Ines Brajac - Academia.edu (original) (raw)
Papers by Ines Brajac
International journal of molecular sciences, May 22, 2024
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
British Journal of Dermatology, Nov 24, 2021
DEAR EDITOR, A 49-year-old man with an unremarkable medical history presented with a generalized ... more DEAR EDITOR, A 49-year-old man with an unremarkable medical history presented with a generalized painful rash 10 days after he was given his first dose of the SARS-CoV-2 Oxford AstraZeneca vaccine. He had erythematous papules and targetoid plaques, along with haemorrhagic blisters on his hands and feet (a–d). Histopathological analysis revealed a dense perivascular, periadnexal and diffuse neutrophilic infiltrate with marked leucocytoclasia involving the upper and mid-dermis. There was massive oedema of the papillary dermis, resulting in subepidermal blistering with extravasated erythrocytes (e, f). These findings were consistent with Sweet syndrome. The patient responded well to systemic corticosteroids, thromboprophylaxis and hyperbaric oxygen therapy. We decided not to recommend the second dose of vaccine in our patient, considering a possible link between vaccination and Sweet syndrome. T. Zagar, N. Hla ca iD , I. Brajac, L. Prpi c-Massari, S. Peternel iD 1,2 and M. Ka stelan Department of Dermatovenereology, Clinical Hospital Centre Rijeka, Rijeka, Croatia; and Faculty of Medicine, University of Rijeka, Rijeka, Croatia
Dermatologic Therapy, Sep 7, 2022
The inheritance of psoriasis is polygenic. One locus is with certainity located within the 6p chr... more The inheritance of psoriasis is polygenic. One locus is with certainity located within the 6p chromosome MHC region. Due to linkage disequilibrium in MHC region, Cw6 allele is associated with B57, DRB1*0701, DQA1*0201 and DQB1*0201 or DQB1*0303 alleles, forming the Caucasian extended haplotype EH-57.1 named according to the B allele. We therefore analyzed the distribution of Caucasian extended haplotype in Croatian patients with psoriasis by hibridization with specific oligonucleotides. Type I psoriasis (early onset, positive family history) showed significant association with DRB1*0701 (p 0.00001), DQA1*0201 (p 0.00001), DQB1*0201 (p=0.0006) and DQB1*0303 alleles (p=0.0008). Patients with type II psoriasis (late onset, no family history) did not show association with any class II alleles. The Caucasian extended haplotype Cw*0602-B57-DRB1*0701-DQA1*0201-DQB1*0201 was with significantly higher frequency present in type I patients (p 0.00001 ; RR=7.72). This haplotype did not appear at all in type II psoriatics. Our results show that type I but not type II psoriasis is associated with Cw*0602-B57-DRB1*0701-DQA1*0201-DQB1*0201 extended haplotype in Croatian population.
U poglavlju opisane su upalne bolesti folikula dlake koje dovode do trajnog gubitka dlake uz razv... more U poglavlju opisane su upalne bolesti folikula dlake koje dovode do trajnog gubitka dlake uz razvoj ožiljkastog tkiva. Opisana je etiopatogeneza, klinicka slika te lijece nje navedenih bolesti.
Acta Dermatovenerologica Croatica, Mar 13, 2009
Infliximab is an anti-tumor necrosis factor-monoclonal antibody shown to be effective in the trea... more Infliximab is an anti-tumor necrosis factor-monoclonal antibody shown to be effective in the treatment of moderate-to-severe psoriasis and psoriatic arthritis. We report on the first two patients in Croatia in which the efficacy of infliximab therapy was monitored and evaluated primarily on the basis of cutaneous manifestations of psoriasis. Both patients had severe, treatment-resistant chronic plaque psoriasis and psoriatic arthritis and were on methotrexate therapy before the initiation and throughout the course of infliximab treatment. Infliximab was administered intravenously at a dose of 4 or 5 mg/kg at week 0, 2, 6 and every 8 weeks thereafter. Disease severity was measured before each infusion by means of Psoriasis Area and Severity Index (PASI) score. A remarkable clinical response was achieved in both patients with a 50% or greater improvement in baseline PASI at week 2 after therapy initiation and a 90% or greater improvement at week 6 in one patient and at week 14 in the other. Both patients also reported a significant decline in their arthritis symptoms shortly after the introduction of infliximab. The concomitant use of infliximab and methotrexate in these two patients resulted in rapid and sustained remission of psoriasis with no major adverse effects detected.
