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Zagreb, Croatia

Raguz M.,University of Zagreb | Brcina N.,Health Center Zagreb East | Marinac D.,Health Center Primorsko goranska County Rijeka | Gjurasin M.,Childrens Hospital Zagreb
Wiener Klinische Wochenschrift | Year: 2014

Background: This retrospective study was designed to evaluate whether patients with hydrocephalus associated with central nervous system (CNS) anomalies, compared with patients with hydrocephalus and absent CNS anomalies, present with significantly higher rate of postoperative complications, including more serious clinical presentation, increased life threat, and higher postoperative or late mortality rate. Methods: We performed a retrospective study using medical records of 100 patients of pediatric and adolescent age (0-18 years) between 2004 and 2010 treated with operative cerebrospinal fluid (CSF) shunt placement. Results: In both groups of patients, there were 43 postoperative complications, including 12 mechanical obstructions of the CSF drainage systems, 13 disconnections, 11 dislocations of proximal catheter, 6 inflammatory complications (meningitis), and 1 latex allergy. Patients with hydrocephalus associated with CNS anomalies were presented with statistically higher rate of postoperative complications (U = 303.5, z = -3.27, p = 0.001), higher number of operations, at least one complication more per patient, more complicated clinical course, higher life threat, and higher late mortality rate. Conclusions: After installing the CSF drain system, children and adolescents with hydrocephalus associated with anomalies of the CNS require regular and careful follow-up. © 2013 Springer-Verlag Wien. Source

Sekelj S.,General Hospital Dr. J. Bencevic | Dekaris I.,University of Zagreb | Balog T.,Ruder Boskovic Institute | Mahovne I.,General Hospital Dr. J. Bencevic | And 4 more authors.
Current Eye Research | Year: 2015

Abstract Purpose: To evaluate whether the vascular endothelial growth factor A (VEGF-A) in the recipient cornea measured at the time of penetrating keratoplasty (PK) can act as a prognostic factor for corneal graft reaction development. Methods: The study included 25 eyes (of 25 patients) scheduled for PK. According to preoperative clinical finding, patients were divided into three groups: inflammatory with neovascularization (n = 11); inflammatory without neovascularization (n = 7); and non-inflammatory (n = 7). One half of the recipient cornea was analyzed for the levels of VEGF-A protein using a commercial enzyme-linked immunosorbent assay; the other half was analyzed to determine the loci of VEGF-A production by immunohistochemistry. The frequencies of corneal graft reaction and rejection were recorded, together with the improvement of visual acuity. Twenty-five donor corneas obtained from cadaver eyes represented the control group (n = 25). Results: There was a statistically significant difference in the levels of VEGF-A protein between the recipient corneal buttons obtained from eyes with inflammatory changes and neovascularization, and those from the non-inflammatory group and controls (p < 0.01). The level of VEGF-A was 287.74 pg/ml (standard deviation [SD] = 129.181) in the inflammatory with corneal neovascularization group, 227.64 pg/ml (SD = 85.590) in the inflammatory without neovascularization group, 115.37 pg/ml (SD = 105.93) in the non-inflammatory group, and 142.28 pg/ml (SD = 93.081) in the control group. Graft reaction/rejection rate was 54.5%/45.5% in the inflammatory with neovascularization group, 14.3%/0% in the inflammatory without neovascularization group, and 14.3%/14.3% in non-inflammatory group. Patients who developed clinical signs of graft reaction during the postoperative follow-up had a significantly higher level of VEGF-A (307.4 pg/ml, SD = 100.058) compared with those without any signs of graft reaction (182.8 pg/ml, SD = 124.987). Conclusion: Our results suggest that both graft reaction and final graft rejection occur more often in patients with increased levels of VEGF-A in a recipient cornea at the time of PK. © 2014 Informa Healthcare USA, Inc. All rights reserved: reproduction in whole or part not permitted. Source

Kelava I.,University of Zagreb | Tomicic K.,University of Zagreb | Kokic M.,Health Center Zagreb East | Corusic A.,University of Zagreb | And 6 more authors.
Croatian Medical Journal | Year: 2012

Aim: To analyze and interpret incidence and mortality trends of breast and ovarian cancers and incidence trends of cervical and endometrial cancers in Croatia for the period 1988-2008. Methods: Incidence data were obtained from the Croatian National Cancer Registry. Themortality data were obtained from the World Health Organization (WHO) mortality database. Trends of incidence and mortality were analysed by joinpoint regression analysis. Results: Joinpoint analysis showed an increase in the incidence of breast cancer with estimated annual percent of change (EAPC) of 2.6% (95% confidence interval [CI], 1.9 to 3.4). The mortality rate was stable, with the EAPC of 0.3%. Endometrial cancer showed an increasing incidence trend, with EAPC of 0.8% (95% CI, 0.2 to 1.4), while cervical cancer showed a decreasing incidence trend, with EAPC of -1.0 (95% CI, -1.6 to -0.4). Ovarian cancer incidence showed three trends, but the average annual percent change (AAPC) for the overall period was not significant, with a stable trend of 0.1%. Ovarian cancer mortality was increasing since 1992, with EAPC of 1.2% (95% CI, 0.4 to 1.9), while the trend for overall period was stable with AAPC 0.1%. Conclusion: Incidence trends of breast, endometrial, and ovarian cancers in Croatia 1988-2008 are similar to the trends observed in most of the European countries, while the modest decline in cervical cancer incidence and lack of decline in breast cancer mortality suggest suboptimal cancer prevention and control. Source

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