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Acta Clin Croat 2018 Oct;57(Suppl 1):85-88

Ljudevit Jurak Department of Pathology and Cytology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.

Prostate adenocarcinoma with Paneth cell-like neuroendocrine differentiation is a rare entity. Foci of scattered cells and small clusters are found in the majority of described cases, although cases with predominant Paneth cell-like features have also been recorded. These cells contain eosinophilic cytoplasmic inclusions and lack androgen receptors, and are consequently immune to hormone therapy. Read More

Acta Clin Croat 2018 Jun;57(Suppl 1):77-84

Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.

Stress urinary incontinence (SUI) continues to present a major complication after radical prostatectomy. Suburethral slings represent one of the less invasive options for postprostatectomy SUI, and a more recent addition is a transobturator sling, the AdVance®. We report our results with the AdVance® sling for the management of postoperative SUI. Read More

Acta Clin Croat 2018 Oct;57(Suppl 1):71-76

Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb.

The aim of this study was to determine the incidence of incidental prostate cancer and its clinical significance among patients who underwent transurethral prostate resection or transvesical adenomectomy for benign prostate hyperplasia at the Department of Urology in Sestre milosrdnice University Hospital Center from January 1997 to December 2017. A total of 277/4,372 (6.34%) patients from our cohort were diagnosed with incidental prostate cancer (mean age 74. Read More

Acta Clin Croat 2018 Oct;57(Suppl 1):66-70

Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.

Prostatic artery embolization is a minimally invasive endovascular treatment that improves lower urinary tract symptoms in men with benign prostatic hyperplasia. Although further randomized studies and long-term evidence is still needed for this method to be fully incorporated into treatment guidelines for benign prostatic hyperplasia, current studies show that this method can be an effective and safe alternative in patients with a significantly enlarged prostate gland who are not good surgical candidates. Therefore, we present the theory, technical details and potential benefits of this method as we review the current evidence on prostatic artery embolization. Read More

Acta Clin Croat 2018 Oct;57(Suppl 1):61-65

Sestre milosrdnice University Hospital Center, Zagreb.

Pelvic lymph node dissection (PLND) during radical prostatectomy (RP) is the most accurate staging modality for lymph node assessment in patients with prostate cancer. It is recommended in all patients with intermediate or high-risk disease undergoing radical prostatectomy. The goal of our study was to assess unfavorable clinicopathological characteristics in patients with omitted lymphadenectomy (PLND) during radical prostatectomy based on the nomogram proposed by Briganti and colleagues. Read More

Acta Clin Croat 2018 Oct;57(Suppl 1):56-60

Ljudevit Jurak Department of Pathology and Cytology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

LMO2 (LIM domain only) is a member of transcription factor family of proteins characterized by their cysteine-rich, zinc-binding LIM domains. Its expression in prostate cancer cells, as well as in adjacent stroma, is described in a study in a cohort of 83 patients treated with radical prostatectomy for clinically localized prostate adenocarcinoma. Authors found that LMO2 overexpression in prostate cancer was strongly associated with features indicative of worse prognosis (higher preoperative PSA, higher Gleason score, positive surgical margins, and extraprostatic extension of disease). Read More

Acta Clin Croat 2018 Oct;57(Suppl 1):50-55

Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.

One of the main reasons for the introduction of a new grading system was Gleason sum 7, which differed significantly in the prognosis of the disease depending on the primary Gleason. The aim of this study was to compare grade group 2 and grade group 3, and the impact of cancer percentages in final pathology reports after radical prostatectomy on the occurrence of T3 stage of the disease after radical prostatectomy of clinically localized prostate cancer. The study covered 365 patients with clinically localized prostate cancer who underwent radical retropubic prostatectomy (RRP) over the period of two years. Read More

Acta Clin Croat 2018 Oct;57(Suppl 1):46-49

Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb.

The objective of this study was to determine differential expression of TFF1, TFF2 and TFF3 genes and proteins in breast tumor subtypes. In addition, we investigated the correlation between TFF genes within tumor subgroups, and TFF genes with clinical and pathologic characteristics of the tumor. Study group included 122 patients with surgically removed breast tumors. Read More

Acta Clin Croat 2018 Oct;57(Suppl 1):40-45

Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb.

