Acta clinica Croatica
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Acta clinica Croatica · Nov 2022
Review Case ReportsSURGICAL MANAGEMENT OF A PENETRATING BRAIN WOUND AND ASSOCIATED PERFORATING OCULAR INJURY CAUSED BY A LOW-VELOCITY SHARP METALLIC OBJECT: A CASE REPORT AND LITERATURE REVIEW.
Penetrating traumatic brain injury accompanied by perforating ocular injury caused by low-velocity foreign bodies is a life-threatening condition, a surgical emergency and a major challenge in surgical practice, representing a severe subtype of non-missile traumatic brain injury, which is a relatively rare pathology among civilians. Optimal management of such an injury remains controversial, requiring full understanding of its pathophysiology and a multidisciplinary expert approach. Herein, we report a case of penetrating brain and associated perforating eye injury and discuss relevant literature providing further insight into this demanding complex multi-organ injury. ⋯ The vision to his left eye was completely and permanently lost. In conclusion, management of non-missile transorbital penetrating brain injury can be satisfactory when proper clinical and radiologic evaluation, and amply, less radical surgical approach is performed early. A multidisciplinary routine is a prerequisite in achieving a favorable management outcome.
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Acta clinica Croatica · Nov 2022
ReviewURINE CYTOLOGY AND AXILLARY TESTING FOR INTERPRETATION AND FOLLOW-UP OF URINARY TUMORS.
Microscopic appearance of cells in urine cytological samples is the formal diagnostic approach adjunct to cystoscopy for the detection and follow-up of urinary tumors. However, cystoscopy is a surgical method and cytology may miss low-grade papillary tumors. ⋯ When combined with conventional cytology, uro-oncological diagnostic performance is improved. We review the value of these non-invasive modalities in comparison with urine cytomorphology in the work-up of urothelial malignancies.
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The year 2022 marked the one-hundredth anniversary of the first application of insulin. November 14th, the birth date of one of its main discoverers, Frederick Banting, was designated as World Diabetes Day. This paper comprises a narrative review of the history of the discovery of diabetes and insulin, progress in insulin development, important breakthroughs in insulin production and delivery, and a short commentary regarding potential future developments in insulin treatment. ⋯ Groundbreaking discoveries during the early 20th century have resulted in type 1 diabetes mellitus becoming a treatable, chronic condition. The relationship between good glycemic control and reduced occurrence of diabetes complications was established, which has enticed further development and refinements in insulin treatment, ranging from the purification and increased quality of insulin itself, as well as various inventions in its administration. Despite great achievements in insulin therapy so far, future research aims to avoid the need for subcutaneous administration and to create non-invasive means of insulin application.
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Acta clinica Croatica · Nov 2022
Review Case ReportsTRANSVENOUS APPROACH FOR INDIRECT CAROTID-CAVERNOUS FISTULA USING DETACHABLE COILS: A CASE REPORT AND REVIEW OF TREATMENT OPTIONS.
Carotid-cavernous fistula (CCF) is a relatively rare pathology with a low incidence compared with other vascular pathologies. They can be classified based on hemodynamics as low- or high-flow fistulas, and anatomically as direct or indirect fistulas. Anatomy of the shunt somewhat dictates the selection of endovascular treatment, meaning the venous or arterial approach and selection of embolizing materials. ⋯ Herein, we report a case of an 80-year-old woman treated for indirect CCF using detachable coils. We also provide a brief review of the literature, including recent advances in treatment of said entities. In conclusion, selection of both the approach and material used depends on the operator's experience and preference.
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Acta clinica Croatica · Nov 2022
ESTIMATION OF THE GLOMERULAR FILTRATION RATE IN CHILDREN WITH HEMOPHILIA.
Estimated glomerular filtration rate (eGFR) is one of the best-performing methods in evaluating kidney function. There are limited data regarding the estimated glomerular filtration rate in children and young adults with hemophilia. The aim of this study was to determine the difference between three commonly used estimated glomerular filtration rate equations in the pediatric population in a cohort of patients with hemophilia. ⋯ A correlation between the three eGFR methods was present, but with significant differences between them. Due to the observed differences between eGFR in pediatric patients with hemophilia, further research is needed to find the optimal measurement method for eGFR. Nevertheless, we recommend implementing eGFR equations in routine clinical monitoring of pediatric patients with hemophilia.