Characteristic features of convexity meningoma

Cilj istraživanja: Cilj je istraživanja ispitati postoji li povezanost između demografskih čimbenika (dob i spol), stanja svijesti bolesnika, lokalizacije tumora, opsežnosti kirurškog uklanjanja i patohistološkog stupnja tumora i konačnog ishoda liječenja meningeoma lubanjskog svoda. Nacrt studije: Provedeno je istraživanje presječnoga tipa. Ispitanici i metode: U istraživanje su uključeni svi bolesnici s dijagnosticiranim meningeomom lubanjskog svoda kirurški liječeni u Klinici za neurokirurgiju Kliničkog bolničkog centra Osijek od 2000. do 2015. godine. Podatci za istraživanje preuzeti su iz povijesti bolesti. Ishod liječenja ispitanika određen je Karnofskyjevim indeksom (KPI) i Glasgowskom ljestvicom ishoda (GOS). Rezultati: Od ukupno 134 ispitanika uključenih u istraživanje, 71,6 % bilo je ženskog spola, a 28,4 % muškog. Medijan dobi ispitanika iznosio je 64,0 godine. Pokazatelji ishoda liječenja, KPI i GOS, statistički su značajno bili povezani s dobi (p < 0,001), stanjem svijesti ispitanika (p < 0,001), Simpsonovim stupnjem opsežnosti kirurškog uklanjanja tumora (p < 0,001) i lokalizacijom tumora (p = 0,049; p = 0,033). Statistički je značajna povezanost patohistološkog stupnja tumora i GOS pokazatelja ishoda (p = 0,036). Zaključak: Spol ispitanika ne utječe na ishod liječenja. Ispitanici mlađe životne dobi i očuvanog stanja svijesti imaju u pravilu bolji ishod liječenja. Ispitanici s povoljno lokaliziranim te potpuno uklonjenim tumorom imaju povoljniji ishod liječenja. Ispitanici s patohistološki benignim tumorom imaju povoljniji ishod liječenja određen GOS vrijednostima. Pouzdani pokazatelji uspješnosti kirurškog liječenja meningeoma lubanjskog svoda su: dob ispitanika, stanje svijesti pri prijemu, lokalizacija i opsežnost kirurškog uklanjanja tumora.Objectives: The aim of the research is to examine the correlation of the demographic factors (age and gender), consciousness of patients at admission, tumor location, the extensiveness of the surgical removal and histological grade of the tumor with the final outcome of the surgical treatment of cerebral convexity meningioma. Study Design: The research is a cross-sectional study. Patients and methods: The research included all patients diagnosed with cranial vault meningioma, treated at the Department of Neurosurgery, University Hospital Centre Osijek from 2000 to 2015. Data were taken from patients’ medical history. The outcome of the treatment was defined by the Karnofsky Performance Index (KPI) and Glasgow Outcome Scale (GOS). Results: There was a total of 134 patients included in the research, 71.6 % were female and 28.4 % male. The median age of patients was 64.0. Indicators of treatment outcomes, KPI and GOS were significantly associated with age (p < 0.001), the admission consciousness (p < 0.001), Simpson degree of extensiveness of the tumor surgical removal (p < 0.001) and tumor location (p = 0.049; p = 0.033). There was a statistically significant correlation between histological grade of the tumor and GOS indicators of outcome (p = 0.036). Conclusion: Patients’ gender does not influence the outcome of the treatment. Younger patients and those with preserved consciousness indicate generally better treatment outcome. Patients with more conveniently localized tumor and those with the tumor completely removed have more favorable treatment outcome. Patients with histologically benign tumors have more favorable treatment outcome, determined by GOS values. The most valuable predictors of the surgical management outcome of convexity meningioma are: patients’ age and state of consciousness at admission, tumor localization, and extensiveness of the tumor surgical resection