Journal of Chemotherapy, 1997
This single-blind (investigator) comparative study was designed to determine the efficacy and tol... more This single-blind (investigator) comparative study was designed to determine the efficacy and tolerability of 1 g of azithromycin vs 500 mg of ciprofloxacin both given as a single oral dose in patients with gonorrhea, who were constantly on the move. One hundred eight patients (59 men and 49 women) with clinically suspected gonococcal infection, confirmed by Gram-stain and culture, were enrolled. Data of 50 patients treated with azithromycin and 51 with ciprofloxacin were evaluable for efficacy and tolerability at the end of the study. After 2 weeks clinical and microbiological cure rates were 96.0% (48 out of 50) for the patients treated with azithromycin and 92.15% (47 out of 51) for the patients treated with ciprofloxacin (p > 0.05). Adverse reactions were reported in 5 patients treated with azithromycin and 6 with ciprofloxacin. In conclusion, 1 g azithromycin is at least as clinically and microbiologically effective and well tolerated as 500 mg of ciprofloxacin in the treatment of gonococcal infections. The drug is particularly useful for sailors and people constantly on the move.
Psoriasis is one of the most common chronic inflammatory skin disorders worldwide with a signific... more Psoriasis is one of the most common chronic inflammatory skin disorders worldwide with a significant number of patients suffering from moderate to severe disease and requiring systemic therapy. Over the past two decades, better knowledge of disease pathophysiology has translated into treatment advances for both primary disease and its associated comorbidities. However, it is important to review the use of biologic or targeted therapy in a clinical setting in order to understand how to optimize therapeutic results and recognize any unmet needs in this patient subpopulation. We conducted a retrospective study on a cohort of patients diagnosed with psoriasis that had received at least one dose of biologic or targeted therapy for the treatment of psoriasis at the Rijeka Clinical Hospital Center. By documenting treatment trends and specific patient characteristics, we will be able to address any unmet needs in this patient population and provide individualized care strategies.
Sažetak. Procjenjuje se da virusne infekcije pridonose nastanku 15-20 % svih malignih tumora ljud... more Sažetak. Procjenjuje se da virusne infekcije pridonose nastanku 15-20 % svih malignih tumora ljudi. Kao obligatorni intracelularni paraziti, virusi kodiraju proteine koji reprogramiraju signalne puteve odgovorne za kontrolu proliferacije, diferencijacije, smrti stanice, genomskog integriteta, kao i prepoznavanja od strane imunološkog sustava. Virusni sustavi podržavaju koncept da je za razvoj tumora potrebna akumulacija međusobno povezanih događaja. Virusi koji su do sada prihvaćeni kao etiološki čimbenici ljudskih malignoma uključuju hepatitis B virus, Epstein-Barr virus, humani papiloma virus, virus leukemije ljudskih T-stanica, hepatitis C virus, te još nekoliko ljudskih onkogenih virusa. Obično protekne niz godina od infekcije do razvoja tumora i većina inficiranih osoba ne razvije rak, iako imunološki kompromitirane osobe pokazuju veći rizik za nastanak tumora povezanih s virusima. Malo je vjerojatno da je virus sam dovoljan da transformira normalnu stanicu u tumorsku. Vjerojatnija je mogućnost da kombinirano djelovanje virusnih proteina i mutacije staničnih gena zajedno vode tumorogenezi.
