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Article ; Online: Tiered daily huddles: the power of teamwork in managing large healthcare organisations.

Mihaljevic, Tomislav

2020 Volume 29, Issue 12, Page(s) 1050–1052

MeSH term(s)	Communication ; Delivery of Health Care ; Humans ; Patient Care Team
Language	English
Publishing date	2020-09-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2592909-4
ISSN	2044-5423 ; 2044-5415
ISSN (online)	2044-5423
ISSN	2044-5415
DOI	10.1136/bmjqs-2019-010575
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Article ; Online: An important cardiac surgery milestone: The first known stopped-heart operation.

Svensson, Lars G / Mihaljevic, Tomislav

JTCVS techniques

2021 Volume 10, Page(s) 460–463

Language	English
Publishing date	2021-08-21
Publishing country	United States
Document type	Case Reports
ISSN	2666-2507
ISSN (online)	2666-2507
DOI	10.1016/j.xjtc.2021.08.025
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Article: Hyperthyroidism and Wnt Signaling Pathway: Influence on Bone Remodeling.

Mudri, Dunja / Bilić Ćurčić, Ines / Meštrović, Lucija / Mihaljević, Ivica / Kizivat, Tomislav

Metabolites

2023 Volume 13, Issue 2

Abstract: Graves' disease is an autoimmune disease of the thyroid gland, characterized by increased production of thyroid hormones, which can affect many different organ systems in the body. Among other problems, it can cause disorders of the skeletal system, ... ...

Abstract	Graves' disease is an autoimmune disease of the thyroid gland, characterized by increased production of thyroid hormones, which can affect many different organ systems in the body. Among other problems, it can cause disorders of the skeletal system, shortening the bone remodeling cycle and causing a decrease in bone density. The Wnt cascade signaling pathway and the β-catenin, as a part of the canonical Wnt pathway, also play roles in maintaining bone mass. Inhibition of the Wnt pathway can cause bone loss, and its stimulation can increase it. The Wnt signaling pathway influences the effectiveness of thyroid hormones by affecting receptors for thyroid hormones and deiodinase, while thyroid hormones can change levels of β-catenin within the cell cytoplasm. This indicates that the Wnt pathway and thyroid hormone levels, including hyperthyroidism, are linked and may act together to change bone density. In this review article, we attempt to explain the interplay between thyroid hormones and the Wnt pathway on bone density, with a focus on directions for further research and treatment options.
Language	English
Publishing date	2023-02-06
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662251-8
ISSN	2218-1989
ISSN	2218-1989
DOI	10.3390/metabo13020241
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Article ; Online: Psycho-social and health predictors of loneliness in older primary care patients and mediating mechanisms linking comorbidities and loneliness.

Trtica, Ljiljana Majnarić / Volarić, Mile / Kurevija, Tomislav / Mihaljević, Silvio / Dupan, Zdravka Krivdić / Wittlinger, Thomas

BMC geriatrics

2023 Volume 23, Issue 1, Page(s) 801

Abstract: Background: Aging is associated with many personal, social, and environmental challenges that increase the risk of loneliness. Loneliness is a painful emotional experience associated with a perceived lack of connection and intimacy. Loneliness ... ...

Abstract	Background: Aging is associated with many personal, social, and environmental challenges that increase the risk of loneliness. Loneliness is a painful emotional experience associated with a perceived lack of connection and intimacy. Loneliness accelerates health deterioration, but the presence of chronic health conditions (comorbidities) in older individuals may potentiate the feeling of loneliness. The relationships between health status and loneliness in older individuals have not been assessed in an integrated manner, although it is necessary for planning efficient interventions. The aim of this study was to fill in this knowledge gap, by attempting to create an integrated model of loneliness in older individuals. Methods: The sample consisted of 189 (58% F) older individuals (> 60 years) (mean ± SD, 78.47 ± 6.65), attendees in Primary Health Care. Different factors associated with loneliness in the older population were assessed, and classified as demographic, environmental, physical (health-related), and psychological, in addition to functional abilities. A set of standard questionnaires was used to assess psychological factors and functional abilities. The hierarchical regression model assessed the effect of particular blocks of factors on status loneliness. The second aim was to analyze how psychological factors mediate associations between health status (comorbidity level) and loneliness. Results: Indicated that increasing comorbidity, anxiety, lack of positive moods, not having hobbies/activities, low perception of social support, impaired cognitive function, and suppression of emotion expression, are significant predictors of loneliness. Mediation analysis informed us of how to help patients with comorbidities feel less lonely. Interventions that were suggested were those that can reduce anxiety and depression, improve cognitive abilities and emotional regulation control, and enhance social support. Conclusions: Results can help understand the pathophysiology loops linking poor health status (comorbidity level) of older individuals and loneliness, and have significant potentials from the translational perspectives, as a decision-support tool.
MeSH term(s)	Humans ; Aged ; Loneliness/psychology ; Aging/psychology ; Pain ; Comorbidity ; Primary Health Care
Language	English
Publishing date	2023-12-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2059865-8
ISSN	1471-2318 ; 1471-2318
ISSN (online)	1471-2318
ISSN	1471-2318
DOI	10.1186/s12877-023-04436-6
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Article: Wnt Inhibitors and Bone Mineral Density in Patients with Graves' Disease Treated with Antithyroid Drugs: A Preliminary Prospective Study.

