Wormian bones are small ossicles appearing within the cranial sutures in more than 40% of skulls, most commonly at the lambdoid suture and pterion. During the skeletal analysis of an unidentified male war victim, we observed multiple wormian bones and a patent metopic suture. Additionally, the right elbow was deformed, probably as a consequence of an old trauma. The skull was analyzed by cranial measurements and computerized tomography, revealing the presence of cranial deformities including hyperbrachicrania, localized reduction in hemispheral widths, increased cranial capacity, and sclerosis of the viscerocranium. Besides unique anatomical features and their anthropological value, such skeletal abnormalities also have a forensic value as the evidence to support the final identification of the victim.

Introduction:The effectiveness and safety of treatment with warfarin are critically dependent on maintaining the international normalized ratio (INR) in the therapeutic range. Besides the dose of warfarin, many factors which interact with the metabolism of warfarin may influence the stability of treatment and the time in which patients' INRs are in the therapeutic range. 1,2 Aim: To establish whether there is a significant seasonal variation in effectiveness of warfarin therapy in adults with atrial fibrillation in a Croatian population. Patients and Methods:We conducted an observational study of a subgroup of patients enrolled in the AMACADo -Atrial fibrillation associated thromboembolic risk MAnagement in CroatiA national Database project, involving 2326 electronic medical records of patients with AF hospitalized in UHC Zagreb from 2010 until 2015. Out of 2326 patients we selected 1110 that were treated with warfarin as permanent anticoagulant therapy, prior to hospitalization, and the rest of patients we excluded from the research. Patient were divided in two categories based on INR values higher than 2.0 (INR > 2.0) and less or equal than 2.0 (INR ≤ 2.0). Furthermore, we analyzed seasonal variation in the INR value during four seasons: spring, summer, autumn and winter. The χ 2 test was used for comparison of categorical variables. Results:Out of 239 patients admitted to hospital during summer 111 had an INR value > 2.0, (46.4%) in comparison with patients admitted during all other seasons (spring, autumn and winter) (324/871, 37.2%). Our results show that a larger proportion of patients was effectively anticoagulated during summer vs. other seasons (p=0.00950174, CI 95%). Conclusion:A seasonal variation in the INR values was observed among adults with atrial fibrillation, possibly due to many different factors such as variations in diet, hydration status and physical activity, and possibly therapy guidance. Seasonal variations in the intensity of warfarin therapy should always be considered in trials exploring thromboembolic complications of atrial fibrillation. The causes of this variations should be further investigated.

Izvorni rad | Original article Deskriptori TUMORI-komplikacije; MALNUTRICIJA-dijagnoza, epidemiologija, etiologija; NUTRITIVNI STATUS; NUTRITIVNA PROCJENA; PROCJENA RIZIKA-metode, statistički podatci; PRESJEČNA ISTRAŽIVANJA; HRVATSKA-epidemiologija SAŽETAK. Cilj istraživanja: Utvrditi trenutačnu prevalenciju znatnoga nutritivnog rizika među onkološkim bolesnicima u Republici Hrvatskoj. Ispitanici i metode: Ova presječna studija ugniježđena je u prospektivnu kohortnu studiju Sekcije mladih onkologa HDIO-a HLZ-a, koja je provedena u Hrvatskoj tijekom 2017. godine na susljednom uzorku onkoloških bolesnika biranome prema redoslijedu dolaska na liječenje. Nutritivni probir proveli smo uporabom upitnika za procjenu nutritivnog rizika NRS-2002. Prema njemu, bolesnik se smatra nutritivno ugroženim ako je rezultat ≥ 3. Rezultati: U istraživanje je uključeno 275 bolesnika, medijana (interkvartilnog raspona) dobi od 61 godine (51-68), među kojima je bila 161 žena (58,5%). Bolesnici su liječeni u jedanaest onkoloških centara u Hrvatskoj. U 60 bolesnika (21,8%; 95%-tni CI 17,1-27,2%) utvrđen je znatan nutritivni rizik (NRS-2002 ≥ 3) koji indicira potrebu za nutritivnom intervencijom. Bilo kakvu nepovoljnu promjenu tijekom 30 dana prije uključivanja, dakle, gubitak tjelesne mase ili smanjen unos hrane, primijetilo je 127 (46,2%) sudionika. Zaključak: Naše istraživanje potvrdilo je da znatan broj onkoloških bolesnika u Hrvatskoj ima neki stupanj nutritivnog rizika te da je u više od četvrtine potrebna nutritivna intervencija. Nutritivni probir prvi je korak u dugoročnoj kontroli komplikacija vezanih uz promijenjen unos hrane i nutritivni rizik, kao i pri poboljšanju kvalitete života onkoloških bolesnika te prognoze ishoda bolesti pa bi ga, s obzirom na prikazane rezultate, trebalo rutinski provoditi.