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Augustin G, Bruketa T, Kunjko K, Romić I, Mikuš M, Vrbanić A, Tropea A. Colonic gallstone ileus: a systematic literature review with a diagnostic-therapeutic algorithm. Updates Surg 2023:10.1007/s13304-023-01537-0. [PMID: 37209317 DOI: 10.1007/s13304-023-01537-0] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 05/10/2023] [Indexed: 05/22/2023]
Abstract
Rare complication of gallstone disease is gallstone ileus. The common location is the small intestine, followed by the stomach. The rarest location is colonic gallstone ileus (CGI). To summarize and define the most appropriate diagnostic methods and therapeutic options for CGI based on the paucity of published data. Literature searches of English-, German-, Spanish-, Italian-, Japanese-, Dutch- and Portuguese language articles included and Italian-language articles using PubMed, EMBASE, Web of Science, The Cochrane Library, and Google Scholar. Additional studies were identified from the references of retrieved studies. 113 cases of CGI were recorded with a male to female patient ratio of 1:2.9. The average patient age was 77.7 years (range 45-95 years). The usual location of stone impaction was the sigmoid colon (85.8%), followed by a descending colon (6.6%), transverse colon (4.7%), rectum (1.9%), and lastly, ascending colon (0.9%). Gallstones ranged from 2 to 10 cm. The duration of symptoms was variable (1 day to 2 months), with commonly reported abdominal distension, obstipation, and vomiting; 85.2% of patients had previous biliary symptoms. Diverticular disease was present in 81.8% of patients. During the last 23 years, CT scan was the most common imaging method (91.5%), confirming the ectopic gallstone in 86.7% of cases, pneumobilia in 65.3%, and cholecytocolonic fistula in 68%. The treatment option included laparotomy with cololithotomy and primary closure (24.7%), laparotomy and cololithotomy with diverting stoma (14.2%), colonic resection with anastomosis (7.9%), colonic resection with a colostomy (12.4%), laparoscopy with cololithotomy with primary closure (2.6%), laparoscopy with cololithotomy with a colostomy (0.9%), colostomy without gallstone extraction (5.3%), endoscopic mechanical lithotripsy (success rate 41.1%), extracorporeal shock wave lithotripsy (1.8%). The cholecystectomy rate was 46.7%; during the initial procedure 25%, and as a separate procedure, 21.7%; 53.3% of patients had no cholecystectomy. The survival rate was 87%. CGI is the rarest presentation of gallstone ileus, mainly in women over 70 years of age, with gallstones over 2 cm, and predominantly in the sigmoid colon. Abdominal CT is diagnostic. Nonoperative treatment, particularly in subacute presentations, should be the first-line treatment. Laparotomy with cololithotomy or colonic resection is a standard procedure with favorable outcomes. There are no robust data on whether primary or delayed cholecystectomy is mandatory as a part of CGI management.
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Affiliation(s)
- Goran Augustin
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Tomislav Bruketa
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Kristian Kunjko
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ivan Romić
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Mislav Mikuš
- Department of Gynecology and Obstetrics, University Hospital Centre Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia.
| | - Adam Vrbanić
- Department of Gynecology and Obstetrics, University Hospital Centre Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
| | - Alessandro Tropea
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT, University of Pittsburgh Medical Center, Palermo, Italy
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Bakula B, Karačić A, Stanić G, Romić I, Bakula M, Bogut A. Colorectal adenocarcinoma presenting with a pathological fracture due to a solitary bone metastasis to the tibia: a case report and literature review. Prz Gastroenterol 2023; 18:115-122. [PMID: 37007751 PMCID: PMC10050980 DOI: 10.5114/pg.2023.126044] [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] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/12/2021] [Indexed: 04/04/2023]
Abstract
Introduction Solitary bone metastasis of colorectal carcinoma (CRC) without other metastasis sites is extremely rare and can be found in less than 1% of patients with CRC. Aim In the present study, we report the first case of a solitary tibia metastasis and its pathologic fracture as the first presenting feature of a colorectal adenocarcinoma. Material and methods A 78-year-old female patient presented to our emergency department due to atraumatic pretibial swelling. Plain radiography did not detect any pathology. The swelling was incised and serous-bloody collection was evacuated, and the patient was discharged. On the 17th postoperative day, during a regular walk, the patient fell down and broke her leg, which transpired to be a pathologic fracture of the proximal tibial diaphysis, confirmed by X-ray. A biopsy of the altered bone tissue from the fracture site revealed metastatic colorectal adenocarcinoma. On colonoscopy, a circular mass in the upper rectum was found. Conclusions Solitary bone metastases are most commonly found in bones that are related to venous drainage via the paravertebral plexus of Batson - the pelvis, vertebrae, and sacrum. Long bones are extremely rare localizations of solitary CRC metastases, with only few cases published so far in medical literature. In our case, the patient`s first symptom was related to the osseous tibial metastasis - leg swelling. No tumour was suspected until the pathologic fracture occurred. It is important to consider osseous metastasis in every patient with unexplained swelling, haematoma, or pain of the extremities and make a bone scan to recognize the metastasis early.
