Značaj i simbolika psa na sepulkralnim spomenicima Salone

The paper focuses on the Salonitan sepulchral monuments featuring dogs as a motif. The main goals have been to study the relationship between man and dog by contextualizing these iconographic motifs in various aspects such as hunting, cult, and the individualistic approach to the dog as a pet; and to use the analysis of the monuments to reconstruct the position and complex significance of the dog in the Roman society, revealing the symbolism of certain artistic templates found on the sepulchral monuments of Salona.U radu su obrađeni salonitanski sepulkralni spomenici s motivom psa. Dva su osnovna cilja: prvi je proučiti odnos čovjeka i psa kontekstualizirajući ikonografske motive kroz različite aspekte kao što su lov, kult te individualistički pristup pojedinca prema psu kao kućnom ljubimcu; drugi cilj je, analizirajući spomenike, rekonstruirati predodžbu o položaju i slojevitom značenju psa u rimskom društvu, otkrivajući i simboliku određenih likovnih predložaka zastupljenih na salonitanskim sepulkralnim spomenicima

Zbrinjavanje otežanog dišnog puta – vječni izazov: prikaz bolesnika

Introduction: Obtaining a secured airway is a vital aspect during reconstructive surgery in patients with extensive post-burn mentosternal scar contractures. Such contractures can potentially lead to a “can’t intubate, can’t ventilate” scenario, otherwise rare but life-threatening situation. We present a case of successful management of a paediatric case of anticipated difficult airway due to burn injury. Case description: A 14-year-old boy presented for repair of an extensive skin contracture of the neck, thorax and face due to mutilating scarring. The boy was treated for 80% burn caused by gasoline flame 14 months prior to this surgery. Burn healing and scarring resulted in massive distortion of the facial and cervical anatomy, all implying difficult airway with a high probability of “can’t intubate, can’t ventilate” situation. Flexible fiberoptic bronchoscope with loaded cuffed endotracheal tube N° 6.0 was used for visualisation of vocal cords through the mouth in light sedation with spontaneous breathing. After visualisation of the vocal cords, fentanyl (Fentanyl, GlaxoSmithKline) and thiopental (Thiopental, Rotexmedica) were administered and the trachea was intubated at the first attempt. Balanced general anaesthesia was initiated and planned surgical procedure was successfully completed. The trachea was extubated on the first postoperative day without any complication. Conclusion: Difficult paediatric airway and particularly “can’t intubate, can’t ventilate” situation is a problem associated with significant risks and complications. Anticipating a difficult airway, having a structured approach with appropriate preparation, and understanding of difficult airway management algorithms are essential for success.Uvod: Zbrinjavanje dišnog puta od vitalne je važnosti za bolesnika kod kojeg je indiciran rekonstruktivni zahvat nakon opsežnihopeklina lica i vrata. Kontrakture koje nastaju nakon takvih ozljeda mogu dovesti do nemogućnosti intubacije i ventilacije, što predstavljarijetku ali životno ugrožavajuću situaciju. Prikazati ćemo uspješno zbrinjavanje pedijatrijskog bolesnika sa očekivano otežanimzbrinjavanjem dišnog puta.Prikaz slučaja: Četrnaestogodišnji dječak sa opsežnom opeklinom lica, vrata i prsnog koša bio je predviđen za rekonstruktivni zahvat.Cijeljenje opekline, koja je nastala 14 mjeseci prije planiranog zahvata, rezultiralo je opsežnom kontrakturom i promjenom anatomijelica i vrata. Radi promijenjenih anatomskih odnosa bilo je očekivano da će zbrinjavanje dišnog puta biti otežano. Za vizualizacijuglasnica korišten je fleksibilni fiberoptički bronhoskop s pripremljenim endotrahealnim tubusom dok je bolesnik bio u plitkoj sedacijii disao spontano. Nakon vizualizacije glasnica bolesnik je dobio fentanil (Fentanyl, GlaxoSmithKline) i tiopental (Thiopental, Rotexmedica)te je potom intubiran iz prvog pokušaja. Nastavljena je balansirana opća anestezija, planirani zahvat je uspješno dovršen.Bolesnik je ekstubiran prvi postoperativni dan bez ikakvih komplikacija.Zaključak: Otežani dišni put u pedijatrijskih bolesnika je problem povezan s brojnim rizicima i komplikacijama. Prepoznavanje otežanogdišnog puta uz adekvatnu pripremu i poznavanje algoritama za zbrinjavanje otežanog dišnog puta ključno je za sigurnostbolesnika