The aim of this prospective clinical study was to determine the detection rate of prostate cancers by multiparametric magnetic resonance and transrectal ultrasound (mpMRI-TRUS) cognitive fusion biopsies in patients with a previously negative TRUS-guided biopsy. Between 1 October 2016 and 1 July 2017, in 101 consecutive patients with elevated antigen (PSA) and/or positive digital rectal examination and after a negative first TRUS biopsy, a second, repeated prostate biopsy was performed. In 24 patients, cognitive fusion mpMRI-TRUS biopsy of the prostate with 8-10 system cores and 1-3 target biopsies was performed, in line with the European Association of Urology guidelines. Read More

Acta Clin Croat 2018 Oct;57(Suppl 1):35-39

Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb.

Multiparametric magnetic resonance is assuming an increasingly important role in the diagnosis, initial assessment and monitoring of patients with prostate cancer. This paper offers a more complex insight into the application of magnetic resonance imaging with prostate cancer, with a current literature overview. The focus is on the problem of initial prostate cancer evaluation which strongly affects further decision-making and therapeutic interventions. Read More

Acta Clin Croat 2018 Oct;57(Suppl 1):27-34

Croatian National Cancer Registry, Croatian Institute of Public Health, Zagreb.

Prostate cancer represents a significant public health burden in Croatia, as well as in other developed countries. The aim of this paper was to present the current epidemiological situation in Croatia in comparison to other similar countries, using basic indicators such as incidence, mortality, prevalence and survival, and to discuss future possibilities in this field. The incidence of prostate cancer in Croatia has been rapidly increasing since the mid-nineties; recent data indicates that the trend is levelling off. Read More

Acta Clin Croat 2018 Oct;57(Suppl 1):21-26

Sestre milosrdnice University Hospital Center, Zagreb.

The Department of Urology at the Sestre milosrdnice University Hospital Center is the oldest urological institution in the Republic of Croatia and this part of Europe. Today, the Department is a modern tertiary healthcare institution, where the most complex methods of urological practice are performed using modern medical devices and highly sophisticated technology. In 2011, our urology specialist education program was certified by the European Board of Urology (EBU) as the only one of its kind in Croatia. Read More

Acta Clin Croat 2018 Oct;57(Suppl 1):9-20

Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.

The history of Croatian urology clearly shows its affiliation to the medical and civilizational circle of the Western world. The Department of Urology at the Sestre milosrdnice University Hospital Center is the oldest urology institution in the Republic of Croatia. The Department was established in 1894, when the new Sestre milosrdnice Hospital was open in Vinogradska cesta in Zagreb. Read More

Acta Clin Croat 2018 Jun;57(2):383-390

Institute of Anesthesiology and Intensive Care, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

Four thousand cardiac implantable electronic devices (CIED) are implanted yearly in Croatia with constant increase. General anesthesia and surgery carry some specific risk for the patients with implanted CIEDs. Since most of the surgical procedures are performed in institutions without reprogramming devices available, or in the periods when they are unavailable, these guidelines aim to standardize the protocol for perioperative management of these patients. Read More

Acta Clin Croat 2018 Jun;57(2):377-382

Department of Orthopedic Surgery, Zagreb University Hospital Centre, Zagreb, Croatia.

Lateral inverted osteochondral fracture of the talus (LIFT) is a rare variant of stage IV osteochondral lesion of the talus (OLT), where the fragment is inverted in situ by 180°. The management of LIFT lesion is very challenging and early recognition crucial, given that treatment options depend on the articular cartilage condition and sufficiency of the adjacent bone of the displaced fragment. We describe two LIFT cases referred from other institutions after unsuccessful conservative treatment of OLT. Read More

Acta Clin Croat 2018 Jun;57(2):372-376

Department of Oncology and Nuclear medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.