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Affiliation(s)
- Branko Bakula
- Department of Surgery, University Hospital Sveti Duh, Zagreb, Croatia
| | - Andrija Karačić
- Department of Surgery, University Hospital Sveti Duh, Zagreb, Croatia
- Address for correspondence: Andrija Karačić MD, Department of Surgery, University Hospital Sveti Duh, Zagreb, Croatia, Sveti Duh 64, 10 000 Zagreb, Croatia, e-mail:
| | - Gabrijela Stanić
- Department of Pathology, University Hospital Sveti Duh, Zagreb, Croatia
| | - Ivan Romić
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Mirko Bakula
- Department of Urology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ante Bogut
- Department of Gastroenterology, University Hospital Mostar, Mostar, Bosnia and Herzegovinia
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Abstract
Patterns in nature are fascinating both aesthetically and scientifically. Alan Turing's celebrated reaction-diffusion model of pattern formation from the 1950s has been extended to an astounding diversity of applications: from cancer medicine, via nanoparticle fabrication, to computer architecture. Recently, several authors have studied pattern formation in underlying networks, but thus far, controlling a reaction-diffusion system in a network to obtain a particular pattern has remained elusive. We present a solution to this problem in the form of an analytical framework and numerical algorithm for optimal control of Turing patterns in networks. We demonstrate our method's effectiveness and discuss factors that affect its performance. We also pave the way for multidisciplinary applications of our framework beyond reaction-diffusion models.
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Affiliation(s)
- Shupeng Gao
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, People's Republic of China.,School of Artificial Intelligence, Optics, and Electronics (iOPEN), Northwestern Polytechnical University, Xi'an 710072, People's Republic of China
| | - Lili Chang
- Complex Systems Research Center, Shanxi University, Taiyuan 030006, People's Republic of China.,Shanxi Key Laboratory of Mathematical Techniques and Big Data Analysis for Disease Control and Prevention, Taiyuan 030006, People's Republic of China
| | - Ivan Romić
- School of Artificial Intelligence, Optics, and Electronics (iOPEN), Northwestern Polytechnical University, Xi'an 710072, People's Republic of China.,Statistics and Mathematics College, Yunnan University of Finance and Economics, Kunming 650221, People's Republic of China.,Graduate School of Economics, Osaka City University, Osaka 558-8585, Japan
| | - Zhen Wang
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, People's Republic of China.,School of Artificial Intelligence, Optics, and Electronics (iOPEN), Northwestern Polytechnical University, Xi'an 710072, People's Republic of China
| | - Marko Jusup
- Tokyo Tech World Hub Research Initiative (WRHI), Institute of Innovative Research, Tokyo Institute of Technology, Yokohama 152-8550, Japan
| | - Petter Holme
- Tokyo Tech World Hub Research Initiative (WRHI), Institute of Innovative Research, Tokyo Institute of Technology, Yokohama 152-8550, Japan
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Abstract
Public goods, ranging from judiciary to sanitation to parkland, permeate daily life. They have been a subject of intense interdisciplinary study, with a traditional focus being on participation levels in isolated public goods games (PGGs) as opposed to a more recent focus on participation in PGGs embedded into complex social networks. We merged the two perspectives by arranging voluntary participants into one of three network configurations, upon which volunteers played a number of iterated PGGs within their network neighborhood. The purpose was to test whether the topology of social networks or a freedom to express preferences for some local public goods over others affect participation. The results show that changes in social networks are of little consequence, yet volunteers significantly increase participation when they freely express preferences. Surprisingly, the increase in participation happens from the very beginning of the game experiment, before any information about how others play can be gathered. Such information does get used later in the game as volunteers seek to correlate contributions with higher returns, thus adding significant value to public goods overall. These results are ascribable to a small number of behavioral phenotypes, and suggest that societies may be better off with bottom-up schemes for public goods provision.
