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Papes D, Cavar S, Sabolic I, Pasini M, Jurca I, Antabak A, Luetic T. Internal Spermatic Vein to Superficial Epigastric Vein Microsurgical Bypass in Varicocele Treatment. Eur J Pediatr Surg 2023; 33:138-143. [PMID: 36104092 DOI: 10.1055/s-0042-1750053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Identification and preservation of testicular artery and lymphatic vessels during microsurgical varicocelectomy can be tedious if adhered encompassing venous network is encountered. A venous bypass from internal spermatic to saphenous or inferior epigastric vein, that have been described for varicocele treatment, may be used in such situations. This paper describes a simplified modification of the venous bypass technique that reroutes the testicular blood to the superficial epigastric vein, which can easily be found in the incisional wound. Surgical technique and anastomotic patency test are described, and indications and results are discussed. MATERIALS AND METHODS During 2020 and 2021, 32 adolescent patients underwent microsurgical varicocelectomy. In eight patients additional microsurgical testicular vein-superficial epigastric vein microvascular bypass was done. The indication for bypass was difficult identification of testicular artery and/or lymphatic vessels due to adhered venous plexus. RESULTS Varicocele resolution was noted in all eight patients with clinical and/or semen analysis improvement. There were no complications or recurrences. Average length of procedure was 65 minutes. All patients were discharged within 24 hours and no antiplatelet or anticoagulant therapy was used. CONCLUSION Testicular vein to superficial epigastric vein anastomosis is a useful and simplified venous bypass technique that reroutes the blood from the pampiniform plexus to the femoral vein. It can be done as an adjunct to microsurgical varicocelectomy in selected patients through a standard incision.
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Affiliation(s)
- Dino Papes
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Stanko Cavar
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ivana Sabolic
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Miram Pasini
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ivana Jurca
- Department of Radiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Anko Antabak
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Tomislav Luetic
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
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Antabak A, Boršćak N, Čagalj M, Ivelj R, Bumči I, Papeš D, Ćavar S, Bogović M, Bulić K, Luetić T. TREATMENT OF PEDIATRIC FEMORAL FRACTURES IN THE CITY OF ZAGREB. Acta Clin Croat 2020; 59:686-695. [PMID: 34285439 PMCID: PMC8253082 DOI: 10.20471/acc.2020.59.04.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 10/29/2018] [Indexed: 11/24/2022] Open
Abstract
Femur fractures in children can be treated with a number of operative and conservative methods. Numerous factors determine which method is optimal for a specific fracture. The aim of this research was to analyze distribution of femur fractures in children living in the urban communities of Zagreb and Zagreb County by localization, type and frequency of treatment methods used according to age and fracture mechanism. The research included 103 children aged up to 18 years, treated for femur fractures at the Zagreb University Hospital Centre and Zagreb Children’s Hospital. Data were collected from these institutions and a retrospective study covered the 2010-2015 period. The cause of fracture and diagnosis were coded with the help of the International Statistical Classification of Diseases and Related Health Problems. Operative treatment was applied in 55% of cases, which is contrary to previous researches. The highest incidence of femur fractures was recorded in the 0- to 4-year age groups, accounting for 49.1% of all fractures. These fractures mostly occurred due to falls and were more often treated with non-operative methods. All other age groups were mostly treated with operative methods. Coxofemoral immobilization and traction were used as non-operative methods, whereas flexible intramedullary nailing was the most frequently used operative method. The treatment depended on age, complexity of the fracture, fracture type, fragment displacement, and associated injuries. The cause was also an important factor on choosing the treatment method. Non-operative treatment was mostly used for fractures caused by falls (64.71% of cases due to falls) and operative treatment was mostly used for fractures caused by traffic accidents (79.4% of cases due to traffic accidents). It is a wide-known opinion that the best treatment for femur fractures in children is non-operative treatment. However, recent studies have shown that the use of operative methods in femur fracture treatment is growing. Our cohort of children treated during a five-year period (2010-2015) also underwent operative treatment more often than non-operative one. Two non-operative and eight operative methods were used. With such a large number of methods, it is clear that there is no unique method for all fractures. However, it is clear that the trend of using operative treatment is connected to the perennial trend of considerable sociodemographic and socioeconomic changes in urban settings such as Zagreb. Lifestyle changes directly affect the prevalence of femur fractures among children, as well as approach to treatment choice. General opinion is that most of fractures that occur at an early age can be treated with non-operative methods. Our research on femur fractures in children confirmed this rule. The youngest age group that had the highest incidence of fractures (49.1% of all fractures) was treated with non-operative methods in 75% of cases. Operative methods prevailed in other age groups. Similar results have been published by other authors. In conclusion, nearly half of all femur fractures (49.1%) occurred at a young age (0-4 years). Diaphysis fractures were most common. Most of the fractures that occurred during the 2010-2015 period were treated with operative methods, mostly in children aged 5-9 years. Out of eight different operative methods, elastic stable intramedullary osteosynthesis was most frequently used (60%). Coxofemoral immobilization and traction were used as non-operative methods.
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Affiliation(s)
| | - Nikolina Boršćak
- 1Zagreb University Hospital Centre, Department of Surgery, Division of Pediatric Surgery, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Zagreb Children's Hospital, Department of Surgery, Division of Traumatology, Zagreb, Croatia
| | - Marija Čagalj
- 1Zagreb University Hospital Centre, Department of Surgery, Division of Pediatric Surgery, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Zagreb Children's Hospital, Department of Surgery, Division of Traumatology, Zagreb, Croatia
| | - Renato Ivelj
- 1Zagreb University Hospital Centre, Department of Surgery, Division of Pediatric Surgery, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Zagreb Children's Hospital, Department of Surgery, Division of Traumatology, Zagreb, Croatia
| | - Igor Bumči
- 1Zagreb University Hospital Centre, Department of Surgery, Division of Pediatric Surgery, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Zagreb Children's Hospital, Department of Surgery, Division of Traumatology, Zagreb, Croatia
| | - Dino Papeš
- 1Zagreb University Hospital Centre, Department of Surgery, Division of Pediatric Surgery, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Zagreb Children's Hospital, Department of Surgery, Division of Traumatology, Zagreb, Croatia
| | - Stanko Ćavar
- 1Zagreb University Hospital Centre, Department of Surgery, Division of Pediatric Surgery, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Zagreb Children's Hospital, Department of Surgery, Division of Traumatology, Zagreb, Croatia
| | - Marko Bogović
- 1Zagreb University Hospital Centre, Department of Surgery, Division of Pediatric Surgery, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Zagreb Children's Hospital, Department of Surgery, Division of Traumatology, Zagreb, Croatia
| | - Krešimir Bulić
- 1Zagreb University Hospital Centre, Department of Surgery, Division of Pediatric Surgery, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Zagreb Children's Hospital, Department of Surgery, Division of Traumatology, Zagreb, Croatia
| | - Tomislav Luetić
- 1Zagreb University Hospital Centre, Department of Surgery, Division of Pediatric Surgery, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Zagreb Children's Hospital, Department of Surgery, Division of Traumatology, Zagreb, Croatia
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Premuzic V, Mihaljevic D, Pasini M, Mesar I, Luetic T, Antabak A. Durability of tunneled catheters in children is associated with catheter tip depth: A single-center report. Ther Apher Dial 2020; 25:490-496. [PMID: 33026706 DOI: 10.1111/1744-9987.13593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/21/2020] [Accepted: 10/04/2020] [Indexed: 11/26/2022]
Abstract
The aim of this study was to examine the impact of different catheter tip positions on catheter duration and dysfunction of tunneled catheters in children. Catheters were evaluated for place of insertion, time of insertion, catheter tip depth and position, duration of use, and reason for removal. The mean duration of implanted catheters with tips placed in cavo-atrial junction/right atrium was significantly longer with significantly lower percentage of complications than tips placed in superior vena cava. Only catheter tips placed in cavo-atrial junction/right atrium was a predictor of catheter functionality and survival. Shorter catheter survival in children with tunneled catheters is a consequence of a catheter tip depth proximal of CAJ and RA. Our results showed that the main factor responsible for better catheter functionality was not laterality but the depth of the catheter tip, which reduces need for future catheter insertions with increased catheter durability.
