PREVALENCE AND CHARACTERISTICS OF COLORECTAL CANCER IN CLINCAL HOSPITAL CENTER SPLIT FROM 2013 TO 2015

Cilj: Cilj ovog istraživanja bio je odrediti obilježlja kolorektalnih karcinoma i broj novodijagnosticiranih osoba u KBC-u Split u trogodišnjem razdoblju od 2013.do 2015. godine. Materijal i metode: Podaci o broju novooboljelih od kolorektalnog karcinoma dobiveni su iz arhive KBC-a Split, uključujući kolonoskopske nalaze, te pathohistološke nalaze uzoraka uzetih prilikom izvođenja tih kolonoskopija. Osim toga, korišteni su i rezultati Nacionalnog programa ranog otkrivanja raka debelog crijeva, odnosno endoskopski nalazi u slučaju pozitivnog testu na okultno krvarenje u stolici. Rezultati: Dobiveni rezultati su potvrdili podatke iz literature o visokoj učestalosti kolorektalnog karcinoma. U istraživanom razdoblju 2013. do 2015. godine dijagnosticirana su 272 pacijenta s kolorektalnim karcinomom; 187 muškaraca (68.75%) i 83 žene (30.52%). Najčešća lokalizacija je u rektumu i sigmoidnom dijelu debelog crijeva. Zbog poteškoća kao što su opstrukcija, prisutnost fekalnih masa, pretjerana izvijuganost crijeva, češće je urađena djelomična negoli totalna kolonoskopija. U slučaju postojanja opstrukcije, u većem broju slučajeva se radilo o djelomičnoj opstrukciji. Više od 90% KRK su adenokarcinomi podrijetlom iz epitelnih stanica kolorektalne sluznice. U endoskopskim nalazima karcinom je najčešće opisan kao proliferativna neoplastična tvorba, rjeđe kao tumor polipoidnog oblika, a najrjeđi je ulcero-proliferativni oblik karcinoma. Zaključci: Kolorektalni karcinom je na trećem mjestu po učestalosti i treći najčešći uzrok smrti od karcinoma i kod muškaraca i kod žena. Većina tih karcinoma i smrti uzorkovane istima se može prevenirati primjenom postojećih znanja o prevenciji karcinoma, češćim provođenjem testova probira i time da se osigura da svaki pacijent dobije najbolji tretman u što bržem vremenu. Testovi probira (tzv. screening testovi) imaju potencijal da preveniraju kolorektalni karcinom zato jer mogu detektirati prekarcenozne izrasline, tj.polipe, u kolonu i rektumu. Iako se većina polipa neće pretvoriti u karcinome, njihovim uklanjanjem može se prevenirati nastanak karcinoma. Osim toga, redovitim screening pregledima povećava se šansa da se karcinom otkrije u ranom stadiju, kad je mogućnost izlječenja veća, tretmani manje opširni i oporavak brži. Uz praćenje preporučenih screening smjernica, osobe mogu i dodatno reducirati rizik nastanka ili smrti od kolorektalnog karcinoma na način da održavaju zdravu tjelesnu težinu, redovito se bave tjelesnom aktivnošću, jedu zdravu hranu, ograniče unos alkohola i ne puše.Objectives: The aim of this research is to determine characteristic of colorectal cancer and number of new cases in Clinical Hospital Centre Split from 2013. to 2015. Material and Methods: Data on the number of new cases of colorectal cancer were obtained from hospital archive, including colonoscopy findings and pathohistological diagnosis of biopsy samples taken during a colonoscopy. Furthermore, data from National programme for early detection of colorectal cancer were also included in this research, precisely, we analysed findings from colonoscopy performed because of positive screening test. Results: The results confirmed literature data of high incidence of colorectal cancer. In period from 2013. to 2015, there were 272 new cases of colorectal cancer; 68.75% of those were men (187) and 30.52 were woman (83). The most common location were in rectum and sigmoid colon. Partial colonoscopy was performed more often than total colonoscopy because of difficulties like opstruction, presence of fecal content and convolution of colon. More of 90% of colorectal carcinomas are adenocarcinomas originating from epithelial cells of the colorectal mucosa. During colonoscopy, cancer was mostly described as proliferative neoplastic tumor, less often as a polypoid lesure and rarest as ulcerate lesions. Conclusion: Colorectal cancer is the third most commonly diagnosed can¬cer and the third leading cause of cancer death in both men and women. The major¬ity of these cancers and deaths could be prevented by applying existing knowledge about cancer prevention, increasing the use of recommended screening tests, and ensuring that all patients receive timely, standard treatment. Screening has the potential to prevent colorectal cancer because it can detect precancerous growths, called polyps, in the colon and rectum. Although most polyps will not become cancerous, removing them can prevent cancer from occurring. Further¬more, regular screening increases the likelihood that colorectal cancers that do develop will be detected at an early stage, when they are more likely to be cured, treatment is less extensive, and recovery is faster. In addition to following recommended screening guidelines, people can reduce their risk of developing or dying from colorectal cancer by maintaining a healthy body weight; engaging in regular physical activity; eating a healthy, well-balanced diet; limiting alcohol consumption; and not smoking

