Institutional practices and policies in acid-base testing: a self reported Croatian survey study on behalf of the Croatian society of medical biochemistry and laboratory medicine Working Group for acid-base balance

ntroduction: The aim of this survey study was to assess the current practices and policies in use related to the various steps in the blood gas testing process, across hospital laboratories in Croatia. Materials and methods: First questionnaire was sent by email to all medical biochemistry laboratories (N = 104) within general, specialized and clinical hospitals and university hospital centres to identify laboratories which perform blood gas analysis. Second questionnaire with detailed questions about sample collection, analysis and quality control procedures, was sent only to 47 laboratories identified by the first survey. Questionnaire was designed as combination of questions and statements with Likert scale. Third questionnaire was sent to all participating laboratories (N=47) for additional clarification for either indeterminate or unclear answers. Results: Blood gas analysis is performed in 47/104 hospital laboratories in Croatia. In 25/41 (0.61) of the laboratories capillary blood gas sampling is the preferred sample type for adult patient population, whereas arterial blood sample is preferentially used in only 5/44 laboratories (0.11). Blood sampling and sample processing for capillary samples is done almost always by laboratory technicians (36/41 and 37/44, respectively), whereas arterial blood sampling is almost always done by the physician (24/29) and only rarely by a nurse (5/28). Sample acceptance criteria and sample analysis are in accordance with international recommendations for majority of laboratories. 43/44 laboratories participate in the national EQA program. POCT analyzers are installed outside of the laboratory in 20/47 (0.43) institutions. Laboratory staff is responsible for education and training of ward personnel, quality control and instrument maintenance in only 12/22, 11/20 and 9/20 institutions, respectively. Conclusions: Practices related to collection and analysis for blood gases in Croatia are not standardised and vary substantially between laboratories. POCT analyzers are not under the direct supervision by laboratory personnel in a large proportion of surveyed institutions. Collective efforts should be made to harmonize and improve policies and procedures related to blood gas testing in Croatian laboratories

Dark brown serum and plasma samples: a case report

This case report describes occurrence of unusual, dark brown coloration of citrate plasma and serum samples in a female 68 years old patient admitted into Emergency department (ED). Patient complained of nausea and vomiting, fever up to 38.9°C, colicky pain in abdomen, diminished urinary output and yellowish skin tone. Her medical history included arterial hypertension, hypothyroidism and facial squamous cell carcinoma. For previous two years, she was treated with tuberculostatic therapy for Mycobacterium avium positive interstitial lung disease. Regular follow-up showed no signs of active disease. Upon admission to ED, complete blood count (CBC) analysis showed low red blood count (RBC) (3.76 x1012/L (reference interval (RI) 3.86 – 5.08 x1012/L)), low haemoglobin (Hb) concentration (111 g/L (RI 119 - 157 g/L)) and low haematocrit (Hct) (0.310 L/L (RI 0.360 – 0.470 L/L)). Biochemistry analytes were high, with foremost lactate dehydrogenase (LD) activity (2900 U/L, RI < 240 U/L). After communication with the clinician, methaemoglobin measured in arterial blood gas sample was reported. Patient was admitted to the Intensive care unit and upon reflex testing of haptoglobin, intravascular haemolysis was confirmed. This case indicates that every case of brown coloration of the serum must be promptly communicated to the clinician. Reflex testing assured timely diagnosis and favourable patient outcome

e-Vocabulary and e-Learning

A vocabulary is a linguistic resource that helps manage, query and retrieve information and/or knowledge via words. If vocabularies are built and used in electronic format, they are referred as e-vocabularies. E-vocabularies have been used in Education to help teachers and students to, amongst many issues, (1) comprehend and relate the concepts and the objects of a given knowledge domain; (2) understand and learn languages, be they specialized or not; and (3) identify, describe and query knowledge and digital educational resources. Despite its utility, it is in this field where vocabularies seem to be less systematically developed, known, studied, analyzed, compared and/or linked. For this reason, we thought it was an opportunity to edit a dedicated volume with real experiences concerning the construction, use and evaluation of electronic vocabularies relating to education, and their application to the Internet and e-learning. The result is, finally, this Special Issue with five papers that represent part of the current state-of-the-art in the construction and use of e-vocabularies and educatio

