Acta clinica Croatica
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Acta clinica Croatica · Mar 2022
ReviewCOMMON VARIABLE IMMUNODEFICIENCY: PREDISPOSING OR PROTECTIVE FACTOR FOR SEVERE COMPLICATIONS OF COVID-19?
Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The usual presentation of the disease is a common cold-like illness but it can present with more severe and sometimes fatal manifestations. Immunocompromised patients such as those with common variable immunodeficiency (CVID) also are among the infected population. ⋯ It is still unknown whether primary immunodeficiency interacts as a predisposing or protective factor against the severe forms of COVID-19. Substitute immunoglobulin (IG) therapy is the only treatment option for CVID. Some reports suggest that early administration of intravenous IGs or convalescent plasma infusion may positively influence the outcome of COVID-19 in these patients.
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Acta clinica Croatica · Mar 2022
Case ReportsSPINAL SUBDURAL HEMATOMA ASSOCIATED WITH LUMBAR PUNCTURE - A CASE REPORT.
Spinal subdural hematoma caused by lumbar puncture is a rare state of acute blood clot in spinal subdural space, and in some cases, it can be the cause of local compression and consecutive neurological symptoms. We present a 36-year-old female patient who was hospitalized due to persistent headache despite pharmacological therapy. Therefore, we performed lumbar puncture in order to measure intracranial pressure and evaluate cerebrospinal fluid. ⋯ The patient reported gradual regression of pain in the LS region over the next few days, therefore conservative treatment was applied. Patients with a previously known blood clotting disorder and patients on anticoagulation therapy have worse outcome as compared with patients without such disorders. During treatment, it is necessary to monitor patient clinical state and consider the need of surgical treatment.
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Acta clinica Croatica · Mar 2022
COMPARATIVE RADIOLOGICAL DIAGNOSTICS OF ACUTE TRIANGULAR FIBROCARTILAGE COMPLEX INJURIES.
The aim was to analyze patients with clinical diagnosis of triangular fibrocartilage complex (TFCC) lesion using standard x-ray, ultrasound, conventional magnetic resonance imaging (MRI) and MR arthrography (MRA); to evaluate the accuracy of MRA compared with MRI in the diagnosis of this lesion; and to evaluate ultrasound as a method of diagnosing TFCC lesion. We analyzed 72 patients (46 female and 26 male; age range, 22-61 years; mean age 37 years; 50 right and 22 left wrists) with suspected TFCC lesion with clinical examination, standard x-rays, and ultrasound. We confirmed patients with traumatic TFCC injury on MRI and MRA. ⋯ Ultrasound is useful for visualizing intra-articular effusion, soft tissue, bone surface, and for early detection of occult fractures. MRI is a better diagnostic modality, fully able to visualize the TFCC cartilage and ligaments. MRA is consistently and accurately able to visualize structural abnormalities of TFCC.
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Acta clinica Croatica · Mar 2022
ReviewULTRASOUND DIAGNOSIS OF MACROSOMIA AMONG WOMEN WITH GESTATIONAL DIABETES - REVIEW OF THE LITERATURE.
Pregnancies burdened with gestational diabetes (GDM) are more likely to end in birth of a macrosomic child, where the frequency of operative termination of pregnancy is more common, accompanied with more complications and injuries of both mother and child in comparison to the general population. The need to calculate fetal weight right before delivery has led to the development of numerous methods for greater estimation accuracy. We reviewed the related literature from 1980 to 2020, using the terms macrosomia, ultrasound assessment, gestational diabetes, and relevant articles were considered in preparation of this article. ⋯ Some methods involve the addition of other mother and child conditions to increase reliability of the method in recognizing macrosomia. In daily work, especially with pregnant women suffering from GDM, it is necessary to have reliable data on the estimated fetal weight before making the correct clinical decision on how to terminate the pregnancy. In this regard, we bring a review of the literature related to the assessment of fetal macrosomia, especially in women with GDM.
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Acta clinica Croatica · Mar 2022
Review Case ReportsNONMELANOMA SKIN CANCER IN A HEART TRANSPLANT PATIENT: A CASE REPORT AND REVIEW OF THE LITERATURE.
Nonmelanoma skin cancers (NMSC) are the most common malignancies in solid organ transplant recipients. The most common types of skin cancer in these patients are squamous cell carcinoma (SCC), followed by basal cell carcinoma. In immunosuppressed patients, specifically patients after solid organ transplantation, these carcinomas tend to be more aggressive and have a much higher incidence of metastasizing compared to general population. ⋯ However, the lesion on the scalp relapsed after it had been treated surgically three times and therefore superficial x-ray radiation therapy was administered due to its localization and extensive size. In the next year, five more new SCCs occurred throughout the patient's body and all of them were removed surgically. Soon afterwards, the patient died from adenocarcinoma of the colon which rapidly progressed and metastasized.