36 research outputs found
Efekat upotrebe fitaze na proizvodne rezultate i Ävrstinu tibije brojlera
The effect of microbial phytase in corn/soybean meal diets for broilers on performances and tibia characteristics were investigated. The trial was carried out on 200 Arbor Acres broilers of both sexes divided into four groups. The broilers were fed with complete mixtures with different levels of P (0.80 and 0.57% total P and 0.46 and 0.25% available P), with or without phytase. Reduction of the dietary total and available P levels for experimental broilers induced lower body mass and gain as well as higher fed conversion. However, by introduction phytase into diets negative effects of phosphorus reduction were, to some extent alleviated. Addition of phytase into diets decreased serum Ca and increased serum P. Reduction of the dietary P level had no significant effect on serum Ca, but had negative effects on serum P (p (lt) 0.01). The obtained results of bone analysis show that phytase was effective in increasing investigated parameters, but no significant differences were found among groups.Ispitivan je uticaj mikrobijalne fitaze dodate smeÅ”ama na bazi kukuruza i sojine saÄme na proizvodne rezultate i Ävrstinu tibije brojlera. Brojleri podeljeni u 4 grupe, su hranjeni obrocima sa razliÄitim koliÄinama P (0,80 i 0,57% ukupnog P i 0,46 i 0,25% iskoristivog P), bez ili sa dodatkom fitaze. Smanjivanje sadržaja P u smeÅ”ama izazvalo je proporcionalno smanjivanje telesne mase, dnevnog prirasta i pogorÅ”anje konverzije hrane, dok je dodatak fitaze doprineo poboljÅ”anju vrednosti ispitivanih parametara. Dodatkom fitaze uoÄeno je smanjivanje koncentracije Ca, odnosno poveÄanje koncentracije P u krvi. Smanjivanje sadržaja P u smeÅ”ama, nije imalo znaÄajan uticaj na koncentraciju Ca, ali je znaÄajno negativno uticalo na koncentraciju P u krvi (p (lt) 0,01). Dodatak fitaze u smeÅ”e sa smanjenom koliÄinom P nije znaÄajno uticao na koncentraciju Ca i P u krvi. Dodatak fitaze u smeÅ”e sa adekvatnim i smanjenim sadržajem P doprineo je poveÄanju Ävrstine tibije, sadržaj pepela i Ca u tibiji. Dodatak fitaze nije imao posebno izražene efekte na sadržaj fosfora u tibiji
Ectopic parathyroid tumor in thorax ā case report
Cilj: Prikazati pacijenticu s primarnim hiperparatireoidizmom zbog ektopiÄnog smjeÅ”tenog tumora doÅ”titne žlijezde u toraksu. Prikaz sluÄaja: 64-godiÅ”nja pacijentica s od ranije poznatom hipotireozom i hipertenzijom manifestirala se slikom normocitne anemije, bubrežne insuficijencije i smetnjama gutanja. Zbog navedenih simptoma uÄinjena je viÅ”eslojna kompjutorizirana tomografija (MSCT) toraksa koja je pokazala tvorbu u stražnjem gornjem medijastinumu, uz promjene na kostima i sumnju na sekundarizme. U sklopu nefroloÅ”ke obrade uoÄene su izrazito visoke vrijednosti serumskog kalcija (> 3 mmol/L) i paratireoidnog hormona (PTH) (200 pmol/L), Å”to je ukazalo da se najvjerojatnije radi o primarnom hiperparatireoidizmu. UÄinjena je dodatna obrada: scintigrafija doÅ”titnih žlijezda, punkcija navedene tvorbe i citoloÅ”ka analiza. Navedene dijagnostiÄke metode potvrdile su da se radi o primarnom hiperparatireoidizmu najvjerojatnije adenoma ektopiÄno smjeÅ”tene doÅ”titne žlijezde. Pacijentica je podvrgnuta operativnom zahvatu, torakotomiji te odstranjenju navedene tvorbe. Postoperativni kirurÅ”ki tijek bio je uredan. U laboratorijskim nalazima javila se oÄekivana hipokalcemija, zbog sindroma āgladne kostiā koja je medikamentozno tretirana. Naknadno prispjeli patohistoloÅ”ki nalaz ukazao je na to da se radi o novotvorini doÅ”titne žlijezde nesigurnog malignog potencijala. S obzirom na to da je jedini