Biliary brush cytology for the diagnosis of malignancy: a single center experience [Citološki razmazi brisa četkicom u dijagnostici malignih promjena bilijarnog stabla: naše iskustvo]

Differentiation between benign and malignant biliary strictures is critical to the provision of adequate treatment. Brush cytology during the endoscopic retrograde cholangiopancreatography (ERCP) is the most commonly used method for obtaining tissue confirmation of the nature of biliary strictures. It’s specificity is remarkably high but reported sensitivities for the diagnosis of malignancy are low. Aim of our study was to assess sensitivity and specificity of biliary brush cytology in our institution, to find out main causes of false negative diagnoses and to confirm impression that the team approach has impact on sensitivity. Gold standard for diagnosis was definitive surgical histology or adequate clinical follow up for minimum of six month. Direct smears made by cytotechnician at the endoscopy room, and stained according to Papanicolaou and May-Grünwald Giemsa (MGG) were examined for well-recognized features of malignancy on conventional smears as a part of diagnostic routine. Cytologic diagnoses were benign, atypical/reactive, suspicious for malignancy and malignant. Of 143 brushings with available definitive diagnosis 36 (25%) had malignant cytologic diagnosis and 91(63.6%) were classified as benign, 3 were atypical/reactive and 13 suspicious for malignancy with 20 »false-negative« cases. When specimens with atypical and suspicious cytology were excluded from data analysis sensitivity was 64% and specificity was 100% and when suspicious findings were taken into account as true positives sensitivity rose to 71%. We find that biliary brush cytology, although mainly depending on the skill of endoscopist, as well as the experience of the cytologist, is a valuable method for obtaining accurate tissue diagnosis of biliary strictures, thus solving eternal diagnostic dilemma: benign or malignant

Poligon prepreka u funkciji procjene biotičkih motoričkih znanja šestogodišnjaka

The study was conducted in order to determine the appropriateness of assessment of the level of fundamental movement skill development of six-year-old children by using an obstacle polygon. In accordance with the aim of the study, a sample of 78 six-year-old pupils (39 boys and 39 girls) was used. Through high inter-item correlation and high Cronbach\u27s alpha coefficient, the results clearly indicate excellent reliability of the measuring instrument. Furthermore, normality of the distribution clearly points to the good discriminative power of the polygon. The t-test showed no differences between boys and girls in both the applied polygon and morphological features. The results of the multiple regression analysis with two predictors showed no impact of the used morphological features on the performance of fundamental movement skill assessment manifested through the obstacle polygon. The obtained results clearly point to a very high applicability of the polygon in the physical education curriculum as an instrument for assessment and verification of fundamental movement skills among six-year-old children. Istraživanje je provedeno s ciljem utvrđivanja prikladnosti i mogućnosti procjene stupnja razvijenosti biotičkih motoričkih znanja šestogodišnjaka koristeći se poligonom prepreka. U skladu s navedenim koristit će se uzorak od 78 učenika (39 dječaka, 39 djevojčica) u dobi od 6 godina. Kroz visoke iner-item korelacije i visoki Chronbach alpha koeficijent, rezultati jasno ukazuju na zadovoljavajuću pouzdanost mjernog instrumenta. Nadalje, rezultati KS testa jasno ukazuju na dobru strukturu odnosno osjetljivost poligona. T-testom je utvrđeno nepostojanje razlika između dječaka i djevojčica kako u primijenjenom poligonu tako i u morfološkim karakteristikama. Nadalje, rezultati višestruke regresijske analize sa dva prediktora pokazali su da ne postoji utjecaj morfoloških karakteristika na izvedbu poligona za procjenu biotičkih motoričkih znanja. Dobiveni rezultati nedvosmisleno ukazuju na praktičnost i primjenjivost poligona u nastavnom procesu tjelesne i zdravstvene kulture kao sredstva za procjenu i provjeru biotičkih motoričkih znanja

MANAGEMENT OF DEVELOPMENT PHASES IN SPORT

Abstrac

Biliary Brush Cytology for the Diagnosis of Malignancy: A Single Center Experience

Differentiation between benign and malignant biliary strictures is critical to the provision of adequate treatment. Brush cytology during the endoscopic retrograde cholangiopancreatography (ERCP) is the most commonly used method for obtaining tissue confirmation of the nature of biliary strictures. It’s specificity is remarkably high but reported sensitivities for the diagnosis of malignancy are low. Aim of our study was to assess sensitivity and specificity of biliary brush cytology in our institution, to find out main causes of false negative diagnoses and to confirm impression that the team approach has impact on sensitivity. Gold standard for diagnosis was definitive surgical histology or adequate clinical follow up for minimum of six month. Direct smears made by cytotechnician at the endoscopy room, and stained according to Papanicolaou and May-Grünwald Giemsa (MGG) were examined for well-recognized features of malignancy on conventional smears as a part of diagnostic routine. Cytologic diagnoses were benign, atypical/reactive, suspicious for malignancy and malignant. Of 143 brushings with available definitive diagnosis 36 (25%) had malignant cytologic diagnosis and 91(63.6%) were classified as benign, 3 were atypical/reactive and 13 suspicious for malignancy with 20 »false-negative« cases. When specimens with atypical and suspicious cytology were excluded from data analysis sensitivity was 64% and specificity was 100% and when suspicious findings were taken into account as true positives sensitivity rose to 71%. We find that biliary brush cytology, although mainly depending on the skill of endoscopist, as well as the experience of the cytologist, is a valuable method for obtaining accurate tissue diagnosis of biliary strictures, thus solving eternal diagnostic dilemma: benign or malignant