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Affiliation(s)
- Vedran Premuzic
- Department for Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Dragan Mihaljevic
- Anesthesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Miram Pasini
- Pediatric Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ines Mesar
- Department for Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Tomislav Luetic
- Pediatric Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Anko Antabak
- Pediatric Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
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Pasini M, Šimić A, Augustin G, Ninković D, Grizelj R, Papeš D, Sabolić I, Ćavar S, Antabak A, Luetić T. Laparoscopic duodenoduodenostomy in a neonate with annular pancreas. LV 2020; 142. [DOI: 10.26800/lv-142-7-8-36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Affiliation(s)
| | - Andrea Šimić
- Odjel za opću i dječju kirurgiju, Služba za kirurgiju
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Grizelj R, Sindičić Dessardo N, Bulić K, Luetić T, Mikulić D, Antabak A, Sjekavica I, Alduk AM, Konosić S, Režek Tomašić K, Ćaleta T, Pleško S, Šarić D, Vuković J. Successful separation of xypho-omphalopagus conjoined twins with extrauterine twin-twin transfusion syndrome: a case report. Croat Med J 2019. [PMID: 31483115 PMCID: PMC6734570 DOI: 10.3325/cmj.2019.60.301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Conjoined twining is a rare medical phenomenon, with an overall prevalence of 1.47 per 100 000 births. This report describes a successful separation of xypho-omphalopagus conjoined twins complicated by unbalanced blood shunting through the porto-systemic anastomoses within the shared liver parenchyma. Significant extrauterine twin-twin transfusion syndrome caused by unbalanced shunting is an extremely rare, and probably under-recognized, hemodynamic complication in conjoined twins necessitating urgent separation. Progressive deterioration with a poor outcome can be prevented if the condition is recognized in a timely manner.
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Affiliation(s)
- Ruža Grizelj
- Ruža Grizelj, Department of Pediatrics, University of Zagreb School of Medicine, University Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia,
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Mance M, Bulic K, Antabak A, Miloševic M. The influence of size, depth and histologic characteristics of invasive ductal breast carcinoma on thermographic properties of the breast. EXCLI J 2019; 18:549-557. [PMID: 31611739 PMCID: PMC6785770 DOI: 10.17179/excli2019-1600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/18/2019] [Indexed: 12/24/2022]
Abstract
Invasive breast carcinoma is the most common oncologic disease worldwide. The existing diagnostic methods use morphologic changes in the breast to diagnose a carcinoma when it has reached a certain size. Therefore, it is important to augment the morphologic diagnostic examinations with a new method that focuses on characteristics other than morphology such as electromagnetic changes produced by cancer. 50 adult female patients with confirmed ductal carcinoma following a core biopsy due to a suspicious breast mass were included in the study. They underwent breast thermography using a specially designed infrared camera. The data collected was statistically analyzed to determine how the presence of a tumor and its histologic characteristics influence breast thermographic properties. Twenty eight [56 %] patients in the study had an abnormal thermogram. Following statistical analysis, it was found that temperature of the diseased breast was directly correlated to tumor volume [p=0.009] and negatively correlated to depth of tumor [p=0.042]. Tumors that were ER+ and PR+ tumors produced warmer temperatures [p=0.017 and p=0.038 respectively] than tumors without these receptors. HER2 status and Ki-67 index had no statistical correlation with breast temperature. Tumor size, distance from the skin surface and receptor status cause changes in breast thermographic properties. Despite technical advances in the field of thermography, there are still contradictory results associated with thermography. Its diagnostic abilities are generally poorer than conventional methods and its use in breast cancer screening or as an adjunctive tool for diagnostic purposes is not recommended.
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Affiliation(s)
- Marko Mance
- Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital Center Zagreb, Kišpaticeva 12, 10 000 Zagreb, Croatia
| | - Krešimir Bulic
- Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital Center Zagreb, Kišpaticeva 12, 10 000 Zagreb, Croatia
| | - Anko Antabak
- Department of Pediatric Surgery, University Hospital Center Zagreb, Kišpati?eva 12, 10 000 Zagreb, Croatia
| | - Milan Miloševic
- University of Zagreb, School of Medicine. Mirogojska cesta 16, 10000, Zagreb
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Luetić T, Radoš M, Vuković J, Grizelj R, Papeš D, Ćavar S, Antabak A. Embolization of a Rapidly Involuting Congenital Hepatic Hemangioma via the Umbilical Vein in a Neonate. J Vasc Interv Radiol 2019; 30:1625-1628. [DOI: 10.1016/j.jvir.2018.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 10/26/2022] Open
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Papes D, Šnajdar I, Ćavar S, Antabak A, Bulić K, Bartoniček D, Dobrota S, Luetić T. Pediatric Iatrogenic Arteriovenous Fistulas. Am Surg 2019; 85:e262-e265. [PMID: 31126384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Affiliation(s)
- Dino Papes
- Department of Pediatric Surgery University Hospital Centre Zagreb Zagreb, Croatia
| | - Irena Šnajdar
- Department of Pediatric Surgery University Hospital Centre Zagreb Zagreb, Croatia
| | - Stanko Ćavar
- Department of Pediatric Surgery University Hospital Centre Zagreb Zagreb, Croatia
| | - Anko Antabak
- Department of Pediatric Surgery University Hospital Centre Zagreb Zagreb, Croatia
| | - Kresimir Bulić
- Department of Pediatric Surgery University Hospital Centre Zagreb Zagreb, Croatia
| | - Dorotea Bartoniček
- Department of Pediatric Cardiology University Hospital Centre Zagreb Zagreb, Croatia
| | - Savko Dobrota
- Department of Radiology University Hospital Centre Zagreb Zagreb, Croatia
| | - Tomislav Luetić
- Department of Pediatric Surgery University Hospital Centre Zagreb Zagreb, Croatia
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Antabak A, Bračić K, Karlo K, Bulić K, Papeš D, Augustin G, Ćavar S, Luetić T. Forearm fractures in Zagreb children. LV 2019; 141:14-19. [DOI: 10.26800/lv-141-1-2-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
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Augustin G, Čižmešija Z, Žedelj J, Petrović I, Ivković V, Antabak A, Mijatović D, Škegro M. LAPAROSCOPIC APPENDECTOMY DOES NOT INCREASE THE RATE OF NEGATIVE APPENDECTOMY along with a lower rate of perforated appendicitis - RESULTS IN 1899 PATIENTS at Zagreb UHC. Acta Clin Croat 2018; 57:503-509. [PMID: 31168184 PMCID: PMC6536279 DOI: 10.20471/acc.2018.57.03.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
SUMMARY – Laparoscopic appendectomy is the method of choice of many professional societies owing to its many advantages. The question arises whether surgeons urge more easily to laparoscopic exploration due to its less invasiveness, faster recovery and adequate exploration of the entire abdominal cavity than to observation in unequivocal cases. This retrospective analysis (2009-2016) included 1899 patients undergoing laparoscopic (lap) or gridiron intra-abdominal approach treated at Zagreb University Hospital Centre. The analysis included total negative appendectomy, negative-negative appendectomy (normal appendix and no other pathology found), and negative-positive appendectomy (normal appendix but another pathology found) in children (≤16 years) and adults. There was no statistically significant difference in the rates of negative appendectomy (children) – lap vs. open (p=0.24); negative appendectomy (adults) – lap vs. open (p=0.15); negative-negative appendectomy (children) – lap vs. open (p=0.36); negative-negative appendectomy (adults) – lap vs. open (p=0.21); negative-positive appendectomy (children) – lap vs. open (p=0.53); negative-positive appendectomy (adults) – lap vs. open (p=0.56); and laparoscopy group negative appendectomy in children vs. adults (p=0.56). There was a statistically significantly higher perforation rate with the open approach in total (p<0.0001), in children (p<0.0001) and in adults (p=0.02). There was no statistically significant difference between adults and children in the perforation rate with laparoscopic approach (p=0.24) and perforation rate with open approach (p=0.29). Results confirmed that there was no statistically significant difference in the rate of negative appendectomy in all subgroups. It is concluded that laparoscopic appendectomy should be offered as the method of choice in any patient population with suspicion of acute appendicitis.
