Croatian medical journal
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Croatian medical journal · Dec 2023
Case ReportsBilateral facial nerve palsy as a presentation of coexisting neuroborreliosis and post-acute COVID-19 syndrome.
Bilateral simultaneous facial nerve palsy is an extremely rare condition that may be induced by infection (bacterial, viral, or fungal) or noninfective causes (autoimmune, traumatic, or structural). The treatment depends on the underlying disorder, and, if it is introduced on time, the disease is in most cases completely reversible. We report on a patient with bilateral simultaneous facial nerve palsy without an obvious cause. ⋯ Serological tests revealed Borrelia burgdorferi, and the result was confirmed by an enzyme-linked immunosorbent assay (IgM positivity). After 14 days of antibiotic therapy, the symptoms resolved completely without sequelae. This report shows that the symptoms of bilateral simultaneous facial nerve palsy may completely resolve if thorough clinical investigation and an appropriate early treatment are applied.
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Croatian medical journal · Dec 2023
ReviewFormation and elimination of soluble fibrin and D-dimer in the bloodstream.
Soluble fibrin is composed mainly of desA fibrin and fibrinogen oligomers consisting of fewer than 16 monomers partially cross-linked by factor XIIIa. Soluble fibrin cannot stimulate Glu-plasminogen activation by tissue plasminogen activator (t-PA); therefore, it may not be a direct predecessor of D-dimer. However, within the microcirculatory system, soluble fibrin oligomers may form microclots. ⋯ Therefore, the exact mechanisms of fibrin clots formation and elimination in normal and pathological conditions remain unclear. In this study, we reviewed findings on the molecular mechanisms of the formation and dissolution of fibrin clots, fibrin-dependent activation of Glu-plasminogen by t-PA, and blood plasma behavior in the microcirculatory system. Finally, we proposed a model that explains the relations of D-dimer and soluble fibrin underlying the common and separate mechanisms of their formation and elimination.
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Croatian medical journal · Dec 2023
Cognitive functioning is prognostic in patients with IDH1-wild type and MGMT-unmethylated high-grade gliomas.
To investigate the prognostic factors of survival in patients with high-grade gliomas without isocitrate dehydrogenase-1 (IDH) mutation and O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation. ⋯ Cognitive functioning in the domain of verbal fluency was associated with overall survival independently of age and the extent of surgery. Cognitive functioning could be an important stratifying tool in this group of patients lacking other predictors.
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Croatian medical journal · Dec 2023
Case ReportsSuccessful treatment of late obstetric ethylene glycol intoxication with ethanol via the enteral route: a case report.
Late obstetric ethylene glycol intoxication represents a diagnostic challenge for acute care physicians and an impending life threat with life-long implications for both the mother and the fetus. The metabolism of ethylene glycol to its toxic metabolites during late pregnancy is unpredictable due to maternal physiological changes. Namely, the hallmark signs and symptoms of ethylene glycol intoxication can mimic those of late pregnancy-related high blood pressure disorders, which makes it difficult to correctly diagnose the condition. ⋯ The parturient was stabilized by inhibiting ethylene glycol metabolism, alongside general supportive care measures. The enhancement of its toxic metabolites was eliminated by administering ethanol via the enteral route, which progressively improved the parturient's clinical course and led to the on-term delivery of a healthy child. Our case shows the importance of a meticulous emergent assessment, prompt diagnosis, and carefully planned multidisciplinary treatment in the emergency department in improving outcomes after ethylene glycol intoxication in late pregnancy.
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Croatian medical journal · Dec 2023
Benign and malignant prostate neoplasms show different spatial organization of collagen.
To compare the indicators of the spatial organization of collagen and its regulating factors between benign and malignant prostate neoplasms. ⋯ Collagen matrix spatial organization features, as well as its regulatory factors, could be potential biomarkers of malignant prostate neoplasms.