Acta clinica Croatica
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Acta clinica Croatica · Jun 2020
Case ReportsA 27-year-old patient with congenital bladder exstrophy and recurrent pelvic organ prolapse: a case report.
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. ⋯ After 36 months, the patient was still asymptomatic with no evidence for prolapse recurrence. This case demonstrates diagnostic challenges and surgical dilemmas in treatment strategy for patients with BE and co-existent POP. Furthermore, routine long-term surveillance is necessary in terms of renal function, urinary continence, malignancy and possible obstetric issues.
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Acta clinica Croatica · Jun 2020
Regional and sociodemographic determinants of the prevalence of overweight and obesity in children aged 7-9 years in Croatia.
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. ⋯ The risk of overweight and obesity was increased in boys living in the Adriatic region (ORadj=1.33; 95% CI 1.03-1.71) and in girls with high-school educated mothers (ORadj=1.36; 95% CI 1.11-1.66). Girls with unemployed mothers had a lower risk of overweight and obesity (ORadj=0.73; 95% CI 0.58-0.92). The observed prevalence of childhood overweight and obesity warrants national and local time-bound targets for reduction of childhood obesity, accompanied by detailed action plans and monitoring mechanisms.
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Acta clinica Croatica · Jun 2020
Autologous Fat Augmentation in the Treatment of Unilateral Vocal Fold Paralysis - A 15-year Experience in a Single Institution.
Autologous fat vocal fold augmentation is a widespread surgical procedure that aims to repair glottal incompetence in patients with unilateral vocal fold paralysis (UVFP). However, there are some concerns in the literature about the long-term results of this technique. At the ENT Department of the Zagreb University Hospital Centre, this technique has been in use for more than 15 years, and a retrospective medical chart review was conducted from June 2005 to November 2019. ⋯ All tested voice outcome parameters (maximum phonation time (MPT), jitter, shimmer, noise-to-harmonic ratio (NHR)) significantly improved after surgery, both early and late postoperatively (p<0.001). The reoperation rate was only 10.3% (8/78), with the majority of patients in our series experiencing long-term benefits from this surgical procedure. According to the results of our study, autologous fat vocal fold augmentation appears to be a highly useful and effective surgical technique with long-lasting results in the majority of patients suffering from UVFP.
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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
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.