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Affiliation(s)
| | - Zrinka Čižmešija
- 1Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia; 2School of Medicine, University of Zagreb (cand. med.), Zagreb, Croatia; 3Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Jurica Žedelj
- 1Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia; 2School of Medicine, University of Zagreb (cand. med.), Zagreb, Croatia; 3Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Igor Petrović
- 1Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia; 2School of Medicine, University of Zagreb (cand. med.), Zagreb, Croatia; 3Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Vanja Ivković
- 1Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia; 2School of Medicine, University of Zagreb (cand. med.), Zagreb, Croatia; 3Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Anko Antabak
- 1Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia; 2School of Medicine, University of Zagreb (cand. med.), Zagreb, Croatia; 3Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Davor Mijatović
- 1Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia; 2School of Medicine, University of Zagreb (cand. med.), Zagreb, Croatia; 3Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Mate Škegro
- 1Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia; 2School of Medicine, University of Zagreb (cand. med.), Zagreb, Croatia; 3Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
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Antabak A, Perko M, Papeš D, Bulić K, Bogović M, Luetić T, Ćavar S, Augustin G, Kovač T, Ivelj R, Jurić F. DISTAL TIBIAL EPIPHYSEAL FRACTURES. LV 2018; 140:200-205. [DOI: 10.26800/lv-140-7-8-26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
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Antabak A, Berović M, Seiwerth S, Papeš D, Bulić K, Bogović M, Luetić T, Ćavar S, Augustin G. ALVARADO SCORE IN CHILDREN WITH DIAGNOSIS OF ACUTE APPENDICITIS. LV 2018; 140:120-125. [DOI: 10.26800/lv-140-3-4-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
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Bulic K, Antabak A, Lorencin M. Near-Complete Hand Loss Following an Unintentional, Intra-arterial Medicine Injection in an Infant. J Pediatr Intensive Care 2018; 7:43-45. [PMID: 31073466 DOI: 10.1055/s-0037-1601336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 02/18/2017] [Indexed: 10/19/2022] Open
Abstract
Unintentional, intra-arterial administration of medicines can lead to very serious sequelae, including limb loss. We present a case of a 13-week-old boy who was unintentionally given phenobarbital into his right radial artery, which resulted in a near-complete hand amputation. Pediatric patients are under increased risk of such injuries due to their small vessel size and their inability to express immediate complaints, which often leads to a delayed recognition of the condition. As no specific treatment algorithms have been established, the mainstay of therapy is supportive care aimed at maintaining vascular patency. Prompt recognition is imperative in avoiding potentially detrimental effects; therefore, all personnel administering intravenous therapy should be aware of this possibility and be acquainted with the initial supportive measures.
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Affiliation(s)
- Kresimir Bulic
- Department of Surgery, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Anko Antabak
- Department of Surgery, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Mia Lorencin
- Department of Surgery, University of Zagreb School of Medicine, Zagreb, Croatia
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Bačić I, Karlo R, Zadro AŠ, Zadro Z, Skitarelić N, Antabak A. Tumor angiogenesis as an important prognostic factor in advanced non-small cell lung cancer (Stage IIIA). Oncol Lett 2017; 15:2335-2339. [PMID: 29434942 PMCID: PMC5777107 DOI: 10.3892/ol.2017.7576] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 11/07/2017] [Indexed: 12/03/2022] Open
Abstract
The aim of the present study was to evaluate angiogenesis by determining the micro vascular density (MVD) and the expression of vascular endothelial growth factor (VEGF-A) in advanced non-small cell lung cancer (NSCLC) tumor samples, and to analyze their associations with clinical parameters and survival. Tumor tissue specimens of fifty patients (41 males and 9 females), who underwent radical surgical treatment for NSCLC in stage IIIA (T1-3N2) were collected for immunohistochemical analysis. MVD evaluation was performed using an anti-CD31 monoclonal antibody and VEGF-A expression using a polyclonal anti-VEGF-A antibody. The results were associated with two-year survival. Statistical analysis revealed significant associations in the level of angiogenesis (high MVD) and shorter survival of patients with NSCLC (P=0.0007). VEGF-A expression showed no association with micro vascular density (P=0.51) or survival (P=0.68). There was no significant association between MVD and VEGF-A. The measurable, clinical MVD parameters could be used as a reliable prognostic factor for the survival of patients with advanced NSCLC.
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Affiliation(s)
- Ivan Bačić
- Department of Surgery, Zadar General Hospital, Zadar 23000, Croatia.,Department of Health Studies, University of Zadar, Zadar 23000, Croatia
| | - Robert Karlo
- Department of Surgery, Zadar General Hospital, Zadar 23000, Croatia.,Department of Health Studies, University of Zadar, Zadar 23000, Croatia
| | - Ana Šoštarić Zadro
- Department of Radiology, University Hospital for Infectious Diseases, Zagreb 10000, Croatia
| | - Zvonko Zadro
- Department of Surgery, University Hospital, Sveti Duh, University of Zagreb, Zagreb 10000, Croatia
| | - Neven Skitarelić
- Department of Health Studies, University of Zadar, Zadar 23000, Croatia.,Department of Otorhinolaryngology, Zadar General Hospital, Zadar 23000, Croatia
| | - Anko Antabak
- Surgery Clinic, University Hospital Centre Zagreb, Zagreb 10000, Croatia
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Antabak A, Halužan D, Chouehne A, Mance M, Fuchs N, Prlić I, Bešlić I, Bencetić Klaić Z. Analysis of Airborne Dust as a Result of Plaster Cast Sawing. Acta Clin Croat 2017; 56:600-608. [PMID: 29590712 DOI: 10.20471/acc.2017.56.04.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Plaster splints are used daily in surgical and orthopedic fields in order to immobilize injured children and adults. The aim of this study was to measure the aerodynamic diameter and concentration of dust particles in the air caused by sawing plaster splints (calcium sulfate dehy-drate). We performed fractional measurements of airborne dust particles. The measured particles, which can potentially be inhaled, may have a specific negative effect on human health. Measurements were conducted in laboratory research facilities that simulated hospital conditions within a casting room and the associated waiting room. Measurements within the casting room were made using two particle collector devices and one laser photometer. The measurement for the simulated waiting room was performed using the same principles and devices. The collected plaster dust particles differed in aerodynamic diameter and concentration according to the various locations observed. The highest concentration of particles of all sizes was recorded at the site of cast sawing. There was direct correlation between distance from the source and concentration of airborne particles; this concentration was lowest in the waiting room. The concentrations of plaster dust recorded were lower than the recommended minimal limit values for total and respiratory fractions in Croatia. Accordingly, it can be assumed that sawing of plaster splints has no harmful health effects on the exposed patients and health personnel.
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Affiliation(s)
| | - Damir Halužan
- Department of Surgery, Zagreb University Hospital Center, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Marko Mance
- Department of Surgery, Zagreb University Hospital Center, Zagreb, Croatia
| | - Nino Fuchs
- Department of Surgery, Zagreb University Hospital Center, Zagreb, Croatia
| | - Ivica Prlić
- Institute of Medical Research and Occupational Health, Zagreb, Croatia
| | - Ivan Bešlić
- Institute of Medical Research and Occupational Health, Zagreb, Croatia
| | - Zvjezdana Bencetić Klaić
- Andrija Mohorovičić Geophysical Institute, Department of Geophysics, Faculty of Science, University of Zagreb, Zagreb, Croatia
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Antabak A, Čagalj M, Boršćak N, Ivelj R, Papeš D, Halužan D, Romić I, Luetić T. [FEMUR FRACTURES IN CHILDREN – CAUSES AND MECHANISMS OF INJURY]. Lijec Vjesn 2017; 139:24-28. [PMID: 30148588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Children are often exposed to injuries due to their hyperactivity. Femur fractures can however leave permanent consequences despite adequate treatment. The high prevalence and possible invalidity justify research in the field of prevention of this injury. But prevention is possible only by knowing the causes and circumstances of the fractures. The aim of this research is to analyze the circumstances and places of occurrence in femur fractures according to children age groups. This retrospective study includes 103 children up to the age of 18 years treated at the University Hospital Center of Medicine Zagreb, or at the Clinic for children diseases Zagreb in the period from 2012 to 2016. The study includes 35 (33 %) girls and 71 (67 %) boys, a total of 106 children with femur fractures. The average age was five years. The majority of the injured children, 52 children (55,2 %), belonged to the youngest age group from 0 to 4 years of age. Diaphysis fractures were the most common with 66 fractures (62 %), and the rarest were fractures of the distal metaphysis with 15 fractures (13 %). The fractures occurred at home in 41 cases (38 %), in the street in 38 cases (36 %), at recreation in 22 cases (21 5), and at school or kindergarten in 3 cases (3 %). The most common causes of femur fractures were falls in 38 cases (57,5 %), motor vehicle accidents in 35 cases (33 %), and crashes and blows in 10 cases (9,5 %). One third of the children with femur fractures had associated injuries, and four fifths of them were caused by motor vehicle accidents. The results of this study show that femur fractures are most frequent in the youngest age groups, and are generally a consequence of accidents at home (mostly falls), seldom in the streets or recreational places. Parents of preschool children should be educated about prevention of falling at their homes, and parents of school children should be educated about the dangers of fractures at recreational places and traffic.