PubMed, Jun 1, 2018
The clinical triad of pyoderma gangrenosum (PG), acne and suppurative hidradenitis (HS) has been ... more The clinical triad of pyoderma gangrenosum (PG), acne and suppurative hidradenitis (HS) has been described under the acronym PASH syndrome and is considered to represent a distinct entity in the group of autoinflammatory diseases. It is a fairly new, only recently recognized disorder with a limited number of reported cases and without defined treatment recommendations. We aimed to summarize currently available data on the use of tumor necrosis factor (TNF) antagonists in the management of PASH syndrome and report on our own experience with the use of adalimumab in a patient presenting with this specific constellation of clinical signs and symptoms. Among the 11 cases identified in the literature, infliximab and adalimumab were the most commonly used agents, both exhibiting favorable effects in the majority of, but not all, patients. This was particularly evident in terms of relatively rapid remission of PG whereas HS lesions seemed to be more resistant to treatment. In our patient, adalimumab monotherapy resulted in a remarkable and sustained remission, although significant improvement of HS lesions was observed only from week 16 of therapy onwards. In summary, TNF antagonists are a promising treatment for PASH; however, conclusions regarding the choice of a specific agent, optimal dosing or use in combination with other treatment modalities cannot yet be drawn.
Sexually transmitted infections (STIs) are the major global cause of acute illnesess, long term d... more Sexually transmitted infections (STIs) are the major global cause of acute illnesess, long term disability, and infertility with severe medical and psychological consequences. It is not unusual that patients presenting with symptoms of single STI, have multiple underlaying STIs at the same time. Therefore, it is important to understand the significance of revealing and diagnosing multiple STIs. Our recent pilot study in 2007 that included patients presenting with STI, determined the incidence of the concurrent STI among 49 participants. The aim of this study was to asses the incidence of concurrent STIs conducted on a larger population of STI patients. A total of 402 patients attending Department of Dermatovenereology were included. Based on the anamnesis, presenting clinical symptoms and laboratory test results they were given the STI diagnosis. All of the participants were tested for seven STIs: syphilis, gonorrhoea, trichomoniasis, candidiasis, Human papilloma virus, HIV, Chlamydia trachomatis and Herpes genitalis. Because females usually seek for medical treatment at gynaecologyst, the majority of participants were males. This study presents multiple concurrent STIs among patients that family doctors, dermatovenereologists and gynaecologists should be aware of when treating STI patients.
International journal of molecular sciences, May 22, 2024
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
British Journal of Dermatology, Nov 24, 2021
DEAR EDITOR, A 49-year-old man with an unremarkable medical history presented with a generalized ... more DEAR EDITOR, A 49-year-old man with an unremarkable medical history presented with a generalized painful rash 10 days after he was given his first dose of the SARS-CoV-2 Oxford AstraZeneca vaccine. He had erythematous papules and targetoid plaques, along with haemorrhagic blisters on his hands and feet (a–d). Histopathological analysis revealed a dense perivascular, periadnexal and diffuse neutrophilic infiltrate with marked leucocytoclasia involving the upper and mid-dermis. There was massive oedema of the papillary dermis, resulting in subepidermal blistering with extravasated erythrocytes (e, f). These findings were consistent with Sweet syndrome. The patient responded well to systemic corticosteroids, thromboprophylaxis and hyperbaric oxygen therapy. We decided not to recommend the second dose of vaccine in our patient, considering a possible link between vaccination and Sweet syndrome. T. Zagar, N. Hla ca iD , I. Brajac, L. Prpi c-Massari, S. Peternel iD 1,2 and M. Ka stelan Department of Dermatovenereology, Clinical Hospital Centre Rijeka, Rijeka, Croatia; and Faculty of Medicine, University of Rijeka, Rijeka, Croatia
Dermatologic Therapy, Sep 7, 2022
The inheritance of psoriasis is polygenic. One locus is with certainity located within the 6p chr... more The inheritance of psoriasis is polygenic. One locus is with certainity located within the 6p chromosome MHC region. Due to linkage disequilibrium in MHC region, Cw6 allele is associated with B57, DRB1*0701, DQA1*0201 and DQB1*0201 or DQB1*0303 alleles, forming the Caucasian extended haplotype EH-57.1 named according to the B allele. We therefore analyzed the distribution of Caucasian extended haplotype in Croatian patients with psoriasis by hibridization with specific oligonucleotides. Type I psoriasis (early onset, positive family history) showed significant association with DRB1*0701 (p 0.00001), DQA1*0201 (p 0.00001), DQB1*0201 (p=0.0006) and DQB1*0303 alleles (p=0.0008). Patients with type II psoriasis (late onset, no family history) did not show association with any class II alleles. The Caucasian extended haplotype Cw*0602-B57-DRB1*0701-DQA1*0201-DQB1*0201 was with significantly higher frequency present in type I patients (p 0.00001 ; RR=7.72). This haplotype did not appear at all in type II psoriatics. Our results show that type I but not type II psoriasis is associated with Cw*0602-B57-DRB1*0701-DQA1*0201-DQB1*0201 extended haplotype in Croatian population.
