Genital tuberculosis is a rare and unexpected disease in European countries including Croatia. Diagnosis of female genital tract tuberculosis is challenging and is rarely pin-pointed by clinical ...symptoms because of their low specificity. The authors decided to present a case of genitourinary tuberculosis in a young, immunocompetent fertile woman with high clinical suspicion of abdominal tumor mass. Although considered a desease of the past, rare clinical presentation of genital tuberculosis should be expected and taken into account. Key words: Tuberculosis; Genitourinary tract; Young women; Abdominal tumor
Primary Sjögren's syndrome (pSS) patients have higher prevalence of endothelial dysfunction and premature atherosclerosis. Recent studies investigated adropin, a secretory protein that can regulate ...lipid metabolism and insulin resistance and protect endothelial cells' function and that has an anti-inflammatory effect. The aim of this study was to determine adropin levels in pSS patients compared to healthy controls. Additional goals were exploring the correlation between adropin and several metabolic and immunological parameters in pSS, including disease specific antibodies, EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI), and Sjögren's Syndrome Disease Damage Index (SSDDI). This research included 52 pSS patients and 52 healthy controls. pSS patients have significantly higher adropin levels compared to the control group (3.76 ± 0.68 vs. 3.14 ± 0.69 ng/mL,
< 0.001). Correlation analysis showed that adropin levels in pSS patients have positive correlation with high-density lipoprotein (HDL) (r = 0.290,
= 0.036) and anti SSA/Ro52 antibodies (r = 0.307,
= 0.026) and negative correlation with SSDDI (r = -0.401,
= 0.003). Multivariant linear regression showed that adropin levels are independently associated with HDL (β ± SE, 0.903 ± 0.283,
= 0.002) and SSDDI (β ± SE, -0.202 ± 0.073,
= 0.008). Our findings imply that adropin could be involved in the pathophysiology of pSS, yet it remains to be elucidated in future studies whether adropin has a protective or detrimental role in this setting.
Summary
Background
Whiplash injury of the cervical spine is the most common injury after a car accident and in 25% of patients it progresses into chronic neck pain.
Aim of the study
To investigate ...the difference in neck muscle stiffness using shear wave ultrasound elastography between subjects who suffered an uncomplicated whiplash injury and a control group. Possible recognition of patients who insist on physical therapy in order to support their false whiplash injury claims.
Methods
This study included 75 whiplash injury patients and 75 control subjects. Trapezius, splenius capitis and sternocleidomastoid muscles were examined by ultrasound shear wave elastography.
Results
Increased muscle stiffness was noticed in trapezius muscle bilaterally in the whiplash group when compared to the control group (
p
< 0.001; right 57.47 ± 13.82 kPa vs. 87.84 ± 23.23 kPa; left 54.4 ± 12.68 kPa vs. 87.21 ± 26.47 kPa). Muscle stiffness in splenius capitis and sternocleidomastoid muscles was not suitable for analysis because of asymmetrical data distribution. Patients with less than 76 kPa of muscle stiffness in trapezius muscle are unlikely to belong in whiplash injury group (sensitivity 90% for right and 97% for left trapezius muscle, specificity 72% and 73%, respectively).
Conclusion
Patients measuring below 76 kPa of muscle stiffness in the trapezius muscle might have no whiplash injury. Further follow-up of the patients measuring higher than cut-off value might be beneficial for detecting patients with prolonged neck muscle spasm that can lead to chronic cervical pain syndrome.
A prospective observational study comparing shear wave elastography (SWE) of trapezius muscle with Neck Disability Index (NDI) in a prediction model of health status six months after a whiplash ...injury. Both SWE values, measured by two radiologists, and NDI scores were obtained at baseline and after physical therapy (PT) (6-month period). Those values were compared with a 3-point Likert scale (no, partial or full recovery). Twenty-two subjects completed the study. A decrease in trapezius stiffness was detected by both radiologists, statistically significant for one (Δ10.1 kPa; p = 0.04) but not for the second radiologist (Δ8.63 kPa; p = 0.07). The measurements showed excellent intra-observer (ICC 0.75–0.94) and inter-observer (ICC 0.78–0.88) reliability. After six months, fully recovered patients showed lower NDI scores than partially recovered patients (Δ22.98; p < 0.001). SWE values did not differ with the recovery status (55.6 ± 9.7 vs. 57 ± 15.8, Δ1.45; p = 0.82). The single most accurate variable in classifying health status six months after whiplash injury was the relative change of NDI, and it showed the highest accuracy (73.9%) and low Akaike information criterion (AIC = 39.2). Overall, the most accurate classification was obtained when combining NDI and SWE after physical therapy with an accuracy of 77.3% and a decrease in AIC (32.8).
Thyroid-associated orbitopathy (TAO) is a common manifestation of Graves' disease. The aim of the study was to assess the six percent of patients with TAO that develop dysthyroid optic neuropathy ...(DON), which is the most serious complication of TAO. As DON can cause perma-nent damage, it is essential to detect DON early when visual loss is still reversible. Color Doppler ultrasound is a noninvasive diagnostic method, which may be useful in early detection of DON. Thirty-six patients with confirmed Graves' disease and active TAO were included, 21 (58%) of them with early DON (eDON) and 15 (42%) free from any signs of eDON. All study patients underwent Doppler ultrasound examination to determine the blood flow rates in the internal carotid artery, ophthalmic artery, and central retinal artery. Study results showed color Doppler ultrasound examination to have a potential to detect orbital blood flow changes in patients with eDON. Early detection of DON may result in earlier treatment and prevention of permanent optic nerve damage.