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Affiliation(s)
- Lei Shi
- Statistics and Mathematics College, Yunnan University of Finance and Economics, Kunming 650221, China
- Interdisciplinary Research Institute of Data Science, Shanghai Lixin University of Accounting and Finance, Shanghai 201209, China
| | - Ivan Romić
- Statistics and Mathematics College, Yunnan University of Finance and Economics, Kunming 650221, China
- Center for OPTical IMagery Analysis and Learning, Northwestern Polytechnical University, Xi'an 710072, China
- Graduate School of Economics, Osaka City University, Osaka 558-8585, Japan
| | - Yongjuan Ma
- Statistics and Mathematics College, Yunnan University of Finance and Economics, Kunming 650221, China
| | - Zhen Wang
- Center for OPTical IMagery Analysis and Learning, Northwestern Polytechnical University, Xi'an 710072, China;
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Boris Podobnik
- Center for Polymer Studies, Boston University, Boston, MA 02215
- Faculty of Civil Engineering, University of Rijeka, 51000 Rijeka, Croatia
- Zagreb School of Economics and Management, 10000 Zagreb, Croatia
- Luxembourg School of Business, 2453 Luxembourg, Luxembourg
- Faculty of Information Studies in Novo Mesto, SI-8000 Novo Mesto, Slovenia
| | - H Eugene Stanley
- Center for Polymer Studies, Boston University, Boston, MA 02215;
- Tokyo Tech World Research Hub Initiative, Institute of Innovative Research, Tokyo Institute of Technology, Tokyo 152-8550, Japan
| | - Petter Holme
- Tokyo Tech World Research Hub Initiative, Institute of Innovative Research, Tokyo Institute of Technology, Tokyo 152-8550, Japan
| | - Marko Jusup
- Tokyo Tech World Research Hub Initiative, Institute of Innovative Research, Tokyo Institute of Technology, Tokyo 152-8550, Japan
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Jia D, Wang X, Song Z, Romić I, Li X, Jusup M, Wang Z. Evolutionary dynamics drives role specialization in a community of players. J R Soc Interface 2020; 17:20200174. [PMID: 32693747 DOI: 10.1098/rsif.2020.0174] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The progression of game theory from classical to evolutionary and spatial games provided a powerful means to study cooperation, and enabled a better understanding of general cooperation-promoting mechanisms. However, current standard models assume that at any given point players must choose either cooperation or defection, meaning that regardless of the spatial structure in which they exist, they cannot differentiate between their neighbours and adjust their behaviour accordingly. This is at odds with interactions among organisms in nature who are well capable of behaving differently towards different members of their communities. We account for this natural fact by introducing a new type of player-dubbed link players-who can adjust their behaviour to each individual neighbour. This is in contrast to more common node players whose behaviour affects all neighbours in the same way. We proceed to study cooperation in pure and mixed populations, showing that cooperation peaks at moderately low densities of link players. In such conditions, players naturally specialize in different roles. Node players tend to be either cooperators or defectors, while link players form social insulation between cooperative and defecting clusters by acting both as cooperators and defectors. Such fairly complex processes emerging from a simple model reflect some of the complexities observed in experimental studies on social behaviour in microbes and pave a way for the development of richer game models.
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Affiliation(s)
- Danyang Jia
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, People's Republic of China.,Center for OPTical IMagery Analysis and Learning (OPTIMAL), Northwestern Polytechnical University, Xi'an 710072, People's Republic of China
| | - Xinyu Wang
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, People's Republic of China.,Center for OPTical IMagery Analysis and Learning (OPTIMAL), Northwestern Polytechnical University, Xi'an 710072, People's Republic of China
| | - Zhao Song
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, People's Republic of China.,Center for OPTical IMagery Analysis and Learning (OPTIMAL), Northwestern Polytechnical University, Xi'an 710072, People's Republic of China
| | - Ivan Romić
- Center for OPTical IMagery Analysis and Learning (OPTIMAL), Northwestern Polytechnical University, Xi'an 710072, People's Republic of China.,Statistics and Mathematics College, Yunnan University of Finance and Economics, Kunming 650221, People's Republic of China.,Graduate School of Economics, Osaka City University, Osaka 558-8585, Japan
| | - Xuelong Li
- Center for OPTical IMagery Analysis and Learning (OPTIMAL), Northwestern Polytechnical University, Xi'an 710072, People's Republic of China.,School of Computer Science, Northwestern Polytechnical University, Xi'an 710072, People's Republic of China
| | - Marko Jusup
- Tokyo Tech World Research Hub Initiative (WRHI), Institute of Innovative Research, Tokyo Institute of Technology, Tokyo 152-8550, Japan
| | - Zhen Wang
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, People's Republic of China.,Center for OPTical IMagery Analysis and Learning (OPTIMAL), Northwestern Polytechnical University, Xi'an 710072, People's Republic of China
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Grgić D, Prijić R, Romić I, Augustin G, Markoš P, Korša L, Marušić Z, Rustemović N, Krznarić Ž. A Single Small Bowel Hemangioma Detected by Video Capsule Endoscopy in a Patient Presenting with Iron-deficiency Anemia - Two Case Reports. Prague Med Rep 2020; 120:138-143. [PMID: 31935349 DOI: 10.14712/23362936.2019.19] [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] [Indexed: 02/07/2023] Open
Abstract
Hemangioma of the small intestine is a rare vascular malformation which mostly presents as occult gastrointestinal bleeding and iron-deficiency anemia. Patients are often asymptomatic except of fatigue due to anemia. Hemangiomas can arise anywhere in the luminal gastrointestinal tract, with jejunum as the most commonly involved site. They are very hard to recognize mostly due to their localization. Video capsule endoscopy and balloon-assisted enteroscopy have very much improved preoperative diagnostics and made major contribution to establishing the diagnosis - which was very difficult in the past and almost all cases were diagnosed during or after the operation. Surgical resection is still the conventional treatment modality, although with the improvement of endoscopic therapeutic interventions (endoscopic mucosal resection, argon-plasma coagulation) there are more therapeutic possibilities.
