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
COMPUTATIONAL FLUID DYNAMICS IN PATIENTS WITH TRIGEMINAL NEURALGIA - A PRELIMINARY STUDY.
Although earlier studies showed higher values of wall shear stress in neurovascular conflict, hemodynamic patterns in the blood vessel after microvascular decompression are unknown. This study aimed to analyze the hemodynamic features of the offending artery preoperatively and postoperatively using computational fluid dynamics. We retrospectively analyzed 11 patients with trigeminal neuralgia who were surgically treated in our department during 2022. ⋯ In all 11 patients, elevated values of wall shear stress were found in the area of neurovascular contact. Postoperatively, with improvement of the patient clinical status, there was also a decrease in wall shear stress. Computational fluid dynamics analysis of offending vessels in trigeminal neuralgia can be a useful tool in preoperative planning and in assessing treatment outcomes and prognosis.
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Acta clinica Croatica · Dec 2023
PREDICTORS OF INTRAOPERATIVE HYPERTENSION IN NECK SURGERY: A SINGLE CENTER RETROSPECTIVE STUDY.
Intraoperative hypertension (IOHTA) during neck surgery is undesirable because this type of surgery has a propensity to bleed profoundly even in normotensive anesthesia. The purpose of our study was to detect predictors of IOHTA in patients undergoing neck surgery. This single center retrospective study included 880 adult patients who underwent neck surgery under general anesthesia. ⋯ Statistically significant predictors of IOHTA were age (OR 1.438; 95% CI 1.144-1.808; p=0.002), cardiac arrhythmia (OR 1.702; 95% CI 1.129-2.566; p=0.011), Cormack-Lehane grade (OR 1.407; 95% CI 1.054-1.878; p=0.020), and duration of anesthesia (OR 1.005; 95% CI 1.001-1.008; p=0.005). The risk of IOHTA occurrence was lower in patients with induced hypotension (OR 0.024; 95% CI 0.003-0.185; p=0.000). During neck surgery, special attention is needed in patients of older age, those with cardiac arrhythmia, difficult intubation, and longer anesthesia duration because they are at risk of IOHTA.
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Acta clinica Croatica · Dec 2023
INCREASED SEVERE COVID-19-RELATED FATALITY IN HOSPITALIZED MULTIPLE SCLEROSIS PATIENTS.
The aim of this study was to assess the case fatality ratio (CFR) in persons with multiple sclerosis (PwMS) hospitalized due to severe COVID-19, and to investigate the role of risk factors for fatal outcome in this well-defined cohort. This case series study included all PwMS (N=32) with severe COVID-19, who were hospitalized in the COVID-19 referral center in Belgrade from January 2021 to January 2022. Eight out of these 32 patients died from COVID-19 (CFR 25%). ⋯ Multivariate logistic regression analysis showed that progressive forms of MS (p=0.044) and longer hospitalization (p=0.006) significantly increased the risk of death in our MS cohort. In our study, older age, presence of comorbidities, and progressive disease course were independent predictors of increased lethality of COVID-19 in PwMS. More intense monitoring may be warranted in PwMS treated with anti-CD20 agents.