Mudri, Dunja / Kizivat, Tomislav / Mihaljević, Ivica / Bilić Ćurčić, Ines

Metabolites

2022 Volume 12, Issue 8

Abstract: This study aimed to investigate the association of Wnt inhibitors with thyroid hormones, bone turnover markers, and bone mineral density (BMD) in patients with newly diagnosed Graves’ disease (GD) at the beginning of the antithyroid treatment and after a ...

Abstract	This study aimed to investigate the association of Wnt inhibitors with thyroid hormones, bone turnover markers, and bone mineral density (BMD) in patients with newly diagnosed Graves’ disease (GD) at the beginning of the antithyroid treatment and after a follow-up period of one year. The study included 37 patients with newly diagnosed GD who were treated with antithyroid drugs (ATD). At baseline and after one year, thyroid hormones and thyroid-stimulating hormone (TSH), serum concentrations of sclerostin, and Dickkopf-1 (DKK1) were measured by an enzyme-linked immunosorbent assay (ELISA). In addition, BMD was measured by dual-energy X-ray absorptiometry (DXA), and markers of bone turnover including osteocalcin (OC), beta-cross laps (β-CTX), and deoxypyridinoline (DPD) were determined. After one year of ATD therapy sclerostin levels were significantly decreased (p < 0.001), whereas DKK1 levels were significantly increased (p = 0.01). In addition, BMD of the lumbar spine, total hip, and femoral neck was significantly improved (p < 0.001), accompanied by an increase in OC, β-CTX, and DPD concentrations (p < 0.001). At baseline, sclerostin levels were positively associated with free triiodothyronine (FT3). Following ATD therapy, a positive correlation was observed between FT3 and DKK1 (p = 0.003), whereas a negative correlation was found between TSH and DKK1 (p = 0.04). Correlation analysis demonstrated no association of the sclerostin and DKK1 with other bone remodeling biomarkers OC, β-CTX, or DPD. Also, no significant correlation between sclerostin or DKK1 and T-score or BMD of the lumbar spine, hip, and femoral neck was observed at both time points. Conclusion: Observed differences in sclerostin and DKK1 serum following GD treatment indicate involvement of Wnt inhibitors in the etiopathogenesis of bone loss associated with hyperthyroidism. Furthermore, both sclerostin and DKK1 are involved in the reversal of changes in bone metabolism following ATD therapy, thus presenting potentially valuable bone remodeling markers worth further investigation.
Language	English
Publishing date	2022-07-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662251-8
ISSN	2218-1989
ISSN	2218-1989
DOI	10.3390/metabo12080711
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Article ; Online: IMPACT OF GRAVES' DISEASE AND ANTITHYROID DRUG THERAPY ON BONE MINERAL DENSITY - PATHOPHYSIOLOGICAL MECHANISMS AND CLINICAL RELEVANCE.

Mudri, Dunja / Kizivat, Tomislav / Smolić, Martina / Mihaljević, Ivica / Smolić, Robert / Raguž Lučić, Nikola / Bilić-Ćurčić, Ines

Acta clinica Croatica

2023 Volume 61, Issue 3, Page(s) 496–504

Abstract: Graves' disease is an autoimmune disease characterized by excessive thyroid hormone production. One of the consequences of that state can be a decrease in bone mineral density (BMD). Graves' disease is often treated with antithyroid drugs (ATD) as first ... ...

