Damir Mihić - Academia.edu (original) (raw)

Papers by Damir Mihić

Hemoadsorption as adjunctive therapy in patients with infective endocarditis of the aortic valve: a case report

Cardiologia Croatica

Prognostic significance of inflammatory scoring systems in critically ill patients with COVID-19 infection

Medica Jadertina

Aim: The outbreak of novel coronavirus pneumonia that was first detected in Wuhan in December 201... more Aim: The outbreak of novel coronavirus pneumonia that was first detected in Wuhan in December 2019 resulted in a worldwide pandemic. Approximately 25% of confirmed cases developed a severe disease and the need for intensive care unit admission. The aim of this study was to determine the role of three inflammatory scoring systems, C-reactive protein/albumin ratio, fibrinogen/albumin ratio, C-reactive protein/lymphocyte ratio and their association with survival, comorbidities, and the occurrence of additional complications in the intensive care of these patients. Materials and methods: This retrospective study was conducted based on data collected by the Department of Respiratory Center. Ethical approval for the study was obtained from the Ethics Committee of Osijek University Hospital. This study analysed data retrospectively between October and December 2020, and included 137 critically ill patients with a diagnosis of COVID-19. Results: Data analysis of three examined inflammatory ...

Case Reports in Medicine, May 28, 2022

Lemierre's syndrome refers to the septic thrombophlebitis of the internal jugular vein. e conditi... more Lemierre's syndrome refers to the septic thrombophlebitis of the internal jugular vein. e condition typically begins with an oropharyngeal infection and frequently involves in ammation within the wall of the vein, infected thrombus within the lumen, surrounding soft tissue in ammation, persistent bacteremia, and septic emboli. Lemierre's syndrome is a rare disease; it occurs most commonly in otherwise healthy young adults. e most common etiologic agent is Fusobacterium necrophorum. We present a case of Lemierre's syndrome in a young girl and the role of extracorporeal method of blood puri cation with continuous venous hemodia ltration with the use of a highly adsorptive membrane (AN69 HeprAN), thus achieving the combined elimination of cytokines and endotoxins. e use of advanced methods, along with an antibiotic and surgical treatment, will certainly help reduce mortality in this syndrome.

Pathohistological association of right heart collagen with waist circumference: preliminary data

Ateroskleroza.emed.hr, 2021

Medicina

Nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) have significant r... more Nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) have significant roles in the development of a hyperinflammatory state in infectious diseases. We aimed to investigate the association of the serum concentrations of Nrf2 and HO-1 with the severity of COVID-19 disease. The study included 40 subjects with mild and moderately severe forms of the disease (MEWS scoring system ≤2). Twenty of the subjects had MEWS scores of 3 or 4, which indicate a severe form of the disease, and twenty subjects had a MEWS score of ≥5, which indicates a critical form of the disease. HO-1 and Nrf2 were measured using the commercially available Enzyme-Linked Immunosorbent Assay (ELISA). Subjects with the most severe form of COVID-19 (critically ill) had a lower concentration of Nrf2 that negatively correlated with the markers of hyperinflammatory response (CRP, IL-6, ferritin). This observation was not made for HO-1, and the correlation between Nrf2 and HO-1 values was not establ...

Cannabis and Cannabinoid Research

Background: One of the major challenges in improving sepsis care is early prediction of sepsis co... more Background: One of the major challenges in improving sepsis care is early prediction of sepsis complications. The endocannabinoid system has been intensely studied in recent years; however, little is known about its role in sepsis in humans. This study aimed to assess the prognostic role of endocannabinoids, anandamide (AEA) and 2arachidonoylglycerol (2-AG), as early predictors of mortality, invasive mechanical ventilation (IMV) requirement, and length of stay (LOS) in patients with sepsis. Materials and Methods: In total, 106 patients with confirmed sepsis were enrolled in this study. The patients were divided into groups according to mortality outcome (survival, N = 53; nonsurvival, N = 53), IMV requirement (IMV group, N = 26; non-IMV group, N = 80), and LOS (LOS < 10 days, N = 59; LOS ‡ 10 days, N = 47). Patients' clinical status was assessed along with laboratory biomarkers as well as AEA and 2-AG concentration measurements early on admission to emergency units. AEA and 2-AG levels were measured by enzyme-linked immunosorbent assay (ELISA) using an ELISA processor, EtiMax 3000 (DiaSorin, Saluggia, Italy). The predictive value of AEA and 2-AG for the studied sepsis outcomes and complications was analyzed using univariate and multivariate analyses and receiver operating characteristic (ROC) curve analysis. Results: Two endocannabinoids showed no significant difference between survivors and nonsurvivors, although an AEA concentration < 7.16 lg/L predicted mortality outcome with a sensitivity of 57% (95% confidence interval [CI] 42-71) and specificity of 80% (95% CI 66-91). AEA concentrations £ 17.84 lg/L predicted LOS ‡ 10 days with sensitivity of 98% (95% CI 89-100) and specificity of 34% (95% CI 22-47). When analyzing IMV requirement, levels of AEA and 2-AG were significantly lower within the IMV group compared with the non-IMV group (5.94 lg/L [2.04-9.44] and 6.70 lg/L [3.50-27.04], p = 0.043, and 5.68 lg/L [2.30-8.60] and 9.58 lg/L [4.83-40.05], p = 0.002, respectively). The 2-AG showed the best performance for IMV requirement prediction, with both sensitivity and specificity of 69% (p < 0.001). Endocannabinoid AEA was an independent risk factor of LOS ‡ 10 days (odds ratio [OR] 23.59; 95% CI 3.03-183.83; p = 0.003) and IMV requirement in sepsis (OR 0.79; 95% CI, 0.67-0.93; p = 0.004). Conclusion: Low AEA concentration is a prognostic factor of hospital LOS longer than 10 days. Lower AEA and 2-AG concentrations obtained at the time of admission to the hospital are predictors of IMV requirement.

