The purpose of this investigation was to determine the atherosclerotic changes in patients with vascular parkinsonism and in patients with idiopathic Parkinson's disease, in order to evaluate the ...possible influence of the extracranial pathology of carotid arteries in developing lacunar cerebral infarcts. Degree of stenosis and plaque morphology of the extracranial part of carotids in both group of patients were evaluated by color Doppler flow imaging ultrasound investigation and the results were compared. We selected two matched groups of patients with parkinsonism: 22 patients with vascular parkinsonism, and 28 with idiopathic Parkinson's disease.The atherosclerotic changes found in patients with Parkinson's disease showed mild carotid lesions with mostly stable calcified plaques and lesser risk for embolic cerebral intravascular events contrary to the higher degree of carotid stenosis found in patients with vascular parkinsonism with mostly mixed plaques prone to embolization. Therefore, we suggest performing ultrasonographic examination of the extracranial part of carotid arteries in all patients with parkinsonism to assess risk of vascular accidents originating from carotid lesions. That would enable adequate treatment of parkinsonism and prevent further occurrence of intracranial vascular changes.
Role of zinc in chronic gastritis Marjanović, Ksenija; Dovhanj, Jasna; Kljaić, Ksenija ...
Collegium antropologicum
34, Številka:
2
Journal Article
Recenzirano
Oxidative stress occurs in inflammation of gastric mucosa. The role of zinc in modulating oxidative stress has recently been recognized. Zn deficiency results in an increased sensitivity to oxidative ...stress and have a higher risk of musoca damage in inflammation. The aim of this study was to determine wheather chronic inflammation affects on the concentration of Zn2+ ions in gastric mucosa of patients with chronic gastritis. Forthy-three patients with chronic gastitis were enrolled. Patients were endoscoped. Histology and scoring of gastritis was performed following the guidelines of the updated Sydney system. Endoscopic finding of mucosa were scored according to a Lanza scoring system. The diagnosis of Helicobacter pylori (H. pylori) infection, histopathologic changes, intensity of inflammation and zinc concentration were determined from biopsies of gastric mucosa. The atomic absorption spectrophotometer was used to determine tissue concentrations of zinc. Twenty of 43 patients with chronic gastritis were uninfected by H. pylori. There was no statistically significant difference in tissue concentrations of zinc between H. pylori-positive and H. pylori-negative patients. From those infected patients 53.3% had chronic active gastritis. There was no statistically significant difference in tissue concentrations of zinc between patients with chronic active gastritis and patients with chronic inactive gastritis (p = 0.966). Zn in antrum showed positive correlation with density of H. pylori in antrum (Spearman' rho = 0.481, p = 0.020), negative correlation with density of H. pylori in corpus (Spearman' rho = -0.492, p = 0.017) and with zinc in corpus (Spearman' rho = 0.631, p =0.001). Tissue concentration of zinc was not affected by chronic inflammation of gastric mucosa in patients with chronic gastritis.
Interrupted aortic arch (IAA) is a congenital defect characterized by loss of luminal continuity between the ascending and descending aorta1. It is a rare malformation with an estimated incidence of ...perinatally diagnosed cases of 3 per million live births3. The condition is considered extremely rare in adults. However, its true prevalence in this population is unknown. We have found 30 case reports of IAA in adults in literature, 5 of whom were older than 50 years. Four of them had type A IAA. Arterial hypertension is a typical co-morbidity. In this report we describe a 60-year-old male patient who had a type A asymptomatic IAA. Although we initially suspected the aortic coarctation, further invasive procedures revealed complete interruption of the aortic arch just distal to the origin of the left subclavian artery. The patient underwent surgical repair, followed by full recovery and near-normalization of blood pressure.
