962 results match your criteria: "University hospital Dubrava[Affiliation]"

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.

View Article and Find Full Text PDF

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

Br J Anaesth

January 2025

Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.

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.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF

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

BMC Prim Care

December 2024

Department of Endocrinology, University hospital Dubrava, Zagreb, Croatia, and School of Medicine, and University of Zagreb, Zagreb, 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.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF

: 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.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF

Comparison of oral cancer versus competing factors as cause of death: Single institution experience with long-term follow up.

J Craniomaxillofac Surg

November 2024

University of Zagreb School of Medicine, Department of Hematology, University Hospital Dubrava, Avenue Gojko Susak 6, 10000, Zagreb, Croatia.

Article Synopsis
  • - Patients with oral cancer who are clinically node-negative (cN0) and treated primarily with surgery show significant mortality risks from competing causes, not just cancer recurrence.
  • - In a study of 152 long-term survivors, 76 patients died, with 22.4% of deaths caused by the primary tumor recurrence and 27.6% from other factors, primarily cardiovascular disease and second primary cancers.
  • - The findings suggest that while these patients can be highly curable for their initial cancer, nearly one-third die from other causes, emphasizing the need for tailored follow-up care focusing on these specific risks after the fourth year of treatment.
View Article and Find Full Text PDF
Article Synopsis
  • The LANDMARK trial compared the balloon-expandable Myval transcatheter heart valve (THV) series to the SAPIEN and Evolut THV series in 768 patients to evaluate safety and effectiveness.
  • Results showed that Myval achieved non-inferiority to SAPIEN (24.7% vs 24.1%) and Evolut (24.7% vs 30.0%) regarding a primary composite safety endpoint.
  • Additionally, while Myval had better pressure gradient metrics compared to SAPIEN, Evolut showed slightly higher rates of prosthetic valve regurgitation compared to Myval but no significant difference between Myval and SAPIEN.
View Article and Find Full Text PDF
Article Synopsis
  • - Mental health issues are becoming more prevalent, necessitating careful management of psychotropic medications in outpatient settings to prevent potentially harmful drug interactions.
  • - A study analyzed 492 outpatient cases, revealing an average of 1.64 prescribed psychotropic drugs and an alarming 2.2 potential drug-drug interactions (pDDIs) per patient, with about 47.6% involving psychotropics.
  • - Younger patients (under 65) were found to receive more psychotropic medications, and key drugs involved in interactions included benzodiazepines, promazine, and zolpidem, highlighting the need for pharmacists to intervene and enhance patient safety.
View Article and Find Full Text PDF
Article Synopsis
  • Frontline healthcare professionals working with COVID-19 patients are experiencing significant mental health challenges, notably burnout, depression, anxiety, and stress, with 227 participants from two hospitals in Croatia contributing to the study.
  • Results indicated that physicians generally experienced higher burnout levels, while nurses reported increased anxiety, with nurses in Zagreb showing worse mental health outcomes compared to those in Split.
  • Gender and personality traits played a role in mental health, where female gender and being a physician were associated with higher psychological symptoms, while traits like emotional stability and resilience correlated with better life satisfaction.
View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF

Background And Objectives: The commonly used antiseizure medication lamotrigine is a substrate to ATP binding cassette subfamily G member 2 (ABCG2) transporter. The objective of this study was to evaluate the effect of the common loss-of-function polymorphism ABCG2 c.421C>A (rs2231142) on the lamotrigine trough concentrations at steady state in adults with epilepsy.

View Article and Find Full Text PDF

Higher red blood cell distribution width (RDW) levels have gained attention in the prognostication of many chronic metabolic and malignant diseases, as well as coronavirus disease 2019 (COVID-19). We aimed to evaluate whether accounting for RDW might contribute to risk stratification when added to commonly used risk scoring systems in adult COVID-19 patients. We retrospectively analyzed a cohort of 3212 non-critical COVID-19 patients hospitalized in a tertiary-level institution from March 2020 to June 2021.

View Article and Find Full Text PDF

Objective: To evaluate the diagnostic performance of abbreviated breast MRI compared with mammography in women with a family history of breast cancer included in the Croatian National Breast Screening Program.

Methods: 178 women with a family history of breast cancer aged 50 to 69 underwent abbreviated breast MRI and mammography. Radiological findings for each method were categorized according to the BI-RADS classification.

