BULLYING THROUGH THE INTERNET - CYBERBULLYING

Introduction: Bullying is an aggressive, intentional act carried out by a group or an individual repeatedly and over time against a victim who cannot easily defend himself or herself. However, with the advent of electronic communication via the internet and mobile phones has led to appearence of a new form of violence, i.e. cyberbullying. Cyberbullying is define as “willful and repeated harm inflicted through computer, cell phones and other electronic device”. The aim of this paper is to point to the growing problem of cyberbullying. Methods: Review the research and theoretical literature. Results: Bullying through the Internet tends to occur at a later age, around 14 years, when children spend more time on their mobile phones and social networking sites. Estimates indicate that between 15% and 35% of young people have been victims of cyberbullying and between 10% and 20% of individuals admit to having cyberbullied others. Perpetrators of cyberbullying have a degree of anonymity not possible in traditional bullying, and the potential exposure and embarrassment of the victim is on a larger scale. It is possible to victimize a peer within their own home or elsewhere at any time of day or night, and should they remove themselves from the site, the messages often accumulate. Victims of bullying often have mental health problems, including depressive symptomatology, self-harm and suicidal behaviors. Conclusions: This presents new challenges for individuals, families, schools, professionals, researchers, and policy makers

PRESCRIBING PATTERNS IN ADOLESCENT PSYCHIATRIC PRACTICE: AN IMPORTANT ROLE OF ANTIPSYCHOTICS

Background: Many adolescents affected by psychiatric disorders require pharmacological treatment. Knowing which medication is being used is of utmost importance. Our main objective was to gain insight into prescribing patterns at the Department of child and adolescent psychiatry, Clinical Hospital Centre Rijeka. In addition, we looked for potential differences between adolescents regarding their pharmacotherapy status. Subjects and methods: The data from medical charts of 227 adolescents (55% females), age 12-18 years (16.4±1.18) were analysed. All of them were treated as outpatients during one year period (2014/15). Medical charts were obtained from the computerized archive system of Clinical Hospital Centre. Prescribed drug patterns were taken into account if patients have been taking medication for at least one month. Results: Most of the patients, 162 (71.4%), were treated with psychiatric medication. In the pharmacologically treated group, adolescents were older (t=-4.678; p<0.001), predominately male (χ2=5.175, p=0.023) and hospitalized (χ2=20.612, p<0.0001). Accordingly, male (OR=2.09, P<0.05) and hospitalized (OR=15.32, P<0.001) adolescents were more disposed to be medicated. Psychotic disorder was the most commonly diagnosed disorder (51 patients). There were 454 different prescribing patterns, mostly prescribed antipsychotics, 36.6% of all prescriptions; followed by 31.5% anxiolytics’ and 23.7% antidepressants’ prescriptions. However, number of patients receiving antipsychotics, anxiolytics and antidepressants was quite similar (103: 110: 99). The highest number of patients was treated with sertraline (58), followed by those treated with risperidone (48). Majority of the patients (104/227) were treated with polytherapy. Conclusion: Prescribing psychiatric pharmacotherapy for adolescents is a common clinical practice. Adolescents that were prescribed pharmacotherapy were significantly older; hospitalized and male adolescents were more prone to be medicated. Antipsychotics were most frequently prescribed drugs. The prescribing patterns are generally consistent with international trends and guidelines; however caution regarding high proportion of polytherapy is necessary

Adolescent compliance in psychiatric treatment

Suradljivost (engl. compliance) je pojam koji označava u kojoj mjeri pacijent provodi upute o liječenju koje mu je dao liječnik. Loša suradnja ugrožava pacijentovo zdravlje i život, a smanjuje i učinkovitost cjelokupnog zdravstvenog sustava. Rezultati istraživanja jako variraju, kako za psihijatrijske, tako i za ostale pacijente. Svrha rada jest dati pregled znanstvene i stručne literature na temu suradljivosti adolescenata u psihijatrijskom liječenju. Nema naznaka za postojanje razlike u suradnji između adolescenata i odraslih; izuzetak su adolescenti liječeni od prve psihotične epizode koji bolje surađuju od odraslih s istom dijagnozom. Do sada nije potvrđeno da sociodemografski čimbenici utječu na suradljivost adolescenata.Compliance is a term that indicates to what extent the patient follows the medical instructions. Poor compliance reduces treatment efficiency and the efficiency of the overall health system. Research results vary widely, both for psychiatric patients and other patients. The purpose of this paper is to review available literature on adolescent’s compliance to the psychiatric treatment. There is no indication of differences in adolescent or adult compliance levels, with one exception: adolescent treated for the first psychotic episode cooperate better than adults with the same diagnosis. So far it has not been confirmed that socio-demographic factors affect adolescent’s compliance

Successful Use of Silver Impregnated Hydrofiber Dressing in the Treatment of Kerion Celsi Caused by Microsporum gypseum

A method of treatment of tinea capitis is presented in the case of a 10-year-old boy who was referred to the pediatric surgical unit for the treatment of a skin lesion on the scalp which had persisted for more than two months. The initial dermatological examination led to the clinical diagnosis of inflammation of the scalp, while mycological analysis revealed an uncommon dermatophyte agent, Microsporum gypseum, in the culture. The lesion was subsequently treated with local and oral antifungal agents, but the antifungal therapy was discontinued due to developed liver dysfunction and replaced with treatment using a silver impregnated hydrofiber dressing. During one month of follow-up, the patient\u27s scalp lesion cleared completely. The treatment of tinea capitis is discussed.</p

Usporedba kratkoročnih ishoda perkutane radiofrekventne i mikrovalne ablacije u liječenju malih tumora bubrega