Lomovi gornjeg okrajka natkoljenične kosti u starih osoba

Fractures of the proximal femur are a substantial problem in the elderly. These fractures primarily are due to bone fragility in the elderly caused by osteoporosis. This population is burdened with numerous chronic illnesses that aggravate and complicate surgical treatment of the injured. According to latest figures, death rates among patients with these fractures are by 15% higher than in those free from these injuries, and 20% of the injured will never be able to walk independently again. According to our own experience and literature data, surgical treatment significantly reduces the mortality of the injured and improves their quality of life by providing by far better functional results than conservative treatment. Results of operative treatment for proximal femur fractures were compared between two periods of time at a 10-year interval (1988/1989 and 1998/1999). Comparison between these two time periods showed the frequency of hospital admission and operative treatment for this pathology to have increased by more than 100% in 10 years, so that at present this group of patients account for more than 45% of the capacity and operative schedule of the Division of Traumatology, Department of Surgery, Sestre milosrdnice University Hospital in Zagreb. During the latter 2-year period (1998/1999), there were 372 injured in total, 78 (21%) of them male and 294 (79%) female, mean age 73 years (69 in male and 79 in female patients). The mean duration of hospitalization was 15 days with 5-day waiting for the operation. During the same time period, eight (2%) patients were treated conservatively. A 2.5% (n=9) perioperative mortality rate was recorded. Fracture of the neck of femur was found in 152 (41%) patients; 47% of them were treated by use of partial hip prosthesis, 10% with total hip prosthesis, and 42% with a 130-degree angle plate. Out of 205 pertrochanteric fractures, 130-degree angle plate was used in 50%, 95-degree angle plate in 22%, and dynamic hip screw in 28% of cases. Operative treatment combined with a well planned rehabilitation program consistent with the type of surgery and individual patient condition has evident and great advantages, and has been recognized as the treatment of choice for this pathology.Lom gornjega okrajka natkoljenične kosti u starih osoba uvijek predstavlja aktualan problem. Mnogo je uzroka loma natkoljenične kosti u toj životnoj dobi, ali je u središtu zbivanja ipak osteoporoza i biomehaničko slabljenje kosti. Prema današnjim saznanjima može se ustvrditi da je opća smrtnost ove dobne skupine za 15% niža od unesrećenih koji su slomili proksimalni okrajak bedrene kosti, te su prema suvremenim znanstvenim spoznajama operacijski liječeni. U ovom su radu uspoređene dvije skupine ispitanika u razmaku od deset godina (2000./1999. i 1998./1989.). Najznačajniji je podatak da je u deset godina za 100% povećan broj hospitaliziranih zbog navedene ozljede, te je time oko 45% kapaciteta traumatološkog odjela Klinike za kirurgiju kliničke bolnice “Sestre milosrdnice” zauzet gerijatrijskom traumatologijom. U razdoblju od dvije godine, 2000./1999., bilo je ukupno 372 ozlijeđenika s lomom u navedenoj regiji. Od toga je 21% (n=78) muškaraca i 79%(n=204) žena. prosječna dob je bila 73 godine, i to 69 za muškarce i 79 za žene. Prosječno trajanje boravka u bolnici bilo je 15 dana, s čekanjem na operaciju u prosjeku 5 dana. Svega je 2% bolesnika liječeno konzervativnim postupkom zbog kon¬traindikacija za operaciju. Zabilježena je perioperacijska smrtnost od 2,5% ili devet slučajeva. Od ukupnoga broja ozlijeđenika, 152 (41%) ih je imalo lom vrata bedrene kosti, 205 (55%) pertrohanterni lom, a 15 (4%) subtrohanterni lom. Operacijsko liječenje uz odgovarajući rehabilitacijski postupak ima velike prednosti i predstavlja metodu izbora u liječenju lomova gornjega okrajka natkoljenične kosti u starih osoba

