Acta clinica Croatica
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Acta clinica Croatica · Dec 2023
ReviewMANAGEMENT OF ACUTE APPENDICITIS DURING COVID-19 PANDEMIC IN CROATIA: A SINGLE-CENTER STUDY.
The aim of the study was to evaluate the impact of the COVID-19 pandemic on the number of patients presenting to the emergency room with acute appendicitis and subsequent results of surgical treatment. Our single center retrospective study was conducted in Sestre milosrdnice University Hospital Center, Zagreb, Croatia. ⋯ The results showed a statistically significant increase in the ratio of open laparotomies (p=0.006) and ratio of perforated appendicitis (p=0.047) during the COVID-19 pandemic in relation to the pre-pandemic period. The time between symptom onset and hospitalization, measured in days, did not demonstrate a statistically significant increase (p=0.379), and minor increase in the postoperative length of stay was not statistically significant either (p=0.879).
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Acta clinica Croatica · Dec 2023
ReviewMUSCULOSKELETAL MANIFESTATIONS OF SYSTEMIC LUPUS ERYTHEMATOSUS.
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that most commonly affects the young, working, female population. Musculoskeletal manifestations are one of the most prevalent and presenting features in SLE. Arthralgia, myalgia, non-erosive arthritis, myositis but also tenosynovitis and enthesitis are present in more than 90% of SLE patients. ⋯ There are many radiological imaging methods, i.e., classic radiograms, ultrasound, bone scintigraphy, and magnetic resonance imaging that provide morphological information regarding damage and activity of musculoskeletal diseases in SLE and other rheumatic diseases. Musculoskeletal ultrasound stands out as an accessible and affordable method. Recognizing musculoskeletal manifestations may help establish an early diagnosis of SLE and assess disease activity, thus leading to early initiation of treatment and preventing chronic and irreversible changes with a beneficial effect on the quality of life.
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Acta clinica Croatica · Dec 2023
THE PREDICTIVE ROLE OF LEPTIN IN MALNUTRITION-INFLAMMATION COMPLEX SYNDROME IN HEMODIALYSIS PATIENTS.
Leptin is a protein hormone secreted by adipocytes. Its role in malnutrition-inflammation complex syndrome (MICS) in hemodialysis (HD) patients has not been fully resolved yet. We aimed to assess the predictive role of serum leptin in MICS in maintenance HD patients. ⋯ Leptin exhibited good sensitivity (0.89), while its specificity was similar to that of other nutritional and inflammatory parameters (0.45 for leptin vs. 0.65 for body mass index, 0.46 for MIS, 0.63 for C-reactive protein, 0.44 for albumins, 0.47 for ferritin and 0.50 for transferrin). The ROC curve analysis identified leptin levels of ≤3.4 ng/mL in men and ≤11.4 ng/mL in women to have the best predictive value for MICS. In conclusion, leptin appears to be a reliable marker of MICS.
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Hypertensive nephropathy (HN) is characterized by kidney damage due to chronic high blood pressure. Podocytes play a crucial role in the pathogenesis of HN, thus, nephrin could be important in the early diagnosis of HN. The aim of the study was to investigate the association of urinary nephrin (u-nephrin) levels with clinical and laboratory characteristics in patients with HN and to test diagnostic relevance of u-nephrin as an early biomarker of HN. ⋯ The levels of u-nephrin increased gradually with the stage of CKD. ROC curve plotted for u-nephrin showed 89.7% sensitivity and 88.8% specificity, while UM/CR showed a sensitivity of 44.8% and specificity of 86.1% to detect HN in the early stage. It is concluded that u-nephrin can be useful as an early biomarker of HN.
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Acta clinica Croatica · Dec 2023
Comparative StudyUNCEMENTED VERSUS HYBRID TOTAL HIP ARTHROPLASTY: REVISION RATE, REVISION RISK FACTORS, AND REVISION CAUSE.
Total hip arthroplasty (THA) is one of the most successful surgeries. Cemented, uncemented and hybrid methods of implant fixation can be used with different chances for implant survival. There is no consensus on the best fixation method. ⋯ The linear wear of polyethylene was the main cause of revision in uncemented THA (p<0.001). In hybrid group, larger revision replacing the femoral component was most often performed. Uncemented THA showed a lower revision rate, lower revision risk, and required 'minor' revisions compared to the hybrid ones.