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Acta Clin Croat 2020 Jun;59(2):377-381

1Faculty of Medicine in Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 2Department of Maxillofacial and Oral Surgery, Osijek University Hospital Centre, Osijek, Croatia; 3Department of Ophthalmology, Osijek University Hospital Centre, Osijek, Croatia.

Blepharospasm is an idiopathic condition characterized by involuntary eyelid closure mainly caused by bilateral tonic-clonic contractions of the orbicularis oculi muscle. It results in patient inability to open their eyes, thus significantly impairing their ability to perform activities of daily living. First-line treatment for blepharospasm are primarily botulinum toxin type A injections. Read More

Acta Clin Croat 2020 Jun;59(2):373-376

1Zagreb University Hospital Centre, Department of Obstetrics and Gynecology, Zagreb, Croatia; 2Mostar University Hospital, Department of Obstetrics and Gynecology, Mostar, Bosnia and Herzegovina.

Bladder exstrophy (BE) is a rare congenital malformation estimated to occur in up to 1/250,000 female live births. The evidence supporting the incidence, uterine preservation and its overall fertility rate in patients with pelvic organ prolapse (POP) and BE is not precisely determined. We report a case of BE and POP in a 27-year-old nulliparous Caucasian. Read More

Acta Clin Croat 2020 Jun;59(2):368-372

1University Hospital of Foča, Department of Radiology, University of East Sarajevo, Foča, Republika Srpska, Bosnia and Herzegovina; 2Srebrnjak Children's Hospital, Zagreb, Croatia; 3Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.

Acute osteomyelitis is pyogenic infection of the bone and bone marrow. We report a case of successful diagnosis and treatment in a 12-year-old boy with right shoulder joint osteoarthritis. On admission, he was febrile (39. Read More

Acta Clin Croat 2020 Jun;59(2):365-367

1Department of Obstetrics and Gynecology, Sveti Duh University Hospital; Croatian Catholic University, Zagreb, Croatia; 2Praxis Prof. Zlatko Hrgovic, Frankfurt am Main, Frauenklinik Offenbach, Offenbach, Germany.

Primary breast lymphoma accounts for 0.04%-0.5% of all breast malignancies. Read More

Acta Clin Croat 2020 Jun;59(2):359-364

1Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 3University of Applied Health Sciences, Zagreb, Croatia; 4Josip Juraj Strossmayer University of Osijek, School of Dental Medicine and Health, Osijek, Croatia; 5Department of Neurology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 6Department of Radiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 7Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia.

Neoplastic etiology of intracranial cerebral aneurysm is rare. Yet, the risk of its development is higher in malignant tumor patients receiving radiation therapy. Due to the possible negative effects of irradiation on intracranial vessel walls, the risk of aneurysm formation after radiation therapy, which is crucial for some types of breast cancer patients, continues to be a matter of debate. Read More

Acta Clin Croat 2020 Jun;59(2):351-358

1Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Department of Internal Medicine, Family Medicine and History of Medicine, Osijek, Croatia; 2Čakovec County Hospital, Čakovec, Croatia; 3Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Rudjer Bošković Institute, Division of Molecular Medicine, Zagreb, Croatia; 5Rudjer Bošković Institute, Division of Molecular Biology, Zagreb, Croatia; 6Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Department of Department of Gynecology and Obstetrics, Osijek, Croatia; 7Dr Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia.

The role of T regulatory lymphocytes (T) particularly in cancer is well known. The goal of the present study was to determine the contribution of these lymphocytes in the regulation of anti-tumor immunity of CBA/HZgr mice against MC-2 fibrosarcoma (4 generation of methylcholanthrene induced tumor). The levels of T lymphocytes (CD4+, CD8+ and CD4+CD25+) were determined 8 and 20 days after tumor transplantation. Read More

Acta Clin Croat 2020 Jun;59(2):344-350

1Department of Endocrinology and Diabetes, Split University Hospital Centre Split, Croatia; 2Department of Pathophysiology, University of Split School of Medicine, Split, Croatia.

