What Can Be Done With Benign Stenosis of the Esophagus?

Uzroci nastanka benignih stenoza jednjaka mogu biti razni, ali one su najčešće uzrokovane dugotrajnim gastroezofagealnim refluksom. Cilj je rada prikazati vlastita iskustva kod dilatacije benignih stenoza jednjaka rigidnim / mehaničkim dilatatorom. U razdoblju od ožujka 2014. godine do prosinca 2015. godine na Zavodu za hepatogastroenterologiju Klinike za unutarnje bolesti Kliničke bolnice „Sveti Duh” u 14-ero pacijenata učinjeno je ukupno 49 dilatacija benignih stenoza jednjaka dilatatorima Savary-Gilliard. Dilatacija je učinjena pod kontrolom rendgena. Zahvat je izveden bez proceduralnih i poslijeproceduralnih komplikacija. U naših pacijenata, dilatacija benignih stenoza jednjaka mehaničkim dilatatorima pokazala se vrlo korisnom u rješavanju ili ublažavanju disfagije i prevenciji nastanka recidiva.Etiology of benign esophageal stenosis can be diverse, but this condition is most commonly caused by long term gastroesophageal reflux. The aim of this article is to present our experiences with dilation of benign esophageal stenosis with rigid/mechanical dilator. In the period between March 2014 and December 2015 at the Department of hepatogastroenterology of the Clinic of Internal Medicine, University Hospital “Sveti Duh”, we have performed 49 dilations with Savary- Gilliard dilators in 14 patients with benign esophageal stenosis. Dilation was performed under X-ray control. There were no complications during the procedure or afterwards. In our patients, dilation of benign esophageal stenosis with mechanical dilators has been recognized as highly efficient in resolving or alleviating dysphagia and prevention of relapse

What Can Be Done With Benign Stenosis of the Esophagus?

Uzroci nastanka benignih stenoza jednjaka mogu biti razni, ali one su najčešće uzrokovane dugotrajnim gastroezofagealnim refluksom. Cilj je rada prikazati vlastita iskustva kod dilatacije benignih stenoza jednjaka rigidnim / mehaničkim dilatatorom. U razdoblju od ožujka 2014. godine do prosinca 2015. godine na Zavodu za hepatogastroenterologiju Klinike za unutarnje bolesti Kliničke bolnice „Sveti Duh” u 14-ero pacijenata učinjeno je ukupno 49 dilatacija benignih stenoza jednjaka dilatatorima Savary-Gilliard. Dilatacija je učinjena pod kontrolom rendgena. Zahvat je izveden bez proceduralnih i poslijeproceduralnih komplikacija. U naših pacijenata, dilatacija benignih stenoza jednjaka mehaničkim dilatatorima pokazala se vrlo korisnom u rješavanju ili ublažavanju disfagije i prevenciji nastanka recidiva.Etiology of benign esophageal stenosis can be diverse, but this condition is most commonly caused by long term gastroesophageal reflux. The aim of this article is to present our experiences with dilation of benign esophageal stenosis with rigid/mechanical dilator. In the period between March 2014 and December 2015 at the Department of hepatogastroenterology of the Clinic of Internal Medicine, University Hospital “Sveti Duh”, we have performed 49 dilations with Savary- Gilliard dilators in 14 patients with benign esophageal stenosis. Dilation was performed under X-ray control. There were no complications during the procedure or afterwards. In our patients, dilation of benign esophageal stenosis with mechanical dilators has been recognized as highly efficient in resolving or alleviating dysphagia and prevention of relapse

The place and role of serologic methods in detecting Helicobacter pylori infection

The aim of the study was to determine the place and role of serologic methods in detecting Helicobacter pylori (H. pylori) infection, on the basis of estimated enzyme-linked immunosorbent assay (ELISA) and complement fixation test (CFT) sensitivity and specificity. A total of 549 patients were included in the study. ELISA and CFT as serologic methods were compared with invasive methods (rapid urease test--CLO test, culture, histology). The sensitivity of serologic methods was above 90%, and their specificity was around 80%. Study results confirmed the value, reliability and usefulness of serologic methods in the detection of H. pylori infection