Prevalence of Metabolic X Syndrome in the Interior of Croatia: The Baranja Region

Metabolic syndrome (MS), a constellation of metabolic risk factors associated with development of cardiovascular diseases and type 2 diabetes, has emerged as a public health problem of enormous proportions in developed and developing countries. We have reported previously its prevalence in several isolated island populations in the Eastern Adriatic coast of Croatia. In spite of leading a relatively traditional life style pattern including the practice of a typical Mediterranean diet, the prevalence of MS in these populations is high and comparable to those in developed nations. However, data on prevalence of the syndrome in mainland Croatia is limited. We have, therefore, conducted a study in an outbred population comprising of Croats, Hungarians and Serbs from the Baranja region of mainland Croatia. Although this is an ethnically heterogenous population, the constituent groups exchange mates and therefore, are not reproductively isolated. The life style patterns are also similar. We observed similar prevalence of MS in these groups. We assessed MS following the definitions prescribed in the guidelines of the World Health Organization (WHO) and the National Cholesterol Education Program (NCEP). Overall prevalence is considerably high in this cosmopolitan group, by WHO criteria 26% in males and 38% in females, and by NCEP criteria 84% in males and 71% in females. It is likely that, in addition to genetic risk factors, a host of environmental factors that include dietary habit and relatively urban life style in a modernized society influence the levels of the constituent metabolic traits leading to increase prevalence of MS

FINALNI REZULTAT NA TURNEJI 4 SKAKAONICE 2008/09 U ODNOSU NA REZULTATE UNUTAR POJEDINIH NATJECANJA

The aim of this article was relation determination of final score position on Ski- jump Tournament 2008/09 with particular competition phases. As methodological ex- ploration, research was conducted with intention of determination of competition phases of individual ski-jumping location. Data of 67 jumpers that at least once (of 4 possible situations) take one of 50 best places were taken as official results. Correlation analysis were applied, and average correlation of individual matches also, for total sample as well as for sub-samples of 30, 20, 15 and 10 jumpers that were best positioned at the end of Tournament. Results have shown a set of information existence that is best to explain as: a) tactical introduction, b) real positioning, c) technical test, and d) value confirma- tion. Originality of research is expressed in the defining total logic of particular jumping location, and limitations of research could be defined in the part that correspond with extraordinary situations like whether conditions, bad mistakes of best jumpers and even- tually connected with total position of some jumpers in World cup. With those situations respect research for sure remains highly methodologically positione

RAZLIKE PARAMETARA SLOBODNOG VREMENA UČENICA I UČENIKA GIMNAZIJA

The aim of this research was to determine gender differences in middle school samples, i.e. male and female students of grammar schools. Examinee’s data (647 fema- les and 400 males) were collected by questionnaire that consist 60 indicators of leisure time and physical exercise with offered scale of 5 answers from “totally disagree” to “totally agree”. Data were processed by normalization, elementary statistics, and for this work purposes it was Analysis of variance for independent samples applied. The result shows us that gender samples expressed statistically significant differences in 21 variables that could be grouped in three set of attitudes: a) activity perception, b) way of activation, and 3) systematic support. It was assumed that results reflect significant part of conservative attitudes, but it is possible that differences come-out from ordinary gen- ders role acceptance as well as from biological presumptions. Methodologically, work brings applicable results without statistical limitations except in the part which demands transparency forward samples from other locations and schools

DIGITALIZATION OF OBJECTS

Abstract Computer supported technologies such as CAD, CAM, CAE and others, requir

Prevalence of metabolic syndrome in the interior of Croatia: the Baranja region

Metabolic syndrome (MS), a constellation of metabolic risk factors associated with development of cardiovascular diseases and Type 2 diabetes (T2D), has emerged as a public health problem of enormous proportions in developed and developing countries. We have reported previously its prevalence in several island populations of the Eastern Adriatic coast of Croatia. In spite of leading a relatively traditional life style pattern including adherence to a Mediterranean diet, the prevalence of MS in these populations is high and comparable to that in developed nations. However, data on prevalence of MS among the mainland Croatian populations is limited. Therefore, we conducted a study in an outbred population comprising of Croats, Hungarians and Serbs from the Baranja region of mainland Croatia. Although this is an ethnically heterogeneous population, the constituent groups exchange mates and therefore, are not reproductively isolated. The life style patterns are also similar. Overall prevalence of MS, assessed by the National Cholesterol Education Program (NCEP) criteria, is 40% (35% in males and 42% in females) with Body Mass Index (BMI) as the predictor of obesity and 42% (52% in males and 39% in females) with Waist Hip Ratio (WHR) as the predictor of obesity. It is likely that, in addition to genetic risk factors, a host of environmental factors that include dietary habits and relatively urban life style in a modernized society have influenced the levels of the constituent metabolic traits leading to an increased prevalence of MS