Characteristics of the skull base meningothelial tumors

Cilj istraživanja: Ispitati postoji li povezanost između bolesnikove dobi i spola, kao i stanja svijesti, lokalizacije tumora, opsežnosti kirurškog uklanjanja, patohistološkog stupnja tumora, poslijeoperacijskih komplikacija i konačnog ishoda liječenja meningeoma lubanjske osnovice. Nacrt studije: Presječna studija. Ispitanici i metode: U istraživanje su uključeni svi bolesnici s dijagnosticiranim meningeomom lubanjske osnovice koji su liječeni u Klinici za neurokirurgiju KBC-a Osijek u razdoblju od 2000. do 2015. godine. Podatci ispitanika preuzeti su iz medicinske dokumentacije pohranjene u arhivu Klinike za neurokirurgiju KBC-a Osijek. Konačni ishod liječenja određen je Karnofskyjevim indeksom (KPI) pri otpustu iz bolnice te Glasgowskom ljestvicom ishoda (GOS) unutar jedne godine od otpusta iz bolnice. Rezultati: Meningeom lubanjske osnovice dijagnosticiran je u 109 bolesnika. Medijan dobi bio je 63,0 godine, a značajno je više bilo ispitanika ženskoga spola (72,5 %). Pokazatelji ishoda, GOS i KPI, statistički su značajno povezani s dobi (p = 0,043; p = 0,047), stanjem svijesti bolesnika (p = 0,010; p < 0,001) i opsežnosti kirurškog uklanjanja tumora (p = 0,032; p < 0,001). Nije bilo statistički značajne povezanosti spola, lokalizacije tumora, patohistološkog stupnja tumora i poslijeoperacijskih komplikacija s ishodom liječenja. Zaključak: Bolesnici starije životne dobi imaju lošiji ishod liječenja. Spol bolesnika ne utječe na ishod liječenja. Bolesnici s očuvanim ili manje narušenim stanjem svijesti imaju bolji ishod liječenja. Lokalizacija tumora bitno ne utječe na ishod liječenja. Bolesnici kojima je tumor uklonjen u cijelosti imaju bolji ishod liječenja. Patohistološki stupanj i poslijeoperacijske komplikacije ne utječu na ishod liječenja.Objectives: To examine whether is a correlation between patient age and gender, level of consciousness, tumor localization, extent of surgical resection, pathohistological grade of tumor, postoperative complications and outcome of skull base meningioma management. Study Design: Cross-sectional study. Patients and methods: The study included all patients with skull base meningioma treated at the Department of Neurosurgery, Osijek Clinical Hospital Centre from 2000 to 2015. The partients' data were obtained from medical records contained in the archive of the Department of Neurosurgery, Osijek Clinical Hospital Centre. The outcome measure was obtained by Karnofsky Performance Index (KPI) at discharge and Glasgow Outcome Scale (GOS) at one year follow-up. Results: Skull base meningioma was diagnosed in 109 patients. Median age was 63 years, with a significantly female predominance (72.5 %). Outcome measure variables, GOS and KPI, showed statistically significant correlation with patients' age (p = 0.043; p = 0.047), level of consciousness at admission (p = 0.010; p < 0.001) and extent of surgical resection (p = 0.032; p < 0.001). There was no statistically significant correlation between the outcome and certain variables such as gender, tumor localization and pathohistological grade, as well as postoperative complications. Conclusion: The outcome was correlated to patients’ age, but not their gender. Older patients experienced a poorer outcome. The level of consciousness at admission was a strong outcome predictor too. Patients whose consciousness was unaffected had a better chance of favorable outcome. The outcome was not affected by tumor localization, pathohistological grade and/or postoperative complications. However, it was much better in patients whose tumor was completely resected

