KIRURŠKO LIJEČENJE VRATNE SPONDILOTIČNE MIJELOPATIJE

Cilj istraživanja: Cilj ovog rada je prikazati i usporediti tehnike operacijskih zahvata na vratnim kralješcima, te analizom određenih pokazatelja ukazati na prednosti i nedostatke kod istih. Materijali i metode: Analizom povijesti bolesti kod bolesnika koji su imali operaciju na vratnim kralješcima u navedenom razdoblju uporabljene su sljedeće metode: - broj pacijenata po spolu, - dob bolesnika, - simptomi bolesti, - obavljeni pregledi, te - metode kirurškog liječenja po spolu. Rezultati: U istraživanje je uključeno 74 pacijenta (36 muškaraca, te 38 žena u dobi od 36 do 65 godina), koji se liječe različitim metodama neurokirurgije. Rezultati su pokazali da postoje određene razlike u načinu ustanovljavanja i liječenja vratne spondilotične mijelopatije što potvrđuje i odnos poboljšanja zdravstvenog stanja kod pacijenata. Vidljiva je prednost pojedinih načina uspostavljanja dijagnoze pred drugima (u ovom slučaju MR-a pred ostalim načinima), te pojedinih operativnih zahvata. Ipak statističkom analizom i određivanjem p vrijednosti nije utvrđena značajna razlika među operativnim zahvatima u smislu efikasnosti i uspješnosti tj. sve su operacije jednako uspješne tj. neuspješne. Zaključak: Pacijenti trebaju biti pažljivo kontrolirani u neposrednom postoperativnom toku ta bi se na vrijeme otkrili simptomi i znaci neurološkog pogoršanja i kako bi pravovremena intervencija u ovim slučajevima dovela do povoljnog ishoda. Neurološki pregled je još uvijek najefikasniji i najkorisniji način praćenja postoperativnih medularnih funkcija.The aim of the research: The aim of this paper is to show and compare the techniques of surgical procedures in the cervical vertebrae, and analysis of specific indicators to point out the advantages and disadvantages with them . Materials and methods: By analyzing the history of the disease in patients who have had surgery on the vertebrae in the mentioned period, used the following methods : - the number of patients by gender, - age of the patient, - the symptoms of the disease, - carried out checks, and - methods of surgical treatment by gender. Results: The study included 74 patients ( 36 men and 38 women aged 36-65 years ), which are treated with different methods of neurosurgery. The results showed that there were statistically significant differences in the way the establishment and treatment of the CSM-a, as evidenced by the attitude of improving the health status of patients . The apparent advantage of the individual modes of diagnosis in front of others (in this case MRI over other modes), and certain surgeries. Conclusion: Patients should be carefully controlled in the immediate postoperative period, this would be the time to discover the symptoms and signs of neurological deterioration and to timely intervention in these cases led to a favorable outcome. Neurological examination is still the most efficient and useful way of keeping track of postoperative medullary function

