STRESS AND MOBBING AT WORK IN CROATIAN LEGISLATURE

Ovaj članak obrađuje problematiku stresa i zlostavljanja na radu s podacima istraživanja ovog fenomena koje je provedeno tijekom 2000. godine u članicama Europske unije. Istraživanje je bilo osnova za donošenje Okvirnog sporazuma koji se odnosi na stres prouzročen na radnom mjestu. Stresu i zlostavljanju na radu dana je posebna pozornost koje definiraju osnovna načela Zakona o radu kojima se zabranjuje diskriminacija na području radnih odnosa u Republici Hrvatskoj. Iz iznesenih konstatacija nedvojbeno proizlazi da stres nije bolest, ali izloženost stresu može prouzročiti bolest. Stajalište autorice je da u Hrvatskoj pravog strateškog mobinga ima znatno manje nego u članicama Europske unije, i to prvenstveno iz razloga što je u Hrvatskoj jednostavnije otpustiti radnika nego što je to u zemljama Europske unije, kao i da mobing, odnosno zlostavljanje na radnom mjestu, dovodi do trajnog oštećenja zdravlja.SUMMARY: The paper focuses on the problem of stress and mobbing at work and provides data obtained in the study conducted with regard to this issue in the course of 2000 in the countries members of the European Union. The study served as the basis for a Frame Agreement referring to stress caused by work environment. Stress and mobbing were given special attention in the formulation of the basic principles utilised in the drafting of the Labour Act, forbidding any discrimination in labour relations in the Republic of Croatia. Findings show without a doubt that stress is not a disease but exposure to stress may cause disease. The author supports the view that in Croatia the incidence of real mobbing is significantly lower than in the members of the European Union, primarily because in Croatia it is relatively simpler to fire a worker than it is the case in European countries. Another conviction expressed by the author is that stress leads to permanent impairment of health

Increased Glomerular Filtration Rate in Early Stage of Balkan Endemic Nephropathy

Background: A previous study indicated that Balkan endemic nephropathy (BEN) patients in the early stage of the disease had significantly higher creatinine clearance (Ccr) than healthy persons. The aim of the study was to assess whether tubular creatinine secretion affects Ccr in early stages of BEN and to check the applicability of serum creatinine-based glomerular filtration rate (GFR) equations in these patients. Methods: The study involved 21 BEN patients with estimated GFR (eGFR) above 60 mL/min/1.73 m(2), excluding any conditions that could affect GFR or tubular creatinine secretion, and 15 healthy controls. In all participants Ccr with and without cimetidine and iohexol clearance (mGFR) were measured and eGFR calculated using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease Study (MDRD) equations. Glomerular hyperfiltration cutoff (GFR-HF) was calculated. Results: There was no significant difference between the groups in Ccr before and after cimetidine or for eGFR, but mGFR was significantly higher in BEN patients than in controls (122.02 +/- 28.03 mL/min/1.73 m(2) vs. 101.15 +/- 27.32 mL/min/1.73 m(2); p = 0.032). Cimetidine administration reduced Ccr by 10% in both groups. The ratio of Ccr to mGFR was significantly above one in seven BEN patients and five controls and their mGFR values were similar. Seven other patients and eight controls had this ratio equal to one, while values below one were recorded for seven more patients and two controls. mGFR of all these 14 patients was significantly higher than that of healthy controls (129.88 +/- 27.52 mL/min/1.73 m(2) vs. 107.43 +/- 19.51 mL/min/1.73 m(2); p = 0.009). Mean GFR-HF was significantly higher than mGFR in controls, but these two values were similar in BEN patients. eGFR underestimated mGFR in both BEN patients and controls. Conclusion: The ratio of Ccr to mGFR and mGFR to GFR-HF indicated that elevated mGFR in early stages of BEN could be explained by increased glomerular filtration, but tubular creatinine secretion augmented Ccr in a smaller proportion of patients, who did not differ from healthy subjects

Interdisciplinary crossover for rapid advancements - collaboration between medical and engineering scientists with the focus on Serbia

Over the past decades, development of engineering sciences has vastly contributed to advancements in medicine by production of numerous devices for diagnostics and treatment. In the middle of the 20th century, a new scientific field, biomedical engineering (BE), was established, which has developed into an extremely complex scientific discipline requiring a distinctive educational profile. Various study programs in BE have been established at universities around the world but also at several universities in Serbia. Also, intensive research in this field is performed at several scientific institutions in Serbia. In the present paper, short summaries of the research results of several groups of engineers and medical doctors are presented as an illustration of the wide field of BE research and possibilities of its application in diagnosis and therapy of various diseases

Interdisciplinary crossover for rapid advancements: Collaboration between medical and engineering scientists with the focus on Serbia