PHARMACOLOGY OF BIOLOGIC MEDICATIONS

Unutar skupine upalnih bolesti crijeva dva su najpoznatija entiteta - Crohnova bolest i ulcerozni kolitis. Razumijevanje njihove patofiziologije te slijeda inflamatorne kaskade dovelo je do otkrića lijekova koji mogu selektivno djelovati na određenu molekulu ili signalni put te ispraviti neravnotežu proinflamatornih i antiinflamatornih medijatora. Prvi su razvijeni antagonisti TNF-; solubilni receptori poput etanercepta te monoklonalna antitijela. Infliksimab je širom svijeta odobren za liječenje umjerenog do teškog te fistulizirajućeg oblika aktivne Crohnove bolesti te teškog oblika ulceroznog kolitisa u odraslih bolesnika koji ne reagiraju na punu i adekvatnu terapiju nekim kortikosteroidom i/ili imunosupresivom, odnosno u onih koji ne podnose ili u kojih postoje medicinske kontraindikacije za takvu terapiju te za liječenje teškog oblika aktivne bolesti kod djece. Razvoj antitijela na infliksimab koji dovode do gubitka djelotvornosti lijeka i alergijskih reakcija otvorile su mjesto primjeni adalimumaba. Na osnovi dostupnih podataka iz pretkliničkih i ranih faza kliničkog ispitivanja još jedan TNF-antagonist (certolizumab), inhibitori Th 1 polarizacije (fontolizumab, ustekinumab) te inhibitor selektivnih adhezijskih molekula (natalizumab) potencijalno kandidiraju za nove biološke lijekove u liječenju upalnih bolesti crijevaTwo major types of inflammatory bowel diseases (IBD) are Crohn’s disease (CD) and ulcerative colitis (UC). Insights into their pathophysiology and inflammatory cascade have lead to the discovery of medications that can have a selective effect on a particular molecule or signal pathway and correct an imbalance in pro- and anti-inflammatory mediators. The first to be developed were the TNF-antagonists, soluble receptors like etanercept and monoclonal antibodies. Infliximab has been approved worldwide for treatment of moderate to severe and active fistulizing forms of Crohn’s disease, as well as for severe forms of ulcerative colitis in adults who do not react to full and adequate corticosteroid and/or immunosuppressive therapy, i.e. for patients who have problems with or medical contraindications to such therapy and for treatments of severe forms of active disease in children. Adalimumab can be applied in cases when antibodies develop as a reaction to infliximab, leading to reduced drug efficacy and allergic reactions. According to the available data from preclinical tests and earlier phases of clinical tests, potential candidates for new biological medications in treating IBDs are another TNF-antagonist (certolizumab), inhibitors of Th1 polarisation (fontolizumab,ustekinumab) and selective adhesion-molecule inhibitors (natalizumab

The Place and Role of Serologic Methods in Detecting Helicobacter Pylori Infection

The aim of the study was to determine the place and role of serologic methods in detecting Helicobacter pylori (H. pylori) infection, on the basis of estimated enzyme-linked immunosorbent assay (ELISA) and complement fixation test (CFT) sensitivity and specificity. A total of 549 patients were included in the study. ELISA and CFT as serologic methods were compared with invasive methods (rapid urease test – CLO test, culture, histology). The sensitivity of serologic methods was above 90%, and their specificity was around 80%. Study results confirmed the value, reliability and usefulness of serologic methods in the detection of H. pylori infection

Laboratory Tests in Liver Diseases

Rutinsko određivanje laboratorijskih nalaza koji uključuju pokazatelje jetrene funkcije dovelo je do velikog broja pacijenata kod kojih se bilježi povišena razina jednog ili više jetrenih nalaza. Vrijednosti jetrenih enzima mogu nas uputiti radi li se o poremećaju i/ili oštećenju jetrenih stanica, kada govorimo o hepatocelularnom oštećenju, karakteriziranom porastom aminotransferaza (AST i ALT), o poremećaju na razini bilijarnih vodova i kanalića (GGT i ALP, uz vrijednosti ukupnog i direktnog bilirubina) ili se radi o poremećenoj sintetskoj funkciji jetre (albumini, poremećaj koagulacijskih parametara). Kako bismo olakšali daljnje postupanje s takvim pacijentima, donosimo pregled najčešćih karakteristika i uzroka jetrene lezije, preporuke za daljnju obradu i praćenje takvih bolesnika u domeni primarne i sekundarne zdravstvene zaštite.Routine laboratory liver function tests have shown that a large number of patients have elevated levels of one or more liver function indicators. Liver enzyme values indicate whether a patient suffers from liver cell disease and/or injury, where we distinguish between hepatocellular injury, which is characterized by elevated AST and ALT, biliary injury (ALP and GGT, with total and direct bilirubin) or impaired hepatic synthetic function (albumin, abnormal coagulation parameters). In order to facilitate patient management, the paper outlines the most common features and causes of liver injury, and provides recommendations for workup and follow-up of such patients in primary and secondary healthcare

Percentuale dei grassi e composizione degli acidi grassi nel prosciutto istriano e dalmata

