PREDIKTIVNA VRIJEDNOST 
 KONCENTRACIJE 
 5-HIDROKSIINDOLOCTENE KISELINE U 
 URINU DJECE S AKUTNOM UPALOM 
 CRVULJKA

Bosak Veršić, Ana

prikaz prve stranice dokumenta PREDIKTIVNA VRIJEDNOST KONCENTRACIJE 5-HIDROKSIINDOLOCTENE KISELINE U URINU DJECE S AKUTNOM UPALOM CRVULJKA

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doctoral thesis

PREDIKTIVNA VRIJEDNOST KONCENTRACIJE 5-HIDROKSIINDOLOCTENE KISELINE U URINU DJECE S AKUTNOM UPALOM CRVULJKA

Rijeka: University of Rijeka, Faculty of Medicine, 2017. urn:nbn:hr:184:250001

Bosak Veršić, Ana

University of Rijeka
Faculty of Medicine
Department of Surgery

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APA 6th Edition

Bosak Veršić, A. (2017). PREDIKTIVNA VRIJEDNOST KONCENTRACIJE 5-HIDROKSIINDOLOCTENE KISELINE U URINU DJECE S AKUTNOM UPALOM CRVULJKA (Doctoral thesis). Rijeka: University of Rijeka, Faculty of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:184:250001

MLA 8th Edition

Bosak Veršić, Ana. "PREDIKTIVNA VRIJEDNOST KONCENTRACIJE 5-HIDROKSIINDOLOCTENE KISELINE U URINU DJECE S AKUTNOM UPALOM CRVULJKA." Doctoral thesis, University of Rijeka, Faculty of Medicine, 2017. https://urn.nsk.hr/urn:nbn:hr:184:250001

Chicago 17th Edition

Harvard

Bosak Veršić, A. (2017). 'PREDIKTIVNA VRIJEDNOST KONCENTRACIJE 5-HIDROKSIINDOLOCTENE KISELINE U URINU DJECE S AKUTNOM UPALOM CRVULJKA', Doctoral thesis, University of Rijeka, Faculty of Medicine, accessed 20 March 2025, https://urn.nsk.hr/urn:nbn:hr:184:250001

Vancouver

Bosak Veršić A. PREDIKTIVNA VRIJEDNOST KONCENTRACIJE 5-HIDROKSIINDOLOCTENE KISELINE U URINU DJECE S AKUTNOM UPALOM CRVULJKA [Doctoral thesis]. Rijeka: University of Rijeka, Faculty of Medicine; 2017 [cited 2025 March 20] Available at: https://urn.nsk.hr/urn:nbn:hr:184:250001

IEEE

A. Bosak Veršić, "PREDIKTIVNA VRIJEDNOST KONCENTRACIJE 5-HIDROKSIINDOLOCTENE KISELINE U URINU DJECE S AKUTNOM UPALOM CRVULJKA", Doctoral thesis, University of Rijeka, Faculty of Medicine, Rijeka, 2017. Available at: https://urn.nsk.hr/urn:nbn:hr:184:250001