Papillary thyroid carcinoma (PTC) is considered one of the most favorable tumors, indolent, with rare distant dissemination. Lungs and bones are the most common metastatic sites. Unusual sites of PTC distant metastases are extremely rare. Read More

Acta Clin Croat 2018 Jun;57(2):366-371

Department of Pathology, Merkur University Hospital, Zagreb, Croatia.

Schwannoma as an extracranial nerve sheath tumor rarely affects brachial plexus. Due to the fact that brachial plexus schwannomas are a rare entity and due to the brachial plexus anatomic complexity, schwannomas in this region present a challenge for surgeons. We present a case of a 49-year-old female patient with a slow growing painless mass in the right supraclavicular region that was diagnosed as schwannoma and operated at our department. Read More

Acta Clin Croat 2018 Jun;57(2):362-365

Department of Hematology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

T-cell large granular lymphocytic leukemia (T-LGLL) is an uncommon but probably underdiagnosed disease caused by clonal proliferation of large granular lymphocytes. Diagnosis is typically based on the high number of morphologically characteristic lymphoid cells and finding of an abnormal immunophenotype by flow cytometry. Because of its relatively indolent clinical behavior, observation is often an appropriate therapy. Read More

Acta Clin Croat 2018 Jun;57(2):352-361

Dubrava University Hospital, Zagreb, Croatia.

Multiple sclerosis (MS) is a multicomponent disease characterized by inflammation, neurodegeneration, and cancellation of the central nervous system recovery mechanisms. The cause of MS is still unknown, but it is undeniable that genetic, environmental and immune factors are involved in the etiopathogenesis of this complex and heterogeneous disease. From the aspect of immunopathogenesis, until recently the opinion prevailed that autoreactive T lymphocytes played a major role, the activation of which is a key step in MS. Read More

Acta Clin Croat 2018 Jun;57(2):342-351

Department of Dermatovenereology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.

Although cheilitis as a term describing lip inflammation has been identified and recognized for a long time, until now there have been no clear recommendations for its work-up and classification. The disease may appear as an isolated condition or as part of certain systemic diseases/conditions (such as anemia due to vitamin B12 or iron deficiency) or local infections (e.g. Read More

Acta Clin Croat 2018 Jun;57(2):335-341

Department of Diagnostic and Interventional Radiology, Osijek University Hospital Center, Osijek, Croatia.

Objectives of the study were to observe supraspinatus muscle thickness in patients with supraspinatus tendon pathology using ultrasound (US) and examining inter- and intra-rater reliability, and to compare muscle thickness with cross-sectional area (CSA) and occupation ratio measured by both US and magnetic resonance imaging (MRI). The investigation was designed as a prospective cohort study. Two groups of patients were included in the study: 43 patients with tendon rupture and 44 patients without tendon rupture as a control group. Read More

Acta Clin Croat 2018 Jun;57(2):327-334

Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.

The aim was to compare the efficacy of a single intravitreal injection of perfluoropropane (C3F8) and sulfur hexafluoride (SF6) in releasing vitreomacular traction (VMT). This prospective study included two groups of patients with symptomatic VMT confirmed by spectral-domain optical coherence tomography (SD-OCT). Patients from both groups received a single intravitreal injection of expansile gas. Read More

Acta Clin Croat 2018 Jun;57(2):316-326

Department of Psychiatry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

Saliva is a complex body fluid that has various functions in the oral cavity. Central nervous system has the most important role in regulating salivation. Saliva as a sample is suitable for simplicity of sampling and because it contains analytes in the free active form. Read More

Acta Clin Croat 2018 Jun;57(2):312-315

School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.

The aim of this clinical study was to compare low-level laser therapy (LLLT) switched on and switched off in the treatment of burning mouth syndrome (BMS). BMS is a debilitating condition for patients and highly demanding for physicians, characterized by burning symptoms in the oral cavity. Despite extensive research, so far only cognitive behavioral therapy and clonazepam have been proven successful for its treatment in randomized controlled trials. Read More

Acta Clin Croat 2018 Jun;57(2):307-311

Department of Pediatrics, Zagreb University Hospital Centre, University of Zagreb School of Medicine, Zagreb, Croatia.

