Sources of information about complementary and alternative medicine commonly used by oncology patients and healthcare professionals

Complementary and Alternative Medicine (CAM) is increasingly utilized in oncology care; however, significant disparities exist regarding the trusted sources of CAM information among oncology patients and healthcare professionals. This study aimed to systematically evaluate these information sources, their credibility, and their influence on medical decision-making. A cross-sectional study was conducted at the Sisters of Mercy University Hospital Center in Zagreb from November 2022 to May 2023. The sample consisted of 832 respondents, comprising 411 oncology patients and 421 healthcare professionals, including 100 physicians, 321 nurses, and technicians. Data were collected using a survey questionnaire based on modified CHBQ and IMAQ instruments. Descriptive and inferential statistical methods were applied, including one-way analysis of variance (ANOVA) and Tukey's test to identify differences among groups. The most common sources of CAM information for patients were family and friends (82.6%), while healthcare professionals were more inclined to use the internet and media (61.4%). Statistically significant differences in attitudes were identified between patients and healthcare professionals regarding their information sources (p < 0.05). These findings underscore a pressing need for standardized, evidence-based complementary and alternative medicine (CAM) education that is tailored to both patients and healthcare providers. Addressing these disparities through targeted educational interventions could enhance informed decision-making, reduce misinformation, and optimize the delivery of integrative oncology care. Future research should focus on developing verified CAM information frameworks to ensure a more consistent and scientifically grounded approach in oncology settings

Delayed Intracerebral Hemorrhage after Deep Brain Stimulation for Parkinson’s Disease

Introduction: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established treatment for advanced Parkinson’s disease (PD), offering significant symptomatic relief. Although DBS is generally considered safe, it carries risks, including the potential for delayed complications such as intracerebral hemorrhage (ICH). Case Presentation: We present a rare case of a 67-year-old male with PD who developed delayed ICH after undergoing bilateral STN DBS. Initially, the patient showed no neurological deficits postoperatively, with imaging confirming correct lead placement and no signs of hemorrhage. However, on the second postoperative day, the patient developed sudden right-sided hemiparesis. A CT scan revealed ICH alongside the left lead. The hemorrhage was managed conservatively, and the patient underwent extensive physical therapy, leading to significant improvement. Over the next 2 weeks, the patient’s condition improved, and follow-up CT scans showed complete resolution of the ICH. At this point, the left lead stimulation was initiated, further improving the patient’s PD symptoms. This case illustrates the potential for delayed ICH following STN DBS, emphasizing the need for ongoing monitoring and individualized treatment strategies. Conclusion: This case underscores the importance of vigilant postoperative monitoring and individualized management strategies in STN DBS patients. Early detection and appropriate management of complications such as ICH are crucial for minimizing risks and ensuring optimal patient outcomes. The potential for delayed complications highlights the need for continuous follow-up, even in the absence of immediate postoperative issues

Clinical strategies for managing acute intermittent porphyria : biochemical insights in targeting pain pathways and implementing them into clinical practice

This paper investigates clinical strategies for management and therapy of acute intermittent porphyria using a biochemical approach to understand and utilize the pathophysiology of the disease in special regard to its pain symptoms and pain pathways. Specifically, the thesis focuses on the toxicity of ALA (alpha aminolevulinic acid) as well as the biochemical implications of AIP regarding the heme biosynthesis disruption. Furthermore, literature regarding several treatment options with novel approaches were reviewed to connect and bridge the intricate pain pathophysiology of AIP with modern strategies of treatment. In exact, the genesis of several metabolic implications of AIP were explored. Studies regarding the interaction of the glucose metabolism and its connection to ALAS (alpha aminolevulnic acid synthase) as well as literature regarding experimental therapies with gene modification and vector associated enzyme delivery were revised to propose new ways of clinical AIP therapy with an emphasis on pain management

The Impact of Isotonic Seawater on Subjective and Objective Nose Patency in Athletes: A Randomized Controlled Trial

