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    Branimir Anić

    The aim of the study was to investigate correlation of vitamin D status meassured as 25-hydoxyvitamin D (25(OH)D) concentration with bone mineral density (BMD) in Croatian postmenopausal women. This study was based on the sample of 194... more
    The aim of the study was to investigate correlation of vitamin D status meassured as 25-hydoxyvitamin D (25(OH)D) concentration with bone mineral density (BMD) in Croatian postmenopausal women. This study was based on the sample of 194 adult, postmenopausal women aged 50 years or over from Croatia. Assessment of 25(OH)D concentration and BMD by dual-energy xray absorptiometry (DXA) was performed to all participants. The average age of the participants in this study was 60.6 years. The average menopause duration was 11.4 years. Among the included participants only 13.9% of women complied with diagnostic criteria for osteoporosis. Mean serum concentration of 25(OH)D was 49.1 nmol/L (+/-17.1 SD). The prevalence of severe vitamin D deficiency was significantly higher in participants with osteoporosis compared with participants with normal BMD (<30 nmol/L; 29.6% vs. 9.8%). Correlation between serum 25(OH)D concentration and BMD was significant and positive at the proximal femur (r=0.1...
    Hidradenitis suppurativa is a chronic inflammatory disorder characterized by occlusion of the follicular pilosebaceous units of the skin. The treatment options are sometimes very limited and unpleasant odor and abundant drainage... more
    Hidradenitis suppurativa is a chronic inflammatory disorder characterized by occlusion of the follicular pilosebaceous units of the skin. The treatment options are sometimes very limited and unpleasant odor and abundant drainage complicate the disease. Ankylosing spondylitis is a form of seronegative spondyloarthritis with predominantly axial but also peripheral joint involvement. Both of the conditions lower the patient’s quality of life and affect everyday activities. We describe a 39-year-old male patient with both diseases treated with different medications with only a modest result. After the initiation of a tumor necrosis factor α (TNF-α) inhibitor (adalimumab) the patient experienced first the musculoskeletal and later on the skin improvement. The introduction of TNF-α inhibitors should be considered early in the treatment of overlapping hidradenitis suppurativa and the spondyloarthritis spectrum of conditions. Available medical data confirm the positive results and beneficia...
    treatment of inflammatory rheumatic diseases and control of disease activity have considerably improved after the introduction of biologic therapy over a decade ago. The safety profile of biologic therapy in the preconception period as... more
    treatment of inflammatory rheumatic diseases and control of disease activity have considerably improved after the introduction of biologic therapy over a decade ago. The safety profile of biologic therapy in the preconception period as well as during pregnancy and lactation is neccessary to consider when planning the treatment of young female patients. neither the Food and drug administration agency nor the european Medicines agency have declared biologic therapy safe during pregnancy. Both the european league against rheumatism and the British society for rheumatology proposed guidelines for the treatment of female rheumatology patients during pregnancy and lactation, and the american college of rheumatology is currently developing guidelines for the therapeutic approach during pregnancy. on the other hand, there are numerous publications of pregnancy outcomes in patients treated with biologic therapy, with a small number of adverse effects. We analyzed the modalities of biologic t...
    In this study, we aimed to assess the prevalence of uncommon staining patterns found during testing for the presence of antinuclear antibodies (ANA) and to determine their association with certain antibodies and clinical diagnoses.... more
    In this study, we aimed to assess the prevalence of uncommon staining patterns found during testing for the presence of antinuclear antibodies (ANA) and to determine their association with certain antibodies and clinical diagnoses. Presence of ANA and the staining pattern was determined in 10955 samples using indirect immunofluorescence (IIF) on HEp-2 cells. ANA-positive samples were assessed for presence of 14 specific antibody types using a microbead based system. Demographic data (age, sex) and clinical diagnoses were collected from the referral documentation. Particular staining patterns were then compared with a representative comparison group comprised of samples with common staining patterns using these criteria. There were 22 patterns present in less than 3% of samples each and these were jointly present in 42.43% of ANA-positive samples. Specific antibodies were found in proportions similar to the comparison group (46.06%) and varied significantly between patterns. Likewise...