Macrophage activation syndrome (MAS) is a potentially fatal complication of systemic juvenile idiopathic arthritis (sJIA), caused by exaggerated but ineffective immune response. The aim of the study was to compare the capacity of the HLH-2004 guidelines with the capacity of the MAS guidelines from 2005, and with the new set of classification criteria from 2016 in diagnosing MAS complicating sJIA. The study included 35 children aged 1-18 diagnosed with sJIA according to ILAR criteria and treated at the Department of Pediatrics, Division of Immunology and Rheu-matology, Zagreb University Hospital Centre, in the period from 2009 to 2015. Read More

Acta Clin Croat 2018 Jun;57(2):301-306

Department of Ophthalmology, Rijeka University Hospital Center, Rijeka, Croatia.

Thyroid-associated orbitopathy (TAO) is a common manifestation of Graves' disease. The aim of the study was to assess the six percent of patients with TAO that develop dysthyroid optic neuropathy (DON), which is the most serious complication of TAO. As DON can cause perma-nent damage, it is essential to detect DON early when visual loss is still reversible. Read More

Acta Clin Croat 2018 Jun;57(2):292-300

Department of Gastroenterology, Hepatology and Clinical Nutrition, Dubrava University Hospital, Zagreb, Croatia.

The aim of the study was to explore predictive value of the ALBI, PALBI and MELD scores on survival in patients resected for hepatocellular carcinoma with compensated liver cirrhosis and no macrovascular infiltration. In this retrospective study, longitudinal survival analysis was performed. We analyzed patient/tumor characteristics and MELD, ALBI and PALBI scores as liver function tests for predicting survival outcome. Read More

Acta Clin Croat 2018 Jun;57(2):71-81

Faculty of Health Sciences, University of Ljubljana, Chair of Biomedicine in Health Care, Ljubljana, Slovenia.

In the liver, there are many vascular variants, which are important in liver surgery, the presence of accessory right hepatic veins (aRHVs) in particular. Th eir frequency, number and diameter vary considerably. Detailed imaging diagnostics with computed tomography (CT) should be undertaken before surgery. Read More

Acta Clin Croat 2018 Jun;57(2):278-285

Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Zagreb University Hospital Center, Zagreb, Croatia.

The aim of this in vitro study was to evaluate cytotoxicity and genotoxicity of six different dental nanocomposite materials, three conventional ones and three flowable composite resin materials, in human lymphocytes. The following materials were tested: Tetric EvoCeram, Tetric EvoFlow, Filtek Ultimate, Filtek Ultimate Flow, G-aenial and G-aenial Flo. Cytotoxicity was evaluated for two mass concentrations (0. Read More

Acta Clin Croat 2018 Jun;57(2):264-277

Department of Histology and Embryology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.

The objective of this study was to determine differential expression of TFF1, TFF2 and TFF3 genes and proteins in breast tumor subtypes. In addition, we investigated the correlation between TFF genes within tumor subgroups, and TFF genes with clinical and pathologic characteristics of the tumor. Study group included 122 patients with surgically removed breast tumors. Read More

Acta Clin Croat 2018 Jun;57(2):257-263

Department of Pulmonology, Clinical Center of Serbia, Belgrade, Serbia.

Currently, topical are studies that examine different reasons for delay of tuberculosis (TB) diagnosis and its impact on disease prognosis. The aim was to examine three time periods associated with treatment delay: patient related, health system related and total delay. This retrospective-prospective study included 100 consecutive patients hospitalized at Department of Pulmonology, Clinical Center of Serbia, in the period from March to December 2015. Read More

Acta Clin Croat 2018 Jun;57(2):251-256

School of Medicine, University of Zagreb, Institute of Pathology and Zagreb University Hospital Centre, Clinical Department of Pathology and Cytology, Zagreb, Croatia.

Lung cancer as the major cause of cancer mortality worldwide includes several histologic subtypes evolving from numerous genetic and epigenetic changes emerging in alveolar, bronchiolar and bronchial epithelium. The majority of cases are diagnosed in advanced stage (i.e. Read More

Acta Clin Croat 2018 Jun;57(2):243-250

Department of Ophthalmology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

The aim of this study was to assess the effect of different visual impairment levels on difference in the subjective quality of life estimation. We included 150 patients with glaucoma whose best-corrected visual acuity in the better-seeing eye was 0.5 and less. Read More

Acta Clin Croat 2018 Jun;57(2):235-242

University of Applied Health Sciences, Zagreb, Croatia.