PREVALENCE AND CHARACTERISTICS OF COLORECTAL CANCER IN CLINCAL HOSPITAL CENTER SPLIT FROM 2013 TO 2015

Cilj: Cilj ovog istraživanja bio je odrediti obilježlja kolorektalnih karcinoma i broj novodijagnosticiranih osoba u KBC-u Split u trogodišnjem razdoblju od 2013.do 2015. godine. Materijal i metode: Podaci o broju novooboljelih od kolorektalnog karcinoma dobiveni su iz arhive KBC-a Split, uključujući kolonoskopske nalaze, te pathohistološke nalaze uzoraka uzetih prilikom izvođenja tih kolonoskopija. Osim toga, korišteni su i rezultati Nacionalnog programa ranog otkrivanja raka debelog crijeva, odnosno endoskopski nalazi u slučaju pozitivnog testu na okultno krvarenje u stolici. Rezultati: Dobiveni rezultati su potvrdili podatke iz literature o visokoj učestalosti kolorektalnog karcinoma. U istraživanom razdoblju 2013. do 2015. godine dijagnosticirana su 272 pacijenta s kolorektalnim karcinomom; 187 muškaraca (68.75%) i 83 žene (30.52%). Najčešća lokalizacija je u rektumu i sigmoidnom dijelu debelog crijeva. Zbog poteškoća kao što su opstrukcija, prisutnost fekalnih masa, pretjerana izvijuganost crijeva, češće je urađena djelomična negoli totalna kolonoskopija. U slučaju postojanja opstrukcije, u većem broju slučajeva se radilo o djelomičnoj opstrukciji. Više od 90% KRK su adenokarcinomi podrijetlom iz epitelnih stanica kolorektalne sluznice. U endoskopskim nalazima karcinom je najčešće opisan kao proliferativna neoplastična tvorba, rjeđe kao tumor polipoidnog oblika, a najrjeđi je ulcero-proliferativni oblik karcinoma. Zaključci: Kolorektalni karcinom je na trećem mjestu po učestalosti i treći najčešći uzrok smrti od karcinoma i kod muškaraca i kod žena. Većina tih karcinoma i smrti uzorkovane istima se može prevenirati primjenom postojećih znanja o prevenciji karcinoma, češćim provođenjem testova probira i time da se osigura da svaki pacijent dobije najbolji tretman u što bržem vremenu. Testovi probira (tzv. screening testovi) imaju potencijal da preveniraju kolorektalni karcinom zato jer mogu detektirati prekarcenozne izrasline, tj.polipe, u kolonu i rektumu. Iako se većina polipa neće pretvoriti u karcinome, njihovim uklanjanjem može se prevenirati nastanak karcinoma. Osim toga, redovitim screening pregledima povećava se šansa da se karcinom otkrije u ranom stadiju, kad je mogućnost izlječenja veća, tretmani manje opširni i oporavak brži. Uz praćenje preporučenih screening smjernica, osobe mogu i dodatno reducirati rizik nastanka ili smrti od kolorektalnog karcinoma na način da održavaju zdravu tjelesnu težinu, redovito se bave tjelesnom aktivnošću, jedu zdravu hranu, ograniče unos alkohola i ne puše.Objectives: The aim of this research is to determine characteristic of colorectal cancer and number of new cases in Clinical Hospital Centre Split from 2013. to 2015. Material and Methods: Data on the number of new cases of colorectal cancer were obtained from hospital archive, including colonoscopy findings and pathohistological diagnosis of biopsy samples taken during a colonoscopy. Furthermore, data from National programme for early detection of colorectal cancer were also included in this research, precisely, we analysed findings from colonoscopy performed because of positive screening test. Results: The results confirmed literature data of high incidence of colorectal cancer. In period from 2013. to 2015, there were 272 new cases of colorectal cancer; 68.75% of those were men (187) and 30.52 were woman (83). The most common location were in rectum and sigmoid colon. Partial colonoscopy was performed more often than total colonoscopy because of difficulties like opstruction, presence of fecal content and convolution of colon. More of 90% of colorectal carcinomas are adenocarcinomas originating from epithelial cells of the colorectal mucosa. During colonoscopy, cancer was mostly described as proliferative neoplastic tumor, less often as a polypoid lesure and rarest as ulcerate lesions. Conclusion: Colorectal cancer is the third most commonly diagnosed can¬cer and the third leading cause of cancer death in both men and women. The major¬ity of these cancers and deaths could be prevented by applying existing knowledge about cancer prevention, increasing the use of recommended screening tests, and ensuring that all patients receive timely, standard treatment. Screening has the potential to prevent colorectal cancer because it can detect precancerous growths, called polyps, in the colon and rectum. Although most polyps will not become cancerous, removing them can prevent cancer from occurring. Further¬more, regular screening increases the likelihood that colorectal cancers that do develop will be detected at an early stage, when they are more likely to be cured, treatment is less extensive, and recovery is faster. In addition to following recommended screening guidelines, people can reduce their risk of developing or dying from colorectal cancer by maintaining a healthy body weight; engaging in regular physical activity; eating a healthy, well-balanced diet; limiting alcohol consumption; and not smoking