    Experts in the field of rheu-matoid arthritis, psoriatic arthritis and disease-modifying anti-rheumatic drug (DMARD) therapy shared their knowledge of the latest advances in arthritis care. Lecturers were the most distinguished European... more
    Experts in the field of rheu-matoid arthritis, psoriatic arthritis and disease-modifying anti-rheumatic drug (DMARD) therapy shared their knowledge of the latest advances in arthritis care. Lecturers were the most distinguished European rheuma-tologists, Professorswell. Cochairs were Professors Josef Smolen and Piet van Riel. Advances in our understanding of the mechanism of action of DMARD therapy were thoroughly explained , the benefits of monotherapy and combination therapy were evaluated, highlighting the potential advantages of the newest therapies. Apart from plenary sessions, parallel interactive workshops utilizing pertinent case studies were held to discuss these topics in detail. The insight gained at the meeting enabled the participants to address the patient needs more effectively using current and novel treatments for rheuma-toid arthritis and psoriatic arthritis. Before the beginning of the meeting, written materials in three areas were distributed to the participants:...
    Capillaroscopy is a noninvasive and harmless morphological method for examination of the nailfold capillaries in both suspected and already diagnosed patients with systemic connective disease. The most useful aspect is in discrimination... more
    Capillaroscopy is a noninvasive and harmless morphological method for examination of the nailfold capillaries in both suspected and already diagnosed patients with systemic connective disease. The most useful aspect is in discrimination between the patients with primary and secondary Raynaud's phenomenon. Many of the mentioned features should make capillaroscopy a part of the diagnostic algorithm and follow-up in everyday rheumatologic practice.
    161 1Klinika za reumatske bolesti i rehabilitaciju Referentni centar MZSS RH za reumatoidni artritis Klinički bolnički centar Zagreb Kišpatićeva 12 10000 Zagreb 2Zavod za kliničku imunologiju i reumatologiju Klinika za unutarnje bolesti... more
    161 1Klinika za reumatske bolesti i rehabilitaciju Referentni centar MZSS RH za reumatoidni artritis Klinički bolnički centar Zagreb Kišpatićeva 12 10000 Zagreb 2Zavod za kliničku imunologiju i reumatologiju Klinika za unutarnje bolesti Klinički bolnički centar Zagreb Kišpatićeva 12 10000 Zagreb 3Odjel za reumatologiju i kliničku imunologiju Klinika za internu medicinu Klinički bolnički centar Rijeka Krešimirova 42 51000 Rijeka 4Klinika za reumatologiju, fi zikalnu medicinu i rehabilitaciju Referentni centar MZSS RH za spondiloartropatije Klinička bolnica “Sestre milosrdnice” Vinogradska 29 10000 Zagreb 5Odsjek za kliničku imunologiju i reumatologiju Klinika za unutarnje bolesti Klinički bolnički centar Split Spinčićeva 1 21000 Split SPONZORIRANO PRIOPĆENJE SPONSORED COMMUNICATION
    IgA nephropathy (IgAN) is a rather uncommon complication of TNF-alpha inhibition with a range of findings such as asymptomatic microscopic/macroscopic hematuria or different degrees of proteinuria and could progress to end-stage renal... more
    IgA nephropathy (IgAN) is a rather uncommon complication of TNF-alpha inhibition with a range of findings such as asymptomatic microscopic/macroscopic hematuria or different degrees of proteinuria and could progress to end-stage renal disease. We are reporting three patients with longstanding rheumatoid arthritis (RA), which developed IgAN while receiving TNF-alpha inhibitors. All off our three patients had RA, which lasted 2–4 years, and none of them had a prior history of chronic kidney disease. Two patients were treated with adalimumab while one patient was treated with golimumab. Discontinuation of anti-TNF-alpha therapy and initiation of immunosuppressive therapy led to improvement in serologic abnormalities and renal function in two patients, while the third patient’s 24-hour proteinuria was only partially reduced, which supports previous reports on TNF-alpha inhibitor induced autoimmunity. Two of our patients had previously been diagnosed with type 2 diabetes mellitus while t...