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Antabak A, Bogović M, Vuković J, Grizelj R, Babić VB, Papeš D, Luetić T. Postoperative Gastric Perforation in a Newborn with Duodenal Atresia. J Neonatal Surg 2016; 5:62. [PMID: 27896170 PMCID: PMC5117285 DOI: 10.21699/jns.v5i4.469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 09/03/2016] [Indexed: 11/11/2022] Open
Abstract
Gastric perforation (GP) in neonates is a rare entity with high mortality. Although the etiology is not completely understood, it mostly occurs in premature neonates on assisted ventilation. Combination of duodenal atresia and gastric perforation is very rare. We present a case duodenal atresia who developed gastric perforation after operetion for duodenal atresia. Analysis of the patient medical record and histology report did not reveal the etiology of the perforation.
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Affiliation(s)
- Anko Antabak
- Department of Surgery, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | - Marko Bogović
- Department of Surgery, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | - Jurica Vuković
- Department of Pediatrics, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | - Ruža Grizelj
- Department of Pediatrics, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | | | - Dino Papeš
- Department of Surgery, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | - Tomislav Luetić
- Department of Surgery, Clinical Hospital Center Zagreb, Zagreb, Croatia
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Antabak A, Brajčinović M, Bradić L, Barišić B, Andabak M, Halužan D, Fuchs N, Haramina T, Ćurković S, Luetić T, Šiško J, Prlić I. [EXOTHERMIC REACTIONS OF PLASTER IMMOBILIZATION – ANALYSIS OF THREE KINDS OF PLASTER BANDAGES]. Lijec Vjesn 2016; 138:250-254. [PMID: 30148545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Exothermic reaction of plaster is a very important characteristic to understand, especially when it comes to complications which can occur during local temperature change during molding plaster of Paris. And these complications directly influence the speed and quality of treatment. In this paper we measured temperatures of plaster bandage tiles 10×10 cm, from three different manufacturers in Croatian hospitals: Safix plus (Hartmann, Germany), Cellona (Lohmann &Rauscher, Austria) and Gipsan ( Ivo Lola Ribar, Croatia). We made three different plaster tiles 10×10 cm, from 10, 15 and 30 layers of plaster bandages. We immersed plaster tiles in two different water temperatures, one group in water 22 °C, and another in 34 °C. Although all plaster bandages have similar chemical characteristics, we have measured some differences. All three kinds of plaster bandages used in Croatia have low exothermic reaction when plaster molding is done in standard conditions, average local temperature is low and there is no danger of local burns. We immersed a plaster tile with 15 layers in water on 34° C, and highest average temperature was measured at Gipsan (46.2 °C), then Cellona (41.3 °C) and Safix plus (38.9 °C). On the same water immersion temperature, on plaster tile with 30 layers average temperatures were Gipsan (48.4°C), Cellona (45.4 °C), and lowest in Safix plus (41.3 °C). Plaster tiles form all manufacturers, when used 15-30 layers thick, and water immersion temperature is 34°C, develop average temperature over 40°C, in duration from 8-12 minutes. Between three different plaster bandages analyzed, Gipsan (Ivo Lola Ribar, Croatia) developed highest temperature, and some plaster tiles were measured over 50 °C.
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Antabak A, Andabak M, Barišić B, Papeš D, Romić I, Fuchs N, Luetić T. FRACTURE OF THE HUMERUS IN CHILDREN – CAUSES AND MECHANISMS OF INJURY. Lijec Vjesn 2016; 138:74-78. [PMID: 30146852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Due to hyperactivity, children are often exposed to injuries of the upper arm and fractures of the humerus can leave permanent damage even after the surgical treatment. The high incidence of fractures justifi es questioning the possible prevention of this injury. Preventive actions are possible only with the knowledge of the causes and circumstances of the fracture. Aim is to analyze the circumstances of the injury, critical places and activities engaged in at the time of the humeral fracture by age groups. The paper analyzed 102 children that were treated at the University Hospital Centre in Zagreb due to fractures of the humerus in the period from 2010 to 2014. In this study, we analyzed 45 girls (44%) and 57 boys (56%). The average age of children was 8.3 years. Fractures of the distal third of the humerus accounted for 4/5 of all analyzed fractures. The right hand was affected more frequently. Nearly 80% of fractures were unstable, which generally require surgical treatment. The injury occurred most often among the 5-9 year-olds. Most injuries took place at the recreational facilities (47%), followed by injuries at home (31%), on streets or roads (15%) and at school or kindergarten (7%). Mechanism of the injury was mainly a fall onto the arm (94%) and the rest of the injuries were due to a direct blow. Almost half of the children got injured in sports or recreational activities. Due to close physical contact and engagement in games, children in preschool and early school age are by far the most susceptible to injuries. To reduce the incidence of such injuries, preventive actions should be taken during daily activities under the supervision of parents towards the most vulnerable age group (5-9 years), along with increasing the supervision in preschools and schools. Of all the activities, the most dangerous to cause fractures of the humerus occur in sports grounds and recreational facilities of preschool children and children in the lower grades of elementary school.
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Bogović M, Papeš D, Mitar D, Smiljanić R, Sršen-Medančić S, Ćavar S, Antabak A, Luetić T. Abdominal Aortic Thrombosis in a Healthy Neonate. Ann Vasc Surg 2016; 32:131.e7-9. [PMID: 26802308 DOI: 10.1016/j.avsg.2015.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 10/29/2015] [Accepted: 10/29/2015] [Indexed: 11/27/2022]
Abstract
Abdominal aortic thrombosis is a rare entity in neonates and has mostly been associated with umbilical artery or cardiac catheterization. We present a complicated case of an otherwise healthy neonate who developed thrombosis of abdominal aorta with renal failure. Therapy with intravenous heparin was unsuccessful, and thrombolysis was contraindicated because of disseminated intravascular coagulation so we decided to perform open thrombectomy using the left retroperitoneal approach. The following day, thrombosis recurred in the same extent and despite high risk of bleeding Alteplase was eventually given, which resulted in recanalization of the aorta 6 hours later. Renal function recovered, dialysis was discontinued, and further course was uneventful. The treatment of abdominal aortic thrombosis in neonates should be considered on a case-by-case basis because the available data on the condition are limited to case report and series. If open thrombectomy is performed, retroperitoneal approach should be preferred because it allows for easy institution of peritoneal dialysis should the need arise.