Although the gold standard in the management of kidney tumors is surgical treatment, thermal ablation methods are a viable therapeutic option for patients with small (<4 cm) renal masses who are poor surgical candidates. The aim of this study was to compare the technical success, primary efficacy and complication rate of percutaneous radiofrequency and microwave ablation in the treatment of small renal masses. A retrospective analysis of consecutive patients with small renal masses treated with radiofrequency or microwave ablation between December 2017 and January 2022 was conducted. Response to the ablative therapy was assessed on contrast-enhanced computed tomography examination after 3 months. Ablations of 44 kidney lesions were performed in 43 patients. Sixteen lesions were treated with radiofrequency and 28 with microwave ablation. Both methods were associated with high technical success (100%). Primary efficacy rates of radiofrequency and microwave ablation were 81.3% and 89.3%, respectively. Ablation-related complications were noted only in the patients treated with microwave ablation (18.5%), all of them being low grade (Clavien-Dindo 1 and 2). Radiofrequency and microwave ablation exhibited comparable efficacy in the treatment of small renal masses. Microwave ablation was associated with a comparatively higher number of complications.Iako je zlatni standard u liječenju tumora bubrega kirurško liječenje, metode termalne ablacije dobar su izbor za bolesnike s malim (<4 cm) tumorima bubrega koji nisu kandidati za operativni zahvat. Cilj ovoga rada je usporediti tehnički uspjeh, odgovor na terapiju i učestalost komplikacija perkutane radiofrekventne i mikrovalne ablacije u liječenju malih tumora bubrega. Učinjena je retrospektivna analiza uzastopnih bolesnika s malim tumorima bubrega liječenih radiofrekventnom ili mikrovalnom ablacijom između prosinca 2017. i siječnja 2022. godine. Odgovor na terapiju procijenjen je na temelju pregleda kompjutoriziranom tomografijom 3 mjeseca nakon zahvata. Ablacijom su liječene 44 lezije kod 43 bolesnika, pri čemu je 16 lezija liječeno radiofrekventnom, a 28 mikrovalnom ablacijom. Kod obje metode postignuta je visoka razina tehničkog uspjeha (100%). Potpun odgovor na terapiju zabilježen je kod 81,3% lezija liječenih radiofrekventnom i 89,3% lezija liječenih mikrovalnom ablacijom. Komplikacije vezane uz ablaciju zabilježene su samo kod bolesnika liječenih mikrovalnom ablacijom (18,5%), no sve su bile niskog gradusa (Clavien-Dindo 1 i 2). Radiofrekventna i mikrovalna ablacija podjednako su uspješne u liječenju malih tumora bubrega, pri čemu je mikrovalna ablacija povezana s usporedbeno većim brojem komplikacija

SPONTANEOUS RETROPERITONEAL BLEEDING CAUSED BY RUPTURE OF THE NATIVE KIDNEY ONCOCYTOMA TWELVE YEARS AFTER RENAL TRANSPLANTATION

Transplantacija je metoda izbora nadomještanja bubrežne funkcije za većinu bolesnika u terminalnoj fazi bubrežnog zatajivanja koji nemaju kontraindikacija za primjenu imunosupresijske terapije. Imunosupresijski lijekovi se povezuju s brojnim komplikacijama među kojima je i povećana učestalost tumora. Prikazujemo bolesnika koji je tijekom 25 godina liječenja prošao put od dijalize preko dvije transplantacije bubrega da bi na kraju nakon razvoja spontanog retroperitonealnog hematoma ponovno započeo liječenje hemodijalizom. Tek je prilikom reoperacije otkriveno da se radi o krvarenju iz onkocitoma vlastitog bubrega. Naglašavamo važnost redovitog praćenja vlastitih bubrega što je izuzetno teško zbog izražene fibroze koja otežava prikaz organa ultrazvukom.Renal transplantation is the method of choice for renal replacement therapy in the majority of patients. Immunosuppressive drugs may increase the risk of developing malignancies. We present a case of a patient having undergone different renal replacement methods over 25 years. He had good graft function at 12 years of transplantation. Development of spontaneous retroperitoneal hematoma caused by rupture of the native kidney oncocytoma was complicated with sepsis and deterioration of graft function. We emphasize the importance of regular ultrasonography follow-up of native kidney, which is challenging because of ibrous changes

SPONTANEOUS RETROPERITONEAL BLEEDING CAUSED BY RUPTURE OF THE NATIVE KIDNEY ONCOCYTOMA TWELVE YEARS AFTER RENAL TRANSPLANTATION

Transplantacija je metoda izbora nadomještanja bubrežne funkcije za većinu bolesnika u terminalnoj fazi bubrežnog zatajivanja koji nemaju kontraindikacija za primjenu imunosupresijske terapije. Imunosupresijski lijekovi se povezuju s brojnim komplikacijama među kojima je i povećana učestalost tumora. Prikazujemo bolesnika koji je tijekom 25 godina liječenja prošao put od dijalize preko dvije transplantacije bubrega da bi na kraju nakon razvoja spontanog retroperitonealnog hematoma ponovno započeo liječenje hemodijalizom. Tek je prilikom reoperacije otkriveno da se radi o krvarenju iz onkocitoma vlastitog bubrega. Naglašavamo važnost redovitog praćenja vlastitih bubrega što je izuzetno teško zbog izražene fibroze koja otežava prikaz organa ultrazvukom.Renal transplantation is the method of choice for renal replacement therapy in the majority of patients. Immunosuppressive drugs may increase the risk of developing malignancies. We present a case of a patient having undergone different renal replacement methods over 25 years. He had good graft function at 12 years of transplantation. Development of spontaneous retroperitoneal hematoma caused by rupture of the native kidney oncocytoma was complicated with sepsis and deterioration of graft function. We emphasize the importance of regular ultrasonography follow-up of native kidney, which is challenging because of ibrous changes