Medical activity is assumed to be service activity the effects of which can be measured. The SERVQUAL scale was used as a starting point for our research, which resulted in a new, adopted scale called MEDQUAL. The MEDQUAL scale aims to measure the quality of healthcare provided by medical staff of one hospital department instead of the overall quality of hospital services or parts of services on which medical staff in one department has no influence. Read More

Acta Clin Croat 2018 Jun;57(2):227-234

Department of Dental Anthropology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.

The aim of the study was to analyze zygomatic air cell defect (ZACD) incidence using magnetic resonance imaging (MRI) and validity of panoramic radiograph as a comparative method of ZACD diagnostics. The connection between ZACD incidence, age, left/right temporomandibular joint (TMJ) and comorbidity with diagnosis of TMJ disorder was analyzed. Panoramic radiographs and MRIs of 140 TMJs of 70 consecutive patients with previously confirmed TMJ diagnosis were compared in the study. Read More

Acta Clin Croat 2018 Mar;57(1):190-215

Dubrava University Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia.

Recent developments in the diagnosis and treatment of chronic lymphocytic leukemia (B-CLL) have led to change of approach in clinical practice. New treatments have been approved based on the results of randomized multicenter trials for first line and for salvage therapy, and the results of numerous ongoing clinical trials are permanently providing new answers and further refining of therapeutic strategies. This is paralleled by substantial increase in understanding the disease genetics due to major advances in the next generation sequencing (NGS) technology. Read More

Acta Clin Croat 2018 Mar;57(1):187-189

Çukurova University, School of Medicine, Department of Pediatric Emergency, Adana, Turkey.

Polyethylene glycol electrolyte (PEG-3350) solution is usually used for bowel emptying before colonoscopy in adults. It has also been reported to be safe in children. It is thought that bowel irrigation with this solution can be a useful treatment alternative for poisoning with slow releasing drugs, swallowed packaged substances, enteric coated drugs, drugs not binding to charcoal, and heavy metals in children. Read More

Acta Clin Croat 2018 Mar;57(1):181-186

University Department of Neurology, Split University Hospital Center, Split, Croatia.

Hepatic encephalopathy (HE) is a brain dysfunction caused by liver failure. Clinically, it can manifests as a wide spectrum of neurological or psychiatric abnormalities. This report presents a case of a 43-year-old male with HE and asymmetric kinetic, postural and resting tremor of upper extremities. Read More

Acta Clin Croat 2018 Mar;57(1):177-180

Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

We report a unique case of undetectable serum levels of anti-müllerian hormone (AMH) in women with polycystic ovary syndrome (PCOS) who developed ovarian hyperstimulation syndrome (OHSS) during in vitro fertilization (IVF). A case is described of a 28-year-old woman with clinical symptoms of PCOS and AMH serum level below analytical sensitivity (<1.0 pmol/L). Read More

Acta Clin Croat 2018 Mar;57(1):173-176

University Eye Department, Faculty of Dental Medicine and Health Care Osijek, Faculty of Medicine Osijek, Josip Juraj Strossmayer University in Osijek, Sveti Duh University Hospital, Zagreb, Croatia.

Dermis-fat graft has been proven as a useful replacement tissue for eyelid and orbit reconstruction, but there is no evidence in the literature that it can be used for correction of upper eyelid retraction. This is the first report that presents two cases (four eyelids) of dermis-fat graft usage as a spacer in the treatment of severe recurrent upper eyelid retraction due to Graves' orbitopathy. Improvement was achieved with minimum complications, patient symptoms were reduced, and the results were stable almost three years after the procedure. Read More

Acta Clin Croat 2018 Mar;57(1):166-172

Stubičke Toplice Special Hospital for Medical Rehabilitation, Stubičke Toplice, Croatia.