KIRURŠKO LIJEČENJE VRATNE SPONDILOTIČNE MIJELOPATIJE

Cilj istraživanja: Cilj ovog rada je prikazati i usporediti tehnike operacijskih zahvata na vratnim kralješcima, te analizom određenih pokazatelja ukazati na prednosti i nedostatke kod istih. Materijali i metode: Analizom povijesti bolesti kod bolesnika koji su imali operaciju na vratnim kralješcima u navedenom razdoblju uporabljene su sljedeće metode: - broj pacijenata po spolu, - dob bolesnika, - simptomi bolesti, - obavljeni pregledi, te - metode kirurškog liječenja po spolu. Rezultati: U istraživanje je uključeno 74 pacijenta (36 muškaraca, te 38 žena u dobi od 36 do 65 godina), koji se liječe različitim metodama neurokirurgije. Rezultati su pokazali da postoje određene razlike u načinu ustanovljavanja i liječenja vratne spondilotične mijelopatije što potvrđuje i odnos poboljšanja zdravstvenog stanja kod pacijenata. Vidljiva je prednost pojedinih načina uspostavljanja dijagnoze pred drugima (u ovom slučaju MR-a pred ostalim načinima), te pojedinih operativnih zahvata. Ipak statističkom analizom i određivanjem p vrijednosti nije utvrđena značajna razlika među operativnim zahvatima u smislu efikasnosti i uspješnosti tj. sve su operacije jednako uspješne tj. neuspješne. Zaključak: Pacijenti trebaju biti pažljivo kontrolirani u neposrednom postoperativnom toku ta bi se na vrijeme otkrili simptomi i znaci neurološkog pogoršanja i kako bi pravovremena intervencija u ovim slučajevima dovela do povoljnog ishoda. Neurološki pregled je još uvijek najefikasniji i najkorisniji način praćenja postoperativnih medularnih funkcija.The aim of the research: The aim of this paper is to show and compare the techniques of surgical procedures in the cervical vertebrae, and analysis of specific indicators to point out the advantages and disadvantages with them . Materials and methods: By analyzing the history of the disease in patients who have had surgery on the vertebrae in the mentioned period, used the following methods : - the number of patients by gender, - age of the patient, - the symptoms of the disease, - carried out checks, and - methods of surgical treatment by gender. Results: The study included 74 patients ( 36 men and 38 women aged 36-65 years ), which are treated with different methods of neurosurgery. The results showed that there were statistically significant differences in the way the establishment and treatment of the CSM-a, as evidenced by the attitude of improving the health status of patients . The apparent advantage of the individual modes of diagnosis in front of others (in this case MRI over other modes), and certain surgeries. Conclusion: Patients should be carefully controlled in the immediate postoperative period, this would be the time to discover the symptoms and signs of neurological deterioration and to timely intervention in these cases led to a favorable outcome. Neurological examination is still the most efficient and useful way of keeping track of postoperative medullary function

KIRURŠKO LIJEČENJE VRATNE SPONDILOTIČNE MIJELOPATIJE

Cilj istraživanja: Cilj ovog rada je prikazati i usporediti tehnike operacijskih zahvata na vratnim kralješcima, te analizom određenih pokazatelja ukazati na prednosti i nedostatke kod istih. Materijali i metode: Analizom povijesti bolesti kod bolesnika koji su imali operaciju na vratnim kralješcima u navedenom razdoblju uporabljene su sljedeće metode: - broj pacijenata po spolu, - dob bolesnika, - simptomi bolesti, - obavljeni pregledi, te - metode kirurškog liječenja po spolu. Rezultati: U istraživanje je uključeno 74 pacijenta (36 muškaraca, te 38 žena u dobi od 36 do 65 godina), koji se liječe različitim metodama neurokirurgije. Rezultati su pokazali da postoje određene razlike u načinu ustanovljavanja i liječenja vratne spondilotične mijelopatije što potvrđuje i odnos poboljšanja zdravstvenog stanja kod pacijenata. Vidljiva je prednost pojedinih načina uspostavljanja dijagnoze pred drugima (u ovom slučaju MR-a pred ostalim načinima), te pojedinih operativnih zahvata. Ipak statističkom analizom i određivanjem p vrijednosti nije utvrđena značajna razlika među operativnim zahvatima u smislu efikasnosti i uspješnosti tj. sve su operacije jednako uspješne tj. neuspješne. Zaključak: Pacijenti trebaju biti pažljivo kontrolirani u neposrednom postoperativnom toku ta bi se na vrijeme otkrili simptomi i znaci neurološkog pogoršanja i kako bi pravovremena intervencija u ovim slučajevima dovela do povoljnog ishoda. Neurološki pregled je još uvijek najefikasniji i najkorisniji način praćenja postoperativnih medularnih funkcija.The aim of the research: The aim of this paper is to show and compare the techniques of surgical procedures in the cervical vertebrae, and analysis of specific indicators to point out the advantages and disadvantages with them . Materials and methods: By analyzing the history of the disease in patients who have had surgery on the vertebrae in the mentioned period, used the following methods : - the number of patients by gender, - age of the patient, - the symptoms of the disease, - carried out checks, and - methods of surgical treatment by gender. Results: The study included 74 patients ( 36 men and 38 women aged 36-65 years ), which are treated with different methods of neurosurgery. The results showed that there were statistically significant differences in the way the establishment and treatment of the CSM-a, as evidenced by the attitude of improving the health status of patients . The apparent advantage of the individual modes of diagnosis in front of others (in this case MRI over other modes), and certain surgeries. Conclusion: Patients should be carefully controlled in the immediate postoperative period, this would be the time to discover the symptoms and signs of neurological deterioration and to timely intervention in these cases led to a favorable outcome. Neurological examination is still the most efficient and useful way of keeping track of postoperative medullary function