THE SPREAD OF IRON DEFICIENCY ANEMIA IN BOTANICA TERRITORIAL MEDICAL ASSOCIATION LAST 4 YEARS

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Prevalența și incidența anemiei feriprive (AF) au fost și rămân cele mai înalte dintre bolile sângelui. Grupele de risc pentru AF o constituie sugarii, adolescentele, gravidele și femeile de vârste fertilă. În anii precedenți, activitatea medicilor de familie a fost marcată de pandemia COVID-19, limitând realizarea profilaxiilor primare și secundare. Scopul lucrării. Evaluarea răspândirii anemiei feriprive la populația din Asociația Medicală Teritorială (AMT) Botanica în ultimii 4 ani. Material și metode. În calitate de material de cercetare ne-au servit rapoartele statistice anuale (F-12) din cadrul Centrelor Medicilor de Familie (CMF) din sectorul Botanica, centralizate apoi la nivelul AMT Botanica, pentru perioada anilor 2019-2022. Rezultate. Prevalența bolilor sângelui în anul 2019 a fost de 97,3%, cu o înjumătățire în anul pandemic 2020 până la 49.2%, urmată de o creștere ușoară ajungând în 2022 – 59,3%. Aceeași tendință s-a observat analizând dinamica incidenței: în 2019 –39,1%, cu scădere în anul 2020 – 19,1%, cu o elevare în 2021 – 23,0% și în 2022- 32,1%. Relevanțe se constată la evaluarea cifrelor absolute, astfel în anul 2019 din totalul de 1125 de cazuri de boli ale sângelui și organelor hematopoietice, 1104 – i-au revenit AF, inclusiv 573 la copii și adolescenți. Anul 2020 a evidențiat o reducere cu 1/2, constituind 650, dintre care AF – 630, inclusiv copii și adolescenți 227 cazuri. În ultimii 2 ani s-a observat o ascensiune lentă, 2021- 668 de cazuri (AF – 617, inclusiv 266 copii), iar în 2022 – 758 cazuri la evidență (AF – 711, inclusiv copii 297). Concluzii. AF rămâne pe primul loc în structura morbidității hematologice în AMT Botanica. Pandemia COVID-19 a influențat atât adresabilitatea, cât și depistarea activă a anemiei feriprive în grupele de risc, care necesită în continuare eforturi comune a echipei medicilor de familie.Background. The prevalence and incidence of iron deficiency anemia (IDA) have been and remain the highest among blood diseases. Risk groups for IDA are infants, teenagers, pregnant women and women of childbearing age. In previous years, the activity of family doctors was marked by the COVID-19 pandemic, limiting the primary and secondary prophylaxis. Objective of the study. Evaluation of the spread of iron deficiency anemia in the population of the Territorial Medical Association (TMA) Botanica during the last 4 years. Material and methods. As research material, the annual statistical reports (F-12) from the Family Physician Centers (FPC) of the Botanica region then centralized at the TMA Botanica level, for the period of 2019-2022 served us. Results. The prevalence of blood diseases in 2019 was 97.3%, with a halving in the pandemic year 2020 to 49.2%, followed by a slight increase reaching in 2022 – 59.3%. The same trend was observed analyzing the incidence dynamics: in 2019 – 39.1%, with a decrease in 2020 – 19.1%, with an increase in 2021 – 23.0% and in 2022- 32.1%. Relevance is found when evaluating the absolute numbers, such that in 2019, out of a total of 1125 cases of diseases of the blood and hematopoietic organs, 1104 – were due IDA, including 573 in children and adolescents. The year 2020 showed a 1/2 reduction, constituting 650, of which IDA – 630, including children and adolescents 227 cases. In the last 2 years, a slow rise has been observed, 2021 – 668 cases of blood diseases (IDA – 617, including 266 children), and in 2022 – 758 cases on record (IDA – 711, including 297 children). Conclusions. Iron deficiency anemia remains in first place in the structure of hematological morbidity in TMA Botanica. The COVID-19 pandemic influenced both the addressability and the active detection of iron deficiency anemia, which further requires joint efforts of the family physician team