A rare case of thoracolumbar spondyloptosis after a severe polytraumatic event is presented. Spondyloptosis accounts for a minor proportion of all spine trauma cases and is usually accompanied by ...complete neurological deficit. A 48-year-old man suffered severe polytrauma after having been hit by a truck at the work place. Radiographic scanning revealed multiple traumatic injuries and spondyloptosis at the L1/L2 level in coronal plane. However, despite extensive injuries, ASIA score was estimated as D. The patient underwent urgent multidisciplinary surgery due to severe head injuries. The next surgery was performed to stabilize the thoracolumbar segment and to preserve neurological functions. The surgery included implantation of transpedicular titanium screws via posterior approach. Good postoperative recovery was achieved during early postoperative rehabilitation at our Department, which was estimated as ASIA score D. In conclusion, prompt operative treatment to achieve neural integrity and early rehabilitation should be considered as the gold standard in such complicated injuries. Postoperative recovery largely depends on the quality of rehabilitation, which leads to improvement of patient self-care and normal social and psychological functions. In our case, the good preoperative neurological status of the patient also contributed to better postoperative outcome. Key words: Craniotomy; Spondyloptosis; Hemorrhage, subarachnoid; Neurological rehabilitation; Blindness Prikazuje se rijedak slucaj torako-lumbalne spondiloptoze nakon teske politraume. Manji udio svih trauma kraljeznice odnosi se na spondiloptoze koje su najcesce popracene potpunim neuroloskim deficitom. Muskarac u dobi od 48 godina na radnom mjestu zadobio je politraumatske ozljede nakon udarca kamiona. Radioloska obrada pokazala je visestruke traumatske ozljede i spondiloptozu segmenta L 1/L 2 u koronarnoj projekciji. Unatoc ovoj opseznoj traumi kraljeznice ozljeda je prema ljestvici ASIA procijenjena kao D. Bolesniku je ucinjen hitni multidisciplinski operacijski zahvat u svrhu zbrinjavanja teskih ozljeda glave. Sljedecoj operaciji pristupljeno je radi stabilizacije torako-lumbalnog segmenta i s ciljem ocuvanja neuroloskih funkcija. Operacija je ucinjena uobicajenim straznjim pristupom te implantacijom transpedikularnih vijaka. Zadovoljavajuci poslijeoperacijski oporavak postignut je tijekom rane poslijeoperacijske rehabilitacije u Klinici, procijenjen kao ASIA D. Izvrstan poslijeoperacijski oporavak potvrden je daljnjom ambulantnom kontrolom bolesnika, uz ucinjene neuroloske testove. Poslijeoperacijska neurorehabilitacija smatra se nuznom za sto bolji oporavak fizioloskih funkcija u ovakvim zivotno ugrozavajucim nesrecama. Kljucne rijeci: Kraniotomija; Spondiloptoza; Subarahnoidno krvarenje; Neuroloska rehabilitacija; Sljepoca
The aim of this study was to compare the efficacy of esomeprazole and pantoprazole with regard to healing and relief from gastroesophageal reflux disease-related symptoms. I this multicentre, ...randomized, single-blind study 180 patients (ITT population) diagnosed with endoscopically proven GERD grade A,B,C received esomeprazole (40 mg once daily (o.d.), n = 90) orpantoprazole (40 mg o.d., n = 90). Healing and relief from GERD-related symptoms were assessed at first and final visit (after 4 or 8 weeks of treatment). Esomeprazole 40 mg provided significantly greater healing than pantoprazole 40 mg after 4 weeks of treatment in patients with EE (77.8% vs. 72.2%). Esomeprazole-treated patients were healed after up to 8 weeks of treatment similar those treated with pantoprazole (92.2% vs. 91.1%). The proportion of heartburn-free days was similar in patients treated with esomeprazole and to those treated with pantoprazole.
Svjetski je trend da se na specijalizaciju iz opće kirurgije prijavljuje sve manji broj kvalitetnih mladih liječnika. Problem regrutacije kirurga predstavlja i opasnost za budućnost kirurgije pa je ...potrebno problem na vrijeme prepoznati i adekvatno odgovoriti, pronaći načine kako bi se održao priljev mladih kirurga. Zato je važno znati stoje motiviralo sadašnje kirurge za odabir svoje specijalizacije, što potencijalni kandidati za kirurgiju očekuju od svoje odluke i što uopće motivira mlade ljude kada se odlučuju koju će specijalizaciju izabrati. Sukladno tim spoznajama potrebno je učiniti promjene kako bi proces edukacije na kirurgiji bio prihvatljiv očekivanjima specijalizanata kirurgije.
