Aim To investigate possible differences in serum glucose and sodium and potassium concentrations with respect to age, gender and severity of diabetic ketoacidosis. Methods Medical records from 1 ...January 2017 to 31 December 2019 were reviewed and patients with the diagnosis of diabetic ketoacidosis were selected. Results The study included 52 patients. Glucose concentration was significantly higher in the age group of 25-44 and >65 years compared to the group of 18-24 years (p=0.02). Sodium concentration was significantly higher in the age group 18-24 and >65 years compared to groups 25-44 and 45-65 years (p=0.002). Females had significantly higher sodium concentration than males (p=0.002). Potassium concentration was significantly higher in the age group 25-44 years compared to other groups (p=0.01). Males had significantly higher potassium concentration (p =0.01). Conclusion This study showed that significant differences exist in electrolyte concentration between specific age groups, male and female gender as well as DKA severity. Knowing these differences could help clinicians to promptly recognize and treat electrolyte derangements, leading to better outcome of patients with DKA.
Pheochromocytoma is a rare cause of hypertension in pregnancy. Unrecognized, it carries a great risk for both mother and the foetus. The main reason for missing the diagnosis is the misconception ...that any hypertension occurring in pregnancy is gestational hypertension or pre (eclampsia). As many as 90% of patients report one or more pheochromocytoma-related symptoms antenatally, but the diagnosis is made in 75% of patients, meaning that 3 out of 10 patients are diagnosed after childbirth or post-mortem. The symptoms are similar to other more common causes of hypertension in pregnancy, which presents a major diagnostic challenge. The diagnosis is based on determination of metanephrines in plasma or 24-hour urine. Magnetic resonance imaging (MRI) and ultrasound (US) are used to localize the tumour. If the diagnosis is made before the 24th week of pregnancy, laparoscopic removal of the tumour in the second trimester is recommended. If diagnosed later, the tumour could be removed during or after delivery. Preoperative preparation with alpha blockers is required to stabilize blood pressure. The decision on the mode of delivery depends on several factors, so an experienced multidisciplinary team is needed to minimize maternal and foetal mortality.
Aim.
Comorbidities pose a major challenge for 21st century medicine. The mutual pathophysiological effect of one disease on another can significantly affect their course and prognosis. The aims of ...this study were to examine the frequency of comorbidities and the most common psychiatric and somatic comorbidities and to determine the difference in the incidence of certain diseases by gender and age.
Methods.
Data were recorded in several groups: demographic characteristics, psychiatric and somatic diagnoses classified according to gender, age, and the legally determined ability to work, and correlations of somatic and psychiatric diagnoses.
Results.
The most common psychiatric diagnoses in men were post-traumatic stress disorder (PTSD) (25%) and alcoholism (23%), while in women these were recurrent depressive disorder (19%) and psychosis (10%). A statistically significant difference was found in the incidence of alcoholism and PTSD, which are more common in men than in women. The most common somatic diseases in both sexes were arterial hypertension (M = 33%, F = 46%) and diabetes mellitus (M = 18%, F = 32%). Statistically significant differences were found in the frequency of hypertension (p = 0.03) and epilepsy (p = 0.002), which are more common in men. The ratio alcoholism-hypertension (p = 0.03), alcoholism-diabetes (p < 0.0001), alcoholism-COPD (p < 0.001) was statistically significant.
Conclusion.
It is extremely important to improve the multidisciplinary approach and cooperation in treatment in order to reduce the number of hospitalizations, emergency interventions and suicides and to improve the patients’ quality of life and life expectancy.
The aim of the study was to determine the most common precipitating factors and symptoms of diabetic ketoacidosis and the possible difference according to age, gender and severity of diabetic ...ketoacidosis. Medical records from January 1, 2017 until December 31, 2019 were reviewed and patients diagnosed with diabetic ketoacidosis were selected. The study included 52 patients, median age 34 (interquartile range 21-56) years. There was no statistically significant difference between male and female gender. The severity of diabetic ketoacidosis was moderate in the majority of cases (65.4%; p=0.005). The most common precipitating factor was infection (61.7%). In patients with moderate diabetic ketoacidosis, respiratory infections were more common, while gastrointestinal infections were more common in severe diabetic ketoacidosis (33% and 25%, respectively; p=0.03). Nausea (median age 32 years; p=0.004) and vomiting (median age 31 years; p=0.01) were more common in younger age groups, while altered mental status was more common in the older age group (median age 61 years; p=0.001). Infection was the most common precipitating factor. The most common symptoms in younger age groups were nausea and vomiting, and altered mental status in the older age group.
