Acta clinica Croatica
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The aim of the study was to determine the prevalence of pseudobulbar affect (PBA) in patients with multiple sclerosis (MS) and to analyze the link between PBA and patient age, sex, clinical course of MS, disease duration and degree of disability. The study was conducted on 79 MS patients that underwent inpatient rehabilitation at the Lipik Special Hospital for Medical Rehabilitation in the period from August 15, 2014 to February 15, 2015. PBA is a term used for an emotional disinhibition syndrome characterized by sudden and involuntary episodes of crying or laughing which are not in proportion to the stimulus applied or occur without stimulus. ⋯ There was no statistically significant correlation between PBA, age and degree of disability, although PBA was more common in women and in patients with a secondary progressive form of the disease. We found that 42.4% of respondents with positive CNS-LS criteria for PBA did not inform their neurologist on the presence of sudden mood changes. The high frequency of PBA and the fact that a significant proportion of patients did not inform the neurologist on their affective disturbances call for an active approach to diagnosis and treatment.
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Acta clinica Croatica · Jun 2015
PARTIAL TOPOGRAPHY-GUIDED PHOTOREFRACTIVE KERATECTOMY FOLLOWED BY CORNEAL CROSS LINKING IN THE MANAGEMENT OF PROGRESSIVE KERATOCONUS: OUR INITIAL TEN-MONTH RESULTS.
The aim was to assess the results achieved in keratoconic corneas submitted to the combined partial topography-guided photorefractive keratectomy (TG-PRK) and corneal cross linking (CXL) procedure performed on the same day. Four patients underwent this treatment of one eye. Corneal epithelium removal was performed by 50-micron phototherapeutic keratectomy. ⋯ One eye showed some topographic improvement, but no improvement in UCDVA. No corneal haze, prolonged epithelial healing or endothelial cell loss occurred. During 10-month follow up, the same-day combined TG-PRK and CXL appeared to offer tomographic improvement and better visual acuity in keratoconus patients.
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Acta clinica Croatica · Jun 2015
Case ReportsRENAL CELL CARCINOMA METASTASIS TO THE SINONASAL CAVITY: CASE REPORT.
Renal cell carcinoma accounts for 3% of all adult malignant tumors. Common sites of metastases are lungs, bone, liver, brain and adrenal glands. Metastatic disease to the head and neck ranges from 15% to 30%. ⋯ Although metastases of renal cell carcinoma to the head and neck are very rare, it should be first suspected when investigating a metastatic tumor in this region. Surgical excision offers the best hope for long term survival. In case of unresectable tumor, other treatment options should be considered such as radiotherapy, immunotherapy and chemotherapy.
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Acta clinica Croatica · Mar 2015
Case ReportsJejunoileal perforation and volvulus caused by multiple magnet ingestion.
Foreign body ingestion is a common problem in children, but magnet ingestion is relatively rare. However, when it occurs, it tends to have a high rate of complications. This is a case report of a 3-year-old child who swallowed multiple magnetic toys, subsequently developing jejunoileal perforation and volvulus. This case report indicates that it is best to surgically remove multiple ingested magnets without delay to avoid intestinal perforation, fistula, and other complications such as volvulus.
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Acta clinica Croatica · Mar 2015
Frequency of radial artery anatomic variations in patients undergoing transradial heart catheterization.
Over the last ten years, transradial cardiac catheterization has been increasingly applied, primarily because of its lower incidence of complications compared to the femoral approach. However, one of the greatest flaws of the transradial approach is a relatively high incidence of catheterization failure (1%-5%). Anatomic variations of radial artery are ranked second among the reasons for this. ⋯ Regression analysis revealed that age (p < 0.001), female sex (p = 0.015) and high origin (p = 0.034) considerably contributed to the development of tortuosity. The results indicated the incidence of tortuosity to increase linearly with age. Although it is not a contraindication for continuing with the procedure, we recommend that elderly patients have angiography of radial artery performed at the beginning of the procedure due to the higher frequency of tortuosity.