Conservative medicine in war conditions in the Slavonian-brod hospital (until july 31, 1992)

Zbog ratnih zbivanja učinjena je preobrazba nekih službi KM, kako bi smještajem, organizacijom i opsegom rada mogla optimalno odgovarati novonastaloj teškoj situaciji. Da bi se zaštitili bolesnici i zdravstveni djelatnici od djelovanja topničkih i minobacačkih granata, premješteni su na sigurnija mjesta: podrumske prostorije bolnice, prigradska naselja ili udaljenija mjesta. Veći dio bolničkih zgrada učvršćen je drvenim gredama i vrećama pijeska. Organizirano se reducira broj bolesničkih postelja u svim djelatnostima konzervativne medicine, od 267 u miru na 126, tj.za 53% u ratu. Iz sigurnosnih razloga i bitno smanjenih kapaciteta bolničkih odjela hospitalizirani su samo vitalno ugroženi i teški bolesnici. U svezi s time broj od 5 284 hospitaliziranih u miru pao je u ratu na 3 110 bolesnika, tj. za 41%. Upravo selekcija samo teških bolesnika za prijem na bolničko liječenje, hospitalizacija prognanih i izbjeglih kroničnih neliječenih, zapuštenih i izgladnjelih staraca, bitno je utjecala na znatan porast smrtnosti. Tome je posebno pridonio porast broja rođene nedonešene i nezrele djece, ne samo iz našeg područja nego i susjednih općina istočne i zapadne Slavonije i Bosanske Posavine. Registriran je porast smrtnosti od 60%. u miru na 140% u promatranim ratnim mjesecima, a to je porast od 80%. U Službi za hemodijalizu došlo je u ratu do skoka broja liječenih i porasta smrtnosti, poglavito ranjenika. Naime, dosadašnje mirnodopsko preživljavanje bilo je oko 500%, a u ratnoj godini ono je palo na 375%, tj. mortalitet je porastao na 625%. Najviša smrtnost u toj jedinici zapažena je upravo u ranjenika (820%). Zbog ratnih zbivanja došlo je do pada broja specijalističkih ambulantnih pregleda za 60% - od 69 132 u mirnodopskim mjesecima na 27 549 u ratu.Before the beggining of the war the services of the conservative medicine: for internal diseases, pediatry, infectology, neurology and hemodialysis had suitable rooms, number of beds, various and up-to date equipment and sufficient number of medical staff so they could, through polyclinical services and hospital departments give optimal health protection to the people of our and neighbouring communities of Bosanska Posavina. The capacity of the mentioned departments was 267 beds in adequate up-to-date and functional space. An adequate number (13) of specialist physicians and subspecialists (3 doctors, 4 magisters and a remarkable number of physicians with postgraduate study and diploma) with modern outfit for clinical, laboratorial and X-rays diagnostics enables fast and precise diagnosis, an adequate and efficient treatment and scientific work. The agression on our Republic had its influence on the work of health service as a whole, and on the work of conservative medicine in Health Center in Slavonski Brod as well. First attacks on our town began on September 15th, 1991 from the neighbouring Republic of Bosnia and Herzegovina and from the barracks of the former Yugoslav National Army in Slavonski Brod. In the same time the war extended in Eastern and Western Slavonia and more and more wounded were daily accepted in our hospital. Therefore more beds were located in surgeon department and utmost readiness of all vital services was commanded. The number of the beds in majority of conservative services was lessened and only heavy and urgent cases were accepted. For the security the large part of the building was protected by logs and sandbags. To shelter patients and medical staff from artillery and trench mortar blasts, some services of conservative medicine were dislocated to more secure places in cellars in suburban settlements or far away places. Due to the war the number of beds on departments of conservative medicine was reduced from 267 at the peacetime to 126 in wartime and this is reduction of 53%. The biggest number of beds was reduced in pediatry - for 80 to 20 or from 75%, and the least on internal department - from 89 to 69 or for 25%. From the reasons of security and because of reduced capacities only vitally endangered and heavy patients are accepted. In peacetime the number of hospitalized patients was 5 284 but in the wartime it fell to 3110 patients i. e. for 41% as it is shown on graph 1. The number of hospitalized was: 136 (4%) members of Croatian Army and police, 315 (10%) banished persons and refugees, and 2 959 (86%) civilians The biggest number of Croatian soldiers and policeman (103/136) or 76% were treated on Department of infective diseases. The biggest number of banished persons and refugees was cured on Children department: 195/315 i. e. 62%. The growth of mortality was from 60% in peacetime to 140% in wartime, and it is shown (by departments) on graph 2. The growth of mortality for 80% in war is understandable as only heavy patients were accepted to hospital. The hospitalization of banished and refugees with chronic diseases, many of them uncured, famished and psychicly destroyed old persons added a great deal to the growth of mortality. The growth of the number of prematurely born children from our and neighbouring communities of East and West Slavonia and Bosanska Posavina added to high mortality. In Service for hemodialysis there were more treated but also more passed away, especially wounded. Namely, in peacetime 500% stayed on life but in war it fell to 374% i. e. the mortality grew on 625%. The highest mortality in this service was with wounded (820%). It should be stressed that there were no important differences of the sick of some acute contagious diseases in war and peacetime. There were no records of any classical war contagious disease as were: abdominal typhus, spotted typhusor Q-fever. Also it should be recognized that up to now there have not been registrated epidemics of contagious diseases in spite of transit and permanent stay of large number of refugees and banished persons, nor with hospitalized, neither with out patients

