County Hospital Zadar

Zadar, Croatia

County Hospital Zadar

Zadar, Croatia

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Krakar G.,Childrens Hospital Zagreb | Dakovic I.,Childrens Hospital Zagreb | Delin S.,County Hospital Zadar | Bosnjak V.M.,Childrens Hospital Zagreb
Journal of Child Neurology | Year: 2014

Congenital cytomegalovirus infection is the most common infectious cause of congenital brain injury. Type and severity of congenital cytomegalovirus infection-related brain abnormalities depend on the developmental stage of the central nervous system at the time of fetal infection. The aim of this study was to follow the course of leukoencephalopathy in a patient with congenital cytomegalovirus infection. We describe brain magnetic resonance imaging (MRI) findings of a boy with symptomatic congenital cytomegalovirus infection performed at the age of 3 weeks, 13 months, and 4 and 7 years. Neonatal brain MRI showed most of characteristic findings in congenital cytomegalovirus infection with most prominent white matter abnormalities and cortical dysplasia. MRI follow-up images showed that cortical dysgenesis remained unchanged and static, whereas white matter abnormalities evolved over the years. We propose that leukoencephalopathy in congenital cytomegalovirus infection is not only nonprogressive or static but even evolutive and suggests both underlying disruption and delay of myelination. © The Author(s) 2014.


Drazen Z.,County Hospital Zadar | Neven L.,University of Zagreb | Marko B.,University of Zagreb | Marko N.,County Hospital Zadar | And 4 more authors.
Digestive Diseases and Sciences | Year: 2010

Objective The progression of liver cirrhosis eventually increases cardiac output, while blood pressure and systemic vascular resistance are reduced. A complex behavior of portal hemodynamic to hepatic artery and system circulation has not yet been presented. There is a lack in knowledge about the correlation of local and systemic circulation parameters to the degree of liver failure, with respect to presence of ascites and esophageal varices. Patients and Methods The study sample was 76 patients hospitalized for established alcoholic liver cirrhosis. Patients were divided into groups according to Child-Pugh clinical score; grade A (n = 24), B (n = 18) and C (n = 18). Ascites was found in 28 patients and esophageal varices in 46. Portal vein flow velocity (PVFV), hepatic artery resistance index (HARI), heart and great vessels within mediastinal cavity were assessed with ultrasound devices equipped with spectral Doppler. Results Significant differences in mean blood pressure, systemic vascular resistance index (SVRI) minute volume, cardiac index and PVFV were found in the group of patients with the most severe stage (C). In regard to presence of ascites statistically significant difference was observed in elevated mean blood pressure and SVRI. Correlation was found between conjugated HARI to blood pressure and to SVRI. Conclusions In patients with liver cirrhosis there is an inversely reciprocal relationship of conjugated HARI with PVFV, correlating to disease grade. PVFV in cirrhosis decreases and HARI values were over 0.7. Study demonstrated that combining echocardiography with abdominal Doppler ultrasound served as valuable non-invasive diagnostic insight in liver and systemic circulation among different grade of cirrhosis. © 2009 Springer Science+Business Media, LLC.


Boban M.,University of Rijeka | Boban M.,Josip Juraj Strossmayer University of Osijek | Barisic M.,University of Rijeka | Persic V.,University of Rijeka | And 5 more authors.
Journal of Diabetes and its Complications | Year: 2016

Background: The aim of our study was to analyze muscle strength in patients with recent surgical treatment for ischemic and combined ischemic-valvular heart disease, based on existence of diabetes mellitus. Connections existing between muscle strength and patient characteristics or conventional diagnostic tests were analyzed as well. Methods: Study prospectively included consecutive patients scheduled for cardiovascular rehabilitation 0-3. months after heart surgery. Diagnostics covered drug utilization, anthropometrics, demographics, echocardiography, conventional laboratory, echocardiography, bioelectrical impedance analysis (BIA), and hand grip test (HGT). HGT was analyzed for dominant hand. Results: Patients with diabetes had significantly weaker muscle strength on HGT than controls; 29.4. ±. 12.2. kg vs. 38.2. ±. 14.7. kg (p=0.029), respectively. ROC analysis for HGT and existence of diabetes mellitus were significant; ≤. 40. kg had sensitivity of 89.7% (95%CI: 72.6-97.8), specificity 43.7% (31.9-56.0); AUC 0.669 (0.568-0.760); . p=0.002. HGT significantly correlated with hematocrit (Rho CC. =0.247; . p=0.013), whilst other laboratory or echocardiographic parameters were insignificant (all . p . >. 0.05). HGT also correlated with body weight (Rho CC. =0.510; . p . <. 0.001); height (Rho CC. =0.632; . p . <. 0.001); waist circumference (Rho CC. =0.388; . p . <. 0.001); waist-to-hip ratio (Rho CC. =0.274; . p=0.006) and BIA (Rho CC. =-0.412; . p . <. 0.001). Conclusions: In postoperative recovery of patients with diabetes, muscle strength assessed by HGT is decreased and in relation with nutritional status. Clinically resourceful connections of HGT were also found to hematocrit and utilization of loop diuretics. © 2016 Elsevier Inc.


PubMed | County Hospital Zadar
Type: Comparative Study | Journal: Digestive diseases and sciences | Year: 2010

The progression of liver cirrhosis eventually increases cardiac output, while blood pressure and systemic vascular resistance are reduced. A complex behavior of portal hemodynamic to hepatic artery and system circulation has not yet been presented. There is a lack in knowledge about the correlation of local and systemic circulation parameters to the degree of liver failure, with respect to presence of ascites and esophageal varices.The study sample was 76 patients hospitalized for established alcoholic liver cirrhosis. Patients were divided into groups according to Child-Pugh clinical score; grade A (n = 24), B (n = 18) and C (n = 18). Ascites was found in 28 patients and esophageal varices in 46. Portal vein flow velocity (PVFV), hepatic artery resistance index (HARI), heart and great vessels within mediastinal cavity were assessed with ultrasound devices equipped with spectral Doppler.Significant differences in mean blood pressure, systemic vascular resistance index (SVRI) minute volume, cardiac index and PVFV were found in the group of patients with the most severe stage (C). In regard to presence of ascites statistically significant difference was observed in elevated mean blood pressure and SVRI. Correlation was found between conjugated HARI to blood pressure and to SVRI.In patients with liver cirrhosis there is an inversely reciprocal relationship of conjugated HARI with PVFV, correlating to disease grade. PVFV in cirrhosis decreases and HARI values were over 0.7. Study demonstrated that combining echocardiography with abdominal Doppler ultrasound served as valuable non-invasive diagnostic insight in liver and systemic circulation among different grade of cirrhosis.

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