Background/Objectives: Nasal irrigation with isotonic seawater is a known and oft-used treatment for nasal obstruction in patients with acute and chronic nasal inflammatory disease undergoing therapy with intranasal corticosteroids and antihistamine drugs. Nasal patency in healthy athletes is extremely important; however, to date, the effect of isotonic solutions for nasal irrigation in healthy athletes has not been tested. This randomized controlled trial aimed to investigate the potential synergy of physical exercise and nasal isotonic seawater on airflow and the subjective assessment of nasal patency in healthy, high-level athletes. Methods: The intervention group included 33 healthy athletes who used an isotonic seawater nasal spray daily, with a control group including 31 healthy athletes who did not use any sprays; both groups underwent identical seven-day training periods. The primary outcome measures were subjective NOSE questionnaire scores and secondary peak nasal inspiratory flow (PNIF) measures, while anthropometric and demographic variables were covariates. Results: A significant decrease in subjective nasal resistance scores was observed in the intervention group compared to the control group (binary logistic regression model, p = 0.006, RR 7.695), both in the first and second measurement interval. This effect increased with time (Friedman’s two-way analysis of variance, p < 0.001). Peak nasal inspiratory flow is positively affected by exercise but not by isotonic seawater spray intervention. Conclusions: The effects of nasal isotonic seawater irrigation during intense athletic training are beneficial on subjective nasal patency in the short term, while the effects on objective nasal patency are less clear

Zeolite 5 A mediated palmitic acid detection in tomato seed oil by photoionization detector

Tomato seed oil (TSO) is an edible product characterized by a wide range of molecules, with beneficial effects on human health. Volatile organic compounds (VOC) formed from the degradation of fatty acids, are promising candidates for the characterization of vegetable oils. Hereafter, a sensor based on photoionization detector for palmitic acid is presented. The sensor exploits thermal emission profile analysis from a thin layer of zeolite 5 A. Emissive profiles were acquired through a Photoionization Detector (PID) at 100 degrees C. Specifically, the combination of use of zeolite with pore size of 5.1 & Aring; and an ultraviolet lamp of 10.9 eV allows selective adsorption and detection of palmitic acid in a solution of pentane and TSO. The PID-zeolite sensor was investigated using oils at different dilution and at different storage conditions (-20 degrees C, 4 degrees C and 25 degrees C). Results evidenced that pentane dilution plays a significant role in palmitic acid adsorption, with a maximum emissive profile at similar to 885 mu mol/L. Low temperature storage (-20 degrees C) of samples before analysis results in 1.5 times higher emission peak due to the formation of triple chain molecular arrangement of palmitic acid. Calibration evidenced a linear range from 0.45 mmol/L up to 1.8 mmol/L with a sensitivity of 34.65 ppm center dot mmol(-1)center dot L and an R-2 = 0.92. Real scenario analysis was performed a mixture of TSO with soybean oil (SO) at different storage stability. A significant emissive reduction in palmitic acid was observed in mixed oil, depending on its stability which allows for the evaluation of adulterated samples

Kliničke karakteristike i utjecaj antikoagulantnih lijekova na intrakranijalna krvarenja