    AimTo validate Systemic Lupus International Collaborating Clinics (SLICC)-12 and American College of Rheumatology (ACR)-97 classification criteria on a patient cohort from the University Hospital Center Zagreb.MethodsThis retrospective... more
    AimTo validate Systemic Lupus International Collaborating Clinics (SLICC)-12 and American College of Rheumatology (ACR)-97 classification criteria on a patient cohort from the University Hospital Center Zagreb.MethodsThis retrospective study, conducted from 2014 to 2016, involved 308 patients with systemic lupus erythematosus (SLE) (n = 146) and SLE-allied conditions (n = 162). Patients' medical charts were evaluated by an expert rheumatologist to confirm the clinical diagnosis, regardless of the number of the ACR-97 criteria met. Overall sensitivity and specificity, as well as the sensitivity and specificity according to disease duration, were compared between ACR-97 and SLICC-12 classifications. Predictive value for SLE for both classifications was assessed using logistic regression and receiver operating characteristic (ROC) curves.ResultsThe SLICC-12 criteria had significantly higher sensitivity in early disease, which increased with disease duration. The ACR-97 criteria had higher specificity. The specificity of the SLICC-12 criteria was low and decreased with disease duration. Regression analysis demonstrated the superiority of the SLICC-12 classification criteria over the ACR-97 criteria, with areas under the ROC curve of 0.801 and 0.780, respectively.ConclusionAlthough the SLICC-12 criteria were superior to the ACR-97 and were more sensitive for diagnosing early SLE, their specificity in our population was too low. The sensitivity of the SLICC-12 classification is increased by better defined clinical features within each criterion. Our results contribute to the current initiative for developing new criteria for SLE.
    To assess the causes of early death (ED) and late death (LD) in patients with systemic lupus erythematosus (SLE) and determine the features of deceased SLE patients followed-up in a single Croatian tertiary hospital center, because little... more
    To assess the causes of early death (ED) and late death (LD) in patients with systemic lupus erythematosus (SLE) and determine the features of deceased SLE patients followed-up in a single Croatian tertiary hospital center, because little if any data on causes of death (CODs) in SLE patients are available for Croatia. We identified SLE patients regularly followed-up at the Division of Clinical Immunology and Rheumatology, University Hospital Center Zagreb, who died from 2002 to 2011. Death was ascertained by matching our institutional records with the Croatian National Death Database. Patients were grouped according to their disease duration to ED and LD and compared by demographic characteristics, classification criteria, organ damage, and CODs. We identified 90 patients (68 women), who died at the age of 58±15 years. The most frequent COD category was cardiovascular diseases (40%), followed by infections (33%), active SLE (29%), and malignancies (17%). No significant difference wa...
    Vasculitides are heterogenic group of autoimmune connective tissue diseases which often present difficulties in early diagnosing. Giant cell arteritis is vasculitis of large and medium arteries. It predominantly presents with symptoms of... more
    Vasculitides are heterogenic group of autoimmune connective tissue diseases which often present difficulties in early diagnosing. Giant cell arteritis is vasculitis of large and medium arteries. It predominantly presents with symptoms of affection of the external carotid artery branches. Furthermore, the only symptoms can be constitutional. In clinical practice, vasculitides are sometimes considered as paraneoplastic, but no definite association with malignancies has been established and the mechanisms are still debated. The gold standard for diagnosing giant cell arteritis is a positive temporal artery biopsy, but the results can often be false negative. Additionally, more than half of the patients have aorta and its main branches affected. Considering aforementioned, imaging studies are essential in confirming large-vessel vasculitis, amongst which is highly sensitive PET/CT. We present the case of a 70-year-old female patient with constitutional symptoms and elevated sedimentatio...
