Solitary pulmonary nodule syndrome

Cilj istraživanja: Utvrditi učestalost pojedinih etiologija SPN-ova i dijagnostičkih metoda, CT punkcije i eksplorativne torakotomije, korištenih u njihovom otkrivanju, učestalost kirurških zahvata korištenih u njihovom otklanjanju te razlike u dobi i spolu, u odnosu na etiologiju SPN-ova i operabilnost pacijenata. Nacrt studije: Povijesno kohortno istraživanje. Bolesnici i metode: Istraživanje je provedeno na 72 pacijenata koji su zaprimljeni na Zavod za torakalnu, plastičnu i rekonstrukcijsku kirurgiju KBC-a Osijek s dijagnozom SPN-a. Na 54 (75 %) pacijenata učinjena je eksplorativna torakotomija, a na 18 (25 %) pacijenata CT punkcija. 7 (9,7 %) pacijenata bilo je mlađe od 45 godina, a 65 (90,3 %) starije od 45 godina. Istraživanje je provedeno uz pomoć podataka preuzetih iz medicinske dokumentacije pacijenata. Rezultati: Utvrđen je porast udjela učinjenih eksplorativnih torakotomija u odnosu na ukupan broj torakotomija s 18,8 % 2010. na 25 % 2014. godine. Adenokarcinom je bio najčešća maligna etiologija SPN-a, otkrivena kod 14 (25,9 %) eksplorativnih torakotomija, a planocelularni karcinom otkriven je kod 7 (38,9 %) CT punkcija. Najčešći učinjeni kirurški zahvat bila je lobektomija, izvedena na 15 (30,6 %) pacijenata. Nije postojala statistički značajna razlika između pacijenata mlađih od 45 godina i starijih od 45 godina u odnosu na spol, operabilnost i etiologiju SPN-ova, kao ni statistički značajna razlika u utvrđenoj etiologiji SPN-ova s obzirom primjenjenu CT punkcije ili eksplorativne torakotomije. Zaključak: Potrebna su dodatna istraživanja koja bi usporedila podatke prikupljene na svim KBC-ovima u Hrvatskoj kako bi se ustvrdila učestalost i etiologija SPN-ova na razini cijele države.Objectives: The aim of this study was to determine the frequency of SPN's etiology and diagnostic methods, CT puncture and exploratory thoracotomy used in their detection, the frequency of surgical interventions used in their removal as well as differences in age and gender in relation to the etiology and operability of the patients. Study design: The study is structured as a historical cohort study. Patients and methods: The case group consisted of 72 patients who were admitted to the Institute of Thoracic, Plastic and Reconstructive Surgery, Clinical Hospital Centre in Osijek, with diagnosed SPN. 54 patients (75 %) underwent an exploratory thoracotomy and 18 (25 %) underwent CT-guided needle puncture. 7 patients (9.7 %) were younger than 45 years of age and 65 (90.3 %) were older than 45 years of age. The study was conducted using data obtained from the patients’ medical records. Results: An increase was observed in the share of preformed exploratory thoracotomies in relation to the total number of thoracotomies, from 18.8 % in 2010 to 25% in 2014. Adenocarcinoma was the most common cause of malignant SPN’s and was detected in 14 patients (25.9 %) during exploratory thoracotomy, and squamous cell carcinoma was discovered in 7 patients (38.9 %) by CT-guided needle puncture. The most common surgical procedure performed was lobectomy, carried out in 15 patients (30.6 %). There was no statistically significant difference with regard to the gender, operability and etiology of SPN's between patients younger than 45 years of age and patients older than 45 years of age. Also, there was no statistically significant difference in the established etiology of SPN's diagnosed using CT-guided needle puncture and those diagnosed using exploratory thoracotomy. Conclusion: Additional research that will compare the data collected in all Clinical Hospital Centres in Croatia is necessary, to verify the incidence and etiology of SPN's for the entire country

Readmission of late preterm and term neonates in the neonatal period

Objective: To determine the incidence of hospital readmissions in late preterm and term neonates, the most common reasons for readmission, and analyze the risk factors for readmission in the neonatal period. Methods: Newborn infants admitted to a well-baby nursery ≥ 36 weeks gestation were included in this retrospective cohort study. Data for all infants born in a 3-year period and readmitted in the first 28 days of life were analyzed. Indication for readmission was one diagnosed during initial workup in the pediatric emergency room visit before readmission. Results: The final cohort consisted of 5408 infants. The readmission rate was 4.0% (219/5408). Leading readmission causes were respiratory tract infection (29.58%), jaundice (13.70%), and urinary tract infection (9.59%). The mean ± SD age of readmitted infants was 13.3 ± 7.1 days. The mean ± SD treatment duration of treatment was 5.5 ± 3.0 days. In the multivariate regression analysis, infants that were during the initial hospitalization transferred to special care/NICU had a lower chance of readmission during the neonatal period (p = 0.04, OR = 0.23, 95% CI 0.06–0.93). Infants with mothers aged from 19–24 years had a higher risk of readmission (p = 0.005, OR = 1.62, 95% CI 1.16–2.26). Conclusions: Finding that infants that were during the initial hospitalization transferred to special care or a NICU setting were less likely to require hospitalization in the neonatal period is an interesting one. Further research into how different approach in these settings reduce the risk of readmission is necessary