The main aim of this study was to examine the association of glucose and sodium level with diagnosis and disease outcome of critically ill patients. Glucose and sodium concentrations of 283 patients ...admitted in critical condition to the Intensive Care Unit of the Department of Internal Medicine in a period from November 1, 2015 to February 28, 2017 were reviewed. The most common diagnoses in critically ill patients were acute kidney injury (26.1%) and sepsis (including septic shock, 22.3%). Significantly lower glucose concentration was observed in patients with acute kidney injury (p=0.02), whereas patients in sepsis and septic shock had a significantly higher sodium concentration (p=0.04). Higher glucose level was related to higher mortality rate (p=0.001). On the other hand, sodium level was not significantly associated with survival. Higher mortality, as well as higher glucose concentration were more common in patients older than 65 years (p<0.001). Study results showed significantly lower glucose concentrations in patients with acute kidney injury, whereas in patients older than 65, glucose concentration was significantly higher. Patients in sepsis and septic shock had significantly higher sodium concentrations. Higher concentration of glucose was connected with higher mortality in the elderly, whereas sodium concentration did not show connection with mortality.
Aim:
This study aimed to evaluate serum levels of 25-OH D3 (calcidiol) among students of the Faculty of Medicine Osijek, Croatia, thereby determining to what extent vitamin D deficiency is present.
...Methods:
The present cross-sectional analysis was based on data collected from 60 participants. Blood sampling was done in March 2021. Concentrations of 25-OH D3 were measured using LC/MSMS procedure on Shimadzu LCMS 8050 and RECIPE kit for serum levels of 25-OH-D3.
Results:
The study was conducted on a sample of 60 respondents aged 19 to 28, of whom 16 were men and 44 were women. All subjects had a 25-OH D3 deficiency (<20 ng/ml), while 11 had an extreme deficiency. Mean 25-OH D3 concentration was 11.36 ng/ml, ranging from 7.70 ng/ml to 16.70 ng/ml. There was no statistical significance of 25-OH D3 concentration levels between the sexes (Student’s t-test, P>0.05).
Conclusion:
Vitamin D deficiency was detected in all subjects. In addition to the results of several other studies conducted worldwide that evaluated vitamin D status among medical students, this study further highlights the problem affecting this student subgroup.
Introduction: Parathyroid proliferative disorders include adenoma, hyperplasia and carcinoma. Adenoma and hyperplasia are more commonly found in women, while carcinoma, which is very rare, is equally ...common in both sexes. The aim of this study was to analyze parathyroid tumors location and histopathology and to compare differences between the sexes. Tumors were surgically removed at the University Hospital Centre Osijek between 2016 and 2019.
Patients and Methods: Patients of both sexes who underwent parathyroidectomy for parathyroid tumor at the University Hospital Centre Osijek between 2016 and 2019 were included in the study. Parathyroid tumor samples were histologically analyzed, and their size and histopathology were noted. Existing documentation on patients with parathyroid tumor was used. Analyses were done on archived histologic material stained with hematoxylin and eosin.
Results: Overall, 19 samples of parathyroid tumor were included in this study. Tumors of the parathyroid glands were most commonly localized on the lower left parathyroid (8 cases, 42%), and least commonly on the upper right parathyroid (2 cases, 11%). The most common disorder was adenoma (11 cases, 58%), followed by hyperplasia, while no cases of cancer were diagnosed. Women underwent tumor operations more frequently than men (17 versus 2 cases). There was no correlation between histopathology of parathyroid tumor and sex (Fisher’s exact test, p = 1) or between tumor location and sex (Fisher’s exact test, p = 1).
Conclusion: The most common locations of tumors of the parathyroid glands were the inferior glands; the most common location was the left inferior parathyroid gland and the most common disorder was adenoma. Women were operated on more frequently than men.