potpuno pouzdani pokazatelj zloÄudne prirode bolesti nalaz metastaza, dijagnoza karcinoma nije se mogla postaviti. Vrijednosti PTH-a postoperativno su bile unutar referentnih vrijednosti. Tijekom praÄenja pacijentice u razdoblju od pola godine nakon operativnog zahvata nije doÅ”lo do povrata bolesti. ZakljuÄak: Primarni hiperparatireoidizam Äest je endokrinoloÅ”ki poremeÄaj i o njemu treba razmiÅ”ljati u svakodnevnom radu. Osim poveÄanih doÅ”titnih žlijezda na tipiÄnom mjestu u vratu, moguÄ je razvoj i ektopÄno smjeÅ”tenih doÅ”titnih žlijezda.Introduction: The aim was to present a case of primary hyperparathyroidism due to ectopic parathyroid adenoma localized in thorax. Case report: We report a case of a 64-yearold female patient with hypothyroidism and hypertension in her medical history, presented to us with normocytic anemia, renal insufficiency and dysphagia. Due to swallowing disorder multi-slice computed tomography of thorax was performed and mass in upper-back mediastinum with ossification changes suspicious for metastatic process was found. Within the nephrology examination, hypercalcemia (>3 mmol/L) and elevated parathyroid hormone (PTH) value (200 pmol/L) were noticed, which pointed to the possibility of primary hyperparathyroidism. Consequentially, parathyroid scintigraphy, aspiration biopsy and cytological analysis were performed. Primary hyperparathyroidism was affirmed and ectopic parathyroid adenoma was suggested as possible etiology. The patient has undergone surgical procedure based on thoracotomy with extirpation of the mass. Surgical postoperative course was regular. Postoperative laboratory findings showed hypocalcemia, which was expected due to āhungry boneā syndrome, so medication treatment was necessary. Subsequently, histopathological analysis showed parathyroid tumor with insecure malignant potential. Since metastases were the only satisfied criteria for the malignancy, the diagnosis of parathyroid carcinoma couldnāt be allocated. PTH values after surgery were within the reference range. During a 6-month postoperative follow-up no signs of the disease recurrence were detected. Conclusion: Primary hyperparathyroidism is a very common endocrinology disorder, hence it has to be on a differential diagnosis list in every day clinical practice Except increased parathyroid glands in the typical site in the neck, it is possible to develop ectopic parathyroid glands
Efficacy of Healthy Weight Loss Program in Obesity Treatment: Croatian Experience
We evaluated the efficiency of a six-month outpatient weight loss treatment program combining healthy diet, fat reduction,
psychological counseling, exercise, and orlistat treatment, by measuring body weight and levels of cardiovascular
risk factors in 476 subjects with BMI over 30 or 28 with increased blood pressure, cholesterol, and sugar at the baseline
and at the end of program. After four weeks of adjustment to a mild low-calorie diet (1600 kcal/day) and counseling,
subjects started receiving orlistat (120 mg TID). The mean weight loss after 6 months was 10.9%. Systolic pressure
dropped by 6.7%, diastolic by 4.2%, fasting blood glucose by 10.1%, and total cholesterol by 9.8%. Only 9 subjects (7.8%)
poorly tolerated the treatment. More men than women were able to maintain the achieved weight loss six months after the
program (70.6% vs. 58.3%, respectively). The healthy weight loss program was an efficient approach to obesity treatment
Cholesterol homeostasis is dysregulated in women with preeclampsia
