The use of honey in contemporary wound treatment

Med je prirodan pčelinji proizvod složenoga kemijskoga sastava i zanimljivih fizikalnih i bioloških svojstava. Premda sadrži mikroorganizme u dormantnom stanju, odlikuje se snažnim antimikrobnim učinkom. Suvremena medicina sve obilnije koristi antimikrobna svojstva meda u terapiji rana različite etiologije, na primjer inficiranih kirurških rana i kroničnih venskih ulkusa. Sve brojnija klinička istraživanja izvještavaju o uspješnom korištenju medicinskih pripravaka meda u liječenju inficiranih rana kod kojih je prethodno neuspješno korištena antibiotska terapija. Premda su potrebna dodatna istraživanja, sasvim je jasno da će zbog odličnih rezultata, ekonomičnosti i zadovoljstva pacijenata uporaba meda u liječenju rana zauzimati sve istaknutije mjesto u medicinskoj praksi.Honey is a natural bee product, with complex chemical composition and interesting physical and biological properties. Although it contains dormant microbes, honey has strong antimicrobial effect. This effect is increasingly used in modem medicine for treating wounds of versatile etiology, for example infected surgical wounds and chronic venous ulcers. Numerous clinical trials have reported successful usage of medical-grade honey for treating infected wounds in which antibiotic therapy had previously been unsuccessful. Though additional research is needed, it is clear that the use of honey will take notable place in medical practice due to its excellent results, patient’s satisfaction and for being economic

Raspodjela rizičnih čimbenika za moždani udar u istočnoj Hrvatskoj

The aim of this study was to determine the distribution of risk factors according to age, gender, subtypes and recurrence of stroke in eastern Croatia. The study included 250 acute stroke patients admitted to University Department of Neurology, Osijek University Hospital Centre in 2011. Patients were grouped according to age, gender, subtypes and recurrence of stroke. The study showed significant differences in the distribution of cigarette smoking, diabetes, cardiomyopathy and hyperuricemia according to patient age. According to gender, male patients had a significantly higher prevalence of smoking and alcohol abuse, whereas in female patients the prevalence of arterial hypertension, atrial fibrillation and hyperuricemia was significantly higher. Regarding stroke subtypes, significant differences were noticed in the prevalence of arterial hypertension, atrial fibrillation, cardiomyopathy and cerebral blood vessel stenosis. Atrial fibrillation was significantly more common in first-ever than in recurrent stroke. Study results identified the groups of patients requiring special attention regarding particular risk factors in eastern Croatia and emphasized the need of developing regional strategies of screening, prevention and holistic care for stroke patients.Cilj ovoga istraživanja bio je odrediti raspodjelu rizičnih čimbenika u bolesnika s moždanim udarom u istočnoj Hrvatskoj prema dobi, spolu, podtipovima i ponovnom javljanju. U istraživanje bilo je uključeno 250 bolesnika koji su pretrpjeli akutni moždani udar i primljeni su na Kliniku za neurologiju Kliničkoga bolničkog centra Osijek u 2011. godini. Bolesnici su podijeljeni prema dobi, spolu, podtipovima i ponovnom javljanju. Istraživanje je pokazalo značajne razlike u raspodjeli pušenja cigareta, dijabetesa, kardiomiopatije i hiperuricemije prema dobi bolesnika. Prema spolu, učestalost pušenja i zlouporabe alkohola bila je značajno veća kod muških bolesnika, dok je učestalost arterijske hipertenzije, atrijske fibrilacije i hiperuricemije bila značajno veća kod žena. Prema podtipovima moždanog udara, značajne razlike uočene su kod učestalosti arterijske hipertenzije, atrijske fibrilacije, kardiomiopatije i stenoze cerebralnih krvnih žila. Atrijska fibrilacija bila je značajno češća u prvom nego u ponovljenom moždanom udaru. Naši rezultati pokazuju koje skupine bolesnika u istočnoj Hrvatskoj zahtijevaju posebnu pozornost s obzirom na pojedine rizične čimbenike te naglašavaju potrebu osmišljavanja regionalnih strategija za probir, prevenciju i holističku brigu za oboljele od moždanog udara