Cilj: Istražiti klinička, radiološka i laboratorijska obilježja, te razlike u njima kod bolesnika s intrakranijalnim krvarenjima koji su prethodno uzimali antikoagulantne i antitrombocitne lijekove, u odnosu na one koji nisu. Ispitanici i metode: Prikupili smo podatke bolesnika s intrakranijalnim krvarenjima (IKK) hospitaliziranih u OB Pula, u razdoblju od 01. siječnja 2020. do 01. siječnja 2023. godine. Proveli smo analizu podataka koji su uključivali dob, spol, komorbiditete, vrstu IKK, simptome kod prijma, Glagow Coma Score pri prijmu i otpustu, laboratorijske nalaze, metode i ishod liječenja. Rezultati: Rezultati našeg istraživanja pokazuju kako su u retrogradnom, trogodišnjem praćenju bolesnika sa spontanim intrakranijalnim krvarenjima hospitalizirani odrasli bolesnici i jedno dijete. Jedna trećina bolesnika je prethodno uzimala anitkoagulantne i antitrombocitne lijekove. Odnos između broja muškaraca i žena u skupinama nije se značajno razlikovao. Prosječna dob iznosi 70 godina, dok su bolesnici koji nisu uzimali antikoagulantne i antitrobocitne lijekove bili mlađi. Jedna polovina uzorka imala je barem jedan komorbiditet, a tri četvrtine bolesnika (77,2%) bolovalo je od arterijske hipertenzije koja je najvažniji čimbenik rizika za nastanak IKK. Obje skupine bolesnika razvile su umjeren poremećaj svijesti, a intracerebralno krvarenje je bilo najčešći tip IKK. Samo jedna petina bolesnika podvrgnuta je kirurškom tretmanu. Čimbenici koji su bili povezani s antikoagulantnom terapijom su arterijska hipertenzija, atrijska fibrilacija, aneurizmatski SAH i subduralni hematom. Prosječan broj dana hospitalizacije iznosio je 13,72 dana, a smrtnost tijekom hospitalizacije 41,4%. Zaključak: Utvrđeno je da ne postoje klinički značajne razlike između bolesnika. Također, utvrđeno je kako su bolesnici koji su prethodno koristili antikoagulantne i antitrombocitne lijekove imali veću incidenciju subduralnih hematoma i izoliranog intraventrikularnog krvarenja u odnosu na kontrolnu skupinu bez terapije. Smrtnost kod bolesnika na antikoagulatnoj terapiji iznosila je 48,9%, dok je smrtnost kod nekoaguliranih bolesnika iznosila 37,1%, čime se naglašava važnost ranog prepoznavanja bolesnika na antikoagulantnoj terapiji

Women as Forensic Patients – Comparison of Patients with Schizophrenia and Related Disorders and Those with Other Mental Disorders

Žene su mnogo rjeđe forenzički pacijenti u odnosu na muškarce. Najčešće su hospitalizirane pod dijagnozom iz spektra psihotičnih poremećaja. Ipak, istraživanja pokazuju kako se forenzičke pacijentice mogu podijeliti u određene podskupine s različitim karakteristikama, ovisno o dijagnozi. Stoga je glavni cilj ovoga rada bio prikazati razlike između podskupina forenzičkih pacijentica. Uzorak se sastojao od 31 pacijentice Zavoda za forenzičku psihijatriju “Dr. Vlado Jukić”. Pacijentice su na Zavodu bile hospitalizirane u razdoblju od 2009. do 2023. godine. Podijelili smo ih u dvije podskupine: podskupina pacijentica s dijagnozom shizofrenije ili srodnim poremećajem te podskupina pacijentica kojima su dijagnosticirani drugi psihički poremećaji. Pojedine karakteristike dviju podskupina uspoređivale su se pomoću hi-kvadrat-testa i t-testa. Istraživanje je pokazalo kako se navedene dvije podskupine pacijentica razlikuju. Prva glavna razlika je u razini postignutog obrazovanja. Pacijentice bez dijagnoze shizofrenije ili srodnog poremećaja bile su slabije obrazovane. Druga razlika je u većoj prisutnosti komorbiditeta u pacijentica bez dijagnoze shizofrenije ili srodnog poremećaja. Ove razlike treba uzeti u obzir za unaprjeđenje ishoda liječenja kao i u svrhu prevencije pogoršanja bolesti, a posljedično i prevencije počinjenja samog djela.Women are much less likely to be forensic patients than men. They are most commonly hospitalized for a diagnosis within the psychotic disorder spectrum. However, studies show that female forensic patients can be divided into specific subgroups with different characteristics, depending on their diagnoses. The main aim of this study was, therefore, to reveal the differences between the subgroups of female forensic patients. Our sample consisted of 31 female forensic inpatients of the Department of Forensic Psychiatry “Dr. Vlado Jukić”, who were hospitalized in the period from 2009 to 2023. We divided them into two subgroups: a subgroup of patients diagnosed with schizophrenia or related disorders, and a subgroup of patients diagnosed with other mental disorders. The individual characteristics of the two subgroups were compared using a chi-square test and a t-test. The study showed that differences exist between these two subgroups of patients. The first main difference is in the level of education. Patients who were not diagnosed with schizophrenia or related disorder were less educated. The other difference involved a more frequent occurrence of comorbidity in the patients who were not diagnosed with schizophrenia or related disorder. These differences should be taken into account in order to achieve the best possible treatment outcome and also to prevent the aggravation of the illness, consequently preventing the commission of the offence itself

