Clinical Hospital Center Split

Split, Croatia

Clinical Hospital Center Split

Split, Croatia
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Kutlesa Z.,Clinical Hospital Center Split | Budimir Mrsic D.,University of Split
Journal of Bone and Mineral Metabolism | Year: 2016

A light-to-moderate wine consumption has been shown to provide several beneficial effects on the skeletal system, including reduced risk of bone mass loss and fractures. Wine is rich in phenolic compounds, strong phytoestrogens and natural antioxidants, to which bone protection is mainly attributed. The objective of this review was to give an overview of the exact mechanisms by which wine consumption is involved in bone protection. We found a great variety of in vitro research on the beneficial effects of isolated wine phenolics on the skeletal system, with a significant lack of evidence of their in vivo effects. In addition, we found almost no studies investigating how wine, a mixture of these phenolics dissolved in ethanol, affects the skeletal system. Our results warrant further research on this interesting topic. © 2015, The Japanese Society for Bone and Mineral Research and Springer Japan.

We wanted to examine which of two panretinal photocoagulation (PRP) techniques, classical panretinal photocoagulation (CPRP) and modifield peripheral panretinal photocoagulation PPRP), causes less decline of visual acuity (VA) due to macular edema (ME) in patients with proliferative diabetic retinopathy (PRD). This clinical study includes 180 eyes with PDR with initial papillar neovascularization. The patients were divided into two groups according the RP. PPRP and CPRP showed the decline of VA in all patients, more pronounced in the CPRP group after one week. After three and six months, with CPRP and PPRP the values of VA was stabilized. The result suggests that eyes with PDR and starting epipapillar neovascularisation should be treated with PPRP with priority given to CPRP because it caused better VA.

Jeric M.,University of Split | Roje D.,Clinical Hospital Center Split | Medic N.,University of Split | Strinic T.,Clinical Hospital Center Split | And 2 more authors.
Early Human Development | Year: 2013

Purpose: Maternal nutritional status is one of the most important factors of fetal growth and development. Consequently, the currently increasing prevalence of underweight women worldwide has come in the focus of interest of perinatal medicine. The aim of the study was to assess the effect of low pre-pregnancy body mass index (BMI) on fetal growth. Materials and methods: Data on 4678 pregnant women and their neonates were retrospectively analyzed. Pre-pregnancy BMI of study women was categorized according to the WHO standards. Fetal growth was assessed by birth weight and birth length, birth weight for gestational age, and ponderal index. Results: Study group included 351 (7.6%) women with pregestational BMI<18.5kg/m2, while all women with pregestational BMI 18.5-25kg/m2 (n=3688; 78.8%) served as a control group. The mean birth weight and birth length of neonates born to underweight mothers were by 167g and 0.8cm lower in comparison with the neonates born to mothers of normal nutritional status, respectively (P<0.001 both). The prevalence of small for gestational age (SGA) births was twofold that found in the control group of mothers of normal nutritional status (9.7% vs. 4.9%; P<0.001). The inappropriately low gestational weight gain additionally increased the rate of SGA infants in the group of mothers with low pre-pregnancy BMI (21.4% vs. 10.4%; P=0.02). Pre-pregnancy BMI category did not influence neonatal growth symmetry. Conclusion: Low maternal pregestational BMI is associated with fetal growth assessment. Improvement of the maternal nutritional status before pregnancy can increase the likelihood of perinatal outcome. © 2012 Elsevier Ltd.

Marusic J.,University of Split | Prusac I.K.,Clinical Hospital Center Split | Tomas S.Z.,Clinical Hospital Center Split | Karara J.R.,University of Split | Roje D.,University of Split
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2013