Magnesium, zinc and iron serum levels as potential parameters significant for effective glycemic control in children with type 1 diabetes

Background. Various trace elements contribute to the development of diabetes and its complications through their roles in glucose metabolism and the oxidative stress response. The aim of this study was to ascertain the difference in serum magnesium, zinc and iron concentrations between healthy children and children with type 1 diabetes mellitus (T1DM). This study also aimed to determine whether serum concentrations of magnesium, zinc, and iron in children with T1DM correlated with the duration of the disease and the quality of glycemic control in this group. Material and methods. A total of 99 children with T1DM and 40 healthy children were included in this study. Magnesium, zinc and iron serum levels were assessed using the photometric method. Results. Significantly lower levels of magnesium and zinc (P < 0.001) were observed, between the T1DM group and the healthy control group but no statistically significant differences were found in iron levels (P = 0.13) between the two groups. While there were no statistically significant differences in serum concentrations with respect to the duration of disease, it was, however, discovered that children with poorer glycemic control had significantly lower serum zinc concentrations (P < 0.001) while magnesium and iron levels remained similar (P = 0.07 and 0.21 respectively). Conclusion. This study found that while there was no significant difference in iron serum levels in children with T1DM compared to healthy controls, children with T1DM did have more significantly decreased magnesium and zinc serum levels than the control group. Serum zinc levels in this study also directly correlated to poorer glycemic control. Further studies are required to explore whether magnesium and zinc supplementa­tion, or nutritional intake, could potentially be used to achieve better glycemic control in children with T1DM

Solitary pulmonary nodule syndrome

Cilj istraživanja: Utvrditi učestalost pojedinih etiologija SPN-ova i dijagnostičkih metoda, CT punkcije i eksplorativne torakotomije, korištenih u njihovom otkrivanju, učestalost kirurških zahvata korištenih u njihovom otklanjanju te razlike u dobi i spolu, u odnosu na etiologiju SPN-ova i operabilnost pacijenata. Nacrt studije: Povijesno kohortno istraživanje. Bolesnici i metode: Istraživanje je provedeno na 72 pacijenata koji su zaprimljeni na Zavod za torakalnu, plastičnu i rekonstrukcijsku kirurgiju KBC-a Osijek s dijagnozom SPN-a. Na 54 (75 %) pacijenata učinjena je eksplorativna torakotomija, a na 18 (25 %) pacijenata CT punkcija. 7 (9,7 %) pacijenata bilo je mlađe od 45 godina, a 65 (90,3 %) starije od 45 godina. Istraživanje je provedeno uz pomoć podataka preuzetih iz medicinske dokumentacije pacijenata. Rezultati: Utvrđen je porast udjela učinjenih eksplorativnih torakotomija u odnosu na ukupan broj torakotomija s 18,8 % 2010. na 25 % 2014. godine. Adenokarcinom je bio najčešća maligna etiologija SPN-a, otkrivena kod 14 (25,9 %) eksplorativnih torakotomija, a planocelularni karcinom otkriven je kod 7 (38,9 %) CT punkcija. Najčešći učinjeni kirurški zahvat bila je lobektomija, izvedena na 15 (30,6 %) pacijenata. Nije postojala statistički značajna razlika između pacijenata mlađih od 45 godina i starijih od 45 godina u odnosu na spol, operabilnost i etiologiju SPN-ova, kao ni statistički značajna razlika u utvrđenoj etiologiji SPN-ova s obzirom primjenjenu CT punkcije ili eksplorativne torakotomije. Zaključak: Potrebna su dodatna istraživanja koja bi usporedila podatke prikupljene na svim KBC-ovima u Hrvatskoj kako bi se ustvrdila učestalost i etiologija SPN-ova na razini cijele države.Objectives: The aim of this study was to determine the frequency of SPN's etiology and diagnostic methods, CT puncture and exploratory thoracotomy used in their detection, the frequency of surgical interventions used in their removal as well as differences in age and gender in relation to the etiology and operability of the patients. Study design: The study is structured as a historical cohort study. Patients and methods: The case group consisted of 72 patients who were admitted to the Institute of Thoracic, Plastic and Reconstructive Surgery, Clinical Hospital Centre in Osijek, with diagnosed SPN. 54 patients (75 %) underwent an exploratory thoracotomy and 18 (25 %) underwent CT-guided needle puncture. 7 patients (9.7 %) were younger than 45 years of age and 65 (90.3 %) were older than 45 years of age. The study was conducted using data obtained from the patients’ medical records. Results: An increase was observed in the share of preformed exploratory thoracotomies in relation to the total number of thoracotomies, from 18.8 % in 2010 to 25% in 2014. Adenocarcinoma was the most common cause of malignant SPN’s and was detected in 14 patients (25.9 %) during exploratory thoracotomy, and squamous cell carcinoma was discovered in 7 patients (38.9 %) by CT-guided needle puncture. The most common surgical procedure performed was lobectomy, carried out in 15 patients (30.6 %). There was no statistically significant difference with regard to the gender, operability and etiology of SPN's between patients younger than 45 years of age and patients older than 45 years of age. Also, there was no statistically significant difference in the established etiology of SPN's diagnosed using CT-guided needle puncture and those diagnosed using exploratory thoracotomy. Conclusion: Additional research that will compare the data collected in all Clinical Hospital Centres in Croatia is necessary, to verify the incidence and etiology of SPN's for the entire country

