Obinutuzumab in Combination with Alternative Chlorambucil Schedules in Front-Line Treatment of Chronic Lymphocytic Leukemia: A Study by KroHem, the Croatian Cooperative Group for Hematologic Diseases.

Obinutuzumab was approved for front-line treatment of chronic lymphocytic leukemia in combination with chlorambucil pulses administered every 2 wks. Alternative schedules of chlorambucil enable the administration of higher total chlorambucil doses, and have better antileukemia activity. So far, evidence on the feasibility of combining obinutuzumab with alternative chlorambucil schedules is lacking.

Early noninvasive ventilation in general wards for acute respiratory failure: an international, multicentre, open-label, randomised trial.

Background: The impact of noninvasive ventilation (NIV) managed outside the intensive care unit in patients with early acute respiratory failure remains unclear. We aimed to determine whether adding early NIV prevents the progression to severe respiratory failure.

Methods: In this multinational, randomised, open-label controlled trial, adults with mild acute respiratory failure (arterial oxygen partial pressure/fraction of inspiratory oxygen [Pao/FiO] ratio ≥200) were enrolled across 11 hospitals in Italy, Greece, and Kazakhstan.

Secondary Primary Carcinoma Arising on the Flap Skin in the Oral Cavity-Case Series.

Oral squamous cell carcinoma (OSCC) causes considerable morbidity and mortality rates, posing a major global health burden. The management of the OSCC is multidisciplinary, but still the gold standard is surgical resection and reconstruction of the postablative defect. The appearance of secondary primary OSCC is not uncommon; however, it is quite rare that it appears on the skin of the flap that was used for reconstruction during the previous surgical therapy.

Regular Dynamic Exercise Has a Beneficial Effect on Arterial Stiffness Already in Childhood and Adolescence.

This study aims to assess the parameters of arterial stiffness in active children and adolescents according to the type of sport they practice and compare them with those who do not participate in sport. There were 238 subjects, 80 practiced predominantly dynamic sports, 58 predominantly static sports, and 100 children and adolescents were not regularly included in sports. The control group was volunteers of similar age recruited from elementary schools.

Amino Acid Infusion for Kidney Protection in Cardiac Surgery Patients with Chronic Kidney Disease: A Secondary Analysis of the PROTECTION Trial.

Background: In the PROTECTION trial, intravenous amino acids (AA) decreased the occurrence of acute kidney injury (AKI) in cardiac surgery patients with cardiopulmonary bypass (CPB). Recruitment of renal functional reserve may be responsible for such protection. However, patients with chronic kidney disease (CKD) have diminished renal functional reserve, and AA may be less protective in such patients.

Evaluating academic detailing as an antibiotic stewardship intervention in primary healthcare settings in Croatia.

Background: Acute respiratory tract infections are common in primary healthcare care settings and frequently result in antibiotic prescriptions, despite being primarily viral. There is scarcity of research examining impact of academic detailing (AD) intervention on prescribing practices for these infections in resource-constrained healthcare settings like southeastern Europe. Therefore aim of this study was to evaluate impact of AD intervention as an antimicrobial stewardship measure on antibiotic prescribing for acute respiratory tract infections in primary setting in Croatia which is located in southeastern Europe.

Invasive pneumococcal disease in adults after the introduction of pneumococcal vaccination: a retrospective study in the metropolitan area of Zagreb, Croatia (2010-2022).

Introduction: Invasive pneumococcal disease (IPD) is a severe form of illness caused by with high morbidity and mortality rate in the general population, particularly in children <5 years of age, adults ≥65 years of age and the immunocompromised. As known, pneumococcal vaccination lowers the risk of IPD so the aim of this study was to investigate whether the introduction of pneumococcal vaccination has influenced the incidence and mortality of IPD in adults in Croatia.

Materials And Methods: A retrospective study was conducted among adult patients (aged ≥18 years) hospitalized due to IPD in the metropolitan area of Zagreb from 1 January 2010 to 31 December 2022.

Chronic Total Occlusions in Non-Infarct-Related Coronary Arteries and Long-Term Cardiovascular Mortality in Patients Receiving Percutaneous Coronary Intervention in Acute Coronary Syndromes.

: Patients with non-infarct-related artery chronic total occlusion (non-IRA CTO) found during percutaneous coronary intervention (PCI) in acute coronary syndromes (ACSs) are not rare and have worse clinical outcomes. We aimed to analyze their long-term clinical outcomes in regard to clinical characteristics, revascularization strategies, and adherence to medical therapy. : The dual-center ACS registry of patients treated from Jan 2017 to May 2023 was used to identify 1950 patients with timely PCI in ACS who survived to discharge with documented adequate demographic, clinical, and angiographic characteristics, treatment strategies, and medical therapy adherence during a median follow-up time of 49 months.

A 2-year calorie restriction intervention reduces glycomic biological age biomarkers.