U poglavlju opisane su upalne bolesti folikula dlake koje dovode do trajnog gubitka dlake uz razv... more U poglavlju opisane su upalne bolesti folikula dlake koje dovode do trajnog gubitka dlake uz razvoj ožiljkastog tkiva. Opisana je etiopatogeneza, klinicka slika te lijece nje navedenih bolesti.
Acta Dermatovenerologica Croatica, Mar 13, 2009
Infliximab is an anti-tumor necrosis factor-monoclonal antibody shown to be effective in the trea... more Infliximab is an anti-tumor necrosis factor-monoclonal antibody shown to be effective in the treatment of moderate-to-severe psoriasis and psoriatic arthritis. We report on the first two patients in Croatia in which the efficacy of infliximab therapy was monitored and evaluated primarily on the basis of cutaneous manifestations of psoriasis. Both patients had severe, treatment-resistant chronic plaque psoriasis and psoriatic arthritis and were on methotrexate therapy before the initiation and throughout the course of infliximab treatment. Infliximab was administered intravenously at a dose of 4 or 5 mg/kg at week 0, 2, 6 and every 8 weeks thereafter. Disease severity was measured before each infusion by means of Psoriasis Area and Severity Index (PASI) score. A remarkable clinical response was achieved in both patients with a 50% or greater improvement in baseline PASI at week 2 after therapy initiation and a 90% or greater improvement at week 6 in one patient and at week 14 in the other. Both patients also reported a significant decline in their arthritis symptoms shortly after the introduction of infliximab. The concomitant use of infliximab and methotrexate in these two patients resulted in rapid and sustained remission of psoriasis with no major adverse effects detected.
Journal of Chemotherapy, 1997
This single-blind (investigator) comparative study was designed to determine the efficacy and tol... more This single-blind (investigator) comparative study was designed to determine the efficacy and tolerability of 1 g of azithromycin vs 500 mg of ciprofloxacin both given as a single oral dose in patients with gonorrhea, who were constantly on the move. One hundred eight patients (59 men and 49 women) with clinically suspected gonococcal infection, confirmed by Gram-stain and culture, were enrolled. Data of 50 patients treated with azithromycin and 51 with ciprofloxacin were evaluable for efficacy and tolerability at the end of the study. After 2 weeks clinical and microbiological cure rates were 96.0% (48 out of 50) for the patients treated with azithromycin and 92.15% (47 out of 51) for the patients treated with ciprofloxacin (p > 0.05). Adverse reactions were reported in 5 patients treated with azithromycin and 6 with ciprofloxacin. In conclusion, 1 g azithromycin is at least as clinically and microbiologically effective and well tolerated as 500 mg of ciprofloxacin in the treatment of gonococcal infections. The drug is particularly useful for sailors and people constantly on the move.
Psoriasis is one of the most common chronic inflammatory skin disorders worldwide with a signific... more Psoriasis is one of the most common chronic inflammatory skin disorders worldwide with a significant number of patients suffering from moderate to severe disease and requiring systemic therapy. Over the past two decades, better knowledge of disease pathophysiology has translated into treatment advances for both primary disease and its associated comorbidities. However, it is important to review the use of biologic or targeted therapy in a clinical setting in order to understand how to optimize therapeutic results and recognize any unmet needs in this patient subpopulation. We conducted a retrospective study on a cohort of patients diagnosed with psoriasis that had received at least one dose of biologic or targeted therapy for the treatment of psoriasis at the Rijeka Clinical Hospital Center. By documenting treatment trends and specific patient characteristics, we will be able to address any unmet needs in this patient population and provide individualized care strategies.