Abstract	Graves' disease is an autoimmune disease characterized by excessive thyroid hormone production. One of the consequences of that state can be a decrease in bone mineral density (BMD). Graves' disease is often treated with antithyroid drugs (ATD) as first line therapy, which can lead to disease remission. Moreover, recent data show that improvement in BMD can be expected. However, vitamin D deficiency can coexist along with Graves' disease, which is also involved in the process of bone remodeling. It is still not known whether lower values of vitamin D can contribute to onset of Graves' disease and if its supplementation might be helpful in therapy for hyperthyroidism. In the past couple of decades, osteopenia and osteoporosis have become a major health burden not only in post-menopausal women but also as a result of other diseases, leading to extensive research into various pathophysiological mechanisms responsible for bone remodeling. The Wnt (wingless integrated) signaling pathway is a very important factor in bone homeostasis, especially the canonical pathway. Present data indicate that stimulation of the Wnt pathway leads to bone mass increase and, in contrast, its inhibition leads to bone mass decrease. Hence, inhibitors of the canonical Wnt pathway became the focus of interest, in particular sclerostin and dickkopf 1 (DKK1). Hyperthyroidism and osteopenia/osteoporosis are quite common today and can coexist together or as separate entities. In this article, we aimed to give an overview of possible associations and potential mutual pathophysiological mechanisms.
MeSH term(s)	Humans ; Female ; Antithyroid Agents/therapeutic use ; Bone Density ; Clinical Relevance ; Graves Disease/drug therapy ; Graves Disease/complications ; Hyperthyroidism/complications ; Hyperthyroidism/drug therapy ; Osteoporosis/drug therapy ; Osteoporosis/etiology ; Bone Diseases, Metabolic/drug therapy ; Bone Diseases, Metabolic/etiology
Chemical Substances	Antithyroid Agents
Language	English
Publishing date	2023-07-11
Publishing country	Croatia
Document type	Journal Article ; Review
ZDB-ID	1478635-7
ISSN	1333-9451 ; 0353-9466
ISSN (online)	1333-9451
ISSN	0353-9466
DOI	10.20471/acc.2022.61.03.15
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Article ; Online: Immunomodulatory Effects of SGLT2 Inhibitors-Targeting Inflammation and Oxidative Stress in Aging.

Schönberger, Ema / Mihaljević, Vjera / Steiner, Kristina / Šarić, Sandra / Kurevija, Tomislav / Majnarić, Ljiljana Trtica / Bilić Ćurčić, Ines / Canecki-Varžić, Silvija

International journal of environmental research and public health

2023 Volume 20, Issue 17

Abstract: Given that the increase in the aging population has grown into one of the largest public health issues, inflammation and oxidative stress, which are closely associated with the aging process, became a focus of recent research. Sodium-glucose co- ... ...

Abstract	Given that the increase in the aging population has grown into one of the largest public health issues, inflammation and oxidative stress, which are closely associated with the aging process, became a focus of recent research. Sodium-glucose co-transporter 2 (SGLT2) inhibitors, a group of drugs initially developed as oral antidiabetics, have shown many beneficial effects over time, including improvement in renal function and cardioprotective effects. It has been shown that SGLT2 inhibitors, as a drug class, have an immunomodulatory and antioxidative effect, affecting endothelial function as well as metabolic parameters. Therefore, it is not surprising that various studies have investigated the potential mechanisms of action of SGLT2 inhibitors in age-related diseases. The proposed mechanisms by which SGLT2 inhibitors can achieve their anti-inflammatory effects include influence on AMPK/SIRT1/PGC-1α signaling, various cytokines, and the NLRP3 inflammasome. The antioxidative effect is related to their action on mitochondria and their influence on the signaling pathways of transforming growth factor β and nuclear erythroid 2-related factor 2/antioxidant response element. Also, SGLT2 inhibitors achieve their anti-inflammatory and antioxidative effects by affecting metabolic parameters, such as uric acid reduction, stimulation of ketogenesis, reduction of body weight, lipolysis, and epicardial fat tissue. Finally, SGLT2 inhibitors display anti-atherosclerotic effects that modulate inflammatory reactions, potentially resulting in improvement in endothelial function. This narrative review offers a complete and comprehensive overview of the possible pathophysiologic mechanisms of the SGLT2 inhibitors involved in the aging process and development of age-related disease. However, in order to use SGLT2 inhibitor drugs as an anti-aging therapy, further basic and clinical research is needed to elucidate the potential effects and complex mechanisms they have on inflammation processes.
MeSH term(s)	Humans ; Aged ; Sodium-Glucose Transporter 2 Inhibitors/pharmacology ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use ; Oxidative Stress ; Inflammation/drug therapy ; Hypoglycemic Agents
Chemical Substances	Sodium-Glucose Transporter 2 Inhibitors ; Hypoglycemic Agents
Language	English
Publishing date	2023-08-29
Publishing country	Switzerland
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20176671
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Article ; Online: Invited commentary.

Mihaljevic, Tomislav

The Annals of thoracic surgery

2011 Volume 92, Issue 5, Page(s) 1571–1572

MeSH term(s)	Female ; Heart Ventricles/pathology ; Heart Ventricles/surgery ; Humans ; Male ; Ventricular Remodeling
Language	English
Publishing date	2011-11
Publishing country	Netherlands
Document type	Comment ; Journal Article
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2011.07.037
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Article ; Online: THE PREVALENCE OF SUBCLINICAL HYPOTHYROIDISM IN THE POPULATION OF ELDERLY NURSING HOME RESIDENTS IN ZAGREB.