Cilj ovog istraživanja bio je analizirati udio masti i sastav masnih kiselina u uzorcima M. biceps femoris istarskog i dalmatinskog pršuta. Analiziran je sadržaj zasićenih (SFA), mononezasićeniih (MUFA) i polinezasićenih (PUFA) masnih kiselina. Udio masti u istarskom pršutu bio je 7,45-21,12%, dok u dalmatinskom 9,49-21,29%. Sastav masnih kiselina istarskog i dalmatinskog pršuta nije se razlikovao; istarski i dalmatinski pršuti sadrže 39-41% SFA, 51-53% MUFA i 8% PUFA. Omjer PUFA/SFA u istarskom i dalmatinskom pršutu je 0,20 (preporuka PUFA/SFA > 0,4), dok je omjer n6/n3 iznosio 15-17. Omjer n6/n3 u pršutima, prema preporukama, je općenito blizu gornje dopuštene granice.The aim of this research was to analyze the content of fat and fatty acid composition in samples of M. biceps femoris of Istrian and Dalmatian dry-cured ham. Contents of saturated fatty acids (SFA), monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) were analyzed. Fat content in Istrian dry-cured ham was 7.45 – 21.12%, whereas it was 9.49 – 21.29% in Dalmatian dry-cured ham. The fatty acid content of Istrian and Dalmatian dry-cured ham did not diff er; Istrian and Dalmatian dry-cured hams contain 39 - 41% SFA, 51 - 53% MUFA and 8% PUFA. The ratio of PUFA/SFA in Istrian and Dalmatian dry-cured ham is 0.20 (recommended PUFA/SFA > 0.4), while the ratio of n6/n3 was 15 – 17. According to recommendations, the ratio of n6/n3 in dry-cured hams is generally close to the upper allowable limit.Das Ziel dieser Untersuchung war, den Anteil vom Fett und die Zusammensetzung von Fettsäuren in Prosciutto in Mustern von M. biceps femoris in Prosciutto aus Istrien und Dalmatien zu analysieren. Analysiert wurde der Inhalt von gesättigten (SFA), monoungesättigten (MUFA) und polyungesätigten (PUFA) Fettsäuren. Der Fettanteil im Prosciutto aus Istrien war 7,45 - 21,12 %, im Prosciutto aus Dalmatien 9,49 – 21,29 %. Die Zusammensetzung von Fettsäuren im Prosciutto aus Istrien und aus Dalmatien zeigte keine Unterschiede: sie enthält 39 – 41 % SFA, 51 – 53 % MUFA und 8 % PUFA. Das Verhältnis von PUFA/SFA im Prosciutto aus Istrien und Dalmatien war 0,20 (Empfehlung PUFA/SFA > 0,4), das Verhältnis n6/n3 betrug 15-17. Das Verhältnis n6/n3 in Prosciutto, ist nach Empfehlung im allgemeinen nahe an der oberen genehmigten Grenze.L\u27obiettivo di questa ricerca era di analizzare la percentuale dei grassi e la composizione degli acidi grassi nei campioni M. biceps femoris del prosciutto istriano e dalmata. È stato analizzato il contenuto degli acidi saturi (SFA), acidi monoinsaturi (MUFA) e acidi polinsaturi (PUFA). La percentuale dei grassi nel prosciutto istriano era 7,45-21,12%, mentre nel prosciutto dalmata era 9,49-21,29 %. La composizione degli acidi grassi nel prosciutto istriano e dalmata non è diff erente; il prosciutto istriano e dalmata contengono 39- 41% SFA, 51-53% MUFA e 8% PUFA. La proporzione PUFA/SFA nel prosciutto istriano e dalmata era 0,20 (raccomandazione PUFA/SFA > 0,4), mentre la proporzione n6/n3 era 15-17. La proporzione n6/n3 nei prosciutti, secondo le raccomandazioni, in genere è vicina al limite superior

Fizikalno - kemijske karakteristike prsnog mišića kamenjarki (Alectoris graeca)

Cilj ovog istraživanja je odrediti karakteristike (kemijski sastav i boju mesa) te sastav masnih kiselina prsnog mišića (Musculus pectoralis major) jarebica kamenjarki (Alectoris graeca) sa četiri različita lokaliteta (Pag, Cavtat, Mosor-Seoca, Sitno Gornje). Prsni mišić jarebica kamenjarki ima povoljan kemijski sastav- sadrži 72,75%-73,45% vode, 19,78% - 21,33% proteina te 0,20- 0,54% masti. Ima tamniju boju mesa od mesa prsiju tovljenih pilića (nižu L* vrijednost). Udio zasićenih masnih kiselina (SFA) je 26,64 - 40,34%; mononezasićenih masnih kiselina (MUFA) 16,35 - 46,75% te 26,61 - 52,34% polinezasićenih masnih kiselina (PUFA). Prsno mišićje jarebica kamenjarki grivnih sadrži visok udio omega-6 i omega-3 masnih kiselina u preporučenom omjeru (1:1). Jarebice kamenjarke iz različitih lokaliteta imaju različitu ishranu što se u konačnici očituje i u različitom sastavu masnih kiselina