Outcome of different stroke subtypes

Cilj: odrediti pokazatelje kratkoročnoga ishoda različitih podvrsta moždanoga udara. Metode: opservacijska, prospektivna, kohortna studija. Obuhvaćena je grupa od 130 bolesnika. Korištena klasifikacija za hemoragijski moždani udar: intracerebralna hemoragija i subarahnoidalna hemoragija; za ishemijski moždani udar: TOAST (Trial of ORG 10172 in Acute Stroke Treatment) klasifikacija. Stupanj onesposobljenosti procijenjen je uz pomoć modificirane Rankin skale. Rezultati: najčešća komplikacija moždanoga udara bila je uroinfekcija. Ispitanici s moždanim udarom malih krvnih žila imali su najmanje komplikacija, najmanji funkcionalni deficit i smrtnost, a ispitanici s intracerebralnom hemoragijom imali su najviše komplikacija, najveći funkcionalni deficit i smrtnost. Zaključak: rezultati potvrđuju varijacije u ishodu različitih podvrsta moždanoga udara.Aim: To determine indicators of short-term outcome of different stroke subtypes. Methods: An observational prospective cohort study. Group of 130 patients was studied. Classification used: Hemorrhagic stroke (Intracerebral hemorrhage (ICH), Subarachnoid hemorrhage (SAH)); Ischemic stroke: TOAST (Trial of ORG 10172 in Acute Stroke Treatment) classification. Degree of disability was assessed using the Modified Rankin Scale. Results: The most common stroke complication was urinary infection. Patients with small vessel stroke had the lowest rate of complications, functional deficit and case-fatality and patients with ICH had the highest rate of these indicators. Conclusion: Results confirm variations of outcome in different stroke subtype

Time of delay of stroke patients in Osijek region

Trombolitička terapija poboljšava ishod moždanoga udara (MU) kada se primijeni unutar 3 sata od nastupa simptoma. Cilj istraživanja bio je utvrditi koliko je prosječno vrijeme kašnjenja (VK) bolesnika na osječkom području. Prospektivno je bilježeno VK u 100 bolesnika liječenih na Klinici za neurologiju KBC Osijek. Prosječno je VK 502 minute. Unutar 3 sata stiglo je 53%, unutar 6 sati 66%, unutar 12 sati 79% i unutar 24 sata 90% oboljelih. Stanje još uvijek nije zadovoljavajuće i nužno je daljnje informiranje stanovništva i edukacija o simptomima MU-a.Thrombolytic therapy improves the outcome after ischemic stroke when applied within 3 hours from symptoms onset. The goal of study was to investigate the time of delay for acute stroke patients (pts) treated at Neurology clinic, University Hospital Centre Osijek. The mean time of delay was 502 minutes. 53% of pts arrived within 3 hours, 66% within 6 hrs, 79% within 12 hrs and 90% of pts within 24 hours. The situation is not yet satisfying and efforts to reduce time of delay and to educate population are necessary

Epidemiology of stroke

The epidemiology of stroke may be changing over time as a result of a number of factors, including an aging population and advances in the prevention and treatment of stroke. Epidemiological indicators and research of stroke have great significance in estimating the impact of this disease on the population. Such research states the distribution of this illness and factors by which it is influenced, follows short-term and long-term consequences, as well as socio-economic burden of stroke for the whole community. Data on stroke prevalence is important for creating the right strategies for health care in a specific area. Stroke-relatedmortality in any population is dependent upon three main factors: the incidence of stroke in the population, quality ofmedical care available, and the prevalence of cardiovascular diseases and comorbidities that can affect the likelihood of surviving stroke events. The quality of medical care available influences both the number of individuals suffering from stroke and the proportion of case-fatality among them. Epidemiological data shows that stroke is one of the leading causes of death and long-term disability in most industrialized populations, and the same is true for Croatia. The existing systemof health care for stroke patients does not meet the needs and is not in accordance with latest trends in developed countries.Hence, there is a need for its reorganization and design of the national project for stroke prevention and treatment similar to those in European countries with favorable epidemiological data