The aim of this study was to determine plasma adropin concentration and parameters of insulin resistance in obese male type 2 diabetes mellitus (T2DM) patients before and after 3-month liraglutide treatment. In this interventional study, we enrolled 15 obese male T2DM patients with body mass index (BMI) >35 kg/m, uncontrolled disease and HbA >7.5%, having previously taken taking two oral antidiabetic drugs. Read More

Acta Clin Croat 2020 Jun;59(2):338-343

1Medical Faculty, Ss Cyril and Methodius University, Skopje, Republic of Macedonia; 2University Hospital of Obstetrics and Gynecology, Skopje, Republic of Macedonia; 3Department of Infectious Diseases, Shtip Medical Center, Shtip, Republic of Macedonia; 4Department of Infectious Diseases, Kavadarci Medical Center, Kavadarci, Republic of Macedonia; 5Department of Infectious Diseases, Prilep Medical Center, Prilep, Republic of Macedonia; 6Faculty of Veterinary Medicine, Ss Cyril and Methodius University, Skopje, Republic of Macedonia.

Different outcomes of brucellosis in pregnancy regarding the fetus/neonate and the mother are described. Medical records of five pregnant women with brucellosis were retrospectively analyzed. Patients were treated in several departments of infectious diseases in the Republic of Macedonia between 1995 and 2009. Read More

Acta Clin Croat 2020 Jun;59(2):329-337

1Department of Neurosurgery, Sarajevo University Clinical Center, Sarajevo, Bosnia and Herzegovina; 2Department of Neurosurgery, University of Marburg, Marburg, Germany; 3Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 4University of Applied Health Sciences, Zagreb, Croatia; 5Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 6Josip Juraj Strossmayer University of Osijek, School of Dental Medicine and Health, Osijek, Croatia; 7Department of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia; 8Semmes Murphey Neurologic & Spine Institute, Memphis, TN, United States; 9Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, United States.

Myxopapillary ependymomas (MPE) of the spinal cord are slow-growing benign tumors most frequently found in adults between 30 and 50 years of age. They arise from the ependyma of the filum terminale and are located in the area of the medullary conus and cauda. The recommended treatment option is gross total resection, while patients undergoing subtotal resection usually require radiotherapy. Read More

Acta Clin Croat 2020 Jun;59(2):318-328

1Department of Dermatovenereology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2School of Dental Medicine, University of Zagreb, Zagreb, Croatia; 3Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.

Allergic reactions sometimes participate in the development of perioral and oral diseases, indicating the need for appropriate allergen assessment. This review discusses current knowledge on the potential allergic reactions to different dental materials in patients with oral and perioral diseases. Aside from allergies to various dental materials, similar non-allergic, non-immune contact reactions (irritant or toxic) can occur. Read More

Acta Clin Croat 2020 Jun;59(2):312-317

1Division of Clinical Immunology, Allergology and Rheumatology, Department of Internal Medicine, Dubrava University Hospital, Zagreb, Croatia; 2Division of Hematology, Department of Internal Medicine, School of Medicine, University of Zagreb, Dubrava University Hospital, Zagreb, Croatia; 3Division of Clinical Immunology, Pulmonology and Rheumatology, Department of Internal Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

The aim of this study was to investigate the association of smoking with disease activity, seropositivity, age and gender in patients with rheumatoid arthritis. We included 89 rheumatoid arthritis patients. All patients fulfilled the 2010 American College of Rheumatology/European League Against Rheumatism rheumatoid arthritis classification criteria. Read More

Acta Clin Croat 2020 Jun;59(2):303-311

1Health Promotion Division, Croatian Institute of Public Health, Zagreb, Croatia; 2Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia; 3European Office for Prevention and Control of Noncommunicable Diseases, World Health Organization, Moscow, Russia.

