58 research outputs found
UÄestalost miÅ”iÄno-koÅ”tanih i oÄnih simptoma kod rada s raÄunalom
Computer users most often complain of the eye and locomotor system disorders. The goal of this paper was to find out the frequency and relation between musculoskeletal and eye symptoms among computer workers. The data on musculoskeletal and eye symptoms were provided by two questionnaires. Forty-nine workers were included in the study. Their mean age was 41 years and average length of service 16 years. The average amount of time they spent in front of computers was 6.73 hours per day. Women spent more time working at a computer per day than men (P=0.025). The most frequent complaint in the past year referred to the upper back pain (30.6 % of the workers). Every fourth worker, i.e. 24.5 % of them experienced neck pain in the past year; women more often than men (P=0.024). A health problem which reduced the range of motion and prompted the workers to ask for sick leave was lower back pain. The relation between eye symptoms and the upper back pain experienced in the past year (P=0.004), and in the last week (P=0.031) was statistically signifi cant. Proper exercises for stretching musculoskeletal system, ergonomic computer equipment, and artificial tears could decrease muscular and eye problems, which in turn could enhance productivity and reduce sick leaves.tegoba oÄiju i miÅ”iÄno-koÅ”tanoga sustava kod radnika koji rade s raÄunalom i njihovu povezanost. PomoÄu upitnika uzeti su podaci o miÅ”iÄno-koÅ”tanim i oÄnim simptomima kod rada s raÄunalom. U ispitivanju je sudjelovalo 49 radnika (27 žena i 22 muÅ”karca) prosjeÄne životne dobi od 41 godina i prosjeÄnog trajanja radnog staža od 16 godina koji dnevno rade za raÄunalom u prosjeku 6,73 sata. Žene su znaÄajno duže dnevno radile na raÄunalu od muÅ”karaca (P=0,025). NajviÅ”e se radnika žalilo na bolove u gornjem dijelu leÄa u zadnjih godinu dana (30,6 %). Svaki Äetvrti radnik, tj. 24,5 % radnika imalo je bol u vratu u zadnjoj godini i to statistiÄki znaÄajno ÄeÅ”Äe žene (P=0,024). Tegobe koje ograniÄavaju aktivnost i mogu zahtijevati bolovanje bili su bolovi u donjem dijelu leÄa. StatistiÄki je bila znaÄajna povezanost pojave oÄnih simptoma i bolova u gornjim leÄima u zadnjoj godini (P=0,004) i u zadnjem tjednu (P=0,031). OdgovarajuÄe vježbe rastereÄenja miÅ”iÄno-koÅ”tanoga sustava uz ergonomsku opremu za rad s raÄunalom te smanjenje oÄnih tegoba upotrebom umjetnih suza potrebno je provoditi radi smanjenja miÅ”iÄnih i oÄnih tegoba, Å”to zajedno poveÄava produktivnost i smanjuje bolovanja
Važnost poÄetne hipokloremije za razvitak hiponatrijemije i ishoda bolesti u bolesnika s akutizacijom kroniÄnog srÄanog zatajenja [The importance of initial hypochloremia in developing hyponatremia and adverse outcome in patients with acute heart failure]
Introduction: Heart failure (HF) is a major public health issue currently affecting more than
23 million patients worldwide. Hyponatraemia has been shown to be a predictor of poor
outcome in patients with acute and chronic HF. Therefore, we aimed at finding a marker for
early detection of patients at risk for developing hyponatraemia. To this end, the present study
investigated the relationship between initial serum chloride and follow-up sodium levels in
acute heart failure (AHF) patients.
Patients and methods: The present study was performed as a prospective, single-centre,
observational research with a total of 152 hospitalised AHF patients in The teaching hospital
Sisters of Charity. Patients have been divided in four groups depending on values of sodium
and chloride. Patients were monitored on the second, third and seventh day of hospitalisation
and follow up was done after three months.
Results: Compared to patients with initial normochloraemia, patients with initial
hypochloraemia had a statistically significant higher incidence of hyponatraemia after a 3-
months follow-up [P < 0.001; odds ratio (OR) = 27.08, CI: 4.3 - 170.7]. A similar finding was
obtained upon exclusion of patients with initial hyponatriaemia with Fishers test [P = 0,034;
odds ratio (OR)=15.5,CI:1.7ā140.6]. Binary logistic regression revealed a significantly
increased in-hospital mortality in the hypochloraemic/normonatriaemic (OR=4.08,CI:1.08 ā
15.43,P=0.039),but not in the hypochloraemic/hyponatraemic, normochloraeamic/
hyponatraemic or normonatriaemic/normochloraemic patients. Ejection fraction (EF) at
admission was significantly higher in hypochloraemic/normonatriaemic, compared to
normonatriaemic/normochloraemic patients, but similar to EF in both
hypochloraemic/hyponatraemic and normochloraeamic/hyponatraemic patients. The Nterminal
precursor Brain Natriuretic Peptide (NT-proBNP) levels at admission were
significantly lower in hypochloraemic/normonatriaemic compared to
hypochloraemic/hyponatraemic and normonatriaemic/normochloraemic patients, respectively.