The aim of our study is to evaluate the importance of prognostic factors, both tumor-related and therapy related, and their impact on local recurrence rate of rectal carcinoma. It is also important ...to evaluate impact of chemoradiotherapy (CRT) on local recurrence rate and survival. We used the data of 514 patients with rectal carcinoma treated at Clinic of surgery at University Hospital Centre in Osijek, during the period from 2000 to 2007. Routine follow-up was carried out until March of 2012 or death. Median life expectancy for all patients who underwent surgery was 98 months. 47% of patients with resection without residual tumor (R0) did not develop local recurrence after median of observation of 90 months. 5-year survival rate for patients with R0 resection was 76.4%. The patients who had preoperative serum levels of carcinoembryonic antigen (CEA) within the normal range (< 5 microg/mL) had a significantly better prognosis with 5-year survival of 75.8%, than patients with elevated levels who had 5-year survival of 46.5%. Tumor stage had great influence on survival and was defined by UICC TNM (International Union against Cancer, Tumor Node Metastases) classification, 7th edition. 5-year survival rate was (93.5% for stage I, 87.4% for stage II, 58.2% for stage III, 8.1% for stage IV). Patients with low grade differentiation tumors had 5-year survival rate of 73.5%, and those with high-grade had 38.2%. We have found that preoperative CRT significantly reduces the rate of local recurrence (5.3% vs. 14.1%), but patients who were treated with preoperative CRT did not appear to benefit significantly in terms of their long-term prognosis, because there was no difference in overall survival between the patients who received preoperative radiochemotherapy and those who did not receive it (66.2% vs. 67.8%). It was found that the R-classification, anatomical extent of tumor described by the TNM classification of the UICC, tumor grade, and preoperative CEA serum level were prognostic factors that influenced survival.
Cilj: Cilj rada je ispitati kvalitetu života žena nakon mastektomije i nakon kvadrantektomije, te ispitati razliku u kvaliteti života žena nakon mastektomije u odnosu na kvalitetu života nakon ...kvadrantektomije.
Ispitanici i metode: Prospektivno kohortno istraživanje u kojem su sudjelovale 204 sudionica: 101 sudionica je bila u grupi nakon mastektomije, a 103 sudionice nakon kvadrantektomije. Korištena je anonimna anketa primjenom hrvatske inačice upitnika Europske organizacije za istraživanje i liječenje raka EORTC QLQ-C 30 (version 3), upitnika s modulom raka dojke EORTC QLQ – BR 23.
Rezultati: Na ljestvici EORTC QLQ C 30, mjesec dana nakon operacije, sudionice nakon kvadrantektomije značajno su bolje ocijenile svoj opći zdravstveni status (p = 0,007). Poremećaj spavanja imaju značajno više sudionice s mastektomijom (p = 0,03). Ljestvicom QLQ-BR23 mjesec dana od operacije, sudionice s mastektomijom značajno su lošije ocijenile seksualno funkcioniranje (p < 0,001) i užitak u seksu (p < 0,001), dok su im značajnije izražene nuspojave uz sistemske terapije (p = 0,04). Godinu dana nakon operacije, još uvijek je značajno lošije seksualno funkcioniranje (p < 0,001) i užitak u seksu (p = 0,04) kod sudionica nakon mastektomije. Ukupna skala funkcionalnosti je značajno niža za sudionice s mastektomijom (p = 0,03)
Zaključak: Kvaliteta života žena nakon kvadrantektomije bolja je u odnosu na kvalitetu života nakon mastektomije. Žene kojima je učinjena kvadrantektomija bolje su ocijenile svoj opći zdravstveni status u odnosu na žene kojima je učinjena mastektomija. Seksualno funkcioniranje bolje je u žena s kvadratektomijom.
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