La música como estrategia para fortalecer la pronunciación del idioma inglés en los niños de 4 a 12 años del corregimiento de Puente Iglesias de Fredonia-Antioquia

N/AEn este proyecto de investigación realizado para el diplomado de práctica e investigación pedagógica se tiene el propósito de investigar sobre la manera en que se puede fortalecer la pronunciación del idioma inglés a través de la música de los niños de 4 a 12 años del corregimiento de Puente Iglesias de Fredonia-Antioquia. El método empleado para este estudio fue el cualitativo, donde se partió de la observación de los niños, su familia y su entorno, a su vez se les hicieron algunas indagaciones y en el desarrollo del proyecto se realizó una secuencia didáctica de la cual se tomaron algunas evidencias fotográficas, audiovisuales y audios que dan cuenta del trabajo realizado. Durante el proceso se pudo observar una gran aceptación hacia el aprendizaje del idioma por parte de los niños y sus padres, muestra de ello es que los niños mejoraron su pronunciación en inglés notablemente y aprendieron algunas palabras y expresiones en inglés, ellos estuvieron muy animados y se les pudo ver moviendo más libremente su cuerpo y comunicándose mejor con los demás. La educación es muy importante porque nos permite impactar vidas y transformar comunidades, si se hace con amor y pasión, la recompensa se verá con creces, como en este caso que se les pudo transmitir a los niños la enseñanza de un conocimiento tan importante como lo es el inglés y específicamente su pronunciación a través de la música.In this research project carried out for the pedagogical practice and research diploma, the purpose is to investigate the way in which the pronunciation of the English language can be strengthened through the music of children from 4 to 12 years of age from the village of Puente Iglesias of Fredonia-Antioquia. The method used for this study was qualitative, which started from the observation of the children, their family and their environment, in turn some inquiries were made to them and in the development of the project a didactic sequence was carried out from which some photographic, audiovisual and audio evidence that accounts for the work done. During the process it was possible to observe a great acceptance towards the learning of the language by the children and their parents, proof of this is that the children improved their pronunciation in English remarkably and learned some words and expressions in English, they were very animated and they could be seen moving their bodies more freely and communicating better with others. Education is very important because it allows us to impact lives and transform communities. If it is done with love and passion, the reward will be seen in spades, as in this case, the teaching of knowledge as important as what was taught could be transmitted to children. it is English and specifically its pronunciation through music

Pivot-and-bond model explains microtubule bundle formation

During mitosis, microtubules form a spindle, which is responsible for proper segregation of the genetic material. A common structural element in a mitotic spindle is a parallel bundle, consisting of two or more microtubules growing from the same origin and held together by cross-linking proteins. An interesting question is what are the physical principles underlying the formation and stability of such microtubule bundles. Here we show, by introducing the pivot-and-bond model, that random angular movement of microtubules around the spindle pole and forces exerted by cross-linking proteins can explain the formation of microtubule bundles as observed in our experiments. The model predicts that stable parallel bundles can form in the presence of either passive crosslinkers or plus-end directed motors, but not minus-end directed motors. In the cases where bundles form, the time needed for their formation depends mainly on the concentration of cross-linking proteins and the angular diffusion of the microtubule. In conclusion, the angular motion drives the alignment of microtubules, which in turn allows the cross-linking proteins to connect the microtubules into a stable bundle

