Background: It is well-known that rotating shift work disrupts the circadian rhythm and sleep quality in nurses. With this study, we aimed to compare subjectively and objectively measured sleep quality in nurses, specifically focusing on any differences that arose in relation to shift work. Methods: This prospective, observational, cross-sectional study was conducted in 2025 in Croatia; a total of 140 nurses participated. Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI) and FitBit Charge 3 smartwatch, which monitored sleep over an eight-day period. Results: Most nurses rated their sleep as good or very good, but according to the PSQI questionnaire, all participants were classified as poor sleepers (PSQI > 5). Objective smartwatch measurements showed that nurses working only day shifts had higher sleep scores (median 77, IQR 75–80 vs. 73, IQR 68–76; p < 0.001), significantly longer total sleep duration (median 6.4, IQR 6.3–7.1 vs. 5.5, IQR 5.2–6.2 h; p < 0.001), and longer durations of all sleep stages compared with those working rotating shifts. Conclusions: Most nurses subjectively rated their sleep as good or very good; however, according to the PSQI questionnaire results, all were classified as poor sleepers, with no significant difference related to shift work. Objective measurements using the smartwatch indicated that rotating shift work is associated with significantly poorer sleep quality.

Acute appendicitis is one of the most frequent surgical emergencies. However, its clinical presentation can vary significantly across patient populations. This review summarizes the clinical presentation of acute appendicitis in children, adults, pregnant women, and older adults. While classic symptoms such as abdominal pain that migrates to the right lower quadrant, anorexia, nausea and vomiting are well recognised in the general adult population, they are often absent or altered in children, pregnant women and older adults. In children, symptoms may be nonspecific and and resemble a viral infection, and difficulties in describing pain often contribue to delayd diagnosis and increased risk of perforation. In pregnancy, anatomical displacement of abdominal organs reduce the accuracy of physical examination, complicating decision-making. Older adults commonly present with poorly defined abdominal discomfort, minimal tenderness and reduced inflammatory response due to comorbidities and age-related immune dysfunction, resulting in increased complications and mortality rates. Awareness of these population-specific differences and careful clinical evaluation are essential to prevent diagnostic delays and improve outcomes. Keywords: appendicitis; diagnosis; child; pregnancy; aged

Urtikarija, ili koprivnjača, je jedan od najčešćih razloga dolaska u hitnu službu i često se smatra kao bezazleno kliničko stanje koje se uspješno liječi antihistaminicima. No, što kada se iza naizgled tipičnog osipa krije nešto daleko ozbiljnije? Predstavljen je slučaj 35-godišnje bolesnice koja se javljala u hitnu službu zbog akutne urtikarije koja nije odgovarala na standardnu terapiju. Daljnja dijagnostička obrada, uz primjenu ultrazvuka, otkrila je aktivnu hidatidnu bolest, uzrokovanu ehinokoknom cistom jetre. Ovaj slučaj naglašava važnost širokog diferencijalno dijagnostičkog pristupa pri procjeni bolesnika s atipičnim ili terapijski rezistentnim oblicima urtikarije, jer u rijetkim slučajevima može upućivati na ozbiljnu osnovnu bolest, zahtijevajući pravovremeno prepoznavanje i ciljano liječenje.

Background/Objectives: This study evaluated the diagnostic performance of serum leucine-rich alpha-2-glycoprotein 1 (LRG1) and plasma calprotectin in adults with suspected acute appendicitis, compared them with routine inflammatory markers and clinical scores, and examined their association with abdominal guarding and the discrimination of uncomplicated from complicated appendicitis. Methods: Adults aged ≥18 years were enrolled in two Croatian emergency departments from April 2025 to March 2026. Acute appendicitis was histopathologically confirmed, whereas controls were defined by clinical follow-up or negative appendiceal histopathology. Biomarkers were measured using enzyme-linked immunosorbent assays, and diagnostic performance was assessed using receiver operating characteristic (ROC) analysis with area under the curve (AUC). Results: Among 126 patients, 62 (49.2%) had acute appendicitis and 64 (50.8%) were controls. Serum LRG1 was higher in patients with acute appendicitis than controls (27.4 μg/mL; IQR 25.3–28.0 vs. 23.2 μg/mL; IQR 17.6–27.8; p = 0.01), whereas plasma calprotectin did not differ. LRG1 was higher in cases with abdominal guarding (p = 0.02), but neither biomarker differed significantly between uncomplicated and complicated appendicitis. Conclusions: LRG1 showed limited diagnostic accuracy, while calprotectin showed no meaningful discrimination. The Adult Appendicitis Score and Appendicitis Inflammatory Response score outperformed both biomarkers.

U medicini se ponekad susrećemo sa slučajevima koji zvuče neobično, ali zapravo imaju sasvim logično objašnjenje. Jedan od takvih je i Sindrom Superhika - stanje koje bi legendarni negativac iz serijala Alan Ford s ponosnom nosio kao svoje ime. Iako simptomi poput bolova u trbuhu, mučnine i povraćanja možda ne djeluju neobično, njihova povezanost s prekomjernom konzumacijom alkohola i metaboličkim promjenama može dovesti do alkoholne ketoacidoze – potencijalno opasnog stanja koje se lako previdi. I dok bi protivnici u stripu padali u nesvijest od njegovog ubojitog zadaha, u stvarnom životu taj isti simptom može biti znak metaboličkog kaosa koji zahtijeva hitnu intervenciju.