Flail aortic valve leaflet due to high-voltage electrical injury

Introduction: Electric shock is the set of pathophysiological events resulting from the action of an electric current on the human body1. Electrical injuries involve both direct (caused by contact with electricity arc) and indirect mechanisms (mechanical trauma due to falls). The most common sequels after electrical injury in the heart are arrhythmias and myocardial contusion2. Large arteries like aorta are rarely affected because their rapid flow allows them to dissipate the heat produced by the electric current. However, they are susceptible to medial necrosis, with aneurysm formation and rupture at a later point of time. There is one case in the literature which described aortic valve rupture due to high-voltage electrical injury3. Case report: 47-year-old male patient was admitted to our echo lab for ultrasound examination of the heart. In the last two months he had been complaining about exertional dyspnea. His medical history was quite poor: he had never been admitted to the hospital until two months ago when he had been observed for 24 hours after he had suffered a high-voltage electric injury. The transthoracic echocardiography was performed, and we discovered moderately enlarged left ventricle (LVED volume 180 ml) due to severe aortic regurgitation on bicuspid aortic valve with holo-diastolic retrograde flow. The regurgitation jet that filled the two thirds of left ventricular outflow tract with laceration and flail of bicuspid cusps confirmed on transesophageal ultrasound. The patient underwent surgery. The aortic valve was removed and replaced with a mechanical prosthesis. Conclusion: Cardiac symptoms and echocardiographic findings that initiated two months after a high-voltage electric injury led us to conclusion that bicuspid valve was probably injured by electrical shock. To the authors’ knowledge, this is the first reported case of valvular rupture due to electrical injury in Croatian population

Percutaneous occlusion of malignant left atrial appendage in patient with recurrent ischemic stroke