View Article and Find Full Text PDF
Article Synopsis
  • Pseudothrombocytopenia (PTCP) is a rare issue where platelet counts appear low due to aggregation, leading to possible misdiagnoses and unsafe clinical decisions if not recognized quickly.
  • The most frequent cause of PTCP is ethylenediaminetetraacetic acid (EDTA), and there are various management strategies documented, though expert guidance is limited.
  • A collaborative group in Croatia developed minimal recommendations to help standardize the detection and reporting of platelet counts from EDTA-induced PTCP, aimed at laboratory professionals and healthcare providers involved in blood sample management.
View Article and Find Full Text PDF

Background: Ensuring appropriate computed tomography (CT) utilization optimizes patient care while minimizing radiation exposure. Decision support tools show promise for standardizing appropriateness.

Objectives: In the current study, we aimed to assess CT appropriateness rates using the European Society of Radiology (ESR) iGuide criteria across seven European countries.

View Article and Find Full Text PDF
Article Synopsis
  • The study assessed the link between disease activity and quality of life (QoL) in 143 adult patients with psoriatic arthritis (PsA), finding significant correlations between fatigue levels and various aspects of physical health.
  • Key disease measures, including the Disease Activity Score (DAS28) and functional assessments, were related to physical health outcomes, while markers like ESR and CRP showed no significant correlation.
  • The findings indicate that disease activity in PsA has a mild to moderate effect on health-related quality of life, highlighting the importance of managing both physical symptoms and fatigue in patients.
View Article and Find Full Text PDF
Article Synopsis
  • Pediatric mandibular condyle fractures can lead to serious issues like pain and facial deformities if not treated correctly, yet there’s no agreed-upon treatment method.
  • A study analyzed how these fractures are managed in children aged 0 to 16 across 14 maxillofacial departments worldwide, examining treatment approaches over an 11-year period.
  • The research found that treatment methods varied significantly among departments, with expectant management, closed treatment, and open reduction being utilized, all showing effectiveness with low complication rates.
View Article and Find Full Text PDF

Bipolar radiofrequency ablation of refractory ventricular arrhythmias: results from a multicentre network.

Europace

October 2024

Cardioangiologisches Centrum Bethanien, Department Kardiologie, Markus Krankenhaus, Frankfurt, Germany.

Article Synopsis
  • Advanced bipolar radiofrequency catheter ablation (Bi-RFA) is being studied as a new treatment for patients with ventricular tachycardia (VT) and premature ventricular contractions (PVC) that do not respond to standard unipolar radiofrequency ablation (Uni-RFA).
  • A multicenter registry conducted in Europe showed that out of 91 patients treated with Bi-RFA, 74% achieved elimination of clinical VT/PVC, and 78% experienced a significant reduction in PVC burden during follow-up.
  • The procedure was found to be generally safe and feasible, though there were some major complications reported, indicating that Bi-RFA could be a valid option for managing refractory VT/PVC
View Article and Find Full Text PDF

Effect of adequacy of empirical antibiotic therapy for hospital-acquired bloodstream infections on intensive care unit patient prognosis: a causal inference approach using data from the Eurobact2 study.

Clin Microbiol Infect

December 2024

OUTCOMEREA Research Group, Drancy, France; Institut National de la Santé et de la Recherche Medicale, Infection Antimicrobial Modelisation Evolution, U1137, Team Decision Science in Infectious Diseases, Paris, France; Assistance Publique Hôpitaux de Paris, Bichat hospital, Medical and infectious diseases ICU, F75018, Paris France. Electronic address:

Article Synopsis
  • Hospital-acquired bloodstream infections (HA-BSI) in ICU patients can be life-threatening, and this study aimed to see how early adequate antibiotic treatment affects 28-day mortality rates for patients who survive at least one day after infection onset.
  • Using data from a multicenter study with 2,418 patients, researchers found that those who received adequate treatment within 24 hours had a lower 28-day mortality rate (32.8%) compared to those who were inadequately treated (40%).
  • The study concluded that inadequate antibiotic therapy within 24 hours contributes significantly to 28-day mortality, indicating that quicker treatment could greatly improve patient outcomes in cases of HA-BSI.
View Article and Find Full Text PDF