    ... Pregled bibliografske jedinice broj: 323424. Časopis. Autori: Banić, Marko; Brkić, Tomislav; Anić, Branimir; Grabarević, Željko; Rotkvić, Ivo; Duvnjak, Marko; Kovačević, Igor; Marić, Stela; Troskot, Branko. ... IRB. Pripremili: Ivo... more
    ... Pregled bibliografske jedinice broj: 323424. Časopis. Autori: Banić, Marko; Brkić, Tomislav; Anić, Branimir; Grabarević, Željko; Rotkvić, Ivo; Duvnjak, Marko; Kovačević, Igor; Marić, Stela; Troskot, Branko. ... IRB. Pripremili: Ivo Batistić i Jadranka Stojanovski. Dizajn: Studio8. ...
    Chronic inflammatory rheumatic diseases are becoming one of the central problems of public health services. Prolongation of expected life span due to better diagnostics and better and more efficacious therapeutic procedures resulted in... more
    Chronic inflammatory rheumatic diseases are becoming one of the central problems of public health services. Prolongation of expected life span due to better diagnostics and better and more efficacious therapeutic procedures resulted in increasing number of patients with chronic inflammatory diseases in population. Any serious consideration about health problem must include adequate epidemiologic analysis. This text briefly covers the problems of descriptive and analytic epidemiological studies and shortly addresses results of Croatian epidemiological studies of inflammatory rheumatic diseases in the last ten years.
    Although the SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome was defined as a distinct entity more than 20 years ago, its classification within the spectrum of inflammatory rheumatic diseases and the proper... more
    Although the SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome was defined as a distinct entity more than 20 years ago, its classification within the spectrum of inflammatory rheumatic diseases and the proper therapeutic approach are still a matter of debate. We present four patients diagnosed with the SAPHO syndrome treated and followed-up in our Department, demonstrating the diversity of their clinical courses and their responses to different therapeutic approaches. We also review the clinical, laboratory, and imaging features of the SAPHO syndrome described in the relevant literature. Despite the growing quantity of published data on the clinical features of the syndrome and the recognition of two disease patterns (inflammatory and bone remodeling disease), it is still not clear whether these possible disease subsets require different therapeutic strategies. Tumor necrosis factor-alpha (TNF-α) inhibitors have been suggested to be effective in patients with the ...
    Hereditary angioedema (HAE) is a rare but potentially fatal genetic disorder with nonpitting, nonerythematous, and not pruritic swelling which can affect the hands, feet, face, genitals and visceral mucosa. The type, frequency, and... more
    Hereditary angioedema (HAE) is a rare but potentially fatal genetic disorder with nonpitting, nonerythematous, and not pruritic swelling which can affect the hands, feet, face, genitals and visceral mucosa. The type, frequency, and severity of the attacks vary between patients, and over the lifetime of an individual patient. Efforts in Croatian counties have identified approximately 100 patients (but there must be more undiagnosed patients). The first global guideline for the management of HAE was developed by the World Allergy Organization HAE International Alliance and published in 2012. Based on that document the Working group of Croatian experts was assigned to propose guideline for HAE management in Croatia. HAE is is most often related to decreased or dysfunctional C1 inh with autoactivation of C1 and bradykinin accumulation leading to localized dilatation and increased permeability of blood vessels resulting in tissue swelling. A diagnosis of HAE can be confirmed by measuring...
    Eosinophilic pleural effusion (EPE) is defined as exudative effusion that contains at least 10% eosinophils. The most common conditions associated with EPE are malignancy, infections, post-traumatic and post-surgical conditions,... more
    Eosinophilic pleural effusion (EPE) is defined as exudative effusion that contains at least 10% eosinophils. The most common conditions associated with EPE are malignancy, infections, post-traumatic and post-surgical conditions, hypersensitivity, systemic autoimmune diseases, congestive heart failure, cirrhosis, pulmonary embolus, asbestosis and drug induced EPE. Pleural effusion accompanying autoimmune diseases is most common in patients with systemic lupus erythematosus, rheumatoid arthritis, howewer it rarely occurs in patients with progressive systemic sclerosis and polymiositis. EPE has rarely been reported in association with Churg Strauss syndrome. In about 14-25% of patients EPE can be defined as idiopathic when diagnostic procedures failed to identify the etiology. Treatment of EPE is based on the treatment of primary disease and with idiopathic form a good answer is reached using glucocorticoids. In this case report we presented the patient with idiopathic eosinophilic ple...