Background/objective: In a subset of participants from the CALERIE Phase 2 study we evaluated the effects of 2y of ~25% Calorie Restriction (CR) diet on IgG N-glycosylation (GlycAge), plasma and complement C3 N-glycome as markers of aging and inflammaging.

Methods: Plasma samples from 26 participants in the CR group who completed the CALERIE2 trial and were deemed adherent to the intervention (~>10 % CR at 12 mo) were obtained from the NIA AgingResearchBiobank. Glycomic investigations using UPLC or LC-MS analyses were conducted on samples from baseline (BL), mid-intervention (12 mo) and post-intervention (24 mo), and changes resulting from the 2y CR intervention were examined.

Myocardial deposition of aluminum, arsenic, cadmium, and lead accelerates heart failure and alters UPRmt in humans.

In the myocardium of control subjects and patients undergoing heart transplantation or left ventricular assist device implantation (LVAD), we analyzed concentrations of Al, As, Cd, Pb, and Ni using inductively coupled plasma mass spectrometry. Myocardial generation of oxidative-stress-induced lipid peroxidation was analyzed by quantifying concentration of 4-Hydroxynonenal (4-HNE) with ELISA and pro-apoptotic DAPK2 gene expression was determined with quantitative RT-PCR. Compared to six control hearts, myocardial samples of 128 individuals undergoing heart transplantation or LVAD implantation exhibited a moderate increase in deposition of five tested non-essential elements, which was significantly increased only for Cd and cumulative deposition of Al, As, Cd, and Pb.

Virtue ethics-based research integrity training intervention to change medical students' attitudes and perceptions of organizational ethical climate: A randomized controlled trial.

Background: Universities are increasingly offering training in research integrity (RI) to enhance research quality and foster RI. Despite the importance of integrating scientific virtues into such training, there is a lack of assessment of virtue ethics-based RI training.

Methods: This was a randomised controlled study assessing the impact of a virtue-based training for RI, performed at the University of Split School of Medicine in 2020-2021.

Prolonged corticosteroid therapy and lung abnormalities in patients after severe COVID-19 pneumonia.

Background: Some of the hospitalized patients after severe COVID-19 pneumonia experience significant fall in peripheral saturation despite optimal treatment. Because of immune dysregulation in COVID-19 there are indications that prolonged corticosteroids could be considered in treating patients for persistent radiological sequelae and respiratory symptoms.

Objectives: to investigate lung function and lung sequelae on high-resolution CT (HRCT) im COVID-19 patients who were treated with glucocorticoid therapy in two dose regimens with a control group of patients who did not receive additional glucocorticoid therapy.

Midseptal and Anteroseptal Accessory Pathway Ablation in Children.

The goal of this study is to document outcomes of ablation for high-risk accessory pathways in paediatrics using 3D mapping systems with minimal to zero fluoroscopy. It is a cross-sectional, multicentre study, conducted between 2013 and 2023, and involving four different centres in Hungary, Croatia, Kuwait, and Slovenia. A total of 128 procedures were performed on 111 patients.

Outcomes of Ixazomib Treatment in Relapsed and Refractory Multiple Myeloma: Insights from Croatian Cooperative Group for Hematologic Diseases (KROHEM).

: Ixazomib, used in combination with lenalidomide and dexamethasone (IRd), has shown efficacy in clinical trials for relapsed/refractory multiple myeloma (RRMM). : This study evaluates the real-world effectiveness and safety of IRd in Croatian RRMM patients. A retrospective analysis was conducted on 164 RRMM patients treated with ixazomib at nine Croatian haematology centres from November 2016 to February 2023.

Systemic Lipid Metabolism Dysregulation as a Possible Driving Force of Fracture Non-Unions?

Introduction: Non-unions are fractures that do not heal properly, resulting in a false joint formation at the fracture site. This condition leads to major health issues and imposes a burden on national healthcare systems. The etiology of non-unions is still not fully understood; therefore, we aimed to identify potential systemic factors that may contribute to their formation.

Effects of Sodium-Glucose Co-Transporter 2 Inhibitors on Serum Chloride Concentrations in Patients with Heart Failure.

Background And Aims: In the past few years, some reports have shown that serum chloride concentration is a more powerful prognostic predictor than serum sodium levels in heart failure (HF). Elevated Na/Cl ratio has shown to be independently associated with all-cause death in acute HF. We evaluated changes in serum chloride concentrations and Na/Cl ratio in correlation with various clinical factors during 12 months of follow-up in patients in whom SGLT2is were initiated as part of HF therapy.

Advantages of Ultrafast™ ultrasound in the screening for renal artery disease.

Aim: Renal artery disease is the most common cause of secondary hypertension worldwide. B-mode and Doppler ultrasound are considered the modalities of choice for the imaging of the renal arteries. However, an adequate examination can be plagued by difficulties in patients with unfavorable anatomy.