Aneurysmal Bone Cyst of the Cervical Spine – Case Report

Aneurysmal bone cyst (ABC) is a non-neoplastic locally destructive primary bone lesion mostly occurring within the first two decades of life with female predominance. Cervical spine ABCs are a very rare clinical entity with particularly demanding surgical resection limited by the involvement of nearby neurovascular structures and a risk for cervical spine instability. We present a case of a 17-year-old patient with a symptomatic ABC of the cervical spine who underwent surgical removal of the osseous lesion with good postoperative outcome. There are different therapeutic strategies for ABC management, but complete surgical removal of the cyst remains one of the most important predictors of favorable outcome, although it can be often limited, especially in the cervical region. Previously described lesions have a very high recurrence rate and therefore different additional methods, such as radiotherapy, embolization and sclerosation have been used in addition to surgical resection. Further studies are necessary for development of evidence-based treatment regimens for cervical spine ABCs in pediatric population

Serumska koncentracija vitamina D u bolesnika s vulgarnom psorijazom

Introduction: Psoriasis is a chronic, inflammatory systematic disease that primarily affects the skin. Various factors influence the disease outcome and severity, among which the influence of vitamin D serum levels could potentially be important for disease pathogenesis and therapeutic strategies. Aim: To analyze vitamin D serum levels in patients with psoriasis in comparison to healthy individuals, together with markers of inflammation and disease severity. Methods: The study included patients with psoriasis that formed the case group, while the control group consisted of healthy individuals. The investigated features were demographical data, body mass index (BMI), disease severity, vitamin D serum levels, inflammatory markers, and parathyroid hormone (PTH) levels. Results: The study included 112 participants, 60 in the case group and 52 in the control group with the median age of 49 years. Physical activity was higher in the control group, while the body mass and the BMI were higher in the case group. Participants’ BMI negatively correlated to vitamin D serum levels, as well as C-reactive protein values in the control group and PTH in the case group. There was no significant difference in nicotine and alcohol consumption, sun exposure or vitamin D levels between the two groups. Conclusion: Both groups presented with vitamin D serum levels in the deficiency range. The seasons of the year and the participants’ BMI affected vitamin D status. Vitamin D levels were equally distributed between the groups without influence on disease severity.Uvod: Vulgarna psorijaza kronična je, upalna, sustavna bolest koja se primarno očituje promjenama kože. Različiti čimbenici utječu na ishod liječenja i težinu ove bolesti, a među njima se posebno izdvaja potencijalno važna uloga serumskih koncentracija vitamina D kako u patogenezi tako i kao terapijska opcija. Cilj: Analiza serumskih koncentracija vitamina D u bolesnika koji boluju od vulgarne psorijaze u usporedbi sa zdravom kontrolnom skupinom, kao i procjena težine bolesti i utjecaja upalnih markera. Metode: U istraživanje su uključeni bolesnici koji boluju od vulgarne psorijaze i kontrolna zdrava skupina ispitanika. Istraživana su obilježja kao što su osnovni demografski podaci, indeks tjelesne mase (BMI), klinički stupanj bolesti, serumske vrijednosti vitamina D, upalni parametri te vrijednosti paratireoidnog hormona (PTH). Rezultati: U istraživanje je uključeno 112 ispitanika, 60 oboljelih te 52 ispitanika u kontrolnoj skupini s medijanom dobi od 49 godina. Znatno je viša bila razina tjelesne aktivnosti u kontrolnoj skupini, dok su među oboljelima zabilježeni veća tjelesna masa i BMI. Utvrđena je negativna korelacija između serumskih vrijednosti vitamina D i BMI-ja, kao i razine C-reaktivnog proteina u kontrolnoj skupini, odnosno vrijednosti PTH-a u oboljelih. Prilikom ispitivanja utjecaja konzumacije alkohola i nikotina, izloženosti Sunčevim zrakama i serumskih vrijednosti vitamina B nije bilo znatnih razlika između skupina. Zaključak: Zabilježene su niske koncentracije vitamina D u obje skupine ispitanika. Godišnja doba i BMI utječu na razinu vitamina D. Nije uočena snižena koncentracija vitamina D u bolesnika sa psorijazom ili utjecaj na težinu bolesti