    Pancreatic exocrine insufficiency is a major consequence of pancreatic diseases (e. g. chronic pancreatitis and cystic fibrosis), extrapancreatic diseases like celiac disease and Crohn's disease, and gastrointestinal and pancreatic... more
    Pancreatic exocrine insufficiency is a major consequence of pancreatic diseases (e. g. chronic pancreatitis and cystic fibrosis), extrapancreatic diseases like celiac disease and Crohn's disease, and gastrointestinal and pancreatic surgical resections. Recognition of this entity is highly relevant to avoid malnutrition-related morbidity and mortality. The main clinical consequence of PEI is fat maldigestion and malabsorption, resulting in steatorrhoea. Pancreatic exocrine function should be assessed by measuring levels of faecal elastase-1. Pancreatic enzyme replacement therapy is the mainstay of treatment for PEI. Administration of enzymes in form of enteric-coated minimicrospheres avoids acid-mediated lipase inactivation and ensures gastric emptying of enzymes in parallel with nutrients. In adults, the initial recommended dose of pancreatic enzymes is 25.000 units of lipase per meal, titrating up to a maximum of 80000 units of lipase per meal. Large meals require 25.000 - 80.0...
    In the last decade there has been a rising recognition of potential clinical significance of the vitamin D. Vitamin D regulates about 3% of the human genome. Thus, vitamin D deficiency is common and high in various populations across the... more
    In the last decade there has been a rising recognition of potential clinical significance of the vitamin D. Vitamin D regulates about 3% of the human genome. Thus, vitamin D deficiency is common and high in various populations across the world including Croatia. In this paper vitamin D metabolism and up to date knowledge of vitamin D function in calcium metabolism, muscular function and in prevention of infection, malignancy, autoimmune and cardiovascular diseases is presented. Reasons for pandemic vitamin D deficiency and guidelines for vitamin D supplementation are given.
    Capillaroscopy is a noninvasive and harmless morphological method for examination of the nailfold capillaries in both suspected and already diagnosed patients with systemic connective disease. The most useful aspect is in discrimination... more
    Capillaroscopy is a noninvasive and harmless morphological method for examination of the nailfold capillaries in both suspected and already diagnosed patients with systemic connective disease. The most useful aspect is in discrimination between the patients with primary and secondary Raynaud's phenomenon. Many of the mentioned features should make capillaroscopy a part of the diagnostic algorithm and follow-up in everyday rheumatologic practice.
    Osteoarthritis of the hip and the knee belongs to one of the most disabiliting conditions. Treatment goals for these patients include a reduction in pain, an improvement in joint mobility and to limit functional impairment. To properly... more
    Osteoarthritis of the hip and the knee belongs to one of the most disabiliting conditions. Treatment goals for these patients include a reduction in pain, an improvement in joint mobility and to limit functional impairment. To properly manage osteoarthritis, both nonpharmacologic (non-interventional) and pharmacologic modalities may be employed, while minority of patients will require surgery. According to the available evidence for available therapies and experts' opinion here we present guidelines for the treatment of hip and the knee osteoarthritis in Croatia.
    The aim of the study was to determine the frequency of functional and organic dyspepsia and possible predictors for organic dyspepsia in coronary artery disease (CAD) patients. The 150 patients (109 men; mean age 62.61 +/- 10.23 yr)... more
    The aim of the study was to determine the frequency of functional and organic dyspepsia and possible predictors for organic dyspepsia in coronary artery disease (CAD) patients. The 150 patients (109 men; mean age 62.61 +/- 10.23 yr) undergoing coronary artery by-pass grafting because of stable pectoral angina due to significant CAD were enrolled in the study. Dyspepsia was determined by the existence of epigastralgy, heartburn, nausea and vomiting. Dyspepsia with endoscopic lesions was defined as organic, and dyspepsia with normal endoscopy was defined as functional. Multivariate analysis (logistic regression) was used to estimate predictive values of some independent clinical and demographic variables in relation to organic dyspepsia (dependent variable). One hundred thirty-five (90%) patients had at least one symptom of dyspepsia. Eighty five patients (63%) had organic dyspepsia, and 50 (37%) patients had functional dyspepsia (P < 0.001). Patients with organic dyspepsia had mor...