Jukić, Tomislav / Vidranski, Valentina / Blažeković, Ivan / Prpić, Marin / Jakšić, Ivan / Pourmodjib, Kiarash / Mihaljević, Ivan / Franceschi, Maja / Fröbe, Ana / Kusić, Zvonko

Acta clinica Croatica

2022 Volume 61, Issue 1, Page(s) 38–45

Abstract: The aim of the study was to investigate the prevalence of thyroid dysfunction, positive thyroid peroxidase antibodies (TPOAb) and hypercholesterolemia in elderly and younger subjects, and the association of subclinical hypothyroidism with ... ...

Abstract	The aim of the study was to investigate the prevalence of thyroid dysfunction, positive thyroid peroxidase antibodies (TPOAb) and hypercholesterolemia in elderly and younger subjects, and the association of subclinical hypothyroidism with hypercholesterolemia. The study included 204 elderly (136 females and 68 males, age median 71, range 60-92 years), and 83 younger control subjects (63 females and 20 males, age median 45, range 19-55 years). Subjects with prior thyroid dysfunction were excluded. Serum thyrotropin (TSH), free triiodothyronine (FT3), free thyroxine (FT4), TPOAb, total cholesterol, height and weight were measured. Mann-Whitney, χ
MeSH term(s)	Male ; Female ; Humans ; Aged ; Middle Aged ; Aged, 80 and over ; Young Adult ; Adult ; Thyrotropin ; Prevalence ; Hypercholesterolemia/epidemiology ; Hypothyroidism/epidemiology ; Nursing Homes ; Cholesterol
Chemical Substances	Thyrotropin (9002-71-5) ; Cholesterol (97C5T2UQ7J)
Language	English
Publishing date	2022-11-08
Publishing country	Croatia
Document type	Journal Article
ZDB-ID	1478635-7
ISSN	1333-9451 ; 0353-9466
ISSN (online)	1333-9451
ISSN	0353-9466
DOI	10.20471/acc.2022.61.01.05
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Article ; Online: ANESTHESIA FOR ROBOT-ASSISTED RADICAL PROSTATECTOMY - A CHALLENGE FOR ANAESTHESIOLOGIST.

Bačak Kocman, Iva / Mihaljević, Slobodan / Goluža, Eleonora / Peršin Beraković, Andrea / Margaretić Piljek, Nataša / Kuliš, Tomislav / Hudolin, Tvrtko / Knežević, Nikola / Kaštelan, Željko

Acta clinica Croatica

2023 Volume 61, Issue Suppl 3, Page(s) 76–80

Abstract: Mininimally invasive surgery has become one of the most popular ones over the last few decades due to many benefits. The advantages are minimal surgical incision, reduced blood loss, reduced postoperative pain, faster postoperative recovery, shorter ... ...

Abstract	Mininimally invasive surgery has become one of the most popular ones over the last few decades due to many benefits. The advantages are minimal surgical incision, reduced blood loss, reduced postoperative pain, faster postoperative recovery, shorter hospital stay, lower morbidity and better outcomes compared to open surgery. The most common robotic procedures in urology are radical prostatectomies. In UHC Zagreb, since November 2019 until now, there have been more than 180 robotic assisted radical prostatectomies (RALP) using Senhance robotic system performed. As a procedure with many possible complications, it represents a challenge for anaesthesiologist. Some of the problems the anaesthesiologists have to face are related to limited patient access, possible difficulties connected with positioning, pneumoperitoneum, subcutaneous emphysema, possible airway oedema. Pneumoperitoneum has impact on almost every system: cardiovascular, renal, respiratory, gastrointestinal and other. Detailed understanding of physiological changes of RALP, with intraoperative impact on nearly every body system is ultimate. Careful preoperative evaluation and intraoperative conduction minimize the risk of complications, and help patients to reach full recovery in a very short time. Excellent outcomes are the result of individualized approach to the patient and good communication between team members.
MeSH term(s)	Male ; Humans ; Robotic Surgical Procedures/adverse effects ; Robotic Surgical Procedures/methods ; Robotics ; Pneumoperitoneum/complications ; Laparoscopy/methods ; Anesthesia/adverse effects ; Prostatectomy/adverse effects ; Prostatectomy/methods ; Postoperative Complications/prevention & control ; Postoperative Complications/etiology
Language	English
Publishing date	2023-03-15
Publishing country	Croatia
Document type	Journal Article ; Review
ZDB-ID	1478635-7
ISSN	1333-9451 ; 0353-9466
ISSN (online)	1333-9451
ISSN	0353-9466
DOI	10.20471/acc.2022.61.s3.11
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