Introduction The link between preeclampsia and dyslipidemia has been established. Even though lipid profile parameters have been intensively investigated in the pathology of preeclampsia, their accurate molecular mechanisms of action have not been fully decoded. Objectives We aimed to identify the specifics of cholesterol metabolism in women affected by lateāonset preeclampsia and single out potential biomarkers associated with lateāonset syndrome. Patient s and methods A total of 90 pregnant women with a priori risk for preeclampsia were monitored at 4 time points during gestation and, based on the outcome of pregnancy, they were classified into the highārisk group (70 women) and the preeclampsia group (20 women). Cholesterol metabolic profiling was done using liquid chromatographyātandem mass spectrometry. Result s The only significant change in the preeclampsia group was an increase in the lathosterol level (P = 0.001). The firstātrimester lathosterol level was higher in the preeclampsia group compared with the highārisk group (P = 0.02). Further, in the preeclampsia group, positive correlations were found between desmosterol and Ī²āsitosterol (Ļ = 0.474; P = 0.03) in the third trimester, desmosterol and campesterol changes between the second and the first (Ļ = 0.546; P = 0.02), and the third and first trimesters (Ļ = 0.754; P <0.001), as well as between the desmosterol and Ī²āsitosterol differences between the third and first trimesters (Ļ = 0.568; P = 0.01). No similar correlations were found in the highārisk group. Conclusions Lateāonset preeclampsia could be associated with an altered lipid profile. By studying the quantitative metabolic signatures of cholesterol, we might assume that both cholesterol synthesis and absorption are increased, that is, there is an imbalance in the cholesterol homeostasis regulation in women affected by the disease
Kombinovano prisustvo genskih polimorfizma faktora koagulacije XIII V34L i inhibitora plazminogen aktivatora 1 4G/5G znaÄajno utiÄe na rizik od spontanog pobaÄaja u srpskoj populaciji
Background:Recurrent pregnancy loss (RPL) is a heterogeneous condition affecting up to 5% of women of reproductive age. Inherited thrombophilia have been postulated as one of the causes of RPL. Here we examined the prevalence of nine thrombophilic gene polymorphisms among women with history of recurrent miscarriages and fertile controls.Methods:The study included 70 women with history of at least three early pregnancy losses and 31 fertile controls with no miscarriages. We investigated mutations in genes responsible for clotting and fibrinolysis, including factor V(FV) Leiden, FV H1299R, factor II (FII) G20210A, methyl-ene tetrahydrofolate reductase (MTHFR) C677T and A1298C, factor XIII (FXIII) V34L, plasminogen activator inhibitor-1 (PAI-1) 4G/5G and endothelial protein C receptor (EPCR) H1 and H3 haplotypes using reverse polymerase chain reaction ViennaLab cardiovascular disease StrippAssays. Results:Our results showed no significant increase inprevalence of tested polymorphisms in women with RPL. However, relative risk for PRL among women heterozygousfor FXIII V34L was 2.81 times increased (OR 2.81, 95% CI1.15ā6.87, P=0.023). Haplotype analysis showed that combined presence of high-risk genotypes for FXIII andPAI-1 significantly increases risk for RPL (OR 13.98, CI95% 1.11ā17.46, P=0.044).Conclusions:This is the first study in Serbian population that investigated prevalence of FVR2, A1298C, FXIII V34Land EPCR gene variants. Compound heterozygosity forFXIII V34L and PAI-1 4G is significant risk factor for recur-rent miscarriage. Our results should be viewed in context of small case-control study, so further large prospective studies are need for confirmation of our