The aim of this study was to determine the prevalence and analyze the determinants of overweight and obesity among Croatian schoolchildren aged 7-9 years in relation to sociodemographic factors. This study used data that were gathered as part of the WHO Europe Childhood Obesity Surveillance Initiative in 2015/2016. The sample for the study was nationally representative. Read More

Acta Clin Croat 2020 Jun;59(2):294-302

1Community Health Center, Rožaje, Montenegro; 2Department of Gynecology and Obstetrics, Faculty of Medicine, University of Prishtina, Kosovska Mitrovica, Serbia; 3Department of Psychology, Faculty of Medicine, University of Prishtina, Kosovska Mitrovica, Serbia; 4Institute for Preventive Medicine, Faculty of Medicine, University of Prishtina, Kosovska Mitrovica, Serbia; 5Department of Obstetrics and Gynecology, State Hospital, Novi Pazar, Serbia.

The objective of our research was to compare the results of human papillomavirus (HPV) typing and occurrence of the most important risk factors for cervical cancer obtained in the towns of northern, central and southern regions of Montenegro, in subjects between 30 and 35 years of age, in accordance with the new screening program introduced by the Ministry of Health of Montenegro in 2018. The study included 400 patients aged 30-35 years from Rožaje, Berane, Budva and Podgorica, 100 from each town, who underwent HPV typing in accordance with the latest screening program for early detection and prevention of cervical cancer, approved by the Ministry of Health of Montenegro in 2018. The material was obtained and sampled at the Health Clinics in Rožaje, Berane, Podgorica and Budva. Read More

Acta Clin Croat 2020 Jun;59(2):285-293

1Marketing Department, Faculty of Economics & Business, University of Zagreb, Zagreb, Croatia; 2Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

Hospital healthcare service quality measurement represents an important approach for advancing healthcare systems. This paper presents preliminary results of a research on the quality of healthcare services provided by a large, public, university hospital centre in Croatia, based on the Gaps Model of Service Quality and the SERVQUAL instrument. The importance of particular service quality dimensions was analyzed, as well as the gaps between patient perceptions and expectations of healthcare services provided by 18 departments of the university hospital centre. Read More

Acta Clin Croat 2020 Jun;59(2):277-284

1Department of Obstetrics and Gynecology, Division of Gynecological Oncology, Akdeniz University School of Medicine Hospital, Antalya, Turkey; 2Department of Obstetrics and Gynecology, Antalya Education & Research Hospital, Antalya, Turkey.

No definite consensus exists currently regarding the appropriate age at which to start cervical cancer screening. We analyzed the effectiveness of age in abnormal histology outcomes in women aged 20-29. Data on women aged 20-29 having undergone opportunistic cervical cancer screening with cytology during the 2014-2019 period were retrospectively reviewed. Read More

Acta Clin Croat 2020 Jun;59(2):270-276

1Krapinske Toplice Special Hospital for Medical rehabilitation, Krapinske Toplice, Croatia; 2Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Akromion Special Hospital for Orthopedic Surgery, Krapinske Toplice, Croatia; 4School of Medicine, University of Split, Split, Croatia.

The aim of this study was to determine conventional ultrasonography characteristics of calcium deposits in patients diagnosed with calcific tendinopathy, to determine vascularization around deposits by power Doppler, and to compare morphological and power Doppler findings with clinical findings by use of two questionnaires. Pain and function were evaluated using the visual analog scale and two questionnaires, Constant Shoulder Score and Oxford Shoulder Score. All subjects underwent ultrasonography examination and evaluation of vascularization (flow) along calcium deposit using power Doppler. Read More

Acta Clin Croat 2020 Jun;59(2):260-269

1Zadar General Hospital, Department of Pediatrics, Zadar, Croatia; 2School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Special Hospital for Developmental Neurology and Rehabilitation, Zagreb, Croatia; 4Krapinske Toplice Special Hospital for Medical Rehabilitation, Krapinske Toplice, Croatia; 5Osijek University Hospital Centre, Department of Pediatrics, Osijek, Croatia; 6Požega General Hospital, Department of Pediatrics, Požega, Croatia; 7Zagreb Children's Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia.