As an interesting fact study showed that there is positive correlation between chloride and
low-density lipoprotein (LDL), high-density lipoprotein cholesterol (HDL) and total
cholesterol both predictors of mortality in heart failure. Recent studies have showed that
hypochloraemia is strongly and independently associated with mortality in patients with heart
failure. Also, there are studies showing that the higher cholesterol levels are associated with
better outcomes in patients with heart failure. Until now, those two variables have not been
linked before.
Conclusion: Chloride, a long forgotten electrolyte, emerges as a possible predictor for the
development of hyponatraemia in patients with AHF. Our study showed that initial low serum
chloride concentration is predictive of developing hyponatraemia and associated with
increased in-hospital mortality in AHF patients. Chloride could be used to start appropriate
therapy early enough to prevent development of hyponatraemia and thereby associated
complications and poor outcome of AHF patients. The main advantage of that chloride-status
based diagnostics is its wide availability and practicability
Rad od kuÄe i miÅ”iÄno-koÅ”tani bol tijekom epidemije COVID-19 ā pilot-istraživanje
One of the side-effects of the COVID-19 pandemic is a global change in work ergonomic patterns as millions of people replaced their usual work environment with home to limit the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection. The aim of our cross-sectional pilot study was to identify musculoskeletal pain that may have resulted from this change and included 232 telecommunications company workers of both genders [121 (52.2 %) men aged 23ā62 (median 41; interquartile range 33ā46 yrs.) and 111 (47.8 %) women aged 23ā53 (median 40; interquartile range 33ā44)] who had been working from home for eight months (from 16 March to 4 December 2020) before they joined the study. The participants were asked to fill in our web-based questionnaire by self-assessing their experience of hand, lower back, and upper back/neck pain while working at home and by describing their work setting and physical activity. Compared to previous work at the office, 90 (39.1 %) participants reported stronger pain in the lower back, 105 (45.7 %) in the upper back/neck, and 63 (27.2 %) in their hands. Only one third did not report any musculoskeletal problems related to work from home. Significantly fewer men than women reported hand, lower back, and upper back/neck pain (p=0.033, p=0.001 and p=0.013, respectively). Sixty-nine workers (29.9 %) reported to work in a separate room, 75 (32.4 %) worked in a separate section of a room with other household members, whereas 87 (37.7 %) had no separate work space, 30 of whom most often worked in the dining room. Ninety-five participants (40.9 %) had no office desk to work at, and only 75 (32.3 %) used an ergonomic chair. Of those who shared their household with others (N=164), 116 (70.7 %) complained about constant or occasional disturbances. Over a half of all participants (52 %) said that they worked longer hours from home than at work, predominantly women (p=0.05). Only 69 participants (29.9 %) were taking frequent breaks, predominantly older ones (p=0.006). Our findings clearly point to a need to inform home workers how to make more ergonomic use of non-ergonomic equipment, use breaks, and exercise and to inform employers how to better organise working hours to meet the needs of work from homePandemija izazvana Å”irenjem koronavirusa teÅ”kog akutnog respiratornog sindroma 2 dovela je do znaÄajnih promjena u globalnoj ergonomiji rada. Naime, tisuÄe zaposlenika iznenada su uobiÄajene radne prostore zamijenile kuÄnim prostorom ne bi li se smanjilo Å”irenje virusa i obuzdala pandemija. Kako bi se opisale miÅ”iÄno-koÅ”tane tegobe u uvjetima rada od kuÄe te analizirali novonastali uvjeti rada od kuÄe, ovo presjeÄno pilot-istraživanje obuhvatilo je 232 zaposlenika telekomunikacijske tvrtke: 121 muÅ”karca (52,2 %) u dobi od 23 do 62 godine i 111 žena (47,8 %) u dobi od 23 do 53 godine, koji su radili od kuÄe osam mjeseci, tj. od 16. 3. 2020. do 4. 12. 