findings.Uvod: Ponavljani spontani pobaÄaji (PSP) su etioloÅ”ki heterogeni i javljaju se kod 5% parova u reproduktivnom period. Jedan od moguÄih uzroka PSP su i nasledne trombofilije. U okviru ove studije analizirali smo uÄestalost devet trombofilnih polimorfizama kod pacijentkinja sa ponavljanim spontanim pobaÄajima. Metode: Ispitanici su u studiji podeljeni u dve grupe na osnovu anamnestiÄkih podataka o broju spontanih pobaÄaja (70 u grupi sa PSP i 31 u kontrolnoj grupi). Ispitivani su sledeÄi genski polimorfizmi: faktor V Lajden (FVL), FVR2, faktor II (FII) G21210A, metilentetrahidrofolat reduktaza (MTHFR) C677T i A1298C polimorfizmi, inhibitor aktivatora plazminogena 1 (PAI-1) 4G/5G, faktor XIII (FXIII) V34L i endotelni protein C receptor (EPRC) H1, H2 i H3 haplotipovi. Za detekciju navedenih polimorfizama je koriÅ”Äena metoda multipleks reakcije lanÄanog umnožavanja i reverzne hibridizacije na ViennaLab stripovima. Rezultati: Dobijeni rezultati nisu pokazali poveÄanu uÄestalost ispitivanih polimorfizama u grupi sa PSP. PosmatrajuÄi uticaj pojedinaÄnih polimorfizama na ishod trudnoÄe pokazano je da polimorfizam FXIII V34L poveÄava rizik za ponavljane spontane pobaÄaje (OR 2,81, 95%CI 1,15-6,87, P=0,023). Analizom haplotipova ustanovljeno je da kombinovano prisustvo V34L i PAI-1 4G varijanti znaÄajno poveÄava rizik za PSP (OR 13,98, CI 95% 1,11-17,46, P=0,044). ZakljuÄak: Ovo je prva studija koja je ispitivala prevalencu FVR2, A1298C, FXIII V34L and EPCR polimorfizama u populaciji žena iz Srbije. Složeni heterozigoti za FXIII V34L i PAI-1 4G polimorfizme imaju znaÄajno poviÅ”en rizik sa ponavljane gubitke trudnoÄe. Radi potvrde dobijenih rezultata potrebne su veÄe prospektivne studije
Effects of Obesity Reduction on Cardiovascular Risk Factors: Comparison of Individual and Group Treatment ā Substudy of the Croatian Healthy Weight Loss Programme
Prevention of obesity may help reduce the morbidity and mortality from cardiovascular diseases. In Croatia, over half of adult population is overweight. Aldo the basic medical principles of healthy weight-loss programmes are well known, it is believed that mainly because of the leak of successful therapeutic approach obesity remains the most challenging changeable cardiovascular risk factor in nowadays clinical practice. Objective of this Croatian Healthy Weight Loss Programme substudy was to determine effects and differences between the intensive group and intensive individual weight-loss program on weight loss and cardiovascular risk factor. A clinical trial included 476 adults whose body mass index (BMI) was >30 or >28 accompanied by increased blood pressure, glucose, and cholesterol. The study participants completed either a group (n=243) or individually-based (n=233) 6-month weight-loss program consisting of education, low-fat diet, pharmacological treatment with orlistat, psychological counselling, and exercise. Body weight, body mass index, blood pressure, blood sugar, and blood cholesterol were measured in all participants after 3 and 6 months. The average weight loss was 12.2 (13%) kg and 7.6 (9%) kg in the group and individual program, respectively. Beside the weight reduction, the levels of blood cholesterol, glucose, and blood pressure were also significantly reduced in comparison with baseline, decreasing to normal values in all participants (P<0.001 for all). Decrease in the monitored parameters was greater in participants in the group program. The weight loss program provided a healthy loss of extra weight in the period of 6 months. The group program produced greater decrease in body weight, body mass index, blood pressure, glucose, and cholesterol than the individual program