The region of the Middle East has been for centuries space of interweaving of interests of power holders, both within the countries of the region and major world powers. The favorable geographical ...position and significant reserves of natural resources, principally oil, make the Middle East, in terms of security, very sensitive. Clash of civilizations and religions in the region and the locations of the most important holy places for both Christianity and Islam was historically a stumbling rock and a great obstacle to peace and prosperity. The aim of this article is to point out and to attempt to answer the question of how Islamic State can influence on global security. Considering the complexity of the security reality in the Middle East, it can be said that the importance is reflected in the fact that it provides a contribution to its knowing the aspect that arises from the problem issues.
The region of the Middle East has been for centuries space of interweaving of interests of power holders, both within the countries of the region and major world powers. The favorable geographical ...position and significant reserves of natural resources, principally oil, make the Middle East, in terms of security, very sensitive. Clash of civilizations and religions in the region and the locations of the most important holy places for both Christianity and Islam was historically a stumbling rock and a great obstacle to peace and prosperity. The aim of this article is to point out and to attempt to answer the question of how Islamic State can influence on global security. Considering the complexity of the security reality in the Middle East, it can be said that the importance is reflected in the fact that it provides a contribution to its knowing the aspect that arises from the problem issues.
The primary objective of this study is to investigate the maintenance difference in basic anthropometric characteristics and to outline the dynamics of respiratory function change in youngsters ...athletes exposed to passive smoking (PS) and athletes not exposed to passive smoking in their families (NPS). High and weight were determined as basis anthropometric characteristics. Measured parameters for respiratory function were vital capacity (VC), forced expiratory volume in the first second (FEV1), maximum expiratory flow (PEF), forced expiratory flow at 50% forced vital capacity (MEF 50) and forced expiratory flow at 25% forced vital capacity (MEF 25). Significant statistical differences in separate spirometric variable were found in three variables (FEV1, MEF50, and MEF25) for group older youngsters. Analysis of variance showed statistical differences between athletes unexposed to passive smoking (NPS) and athletes exposed to passive smoking (PS) in even four spirometric variables (VC, FEV1, MEF50 and MEF25).
As a rule, asbestosis is a disease of workers who are occupationally exposed to inhalation of asbestos dust, leaving permanent alterations on the lung parenchyma or pleura. In our ten-year study, we ...investigated 318 workers with pleural asbestosis from whom we took medical history which included occupational exposure to asbestos, radiological examinations and lung function, which is mandatory for the diagnosis and the follow up of the disease. We analysed functional parameters such as forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) and intermediate forced expiratory flow at 25% to 75% (FEF25%-75%). In addition, we investigated the predicted values of functional parameters according to smoking and non-smoking habits. We found a significant reduction in vital capacity, particularly in smokers after 25 years of exposure to asbestos. During the first 15 years, values of vital capacity on the group basis remained inside the 80% of the normal values and were not significant for assessing the dynamics of the lung function. To better assess the effects of occupational asbestos exposure, it is necessary to interpret lung function data not only on the group basis, but also for each subject individually.
Azbestoza je bolest izazvana udisanjem azbestnih čestica koje ostavljaju trajne promjene na parenhimu pluća i/ili pleuri. Dijagnoza se postavlja na osnovi anamnestičkih podataka, uvidom u profesionalnu izloženost azbestu i radiološkom obradom te patohistološkom potvrdom promjena na plućima i/ili pleuri. Funkcionalna obrada pluća obavezna je u postavljanju dijagnoze i praćenju bolesti. Tijekom desetogodišnjeg istraživanja funkcionalno smo obradili 318 osoba profesionalno izloženih azbestu s dokazanom azbestozom pleure. Analizirane su vrijednosti funkcionalnih parametara, i to forsiranoga vitalnog kapaciteta (FVC), forsiranoga ekspiracijskog volumena u prvoj sekundi (FEV1) i srednjega ekspiracijskog protoka (FEF25%--75%)). Dokazan je statistički signifikantan pad vrijednosti FVC i FEV1. Dodatno smo istražili vrijednosti funkcionalnih parametara kod naših ispitanika s navikom pušenja i nepušača. U obje skupine prisutno je značajno sniženje vrijednosti vitalnog kapaciteta tijekom istraživanja, s tim da nakon 25 godina izloženosti azbestu kod pušača dolazi do naglog pada vrijednosti vitalnog kapaciteta u odnosu na nepušače. Bitno je uočiti da tijekom prvih 15 godina vrijednosti vitalnog kapaciteta ostaju unutar 80% normalnih vrijednosti te nemaju značenja za praćenje dinamike funkcije pluća kod azbestne bolesti. Individualnim praćenjem profesionalno izloženih radnika ostvaruje se bolji uvid u dinamiku funkcije pluća kod azbestne bolesti.
The aim of this study is to evaluate connection of plasma level of beta2-microglobulin, C-reactive protein and uric acid as well as sonographic parameters like thickness of synovial membrane, ...thickness of femoral condylar cartilage and presence of joint effusion and Baker's cysts with bilateral knee pain in dialyzed patients, comparing them with parameters in asymptomatic dialyzed patients. Plasma levels of beta2-microglobulin and C-reactive protein were significantly higher in symptomatic patients while uric acid level showed no difference among the groups. In symptomatic patients synovial membrane was thicker and in those patients there were more knee effusions and Baker's cysts. Thickness of femoral condylar cartilage showed no difference between groups. That suggests that inflammatory mechanisms developing from beta2-microglobulin accumulation could be important factor in bilateral knee pain in dialyzed patients even in shorter duration dialysis.
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