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

Reporting categories in urine test strip analysis: Croatian survey and call for action

Introduction: In line with the national recommendations, Croatian medical laboratories report urine test strip qualitative analysis results using a categorized scale with defined number of categories. Since concentration ranges for measured analytes have not been provided by national professional authority, it is up to the laboratories to define their own categories. The aim of study was to assess the comparability of concentrations assigned to different categories used in reporting the results of dipstick urinalysis in Croatian laboratories. Material and methods: A questionnaire was e-mailed to all Croatian medical laboratories (N = 195). They were asked to provide the number of categories and respective concentrations for each parameter. Data were described as numbers and percentages. Values above the upper reference range limit, which were assigned as normal and/or trace category, were considered as false negative. Results: Response rate was 71% (139/195). Seventy percent (98/139) of laboratories report their results with either higher (77/98; 79%) or lower (2/98; 2%) number of categories, relative to the national recommendation, whereas 19/98 (19%) report their results as concentrations. Great heterogeneity of reporting categories was observed. Multiple categories were assigned to same concentrations and there was a large overlap of concentrations for most categories. Considerable proportion of laboratories reported false negative results for ketones (42%), leukocytes (30%) and glucose (21%). Conclusions: The concentrations assigned to categories used to report the results of dipstick urinalysis are not comparable among Croatian medical laboratories. There is an urgent need for harmonization and standardization of reporting the results of urine dipstick analysis in Croatia

Haemolysis and lipemia interfere with resistin and myeloperoxidase BioVendor ELISA assays

Introduction: The aim of our study was to investigate the influence of haemolysis and lipemia on resistin (RES) and myeloperoxidase (MPO) measurement by BioVendor enzyme-linked immunosorbent assays (ELISA). Materials and methods: Blood was taken from healthy volunteers into lithium heparin tubes. Plasma samples were spiked with Lipofundin® emulsion (B. Braun Melsungen AG, Germany) for lipemia interference testing. Haemolysed samples were obtained by drawing aliquots of heparinized blood through a 26 gauge needle. Index of haemolysis (H), lipemia (L) and triglyceride concentration were measured on Abbott Architect c8000. Haemoglobin concentration was measured on Sysmex XN-1000. Concentrations of RES and MPO in all samples were determined with RES and MPO ELISA kits (BioVendor, Czech Republic). All measurements were performed in triplicate. Biases from the native samples were calculated for both analytes and compared with an arbitrary value (e.g. ± 10%). Results: Triglyceride concentration in the investigated samples ranged from 0.57 to 38.23 mmol/L, which corresponds to L index from - 0.01 to 13.77. Haemoglobin concentration in all samples ranged from 0 to 8 g/L which correspond to H index from 0.05 to 8.77. Both MPO and RES showed significant biases at 1 g/L haemoglobin (58.7% and 66.7%, respectively). Also, both MPO and RES showed significant biases at 4.66 mmol/L triglycerides (33.8% and - 12.2%, respectively). Conclusions: Resistin BioVendor assays are affected by haemolysis and lipemia already at low degree of interferent. Haemolysis was found to interfere at 1 g/L haemoglobin for both assays, while lipemia interferes at 4.66 mmol/L of triglycerides

Pengaruh Akuntabilitas dan Transparansi Terhadap Minat Muzakki Membayar Zakat di BAZNAS Sragen

This study aims to analyze the effect of accountability and transparency on muzakki's interest in paying zakat. The population in this study are people who pay zakat in BAZNAS, Sragen Regency. The sample in this study produced 100 respondents. The sample selection technique used purposive sampling and then used the Slovin formula. The data analysis method in this study uses multiple linear regression. The results of this study indicate that partially the accountability variable that affects the interest in paying zakat, then partially the transparency variable does not have a significant effect on the interest of muzakki to pay zakat. Simultaneously, the variables of accountability and transparency have an effect on the interest in paying zakat