Introduction: The left atrial appendage (LAA) is the most common place of thrombosis in patients with atrial fibrillation (AF). Numerous studies have shown that oral anticoagulation (OAC) significantly reduces the risk of thromboembolism. However, there are no recommendations regarding how to treat cardioembolic recurrent strokes when patients are well anticoagulated.1-3 Case report: 68-years-old male with permanent non-valvular AF, currently taking apixaban, was hospitalized for the second time due to recurrent ischemic cerebrovascular stroke. At the time of his first presentation six months ago, he was well anticoagulated with warfarin (international normalized ratio was 3.56) and have had a CHA2DS2VASc score 2. He had no significant carotid disease or mobile aortic arch atheroma. Transesophageal echocardiography (TEE) revealed a significantly dilated left atrium (LA) with dense spontaneous echo contrast (SEC). There was no organized thrombus in the LA nor in the LAA. The contractile function of the LAA was severely decreased, with peak systolic velocity of 33 cm/s on Doppler evaluation. Despite taking effective anticoagulant medications for both times our patient experienced recurrent ischemic stroke and yet again had dense SEC in the LA and LAA. In order to prevent upcoming cardioembolic event, we decided to preform percutaneous LAA closure with Amplatzer Amulet device under TEE guidance. Successful LAA closure was confirmed by color Doppler imaging and a single postocclusion angiography. The patient was discharged with OAC (warfarin) in addition of 100 mg/day of acetylsalicylic acid to prevent thrombus formation on device. Follow up TEE was performed one month after the procedure. Good position of LAA occluding device was confirmed with no evidence of thrombus formation on the left atrial face of the device. Conclusion: In general, after implantation of LAA occluding device, OAC is not indicated. However, combination therapy with indefinite OAC plus LAA closure in patients with AF with recurrent strokes despite good anticoagulation should be considered in order to prevent a new stroke