Characteristics of the skull base meningothelial tumors

Cilj istraživanja: Ispitati postoji li povezanost između bolesnikove dobi i spola, kao i stanja svijesti, lokalizacije tumora, opsežnosti kirurškog uklanjanja, patohistološkog stupnja tumora, poslijeoperacijskih komplikacija i konačnog ishoda liječenja meningeoma lubanjske osnovice. Nacrt studije: Presječna studija. Ispitanici i metode: U istraživanje su uključeni svi bolesnici s dijagnosticiranim meningeomom lubanjske osnovice koji su liječeni u Klinici za neurokirurgiju KBC-a Osijek u razdoblju od 2000. do 2015. godine. Podatci ispitanika preuzeti su iz medicinske dokumentacije pohranjene u arhivu Klinike za neurokirurgiju KBC-a Osijek. Konačni ishod liječenja određen je Karnofskyjevim indeksom (KPI) pri otpustu iz bolnice te Glasgowskom ljestvicom ishoda (GOS) unutar jedne godine od otpusta iz bolnice. Rezultati: Meningeom lubanjske osnovice dijagnosticiran je u 109 bolesnika. Medijan dobi bio je 63,0 godine, a značajno je više bilo ispitanika ženskoga spola (72,5 %). Pokazatelji ishoda, GOS i KPI, statistički su značajno povezani s dobi (p = 0,043; p = 0,047), stanjem svijesti bolesnika (p = 0,010; p < 0,001) i opsežnosti kirurškog uklanjanja tumora (p = 0,032; p < 0,001). Nije bilo statistički značajne povezanosti spola, lokalizacije tumora, patohistološkog stupnja tumora i poslijeoperacijskih komplikacija s ishodom liječenja. Zaključak: Bolesnici starije životne dobi imaju lošiji ishod liječenja. Spol bolesnika ne utječe na ishod liječenja. Bolesnici s očuvanim ili manje narušenim stanjem svijesti imaju bolji ishod liječenja. Lokalizacija tumora bitno ne utječe na ishod liječenja. Bolesnici kojima je tumor uklonjen u cijelosti imaju bolji ishod liječenja. Patohistološki stupanj i poslijeoperacijske komplikacije ne utječu na ishod liječenja.Objectives: To examine whether is a correlation between patient age and gender, level of consciousness, tumor localization, extent of surgical resection, pathohistological grade of tumor, postoperative complications and outcome of skull base meningioma management. Study Design: Cross-sectional study. Patients and methods: The study included all patients with skull base meningioma treated at the Department of Neurosurgery, Osijek Clinical Hospital Centre from 2000 to 2015. The partients' data were obtained from medical records contained in the archive of the Department of Neurosurgery, Osijek Clinical Hospital Centre. The outcome measure was obtained by Karnofsky Performance Index (KPI) at discharge and Glasgow Outcome Scale (GOS) at one year follow-up. Results: Skull base meningioma was diagnosed in 109 patients. Median age was 63 years, with a significantly female predominance (72.5 %). Outcome measure variables, GOS and KPI, showed statistically significant correlation with patients' age (p = 0.043; p = 0.047), level of consciousness at admission (p = 0.010; p < 0.001) and extent of surgical resection (p = 0.032; p < 0.001). There was no statistically significant correlation between the outcome and certain variables such as gender, tumor localization and pathohistological grade, as well as postoperative complications. Conclusion: The outcome was correlated to patients’ age, but not their gender. Older patients experienced a poorer outcome. The level of consciousness at admission was a strong outcome predictor too. Patients whose consciousness was unaffected had a better chance of favorable outcome. The outcome was not affected by tumor localization, pathohistological grade and/or postoperative complications. However, it was much better in patients whose tumor was completely resected