Acta clinica Croatica
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Acta clinica Croatica · Dec 2023
ReviewMUSCULOSKELETAL MANIFESTATIONS OF SYSTEMIC LUPUS ERYTHEMATOSUS.
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that most commonly affects the young, working, female population. Musculoskeletal manifestations are one of the most prevalent and presenting features in SLE. Arthralgia, myalgia, non-erosive arthritis, myositis but also tenosynovitis and enthesitis are present in more than 90% of SLE patients. ⋯ There are many radiological imaging methods, i.e., classic radiograms, ultrasound, bone scintigraphy, and magnetic resonance imaging that provide morphological information regarding damage and activity of musculoskeletal diseases in SLE and other rheumatic diseases. Musculoskeletal ultrasound stands out as an accessible and affordable method. Recognizing musculoskeletal manifestations may help establish an early diagnosis of SLE and assess disease activity, thus leading to early initiation of treatment and preventing chronic and irreversible changes with a beneficial effect on the quality of life.
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Acta clinica Croatica · Dec 2023
Case ReportsSEBACEOUS CARCINOMA OF THE EYELID AND MUIR-TORRE SYNDROME.
Muir-Torre syndrome is a rare form of hereditary nonpolyposis colorectal cancer syndrome; simplified, it is an association of at least one sebaceous skin tumor and at least one visceral malignancy. It follows an autosomal dominant pattern of inheritance. ⋯ During his treatments, he was examined by experts in different medical fields. After genetic counseling, he also underwent genetic testing.
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Acta clinica Croatica · Dec 2023
Observational StudyEFFECTS OF PREOPERATIVE ANXIETY, DEPRESSION AND PAIN ON QUALITY OF POSTOPERATIVE RECOVERY AND ACUTE POSTOPERATIVE PAIN AFTER RADICAL PROSTATECTOMY: A PROSPECTIVE OBSERVATIONAL STUDY.
Patients with prostate cancer are often in psychological distress and pain preoperatively. The aim of this study was to examine the effects of preoperative anxiety, depression and pain on the quality of postoperative recovery and acute postoperative pain after radical prostatectomy. One hundred and sixty patients scheduled for open or laparoscopic radical prostatectomy were enrolled in a prospective observational study. ⋯ In logistic regression models, preoperative pain was predictor of clinically significant pain at rest (OR, 2.86; 95% CI 1.11-7.36) and STAI-S of clinically significant pain on movement (OR, 2.21; 95% CI, 1.08-4.52). In conclusion, state anxiety had negative impact on QoR and acute pain after radical prostatectomy. Preoperative pain was associated with acute postoperative pain.
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Hypertensive nephropathy (HN) is characterized by kidney damage due to chronic high blood pressure. Podocytes play a crucial role in the pathogenesis of HN, thus, nephrin could be important in the early diagnosis of HN. The aim of the study was to investigate the association of urinary nephrin (u-nephrin) levels with clinical and laboratory characteristics in patients with HN and to test diagnostic relevance of u-nephrin as an early biomarker of HN. ⋯ The levels of u-nephrin increased gradually with the stage of CKD. ROC curve plotted for u-nephrin showed 89.7% sensitivity and 88.8% specificity, while UM/CR showed a sensitivity of 44.8% and specificity of 86.1% to detect HN in the early stage. It is concluded that u-nephrin can be useful as an early biomarker of HN.
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Acta clinica Croatica · Dec 2023
PREDICTORS OF INTRAOPERATIVE HYPERTENSION IN NECK SURGERY: A SINGLE CENTER RETROSPECTIVE STUDY.
Intraoperative hypertension (IOHTA) during neck surgery is undesirable because this type of surgery has a propensity to bleed profoundly even in normotensive anesthesia. The purpose of our study was to detect predictors of IOHTA in patients undergoing neck surgery. This single center retrospective study included 880 adult patients who underwent neck surgery under general anesthesia. ⋯ Statistically significant predictors of IOHTA were age (OR 1.438; 95% CI 1.144-1.808; p=0.002), cardiac arrhythmia (OR 1.702; 95% CI 1.129-2.566; p=0.011), Cormack-Lehane grade (OR 1.407; 95% CI 1.054-1.878; p=0.020), and duration of anesthesia (OR 1.005; 95% CI 1.001-1.008; p=0.005). The risk of IOHTA occurrence was lower in patients with induced hypotension (OR 0.024; 95% CI 0.003-0.185; p=0.000). During neck surgery, special attention is needed in patients of older age, those with cardiac arrhythmia, difficult intubation, and longer anesthesia duration because they are at risk of IOHTA.