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Affiliation(s)
- Marko Bogović
- Department of Surgery, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | - Dino Papeš
- Department of Surgery, Clinical Hospital Center Zagreb, Zagreb, Croatia.
| | - Davorin Mitar
- Department of Surgery, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | - Ranko Smiljanić
- Department of Radiology, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | | | - Stanko Ćavar
- Department of Surgery, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | - Anko Antabak
- Department of Surgery, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | - Tomislav Luetić
- Department of Surgery, Clinical Hospital Center Zagreb, Zagreb, Croatia
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Antabak A, Sisko J, Romić I, Papes D, Pasini M, Haluzan D, Bogović M, Medancić SS, Cavar S, Luetić T, Fuchs N, Andabak M, Prlić I, Curković S. [FRONTAL, AXILLARY AND TYMPANIC TEMPERATURE MEASUREMENTS IN CHILDREN]. Lijec Vjesn 2016; 138:30-33. [PMID: 27290811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of this study was to compare the results of body temperature measurements obtained by standard axillary thermometers with the results of infrared tympanic and frontal skin thermometry in afebrile children. This study comprises a single-center, prospective comparison trial. A total of 345 afebrile children aged 4 to 16 years hospitalized in the pediatric surgery department for elective surgery were included. One thousand axillary, tympanic and frontal measurements were obtained and compared. We used two different infrared thermometers in this study; one type measured the tympanic temperature, the other the temperature on the forehead. The axillary temperature measured with the glass thermometer was set as the standard. Each patient was exposed to a constant environmental temperature for a minimum of 10 min before simultaneous temperature measurements. The mean-frontal temperature 36.9 ± 0.38 °C was equal to the axillary temperature 36.9 ± 0.16 °C. The mean tympanic temperature was 36.3 ± 0.98 °C. The mean difference between the tympanic and axillary temperatures was -0.4 °C. The tympanic temperature had a threefold greater dispersion than frontal and a fivefold greater dispersion than axillary temperature. The results of this study suggest that the axillary temperature measured with glass thermometer has the least dispersion. Somewhat less reliable is the frontal temperature measured with infrared thermometer. The least reliable is tympanic temperature measurement.
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Haluzan D, Davila S, Antabak A, Dobric I, Stipic J, Augustin G, Ehrenfreund T, Prlic I. Thermal changes during healing of distal radius fractures-Preliminary findings. Injury 2015; 46 Suppl 6:S103-6. [PMID: 26596415 DOI: 10.1016/j.injury.2015.10.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The bone healing process is very complex. In simple terms, bone healing comprises three basic steps, the inflammation phase, the repair phase and the remodelling phase. The increase in blood flow around the fracture during the healing process increases the temperature of the surrounding tissue. Infrared thermography is a method of measuring body temperature that can detect temperature changes during bone healing. Studies on the application of thermography in traumatology are scarce, and there are no studies of thermal changes during normal bone healing. The authors have tried to determine the dynamics of thermal changes during bone healing. MATERIAL AND METHODS The Flir ThermaCam B2 (FLIR Systems, Inc., Oregon, USA) was used for all measurements. Thermographic recordings were made one, three, five, 11 and 23 weeks after fracture. The contralateral, healthy, forearm was used for comparison. RESULTS A total of 25 patients of mean age 65.9±10.4 years (range 50-80 years) with fracture of the distal radius were examined in this study. The mean temperature difference between healthy and fractured distal forearm one week after fracture was 1.20±0.48°C, three weeks after fracture was 1.42±0.54°C, five weeks after fracture was 1.04±0.53°C, 11 weeks after fracture was 0.50±0.30°C, and 23 weeks after fracture was 0.22±0.25°C. CONCLUSION Preliminary findings during this research showed significant temperature changes during healing of distal radius fractures. Infrared thermography is a simple and reliable method in clinical practice that could be used as a good follow-up method in traumatology, but further investigations on more patients are needed.
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Affiliation(s)
- Damir Haluzan
- Department of Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia.
| | - Slavko Davila
- Department of Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia; University of Zagreb, School of Medicine, Salata 3, 10 000 Zagreb, Croatia
| | - Anko Antabak
- Department of Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia; University of Zagreb, School of Medicine, Salata 3, 10 000 Zagreb, Croatia
| | - Ivan Dobric
- Department of Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia; University of Zagreb, School of Medicine, Salata 3, 10 000 Zagreb, Croatia
| | - Jagoda Stipic
- Department of Neurology, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia
| | - Goran Augustin
- Department of Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia; University of Zagreb, School of Medicine, Salata 3, 10 000 Zagreb, Croatia
| | - Tin Ehrenfreund
- Department of Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia
| | - Ivica Prlic
- Institute for Medical Research and Occupational Health, Ksaverska cesta 2, 10000 Zagreb, Croatia
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Antabak A, Papes D, Haluzan D, Seiwerth S, Fuchs N, Romic I, Davila S, Luetic T. Reducing damage to the periosteal capillary network caused by internal fixation plating: An experimental study. Injury 2015; 46 Suppl 6:S18-20. [PMID: 26612477 DOI: 10.1016/j.injury.2015.10.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND The importance of the periosteum in fracture healing is well-known. Preserving periosteal vascularisation is essential during internal plate fixation of fractures. METHODS This was an experimental randomised, controlled animal study on nine sheep. Standard dynamic compression plate (DCP) and four different newly designed reefed plates, with different plate-bone contact surface areas and different reef directions, were fixated on to the tibia or radius. After two weeks the plates were removed and the underlying periosteum was analysed. Blood vessels were marked by immunohistochemical staining (CD31 and CD34), microphotographs were taken and blood vessels counted to calculate blood vessel density. RESULTS Median blood vessel density beneath the standard plate was significantly lower than in the intact periosteum (18.0 vs 27.7mm(3)/cm(3)). Blood vessel density in the periosteum beneath plates with reefs was significantly increased compared with the intact periosteum, and was highest beneath the plate with the lowest bone-plate contact area and crosswise reefs (51.5mm(3)/cm(3)), followed by plates with transverse, oblique and longitudinal reefs, respectively. The direction of the reefs did not have much influence on the periosteal capillary network. Lower contact surface area seems to be the main factor that increases blood vessel density beneath the plates. CONCLUSIONS The results show that plates with lower contact surface area stimulate angiogenesis in the underlying periosteum, which results in much higher blood vessel density compared with standard DCP. A randomised clinical trial is needed to prove the clinical relevance of these findings.
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Affiliation(s)
- Anko Antabak
- Department of Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia; Department of Surgery, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.
| | - Dino Papes
- Department of Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia
| | - Damir Haluzan
- Department of Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia
| | - Sven Seiwerth
- Department of Pathology, School of Medicine, University of Zagreb, Salata 2, 10000 Zagreb, Croatia
| | - Nino Fuchs
- Department of Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia
| | - Ivan Romic
- Department of Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia
| | - Slavko Davila
- Department of Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia; Department of Surgery, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Tomislav Luetic
- Department of Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia; Department of Surgery, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Antabak A, Barisić B, Andabak M, Bradić L, Brajcinović M, Haramina T, Haluzan D, Fuchs N, Durkovir S, Curković S, Luetić T, Sisko J, Prlić I. [PHYSICAL PROPERTIES OF PLASTER BANDAGES]. Lijec Vjesn 2015; 137:372-376. [PMID: 26975068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The physical properties of plaster bandages are a very important factor in achieving the basic functions of immobilization (maintaining bone fragments in the best possible position), which directly affects the speed and quality of fracture healing. This paper compares the differences between the physical properties of plaster bandages (mass, specific weight, drying rate, elasticity and strength) and records the differences in plaster modeling of fast bonding 10 cm wide plaster bandages, from three different manufacturers: Safix plus (Hartmann, Germany), Cellona (Lohman Rauscher, Austria) and Gipsan (Ivo Lola Ribar ltd., Croatia). Plaster tiles from ten layers of plaster, dimension 10 x 10 cm were made. The total number of tiles from each manufacturer was 48. The water temperature of 22 °C was used for the first 24 tiles and 34 'C was used for the remainder. The average specific weight of the original packaging was: Cellona (0.52 g/cm3), Gipsan (0.50 g/cm3), Safix plus (0.38 g/cm3). Three days after plaster tile modeling an average specific weight of the tiles was: Gipsan (1.15 g/cm3), Safix plus (1.00 g/cm3), Cellona (1.10 g/cm3). The average humidity of 50% for Safix plus and Cellona plaster tiles was recorded 18 hours after modeling, while for the Gipsan plaster tiles, this humidity value was seen after 48 hours. On the third day after plaster modeling the average humidity of the plaster tiles was 30% for Gipsan, 24% for Safix and 16% for Cellona. Cellona plaster tiles made with 34 °C water achieved the highest elasticity (11.75±3.18 MPa), and Gipsan plaster tiles made with 22 °C had the lowest (7.21±0.9 MPa). Cellona plaster tiles made with 34 °C water showed maximum material strength (4390±838 MPa), and Gipsan plaster tiles made with 22 °C water showed the lowest material strength (771±367 MPa). The rigidity and strength of Cellona and Gipsan plaster are higher in tiles made in warmer water, and for Safix plus are higher in tiles made in cooler water. All three types of plaster differentiate in physical properties. The differences in mass and specific weight before and after plaster modeling are minimal. There are greater differences in drying rate, elasticity and strength between the three different plaster materials.