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Affiliation(s)
- Dora Grgić
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Radovan Prijić
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ivan Romić
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Goran Augustin
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Pave Markoš
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Lea Korša
- Deparment of Pathology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Zlatko Marušić
- Deparment of Pathology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Nadan Rustemović
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Željko Krznarić
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
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Romić I, Nakajima Y. Author Correction: Ecosystem engineering as an energy transfer process: a simple agent-based model. THEOR ECOL-NETH 2017. [DOI: 10.1007/s12080-017-0360-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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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, 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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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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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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Brtan Romić R, Brtan A, Romić I, Cvitanović H, Duvančić T, Lugović-Mihić L. QUALITY OF LIFE AND PERCEPTION OF DISEASE IN PATIENTS WITH CHRONIC LEG ULCER. Acta Clin Croat 2015; 54:309-314. [PMID: 26666100] [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
Chronic wounds on lower extremities most commonly result from chronic venous insufficiency. Chronic leg ulcer impacts the quality of life in a number of ways such as reduced mobility, pain, unpleasant odor, sleep disturbances, social isolation, etc. This study included 100 patients with chronic wounds/lower leg ulcer (59% of women and 41% of men, aged 31 to 89) treated locally with special wound dressings for moist wound healing. Study results showed no age and sex correlation with the quality of life, and all participants evaluated their quality of life and health satisfaction as neither good nor bad, but it was found that the disease mostly affected social relationships and to a lesser extent patient satisfaction with their physical and mental health, and the environment. Results on the disease perception showed that the participants considered their disease to have a significant effect on their life and would last for a relatively long time, but they also believed they had good control of their disease. Also, they considered the disease to have many symptoms affecting them; they were worried about their disease which they understood relatively well; they were aware that treatment could be very helpful; and that the disease had moderate effect on their emotional health. According to sex, the disease was found to have greater effect on women (especially on their emotional condition) and women had more faith in successful treatment, while correlation with age was nonsignificant. This study confirmed the importance of the patient psychological condition and the need of due care of their psychological reactions to and facing with the disease.
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Mance M, Romić I, Majerović M. Detection of Epstein-Barr virus in inflammatory pseudotumour of the spleen: a case report. Wien Klin Wochenschr 2015; 128:442-6. [PMID: 26109554 DOI: 10.1007/s00508-015-0807-6] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 05/11/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Various types of benign and malignant splenic tumours including hemangiomas, lymphagiomas, hamartomas, hemangiosarcomas, malignant lymphomas and metastatic carcinomas share radiological characteristics making it impossible for a physician to determine the definite aetiology of splenic masses noninvasively without histopathological evaluation. It is important that physicians recognize the importance of a careful and continuous follow-up since inflammatory pseudotumours (IPT) are considered to be tumours with an intermediate malignant potential based on their behaviour when they arise in other locations. METHODS Our patient, a 60-year-old woman was evaluated using laboratory, gastroscopy, computed tomography and surgical methods. The resected tumour was evaluated using immunohistochemical methods. RESULTS The patient presented with weight loss, nausea and vomiting, symptoms lasting over a course of a few months. The splenic mass was found incidentally at the time of work up for gastritis and cholelithiasis. Histologically, the tumour differed from typical splenic architecture being composed of atypical spindle cells with inflammatory elements; numerous plasma cells, macrophages, eosinophils and lymphocytes. CONCLUSIONS Although very difficult to diagnose at initial presentation, it is very important for the physician to be aware of the importance of a careful diagnosis since IPT of the spleen are rare and considered to be tumours with an intermediate malignant potential.
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Affiliation(s)
- Marko Mance
- Majerović, University of Zagreb, Zagreb University Hospital Center, Kišpatićeva 12, 10000, Zagreb, Croatia.
| | - Ivan Romić
- Majerović, University of Zagreb, Zagreb University Hospital Center, Kišpatićeva 12, 10000, Zagreb, Croatia
| | - Matea Majerović
- Department of Internal Medicine, University of Zagreb, Zagreb University Hospital Center, Zagreb, Croatia
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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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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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