Objective: To investigate the expression of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10) in villous trophoblast, syncytial knots and decidua placentas from pregnancies complicated with preeclampsia (PE), Hemolysis, Elevated Liver enzymes and Low Platelet count (HELLP) syndrome and gestational age-matched controls. Methods: Study group included 35 placentas from pregnancies complicated with PE and 35 placentas from pregnancies with HELLP syndrome. Control group included 35 placentas from idiopathic preterm labor. Placentas were matched according to the gestational age. Expression of TNF-α, IL-6 and IL-10 was determined by immunohistochemistry and semi-quantitative HSCORE method in villous trophoblast, syncytial knots and decidua. Non-parametric statistics were used for analyses. Results: There was no difference in the expression of TNF-α, IL-6 and IL-10 in all the studied placental segments between PE, HELLP and gestational age-matched control group. TNF-α (F=32, 41, p<0.001), IL-6 (F=58, 53, p<0.001) and IL-10 (F=17, 62, p<0.001) expression was significantly different in different placental cell types, the highest expression of cytokines was in decidua. Conclusion: There was no difference in cytokine expression in villous trophoblast, syncytial knots and decidua among the studied placental groups. The expression of cytokines was highest in decidua in all the studied placental groups. © 2013 Informa UK Ltd All rights reserved.

Culic S.,University of Split | Salamunic I.,Clinical Hospital Center Split | Konjevoda P.,Ruder Boskovic Institute | Dajak S.,Clinical Hospital Center Split | Pavelic J.,Ruder Boskovic Institute
Medical Science Monitor | Year: 2013

Background: Immune thrombocytopenia (ITP) is an immune-mediated platelet disorder in which autoantibody-coated platelets are removed from the blood by monocytic phagocytes and there is impaired platelet production. There is a delicate balance of specific cytokine levels, which has an important role in the immune system and is known to be deregulated in autoimmune diseases. This study was designed to investigate the differences in Th cytokine levels between children and adults with newly diagnosed ITP and to compare these profiles to those found in healthy, age-matched controls. Material/Methods: The concentration of IL-1a, IL-2, IL-3, IL-4, IL-6, IL-10, TNF-a, IFN-a, and IFN-g in serum specimens was analyzed by enzyme-linked immunosorbent assay. Results: At the time of ITP diagnosis, children showed significantly lower serum levels of interleukin IL-2 and tumor necrosis factor TNF-a and higher serum level of IL-3 than healthy controls. Serum level of IL-4 in adult ITP patients was higher than those in control subjects. When compared with adults, children with ITP had lower serum level of IL-4, IL-6 and IFN-g, and higher level of IFN-a. Conclusions: Significant differences in serum cytokine levels between pediatric patients and healthy controls indicate that cytokine disturbances - especially changes in IL-2, IL-3 and TNF-a - might be involved in the pathogenesis of newly diagnosed ITP. TNF-a is the most informative variable for discrimination between healthy children and those with ITP. © Med Sci Monit, 2013.

Roje D.,University of Split | Tomas S.Z.,University of Split | Prusac I.K.,University of Split | Capkun V.,Clinical Hospital Center Split | Tadin I.,University of Split
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2011

Objective. To investigate proliferative, apoptotic, and antiapoptotic activity of placental trophoblast in pregnancies complicated with idiopathic intrauterine growth retardation (IUGR). Methods. Study group included data and placentas from 52 normal singleton term pregnancies with idiopathic IUGR. Records and placentas from 69 singleton pregnancies with normal fetal growth served as a control group. IUGR was defined by birth weight less than 10th percentile of standard values. Children with congenital malformations and those born with the signs of hypoxia, laboratory or clinical signs of preeclampsia or infection, children born to anemic mothers and those born from pregnancies with an increased coagulation system activity were excluded. Results. There was no statistically significant difference in the cytotrophoblast proliferation index value (Z=0.24; P=0.553), trophoblast expression of the Bcl-2 antiapoptotic factor (Z=0.47; P=0.634), and trophoblast apoptotic index (Z=0.51; P=0.613) between the idiopathic IUGR and control group. Conclusion. The proliferative and apoptotic events in the trophoblast of placentas with idiopathic IUGR did not differ from physiologic ones. Study results suggest the IUGR syndrome to have no uniform etiology or even underlying pathophysiology that would determine the possible fetal risk and subsequent long-term consequences for fetal health and life. This imposes the need of a more precise definition and unambiguous distinction between the idiopathic and other forms of IUGR. © 2011 Informa UK, Ltd.

Erceg M.,Clinical Hospital Center Split | Becic K.,University of Split
Journal of Postgraduate Medicine | Year: 2014

A 65-year-old female patient with aseptic loosening of total cemented hip endoprosthesis and pathologic fracture of the femur at the level of the stem of endoprosthesis was presented. As no appropriate endoprosthesis was available due to the war in Croatia and war priority, the problem was managed by femur osteosynthesis and implantation of a partial Austin Moore hip endoprosthesis. The endoprosthesis is still functioning well (for 20 years).To the best of the author's knowledge, nobody has ever treated problem like this using this alternative, an unconventional method, with an Austin Moore endoprosthesis.

