part-time nature, low capital investments and running costs, while small to medium enterprises were under the most pressure. Large enterprises were barely affected as they had secure local and/or international distribution chains and dominated the market. Producers most affected were those that relied on the HoReCa market for product placement and/or had difficulty coping with existing stressors. Bivalve producers generally experienced a higher drop in sales than finfish farms and companies with specialized production were not able to adapt to market changes to the degree that more versatile businesses seemed capable of.
•Overview of COVID-19 effects on finfish and bivalve aquaculture in Croatia.•Two surveys performed on production/sales, employment, supply chain and mitigation.•Farm types (size, species and market) affected most and least by the pandemic.
This study aimed to investigate the changes in internal training intensity, well-being, and countermovement jump (CMJ) performance and to determine their relationship across five weeks of the ...pre-season training phase in professional soccer players. A total of 22 professional male soccer players (age = 21.7 ± 4 years, body height = 185.9 ± 6.3 cm, body weight = 79 ± 6.3 kg, BMI = 22.8 ± 1.4 kg·m−2; VO2max = 52.9 ± 3.2) from the Croatian Second League voluntary participated in this study. The players spent 2230 ± 117 min in 32 technical/tactical and strength/conditioning training sessions, mostly at the low intensity zone (61%), and played 8 friendly matches at a high intensity (>90%). A one-way repeated measure of analysis ANOVA revealed a significant difference between weeks in CMJ performance (F(1,22) = 11.8, p < 0.001), with CMJ height in weeks 4 and 5 being likely to very likely higher than that noted in week 1. Moreover, significant differences between weeks were found in all internal training intensity measures (average F(1,22) = 74.8, p < 0.001 and accumulated weekly internal training intensity F(1,22) = 55.4, p < 0.001, training monotony F(1,22) = 23.9, p < 0.001, and training strain F(1,22) = 34.5, p < 0.001). Likewise, differences were observed for wellness status categories (fatigue F(1,22) = 4.3, p = 0.003, sleep F(1,22) = 7.1, p < 0.001, DOMS F(1,22) = 5.7, p < 0.001, stress F(1,22) = 15.6, p < 0.001), mood F(1,22) = 12.7, p < 0.001, and overall well-being status score (F(1,22) = 13.2, p < 0.001). Correlation analysis showed large negative correlations between average weekly internal training intensity and fatigue (r = −0.63, p = 0.002), DOMS (r = −0.61, p = 0.003), and WBI (r = −0.53, p = 0.011). Additionally, fatigue was significantly associated (large negative correlation) with accumulated weekly internal training intensity (r = −0.51, p = 0.014) and training strain (r = −0.61, p = 0.003). Small, but non-significant, correlations were found between CMJ performance and wellness status measures. These findings highlight the utility and simplicity of monitoring tools to improve athletes’ performance.
This report aimed to investigate the relationship after successful left-sided stapedotomy and postoperative benign paroxysmal positional vertigo (BPPV) due to vitamin D deficiency. A 56-year-old ...woman presented with a complaint of progressive hearing loss and tinnitus in the left ear without dizziness. A successful left-sided stapedotomy was performed, confirming the diagnosis of otosclerosis and closing the air-bone gap to less than 10 dB. Seven days after the stapedotomy, the patient reported dizziness, usually when turning to her left side in the bed. An electrophysiological assessment was performed to investigate vestibular function. Dix Hallpike maneuver showed a typical response, about 5 seconds after repositioning the head, and geotropic, torsional rotary nystagmus of about 30 seconds was registered. Vitamin D deficiency in serum was found. Complete symptom remission was achieved after 7-day-treatment with Epley's maneuver. As a postoperative vertigo complication, BPPV often remains unrecognized after stapes surgery. Canalith repositioning maneuver is treatment for BPPV. Determining serum levels of total calcium and vitamin D may play a significant role in monitoring and reducing the recurrence of dizziness.
Telemedicine is a term that covers all procedures supported by communication technology, which has the purpose of providing health services at a specific spatial distance. This is an area that is ...developing rapidly and has found particular application in otorhinolaryngology, given that a large number of surgeries are performed with the help of endoscopes and microscopes. Telemedicine also represents a significant advantage during the coronavirus pandemic, both in terms of treating patients and monitoring them more effectively. For the purpose of preparing this article, research published on Scopus, PubMed, Google Scholar, and Google was reviewed using the keywords “telemedicine” and “otorhinolaryngology”. This review article provides a summary and the latest insights in this broad and fast-growing area. The development of telemedicine in Croatia as well as a special review of the application of telemedicine during the coronavirus pandemic is also presented in this article.
Open Approach Rhinoplasty Bogović, Vjeran; Milanković, Stjepan Grga; Zubčić, Željko ...
Southeastern European Medical Journal,
12/2019, Letnik:
3, Številka:
2
Journal Article
Recenzirano
Odprti dostop
The aim of this study was to present the advantages and disadvantages of open approach in rhinoplasty. In it, we also present the development of this technique in Croatia and examine its application ...in the last five years at the Department of Otorhinolaryngology and Head and Neck Surgery of the Clinical Hospital Centre Osijek.
