Acta clinica Croatica
-
Acta clinica Croatica · Sep 2011
Biography Historical ArticleFifty-five years (1955-2010) of the Coagulation Section at Laboratory of Hematology, Sestre milosrdnice University Hospital, and its founder, hematologist Ljubomir Popović.
The Coagulation Section at Laboratory of Hematology, Sestre milosrdnice University Hospital, Zagreb, was founded in 1955 by Ljubomir Popović, hematologist and assistant at School of Medicine, University of Zagreb, in cooperation with hard-working laboratory technicians. Apart from papers on hematologic neoplasms, plasmacytoma and lymphoma, Ljubomir Popović published a number of papers in the field of anticoagulant therapy with heparin and oral anticoagulants, some of which are also in use today. After Ljubomir Popović left the Hospital in 1964, the Laboratory was run by Professor Nedjeljko Milić, head of the newly founded Division of Hematology. ⋯ Through that collaboration, high standards in the diagnosis of hemostasis disorders were achieved, from which the currently high level of clinical knowledge about coagulation disorders and their treatment has derived, making Sestre milosrdnice University Hospital one of the leading hospitals in this field in the country. By describing development of the Coagulation Section and the life of its founder Ljubomir Popović, the authors tried to provide an answer to the following question: can today's clinicians still have a deciding role in laboratory development, considering that assessments of different phenomena are always initiated by an interested clinician who is trying to interpret and understand the nature of the disorder? This means that the clinician's place may still be in the laboratory, or else, it will become clear that the laboratory, as well as knowledge in general, has undergone such an expansion that the clinician is no longer able to run it by himself. It is our belief that the answer will assert itself through the survey of the history of the Coagulation Section at Laboratory of Hematology, Division of Hematology, and the lives of its founders and beneficiaries.
-
Acta clinica Croatica · Sep 2011
Human soluble TREM-1: lung and serum levels in patients with bacterial ventilator associated pneumonia.
Human soluble triggering receptor expressed on myeloid cells (sTREM-1) is a glycoprotein of the immunoglobulin superfamily. In normal lung tissue, sTREM-1 is selectively expressed in lung alveolar macrophages specialized for pathogen clearance and is up-regulated in the presence of bacteria and fungi. The aim of this study was to assess sTREM-1 levels in serum and lungs of patients with ventilator associated pneumonia (VAP) and to evaluate its potential diagnostic role. ⋯ In patients with bacterial VAP, a statistically significant difference was found between serum and lung sTREM-1 levels (P < 0.05), with very high levels of sTREM-1 recorded in lung samples (mean value 1565 pg/mL). There was no statistically significant difference in pulmonary sTREM-1 level between the polymicrobial and monomicrobial VAP groups. In conclusion, sTREM-1 is present in a high concentration in the lungs of patients with bacterial VAP. sTREM-1 levels can help in making the diagnosis of bacterial pneumonia as a standalone marker.
-
Acta clinica Croatica · Sep 2011
Management of patients with transient ischemic attack (TIA) at Sestre milosrdnice University Hospital Center.
Improved outcomes were observed in transient ischemic attack (TIA) patients after implementation of recommendations for stroke management and after multiple interventions such as public campaigns focused on raising awareness of stroke and reorganization of health services. The aim of this study was to describe reorganization of in-hospital services to improve the management of patients suspected of having TIA or stroke, and to validate these measures with patient outcomes. Data on 5219 patients examined between January 1 and December 31, 2008 at emergency neurology outpatient department were analyzed. ⋯ In all examined patients, a comprehensive stroke prevention program was started; 427/447 (95%) strokes and 31/99 (31%) TIAs were hospitalized at neurology department. Four (4%) TIA patients developed stroke and were hospitalized, three of them after 2 days (ABCD2 score 3.4 and 5) and one after 7 days (ABCD2 score 5). Preventive measures resulted in a low number of strokes after TIA (< 7%), but a relatively high percentage (44%) of stroke patients ignored initial symptoms and sought medical attention after persistence or worsening of the symptoms.
-
Acta clinica Croatica · Jun 2011
White blood cell count in different stages of chronic periodontitis.
Periodontal disease is considered to be an inflammatory disorder that is related to the accumulation of oral microbial biofilm and the host response to this accumulation. The host reaction to gingival microorganisms is characterized in part by increase in the polymorphonuclear leukocyte counts, which is one of the most important steps in host defense. Exaggerated leukocytes and neutrophils of host response are a very important component in the pathogenesis of periodontal disease. ⋯ In both moderate and severe periodontitis, the results indicated a significantly higher count ofneutrophils (P < 0.001), as well as of both lymphocytes and total leukocytes (P < 0.05). The values of clinical parameters (plaque index, gingival index and bleeding on probing) also showed significant between-group differences (P < 0.005 and P < 0.001, respectively). It is possible that there is a significant relationship between total leukocyte count, neutrophil count and different forms of periodontal disease.
-
Acta clinica Croatica · Jun 2011
ReviewAnesthetic management of patients undergoing pituitary surgery.
Pituitary tumors account for more than 10% of all intracranial tumors. They often present with symptoms of hormonal hypersecretion, although they may also cause hypopituitarism. ⋯ This article provides a review of perioperative concerns regarding transsphenoidal pituitary surgery, encountered in a number of these patients. Thorough understanding of preoperative assessment, intraoperative management and potential complications is fundamental for successful perioperative patient care and avoidance of morbidity and mortality.