Poliklinika „Zlatni cekin“ i dječji vrtić „Cekin“ u Slavonskom Brodu - ustanove za rehabilitaciju i odgoj djece

Centar za rehabilitaciju i odgoj djece „Zlatni cekin“ osnovan je kao jedinstvena ustanova 1993.godine donacijom franjevaca iz Bologne u svrhu rehabilitacije i odgoja djece s posebnim potrebama za istočni dio Hrvatske. Danas su to dvije pravno odvojene ali organizacijski i stručno povezane cjeline: Poliklinika „Zlatni cekin“ i Dječji vrtić „Cekin“. činjenica da je u navedenoj regiji visok postotak djece s posebnim potrebama, uz podatak da su slične ustanove udaljene 200 i više km, bila je i više nego dovoljan razlog za osnivanje ustanove ovog tipa. Nositelj aktivnosti je Franjevački samostan u Slavonskom Brodu, a poslove gradnje, opremanja, organizacije i vođenja rada preuzela je Franjevačka provincija Bosna Srebrena. Dugogodišnji ravnatelj ustanove, zaslužan za mnoga njena radna i organizacijska postignuća je fra Ilija Jerković

PURE BREED PIGEONS MEAT AS VALUABLE NUTRIENT

Otkada postoje kućni golubovi, postoji i zanimanje za njihov uzgoj zbog gospodarske koristi. Uzgoj golubova radi mesa posebna je grana sitnog stočarstva, međutim u malom broju zemalja. Njihov uzgoj odvija se na farmama. U SAD ih se danas nalazi najviše, među njima su i one najveće na svijetu, osnovane još početkom ovoga stoljeća. Nekima je uzgoj golubova jedina ili tek dopunska djelatnost. Osim stotina manjih i srednjih uzgajališta, postoje i brojna specijalizirana velika uzgajališta s više stotina ili tisuća parova golubova. Ona pretežu u sjeveroistočnim i jugoistočnim državama, na obalama Tihog oceana, te oko većih gradova srednjega zapada. Najpoznatije su Carpenter Squab Ranch, Dyer and Davis, Middletons Sons te Palmetto Pigeon Plant. Šezdesetih godina Francuska, Italija i Mađarska uvezle su iz SAD roditeljske parove tovnih golubova. Danas ih te zemlje proizvode ne samo za vlastite potrebe, već i za izvoz (Vogel, 1992.; Pavidid, 1995.). Gospodarski učinkovita proizvodnja temelji se na uzgoju tovnih pasmina golubova što postižu veliki prinos mesa. Ako im se pruže dobri uvjeti držanja uz produženo osvjetljenje i odgovarajuću zdravstvenu zaštitu, te kvalitetnu peletiranu hranu, morali bi biti u rasplodnoj kondiciji 3-4 godine. Tijekom iskorištavanja par golubova godišnje othrani 15 mladunaca tjelesne mase 450-550 g. Oni se odbijaju od roditelja u dobi od 26-28 dana (Vogel, 1992. ; Pavidie, 1994.).Along with their domestication, there is interest in pigeons whose breeding has a certain economic effect. Pigeon breeding, by which we mean pigeon meat production, exists as a particular branch, although in a small number of countries, in the form of pigeon farms. Most of such farms can be found nowadays in the USA and among them are some of the biggest in the world, founded at the beginning of the century. In some of them pigeon breeding is the main activity, while in the others it exists as an additional activity. Beside hundreds of small and middle size farms, there are numerous specialised pigeon-breeding farms with several hundreds or thousands of peons, i. e pigeon pairs .Such farms can be found mostly in the north-eastem and south-eastem states, on the Pacific coast, and in the vicinity of larger cities in the Mid-west. Among the renowned are the Carpenter Squab Ranch, Dyer and Davis, Middletons Sons, the Palmeto Pigeon Plant. ln about 1960. France, ltaly and Hungary imported from the USA parental pigeon couples for meat production.Today these countries produce pigeon meat not only for the local market but for the local market but for export. A successful production is based on fattening pigeons of high meat production performances. Kept in good conditions, meaning here preventive health protection, prolongated lighting, along with optimal temperature and granulated food, they should remain in breeding condition about 3 -4 years. During exploatation period a pair can raise up to 15 youngs a year, weighing 450 - 550 g. which are weaned at the age of 26 - 28 day

KVAROVI NA BRODSKIM PREKRCAJNIM SREDSTVIMA

U radu se istražuju i utvrđuju elementi koji utječu na funkciju povećanja prekrcajnog učina kod višenamjenskog broda. Održavanje, otklanjanje kvarova i pravilna uporaba prekrcajnih sredstava osnovni su elementi uz tehničke faktore, za održavanje potrebnog prekrcajnog učina