Magnetska rezonanca u procjeni razmjera ozljede kod distorzije skočnog zgloba

The aim of the study was to evaluate the status of all soft tissue and osseous structures by magnetic resonance imaging (MRI) in patients with acute ankle injury. During a two-year period (2001-2003), 50 patients with acute ankle injury (osseous injury excluded by conventional radiography) underwent MRI evaluation within 7 days of injury infliction. The following injuries were confirmed: joint effusion, joint capsule extension, lateral collateral ligament injury, fibular malleolus infraction, flexor hallucis longus tendon injury, brevis and longus peroneus tendon injury, infraction of talus and injury of tibiofibular syndesmosis. Study results pointed to a great variety of capsule-ligament andosseous structure injuries as well as to the existence of injuries undetectable by clinical examinationi and conventional radiography, where MRI proved highly useful in identifying selected patients sustaining ankle injury.Cilj studije bio je procijeniti stanje svih mekih tkiva i koštanih struktura u bolesnika s akutnom ozljedom gležnja pomoću prikaza magnetskom rezonancom (MRI). Tijekom dvogodišnjeg razdoblja (2001. - 2003.) procjena pomoću MRI provedena je u 50 bolesnika s akutnom ozljedom skočnog zgloba (u kojih je koštana ozljeda isključena konvencionalnom radiografijom) unutar 7 dana od nastupa ozljede. MRI je potvrdila slijedeće ozljede: zglobni izljev, ekstenziju zglobne kapsule, ozljedu lateralno kolateralnih ligamenata, infrakciju fibularnog maleolusa, ozljedu tetive dugog palčanog fleksora, ozljedu tetive kratkog i dugog peroneusa, infrakciju talusa i ozljedu tibiofibularne sindesmoze. Dobiveni rezultati pokazali su raznovrsne ozljede kapsulno-ligamentnih i koštanih struktura, kao i postojanje ozljeda nevidljivih na kliničkom pregledu i konvencionalnoj radiografiji, za koje je MRI vrlo korisna dijagnostička metoda u odabranih bolesnika s ozljedom skočnog zgloba

Magnetska rezonanca u procjeni razmjera ozljede kod distorzije skočnog zgloba

The aim of the study was to evaluate the status of all soft tissue and osseous structures by magnetic resonance imaging (MRI) in patients with acute ankle injury. During a two-year period (2001-2003), 50 patients with acute ankle injury (osseous injury excluded by conventional radiography) underwent MRI evaluation within 7 days of injury infliction. The following injuries were confirmed: joint effusion, joint capsule extension, lateral collateral ligament injury, fibular malleolus infraction, flexor hallucis longus tendon injury, brevis and longus peroneus tendon injury, infraction of talus and injury of tibiofibular syndesmosis. Study results pointed to a great variety of capsule-ligament andosseous structure injuries as well as to the existence of injuries undetectable by clinical examinationi and conventional radiography, where MRI proved highly useful in identifying selected patients sustaining ankle injury.Cilj studije bio je procijeniti stanje svih mekih tkiva i koštanih struktura u bolesnika s akutnom ozljedom gležnja pomoću prikaza magnetskom rezonancom (MRI). Tijekom dvogodišnjeg razdoblja (2001. - 2003.) procjena pomoću MRI provedena je u 50 bolesnika s akutnom ozljedom skočnog zgloba (u kojih je koštana ozljeda isključena konvencionalnom radiografijom) unutar 7 dana od nastupa ozljede. MRI je potvrdila slijedeće ozljede: zglobni izljev, ekstenziju zglobne kapsule, ozljedu lateralno kolateralnih ligamenata, infrakciju fibularnog maleolusa, ozljedu tetive dugog palčanog fleksora, ozljedu tetive kratkog i dugog peroneusa, infrakciju talusa i ozljedu tibiofibularne sindesmoze. Dobiveni rezultati pokazali su raznovrsne ozljede kapsulno-ligamentnih i koštanih struktura, kao i postojanje ozljeda nevidljivih na kliničkom pregledu i konvencionalnoj radiografiji, za koje je MRI vrlo korisna dijagnostička metoda u odabranih bolesnika s ozljedom skočnog zgloba

Initial weight loss after restrictive bariatric procedures may predict mid-term weight maintenance: results from a 12-month pilot trial

Background: Bariatric procedures are effective options for weight loss (WL) in the morbidly obese. However, some patients fail to lose any weight after bariatric surgery, and mid-term weight maintenance is variable. The aim of this study was to investigate whether initial WL could predict mid-term weight maintenance. ----- Methods: Eighty patients were enrolled, of whom 44 were treated with the BioEnterics Intragastric Balloon (BIB), 21 with laparoscopic adjustable gastric lap-banding (LAGB), and 15 with laparoscopic sleeve gastrectomy (LSG). Percentage of body WL and percentage of excess weight loss (EWL) were calculated at baseline and after 1, 3, 6, and 12 months. Successful WL was defined as EWL >20% for patients treated with BIB and >50% for patients treated with LAGB and SG. ----- Results: Success in the 6th and 12th month was achieved in 80% and 58% of patients in the BIB group, 33% and 40% in the LAGB group, and 60% and 73% in the LSG group. In the BIB group, WL in the 1st month correlated positively with WL at the 6th and 12th month, and an initial WL >6.5% best predicted success (sensitivity 50%, specificity 80%). A similar association was observed in the LAGB group at the 6th and 12th month and an initial WL >9.4% best predicted success (sensitivity 90.0%, specificity 81.2%). In patients treated with LSG, WL in the 3rd month correlated positively with EWL at the 6th and 12th month, with a cutoff value of 17% (sensitivity 66.7%, specificity 100%). ----- Conclusions: WL in the 1st month in patients treated with BIB and LAGB and WL in the 3rd month in patients treated with LSG could be used as a prognostic factor to predict mid-term weight maintenance