    Due to high metabolic activity and oxygen demands, ischemia of gastroduodenal (GD) mucosa is an important factor in the pathogenesis of its impairment. Comparing the degree of coronary atherosclerosis, for evaluation of severity of... more
    Due to high metabolic activity and oxygen demands, ischemia of gastroduodenal (GD) mucosa is an important factor in the pathogenesis of its impairment. Comparing the degree of coronary atherosclerosis, for evaluation of severity of atherosclerosis, with the prevalence and severity of GD mucosal lesions, we wanted to investigate the possible ischemia of GD mucosa could contribute to its impairment. This prospective study included 150 coronary artery disease (CAD) patients, 109 (72.7%) male and 41 (27.3%) female, average age 62.61 +/- 10.23 years. We noted clinical and anthropometric parameters, standard laboratory findings, treatment until inclusion into the study and standard cardiovascular risk factors. The severity of CAD was assessed by several parameters: 1) number of coronary arteries affected with atherosclerosis, 2) modified Gensa score, and 3) number of coronary arteries with stenosis > 50%. The severity of GD mucosal lesions was assessed by modified Lanza score, and Heli...
    The etiology, pathogenesis, epidemiology, clinical picture, diagnosis, differential diagnosis and treatment of polymyalgia reumatica are presented.
    Drug-induced myopathy and/or rhabdomyolysis have been reported with use of some statins and fibric acid derivatives. The risk of adverse effects is increased with their concomitant use. We report the case of myopathy with rhabdomyolysis... more
    Drug-induced myopathy and/or rhabdomyolysis have been reported with use of some statins and fibric acid derivatives. The risk of adverse effects is increased with their concomitant use. We report the case of myopathy with rhabdomyolysis during the concomitant use of cerivastatin and gemfibrozil.
    Systemic erythematosus lupus (SLE) is a disease with wide range of clinical manifestations, signs and symptoms. Disease outcome depends mostly on the affection of kidneys and central nervous system by the disease. Very important cause of... more
    Systemic erythematosus lupus (SLE) is a disease with wide range of clinical manifestations, signs and symptoms. Disease outcome depends mostly on the affection of kidneys and central nervous system by the disease. Very important cause of death in patients with SLE is infection. Infections are very common among these patients due to aggressive immunosuppressive treatment that is needed for the disease inflammatory activity control. In this case report we have presented a patient with SLE who initially had severe renal affection, but also complications of immunosuppressive therapy that was administered. Even though the disease was accidentally diagnosed, it had a severe clinical progress. Because of lupus nephropathy, in the early phase of the disease we administered aggressive immunosuppressive therapy (combined parenteral therapy of glucocorticoides and cyclophosphamide). As an outcome of the combined effect of disease and immunosuppressive agents used in the treatment of the diseas...
    Spondyloarthritides (SpA) as a group are one of the most common rheumatic disorders with a predominant affection of the spine. Conventinal disease modifying antirheumatic drugs which are effective in rheumatoid arthritis have poor effect... more
    Spondyloarthritides (SpA) as a group are one of the most common rheumatic disorders with a predominant affection of the spine. Conventinal disease modifying antirheumatic drugs which are effective in rheumatoid arthritis have poor effect on spinal inflammation. Today there is confirmed efficacy ofbiologics in spondylitis. This therapy is expensive and potentially hazaradous. Croatian Society for Rheumatology set up recommendations for the use of TNF-alpha blockers in SpA. There are several important points to be considered before their use: diagnosis of Spa, duration and disease activity, previous therapy and it's efficacy, application and efficacy ofbiologics, contraindications and safety preacutions and finally a decision for continuous tretament with biologics.