RELIGIOUSNESS, ANXIETY AND DEPRESSION IN PATIENTS WITH GLAUCOMA, AGE-RELATED MACULAR DEGENERATION AND DIABETIC RETINOPATHY

Background: Many chronic medical conditions such as glaucoma, senile macular degeneration and diabetic retinopathy are further complicated by emotional and psychological disorders. Religiousness represents a part of a social culture and has a significant role in the prevention of mental difficulties of the patients, especially those belonging to older population. The aim of this study was to investigate the connection between religiousness, anxiety, and depression in patients with glaucoma, age-related macular degeneration and diabetic retinopathy and to test their connection related to different diagnosis. Subjects and methods: This cross-sectional study included 163 patients divided into three groups (glaucoma group, senile macular degeneration group and diabetic retinopathy group). Respondents voluntarily agreed to participate in the study and with assistance they fully completed the Scale of Religiousness, Hospital Anxiety and Depression Scale, General Health Questionnaire and demographic information (age, gender, education, employment and marital status). Results: The results showed noticeable religiosity of the respondents (M=18.31, SD=5.28), but also the presence of anxiety (M=7.55, SD=3.73), especially in patients with glaucoma, as well as impaired mental health in AMD patients (M=19.56, SD=4.14). No differences were found in the severity of anxiety, depression, general health and religiosity between groups, but the presence of depression in subjects with age-related macular degeneration significantly affects the level of religiosity (p=0.032). Conclusion: These results unequivocally point to the need for further research and raising awareness of all health professionals about the importance of a holistic approach to the patient regardless of his diagnosis in order to identify the possible effective ways to deal with chronic disease considering all levels of patient\u27s needs

FEAR OF BLINDNESS IN PATIENTS UNDERGOING CATARACT SURGERY

Background: Fear is a negative emotion induced by the threat of danger, pain and harm. Cataract surgery is one of the most performed surgeries in the world. The aim of this study was to investigate and analyze the predominant fears in patients undergoing cataract surgery. Subjects and methods: In this cross-sectional study 152 patients were examined. Self-designed questionnaires to examine emotions of the fear, anxiety, nervousness frequency gratitude was used and insecurity immediately before cataract surgery. We also examined what the greatest fear during the cataract surgery was. The fear of blindness was compared with other life fears such as cancer, memory loss, AIDS, stroke and heart attack. The presence of fear was compared in patients having had previous cataract surgery with those undergoing their first cataract surgery. Including criteria were adults with senile cataract. Excluding criteria was ocular co-morbidity, psychiatric disorders, inability to read, deafness and surgery under general anesthesia. Completed questionnaires were analyzed. Pearson\u27s chi-squared test was used. Results: Fear was the most frequent emotion before cataract surgery, present in 60.5% patients. Fear of blindness was the greatest fear during cataract surgery in 55.3% of patients. There was no statistically significant difference in fear in patients having undergone their first cataract surgery and patients before their second cataract surgery (p<0.05). Conclusion: Fear is the predominant emotion before cataract surgery which is in correlation to the leading life fear - fear of blindness. Good preoperative preparation and a trusting doctor-patient relationship are important for reducing the fear of the procedure