A First Case of Endoscopical Removal of an Eroded Adjustable Gastric Band in Croatia

Laparoscopic gastric banding (LAGB) is one of the most common surgical procedures in the treatment of morbid obesity since it provides good long-term outcomes in weight loss and decrease of comorbidities associated with obesity. Although the procedure has low morbidity and almost none-existing mortality, certain complications can occur. Erosion of the band into the gastric wall is one of the rare complications in LAGB. The reported incidence varies from 1% to 11%, however the largest study reported an incidence of 1,6%. This is in accordance with the incidence in our Centre for obesity, where only one case of erosion occurred among 112 operative procedures. The aim of this paper is to present a patient with gastric band erosion and it’s removal by using the endoscopic techniques as a minimally invasive management method

Analysis of coordinated generation of wind farm and battery energy storage

U ovom radu predlaže se koordinirani pogon vjetrene elektrane i baterijskog sustava pohrane energije. Glavne prednosti navedenog koordiniranog pogona su smanjenje utjecaja pogreške u prognoziranju snage vjetrene elektrane uz produljenje životnog vijeka baterijskog sustava pohrane energije. Najprije se u fazi planiranja opisuje metoda određivanja kapaciteta baterijskog sustava za proračun optimalnog energetskog kapaciteta i nazivne snage baterijskog sustava bazirano na povijesnim mjernim podacima. Zatim se modelira upravljanje kratkoročnom isporukom snage bazirano na prognoziranim snagama vjetra. Predstavljena je studija slučaja kako bi se potvrdila učinkovitost predložene metode.This paper proposes a coordinated operational dispatch scheme for a wind farm with a battery energy storage system (BESS). The main advantages of the proposed dispatch scheme are that it can reduce the impacts of wind power forecast errors while prolonging the lifetime of BESS. The scheme starts from the planning stage, where a BESS capacity determination method is proposed to compute the optimal power capacity and energy capacity of BESS based on historical wind power data. Then, at the operation stage, a flexible short-term BESS-wind farm dispatch scheme is proposed based on the forecasted wind power generation scenarios. A case study is provided to validate the performance of the proposed method

LEADERSHIP TECHNIQUES OF MANIPULATION : Graduate paper

Manipulacija se često svrstava u negativan pojam kojim se ljude tjera ili kontrolira, no ona predstavlja važan alat svakog lidera u vodstvu poduzeća i svojih zaposlenika. Temelj ovog rada čine osnovni oblici manipulacije i razlozi zbog kojih se ona koristi u poslovanju i odnosu s ljudima. Manipulacija je važna za lidere, ovisno o njihovoj sposobnosti i vještini manipuliranja moguće je ostvariti velike napretke u poslovanju. Nije svaka manipulacija dobro prihvaćena pa je bitno razlikovati lidersku i negativnu manipulaciju. Matrica manipulacije dobar je način prikazivanja utjecaja manipulacije nekog poduzeća na okruženje i vlastite radnike. Brojni su primjeri velikih svjetskih lidera čija je manipulacija stvorila velike svjetske kompanije. Posjedovati sposobnost manipuliranja i usmjeravanja ljudi na pravi put velika je zadaća svakog lidera i teško je primjenjiva. Ukoliko ne postoji pravo iskustvo i prava strategija manipulacije može doći do različite percepcije od strane zaposlenika i da će biti drugačije prepoznata od očekivanog.Manipulation often represents the bad term of making people do something or control them, but it is a key aspect of every leader in charge of their companies and employees. A graduate thesis is comparted of basic forms of manipulations and ways for which manipulation is used and for what in organization. Manipulation is very important for leaders, it is possible to achieve great success in business based on skills and capabilities of manipulating. Not all forms of manipulations are appreciated so it is important to distinguish leader manipulation from negative manipulation. Manipulation matrix is a good way of showing the influence of manipulation on one of the companies and their employees. There are countless examples of world leaders that have created world-famous companies. Having the ability to manipulate people and direct them to the correct path is a great work of every leader and hardly applicable. If proper experience and correct strategy of how the manipulation will look like and in what ways will it adjust to every employee in a specific scenario