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Ćurković S, Antabak A, Halužan D, Luetić T, Prlić I, Šiško J. Medical thermography (digital infrared thermal imaging - DITI) in paediatric forearm fractures - A pilot study. Injury 2015; 46 Suppl 6:S36-9. [PMID: 26603613 DOI: 10.1016/j.injury.2015.10.044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Trauma is the most common cause of hospitalisation in children, and forearm fractures comprise 35% of all paediatric fractures. One-third of forearm fractures are distal forearm fractures, which are the most common fractures in the paediatric population. This type of fracture represents an everyday problem for the paediatric surgeon. The three phases of fracture healing in paediatric trauma are associated with skin temperature changes that can be measured and then compared with standard plain radiographs of visible callus formation, and eventually these methods can be used in everyday practice. Thermographic assessment of temperature distribution within the examined tissues enables a quick, non-contact, non-invasive measurement of their temperature. Medical thermography is used as a screening method in other parts of medicine, but the use of this method in traumatology has still not been researched.
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Affiliation(s)
- S Ćurković
- General Hospital Karlovac, Karlovac, Croatia.
| | - A Antabak
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - D Halužan
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - T Luetić
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - I Prlić
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - J Šiško
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
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Antabak A, Matković N, Deutsch JA, Papeš D, Karlo R, Romić I, Fuchs N, Luetić T. RESULTS OF CLAVICLE FRACTURE TREATMENT IN CHILDREN. Acta Clin Croat 2015; 54:345-350. [PMID: 26666106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Treatment of clavicle fracture is principally outpatient. Operative treatment is accompanied by the need for more x-rays and possible complications. Fractures with absolute indications for operative treatment occur only sporadically and these indications are relatively clear, but children often undergo surgery because of relative indications (shortening, fragment displacement, multifragmentary fractures), which are open to debate. In a retrospective study on 256 children, of 44 (17%) patients that received operative treatment only one 17-year-old boy had an absolute indication for surgical intervention. Other indications were fragment distraction (22 mm on average), age, associated injuries, and multifragmentary fracture. The placement of K-wire of appropriate thickness is often difficult, since the wire tends to bend and break, and patients have to undergo two additional operations of plate and screw fixation and later removal. In this retrospective study, we considered the advantages of using titanium or an elastic steel pin. All patients had favorable outcome, although some experienced numbness around the operation scar (4.5%), skin infections around the wire (15%), and/or the implanted K-wire damage (7%).
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Antabak A, Barišić B, Andabak M, Papeš D, Romić I, Fuchs N, Luetić T. [HAND FRACTURES IN CHILDREN - CAUSES AND MECHANISMS OF INJURY]. Lijec Vjesn 2015; 137:306-310. [PMID: 26749954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Hand is extremely exposed to various loads and traumas of everyday tasks and activities, resulting in fist fractures being fairly common injuries. The most common mechanism of injury is a direct blow. This retrospective study analyzed the data on 274 children admitted for hand fractures at Clinical Hospital Center Zagreb in the period from 2006 to 2014. The study included 76 girls (28%) and 198 boys (72%). The average patient age was 11.9 years and most were between 10 and 13 years of age. Phalangeal fractures accounted for 80%, metacarpal fractures for 17%, and carpal fractures for 3% of all injuries. Most commonly injuries occurred during recreation (4 1%), at home (37%), at school (18%) and in the street (4%). Direct blow was the major cause of injury (76%), and 24% were caused by fall. Injuries during sport activities are the most common cause of the hand fractures in pediatric population and direct blow is the main mechanism of injury. The peak incidence is at the age of 10-13 years in boys and girls, so prevention should be aimed at this age group. Preventive actions should be focused on injuries that tend to occur in parks, schools and during sport activities.
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Antabak A, Đapić T, Seiwerth S, Papeš D, Karlo R, Luetić T. [SUBUNGUAL EXOSTOSIS OF THE THUMB - CASE REPORT IN AN EIGHT YEAR OLD GIRL]. Lijec Vjesn 2015; 137:233-235. [PMID: 26502674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Subungual exostosis (SE) is a benign osteocartilaginous tumor of the distal phalanx of the finger, particularly of the toes. It affects both sexes, the most frequently occurring in the second and third decades of life, and very rarely in children younger than eight years. We present subungual exostosis (SE) in a eith year old female child affecting the terminal phalanx of the right thumb. She presented to us with gradually enlarging, painless, subungual hard nodule on the right thumb, spherical appearance size of 12 mm in diameter. Roentogram of the foot showed bony outgrowth arising from the terminal phalanx of right thumb. Lesion was excised with prior ablation of the nail, and sent for histopathological examination. Histology showed evidence of SE. No recurrence at postoperated site was seen till ten months of follow-up.
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Antabak A, Matković N, Papeš D, Karlo R, Romić I, Fuchs N, Madarić M, Stilinović M, Stanić L, Luetić T. [CLAVICLE FRACTURES IN CHILDREN--CIRCUMSTANCES AND CAUSES OF INJURY]. Lijec Vjesn 2015; 137:163-167. [PMID: 26380474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Clavicle fractures in children occur twice as often as in adults. During a child's growth period they account for 10-15% of all fractures sustained. The questions which should be asked are how these fractures are sustained and under which circumstances are the children injured. In the study 256 children with clavicle fractures treated during the period 2008-2013 were analyzed. The underlying cause and place of injuries were classified using the ICD-10 classification system, using environmental causes of injury. The circumstances were in each case accidental injury. Environmental causes were traffic accidents (V01-V99) or mishaps/accidents (W00-X59). Fracture injuries were caused in traffic accidents in 24 (9.4%), and in mishaps/accidents in 232 (90.6%) children. Of the injuries caused by mishaps/accidents, in 204 children these were caused by falls (W00-W19). In 123 of them the injuries were caused by falls from a ground level, and in 81 were from a greater height. Direct blow injuries, caused by another person or a blunt instrument, weere the causes of fractures seen in 28 children. Place of fracture sustainment was dominantly at home. This was followed by injuries sustained outside in recreational areas, while least were suffered at school or kindergarden facilities. Bicycle riding was the cause of clavicle fractures in 48 children, which was 18.7% of all fractures seen. Sports related injuries and fractures were seen in 47 (18.4%) out of 256 children: 30 in football, 10 in defensive sports (wrestling, judo, karate), three in hockey, while basketball and gymnastics accounted for two each. Preschool children were injured more often while in the care of their parents while school aged children were adaquately protected, but in after-school activities they were often injured. The most common injuries after school were those suffered in traffic accidents and recreational sports activities. In the adolescent period, the most common injuries seen were again those in traffic accidents, bicycle riding, recreational sports activities and injuries sustained at home.