Sažetak. Procjenjuje se da virusne infekcije pridonose nastanku 15-20 % svih malignih tumora ljud... more Sažetak. Procjenjuje se da virusne infekcije pridonose nastanku 15-20 % svih malignih tumora ljudi. Kao obligatorni intracelularni paraziti, virusi kodiraju proteine koji reprogramiraju signalne puteve odgovorne za kontrolu proliferacije, diferencijacije, smrti stanice, genomskog integriteta, kao i prepoznavanja od strane imunološkog sustava. Virusni sustavi podržavaju koncept da je za razvoj tumora potrebna akumulacija međusobno povezanih događaja. Virusi koji su do sada prihvaćeni kao etiološki čimbenici ljudskih malignoma uključuju hepatitis B virus, Epstein-Barr virus, humani papiloma virus, virus leukemije ljudskih T-stanica, hepatitis C virus, te još nekoliko ljudskih onkogenih virusa. Obično protekne niz godina od infekcije do razvoja tumora i većina inficiranih osoba ne razvije rak, iako imunološki kompromitirane osobe pokazuju veći rizik za nastanak tumora povezanih s virusima. Malo je vjerojatno da je virus sam dovoljan da transformira normalnu stanicu u tumorsku. Vjerojatnija je mogućnost da kombinirano djelovanje virusnih proteina i mutacije staničnih gena zajedno vode tumorogenezi.
PubMed, Jun 1, 2018
The clinical triad of pyoderma gangrenosum (PG), acne and suppurative hidradenitis (HS) has been ... more The clinical triad of pyoderma gangrenosum (PG), acne and suppurative hidradenitis (HS) has been described under the acronym PASH syndrome and is considered to represent a distinct entity in the group of autoinflammatory diseases. It is a fairly new, only recently recognized disorder with a limited number of reported cases and without defined treatment recommendations. We aimed to summarize currently available data on the use of tumor necrosis factor (TNF) antagonists in the management of PASH syndrome and report on our own experience with the use of adalimumab in a patient presenting with this specific constellation of clinical signs and symptoms. Among the 11 cases identified in the literature, infliximab and adalimumab were the most commonly used agents, both exhibiting favorable effects in the majority of, but not all, patients. This was particularly evident in terms of relatively rapid remission of PG whereas HS lesions seemed to be more resistant to treatment. In our patient, adalimumab monotherapy resulted in a remarkable and sustained remission, although significant improvement of HS lesions was observed only from week 16 of therapy onwards. In summary, TNF antagonists are a promising treatment for PASH; however, conclusions regarding the choice of a specific agent, optimal dosing or use in combination with other treatment modalities cannot yet be drawn.
Sexually transmitted infections (STIs) are the major global cause of acute illnesess, long term d... more Sexually transmitted infections (STIs) are the major global cause of acute illnesess, long term disability, and infertility with severe medical and psychological consequences. It is not unusual that patients presenting with symptoms of single STI, have multiple underlaying STIs at the same time. Therefore, it is important to understand the significance of revealing and diagnosing multiple STIs. Our recent pilot study in 2007 that included patients presenting with STI, determined the incidence of the concurrent STI among 49 participants. The aim of this study was to asses the incidence of concurrent STIs conducted on a larger population of STI patients. A total of 402 patients attending Department of Dermatovenereology were included. Based on the anamnesis, presenting clinical symptoms and laboratory test results they were given the STI diagnosis. All of the participants were tested for seven STIs: syphilis, gonorrhoea, trichomoniasis, candidiasis, Human papilloma virus, HIV, Chlamydia trachomatis and Herpes genitalis. Because females usually seek for medical treatment at gynaecologyst, the majority of participants were males. This study presents multiple concurrent STIs among patients that family doctors, dermatovenereologists and gynaecologists should be aware of when treating STI patients.