The prevalence of allergic diseases among Croatian school children according to the ISAAC Phase One questionnaire.

BACKGROUND: The prevalence of asthma and allergic diseases in children has been increasing worldwide over the past decades. The ISAAC Phase I results supplies valuable information on the worldwide variations in the prevalence of these diseases. Although ISAAC Phase I was completed in 56 countries, not all regions of Croatia were covered. Because of Croatia's high regional diversity, the aim was to explore the prevalence of asthma, allergic rhinitis/rhinoconjuctivitis, and atopic eczema symptoms in the Medimurje region in northern Croatia and compare the results with data from other regions in Croatia and other countries. MATERIAL/METHODS: The study was undertaken between January and April 2005 among 12- to 14-year-old children in 27 elementary schools. Data were collected using the standardized ISAAC written and asthma video questionnaires. RESULTS: A total of 3111 children participated in the study, with a participation rate of 94.33%. 27.6% of the children had symptoms of allergic diseases at some time in their life. Estimated lifetime (ever) prevalence of symptoms were: wheezing 11.86%, allergic rhinitis symptoms 12.21%, and atopic dermatitis symptoms 7.01%. Estimated 12-month prevalence rates were: wheezing 5.11%, allergic rhinitis symptoms 10.87%, allergic rhinoconjunctivitis 7.14%, and atopic dermatitis symptoms 5.34%. CONCLUSIONS: Compared with previous studies conducted in other Croatian regions (the city of Zagreb and a northern Adriatic region) using similar methods, the prevalence of asthma and allergic rhinitis was lower than in the northern Adriatic region but comparable with that in the city of Zagreb, and of atopic dermatitis symptoms in the same range.     

Computer-assisted mosaic arthroplasty using patient-specific instrument guides

Purpose  

Success of mosaic arthroplasty requires that the transplanted plugs be positioned to reconstruct the curvature and height of the original articular surface. This case report demonstrates how to achieve correct plug positioning using patient-specific instrument guides manufactured on a 3D printer.     

Lymphangioleiomyomatosis

Lymphangioleiomyomatosis (LAM) is a progressive and usually fatal interstitial lung disease characterized by an abnormal smooth-muscle proliferation in the lung and axial lymphatics. It affects almost exclusively young women of childbearing age. The presenting features most commonly include dyspnea, symptoms of pneumothorax and cough. Less commonly patients can present with chest pain, pleural or pericardial effusion and lymphedema. Our patient, a 41-year-old woman, complained mainly of fatigue that had lasted for 2 months and finally became febrile and dispneic, especially when lying down. Pulmonary diagnostic procedures revealed several multicystic destruction of lung parenchyma. There was also respiratory insufficiency with O2 saturation of 87% and lung diffusion capacity reduced to 48%. The retroperitoneum was filled with neoplastic mass as shown on an abdominal CT scan. Pathohistologic analysis of retroperitoneal mass together with the radiologic finding of the lungs correlated with the diagnosis of LAM. The patient was prescribed corticosteroid therapy, which led to rapid clinical improvement. After making a definite diagnosis, the patient was recommended further treatment with medroxyprogesterone. This case shows that LAM, although rare, can present a diagnostic problem to clinicians and should always be considered as one of the diagnostic possibilities in young women with nonspecific pulmonary symptoms.     

The population history of the Croatian linguistic minority of Molise (southern Italy): a maternal view

This study examines the mitochondrial DNA (mtDNA) diversity of the Croatian-speaking minority of Molise and evaluates its potential genetic relatedness to the neighbouring Italian groups and the Croatian parental population. Intermatch, genetic distance, and admixture analyses highlighted the genetic similarity between the Croatians of Molise and the neighbouring Italian populations and demonstrated that the Croatian-Italian ethnic minority presents features lying between Croatians and Italians. This finding was confirmed by a phylogeographic approach, which revealed both the prevalence of Croatian and the penetrance of Italian maternal lineages in the Croatian community of Molise. These results suggest that there was no reproductive isolation between the two geographically proximate, yet culturally distinct populations living in Italy. The gene flow between the Croatian-Italians and the surrounding Italian populations indicate, therefore, that ethnic consciousness has not created reproductive barriers and that the Croatian-speaking minority of Molise does not represent a reproductively isolated entity.     