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Papeš D, Sršen Medančić S, Antabak A, Sjekavica I, Luetić T. What is the acceptable rate of negative appendectomy? Comment on "Prospective evaluation of the added value of imaging within the Dutch National Diagnostic Appendicitis Guideline--do we forget our clinical eye"? Dig Surg 2015; 32:181-2. [PMID: 25833673 DOI: 10.1159/000380772] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Dino Papeš
- Department of Surgery, Clinical Hospital Center Zagreb, Zagreb, Croatia
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Antabak A, Stanić L, Matković N, Papeš D, Romić I, Fuchs N, Luetić T. [Radius fractures in children--causes and mechanisms of injury]. Lijec Vjesn 2015; 137:76-80. [PMID: 26065283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Radius fractures are the most common fractures in childhood. The main mechanism of injury is fall onto an outstretched hand. This retrospective study analyzed the data on 201 children admitted for radius fractures at KBC-Zagreb in the period 2011-2013. The study included 85 girls (42.3%) and 116 boys (57.7%) . The average age of the children was 9.6 years. Radius was injured in the distal segment in 79.1% of children. The sites of injuries were: park, campi and beach (24.9% of all children), playground, skate park and swimming pool (23.9%), kindergarten or school (20.9%), at home and around the house (17.9%), in the street (11.4%) and in the store or at a hotel (0.9%). The boys were mostly injured at playgrounds, during skating and at swimming pools (37.1% of all boys), while girls were mostly injured in parks, camps and at beach (42.4% girls). Fall was the major cause of the injury (49.3%), and children usually fell during ice skating and skating (32.3% of all falls). In 20.4% the injury was caused by pushing and hitting. The smallest percentage (9.5%) of children were injured in traffic accidents while riding a bike (only one child was hit by a car). Sport related activities caused injuries in 53.7% of the cases. Sport activities are the most important cause of the radial fractures in the pediatric population and falls during sports are the main mechanism of injury. The peak incidence is at 12 years for boys and at 10 years for girls, so intervention and/or prevention should be aimed at the age groups. Preventive actions should be focused on injuries that tend to occur in parks, schools and during sport activities.
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Antabak A, Lemos P, Magalhaes C. [Day surgery --emphases from IAAS training workshop on ambulatory surgery]. Lijec Vjesn 2015; 137:124-126. [PMID: 26065291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Papeš D, Altarac S, Antabak A, Savić I. Nonvenereal sclerosing lymphangitis of the penis. Acta Dermatovenerol Croat 2015; 23:150-151. [PMID: 26228831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Dino Papeš
- Dino Papeš, MD, Department of Surgery, University Hospital Center Zagreb, Kišpatićeva 12, Zagreb, Croatia;
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Antabak A, Bahtijarević Z. [Child injury prevention in Croatia]. Lijec Vjesn 2014; 136:350-351. [PMID: 25647997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Antabak A, Luetic T, Caleta D, Romic I. H-type Tracheoesophageal Fistula in a Newborn: Determining the Exact Position of Fistula by Intra-operative Guidewire Placement. J Neonatal Surg 2014; 3:36. [PMID: 26023507 PMCID: PMC4420454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 06/10/2014] [Indexed: 11/03/2022] Open
Abstract
H-type tracheoesophageal fistula is a rare congenital anomaly that is seldom diagnosed in the neonatal age. Documenting it and then locating it at surgery are both difficult. A case is presented to highlight the diagnostic and therapeutic utility of trans-fistula guidewire placement.
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Affiliation(s)
- Anko Antabak
- Department of Surgery (Pediatric Surgery), University Hospital Centre, Zagreb
| | - Tomislav Luetic
- Department of Surgery (Pediatric Surgery), University Hospital Centre, Zagreb
| | - Drago Caleta
- Department of Pediatrics, University Hospital Centre, Zagreb
| | - Ivan Romic
- Department of Surgery (Pediatric Surgery), University Hospital Centre, Zagreb
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Antabak A, Luetic T, Caleta D, Romic I. H-type Tracheoesophageal Fistula in a Newborn: Determining the Exact Position of Fistula by Intra-operative Guidewire Placement. J Neonatal Surg 2014. [DOI: 10.47338/jns.v3.100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
H-type tracheoesophageal fistula is a rare congenital anomaly that is seldom diagnosed in the neonatal age. Documenting it and then locating it at surgery are both difficult. A case is presented to highlight the diagnostic and therapeutic utility of trans-fistula guidewire placement.
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Antabak A, Majerović M, Separović I. [Day surgery, Department of Surgery KBC Zagreb, five years experience]. Lijec Vjesn 2014; 136:171-172. [PMID: 25154190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Abstract
BACKGROUND Elastic-stable intramedullary nailing (ESIN), is an accepted method for stabilization of unstable forearm shaft fractures in children. This study analyzed the radiographic and functional outcomes of intramedullary nailing of forearm diaphyseal fractures in children. MATERIALS AND METHODS A retrospective analysis was performed of children with forearm shaft fractures and open epiphyseal plates, treated with ESIN between 2000 and 2012 in our institution. Evaluation of cases was conducted minimum 14 months after osteosynthesis. Clinical results were evaluated according to the criteria developed by Price et al. and Flynn et al. RESULTS The study included 88 (42 boys) children. The average age of children at day injury was 10.5 ± 2.59 years (range 4-16), and at the review clinic was 13.4 ± 1.85 years (range 7-18). Forty six (52.3 %) had right forearm and 42 (47.7%) had left fracture respectively. Open reduction was required in 20 (22.7%) children. Primarily surgically were treated 62 (70.5%) children and 26 (29.5%) were operated as a second procedure after failed conservative management. There was one delayed union. Rotational forearm restriction with values between 11 and 20 degrees was present in nine children. Six children developed radial nerve hypoesthesia which eventually resolved with time. After removal of the implant one child sustained a re-fracture. The overall complication rate was 25%. Complete recovery to the original condition was noted in 76 (86.4%) children, eleven children (12.5%) had good and only one (1.1%) had poor outcome. CONCLUSION Our study suggests that ESIN osteosynthesis for diaphyseal forearm fractures remains a valid technique with very good functional results.
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Affiliation(s)
- Anko Antabak
- Division of Surgery, Department of Paediatric Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia.
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Papeš D, Altarac S, Arslani N, Rajković Z, Antabak A, Ćaćić M. Melanoma of the glans penis and urethra. Urology 2013; 83:6-11. [PMID: 23978371 DOI: 10.1016/j.urology.2013.07.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 06/25/2013] [Accepted: 07/05/2013] [Indexed: 02/03/2023]
Abstract
Primary melanoma of the glans or male urethra is a rare malignant tumor with high mortality. We searched PubMed and found 129 articles reporting on 220 patients. All articles were case reports or case series. Median patient age was 65 years. Median survival was 28 months, with 5-year survival in approximately 10%. All patients who survived over 5 years had a localized disease (stage I/A) with invasion depth <3-3.5 mm. Wide local excision with sentinel lymph node biopsy is the treatment of choice for patients with localized disease. For advanced disease, the prognosis is poor.
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Affiliation(s)
- Dino Papeš
- Department of Surgery, Zagreb Clinical Hospital Center, Zagreb, Croatia.
| | - Silvio Altarac
- Department of Surgery and Urology, Zabok General Hospital, Zabok, Croatia
| | - Nuhi Arslani
- Department of Surgery, University Clinical Center Maribor, Maribor, Slovenia
| | - Zoran Rajković
- Department of Surgery and Urology, Zabok General Hospital, Zabok, Croatia
| | - Anko Antabak
- Department of Surgery, Zagreb Clinical Hospital Center, Zagreb, Croatia
| | - Marko Ćaćić
- Department of Surgery, Zagreb Clinical Hospital Center, Zagreb, Croatia
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Antabak A, Madarić M. [Author reply]. Lijec Vjesn 2013; 135:220-221. [PMID: 23991493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Antabak A, Luetić T, Stilinović M. [Stress in children due to hospitalization and surgery]. Lijec Vjesn 2013; 135:222-223. [PMID: 23991495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Antabak A, Madarić M. [A systematic program of child injury prevention, research of the causes and circumstances of the incident]. Lijec Vjesn 2013; 135:53-54. [PMID: 23607180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Antabak A, Tjesić-Drinković D, Luetić T, Cavar S, Bogović M, Padovan RS, Andabak M. [Treatment of empyema thoracis in children]. Lijec Vjesn 2013; 135:15-20. [PMID: 23607172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Empyema, an accumulation of infected fluid in the thoracic cavity, is commonly secondary to bacterial pneumonia in children. Despite the high prevalence and availability of many medical treatment options, there is no general consensus on the optimal management approach, which would lead to full and rapid recovery. Especially, there are the big differences in treatment options for the child with empyema. Regardless of the differences in the procedures, the ultimate outcomes are good. This article reviews the current literature and discusses the important considerations in managing these patients. This paper describes thoracoscopic and open thoracic surgery procedures in children. The authors present their own observations based on years of experience in the treatment of thoracic empyema.