PREVALENCE AND CHARACTERISTICS OF COLORECTAL CANCER IN CLINCAL HOSPITAL CENTER SPLIT FROM 2013 TO 2015

Cilj: Cilj ovog istraživanja bio je odrediti obilježlja kolorektalnih karcinoma i broj novodijagnosticiranih osoba u KBC-u Split u trogodišnjem razdoblju od 2013.do 2015. godine. Materijal i metode: Podaci o broju novooboljelih od kolorektalnog karcinoma dobiveni su iz arhive KBC-a Split, uključujući kolonoskopske nalaze, te pathohistološke nalaze uzoraka uzetih prilikom izvođenja tih kolonoskopija. Osim toga, korišteni su i rezultati Nacionalnog programa ranog otkrivanja raka debelog crijeva, odnosno endoskopski nalazi u slučaju pozitivnog testu na okultno krvarenje u stolici. Rezultati: Dobiveni rezultati su potvrdili podatke iz literature o visokoj učestalosti kolorektalnog karcinoma. U istraživanom razdoblju 2013. do 2015. godine dijagnosticirana su 272 pacijenta s kolorektalnim karcinomom; 187 muškaraca (68.75%) i 83 žene (30.52%). Najčešća lokalizacija je u rektumu i sigmoidnom dijelu debelog crijeva. Zbog poteškoća kao što su opstrukcija, prisutnost fekalnih masa, pretjerana izvijuganost crijeva, češće je urađena djelomična negoli totalna kolonoskopija. U slučaju postojanja opstrukcije, u većem broju slučajeva se radilo o djelomičnoj opstrukciji. Više od 90% KRK su adenokarcinomi podrijetlom iz epitelnih stanica kolorektalne sluznice. U endoskopskim nalazima karcinom je najčešće opisan kao proliferativna neoplastična tvorba, rjeđe kao tumor polipoidnog oblika, a najrjeđi je ulcero-proliferativni oblik karcinoma. Zaključci: Kolorektalni karcinom je na trećem mjestu po učestalosti i treći najčešći uzrok smrti od karcinoma i kod muškaraca i kod žena. Većina tih karcinoma i smrti uzorkovane istima se može prevenirati primjenom postojećih znanja o prevenciji karcinoma, češćim provođenjem testova probira i time da se osigura da svaki pacijent dobije najbolji tretman u što bržem vremenu. Testovi probira (tzv. screening testovi) imaju potencijal da preveniraju kolorektalni karcinom zato jer mogu detektirati prekarcenozne izrasline, tj.polipe, u kolonu i rektumu. Iako se većina polipa neće pretvoriti u karcinome, njihovim uklanjanjem može se prevenirati nastanak karcinoma. Osim toga, redovitim screening pregledima povećava se šansa da se karcinom otkrije u ranom stadiju, kad je mogućnost izlječenja veća, tretmani manje opširni i oporavak brži. Uz praćenje preporučenih screening smjernica, osobe mogu i dodatno reducirati rizik nastanka ili smrti od kolorektalnog karcinoma na način da održavaju zdravu tjelesnu težinu, redovito se bave tjelesnom aktivnošću, jedu zdravu hranu, ograniče unos alkohola i ne puše.Objectives: The aim of this research is to determine characteristic of colorectal cancer and number of new cases in Clinical Hospital Centre Split from 2013. to 2015. Material and Methods: Data on the number of new cases of colorectal cancer were obtained from hospital archive, including colonoscopy findings and pathohistological diagnosis of biopsy samples taken during a colonoscopy. Furthermore, data from National programme for early detection of colorectal cancer were also included in this research, precisely, we analysed findings from colonoscopy performed because of positive screening test. Results: The results confirmed literature data of high incidence of colorectal cancer. In period from 2013. to 2015, there were 272 new cases of colorectal cancer; 68.75% of those were men (187) and 30.52 were woman (83). The most common location were in rectum and sigmoid colon. Partial colonoscopy was performed more often than total colonoscopy because of difficulties like opstruction, presence of fecal content and convolution of colon. More of 90% of colorectal carcinomas are adenocarcinomas originating from epithelial cells of the colorectal mucosa. During colonoscopy, cancer was mostly described as proliferative neoplastic tumor, less often as a polypoid lesure and rarest as ulcerate lesions. Conclusion: Colorectal cancer is the third most commonly diagnosed can¬cer and the third leading cause of cancer death in both men and women. The major¬ity of these cancers and deaths could be prevented by applying existing knowledge about cancer prevention, increasing the use of recommended screening tests, and ensuring that all patients receive timely, standard treatment. Screening has the potential to prevent colorectal cancer because it can detect precancerous growths, called polyps, in the colon and rectum. Although most polyps will not become cancerous, removing them can prevent cancer from occurring. Further¬more, regular screening increases the likelihood that colorectal cancers that do develop will be detected at an early stage, when they are more likely to be cured, treatment is less extensive, and recovery is faster. In addition to following recommended screening guidelines, people can reduce their risk of developing or dying from colorectal cancer by maintaining a healthy body weight; engaging in regular physical activity; eating a healthy, well-balanced diet; limiting alcohol consumption; and not smoking

Table_1_Completeness of intervention description in invasive cardiology trials: an observational study of ClinicalTrials.gov registry and corresponding publications.docx

IntroductionNon-pharmacological invasive interventions in cardiology are complex and often inadequately reported. Template for Intervention Description and Replication (TIDieR) checklist and guide were developed to aid reporting and assessment of non-pharmacological interventions. The aim of our study was to assess the completeness of describing invasive cardiology interventions in clinical trials at the level of trial registration and corresponding journal article publication.MethodologyWe searched for clinical trials in invasive cardiology registered in Clinicaltrials.gov and corresponding journal publications. We used the 10-item TIDieR checklist for registries and 12-item checklist for journal publications.ResultsOut of 7,017 registry items retrieved by our search, 301 items were included in the analysis. The search for corresponding published articles yielded 192 journal publications. The majority of trials were funded by the industry and were medical device trials. The median number of reported TIDieR items was 4.5 (95% CI 4.49–4.51) out of 10, and while the corresponding journal articles reported 6.5 (95% CI 6.0–6.5) out of 12 TIDieR items.ConclusionRegistration and reporting of invasive cardiology trials is often incomplete and adequate detailed description of the interventions is not provided. TIDieR checklist is an important tool which should be used to ensure rigorous reporting of non-pharmacological interventions in cardiology.</p