EVALUATION OF VIRAL HEPATITIS IN SOLID ORGAN TRANSPLANTATION
UspjeÅ”na transplantacija bubrega je optimalna metoda lijeÄenja bolesnika koji se nalaze u zavrÅ”nom stadiju kroniÄne bubrežne bolesti. Za uspjeh same transplantacije, kao i dugoroÄnog preživljenja bolesnika i njegovog transplantata, nužna je detaljna evaluacija primatelja i potencijalnog darivatelja organa, bilo da se radi o kadaveriÄnom ili živom darivatelju. Poseban problem u sklopu infektivnih bolesti su virusi hepatitisa, osobito virus hepatitisa B (HBV) i C (HCV), a u novije vrijeme sve se viÅ”e spominje i virus hepatitisa E (HEV) kao znaÄajan uzrok kroniÄnog hepatitisa u populaciji bolesnika s transplantatom. UnatoÄ poboljÅ”anju preventivnih mjera posljednjeg desetljeÄa incidencija virusnih hepatitisa je u bolesnika koji se lijeÄe postupcima hemodijalize znaÄajno smanjena. MeÄutim, njihova incidencija i dalje je veÄa u toj skupini bolesnika kao i u bolesnika kojima je transplantiran bubreg u odnosu na opÄu populaciju. Virusni hepatitisi su znaÄajan Äimbenik poveÄanog morbiditeta i mortaliteta u tim populacijama bolesnika, ali i prema veÄini studija znaÄajan Äimbenik disfunkcije bubrežnog transplantata. Naime, u bolesnika koji su podvrgnuti transplantaciji bubrega primarni cilj je oÄuvanje dobre funkcije transplantata, uz primjenu uÄinkovite, a Å”to manje toksiÄne imunosupresivne terapije. Osim toga, nužno je praÄenje i adekvatna terapija virusnih hepatitisa, s obzirom na dobro poznatu Äinjenicu da te infekcije vode prema kroniÄnom hepatitisu, cirozi jetre i hepatocelularnom karcinomu. Nadalje, HBV i HCV mogu inducirati nastanak de novo membranskog glomerulonefritisa u bubrežnom transplantatu.Renal transplantation has significantly improved survival of patients with end-stage renal disease (ESRD). Transplantation is the best treatment in this population of patients. Despite the introduction of various preventive measures, viral hepatitis, i.e. hepaĀ¬titis B virus (HBV) and hepatitis C virus (HCV) infections, are still a major problem because they are common in patients on reĀ¬nal replacement therapy as well as in allograft recipients. They are a significant cause of morbidity and mortality in this patient population. In recent years, hepatitis E virus (HEV) infection has been added as an emergent cause of chronic hepatitis in solid organ transplantation, mainly in renal and liver allograft recipients. Most studies show higher mortality in renal transplant recipiĀ¬ents (RTRs) infected with HBV, compared with RTRs without HBV infection, although this topic is still under debate. Furthermore, HCV infection in RTRs is associated with a significant reduction in patient and graft survival due to liver disease and septic comĀ¬plications related to cirrhosis and immunosuppressive therapy. The immunosuppressive therapy prescribed after transplantation modifies the natural history of chronic HCV infection. Given the high prevalence of HCV and HBV infections in RTRs, a growing incidence of hepatocellular carcinoma and the possible contribution of immunosuppression might be expected in these patients. Therefore, after renal transplantation, early screening with abdominal ultrasound (every 3 months in cirrhotic patients and every 6-12 months in non-cirrhotic RTRs) is necessary when the risk factors such as HBV and HCV are present. The European AssoĀ¬ciation for the Study of the Liver (EASL) recommends that all HbsAg-positive patients who are candidates for solid organ transĀ¬plantation should be treated with nucleoside analogs. The KDIGO guidelines recommend that all HbsAg-positive RTRs