Djeca bez pratnje u svjetlu migrantske krize u Centru za pružanje usluga u zajednici Zagreb - Dugave

Cilj je rada prikazati funkcioniranje postojećeg modela skrbi za djecu bez pratnje – maloljetnih migranata unutar ustanove koja se bavi djecom i mladima s problemima u ponašanju, upozoriti na teškoće u radu i dati smjernice za daljnje postupanje. Centar Dugave zbrinjava djecu bez pratnje – maloljetne migrante još od 1996. godine. U početku su to bila djeca pretežno s područja bivše Jugoslavije, no kako se mijenjala globalna geopolitička i ekonomska situacija, tako se mijenjala i populacija koju smo zbrinjavali. Posljednjih godina, s obzirom na to što se događa na Bliskom istoku, pretežno prihvaća djecu bez pratnje s područja Afganistana, Sirije, Pakistana, Alžira, Maroka, Libije, Jemena itd. Nakon dugogodišnjeg rada na zbrinjavanju djece bez pratnje, može se ustvrditi da takav način smještaja nije adekvatan i da djecu bez pratnje – maloljetne migrante – treba smještati i o njima skrbiti u drugim uvjetima, a nikako ne u ustanovi za djecu i mlade s problemima u ponašanju. Rad je nastao na bazi višegodišnjeg iskustva i autoričina rada s djecom bez pratnje u CPUZ Dugave

Doktor Avram Josif Vinaver (1862-1915) - pionir srpske radiologije

Dr Abraham Joseph Vinaver (1862-1915), a Jew from Poland, was a pioneer of radiology in Serbia. He graduated from the Faculty of Medicine in Warsaw (1887) but lived and worked in Šabac (the Kingdom of Serbia) since 1890. He procured the first X-ray machine and developed a radiological service in Šabac five years after the discovery of X-rays. These were the beginnings of radiology in Serbia. He introduced the application of artesian wells. Dr Abraham Joseph Vinaver - a Participant at the First Congress of Serbian Physicians and Naturalists, Belgrade 1904. "The Diagnostic Importance of X-rays in Lung Disease, especially in Initial Tuberculosis" and "Five Years of Treatment by X-Ray Machines" were the first works in the field of radiology in Serbia by this author. Dr Abraham Joseph Vinaver - Reserve Medical Officer in the Serbian Army. During the Balkan Wars, he was a volunteer with the rank of major engaged in military corps and he participated in the First World War as well. He died of malaria in 1915 in Gevgelija. His dedication to work during the typhus epidemics was put into verses of a poem by his son Stanislav Vinaver. Dr Avram Vinaver Joseph was a nobleman with a great heart, who selflessly sacrificed himself for the Serbian people and Serbia. He gave his contribution to the development of health services in Serbia, both in peacetime and wartime conditions. Dr Abraham Joseph Vinaver laid the foundations for today’s radiology in SerbiaDoktor Avram Josif Vinaver (1862−1915), Jevrejin iz Poljske, bio je pionir srpske radiologije. Diplomirao je na Medicinskom fakultetu u Varšavi (1887). Od 1890. godine živeo je i radio u Šapcu (Kraljevina Srbija). Nabavio je prvi rendgenski aparat i razvio radiološku službu u Šapcu, pet godina po otkriću X-zraka. Bili su to počeci radiologije u Srbiji. Uveo je u primenu arterške bunare. Dr Avram Josif Vinaver − učesnik Prvog kongresa srpskih lekara i prirodnjaka, Beograd 1904. godine. „Dijagnostička važnost Rentgenovih zrakova kod bolesti pluća, naročito kod početne tuberkuloze” i „Pet godina lečenja Rentgenovim zracima” bila su prva saopštenja iz oblasti radiologije u Srbiji ovog autora. Dr Avram Josif Vinaver - rezervni sanitetski major srpske vojske. Za vreme Balkanskih ratova bio je dobrovoljac sa činom majora angažovan u vojnom sanitetu. Učesnik je i I svetskog rata. Umro je od malarije 1915. godine u Đevđeliji. O požrtvovanom radu dr Avrama Josifa Vinavera u vreme epidemije pegavog tifusa u Srbiji svedoči i pesma njegovog sina Stanislava Vinavera. Doktor Avram Josif Vinaver je bio čovek plemenitog srca koji se nesebično žrtvovao za srpski narod i Srbiju. Dao je doprinos razvoju zdravstvene zaštite stanovništva Srbije podjednako i u mirnodopskim i u ratnim uslovima. Doktor Avram Vinaver je postavio temelje današnje radiologije u Srbiji