ANTI-TNF THERAPY AND THE RISK OF MALIGNANCIES AND INFECTIONS IN INFLAMMATORY RHEUMATIC DISEASES - OUR EXPERIENCE

Background: Early diagnosis is the key to successful treatment of inflammatory rheumatic diseases and the use of conventional disease-modifying antirheumatic drugs (csDMARD) and biologic disease-modifying antirheumatic drugs (bDMARD) or biologics have substantially contributed to better disease control. Biological drugs have been approved for the treatment of rheumatoid arthritis (RA), juvenile arthritis (JIA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Subjects and methods: The study involved 79 adult patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS), psoriatic arthritis (PsA) or undifferentiated spondyloarthropathy (USpA) - the last three clinical entities belong to a common group called spondyloarthropathies (SpA); receiving anti-TNF therapy at the department of Rheumatology and Rehabilitation, Clinical Hospital Center Zagreb. The duration of therapy was a minimum of 1 month, with the mean duration of 32.024.0 months. The infections recorded were infections that appeared during treatment or soon after the treatment was stopped. Results: During the course of therapy 17 patients (21.5%) experienced an infection, with the total number of 21 infections. This resulted in an overall incidence rate (IR) of 9.9/100 patient-years. Of the patients with RA 76.5% developed an infection, which was significantly higher than for patients with SpA (p<0.001). The IR/100 patient-years for all infections in RA patients was 23.7 compared to 2.8 in patients with SpA. Female gender was associated with a significantly higher infection rate (70.6%, p=0.005). There were 8 infections that were considered serious, yielding an IR of 3.8/100 patient-years. There was only one malignancy case in our study. Conclusion: Every fifth patient developed an infection during the course of anti-TNF therapy, and more than one third of all infections were serious. RA and female gender was associated with a significantly increased number of infections

RELIGIOUSNESS, ANXIETY AND DEPRESSION IN PATIENTS WITH GLAUCOMA, AGE-RELATED MACULAR DEGENERATION AND DIABETIC RETINOPATHY

Background: Many chronic medical conditions such as glaucoma, senile macular degeneration and diabetic retinopathy are further complicated by emotional and psychological disorders. Religiousness represents a part of a social culture and has a significant role in the prevention of mental difficulties of the patients, especially those belonging to older population. The aim of this study was to investigate the connection between religiousness, anxiety, and depression in patients with glaucoma, age-related macular degeneration and diabetic retinopathy and to test their connection related to different diagnosis. Subjects and methods: This cross-sectional study included 163 patients divided into three groups (glaucoma group, senile macular degeneration group and diabetic retinopathy group). Respondents voluntarily agreed to participate in the study and with assistance they fully completed the Scale of Religiousness, Hospital Anxiety and Depression Scale, General Health Questionnaire and demographic information (age, gender, education, employment and marital status). Results: The results showed noticeable religiosity of the respondents (M=18.31, SD=5.28), but also the presence of anxiety (M=7.55, SD=3.73), especially in patients with glaucoma, as well as impaired mental health in AMD patients (M=19.56, SD=4.14). No differences were found in the severity of anxiety, depression, general health and religiosity between groups, but the presence of depression in subjects with age-related macular degeneration significantly affects the level of religiosity (p=0.032). Conclusion: These results unequivocally point to the need for further research and raising awareness of all health professionals about the importance of a holistic approach to the patient regardless of his diagnosis in order to identify the possible effective ways to deal with chronic disease considering all levels of patient\u27s needs

ANTI-TNF THERAPY AND THE RISK OF MALIGNANCIES AND INFECTIONS IN INFLAMMATORY RHEUMATIC DISEASES - OUR EXPERIENCE

Background: Early diagnosis is the key to successful treatment of inflammatory rheumatic diseases and the use of conventional disease-modifying antirheumatic drugs (csDMARD) and biologic disease-modifying antirheumatic drugs (bDMARD) or biologics have substantially contributed to better disease control. Biological drugs have been approved for the treatment of rheumatoid arthritis (RA), juvenile arthritis (JIA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Subjects and methods: The study involved 79 adult patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS), psoriatic arthritis (PsA) or undifferentiated spondyloarthropathy (USpA) - the last three clinical entities belong to a common group called spondyloarthropathies (SpA); receiving anti-TNF therapy at the department of Rheumatology and Rehabilitation, Clinical Hospital Center Zagreb. The duration of therapy was a minimum of 1 month, with the mean duration of 32.024.0 months. The infections recorded were infections that appeared during treatment or soon after the treatment was stopped. Results: During the course of therapy 17 patients (21.5%) experienced an infection, with the total number of 21 infections. This resulted in an overall incidence rate (IR) of 9.9/100 patient-years. Of the patients with RA 76.5% developed an infection, which was significantly higher than for patients with SpA (p<0.001). The IR/100 patient-years for all infections in RA patients was 23.7 compared to 2.8 in patients with SpA. Female gender was associated with a significantly higher infection rate (70.6%, p=0.005). There were 8 infections that were considered serious, yielding an IR of 3.8/100 patient-years. There was only one malignancy case in our study. Conclusion: Every fifth patient developed an infection during the course of anti-TNF therapy, and more than one third of all infections were serious. RA and female gender was associated with a significantly increased number of infections