receive prophylaxis with tenofovir, entecavir or lamivudine; however, tenofovir and entecavir are preferable to lamivudin. Viral suppresĀ¬sion by inhibiting necro-inflammation may result in reduced fibrosis, thereby improving transplant survival. Active HCV infection in a dialysis patient requires evaluation of liver fibrosis. Antiviral therapy should be given to all HCV-infected dialysis patients in order to achieve a sustained virologic response (SVR) not only to avoid subsequent hepatic deterioration but also to limit the risks of HCV-related posttransplant de novo glomerulonephritis. Systematic vaccination of all HbsAg-negative patients is the best preventive treatment of HBV infection. HbsAg positive donors are only used occasionally, whereas the use of hepatitis B core antibody (HbcAb)+, HbsAg negative donors is more common but remains somewhat controversial. The presence of antibody to HCV is indicative of HCV infection because antibody to HCV appears in peripheral blood within two months of HCV exposure. However, it is important to emphasize that detection of antibody to HCV by serologic screening of the donor is not predictive of HCV transmission. Approximately 50% of patients positive for antibody to HCV have detectable hepatitis C viremia by PCR analysis of peripheral blood. Therefore, all organ donors with PCR analysis positive for HCV will transmit HCV to RTRs. On the other hand, the risk of transmission from an organ donor with negative PCR analysis is unclear. Another problem in the evaluaĀ¬tion of the potential donors of solid organs is the fact that antibody testing by enzyme-linked immunosorbent assays (ELISAs) will not detect recent infections. The use of nucleid acid testing (NAT) could be useful because it involves amplification of viral gene products and thus is not dependent on antibody formation. Therefore, by using this method the period between the infection and detectability, which is known as the window period, could be reduced. However, this method is expensive and time consuming
Radical surgical treatment of urinary bladder cancer: our experiences
Svrha rada je analiza bolesnika oboljelih od raka mokraÄnoga mjehura, kod kojih je uÄinjena radikalna operacija. U razdoblju 1972.-2004. lijeÄili smo 1708 bolesnika sa rakom mokraÄnoga mjehura. Radikalnom kirurÅ”kom zahvatu podvrgnuto je 239 (14%) bolesnika. MuÅ”karaca je bilo 188 (78,7%), a žena 51 (21,3%). NajviÅ”e bolesnika bilo je u dobi izmeÄu 60. i 80. godine (171 - 71,5%). AnamnestiÄki je najÄeÅ”Äi i najvažniji simptom tumora mjehura hematurija 213 (89%). U naÅ”ih bolesnika bilo je 220 (92%) karcinoma prijelaznoga epitela, 13 (5,4%) planocelularnih tumora i 6 (2,5%) adenokarcinoma. Prema TNM klasifikaciji prevladava T3 stadij 118 (49,3%) i T2 stadij 94 (39,3%). Prema histoloÅ”kom kriteriju najÄeÅ”Äi je G3 stadij 186 (77,8%). Radikalnu cistektomiju samu ili kombiniranu s uretrektomijom uÄinili smo kod 203 (85%) bolesnika. Nažalost u 13% bolesnika (T3b i T4 stadij) podvezali smo samo unutarnje ilijaÄne žile zbog uznapredovaloga tumora. Vanjsku supravezikalnu derivaciju urina (Bricker, U-tubing nefrostoma) uÄinili smo kod 188 (78,7%) bolesnika. Unutarnju derivaciju (Coffey, Ureteroileosigmoidostomia, Mainz-Pouch II) rabili smo u 23 (9,6%), a neovesiku (Hautmann, Studer) kod 28 (11,7%) bolesnika. Ranih poslijeoperacijskih komplikacija bilo je 83 (34,7%). MeÄu njima prevladavaju kirurÅ”ke 32 (13,4%) i komplikacije udaljenih organa 23 (9,6%). MeÄu kasnim komplikacijama prevladava uroinfekt 11 (4,6%) i ileus 8 (3,3%), koji su lijeÄeni uglavnom konzervativno. U bolesnika s negativnim Ävorovima 72 (30%) preživjelost je nakon pet godina bila 62%. Kod bolesnika s pozitivnim Ävorovima 59 (24,6%), preživjelost nakon pet godina bila je 44%. NajloÅ”iju prognozu imala je skupinabolesnika (13%), gdje zbog opsežnoga procesa nismo uspjeli uÄiniti cistektomiju. Kod njih su podvezane ilijaÄne žile, a lijeÄeni su radioterapijom i kemoterapijom. Nakon godine dana preživjelost je bila oko 9%.In the period from 1972-2004, 1708 patients with bladder cancer were treated. 