Acta clinica Croatica
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Acta clinica Croatica · Aug 2022
SCABIES CASES MISDIAGNOSED AND TREATED AS ALLERGIC DISEASES: ITCH AS ALARM.
The lack of scabies recognition by physicians is often caused by its similarity with other dermatoses and allergies such as eczema, urticaria, atopic dermatitis, allergic contact dermatitis, etc. The aim of this study was to present the most common misdiagnoses of scabies in physician's work. With the aim of preventing future misdiagnoses in physicians' work, we present 6 cases of patients (1 woman and 5 men, aged 23-82) who had been misdiagnosed prior to admission to our ward (tertiary care unit). ⋯ Additionally, none of our patients had lived in unhygienic conditions or were close to infected persons, but all had concomitant itch. Because of the similarity between scabies and pruritic allergic disorders, it is important to exclude scabies before diagnosing an allergy, based on patient history and skin examination. Early scabies recognition in practice is crucial for minimizing the disease societal impacts.
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Acta clinica Croatica · Aug 2022
THE USE OF MICROBIOLOGICAL AND LABORATORY DATA IN THE CHOICE OF EMPIRICAL ANTIBIOTIC THERAPY IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY - THE ROLE OF LOCAL ANTIBIOGRAMS.
Antibiotic therapy is indicated during acute cholecystitis. However, in the treatment of uncomplicated cholelithiasis, prophylactic use of antibiotics is controversial. Microbiological and laboratory data are the basis for the choice of antibiotic treatment. ⋯ To conclude, the administration of antibiotics in elective patients is not justified. The results of this study indicate that third-generation cephalosporin or ciprofloxacin + metronidazole should be administered in mild and moderate acute cholecystitis, and fourth-generation cephalosporin + metronidazole in severe acute cholecystitis in this local setting. The appropriate use of antibiotic agents is crucial and should be integrated into good clinical practice and standards of care.
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Acta clinica Croatica · Aug 2022
FEASIBILITY OF THE MULTIMODAL SMOKING CESSATION INTERVENTION DURING HOSPITALIZATION WITH SIX-MONTH FOLLOW-UP POST-DISCHARGE: A PILOT STUDY.
The main aim of this pilot project was to introduce multimodal smoking cessation intervention in the hospital setting and to analyze users' satisfaction and efficacy of the intervention within six months post-discharge. Multimodal intervention for smoking cessation was used and it consisted of the "5 A's" model (Ask, Advice, Assess, Assist, Arrange) for behavior change, printed self-help materials for smoking cessation, and telephone counseling (one, three and six months after discharge from the hospital). The main outcome of the study was smoking status at six months. ⋯ Satisfaction with the intervention was very high; 70% of participants rated the intervention as 'excellent'. Therefore, multimodal smoking cessation intervention can be successfully introduced at hospital setting yielding high smoking abstinence rates at six months post-discharge and high level of user satisfaction. Healthcare workers who work in hospitals should be educated so they can provide such intervention on a regular basis.
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Acta clinica Croatica · Aug 2022
Observational StudyCHARACTERISTICS OF CHRONIC RHINOSINUSITIS PHENOTYPES IN PATIENTS UNDERGOING FUNCTIONAL ENDOSCOPIC SINUS SURGERY: AN OBSERVATIONAL COHORT RETROSPECTIVE STUDY.
This study analyzed the characteristics of chronic rhinosinusitis patients with and without nasal polyps failing conservative treatment and undergoing functional endoscopic sinus surgery as part of their treatment for chronic inflammatory sinonasal disease. The aim of this retrospective single-institution cohort study conducted at a university hospital tertiary referral center was to evaluate the characteristics of patients with both disease phenotypes in whom conservative treatment was unsuccessful. Patients who were surgically treated with functional endoscopic sinus surgery performed by two rhinology surgeons during a one-year period (2016) were enrolled in the study. ⋯ Septal deviation was more prevalent in the chronic rhinosinusitis group (55%) as compared to the group with nasal polyps (25%). The ethmoid (17%) and maxillary sinus (13%) were most frequently involved, but most of the patients who needed surgery had involvement of multiple or all sinuses (40%). The reasons for conservative treatment failure in chronic rhinosinusitis are multifactorial, but identifying the most prevalent characteristics in patients treated surgically may be helpful in identifying patients who would benefit most from surgery.
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Acta clinica Croatica · Aug 2022
EFFICACY OF A LIPID-LOWERING DIET ON KEY FATTY ACID RATIOS AND OMEGA-3 INDEX IN HYPERLIPIDEMIC SUBJECTS.
Polyunsaturated fatty acid (PUFA) dietary intake, status and serum key fatty acid (FA) ratios may aid in cardiovascular disease-related risk assessment. The aim of this study was to investigate the effects of lipid-lowering diet on key FA ratios in serum phospholipids and omega-3 index in erythrocyte phospholipids in moderately hyperlipidemic subjects. The study included 41 subjects, mean age 56±6 years. ⋯ Total cholesterol/high-density lipoprotein (HDL), low-density lipoprotein (LDL)/HDL and triacylglycerol/HDL-cholesterol ratios positively correlated with all FA ratios, and negatively correlated with total omega-3 levels in serum phospholipids and omega-3 index in erythrocytes. Total serum omega-3 levels showed strongest association with lipoprotein ratios and positive correlation with homeostatic model assessment (HOMA) index. In conclusion, lipid-lowering diet resulted in decreased serum key FA ratios, increased omega-3 levels, and improved insulin sensitivity that may lead to a lower risk of cardiovascular disease in subjects with moderate hyperlipidemia.