Acta clinica Croatica
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Acta clinica Croatica · Dec 2021
Case ReportsDEEP SEPTIC PELVIC THROMBOPHLEBITIS - A LIFE-THREATENING CONDITION IN POSTPARTUM PERIOD.
Deep septic pelvic thrombophlebitis is a rare but potentially devastating complication in the puerperium. Early diagnosis and aggressive treatment of this postpartum complication is essential. We report a case of a 23-year-old multipara, who presented with persistent high fever and abdominal pain two days after delivery. ⋯ Streptococcus pyogenes group A was cultured from cervical swab. Treatment consisted of broad spectrum antibiotic therapy and low molecular weight heparin. She was dismissed for home care symptom-free fourteen days after delivery and referred to hematologist to diagnose the possible causes of thrombophilia.
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Acta clinica Croatica · Dec 2021
SENSE OF COHERENCE AND SUBJECTIVE WELL-BEING AMONG ADOLESCENTS - THE POTENTIAL IMPACT OF LIVING IN A DORMITORY COMPARED TO LIVING WITH FAMILY.
The aim of the study was to analyze the relationship between the sense of coherence (SOC) and subjective well-being (SWB) as a health promoting resource among adolescents living with parents and those living in dormitories. There were 442 adolescent responders, yielding a response rate of 84.3%. The SOC was measured using the Orientation to Life Questionnaire, while SWB was obtained from the Personal Wellbeing Index. ⋯ Adolescents with better socioeconomic status had a significantly higher SWB if living with parents (76.7 and 85.5, respectively; p=0.003), whereas no difference was found in the dormitory group (78.5 vs. 83.4; p=0.241). The SOC was strongly and positively associated with SWB (correlation coefficient 0.63; p=0.001) and was a key predictor of adolescent SWB (R2=0.373). These findings may prove helpful in future planning and supportive work in schools and dormitories to improve student health.
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Acta clinica Croatica · Dec 2021
ReviewMICROSURGICAL MANAGEMENT OF RECURRENT INTRACRANIAL ANEURYSMS FOLLOWING ENDOVASCULAR TREATMENT: A SINGLE INSTITUTION ILLUSTRATIVE CASE SERIES AND LITERATURE REVIEW.
Microsurgical clipping and endovascular coiling are both effective management modalities for intracranial aneurysms, whereas recent procedures are mainly directed towards endovascular treatment because of its minimally invasive nature. However, such a treatment has been associated with a bigger risk of recurrent aneurysmal growth and re-bleeding urging a selection of optimal strategies to overcome these hazards. ⋯ Considering the results reported in this paper, it seems that careful selective microsurgical neck clipping with/without aneurysmal sac resection and coil extraction remains the preferred management option for recurrent intracranial aneurysms, resulting in high obliteration rates, long-term occlusion stability, and low morbidity/mortality. In conclusion, to bring a satisfactory outcome, the multidisciplinary management of recurrent intracranial aneurysms after endovascular treatment should be adjusted to aneurysm morphology/size/location, and individualized according to patient needs.
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Congenital long QT syndrome (LQTS) is a disorder of myocardial repolarization defined by a prolonged QT interval on electrocardiogram (ECG) that can cause ventricular arrhythmias and lead to sudden cardiac death. LQTS was first described in 1957 and since then its genetic etiology has been researched in many studies, but it is still not fully understood. Depending on the type of monogenic mutation, LQTS is currently divided into 17 subtypes, with LQT1, LQT2, and LQT3 being the most common forms. ⋯ The initial diagnostic evaluation of congenital LQTS includes obtaining detailed personal and multi-generation family history, physical examination, series of 12-lead ECG recordings, and calculation of the LQTS diagnostic score, called Schwartz score. Patients are also advised to undertake 24-hour ambulatory monitoring, treadmill/cycle stress testing, and LQTS genetic testing for definitive confirmation of the diagnosis. Currently available treatment options include lifestyle modifications, medication therapy with emphasis on beta-blockers, device therapy and surgical therapy, with beta-blockers being the first-line treatment option, both in symptomatic and asymptomatic patients.
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Acta clinica Croatica · Dec 2021
ReviewOPPORTUNISTIC SCREENING FOR COLORECTAL CANCER IN HIGH-RISK PATIENTS IN FAMILY MEDICINE PRACTICES IN THE REPUBLIC OF CROATIA.
Colorectal cancer is a malignant neoplasm which has an increasing incidence and represents a global public health problem. The majority of patients are diagnosed after the age of 50, and the risk of developing it over lifetime is 5%. Development of preventive, diagnostic and treatment methods has resulted in a significant reduction in mortality and other negative clinical outcomes. ⋯ It is commonly accepted that screening in high-risk groups should start at an earlier age, with shorter intervals between follow-ups. The basic diagnostic method for screening and monitoring in these patient groups is endoscopic monitoring, or colonoscopy. The aim of this review paper is to present the characteristics of the abovementioned risk groups and provide clear screening recommendations.