2020. Za potrebe ovog istraživanja autori su izradili virtualni upitnik u kojem su ispitanici samostalno procijenili intenzitet bolova u Å”akama, donjem dijelu leÄa te u vratu i gornjem dijelu leÄa tijekom rada od kuÄe, uvjete rada od kuÄe te razinu vlastite tjelesne aktivnosti. U odnosu na vrijeme prije rada od kuÄe, 90 ispitanika (39,1 %) prijavilo je jaÄe bolove u donjem dijelu leÄa tijekom rada od kuÄe, pri Äemu je pogorÅ”anje bola u vratu i gornjem dijelu leÄa prijavilo 105 ispitanika (45,7 %), a bola u Å”akama njih 63 (27,2 %). Samo treÄina zaposlenika nije prijavila miÅ”iÄno-koÅ”tane tegobe tijekom rada od kuÄe. MuÅ”karci su znaÄajno rjeÄe prijavili bol u Å”akama, donjem dijelu leÄa te u vratu i gornjem dijelu leÄa (p=0,033; p=0,001 odnosno p=0,013). Posebnu prostoriju za rad od kuÄe imalo je 69 ispitanika (29,9 %), odvojeni radni prostor njih 75 (32,4 %), a njih 87 (37,7 %) nije imalo radni prostor, pa su najÄeÅ”Äe radili u blagovaonici (njih 30). PisaÄi radni stol za rad nije imalo 95 ispitanika (40,9 %), a ergonomsku radnu stolicu imalo je njih tek 75 (32,3 %). Od ispitanika koji žive s ukuÄanima (N=164), njih 116 (70,7 %) smatralo je da ih ukuÄani ometaju u radu stalno ili povremeno. ViÅ”e od polovice ispitanika (52 %) smatralo je da radi dulje kod kuÄe nego na poslu, i to znaÄajno viÅ”e žene (p=0,05). Samo je 69 ispitanika (29,9 %) uzimalo ÄeÅ”Äe predahe, i to znaÄajno ÄeÅ”Äe stariji zaposlenici (p=0,006). NaÅ”i rezultati upuÄuju na to da, radi sprjeÄavanja miÅ”iÄno-koÅ”tanih tegoba, zaposlenike treba educirati o metodama i naÄinima prilagodbe neergonomske opreme, koriÅ”tenju pauza, potrebi tjelovježbe, a poslodavce treba educirati o potrebi organizacije radnog vremena u novim uvjetima rada od kuÄe
AVAILABILITY OF ANTIDOTES IN EMERGENCY DEPARTMENT: WHICH ONE, HOW MUCH, WHY AND WHEN?
U Hrvatskoj ne postoji razvijena subspecijalizacija iz kliniÄke toksikologije, a samim time nije razvijena ni strategija ni mreža toksikoloÅ”kih centara. Äinjenica je da se u svakodnevnom radu susreÄemo s otrovanjima, a postoji nejednaka dostupnost antidotima u hitnim prijmovima ili centralnim bolniÄkim ljekarnama. Svrha ovog preglednog Älanka je upoznavanje s literaturom o dostupnosti antidota u akutnim bolnicama, vremenske i koliÄinske, ali i vlastitih iskustava o izgradnji takve prakse u OHBP-u KBC-a Zagreb, a s nadom da Äe u buduÄnosti postojati strategija koja Äe dati preporuke o tome koje antidote moramo imati uvijek u hitnom prijmu, kada ih dajemo, u kojim dozama, i kakve zalihe bolnice moraju uvijek imati u centralnim ljekarnama.In this paper, we will try to address a common problem in Croatian hospitals and emergency departments, which is the lack of strategy that determines availability of antidotes. Up to date, there is no specialization that involves clinical toxicology speciļ¬ cally, and furthermore, there is no strategy regarding regional toxicology centers. Some international data on stocking of antidotes in hospitals that provide emergency care will be presented in this paper, and some personal experience of building a system of stocking antidotes in emergency department and hospital pharmacies. Hopefully, in the future, we will be able to create an expert consensus on the subject of which antidotes do we need, how much of them, where they need to be, and how to use them efļ¬ ciently
The impact of zno nanoparticles application on yield components of different wheat genotypes
The properties of zinc oxide nanoparticles (ZnO NPs) and their use have been shown as prominent for application in agriculture since it can bring certain benefits in agricultural production. The objective of this study was to estimate the impact of seed priming with ZnO NPs on yield components, plant height and spike length on wheat. In order to estimate the effects of ZnO nanoparticles on yield component, four winter wheat genotypes namely, NS Pobeda, NS Futura, NS 40S and NK Ingenio were selected. Seeds of each wheat genotypes were primed with different concentrations of ZnO NPs (0, 10, 100 and 1000 mg l-1) for 48 h in dark box by continuous aeration. Primed seeds were after sown in soil pots with 60-70% moisture contents during the till maturity. Considerable improvement was observed in plant height and spike length which increased with rates of ZnO NPs compared to the control. At rates of 10 mg l-1 ZnO NPs, the greatest increases in plant height and spike length were observed for genotypes NS Pobeda and NS Futura. At 100 mg l-1 ZnO NPs, the greatest increase for both traits was observed for genotypes NS 40S and NK Ingenio. Maximum rates of ZnO nanoparticles reduced both observed traits of wheat. The result indicated that ZnO nanoparticles can significantly increase plant height and spike length of wheat, but also plant response to ZnO nanoparticles significantly depends on concentration of application, as well as from wheat genotype
Genotype x Environment Interaction for Wheat Yield Traits Suitable for Selection in Different Seed Priming Conditions