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Affiliation(s)
- Anko Antabak
- Klinika za kirurgiju Medicinskog fakulteta Sveucilista u Zagrebu, KBC Zagreb.
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Antabak A, Jelasic D, Luetić T, Andabak M, Cavar S, Cogelja K, Bogović M. [Testicular capillary hemangioma, report a twelve year patient]. Lijec Vjesn 2012; 134:316-318. [PMID: 23401976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Capillary hemangiomas of the testis are extremly rare tumors. We reported a case of intratesticular hemangioma, unusually localisation of this vascular benign neoplasm. The patient was 12 year old boy, with hydrocele and a palpabile testicular mass. Scrotal sonography revealed varicocele and hydrocele in the left scrotal sac. There was a solid hypoechogenic zone 5 mm in diameter in the left testis. Tumor markers like serum level of beta human chorionic gonadotropin and alpha fetoprotein were normal. The patient underwent surgery, and intraoperativ frozen section showed a capillary hemangioma. The lesion was completly removed, but testis was preserved. Accordingly tu the literature, tumors of vascular origin are extremly rare. Capillary hemangiomas of the testis are similarity to malignant testicular solid tumors during physical examination, ultrasound examination and MR imaging. Before operation, it's hardly differentiate tumors of testis, but intraoperativ frozen section cuold be helpfull to differentiate a hemangioma from other testicular mass. Hemangioma is benign, but lesion must be complete removed to avoid recurence. In cases capillarx hemangimas, tumor enucleation with preservation tissue of the testis is possible if intraoperative frozen section examination can be performed.
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Affiliation(s)
- Anko Antabak
- Klinika za kirurgiju Medicinskog fakulteta Sveucilista u Zagrebu, KBC Zagreb.
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Medancić SS, Ille J, Bogović M, Cavar S, Luetić T, Antabak A, Bogović TZ, Bence-Zigman Z, Batinica S. [Surgical treatment of thyroid gland diseases in childhood--our results]. Lijec Vjesn 2012; 134:276-280. [PMID: 23297512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Thyroid gland diseases are the most common endocrinopathies in children. Vast majority of these conditions are treated with medical therapy but in individualised cases surgery is indicated. Decision about surgical treatment is made in cooperation of pediatric endocrinologist and surgeon, treatment options depend on the nature of the disease while the extent of surgical procedure is determined by the pathological changes present in the gland. In this paper we represent the results of surgical treatment of 41 children at our department from 1991 to 2009 and current trends in surgical treatement of thyroid gland diseases.
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Affiliation(s)
- Suzana Srsen Medancić
- Zavod za djecju kirurgiju, Klinika za kirurgiju Medicinskog fakulteta Sveucilsta u Zagrebu, KBC Zagreb
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Martinac I, Bogović M, Batinica S, Sarnavka V, Frković SH, Matić T, Jakić-Razumović J, Rubin O, Luetić T, Kusec V, Ramadza DP, Begović D, Benjak V, Dasović-Buljević A, Antabak A, Cavar S, Kukin D, Srsen-Medancić S, Barić I. [Congenital hyperinsulinism--novel insights into etiology, diagnosis and treatment]. Lijec Vjesn 2012; 134:286-292. [PMID: 23297514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Congenital hyperinsulinism (CHI) is a major cause of persistent hypoglycemia in the neonatal and early infancy periods. Althought the disease is relatively rare with incidence of about 1:25 000-50 000 live births, the importance of the disease should not be underestimated. Namely, prompt recognition and management of patients with CHI is essential, if permanent neurological impairment is to be avoided. CHI is caused by mutations in one of the 7 genes involved in the regulation of insulin secretion in pancreatic beta-cells. It is important to introduce specific medical therapy as soon as diagnosis is established. Severe, neonatal forms of CHI are often resistant to medications, thus they require surgical procedure. The preoperative genetic testing and scintigraphy are indicated to distinguish histological subtypes of the disease (focal vs. diffuse CHI). Patients with focal disease are usually cured after pancreatic resection, while diffuse disease has much worse prognosis. This manuscript offers novel insights into CHI and emphasizes the role of early diagnosis as crucial for succesful treatment that was recently enriched with novel options.
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Affiliation(s)
- Iva Martinac
- Klinika za pedijatriju Medicinskog fakulteta Sveucilista u Zagrebu, KBC Zagreb
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Antabak A, Luetić T, Cavar S, Davila S, Bogović M, Batinica S. [Results of treatment of tibial fractures in children]. Lijec Vjesn 2012; 134:78-83. [PMID: 22768681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Diaphyseal fractures of both lower leg bones are the most common fractures of lower extremities, and account for about 15% of all fractures of long bones in children. These fractures are usully unstabilae, difficult to reposition, and retention of the fragments, and the process of their treatment is not fully compliant. The paper analyzes the late results of treating 234 children with tibial fractures, depending on the method of treatment (surgical and conservative method). Twenty-three children had open fractures (9.8%). Nonsurgical method was used in the treatment of 194 children, and surgical in 40 children. The most frequent surgical method was closed reposition of the fragments, and percutaneous elastic stable intramedullary nailing with titanium wires. The success of the treatment was measured: residual angular deformities and difference in length between treated and healthy leg. Secondary displacement of fragments after primary conservative treatment was found in 32 children. Angular deformities of the treated tibia was seen in 80 children, 68 (35.0%) treated conservatively and 12 (30.0%) surgically. In 131 (67.5%) conservatively treated and 29 (72.5%) surgically treated children there were no differences in the length of sick and healthy leg. Results of treatment in our children confirmed that there were no statistically significant differences in late effects depending on treatment methods.
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Affiliation(s)
- Anko Antabak
- Klinika za kirurgiju Medicinskog fakulteta Sveucilista u Zagrebu, KBC Zagreb.
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Bilić E, Bojanić K, Pavlović M, Konja J, Femenić R, Dapić T, Antabak A, Anticević D, Murat-Susić S, Husar K, Potocki K, Rajić L. [Treatment of langerhans cell histiocytosis in children]. Lijec Vjesn 2011; 133:376-384. [PMID: 22329293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Langerhans' cell histiocytosis (LCH) is a disease characterised by pathologic accumulation and proliferation of histiocytes, cells from the monocyte-macrophage system, in various tissues and organs. In this retrospective study we analyzed patients charts treated in the Department of pediatric hematology and oncology at the University Hospital Zagreb with the diagnosis of LCH. Twenty-two children were diagnosed between January 1st 1996 and December 31st 2010, and all were treated with chemotherapy. 19 patients survived (86%) and the remaining 3 (14%), all under the age of 2 with multisystem disease, died. At the time of diagnosis 12 children (55%) presented with single-system disease, the most common were bone lesions in 8 children (36%). All children were treated according to protocols LCH-I and LCH -III. Eight children had mild complications of treatment and the disease itself. Diabetes insipidus remains in 4 children.
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Affiliation(s)
- Ernest Bilić
- Klinika za pedijatriju Medicinskog fakulteta Sveuclista u Zagrebu, KBC Zagreb.
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Antabak A, Luetić T, Cavar S, Davila S, Bogović M, Batinica S. [Results of treatment of displaced supracondylar fractures in children]. Lijec Vjesn 2010; 132:272-276. [PMID: 21261023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Supracondylar fractures of humerus are the most common fractures in children. The management of severely displaced, unstable fractures of the humerus in children continues to be controversial. We undertook a retrospective study of 48 children with displaced supracondylar fractures (8 were treated with plaster and 40 with cross percutaneous Kirschner wire pinning). Only three children were treated with open reduction and percutaneous cross-pin fixation. Clinical outcome was evaluated by loss of elbow motion and change of carrying angle. According to Flynn s criteria, results were good or excellent in 93.7% patients. The cubitus varus is the most frequent long-term complication (16.7%). Closed reduction with percutaneous pin fixation is believed to represent a safe, reliable, and efficient method of managing displaced supracondylar fractures.
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Affiliation(s)
- Anko Antabak
- Klinika za kirurgiju Medicinskog fakulteta Sveucilista u Zagrebu, KBC Zagreb.
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