Acta clinica Croatica
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Acta clinica Croatica · Jun 2020
Skip Metastases in Papillary Thyroid Carcinoma - Prevalence, Predictive and Clinicopathological Factors.
Cervical lymph node metastases are frequently found in papillary thyroid carcinoma (PTC) and occur in a stepwise fashion. Skip metastases that omit the central compartment and spread initially in lateral neck levels are present in a certain share of patients, and their significance is poorly understood. The aim of this prospective study was to identify their possible predictors and clinicopathological factors in a group of patients with PTC with lateral lymph node (LLN) metastases. ⋯ Skip metastases occur more frequently in older patients and display certain clinicopathological features like smaller size of the primary tumor and dissemination in less lateral neck levels. In the view of the fact that they are found rather frequently, lateral neck regions should be meticulously investigated in patients with PTC without central lymph node (CLL) metastases.
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Acta clinica Croatica · Jun 2020
PREVALENCE, ETIOLOGY AND RISK FACTORS FOR FALLS IN NEUROLOGICAL PATIENTS ADMITTED TO THE HOSPITAL IN NORTHERN TURKEY.
This study was carried out to determine the prevalence of falls, their etiology and risk factors in neurological patients admitted to the hospital in northern Turkey. A cross-sectional, descriptive design was used. Data were collected by survey that identified socio-demographic and clinical features of the subjects, Hendrich II fall risk model and Berg Balance Scale (BBS). ⋯ The mean score on the Hendrich II fall risk model was 2.7±0.1 for those who had fallen and 2.3±0.1 for those who had not fallen. The respective mean BBS score was 20.7±1.9 and 18.4±1.3. It was found that approximately one-third of neurological patients had fallen before and had restricted their activities due to fear of falls; the great majority of them had a chronic disease and permanently used medicines; and the most important risk factors for falls were advanced age, fear of falls and impaired balance.
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Acta clinica Croatica · Jun 2020
Localization and shape of stenoses in central lung carcinoma - Sensitivity and precision of MDCT VB and FB.
The objective is to present diagnostic capabilities of virtual bronchoscopy (VB) and fiberoptic bronchoscopy (FB) for determining the localization and shape of stenoses in patients with central lung carcinoma. A systematic study was performed on 220 patients aged 11-83 (54.36±17.24) years with endobronchial disease using the FB and VB methods during the 2013-2017 period. Central carcinoma of the lung was found on VB in 130 patients and on FB in 120 patients. ⋯ A significant difference in the localization criterion was found in female patients examined by VB (U-test, p=0.01). VB and FB yielded 86.5% vs. 91.60% precision and 85% vs. 94.5% sensitivity. In conclusion, VB was found to be a successful noninvasive method for determining the localization of lung tumors and shape of stenoses, which are essential in the diagnosis of malignant processes.
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Acta clinica Croatica · Jun 2020
Implementation of an Enhanced Recovery Program After Bariatric Surgery: clinical and cost-effectiveness analysis.
Enhanced recovery after surgery (ERAS) programs are perioperative evidence-based interventions that have the purpose of making the perioperative pathway more efficient in safeguarding patient safety and quality of care. Recently, several ERAS components have been introduced in the setting of bariatric surgery (Enhanced Recovery After Bariatric Surgery, ERABS). The aim of the present study was to evaluate clinical efficiency and cost-effectiveness of the implementation of an ERABS program. ⋯ Economic analysis revealed a different cost distribution between the two groups. On the whole, there were significant savings for almost all the variables taken into consideration, mainly driven by exclusion of using intensive care unit, which is by far more expensive than the average cost of post-anesthesia care unit. Our study confirmed the implementation of an ERABS protocol to have shortened hospital stay and was cost-saving while safeguarding patient safety.
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Acta clinica Croatica · Jun 2020
THE Role of Preoperative carcinoembryonic antigen in recurrence of resectable colorectal carcinoma.
In colorectal carcinoma, carcinoembryonic antigen (CEA) is a recommended marker for surveillance after curative resection. The aim of the present study was to determine the association of preoperative CEA with recurrence of colorectal carcinoma in our population. The study included 55 patients with all operable stages of colorectal adenocarcinoma treated during the 2012-2014 period, evaluated retrospectively and followed-up for recurrence for 2 years. ⋯ A highly significant (p=0.002) moderate positive correlation was recorded in patients aged <50 and moderate positive correlation of borderline significance in males (rs=0.324, p=0.058). Sensitivity was 94.4% and specificity 32.4% in predicting recurrence. Accordingly, preoperative elevated CEA showed a significant weak positive correlation with recurrence while normal preoperative CEA moderately decreased the likelihood of recurrence.