Coincidence of colorectal cancer and diverticular disease of the colon

Uvod: Divertikuloza (DK) debeloga crijeva i karcinom debeloga crijeva (KDC) imaju neke zajedničke karakteristike (npr. češći su u zapadnom dijelu svijeta i kod starijih osoba, slične prehrambene značajke uključene su u obje bolesti) a povremena povezanost između njih je ispitivana. Naš cilj je bio procijeniti koincidenciju KDC-a i DK u kontinentalnoj i primorskoj Hrvatskoj, kao i prehrambenu varijabilnost u našoj populaciji - prehrana s manjim udjelom vlakana u kontinetalnoj Hrvatskoj i mediteranska prehrana u primorskoj Hrvatskoj stvara povoljnu situaciju za istraživanje bolesti sa sumnjom na prehrambenu etiologiju. Metode: Analizirane su medicinske povijesti 710 bolesnika iz kontinentalne regije i 406 bolesnika iz primorske regije s dijagnozom KDC od 2011. do 2016. godine s obzirom na prevalenciju DK. Skupine su nadalje podijeljene prema različitim dobnim i spolnim skupinama, a prevalencija DK u svakoj skupini izračunata je i uspoređena. Analizirane su i distribucije DK i KDC-a za skupine KDC u usporedbi s DK. Rezultati: Prevalencija DK u skupini KDC u obalnom području iznosila je 32,3%, a u kontinentalnoj regiji 11,5%. Prevalencija DK u primorskom području bila je znatno veća u ukupnom broju u usporedbi s kontinentalnom regijom, kao i u ukupnom broju muškaraca i žena, te u dobno stratificiranoj skupini > 65. Lijevi kolon je češće zahvaćen s DK i KDC u obje skupine. Zaključci: Naši podaci upućuju da bolesnici s KDC i DK mogu proizaći iz različitih ispitivanih skupina, a učinak prehrane tek treba ustanoviti.Background: Diverticular disease (DD) of the colon and colorectal cancer (CRC) have common characteristics (e.g. more common in the westernized world and in the elderly, similar dietary features implicated for both diseases) and a casual relationship between them has been suggested. Our aim was to evaluate the coincidence of CRC and DD in continental and coastal Croatia as a dietary variability observed in our population – low fiber diet in the continent and Mediterranean diet on the coast creates a favourable situation for the investigation of diseases with suspected nutritional aetiology. Methods: Medical histories of 710 patients from the continental region and 406 from the coastal region diagnosed with CRC from 2011 to 2016 were analyzed with regard to the prevalence of DD. The groups were furthermore divided in different age and sex groups and the prevalence of DD in each group was calculated and compared. Distribution of DD and CRC in the colon for the groups of CRC in concomitance with DD were also analyzed. Results: The prevalence of DD among the CRC group in the coastal region was 32.3% and in the continental region 11.5%. The prevalence of DD in the coastal region was significantly higher in the overall number compared to the continental region as well as in the overall number of men and women, and in the age-stratified group > 65. The left colon was affected more often with DD and CRC in both groups. Conclusions: Our findings suggest that patients with CRC and DD could derive from distinct groups and the effect of the diet has yet to be established

Quantitative Analysis of Troponin I Serum Values in Patients with Acute Cholecystitis

The diagnosis and staging of acute cholecystitis, upon a lot of diagnostic methods and some scoring systems, is still a great clinical problem. The aim of the study was to investigate if serum Troponin I is elevated in patients with acute cholecystitis. Following informed consent, 65 patients with clinical and laboratory signs of acute cholecystitis were enrolled. All patients had measured serum Troponin I level and an abdominal ultrasound was done before definitive treatment was performed. Increased serum Troponin I level was found in most patients with severe form of acute cholecystitis (p6 mm) thickness (r=0.58). Our study confirms that in most patients with severe and acute cholecystitis, serum Troponin I is increased. Troponin I level is in a lower range than it would be in patients with cardiac muscle damage or necrosis. Measuring serum Troponin I is a fast, reliable and widely performed test that could, with other routinely measured parameters, help in early diagnosis of the severe form of acute cholecystitis