The impact of MITF expression on tumor-infiltrating lymphocytes in melanoma: Insights into immune microenvironment dynamics

Melanoma progression is influenced by complex interactions between tumor cells and the immune microenvironment. This study examined the relationship between microphthalmia-associated transcription factor (MITF) expression and the immune microenvironment in primary melanoma using a modified classification of tumor-infiltrating lymphocytes (TILs) based on conventional BRISK categories. Archival formalin-fixed, paraffin-embedded tissue samples from 81 primary melanoma patients were analyzed via tissue microarray immunohistochemistry to assess MITF protein levels. TIL patterns were categorized into six groups, refining the traditional BRISK classification to distinguish between continuous and discontinuous infiltration, as well as peripheral vs intratumoral distribution. The analysis revealed that melanomas classified under the BRISK B category exhibited the highest MITF expression, often exceeding 50%. In contrast, tumors in the NON-BRISK and ABSENT TIL groups showed significantly lower MITF expression (mean values: 32.73% ± 16.98% and 22.00% ± 10.54%, respectively), with statistically significant differences (Kruskal–Wallis test, P = 0.027; modified classification, P = 0.011). Additionally, the presence of CD20+ B lymphocytes correlated with increased MITF expression (P = 0.009). MITF gene amplification was detected in 29% of cases, though its association with protein expression showed only a trend (P = 0.058). These findings highlight the complex interplay between MITF expression and TIL distribution in melanoma, suggesting that refined TIL classification may offer deeper insights into tumor immunobiology and help predict responses to immunotherapy

Rectus Abdominis Muscle Endometriosis: A Unique Case Report with a Literature Review

Introduction and importance: Extrapelvic endometriosis, confined exclusively to the body of the rectus abdominis muscle, is a rare form of abdominal wall endometriosis. While its etiopathology remains unclear, it is often diagnosed in healthy women who present with atypical symptoms and localization unrelated to any incision site, or in the absence of a history of endometriosis or previous surgery. Presentation of the case: Here, we describe a unique case of intramuscular endometriosis of the rectus abdominis muscle in a healthy 39-year-old Caucasian woman. The condition was located away from any prior incisional scars and presented without typical symptoms or concurrent pelvic disease, making diagnostic imaging unclear. After partial surgical resection of the endometriotic foci, the diagnosis was confirmed histologically. Progestogen-based supportive medication was initiated to prevent the need for additional surgeries and to reduce the risk of recurrence. After 6 years of follow-up and continued progestogen treatment, the patient remains symptom-free and has shown no recurrence of the disease. Clinical discussion: Endometriosis of the rectus abdominis muscle exhibits specific characteristics in terms of localization, etiopathology, symptomatology, and diagnostic imaging, suggesting that it should be considered a distinct clinical entity. Conclusions: Although rare, primary endometriosis of the rectus abdominis muscle should be included in the differential diagnosis for women of childbearing age. Early diagnosis is essential to avoid delayed recognition, tissue damage, and to minimize the risk of recurrence or malignant transformation. Given the increasing frequency of gynecologic and laparoscopic surgeries worldwide, it is crucial to establish standardized reporting protocols, follow-up timelines, and imaging assessments during specific phases of the menstrual cycle. Standardization will help raise awareness of this disease, and further our understanding of its pathogenesis, risk factors, recurrence patterns, and potential for malignant transformation—factors that are still not fully understood