Retrospectively, from January 2008 to August 2012, 400 patients with septal deviation and/or deformities of the nasal pyramid who underwent open rhinoplasty at the Department of Otorhinolaryngology, Head and Neck Surgery of the Clinical Hospital Centre of Osijek, Croatia were identified. The clinical diagnosis was based on a detailed medical history of the patient and nasal endoscopy. The patients were photographed in six projections before and after the surgery, and followed up on two occasions.
(Bogović V, Milanković SG, Zubčić Ž, Včeva A, Mihalj M, Maleš J, Kotromanović Ž, Grebenar M, Mendeš T, Mihalj H. Open Approach in Rhinoplasty. SEEMEDJ 2019; 3(2); 56-62)
Previous studies suggest the effectiveness of hyperbaric oxygen treatment (HBOT) in idiopathic sudden sensorineural hearing loss (ISSNHL) but it is mostly used as an adjuvant and salvage treatment. ...This study evaluated the effect of primary HBOT according to pretreatment hearing grades and hearing recovery outcomes using modified Siegel's criteria in patients with ISSNHL.
Fifty-nine ISSNHL patients treated with only HBOT were included. A pure-tone audiogram was recorded before and after a course of HBOT (90 min at 203 kPa daily for 20 days). Using the modified Siegel's criteria, patients were divided into groups according to hearing threshold before and after treatment.
Hearing thresholds were significantly lower after HBOT compared to pre-treatment values across all patients (P < 0.001) with a median value of recovery of 22.5 dB (interquartile range 12.5-33.7 dB). Significantly lower hearing threshold values were recorded at 500, 1,000, 2,000, and 4,000 Hz after treatment (P < 0.001). The greatest recovery was at 1,000 Hz, (change in median threshold = 32 dB) but without a significant difference compared to other frequencies (P = 0.10).
HBOT is a legitimate choice as the primary treatment for ISSNHL, especially if it is readily accessible, and if there are contraindications for corticosteroid therapy.
The Institute of Public Health of the Osijek-Baranja County in collaborate with different county institutes provide updated information on the cancer occurrence and trends in the Osijek-Baranja ...County (OBC). The cancers were defined according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), codes of malignant neoplasms of respiratory and intrathoracic organs (C30-C39). The aim of this article was to show the size of cancer problem with the C30-C39 cancer group in the Osijek-Baranja County (OBC). This article processes data on cancer incidence and mortality, appertaining age distribution, median age, cancer survival and length of stay in hospital collected in period 2001-2009. Out of all patients diagnosed with C30-C39 cancers, there were 18.2% of females and 81.8% of males. The total incidence rate in males (119.5/100,000) decreases while the total mortality rate (110.9/100,000) does not change in 9-year period. In the same period, the total mortality rate in females (15.7/100,000) increase moderately. The age-standardized incidence rate was six times higher in males than in females. The overall median age at diagnosis of C30-C39 cancers of both genders was 64.5 years, which exceeds the average age at diagnosis of cancer in general in the OBC by 4.8 years. Five-year relative survival rate was 14.8%, 19.7% for females and 13.7% for males. Male lung and bronchus cancer patients (C34) were 1 year younger at diagnosis of cancer than the respective female patients. An average C30-C39 cancer patient was hospitalized 2.0 times during the course of their illness while the median length of stay in hospital amounted to 16.1 days. The number of hospital admissions in both genders decreased over the 2001-2009 period. In both genders, the total length of stay in hospitals was slightly reduced. Females spent 0.4 days more in hospital than males. The overall incidence and mortality rate in the OBC were among the highest in Europe. However, these rates in females reached neither the Croatian nor the EU average. Other data are similar to those in Europe.
In the last fifty years, an epidemic of reflux disease has occurred as a result of poor eating habits, stress, and activities of the food industry. Part of this disease is laryngopharyngeal reflux, a ...disease characterized by the return of gastric contents to the throat and surrounding organs, leading to hoarseness, coughing, difficulty in swallowing and breathing, and ultimately the development of benign and malignant changes in the larynx. This study is aimed to examine the symptoms and signs of laryngopharyngeal reflux in the study group before and after therapy and to compare the concentration of pepsin in saliva with the above. The prospective longitudinal cohort study included 50 subjects, divided into two groups. The first group consisted of 25 subjects with laryngopharyngeal reflux. The second group consisted of 25 healthy subjects without symptoms and signs of laryngopharyngeal reflux. Symptoms and signs before and after therapy were collected using RSI and RFS questionnaires. Pepsin in saliva was measured with Peptest before and after therapy. The most pronounced symptoms are hoarseness, postnasal drip, and a feeling of "a lump in the throat". The median RSI score after three months of therapy was reduced from 20 to 8. From the first group, 7 subjects had measurable levels of pepsin in saliva, and none after therapy. In the control group, no subjects were found to have pepsin in their saliva. Significant improvement was observed in clinical findings (subglottic edema, posterior commissure hypertrophy, vocal cord edema, dense endolaryngeal secretion) after three months of therapy in subjects with LPR. No association of pepsin with LPR symptoms was observed but there is a significant positive association between pepsin and the clinical finding of erythema/hyperemia. In most cases, we start therapy with medication. It is, therefore, important to emphasize that laryngopharyngeal reflux treatment must always begin with a change in diet, lifestyle, and stress regulation. Treatment must be individual and should include a multidisciplinary team with a nutritionist, psychologist, and psychiatrist.