    Rheumatoid arthritis is a chronic, inflammatory disease with the prevalence about 1%. Rheumatoid arthritis is characterized with synovitis, erosive changes of the joints, pain and functional deficit. Etiology of the disease is unknown. In... more
    Rheumatoid arthritis is a chronic, inflammatory disease with the prevalence about 1%. Rheumatoid arthritis is characterized with synovitis, erosive changes of the joints, pain and functional deficit. Etiology of the disease is unknown. In the pathogenesis of rheumatoid arthritis the key role have proinflammatory citokines, particularly, tumour necrosis factor (TNFalpha). TNFalpha blockers have documented, fast and continuous efficacy with generaly well accepted safety profile. Nowadays, TNFalpha antagonists are established drugs in early and late phase of rheumatoid arthritis. Prescription of TNFalpha antagonists is controlled, according local restrictions, regarding high costs of the therapy. On behalf of the Croatian Society for Rheumatology we propose recommendations for the TNFalpha antagonist therapy in rheumatoid arthritis.
    Recently, many studies showed need to administer vitamin D in treatment of osteoporosis. Vitamin D deficiency was proved in postmenopausal women with osteoporosis. Effects of vitamin D resulted in lower risk of fractures and falls, as... more
    Recently, many studies showed need to administer vitamin D in treatment of osteoporosis. Vitamin D deficiency was proved in postmenopausal women with osteoporosis. Effects of vitamin D resulted in lower risk of fractures and falls, as well as improvement of neuromuscular performances. In more than ten years of practice and several short- and long-term clinical studies alendronate lowered the risk of vertebral and extravertebral fractures, improved BMD of all measured sites in postmenopausal women and men with osteoporosis. Positive results of alendronate were demonstrated in different entities like persons of various ages and grades of lower BMD or patients with glucocorticoid-induced osteoporosis. Combination of vitamin D with efficacious antiresorptive drug alendronate maintains all pharmacological features and proves clinical effects of lx weekly alendronate, partly eliminating need for vitamin D supplementation.
    Reducing pain is a major goal in treating patients with arthritis. Oral controlled-release opioid products enable patients to better maintain pain control due to convenient dosing intervals and sustained blood concentration. Oxycodone is... more
    Reducing pain is a major goal in treating patients with arthritis. Oral controlled-release opioid products enable patients to better maintain pain control due to convenient dosing intervals and sustained blood concentration. Oxycodone is a strong opioid that has proved to be efficacious in analgesic studies of persistent moderate to severe pain in patients with degenerative and inflammatory rheumatic diseases. Beyond significant pain control and better physical function, controlled-release oxycodone improved coping with pain in patients with osteoarthritis.
    The use of immunosuppressive therapy may be associated with significant toxicity. The aim of this study was to investigate the effect of cyclosporine A (CsA) in murine model of experimental colitis. Experimental colitis was induced in... more
    The use of immunosuppressive therapy may be associated with significant toxicity. The aim of this study was to investigate the effect of cyclosporine A (CsA) in murine model of experimental colitis. Experimental colitis was induced in NMRI mice using an enema of 0.2% solution of dinitrofluorobenzene, combined with skin sensitization. After inducing colitis, experimental groups of animals were treated with CsA (1, 3, 5, 10, 25, 50 mg/kg/day) intraperitoneally (i.p.) or intracolonically (i.c.), and control groups were treated with phosphate-buffered saline intraperitoneally or intracolonically, respectively. Colonic inflammatory changes were assessed using a histopathologic score of 0-30, and pooled whole blood samples were processed with monoclonal antibodies for cyclosporine concentration. In addition, two groups of animals with experimental colitis were treated intraperitoneally or intracolonically with 3 mg/kg/day of CsA, and the colons were also taken for immunohistochemistry for...
    Croatian Society for Rheumatology of Croatian Medical Association updated the proposal for the application of TNF-alpha inhibitors in adult patients with spondyloartritides (SpA) in accordance with the new classification of SpA and... more
    Croatian Society for Rheumatology of Croatian Medical Association updated the proposal for the application of TNF-alpha inhibitors in adult patients with spondyloartritides (SpA) in accordance with the new classification of SpA and european recommendations for the treatment of SpA with biologic agents. In this way a standardized method of diagnosis, targeted treatment, monitoring and evaluating outcomes are proposed.

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