多模态可视化教学在神外住院医师中的应用

目的 探讨多模态可视化教学手段对神经外科住院医师规范化培训教学中的应用效果。方法 将本院2019年1月—2020年12月40名神经外科规范化培训住院医师,按照随机数表法分为两组。对照组给予常规教学,实验组实施多模态可视化教学。比较两组教学满意度、神经外科临床理论知识成绩和神经外科临床实操分数。通过数据的比较,分析多模态可视化教学手段对神经外科住院医师规范化培训教学中的应用优势,为临床推广这种教学方式提供依据。结果 实验组的教学满意度是（94.21±3.21）分,而对照组的教学满意度是（83.55±2.21）分。实验组的教学满意度比对照组明显更高（P <0.05）。实验组神经外科临床理论知识成绩、神经外科临床实操分数均高于对照组,且差异均有统计学意义（P <0.05）。结论 神经外科规范化培训住院医师实施多模态可视化教学效果确切,在这种教学模式喜爱,可提高神经外科规范化培训住院医师的理论知识和技能掌握水平,且神经外科规范化培训住院医师对于这种教学模式的满意度高。     

The Kingston periacetabular osteotomy utilizing computer enhancement: a new technique.

OBJECTIVE: To develop a new periacetabular osteotomy technique that can be performed safely and reliably using computer-enhanced technology. MATERIALS AND METHODS: This technique uses a modified posterior approach with a trochanteric osteotomy. A 3D surface model is generated from CT data. The osteotomy is planned using custom software developed by our team. A dynamic reference body is fixed to the iliac crest and the pelvis is registered using an optically tracked probe (Optotrak, Northern Digital, Ontario, Canada). A tracked probe is used to mark the osteotomies in three dimensions. The posterior column is osteotomized between the sciatic notch and hip joint. The pubic ramus is osteotomized under fluoroscopic guidance. The acetabular fragment is rotated into a more appropriate position and fixed with pelvic reconstruction plates. Subjective and objective data are collected pre- and postoperatively. RESULTS: This procedure has been performed on eight patients. Average center-edge angle correction has been 17 degrees. The computer and optical guidance system has provided accurate information in seven of eight cases, and there have been no complications. CONCLUSIONS: This technique has enabled us to perform periacetabular osteotomies with safety and predictability. Using this computer-enhanced technique, periacetabular osteotomy may become a more common procedure in the practice of hip reconstruction surgeons.     

High tibial osteotomy compared with high tibial and Maquet procedures in medial and patellofemoral compartment osteoarthritis

The effect of adding the Maquet tibial tubercle elevating procedure to a valgus high tibial osteotomy (HTO) in combined medial and patellofemoral disease had not been established. This prospective study evaluates clinically and roentgenographically the use of this osteotomy combination versus HTO alone in dual-compartment arthritis. Forty-four patients (46 knees) with dual-compartment disease from 1979 to 1984 were evaluated. Twenty-two patients were treated with 23 HTOs by a senior surgeon, and 22 were treated with 23 combined procedures by another surgeon. The two groups were matched according to age, sex, and preoperative clinical and roentgenographic disability. The minimum follow-up period was two years. All had more than 5 degrees valgus alignment at the follow-up evaluation, with an average of 11.2 degrees in the HTO group and 10.2 degrees in the combined osteotomy group. A modified Hospital for Special Surgery assessment (maximum, 100 points) was used with an optimum pain score of 30 points. All were followed roentgenographically with grading of the three knee compartments. In both groups, the total and pain scores improved significantly postoperatively. There was no statistical difference between the two groups in terms of mean postoperative femorotibial shaft alignment or clinical and roentgenologic outcome. Although HTO was a good procedure for pain relief for dual-compartment disease, the addition of Maquet procedure did not improve the results.     

Revision total hip arthroplasty with osseous allograft reconstruction. A clinical and roentgenographic analysis

One hundred twelve irradiation-sterilized, -70 degrees frozen allografts have been used in 72 patients who were available for follow-up study in a prospective analysis of allograft revision total hip arthroplasty. Clinical objectives were achieved in 85% of patients with a follow-up period ranging from six to 72 months. Based on clinical and roentgenographic analysis, specific recommendations are made to further improve the success rate of revision total hip arthroplasty associated with protrusio, shelf, acetabular, calcar, and large fragment femoral allografts.