The aim of this population-based study was to evaluate the characteristics of cerebral palsy (CP) in relation to the predominant pattern of the Magnetic Resonance Imaging Classification System (MRICS) that was analogously applied to the neonatal/early infant cranial ultrasound (CUS). The study included children born during the 2004-2007 period from the Croatian part (C28 RCP-HR) of the Surveillance of Cerebral Palsy in Europe (SCPE) CP register. Motor functions, accompanying impairments and brain MRI were evaluated in 227 children, 185 of which also had CUS. Read More

Acta Clin Croat 2020 Jun;59(2):252-259

1Department of Medical Physics, Biophysics, Roentgenology and Radiology, Faculty of Medicine, Department of Diagnostic Imaging, St. Kirkovich University Hospital, Trakia University-Stara Zagora, Stara Zagora, Bulgaria; 2Department of Special Surgery/Thoracic Surgery, Vascular Surgery, Pediatric Surgery and Orthopedics and Traumatology, Faculty of Medicine, Division of Thoracic Surgery, St. Kirkovich University Hospital, Trakia University-Stara Zagora, Stara Zagora, Bulgaria.

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. Read More

Acta Clin Croat 2020 Jun;59(2):242-251

1Josip Juraj Strossmayer University in Osijek, Faculty of Medicine, Osijek, Croatia; 2Osijek University Hospital Centre, Osijek, Croatia.

Breast cancer is the most common malignancy in the population of women under 40 years of age. Young age is an independent factor for poor prognosis. In this research, we tried to establish other factors for poor prognosis in stage I-III breast cancer. Read More

Acta Clin Croat 2020 Jun;59(2):233-241

Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

Improving organization and patient care quality in intensive care units is increasingly important as intensive care unit diagnostic and therapeutic procedures account for a growing proportion of hospital services. We identified the lack of comprehensive national and international registries available in the contemporary literature. This paper aims to describe and analyze cardiac intensive care unit (CICU) network at the national level in Croatia and its comparison with more developed countries. Read More

Acta Clin Croat 2020 Jun;59(2):227-232

1Division of Anesthesiology and Intensive Care Unit, Department of Emergency, AUSL Romagna-Cesena, Cesena FC, Italy; 2General and Emergency Surgery, Department of General Surgery, Azienda Ospedaliera, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; 3Division of Anesthesiology and Intensive Care Unit, Department of Cardiology, Thoracic and Vascular Surgery, Critical Care Medicine, Azienda Ospedaliera, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; 4Operations Manager Istituto Clinico Humanitas Mater Domini,Varese, Italy; 5Intensive Care Unit, Azienda Ospedaliera, IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; 6Business Administration/University of Bologna, Department of Management, Bologna, Italy; 7Department of Surgery, Anesthesia and Intensive Care Section, G.B. Morgagni Hospital, AUSL Romagna-Forlì, Forlì FC, Italy.

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. Read More

Acta Clin Croat 2020 Jun;59(2):223-226

1Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran; 2Department of Neurology, Hamadan University of Medical Sciences, Hamadan, Iran; 3Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 4Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Occlusion of the initial segment of internal carotid artery is the most common reason for vascular events in the brain. The purpose of this study was to investigate the effect of one-year treatment with atorvastatin on intima-media thickness (IMT) of carotid arteries as a measure of atherosclerosis in stroke patients. In this prospective interventional study, 44 patients with ischemic stroke were investigated. Read More

Acta Clin Croat 2020 Jun;59(2):216-222

1Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan; 2Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan.

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. Read More

Acta Clin Croat 2020 Jun;59(2):209-215

1University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia.