(Feldi I, Jurić A, Marjanović K, Mihalj H, Bačun T. The Histopathological Findings of Operated Tumors of the Parathyroid Glands and Patient Data: A Single Centre Experience. SEEMEDJ 2020; 4(2); 113-120)
Introduction: To investigate adrenal tumors of patients operated on at the University Hospital Center Osijek from 2016 to 2019 for the purpose of examining the location and histopathological findings ...of the tumors and determining whether there is a difference related to that in terms of the age and sex of the subjects.
Subjects and Methods: This was a cross-sectional study with historical data analysis. The subjects were patients of both sexes (N=23) diagnosed with adrenal tumors (N=23) who underwent surgery at the University Hospital Center Osijek in the period from 2016 to 2019. The archive was used in the University Hospital Center Osijek.
Results: Adrenal tumors were more often unilateral than bilateral. No differences were found in the localization of tumors of the right and left adrenal glands. Benign tumors were more common than malignant tumors and were the most common adenoma. Seventeen women underwent surgery and were 10 years older on average (61.6 years). There were no significant differences regarding tumor occurrence with respect to the patients’ age. Benign tumors were more common in women, but the difference was not statistically significant. Regarding histopathological findings, women were more likely to have adenoma (N=10) and hyperplasia (N=4), while men had other benign tumors (N=3) and metastatic tumors (N=1). However, the difference was not statistically significant.
Conclusion: In patients who have undergone surgery for adrenal tumors, there were more unilateral tumors compared to bilateral ones, but there was no difference in tumor localization (left and right). Benign tumors were more common, the most common of which were adenomas. There were no significant differences with respect to age and sex.
(Lekić I, Banović V, Marjanović K, Kovačić B, Feldi I, Bačun T. Pathohistological Diagnosis of Adrenal Tumors: Experience of a Single Center. SEEMEDJ 2020; 4(2); 108-112)
Aim: The study aimed to examine LDL cholesterol, triglyceride and urate levels in patients of both sexes with type 2 diabetes mellitus (DM2T) in family medicine offices and to examine whether there ...is a difference in these parameters between obese patients and patients with normal body weight with DM2T, and between patients with and without manifest cardiovascular diseases.
Participants and methods: The study was organized as a cross-sectional study. It included 136 participants of both sexes diagnosed with DM2T, who were divided into groups of patients with or without adiposity and into groups of patients with or without experience of cardiovascular event. General and demographic data were collected, as well as data on experiencing cardiovascular events and levels of LDL cholesterol, triglycerides and urates.
Results: The average LDL cholesterol level was 2.93 mmol/L, the average triglyceride level was 1.65 mmol/L and the average urate level was 326.36 µmol/L. Only 12.5% of participants reached target LDL cholesterol levels, while levels of triglycerides and urates were within recommended limits. 24.3% of participants had experienced cardiovascular events and 39.7% of participants were obese. There was no significant difference in levels of LDL cholesterol, triglycerides and urates in participants who had experienced a cardiovascular event and those who had not. There was a significantly higher concentration of triglycerides in obese patients than in patients with normal body weight (p = 0.005).
Conclusion: In addition to regulation of glycaemia in patients with DM2T, statin doses should be increased in order to reach the target levels of LDL cholesterol. When it comes to obese patients, education courses on physical activity and diet should be conducted more often and, if necessary, fibrates should be included in therapy in order to reduce additional cardiovascular risks.
(Šojat* D, Pirić M, Klarić M, Šapina M, Popović Z, Bačun T. Levels of LDL Cholesterol, Triglyceride and Urate in Patients With Type 2 Diabetes Mellitus. SEEMEDJ 2020; 4(1); 32-39)
The significance, mechanisms and consequences of coronary microvascular dysfunction associated with diabetes mellitus are topics into which we have insufficient insight at this time. It is widely ...recognized that endothelial dysfunction that is caused by diabetes in various vascular beds contributes to a wide range of complications and exerts unfavorable effects on microcirculatory regulation. The coronary microcirculation is precisely regulated through a number of interconnected physiological processes with the purpose of matching local blood flow to myocardial metabolic demands. Dysregulation of this network might contribute to varying degrees of pathological consequences. This review discusses the most important findings regarding coronary microvascular dysfunction in diabetes from pre-clinical and clinical perspectives.
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