Afazija u bolesnika s ishemijskim moždanim udarom

Aphasia in ischemic stroke patients is associated with increased mortality, decreased rates of functional recovery, and reduced work capability. The aim was to study the prevalence and characteristics of aphasia in ischemic stroke patients. This prospective, cohort study included 177 patients (94 male and 83 female) hospitalized for ischemic stroke at University Department of Neurology in Osijek in 2010. All patients were examined by a neurologist and speech therapist to specify the subtype of stroke and speech disturbance. The study showed 75 (42.4%) study patients to have aphasia (48.2% of females and 37.2% of males). The most frequent clinical type was expressivereceptive aphasia. Aphasic patients were statistically significantly older (75 vs. 70 years) and showed female predominance (53% vs. 42%). Patients with aphasia also had a threefold share of large vessel stroke (51% vs. 17%) and approximately twofold share of cardioembolic stroke (41% vs. 22%). The share of left hemisphere stroke was nearly twofold in aphasic (61%) compared to non-aphasic (31%) patients. The study showed a high prevalence of aphasia in patients with ischemic stroke, which increased with age, was more pronounced in females and most frequently found in patients suffering from large vessel stroke and cardioembolic stroke.Afazija u bolesnika s ishemijskim moždanim udarom udružena je većom smrtnošću, sniženim stopama funkcijskog oporavka i smanjenom radnom sposobnošću. Cilj je bio ispitati učestalost i značajke afazije u bolesnika s ishemijskim moždanim udarom. U ovu prospektivnu kohortnu studiju bilo je uključeno 177 bolesnika (94 muškaraca i 83 žene) hospitaliziranih zbog ishemijskog moždanog udara na Klinici za neurologiju u Osijeku tijekom 2010. godine. Sve bolesnike pregledao je neurolog i logoped kako bi se utvrdila podvrsta moždanog udara i poremećaj govora. Studija je pokazala da afaziju ima 75 (42,4%) bolesnika (48,2% žena i 37,2% muškaraca). Ekspresivno-receptivna afazija bila je najčešći klinički tip afazije. Bolesnici s afazijom bili su statistički značajno stariji (75 prema 70 godina), a prevladavale su žene (53% prema 42%). Uz to, bolesnici s afazijom imali su trostruko veću učestalost moždanog udara velikih krvnih žila (51% prema 17%) i otprilike dvostruko veću učestalost kardioembolijskog moždanog udara (41% prema 22%). Učestalost moždanog udara lijeve polutke bila je gotovo dvostruka u afazičnih (61%) u usporedbi s neafazičnim (31%) bolesnicima. Istraživanje je pokazalo visoku učestalost afazije u bolesnika s ishemijskim moždanim udarom, koja se povećavala s dobi, bila je više izražena u žena, a najčešće se nalazila u bolesnika s moždanim udarom velikih krvnih žila i onih s kardioembolijskim moždanim udarom

Clinical characteristic of stroke in Eastern Croatia

Analizirana je zastupljenost različitih kliničkih podvrsta moždanoga udara (MU) i njihovih čimbenika rizika u Istočnoj Hrvatskoj. Studijom je obuhvaćeno 130 bolesnika s akutnim MU koji su liječeni u Kliničkoj bolnici Osijek i Općoj bolnici Slavonski Brod. Hemoragijski MU bio je zastupljen u 17,69% (intracerebralna hemoragija u 16,15% i subarahnoidalna hemoragija u 1,54%), a ishemijski MU u 82,31%) bolesnika. Nađena je visoka incidencija lakunamih i kardioembolijskih ishemijskih MU te čimbenika rizika povezanih s nezdravim načinom života. Izrazito je visoka zastupljenost arterijske hipertenzije (77,69%>) i hiperkolesterolemije (45,38%).Clinical subtypes of stroke and their risk factors in Eastern Croatia were analysed. Study comprised 130 patients with stroke, who were treated at University Hospital Osijek and General Hospital Slavonski Brod. Hemorrhagic stroke was presented in 17.69% (intracerebral hemorrhage in 16,15%) and subarachnoid hemorrhage in 1,54%) and ischemic stroke in 82,31%. Collected data showed high incidence of lacunar and cardioembolic subtypes of stroke and risk factors for stroke connected with unhealthy lifestyle. Extremely high incidence of arterial hypertension (77,69%) and hypercholesterolemia (45,38%) was found

Distribution of Stroke Risk Factors in Eastern Croatia

The aim of this study was to determine the distribution of risk factors according to age, gender, subtypes and recurrence of stroke in eastern Croatia. The study included 250 acute stroke patients admitted to University Department of Neurology, Osijek University Hospital Centre in 2011. Patients were grouped according to age, gender, subtypes and recurrence of stroke. The study showed significant differences in the distribution of cigarette smoking, diabetes, cardiomyopathy and hyperuricemia according to patient age. According to gender, male patients had a significantly higher prevalence of smoking and alcohol abuse, whereas in female patients the prevalence of arterial hypertension, atrial fibrillation and hyperuricemia was significantly higher. Regarding stroke subtypes, significant differences were noticed in the prevalence of arterial hypertension, atrial fibrillation, cardiomyopathy and cerebral blood vessel stenosis. Atrial fibrillation was significantly more common in first-ever than in recurrent stroke. Study results identified the groups of patients requiring special attention regarding particular risk factors in eastern Croatia and emphasized the need of developing regional strategies of screening, prevention and holistic care for stroke patients