Napretku medicine su poslednjih decenija veoma mnogo doprineli pronalasci iz različitih oblasti inženjerstva. Polovinom dvadesetog veka uspostavlja se nova naučna oblast, biomedicinsko inženjerstvo (BI), koje se do sada razvilo u veoma složenu naučnu disciplinu koja je zahtevala i poseban obrazovni profil. Na univerzitetima širom sveta, kao i na nekoliko univerziteta u Srbiji ustanovljeni su različiti programi iz oblasti biomedicinskog inženjerstva. Takođe, u nekoliko naučnih institucija u Srbiji sprovode se intenzivna istraživanja u ovoj oblasti. U ovom radu prikazani su rezultati istraživanja nekoliko grupa naučnika iz oblasti inženjerstva i medicine sa ciljem da se ilustruje koliko je široko polje istraživanja u oblasti biomedicinskog inženjerstva i kakve su mogućnosti njihove primene u dijagnostici i lečenju različitih bolesti.Over the past decades, development of engineering sciences has vastly contributed to advancements in medicine by production of numerous devices for diagnostics and treatment. In the middle of the 20th century, a new scientific field, biomedical engineering (BE), was established, which has developed into an extremely complex scientific discipline requiring a distinctive educational profile. Various study programs in BE have been established at universities around the world but also at several universities in Serbia. Also, intensive research in this field is performed at several scientific institutions in Serbia. In the present paper, short summaries of the research results of several groups of engineers and medical doctors are presented as an illustration of the wide field of BE research and possibilities of its application in diagnosis and therapy of various diseases

Usporavaenje progresije hronične insuficijencije bubrega kaptoprilom kod pacova sa spontanom arterijskom hipertenzijom i adriamicinskom nefropatijom

In SHRs with ADR nephropathy treatment with captopril normalized systemic blood pressure, and slowed down CRF progression in their early stage. These functional changes correlate with significant slowing of glomerular and interstitial changes.Uticaj arterijske hipertenzije na progresiju hronične insuficijencije bubrega opisan je u brojnim eksperimentalnim i kliničkim studijama. Samim tim uticaj različitih antihipertenzivnih lekova ka regulisanju pritiska krvi i usporavaju progresne hronične insuficijencije bubrega još uvek je predmet rasprava i neslaganja mnogih naučnika. Cilj ovog rada bio je da se ispita uticaj kaptoprila na kliničke, biohemijske i morfološke promene kod pacova sa spontanom arterijskom hipertenzijom i nefropatijom izazvanom adriamicinom. Šezdeset i devet ženki pacova sa spontanom arterijskom hipertenzijom (stare 24 nedelje) svrstane su u tri grupe: 1. kontrolna grupa - 12; 2. grupa s nefropatijom izazvanom adriamicinom - 27 sa spontanom arterijskom hipertenzijom koja je tretirana adriamicinom (2 mg/kg i.V. dva puta u 20 dana); 3. grupa s nefropatijom izazvanom adriamicinom - grupa S: 30 sa spontanom arterijskom hipertenzijom tretirana adriamicinom i kaptoprilom (60 mg/kg dnevno). Sistolni pritisak krvi meren je na dve nedelje, a analize seruma i urina na početku studije i u 6-oj, 12. i 18. nedele posle druge injekcije adriamicina. Životinje su žrtvovane 6-e, 12. i 18. nedelje od početka tretiranja kaptoprilom. Patomorfološke promene prikazane su semikvantitativno izračunavanjem indeksa glomerula vaskularnog indeksa, kao i indeksa fibroze intersticijuma i infiltracije, i atrofije tubula. Kaptopril je normalizovao sistemski pritisak krvi, ali nije smanjio proteinuriju kod pacova sa spontanom arterijskom hipertenzijom. Ureja i kreatinin u serumu progresivno su rasli u svim ispitivanim grupama pacova, ali brže kod pacova koji su tretirani adriamicinom. Klirens kreatinina najbrže je opadao u grupi kod pacova s nefropatijom izazvanom adriamicmom. Kaptopril smanjuje promene u glomerulima kod pacova sa spontanom arterijskom hipertenzijom i nefropatijom izazvanom adriamicinom s visokom statističkom značajnošću u 18-oj nedelji studije. Promene u intersticijumu kod pacova sa spontanom arterijskom hipertenzijom koji su tretirani adriamicinom uvećavaju ce u toku ogleda, ali statistički značajno sporije u svim nedeljama studije u grupi pacova s nefropatijom izazvanom adriamicinom (grupa C) Kaptopril nije uticao na promene u tubulima kod ovih životinja

The Pharmacokinetics of Recombinant Human Erythropoietin in Balkan Endemic Nephropathy Patients

