Neurologic recovery after penetrating craniocerebral war injury

From June 1, 1991, until December 31, 1992, 116 patients with penetrating craniocerebral war injuries inflicted at the east Slavonian front were treated at the Osijek University Hospital. There were 26 (22.4%) gunshot wounds and 90 (77.6%) wounds inflicted by explosive devices and projectiles. Four years after the injury, a study of the survivors' condition was carried out. No difference was recorded in the survival rate between the patients with gunshot wounds compared with explosive wounds. Rehabilitation produced good results in the survivors, in the prevention of both acute and chronic complications and permanent damage. Older age, lower Glasgow Coma Scale, and level of consciousness were found to be prognostic indicators of outcome.     

Psychological Problems among Head and Neck Cancer Patients in Relation to Utilization of Healthcare and Informal Care and Costs in the First Two Years after Diagnosis

Background: To investigate associations between psychological problems and the use of healthcare and informal care and total costs among head and neck cancer (HNC) patients. Method: Data were used of the NETherlands QUality of Life and Biomedical Cohort study. Anxiety and depression disorder (diagnostic interview), distress, symptoms of anxiety and depression (HADS), and fear of cancer recurrence (FCR) and cancer worry scale (CWS) were measured at baseline and at 12-month follow-up. Care use and costs (questionnaire) were measured at baseline, 3-, 6-, 12-, and 24-month follow-up. Associations between psychological problems and care use/costs were investigated using logistic and multiple regression analyses. Results: Data of 558 patients were used. Distress, symptoms of anxiety or depression, FCR, and/or anxiety disorder at baseline were significantly associated with higher use of primary care, supportive care, and/or informal care (odds ratios (ORs) between 1.55 and 4.76). Symptoms of anxiety, FCR, and/or depression disorder at 12-month follow-up were significantly associated with use of primary care, supportive care, and/or informal care (ORs between 1.74 and 6.42). Distress, symptoms of anxiety, and FCR at baseline were associated with higher total costs. Discussion: HNC patients with psychological problems make more use of healthcare and informal care and have higher costs. This is not the result of worse clinical outcomes.     

Retinal Layers Measurements following Silicone Oil Tamponade for Retinal Detachment Surgery

This study aimed to investigate the influence of silicone oil on the retinal nerve fiber layer (RNFL) thickness in patients with primary rhegmatogenous retinal detachment who underwent vitreoretinal surgery. The study included 47 patients (eyes), who underwent a pars plana vitrectomy with the silicone oil tamponade. The control group included unoperated eye of all participants. Spectral-domain optical coherence tomography (SD-OCT) was used for the measurements of peripapilar and macular RNFL thickness. The average peripapillary RNFL thickness was significantly higher in the silicone oil filled eyes during endotamponade and after its removal. The eyes with elevated IOP had less thickening of the RNFL in comparison to the eyes with normal IOP. Central macular thickness and macular volume were decreased in the silicone oil filled eyes in comparison to the control eyes. In conclusion, silicone oil caused peripapilar RNFL thickening in the vitrectomized eyes during endotamponade and after silicone oil removal.     

Influence of atmospheric versus reduced oxygen concentration on development of human blastocysts in vitro: a prospective study on sibling oocytes

Numerous studies show the beneficial effect of reduced oxygen on the culture of animal embryos in vitro. However, few similar studies have been carried out in humans, and the conclusions from these were contradictory. Using sibling human oocytes, a prospective study was carried out to analyse the effect of 5 and 20% oxygen on prolonged development of embryos. The outcomes measured were fertilization rate and proportion of morphologically optimal embryos, blastocysts and optimal blastocysts developing on day 5. The results were analysed separately for the group of IVF (n = 988 oocytes) and ICSI (n = 928 oocytes) cycles. It was found that low oxygen did not influence fertilization, but in comparison with 20% oxygen, it resulted in a significantly higher proportion of embryos being optimal on day 3 after IVF (59 versus 43.2%; P < 0.001) as well as after ICSI cycles (51.2 versus 28.5%; P < 0.001). In both methods, the lower oxygen concentration improved the blastulation rate (73.2 versus 63.1%; P < 0.05 and 67.4 versus 54.7%; P < 0.001) and increased the proportion of embryos reaching the stage of expanded blastocyst with normal inner cell mass on day 5 (31.1 versus 14.6%; P < 0.001 and 18.9 versus 11.4%; P < 0.01). The ratio of successful embryo development to optimal blastocyst stage on day 5 of culture, calculated for two oxygen concentrations, was 2.1 for IVF and 1.7 for ICSI, in favour of lower oxygen tension.     

Leiomyoma of the uterus and retroperitoneal angioleiomyoma: case report

Retroperitoneal angioleiomyoma is a benign mesenchymal neoplasm that is composed of smooth muscle cells and thick-walled vessels. In a 36-year-old patient a retrouterine and retroperitoneal tumor, 70 x 65 x 50 mm in size, was discovered during a surgical procedure due to uterine myoma. The tumor had a soft consistency and was completely removed. Histopathology showed features of angioleiomyoma. Angioleiomyoma is a rare benign entity; hence a benign course and good prognosis are expected.     

Single fresh and frozen-thawed blastocyst transfer using hyaluronan-rich transfer medium

The purpose of this prospective randomized study was to evaluate use of a hyaluronan-rich transfer medium in fresh and frozen-thawed single blastocyst transfer. The study included 279 single blastocyst transfers in women aged<37 years in their first, second or third treatment cycle. According to the type of single blastocyst transfer (fresh elective or frozen-thawed) the women were divided into two study and two control groups. In both study groups (n=130) transfers were performed using hyaluronan and in the control groups (n=149) a conventional transfer medium was used. The results indicate that fresh elective single blastocyst transfer with hyaluronan results in significantly higher pregnancy rates in a selected subgroup of women; those with >or=2 blastocysts developed to day 5 and a previous implantation failure (55% versus 10%; P=0.012). Overall pregnancy rates after fresh elective and frozen-thawed single blastocyst transfer were similar in both study and control groups.     

Zur Frage der Existenz Eines Besonderen Thyreotropen Hormons für Kaltblüter

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