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

Characteristic features of convexity meningoma

Cilj istraživanja: Cilj je istraživanja ispitati postoji li povezanost između demografskih čimbenika (dob i spol), stanja svijesti bolesnika, lokalizacije tumora, opsežnosti kirurškog uklanjanja i patohistološkog stupnja tumora i konačnog ishoda liječenja meningeoma lubanjskog svoda. Nacrt studije: Provedeno je istraživanje presječnoga tipa. Ispitanici i metode: U istraživanje su uključeni svi bolesnici s dijagnosticiranim meningeomom lubanjskog svoda kirurški liječeni u Klinici za neurokirurgiju Kliničkog bolničkog centra Osijek od 2000. do 2015. godine. Podatci za istraživanje preuzeti su iz povijesti bolesti. Ishod liječenja ispitanika određen je Karnofskyjevim indeksom (KPI) i Glasgowskom ljestvicom ishoda (GOS). Rezultati: Od ukupno 134 ispitanika uključenih u istraživanje, 71,6 % bilo je ženskog spola, a 28,4 % muškog. Medijan dobi ispitanika iznosio je 64,0 godine. Pokazatelji ishoda liječenja, KPI i GOS, statistički su značajno bili povezani s dobi (p < 0,001), stanjem svijesti ispitanika (p < 0,001), Simpsonovim stupnjem opsežnosti kirurškog uklanjanja tumora (p < 0,001) i lokalizacijom tumora (p = 0,049; p = 0,033). Statistički je značajna povezanost patohistološkog stupnja tumora i GOS pokazatelja ishoda (p = 0,036). Zaključak: Spol ispitanika ne utječe na ishod liječenja. Ispitanici mlađe životne dobi i očuvanog stanja svijesti imaju u pravilu bolji ishod liječenja. Ispitanici s povoljno lokaliziranim te potpuno uklonjenim tumorom imaju povoljniji ishod liječenja. Ispitanici s patohistološki benignim tumorom imaju povoljniji ishod liječenja određen GOS vrijednostima. Pouzdani pokazatelji uspješnosti kirurškog liječenja meningeoma lubanjskog svoda su: dob ispitanika, stanje svijesti pri prijemu, lokalizacija i opsežnost kirurškog uklanjanja tumora.Objectives: The aim of the research is to examine the correlation of the demographic factors (age and gender), consciousness of patients at admission, tumor location, the extensiveness of the surgical removal and histological grade of the tumor with the final outcome of the surgical treatment of cerebral convexity meningioma. Study Design: The research is a cross-sectional study. Patients and methods: The research included all patients diagnosed with cranial vault meningioma, treated at the Department of Neurosurgery, University Hospital Centre Osijek from 2000 to 2015. Data were taken from patients’ medical history. The outcome of the treatment was defined by the Karnofsky Performance Index (KPI) and Glasgow Outcome Scale (GOS). Results: There was a total of 134 patients included in the research, 71.6 % were female and 28.4 % male. The median age of patients was 64.0. Indicators of treatment outcomes, KPI and GOS were significantly associated with age (p < 0.001), the admission consciousness (p < 0.001), Simpson degree of extensiveness of the tumor surgical removal (p < 0.001) and tumor location (p = 0.049; p = 0.033). There was a statistically significant correlation between histological grade of the tumor and GOS indicators of outcome (p = 0.036). Conclusion: Patients’ gender does not influence the outcome of the treatment. Younger patients and those with preserved consciousness indicate generally better treatment outcome. Patients with more conveniently localized tumor and those with the tumor completely removed have more favorable treatment outcome. Patients with histologically benign tumors have more favorable treatment outcome, determined by GOS values. The most valuable predictors of the surgical management outcome of convexity meningioma are: patients’ age and state of consciousness at admission, tumor localization, and extensiveness of the tumor surgical resection

First Reported Case of Gabriele-de Vries Syndrome with Spinal Dysraphism

Gabriele-de Vries syndrome is a rare autosomal dominant genetic disease caused by de novo pathogenic variants in the Yin Yang 1 (YY1) gene. Individuals with this syndrome present with multiple congenital anomalies, as well as a delay in development and intellectual disability. Herein, we report the case of a newborn male patient with a novel de novo pathogenic variant in the Guanine Nucleotide-Binding Protein, Alpha Stimulating (GNAS) gene, which was identified by whole-exome sequencing. Our patient suffered from a large open spinal dysraphism which was treated surgically immediately after birth. During the follow-up, facial dysmorphism, bladder and bowel incontinence, and mildly delayed motor and speech development were observed. Congenital central nervous system disorders were also confirmed radiologically. In this case report, we present our diagnostic and treatment approaches to this patient. To our knowledge, this is the first reported case of Gabriele-de Vries syndrome presenting with spinal dysraphism. Extensive genetic evaluation is the cornerstone in treatment of patients with suspected Gabriele-de Vries syndrome. However, in cases with potentially life-threatening conditions, surgery should be strongly considered