KVAROVI NA BRODSKIM PREKRCAJNIM SREDSTVIMA

U radu se istražuju i utvrđuju elementi koji utječu na funkciju povećanja prekrcajnog učina kod višenamjenskog broda. Održavanje, otklanjanje kvarova i pravilna uporaba prekrcajnih sredstava osnovni su elementi uz tehničke faktore, za održavanje potrebnog prekrcajnog učina

Ecology and Biology of the Rare Endemic Land Leech Xerobdella anulata (Xerobdellidae)

The genus Xerobdella contains three species of land leeches confined to the Palearctic region, one of which is X. anulata (Autrum, 1958), an exceptionally rare endemic of the Dinaric Alps. In the current study, we provide new data and a literature overview on this rarely encountered species, presenting its currently known distribution, providing additional data on its morphology and, for the first time, presenting comprehensive data on its habitat preferences and seasonal dynamics. Additionally, we provide novel DNA barcodes for the Dinaric land leech and compare the obtained sequences with the related X. lecomtei. Altogether, 22 specimens of X. anulata were collected using pitfall traps in three habitat types: managed forests with adjacent meadows and a primeval forest in the Dinaric Alps of Croatia. We report the first finding of X. anulata in open habitats, which harbored most of the specimens. Our findings show that X. anulata exhibits surface activity, highlighting the effectiveness of pitfall traps in sampling such elusive taxa, with perspectives for future morphological, phenological and even molecular research

Differential influence of basic psychological needs on burnout and academic achievement in three southeast European countries

Several studies show the importance of basic psychological needs (BPN) for decreasing burnout and increasing grade point average (GPA), but, to our knowledge, no prior study has explored the potential contextual differences in Southeastern European countries. Moreover, even less is known about how this relationship may differ during stressful (exam) and less stressful (beginning of the semester) periods. Measures of the Maslach Burnout Inventory—Student Survey and BPN Satisfaction and Frustration Scale were translated and adapted. The study included a cross-sectional sample of students from Croatia, Serbia and Slovenia during beginning of the semester and exam period. Across all countries and both contexts, students with high autonomy need satisfaction showed the strongest decrease in burnout, followed by those with high competence need satisfaction. Students with high academic achievement showed an increase due to competence need satisfaction. Competence and autonomy need satisfaction were higher beginning of a semester, while burnout was higher during the exam period. BPN play an important role in educational settings—satisfaction of the need for autonomy and competence protects students from burnout, and the need for competence predicts greater academic achievement regardless of culture or time of the semester

Body mass index: short- and long-term impact on kidney transplantation

The topic of pretransplantation body mass index (BMI) is still a matter of controversy. The aim of this study was to investigate the influence of pre transplant BMI on short and long-term outcomes in patients receiving kidney transplant. We have analyzed 521 renal transplant recipients (RTRs). BMI was categorized as follows: less than or equal to 20, more than 20 to less than or equal to 25, more than 25 to less than or equal to 30 and more than 30. The distribution of the RTRs per category of BMI at baseline was: ≤ 20 (14.4%), > 20 to ≤ 25 (50.9%), > 25 ≤ 30 (26.9%) and > 30 (7.9%). In further analysis the patients were stratified into four groups according to their pre transplant BMI values. There was no difference in the rates of delayed graft function between the four analyzed groups of patients. Recipients with normal pre transplant BMI were less likely to develop wound complications in comparison to the recipients with high BMI (p=0.04) and obese recipients (p=0.0001). RTRs with normal BMI were less likely to develop lymphoceles in comparison to the recipients with high BMI (p=0.0003). Obese patients were more likely to develop lymphocele in comparison to the recipients with high BMI (p=0.01). Obese recipients had a longer mean length of hospital stay in comparison to the recipients with normal BMI (p=0.04). There was no significant difference regarding one-year graft and patient survival, as well as due to acute rejection crisis between the investigated groups of recipients. We did not find any significant difference in 5-years patients and graft survival between those RTRs with BMI > 20 to ≤ 25 and to those recipients with BMI > 25. Overweight and obese transplant candidates should not be excluded from kidney transplantation

Antimalarial activity of 9a-N substituted 15-membered azalides with improved in vitro and in vivo activity over azithromycin

Novel classes of antimalarial drugs are needed due to emerging drug resistance. Azithromycin, the first macrolide investigated for malaria treatment and prophylaxis, failed as a single agent and thus novel analogues were envisaged as the next generation with improved activity. We synthesized 42 new 9a-N substituted 15-membered azalides with amide and amine functionalities via simple and inexpensive chemical procedures using easily available building blocks. These compounds exhibited marked advances over azithromycin in vitro in terms of potency against Plasmodium falciparum (over 100-fold) and high selectivity for the parasite and were characterized by moderate oral bioavailability in vivo. Two amines and one amide derivative showed improved in vivo potency in comparison to azithromycin when tested in a mouse efficacy model. Results obtained for compound 6u, including improved in vitro potency, good pharmacokinetic parameters, and in vivo efficacy higher than azithromycin and comparable to chloroquine, warrant its further development for malaria treatment and prophylaxis