Traumatic optic neuropathy (TON) is a serious vision threatening condition that can be caused by ocular or head trauma. Indirect damage to the optic nerve is the most common form of TON occurring in 0.5% to 5% of all closed head trauma cases. Read More

Acta Clin Croat 2018 Mar;57(1):161-165

Department of Pediatrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

Adrenal hemorrhage is a rare clinical entity in the neonatal period, with an incidence of 1.7-2.1/1000 births. Read More

Acta Clin Croat 2018 Mar;57(1):157-160

Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

Rupture of the internal iliac artery is a rare complication in pregnancy that is associated with maternal and fetal morbidity and mortality. We present a case of a 30-year-old primipara admitted to our department in 39th week of gestation after sudden onset of intense abdominal pain. On admission, the patient was pale, tachycardiac, but with normal blood pressure and afebrile. Read More

Acta Clin Croat 2018 Mar;57(1):141-148

School of Dental Medicine, University of Zagreb, Zagreb, Croatia.

In this article, we outline the latest guidelines published by the American Heart Association on sexual activity in patients with coronary artery disease, heart failure, structural heart diseases, arrhythmias, implanted pacemakers or cardioverter defibrillators, as well as on treatment options of sexual dysfunction. Sexual activities are similar to mild/moderate physical activity during a short period. Most patients are recommended to involve in sexual activity after prior comprehensive evaluation of physical condition. Read More

Acta Clin Croat 2018 Mar;57(1):134-140

medical student, University of Zagreb, School of Medicine, Zagreb, Croatia.

The aim of the study was to assess the level of knowledge of midwives working in different clinical settings about oral emergency contraception. The study included 225 midwives; during the period from December 2015 to February 2016, they completed a 16-item web-based survey using the SurveyMonkey software available on the Croatian Midwives Chamber site. In total 277 participants started to fill out the survey and 225 participants responded to all 16 questions. Read More

Acta Clin Croat 2018 Mar;57(1):130-133

Department of Ophthalmology, Osijek University Hospital Centre, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.

The aim of the study was to determine the role of blepharospasm as a protective factor for the anterior segment of the eye by comparing the degree of blepharospasm and changes of the anterior segment structures. The study included sixty female patients older than forty years with the clinical diagnosis of blepharospasm. They were divided into two groups; the first group consisted of patients with stage I and II of blepharospasm with dominant dry eye symptoms, and the second group consisted of patients with stage III and IV of blepharospasm who required interventional therapy (all patients in this study were treated with botulinum toxin type A). Read More

Acta Clin Croat 2018 Mar;57(1):122-129

Department of Pathology and Forensic Medicine, Osijek University Hospital Centre, Osijek, Croatia.

Histologic and radiologic studies describe intramyocardial fat tissue as a normal finding or as part of cardiac pathology. The role of fat cells within the myocardium is not fully understood. The aim of this study was to assess fat tissue distribution in the myocardium of right atrium (RA) and right ventricle (RV) and age differences in subjects free from cardiac disease. Read More

Acta Clin Croat 2018 Mar;57(1):116-121

Department of Obstetrics and Gynecology, Bjelovar General Hospital, Bjelovar, Croatia.

The aim is to present the 60-year experience in modified Ritgen maneuver according to perineal injuries. This retrospective clinical observational study (1950-2010) analyzed the impact of modified Ritgen maneuver delivery technique (controlled fetal head deflexion with left hand and synchronous reduction of perineal strain with extended right hand thumb along the right side of the vulva and perineum without pushing) on peripartum perineal tears at the Maternity Ward, Bjelovar General Hospital in Bjelovar, Croatia, divided into five-year intervals. The rate of perineal tear in general was less than 5% until 2000. Read More

Acta Clin Croat 2018 Mar;57(1):110-115

Department of Nuclear Medicine, Split University Hospital Centre, Split, Croatia.

The aim of this study was to investigate the relationship between globus pharyngeus and laryngopharyngeal reflux, as well as between globus and thyroid volume. A two-year prospective study included 56 patients aged 18-75 with globus symptom. Anthropometric, clinical and laboratory data were collected. Read More