U posljednjih pedesetak godina javlja se epidemija refluksne bolesti kao posljedica loših prehrambenih navika, stresa i aktivnosti prehrambene industrije. Dio ove bolesti je i laringofaringealni refluks (LPR), bolest koju karakterizira vraćanje želučanog sadržaja u grlo i okolne organe, što dovodi do promuklosti, kašlja, otežanog gutanja i disanja, te u konačnici razvoja dobroćudnih i malignih promjena na grkljanu. Cilj ove studije je ispitati simptome i znakove laringofaringealnog refluksa u ispitivanoj skupini prije i nakon terapije, te usporediti koncentraciju pepsina u slini s navedenim. U prospektivno longitudinalno kohortno istraživanje uključeno je 50 ispitanika, podijeljenih u dvije skupine. Prvu skupinu činili su ispitanici s laringofaringealnim refluksom, njih 25. Drugu skupinu činili su zdravi ispitanici bez simptoma i znakova laringofaringealnog refluksa, njih 25. Simptomi i znakovi prije i nakon terapije prikupljeni su pomoću RSI i RFS upitnika. Pepsin u slini je izmjeren pomoću Peptesta prije i nakon terapije. Prema spolu, 29 (58 %) je žena i 21 (42 %) muškarac. Od simptoma, najizraženiji su promuklost, postnazalno slijevanje i osjećaj ''knedle u grlu''. Medijan RSI rezultata nakon tromjesečne terapije snižen je s 20 na 8. Iz prve skupine 7 ispitanika je imalo mjerljivu razinu pepsina u slini, a niti jedan nakon provedene terapije. U kontrolnoj skupini nijednom ispitaniku nije detektiran pepsin u slini. Uočeno je značajno poboljšanje u kliničkim nalazima (subglotički edem, hipertrofija stražnje komisure, edem glasnica, gusti endolaringealni sekret) nakon tromjesečne terapije kod ispitanika s LPR. Nije uočena povezanost pepsina sa simptomima LPR-a, ali postoji značajna pozitivna povezanost između pepsina i kliničkog nalaza eritema / hiperemije. U većini slučajeva LPR terapiju započinjemo lijekovima. Stoga je bitno naglasiti da liječenje LPR uvijek mora započeti promjenom prehrane, načina života i regulacije stresa. Liječenje LPR-a mora biti individualno i treba uključivati multidisciplinarni tim s nutricionistom, psihologom i psihijatrom.
SAŽETAK
U posljednjih pedeset godina globalizacija i urbanizacija značajno su promijenile način i stil života, a s njim i način i stil prehrane. Živimo užurbanim stilom života, svakodnevno smo ...izloženi brojnim stresnim situacijama, konzumiramo gotovu, brzo pripremljenu hranu, gazirana i alkoholna pića, a navedeno prati i prehrambena industrija koja, da bi produžila vijek trajanja namirnica, svu hranu dodatno zakiseljava. Kao posljedica loših prehrambenih navika, konzumiranja hrane kada bismo se trebali odmarati, stresa, ali i djelovanja prehrambene industrije došlo je do epidemije refluksne bolesti. Dio te bolesti jest i laringofaringealni refluks, bolest karakterizirana vraćanjem želučanog sadržaja u grkljan, ždrijelo i okolne organe, što dovodi do promuklosti, kašlja, otežanog gutanja i disanja te u konačnici nastanka dobroćudnih i/ili zloćudnih promjena grkljana. U većine oboljelih ključnu ulogu u nastanku promjena u grkljanu i drugim organima ima pepsin, a kiseli medij mu služi za održavanje proteolitičke aktivnosti. Osim pepsina, soli žučnih kiselina i drugi gastroduodenalni proteini mogu imati ulogu u nastanku upalnih promjena sluznice gornjega aerodigestivnog trakta. Terapiju laringofaringealnog refluksa u većini slučajeva započinjemo medikamentoznim liječenjem, što je krivo i neučinkovito. Stoga je važno naglasiti da liječenje laringofaringealnog refluksa uvijek mora započeti promjenom načina prehrane i promjenom stila života te reguliranjem stresa. Liječenje mora biti individualno i u liječenju ove bolesti mora sudjelovati multidisciplinarni tim u koji moraju biti uključeni nutricionist, psiholog i psihijatar.
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