Comparison of Two Muscle Activity Detection Techniques from Surface EMG Signals Applied to Countermovement Jump

status: publishe

Stężenia magnezu, cynku i żelaza w surowicy jako parametry mogące mieć istotne znaczenie w skutecznej kontroli cukrzycy typu 1 u dzieci

Wstęp. Pierwiastki śladowe przyczyniają się do rozwoju cukrzycy i jej powikłań w związku z ich rolą w metabolizmie glukozy i reakcji na stres oksydacyjny. Celem niniejszego badania było ustalenie różnicy w stężeniach magnezu, cynku i żelaza w surowicy między zdrowymi dziećmi a dziećmi z cukrzycą typu 1 (T1DM). Badanie to miało również na celu ustalenie, czy stężenia magnezu, cynku i żelaza w surowicy u dzieci z T1DM są skorelowane z czasem trwania choroby i jakością kontroli glikemii w tej grupie. Materiał i metody. W badaniu wzięło udział 99 dzieci chorych na T1DM i 40 dzieci zdrowych. Stężenia mag­nezu, cynku i żelaza w surowicy oceniono za pomocą metody fotometrycznej. Wyniki. W grupie dzieci z T1DM stężenia magnezu i cynku (p < 0,001) były istotnie niższe niż w grupie kontrolnej, ale nie stwierdzono statystycznie istotnych różnic między grupami w stężeniach żelaza (p = 0,13). Mimo że stężenia badanych pierwiastków w surowicy nie różniły się istotnie w zależności od czasu trwania choroby, odkryto, że u dzieci z gorszą kontrolą glikemii stężenia cynku w surowicy były znacznie niższe (p < 0,001), podczas gdy stężenia magnezu i żelaza pozostawały zbliżone (p = odpowiednio 0,07 i 0,21). Wnioski. W badaniu wykazano, że chociaż nie było istotnej różnicy w stężeniach żelaza w surowicy między dziećmi z T1DM a zdrową grupą kontrolną, u dzieci z T1DM stężenia magnezu i cynku w surowicy były istotnie niższe niż w grupie kontrolnej. Stężenia cynku w surowicy bezpośrednio korelowały również z gorszą kontrolą glikemii. Konieczne są dalsze badania w celu ustalenia, czy można wykorzystać suplementację magnezu i cynku lub ich spożycie w diecie do uzyskania lepszej kontroli glikemii u dzieci z T1DM

Severe Cranio-Cervical Stenosis in a Child with Saul-Wilson Syndrome: A Case Report

Introduction: Saul Wilson syndrome (SWS) is a rare congenital syndrome characterized by a variety of symptoms, mostly skeletal changes. Saul and Wilson were the first to describe children with extremely short stature and craniofacial dysmorphism. Case report: We present a case of a 15-years-old boy with clinical and radiological characteristics of SWS. Genetic examination identified a pathogenic heterozygous variant in the COG4 gene. Magnetic resonance imaging revealed a critical stenosis of the cranio-cervical junction (CCJ) which required surgical treatment to attempt sufficient neurological decompression. The patient underwent decompression of CCJ under general anesthesia. There was no significant radiological and clinical improvement during the postoperative period. Conclusions: SWS is presented as an extremely rare congenital disease in children. The clinical condition of our patient confined surgical possibilities, therefore further treatment in such patients should be appropriately evaluated

Severe Cranio-Cervical Stenosis in a Child with Saul-Wilson Syndrome: A Case Report

Introduction: Saul Wilson syndrome (SWS) is a rare congenital syndrome characterized by a variety of symptoms, mostly skeletal changes. Saul and Wilson were the first to describe children with extremely short stature and craniofacial dysmorphism. Case report: We present a case of a 15-years-old boy with clinical and radiological characteristics of SWS. Genetic examination identified a pathogenic heterozygous variant in the COG4 gene. Magnetic resonance imaging revealed a critical stenosis of the cranio-cervical junction (CCJ) which required surgical treatment to attempt sufficient neurological decompression. The patient underwent decompression of CCJ under general anesthesia. There was no significant radiological and clinical improvement during the postoperative period. Conclusions: SWS is presented as an extremely rare congenital disease in children. The clinical condition of our patient confined surgical possibilities, therefore further treatment in such patients should be appropriately evaluated