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

THE FREQUENCY OF DUAL DIAGNOSIS AMONG THE USERS OF PSYCHOSOCIAL SERVICES IN THE THERAPEUTIC COMMUNITIES IN THE REPUBLIC OF CROATIA

Introduction: Addiction is a mental state or physical condition that results from the continued use of a substance or performance of a particular activity. Dual diagnosis is the co-occurrence in the same individual of severe mental problems and addiction disease. Objective: To test the frequency of co-occurring disorders among the users of psychosocial services in the therapeutic communities in the Republic of Croatia. Subjects and methods: A cross-sectional study on a sample of 648 members of therapeutic communities was carried out. The data were collected by means of a modified international Pompidou Group’s questionnaire consisting of general sociodemographic data and the data on treatment, risky behaviour and legal problems. Results: More than a half of the total number of subjects had dual diagnosis. The most frequent diagnoses co-occurring with addiction were disorders of adult personality and behaviour and schizophrenia, schizophrenia-like disorders and delusional disorders. Co-occurring disorders were more frequent in women than in men. In the Pope John XXIII Community, the main addiction substance among people of young age was amphetamine, and this change in trends of psychoactive substance abuse should be additionally explored. Conclusion: Somewhat more than a half of users of psychosocial services in the therapeutic communities in the Republic of Croatia had dual diagnosis

Severe acute caffeine poisoning due to intradermal injections: Mesotherapy hazard

Introduction. Caffeine is indicated in the treatment of migraine headaches, as well as neonatal apnea and bradycardia syndrome. In mild poisoning, the most prevalent symptoms are nausea, vomiting, diarrhea, tremor, anxiety and headache. In more severe cases, symptoms consist of heart rythym abnormalities, myocardial infarction and seizures. Due to its common lipolytic effect, caffeine is used in mesotherapy, usually in combination with drugs of similar effect. We presented a patient with acute iatrogenic caffeine poisoning. Case report. A 51-year-old woman, with preexisting hypertension and hypertensive cardiomyopathy was subjected to cosmetic treatment in order to remove fat by intradermal caffeine injections. During the treatment the patient felt sickness, an urge to vomit, and a pronounced deterioration of general condition. Upon examination, the patient exhibited somnolence, hypotension and nonsustained ventricular tachycardia, which was sufficient enough evidence for further hospitalization. On admission to the intensive care unit the patient was anxious with increased heart rate, normotensive, with cold, damp skin, and visible traces of injection sites with surrounding hematomas on the anterior abdominal wall. Paroxysmal supraventricular tachycardia (PSVT) on electrocardiographic monitoring was found. The laboratory analysis determined a lowered potassium level of 2.1 mmol/L (normal range 3,5 - 5.2 mmol/L), and a toxicological analysis (liquid chromatography with ultraviolet detection) proved a toxic concentration of caffeine in plasma - 85.03 mg/L (toxic concentration over 25 mg/L). On application of intensive therapy, antiarrhythmics, and substitution of potassium, as well as both symptomatic and supportive therapy, there was a significant recovery. The patient was discharged without any sequele within four days. Conclusion. A presented rare iatrogenic acute caffeine poisoning occured due to massive absorption of caffeine from the subcutaneous adipose tissue into the circulation when injected directly into the tiny blood vessels, as evidenced by hematoma formation. Poisoning manifestations were registered in gastrointestinal, CNS (anxiety, somnolence) and cardiovascular (hypotension, ventricular tachycardia and nonsustained PSVT) system. In this era of mesotherapeutic treatment promotion, one should keep in mind toxic prevention, with application being carried out exclusively in a specialized institutio

SURGICAL CONDITIONS OF THE ABDOMEN VIEWED ON A NATIVE ABDOMINAL RADIOGRAPH IN AN UPRIGHT POSITION

The paper presents surgical conditions of the abdomen viewed on a native abdominal radiograph in an upright position: atresia anus, the Chilaiditi syndrome, ileus, pneumo-peritoneum, calcified pancreas. Conclusion: A native radiograph of the abdomen in an upright position is a dominant examination method in diagnostics of an acute abdomen, intestinal obstruction and perforation and other pathological conditions of the abdomen

THE FREQUENCY OF DUAL DIAGNOSIS AMONG THE USERS OF PSYCHOSOCIAL SERVICES IN THE THERAPEUTIC COMMUNITIES IN THE REPUBLIC OF CROATIA