Background: Balkan endemic nephropathy (BEN) hemodialysis patients require a higher dose of recombinant human erythropoietin for maintaining target hemoglobin level than patients with other kidney diseases. Objectives: Comparison of the pharmacokinetics of beta-erythropoietin given subcutaneously to hemodialysis patients with BEN or other kidney diseases (non-BEN). Methods: Recombinant human erythropoietin (75U/kg) was administered subcutaneously to 10 BEN and 14 non-BEN hemodialysis patients. The predose plasma level of erythropoietin (Epo) was subtracted from all postdose levels. The relevant pharmacokinetic parameters were calculated after noncompartmental pharmacokinetic analysis using Kinetica software (Thermo Scientific, ver.5.0). Results: Although basal plasma Epo concentration was similar in BEN (20.1 +/- 10.3U/L) and non-BEN (15.1 +/- 8.1U/L; p=.1964) patients, there were significant differences between the groups for elimination rate constant (0.016 +/- 0.006 vs 0.026 +/- 0.011 hr(-1); p=.020) and elimination half-life (50.24 +/- 19.12 vs 33.79 +/- 18.91 hr, p=.048). These differences remained significant after adjustment for patient characteristics (age, sex, hennodialysis duration, ferritin, PTH and ACEI use). No significant differences between groups were found in maximal Epo concentration, time to maximum Epo concentration, area under the curve from time of dosing extrapolated to infinity, clearance, mean residence time of Epo between groups both before and after adjustment. Conclusion: Pharmacokinetic analysis of beta-erythropoietin detected a significantly longer elimination half-life in BEN than in non BEN patients. This finding needs to be confirmed in a well-controlled study with a larger sample size

Dijabetesna nefropatija u tipu 2 dijabetesa: učestalost i faktori rizika

Uvod. Ciljevi rada su bili da se utvrdi učestalost i faktori rizika za dijabetesnunefropatiju (DN) kod bolesnika sa tipom 2 dijabetesa i faktori povezanisa pogoršanjem funkcije bubrega tokom trogodišnjeg perioda.Metode. Studija je obuhvatila 81 bolesnika sa tipom 2 dijabetesa kojisu na početku studije svrstani u dvije grupe: prva, 41 bolesnik sa DN (27muškaraca, 62,03 ± 7,73 godina) i druga, 40 bolesnika bez DN (17 muškogpola, 61,73 ± 11,55 godina). Svim bolesnicima je uzeta anamneza, urađenobjektivni pregled i laboratorijska ispitivanja. Na osnovu rezultata ispitivanja,poslije tri godine bolesnici obje grupe su podijeljeni u podgrupe sanepromjenjenom funkcijom bubrega i podgrupe sa pogoršanjem funkcijedefinisanim kao povećanje proteinurija i/ili smanjenje jačine glomerulskefiltracije (JGF) za više od 25%.Rezultati. Na početku ispitivanja zabilježena je visoka učestalost poznatihfaktora rizika za dijabetes i DN kod obje grupe. Multivarijantna logističkaanaliza izdvojila je ženski pol i trajanje dijabetesa kao značajne prediktoreDN. Nakon tri godine funkcija bubrega se pogoršala kod oko 50% bolesnikasa i bez DN, a u podgrupama sa pogoršanjem funkcije bubrega glikemijanašte i HbA1c su bili statistički značajno veći nego u podgrupama sastabilnom funkcijom bubrega. Linearna regresiona analiza je pokazala daje promjena JGF u trogodišnjem periodu značajno povezana sa starošćubolesnika, trajanjem dijabetesa, sistolnim krvnim pritiskom, razlikom u dijastolnomkrvnom pritisku i proteinuriji. Promjena u proteinuriji značajnoje povezana sa sistolnim krvnim pritiskom, razlikom u dijastolnom krvnompritisku, kao i HbA1c i JGF na kraju studije.Zaključak. Kod bolesnika sa tipom 2 dijabetesa ženski pol i duže trajanjedijabetesa izdvojeni su kao značajni faktori rizika za DN, a starost bolesnika,trajanje dijabetesa, povišen krvni pritisak, loša glikoregulacija kao faktoririzika za pogoršanje funkcije bubrega

Sex-specific differences in the epidemiology, progression, and outcomes of chronic kidney disease

Higher prevalence of chronic kidney disease (CKD) in women than in men was reported all over the world. This difference could be partly explained by longer life expectancy and slower CKD progression rate in women. Potential factors associated with sex differences in CKD progression are as follows: difference in glomerular hemodynamic and the response to angiotensin II; sex hormones – estrogen has protective and testosterone deleterious effects on CKD progression; lifestyle. In most countries, the percentage of men is higher than that of women among incident and prevalent patients on hemodialysis (HD). In HD patients, the Kt/V index overestimates HD adequacy, secondary hyperparathyroidism is more common in women, and women require higher doses of erythropoiesis-stimulating agents for achieving and maintaining the hemoglobin target level. The survival of HD patients is equal for both sexes. In earlier years, an equal percentage of women and men started peritoneal dialysis, but in recent years, a higher percentage of women, especially at younger ages, start peritoneal dialysis. Initial peritoneal transport properties differ between men and women. A smaller percentage of women than men receive deceased donor kidneys, but women are more likely to be living kidney donors. Kidney allograft outcome depends on the sex and age of both the recipient and the donor. Cardiovascular diseases are the most common cause of death for renal replacement therapy patients of both sexes. Although sex-specific differences have been described in CKD patients, the inequality of patients in access to medical care has not been found in most regions of the world