Osteogenesis imperfecta - pamidronate treatment in Split Clinical Hospital Centre

Osteogenesis imperfecta (OI) ili bolest krhkih kostiju je klinički, biokemijski i genski heterogena bolest veziva. Glavna osobina bolesti su lomljive i osteoporotične kosti. Indikacija za početak liječenja postavlja se u djece nakon dva koštana loma. Od 2002.-2010. godine u KBC Split praćeno je i liječeno 7 djevojčica i 6 dječaka u kojih je temeljem kliničke slike postavljena dijagnoza OI. U osmero djece OI tip I, u dvoje tip III, i u po jednomu djetetu tip V, VI i VII. U svrhu dijagnosticiranja bolesti, te tijekom i nakon provedenoga liječenja praćene su vrijednosti mineralne gustoće kostiju. Osmero je djece liječeno intravenskom primjenom pamidronata. Liječenje je poboljšalo mineralnu gustoću kostiju, što je doprinijelo prestanku lomova kostiju u šestero liječene djece. Svim oboljelim osobama preporučeno je i uzimanje hrane bogate kalcijem i vitaminima. Fizikalnu terapiju koristilo je 10-ero djece. Kirurški zahvati zbog ispravljanja deformiteta provedeni su u troje djece. Zaključno, liječenje pamidronatom dokinulo je pojavu prijeloma kostiju i smanjenje bolova u kostima u sve liječene djece, uz istovremeno povećanje vrijednosti mineralne gustoće kostiju, a bez nuspojava uzrokovanih uzimanjem lijeka. U liječenju OI od iznimne je važnosti multidisciplinarni pristup oboljelom djetetu, uz suradnju pedijatra – genetičara s dječjim kirurgom, specijalistom fizikalne medicine i rehabilitacije, i ostalim specijalistima. U KBC-u Split se osobita pozornost poklanja praćenju djece, edukaciji djeteta i roditelja o naravi bolesti, te adekvatnoj rehabilitaciji nakon prijeloma.Osteogenesis imperfecta or brittle bone disease is a clinical, biochemical and genetical heterogeneous disorder of the connective tissue. Fragile and osteoporotic bones are its main feature. From 2002-2010 seven girls and six boys were treated at CHC Split. Based on clinical symptoms, they all had OI, eight of them had type I, two type III and the rest type V, VI and VII respectively. Eight of them were treated with intravenous application of pamidronate. This treatment increased bone density and reduced the incidence of fractures. To all of them we strongly recommended food rich in calcium and vitamins. Ten children undertook physical therapy and three had surgical procedures to correct their deformities. Pamidronate treatment abolished the occurrence of bone fractures and reduced pain in all treated children, along with the increase of bone mineral density, but without side effects caused by the drugs. In this treatment of OI, a multidisciplinary approach is crucial. The cooperation of pediatricians – geneticists with children\u27s surgeons, specialists in physical medicine and rehabilitation, and other specialists is very important. At CHC Split, special attention is needed for monitoring and educating children and parents on the nature of the disease and adequate rehabilitation after fracture

Point prevalence of significant nutritional risk among cancer patients in Croatia – research study of the Section of young oncologists, Croatian society for medical oncology of Croatian medical association

Cilj istraživanja: Utvrditi trenutačnu prevalenciju znatnoga nutritivnog rizika među onkološkim bolesnicima u Republici Hrvatskoj. Ispitanici i metode: Ova presječna studija ugniježđena je u prospektivnu kohortnu studiju Sekcije mladih onkologa HDIO-a HLZ-a, koja je provedena u Hrvatskoj tijekom 2017. godine na susljednom uzorku onkoloških bolesnika biranome prema redoslijedu dolaska na liječenje. Nutritivni probir proveli smo uporabom upitnika za procjenu nutritivnog rizika NRS-2002. Prema njemu, bolesnik se smatra nutritivno ugroženim ako je rezultat ≥ 3. Rezultati: U istraživanje je uključeno 275 bolesnika, medijana (interkvartilnog raspona) dobi od 61 godine (51 – 68), među kojima je bila 161 žena (58,5%). Bolesnici su liječeni u jedanaest onkoloških centara u Hrvatskoj. U 60 bolesnika (21,8%; 95%-tni CI 17,1 – 27,2%) utvrđen je znatan nutritivni rizik (NRS-2002 ≥ 3) koji indicira potrebu za nutritivnom intervencijom. Bilo kakvu nepovoljnu promjenu tijekom 30 dana prije uključivanja, dakle, gubitak tjelesne mase ili smanjen unos hrane, primijetilo je 127 (46,2%) sudionika. Zaključak: Naše istraživanje potvrdilo je da znatan broj onkoloških bolesnika u Hrvatskoj ima neki stupanj nutritivnog rizika te da je u više od četvrtine potrebna nutritivna intervencija. Nutritivni probir prvi je korak u dugoročnoj kontroli komplikacija vezanih uz promijenjen unos hrane i nutritivni rizik, kao i pri poboljšanju kvalitete života onkoloških bolesnika te prognoze ishoda bolesti pa bi ga, s obzirom na prikazane rezultate, trebalo rutinski provoditi.Objective of the Study: To determine the point prevalence of significant nutritional risk among cancer patients in Croatia. Subjects and Methods: This cross-sectional study was nested in the prospective cohort study of the Section of Young Oncologists of the Croatian Society for Medical Oncology, Croatian Medical Association, conducted in Croatia during 2017 on the consecutive sample of cancer patients selected by the order of their arrival to the exam.Nutritional screening was performed using the NRS-2002, According to NRS-2002, the patient is considered to be at significant nutritional risk if the result is ≥3. Results: We included 275 patients treated at eleven cancer centers in Croatia. In 60 patients (21.8%, 95% CI 17.1% -27.2%) we identified the significant nutritional risk (NRS-2002 ≥3) what indicates the need for the nutritional intervention. Any change during 30 days prior to screening, such as loss of body weight or reduced intake of food, was expressed by 127 (46.2%) participants. Conclusion: Our study has confirmed that a significant number of cancer patients in Croatia are in some degree at nutritional risk, and that more than one quarter need nutritional intervention. Nutritional screen poing is the first step in the long-term control of complications associated with altered food intake and nutritional risk, as well as in improving the overall quality of life of cancer patients and the prognosis of disease outcomes, so regarding the presented results, it should be routinely implemented