Clinical Medicine Insights: Cardiology, 2021

Visceral adipose tissue is an independent risk factor for the development of atherosclerotic coro... more Visceral adipose tissue is an independent risk factor for the development of atherosclerotic coronary disease, arterial hypertension, diabetes and metabolic syndrome. Right heart morphology often involves the presence of adipose tissue, which can be quantified by non-invasive imaging methods. The last decade brought a wealth of new insights into the function and morphology of adipose tissue, with great emphasis on its role in the pathogenesis of heart disease. Cardiac adipose tissue is involved in thermogenesis, mechanical protection of the heart and energy storage. However, it can also be an endocrine organ that synthesises numerous pro-inflammatory and anti-inflammatory cytokines, the effect of which is accomplished by paracrine and vasocrine mechanisms. Visceral adipose tissue has several compartments that differ in their embryological origin and vascularisation. Deficiency of cardiac adipose tissue, often due to chronic pathological conditions such as oncological diseases or chr...

Epikardijalno masno tkivo (EMT) ekstraabdominalno je visceralno masno tkivo smješteno između miok... more Epikardijalno masno tkivo (EMT) ekstraabdominalno je visceralno masno tkivo smješteno između miokarda i visceralnog lista perikarda s kojima je embriološki, anatomski i funkcionalno povezano. Debljina epikardijalnoga masnog tkiva danas je prepoznata kao nezavisni rizični čimbenik koronarne bolesti srca (KBS), o čemu svjedoči sve veći broj kliničkih studija. Povećani volumen epikardijalnoga masnog tkiva povezan je s kroničnom upalom i povećanim lučenjem proupalnih citokina koji pogoduju i promoviraju proces aterogeneze. Standardiziranim postupkom ultrazvučnog mjerenja debljine epikardijalnoga masnog tkiva lateralnog zida desnog ventrikula može se s velikom sigurnošću predvidjeti postojanje KBS-a, a uz pomoć kompjutorizirane tomografije ili magnetske rezonancije predvidjeti i rizik od mogućega koronarnog događaja. Povezanost debljine i upale epikardijalnoga masnog tkiva s KBS-om nameće ideju o potencijalnim terapijskim intervencijama radi usporavanja procesa aterogeneze.Epicardial fat...

Based on the clinical experience, it has been observed that when it comes to the impact of SARS-C... more Based on the clinical experience, it has been observed that when it comes to the impact of SARS-CoV-2 virus on the cardiovascular system, it is significant. In patients with COVID-19 infection, the development of myocarditis occurs a few days after the onset of fever. The mechanism of myocardial injury alone, as well as most pathologies caused by the SARS-CoV-2 virus, is the subject of research by many experts, but two basic ways can certainly be assumed: a direct toxic effect of SARS-CoV-2 on myocardial cells and another possible way of myocardial injury is to activate the innate immune response by releasing proinflammatory cytokines, as well as to activate the adaptive mechanisms of the autoimmune type by molecular mimicry. The approach to treatment is the same as for other viral myocarditis; it is non-specific, applied supportive treatment, such as anti-inflammatory drugs, low-dose corticosteroid therapy, and immunoglobulins. The aim of this review is to present the previous expe...

Epikardijalno masno tkivo i koronarna bolest srca

Epicardial fat tissue is extraabdominal visceral fat tissue located between the myocardial muscle... more Epicardial fat tissue is extraabdominal visceral fat tissue located between the myocardial muscle and the visceral pericard and connected to it embryonally and functionally. A large number of clinical studies support the claim that the epicardial adipose tissue thickness is an independent risk factor for coronary disease. The enlarged volume of the epicardial fat tissue is connected to chronical inflammation and strong production of anti inflammatory cytokines which entice the atherogenesis. Coronary disease can be predicted by standard measurement of the epicardial fat thickness of the right ventricle lateral wall. Thus it is possible to predict the risk of a coronary incident by conducting a CT or MR scan. The correlation between epicardial fat thickness and inflammation of the fat tissue suggests the possibility of potential therapeutical interventions with the aim to delay aterogenesis.

Clinical Medicine Insights: Cardiology

International Journal of Case Reports and Images, 2019

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) has become the primary tool f... more Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) has become the primary tool for the treatment of biliary and pancreatic stone diseases. Systemic air embolisms are a rare, but often a fatal complication of ERCP. Case Report: We present a 56-year-old woman, who was hospitalized for routine, elective ERCP due to recurrent cholangitis. The procedure complicated by development systemic air embolism with myocardial and cerebral ischemia. A transesophageal ultrasound was confirmed patent foramen ovale (PFO). Magnetic resonance imaging (MRI) of brain was done and it showed numerous zones of relatively fresh ischemic lesions through both hemispheres of the brain. The patient has survived but with serious consequences. One year after the incident, the patient presented with paresis of the right hand, walking with the assistance. Conclusion: Systemic air embolism presents a rare, but lifethreatening complication, particularly with persons at an increased risk, that is, with a leftto-right shunt.