239 (14 %) of them were treated by means of radical surgical procedures. There were 188 (78.7%) male and 51 (21.3%) female patients. The average age was between 60 and 80 (171 71.5%). The most frequent and the most important symptom of bladder cancer is hematuria 213 (89%). In our patients there were 220 (92%) epithelial cancers, 13 (5.4%) planocellular cancers and 6 (2.5%) adenocarcinomas. According to TNM classification, T3 stage (118 - 49.3%) and T2 stage (94- 39.3%) were predominant in our study. According to histological criteria, the most common was G3 stage (186 -77.8%). Radical cystectomy alone or combined with urethrectomy was done in 203 (85%) patients. Unfortunately, in 13% of patients (T3b and T4 stages) inner iliac blood vessels were tied off due to a progressive cancer. Outer supravesicular urine derivation (Bricker, U-tubing nephrostoma) was done in 188 (78.7%) patients. Inner derivation (Coffey, uretheroileosigmoidostomy, Mainz-Pouch II) was done in 23 (9.6%) and neovesica (Hautmann, Studer) in 28 (11.7%) patients. There were 83 (34.7 %) early postoperative complications. Among them the most dominant ones were surgical 32 (13.4%) and distant organ complications 23 (9.6%). Among late complications, predominant ones were uroinfection 11 (4.6%) and ileus 8 (3.3%), which were treated conservatively. In the patients with negative nodes 72 (30%), the survival rate after five years was 62%. In the patients with positive nodes 59 (24.6%), the survival rate after five years was 44%. The least favorable prognosis was for patients (13%) in whom cystectomy could not be done due to a progressive process. In these patients, iliac blood vessels were tied off and they were treated with radiotherapy and chemotherapy. The survival rate was 9% after one year
MANAGEMENT OF ADRENAL INCIDENTALOMA: THE POSITION STATEMENT OF THE CROATIAN REFERRAL CENTER FOR ADRENAL GLAND DISORDERS
Incidentalomi nadbubrežne žlijezde jesu tumori otkriveni tijekom dijagnostiÄke evaluacije nekoga drugog kliniÄkog stanja. TehnoloÅ”ki napredak radioloÅ”kih ureÄaja i njihova sve veÄa upotreba u svakodnevnoj kliniÄkoj praksi doveli su do ÄeÅ”Äeg otkrivanja ovih tumora ÄineÄi njihovu dijagnostiku i lijeÄenje jednim od najvažnijih izazova moderne endokrinologije. Radi racionalnog pristupa ovim bolesnicima radna skupina koju su Äinili vodeÄi hrvatski struÄnjaci iz podruÄja bolesti nadbubrežne žlijezde, na temelju relevantne znanstvene literature i postojeÄih smjernica europskih i svjetskih druÅ”tava, donijela je preporuke za dijagnostiku i lijeÄenje incidentaloma nadbubrežne žlijezde.Adrenal incidentalomas are tumours of adrenal glands discovered during diagnostic workup for other clinical condition unrelated to adrenal glands. Improvement in imaging techniques and their widespread use in everyday practice have increased detection of adrenal incidentalomas making their management one of the most important challenges of modern endocrinology. Based on the relevant medical literature and guidelines of other international societies a panel of Croatian leading experts in adrenal gland disorders provide practical recommendations for the diagnostics and treatment of adrenal incidentaloma