The important goal in breast cancer treatment is to improve patient quality of life. Due to the huge economic burden, it is necessary to estimate the health state utility values for different breast cancer stages accurately. A group of 114 women filled out the EuroQol-5D-3L questionnaire at two time points. Read More

Acta Clin Croat 2020 Jun;59(2):199-208

1Ondokuz Mayıs University Health Science Faculty, Ondokuz Mayis University Campus, Samsun, Turkey; 2Gazi State Hospital, Samsun, 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). Read More

Acta Clin Croat 2020 Mar;59(1):183-187

1Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 2Department of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia; 3Department of Neurosurgery, Military Medical Academy, Belgrade, Serbia; 4School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 5University of Applied Health Sciences, Zagreb, Croatia.

Giant cavernomas (GC) are rare lesions, with less than 50 cases reported so far. Clinical presentation usually involves epileptic seizures and less typically focal neurological deficit, due to repeated hemorrhages and GC mass effect and consequentially increased intracranial pressure. Although individual cases have been reported, due to the rarity and variable imaging appearance, GCs are usually not considered in the differential diagnosis of large hemorrhagic lesions, especially when significant mass effect is present. Read More

Acta Clin Croat 2020 Mar;59(1):177-182

1Department of Neurosurgery, Bamberg General Hospital, Bamberg, Germany; 2University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia; 3Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana, Slovenia; 4Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 5Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 6University of Applied Health Sciences, Zagreb, Croatia; 7Department of Neurosurgery, Tübingen University Hospital, Tübingen, Germany; 8Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas, USA.

Syringomyelia is characterized by a fluid-filled cavity within the spinal cord. Expansion of the syrinx often results in the clinical course of progressive neurologic deficit. Surgery for syringomyelia generally aims to treat the underlying cause, if it is known. Read More

Acta Clin Croat 2020 Mar;59(1):173-176

1Department of Internal Medicine, Osijek University Hospital Centre, Osijek, Croatia; 2Department of Internal Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Physiology and Immunology, Faculty of Medicine, University of Osijek, Osijek, Croatia; 4Department of Psychiatry, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Psychiatry, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 6University Hospital of Traumatology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 7Department of Surgery, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.

Endocrinopathies are relatively rare causes of erectile dysfunction. Cases of hyperprolactinemia and pituitary adenomas have been previously reported. We present a clinical case of a 27-year-old male with suspected infertility and recent symptoms of erectile dysfunction. Read More

Acta Clin Croat 2020 Mar;59(1):166-172

1Department of Radiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 3Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 4Josip Juraj Strossmayer University of Osijek, School of Dental Medicine and Health, Osijek, Croatia; 5Ministry of Health, Republic of Croatia, Zagreb, Croatia; 6Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia; 7University of Applied Health Sciences, Zagreb, Croatia.

Cerebral ventricular system is a sporadic location of intracranial aneurysms including those of basilar artery tip. Treatment of such aneurysms remains challenging regardless of endovascular or microsurgical techniques applied. Basilar tip aneurysm presenting as third ventricular mass is rarely associated with obstructive hydrocephalus, mimicking midbrain expansive process and urging precise diagnostics and prompt treatment. Read More

Acta Clin Croat 2020 Mar;59(1):161-165

1Department of Pediatrics, Split University Hospital Centre, University of Split School of Medicine, Split, Croatia; 2Department of Pediatrics, Division of Pediatric Rheumatology and Immunology, Zagreb University Hospital Centre, University of Zagreb School of Medicine, Zagreb, Croatia.

Biological agents are widely used in the treatment of autoimmune rheumatic disorders. We report on serious adverse events during treatment with anti-tumor necrosis factor antibody in two of our patients with juvenile idiopathic arthritis. One patient was treated with a biological agent due to juvenile idiopathic arthritis complicated by uveitis, developing miliary tuberculosis during treatment. Read More