Prusac I.K.,Clinical Hospital Center Split | Zekic Tomas S.,University of Split | Roje D.,Clinical Hospital Center Split
Acta Obstetricia et Gynecologica Scandinavica | Year: 2011

Objective. To investigate apoptosis, proliferation and Fas ligand expression of placental trophoblast in the hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome and in pre-eclampsia (PE), and to compare this with normal pregnancies. Design. Prospective study. Setting. University hospital in Croatia. Sample. Placentae from women with HELLP syndrome (n=10), PE (n=10) and normal pregnancies (n=10). Methods. The HELLP syndrome was diagnosed with platelets <100× 109/L, aspartate aminotransferase (AST) and alanine transaminase (ALT) >70U/L and lactic acid dehydrogenase (LDH) > 600U/L. Pre-eclampsia was diagnosed at blood pressure >140/90mmHg, with proteinuria >300mg/L/24hours. For detection of apoptosis and proliferation in villous trophoblast, antibodies M30 and Ki-67 were used. Expression of Fas ligand was assessed using immunohistochemistry and the semiquantitative HSCORE method. Main Outcome Measures. Apoptosis, proliferation and Fas ligand expression in villous trophoblast. Results. Apoptosis, proliferation and Fas ligand expression were higher in villous trophoblast in HELLP syndrome than in the PE group (p=0.015, p=0.018 and p=0.002, respectively) and the control group (p=0.000, p=0.012 and p=0.049, respectively). Placentae from the PE group had higher levels of apoptosis (p=0.019), lower Fas ligand expression (p=0.029) and no difference in proliferation (p=0.887) compared with the control group. Conclusions. There is an increase in apoptosis, proliferation and Fas ligand expression in placentae from women with HELLP syndrome compared with placentae from PE and normal pregnancies. Our findings indicate the possibility of differential mechanisms behind HELLP syndrome and PE. © 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

Vukic Z.,Clinical Hospital Center Split
Przegla̧d lekarski | Year: 2012

Most cystic cystitis cases in children exhibit cysts for an extended period, even after successful treatment of the underlying infection. Not much is known about the dynamics of cyst appearance and disappearance. In long-term follow-up some clinicians suggest complete eradication of the cysts. Contrary, histological studies describe the cystic cystitis as an irreversible process in von Brunn's nests. The endoscopic differentiation from reversible follicular cystitis is hard and uncertain. A group of 21 children with cystic cystitis was diagnosed and staged in a 10-year period. All of them clinically presented with recurrent uroinfections. We examined cystoscopic changes of cystic cystitis before and during the treatment of urinary infection to find objective signs of improvement in endoscopic findings after prolonged antibiotic therapy. Control cystoscopy was performed after a period of six infection-free months. In the average period of 20 months after the beginning of treatment there were no changes in cystic cystitis stage. The examined period seems to be too short for the changes of cystic cystitis to disappear. It is unclear if prolonged antibacterial treatment bears any influence on the number of cysts.

Bezic J.,Clinical Hospital Center Split | Glavina-Durdov M.,Clinical Hospital Center Split
Head and Neck Pathology | Year: 2011

Oncocytic cystadenoma is a rare benign tumor of major salivary glands that in rare occasions may present histologically with intraluminal crystalloids. We report a case of 53-year-old man with a progressively enlarging lump in the left submandibular region. Ultrasound examination revealed a cystic mass with an intraluminal fluid collection. The tumor was surgically removed. Histologic examination yielded a diagnosis of oncocytic cystadenoma with a high concentration of intraluminal crystalloids. The microscopic features of the crystalloids were compatible with nontyrosine (alpha-amylase) crystalloids. When compared with previously published cases in the literature, this is the first report of oncocytic cystadenoma with intraluminal crystalloids arising in the submandibular gland, and the second reported case of the nontyrosine type of crystalloids occurring in association with this tumor. The nontyrosine crystalloids may be highly characteristic to salivary gland tumors with oncocytic differentiation. © 2011 Springer Science+Business Media, LLC.

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