Cite this item: https://urn.nsk.hr/urn:nbn:hr:184:250001

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Title	PREDIKTIVNA VRIJEDNOST KONCENTRACIJE 5-HIDROKSIINDOLOCTENE KISELINE U URINU DJECE S AKUTNOM UPALOM CRVULJKA
Title (english)	PREDICTIVE VALUE OF URINARY 5-HYDROXYINDOLE ACETIC ACID LEVEL IN DIAGNOSIS OF ACUTE APPENDICITIS IN CHILDREN
Author	Ana Bosak Veršić
Mentor	Harry Nikolić (mentor)
Committee member	Mladen Peršić (predsjednik povjerenstva)
Committee member	Anko Antabak (član povjerenstva)
Committee member	Jadranka Varljen (član povjerenstva)
Committee member	Harry Nikolić (član povjerenstva)
Granter	University of Rijeka Faculty of Medicine (Department of Surgery) Rijeka
Defense date and country	2017-05-18, Croatia
Scientific / art field, discipline and subdiscipline	BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Surgery
Scientific / art field, discipline and subdiscipline	BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Pediatrics
Universal decimal classification (UDC)	61 - Medical sciences
Abstract	Cilj: Akutna upala crvuljka najčešća je kirurška hitnoća u djece. Brzo postavljanje dijagnoze i pravovremeno liječenje nužni su za sprječavanje komplikacija. Enterokromafine stanice koje sadrže velike količine serotonina nalaze se većinom u distalnom crvuljku. Metabolit serotonina, 5-hidroksiindoloctena kiselina koja se luči urinom, mogao bi stoga biti prediktivni pokazatelj akutne upale crvuljka. U našem istraživanju određivali smo koncentraciju 5- hidroksiindoloctene kiseline u urinu djece operirane zbog sumnje na akutnu upalu crvuljka te u urinu zdrave djece. Cilj je bio utvrditi postoji li razlika u koncentracijama 5- hidroksiindoloctene kiseline između promatranih skupina djece. Također, analizirali smo kvalitetu Alvarado scorea te apsolutnog broja neutrofila kao prediktivnih pokazatelja akutne upale. Ispitanici i metode: U istraživanje je prospektivno uključeno 93 djece operirane zbog sumnje na akutnu upalu crvuljka te 102 zdrave djece. Koncentracija 5-hidroksiindoloctene kiseline mjerena je HPLC metodom. Rezultati: Akutna upala crvuljka potvrđena je u 81 djeteta, a u preostalih dvanaestoro nađen je drugi uzrok trbušne boli. Kontrolnu skupinu sačinjavalo je 102 zdrave djece. Srednje vrijednosti 5-hidroksiindoloctene kiseline u urinu bile su 24,68±14,21 u kontrolnoj skupini, 22,52±15,96 u djece s drugim uzrokom trbušne boli i 22,98±14,84 µmol/l u djece s akutnim apendicitisom. Statistički značajna razlika među skupinama nije nađena. Odredivši medijan svih izmjerenih vrijednosti 5-hidroksiindoloctene kiseline kao prijelomnu vrijednost, analizirali smo udjele pacijenata s povišenim vrijednostima po skupinama. Statistička analiza nije pokazala značajnu razliku u raspodjeli udjela među skupinama. AUC je bila 0,55 (95 % CI 0,47 to 0,62) s osjetljivošću i specifičnošću 60,4 % i 48,9 %. Nadalje, u djece s akutnom upalom crvuljka vrijednosti apsolutnog broja neutrofila bile su značajno povišene u odnosu na djecu s drugim uzrokom trbušne boli, a koja su operativno liječena. Također, Alvarado score veći od 8 pokazao se indikativnim za akutnu upalu crvuljka. Zaključak: Povišena koncentracija 5-hidroksiindoloctene kiseline u urinu nema prediktivnu vrijednost u akutnoj upali crvuljka. Više vrijednosti apsolutnog broja neutrofila ukazuju na progresiju procesa upale. Alvarado score pouzdan je prediktivni pokazatelj akutne upale crvuljka.
Abstract (english)	Aim: Acute appendicitis is the most common surgical emergency in children. Prompt diagnosis and surgical treatment are required to prevent complications. Enterochromaffin cells that contain large amounts of serotonin are mostly located in the distal appendix. Serotonin metabolite 5-hydroxyindoleacetic acid that is excreted in urine could therefore be a marker for acute appendicitis. We tested urinary 5-hydroxyindoleacetic acid concentrations in spot urine samples of children operated for the suspicion of acute appendicitis and in urine samples of healthy children to establish whether there was a difference in concentrations among the observed groups. Furthermore, we analysed the quality of Alvarado score and absolute neutrophil count as the predictors of acute appendicitis. Materials and methods: We enrolled 93 patients who underwent surgery for the suspicion of acute appendicitis and 102 healthy children. Their 5-hydroxyindoleacetic acid was measured using HPLC. Results: Acute appendicitis was confirmed in 81 children, whereas there were other explanations for abdominal pain in the remaining 12 patients in the non-appendicitis group. The control group comprised 102 healthy children. Mean levels of 5-hydroxyindoleacetic acid were 24.68±14.21 in the control group, 22.52±15.96 in the non-appendicitis group and 22.98±14.84 µmol/l in children with acute appendicitis. Taking the median of all measured 5- hidroxyindoleacetic acid values as a cut-off, we analysed the proportions of patients with elevated values among the groups. Statically significant difference was not shown. AUC was 0.55 (95 % CI 0.47 to 0.62) with sensitivity and specificity of 60.4 % and 48.9 %, respectively. In children with acute appendicitis the absolute neutrophil count values were significantly elevated when compared to those with another cause of abdominal pain. Alvarado score higher than 8 was identified as a good predictor of acute appendicitis. Conclusion: Urine 5-hydroxyindoleacetic acid concentration measured in spot samples is not a reliable method for diagnosing acute appendicitis in children. Higher values of absolute neutrophil count suggest there is a progression of the inflammatory process in the vermiform appendix. Alvarado score is a good predictor of acute appendicitis.
Keywords
Keywords (english)
Language	croatian
URN:NBN	urn:nbn:hr:184:250001
Study programme	Title: Biomedicine Postgraduate (doctoral) study programme Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
Type of resource	Text
File origin	Born digital
Access conditions	Access restricted to students and staff of home institution
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Repository	Repository of the University of Rijeka, Faculty of Medicine
Created on	2022-03-16 17:57:30