Introduction: Addiction is a mental state or physical condition that results from the continued use of a substance or performance of a particular activity. Dual diagnosis is the co-occurrence in the same individual of severe mental problems and addiction disease. Objective: To test the frequency of co-occurring disorders among the users of psychosocial services in the therapeutic communities in the Republic of Croatia. Subjects and methods: A cross-sectional study on a sample of 648 members of therapeutic communities was carried out. The data were collected by means of a modified international Pompidou Group’s questionnaire consisting of general sociodemographic data and the data on treatment, risky behaviour and legal problems. Results: More than a half of the total number of subjects had dual diagnosis. The most frequent diagnoses co-occurring with addiction were disorders of adult personality and behaviour and schizophrenia, schizophrenia-like disorders and delusional disorders. Co-occurring disorders were more frequent in women than in men. In the Pope John XXIII Community, the main addiction substance among people of young age was amphetamine, and this change in trends of psychoactive substance abuse should be additionally explored. Conclusion: Somewhat more than a half of users of psychosocial services in the therapeutic communities in the Republic of Croatia had dual diagnosis

STAGE 5 RETINOPATHY OF PREMATURITY IN ONE EYE – CASE REPORT

Retinopathy of prematurity (ROP) is a leading cause of blindness in children and one of the most important reasons of blindness in the perinatal period. The aim of the paper was to present a nine-month-old baby boy with esotropia, microphtalmos and completely detached retina in one eye, as the end stage of the disease, who had not been checked for ROP. The boy was born in the 32nd gestational week, with 1670 g birth weight. Indirect ophthalmoscope examination and ultrasonography of the left eye showed stage 5 retinopathy of prematurity. On the right eye, the finding was valid. Retinopathy of prematurity today needs recognition, understanding and awareness among ophthalmologists, pediatricians, neonatologists. Early diagnosis of damage is important in the treatment of ROP

MR Assessment of Bile Duct Size in Healthy Individuals: Comparison with US Measurements

The purpose of the study was to determine the difference in extrahepatic bile duct (EBD) size measured by magnetic resonance (MR) compared with those measured by ultrasound (US). Changes of EBD size related to aging were analyzed too. Size of EBD was measured in 76 randomly selected healthy individuals. Three radiologists blinded to the result of other study preformed measurements by US and three different T2 weighted MR sequences. Correlation and linear regression analysis of obtained data were performed. The mean diameter of EBD measured by US was 3.17mmand by MR was 3.14 mm on thick slab rapid acquisition with relaxation enhancement (TSE), 3.26 mm on thin section single-shot TSE (HASTE) and 3.30 mm on coronal fully rewound gradient echo (True FISP). There was no statistical difference between US and different MR sequences (p<0.05). A trend of increase of EBD with age (0.0155 mm per year, p=0.0954) was observed. Size of EBD highly correlated for each MR sequence with US measurement validating use of MR as a reliable method for evaluation of EBD size. This conclusion is stressed by increase of EBD size with age demonstrated by all measuring method

Inbred linije iz različitih ciklusa selekcije donori poželjnih alela za popravku F1 hibrida kukuruza

Eight BSSS and BSCB1 inbred lines of different cycles of selection were studied with the aim to evaluate which inbreds had the highest relative values of favourable alleles for the improvement of the grain yield trait in an elite single cross maize hybrid. Based on estimated parameters μG, UBND, PTC and NI it was determined that the inbreds B73 (C5) and B84 (C7), originating form the synthetic population BSSS had highest number of favourable alleles for the improvement of the grain yield. Both these inbreds belong to the later cycles of recurrent selections and proved to be better donors of favourable alleles than inbreds belonging to the earlier cycles of selection. The rank correlations of used parameters were positive and highly significant, while the highest values of correlations for yield were determined between μG and NI, that is PTC and NI. The highest grain yield was recorded in the hybrid ZPL2 x B73, which also had the highest value of heterosis (174.9%) in the trial for estimation of loci relative values.Ispitivano je osam inbred linija različitih ciklusa selekcije poreklom iz BSSS i BSCB1 izvora sa ciljem da se oceni koja ima najveće relativne vrednosti poželjnih alela za popravku osobine prinos zrna kod elitnog dvolinijskog hibrida kukuruza. Na osnovu izračunatih parametara μG*, UBND, PTC i NI utvrđeno je da najveći broj poželjnih dominantnih alela za popravku prinosa zrna pokazale su inbred linije B73(C5) i B84(C7) iz sintetičke populacije BSSS. Obe ove linije su iz kasnijih ciklusa rekurentne selekcije i pokazale su se kao bolji donori poželjnih alela u odnosu na linije iz ranijih ciklusa. Korelacije ranga između korišćenih parametara bile su pozitivne i visoko značajne, dok su najveće vrednosti korelacije za prinos utvrđene između μG*i NI, odnosno PTC i NI. Najveći prinos zrna je imao hibrid ZPL2 x B73 koji je u ogledu za procenu relativne vrednosti lokusa pokazao i najveću vrednost heterozisa (174,9%)