Different seed priming treatments are widely used in order to improve the nutritional status of wheat, as well as to improve its grain yield and yield- related traits. The present study aimed to evaluate the impact of seed priming with zinc oxide nanoparticles (ZnO NPs) on the yield related traits, such as, field emergence, plant height, spike length and grain yield per plant of four winter wheat genotypes (Triticum aestivum L.) during two vegetation seasons of 2018/2019 and 2019/2020. The seeds of each wheat genotypes were primed with different concentrations of ZnO NPs (0 mg L-1, 10 mg L-1, 100 mg L-1 and 1000 mg L-1) for 48 h in a dark box by continuous aeration and were sown in soil pots with 60-70% moisture content until full maturity. The additive main effects and multiplicative interaction (AMMI) models were used to study the genotype environment effects. The results indicated that the plants response to ZnO nanoparticles significantly increased all of the observed traits of the wheat, while its maximum rates reduced the traits of the wheat. The AMMI analysis revealed the very complex nature of the variation observed in the trial and showed the significant effect of the GxE interaction, in which the first main component was significant for all components
Serum concentrations of free fatty acids are associated with 3-month mortality in acute heart failure patients
Background: Plasma free fatty acids (FFA) are higher in heart failure (HF) patients compared to healthy controls. Considering that the extent of FFA elevation in HF might mirror the severity of HF, we hypothesized that the serum levels of FFA may be a useful prognostic indicator for 3-month mortality in acute heart failure (AHF). ----- Methods: We analyzed the serum samples of AHF patients obtained at admission to the emergency department. Serum levels of FFA were analyzed using an enzymatic reagent on an automatic analyzer. ----- Results: Out of 152 included AHF patients that were originally included, serum samples of 132 patients were available for the quantification of FFA. Of these, 35 (26.5%) died within 3 months of onset of AHF. These patients had significantly higher serum levels of FFA compared to AHF patients who were alive 3 months after onset of AHF. Univariable logistic regression analyses showed a significant positive association of FFA levels with 3-month mortality (odds ratio [OR] 2.76 [95% confidence interval 1.32-6.27], p = 0.010). Importantly, this association remained significant after adjusting for age and sex, as well as for further clinical and laboratory parameters that showed a significant association with 3-month mortality in the univariate analyses. ----- Conclusions: We conclude that the admission serum levels of FFA are associated with 3-month mortality in AHF patients. Therefore, measurements of circulating FFA levels may help identifying high-risk AHF patients
Serum concentrations of Citrate, Tyrosine, 2- and 3- Hydroxybutyrate are associated with increased 3-month mortality in acute heart failure patients
Considering the already established relationship between the extent of the metabolic dysfunction and the severity of heart failure (HF), it is conceivable that the metabolomic profile of the serum may have a prognostic capacity for 3-month mortality in acute heart failure (AHF). Out of 152 recruited patients, 130 serum samples were subjected to the metabolomic analyses. The 3-month mortality rate was 24.6% (32 patients). Metabolomic profiling by nuclear magnetic resonance spectroscopy found that the serum levels of 2-hydroxybutyrate (2-HB), 3-hydoxybutyrate (3-HB), lactate, citrate, and tyrosine, were higher in patients who died within 3 months compared to those who were alive 3 months after onset of AHF, which was confirmed by univariable logistic regression analyses (p = 0.009, p = 0.005, p = 0.008, p<0.001, and p<0.001, respectively). These associations still remained significant for all tested metabolites except for lactate after adjusting for established prognostic parameters in HF. In conclusion, serum levels of 2-HB, 3-HB, tyrosine, and citrate measured at admission are associated with an increased 3-month mortality rate in AHF patients and might thus be of prognostic value in AHF
Metabolic syndrome modulates association between endothelial lipase and lipid/lipoprotein plasma levels in acute heart failure patients
We hypothesised that the established association of endothelial lipase (EL) plasma levels with atherogenic lipid profile is altered in acute heart failure (AHF) and additionally affected by overlapping metabolic syndrome (MetS). We examined the association of EL plasma levels and lipid/lipoprotein plasma levels in AHF patients without and with overlapping MetS. The study was performed as a single-centre, observational study on 152 AHF patients, out of which 85 had overlapping MetS. In the no-MetS group, EL plasma levels were significantly positively correlated with plasma levels of atherogenic lipids/lipoproteins, including total cholesterol, low-density lipoprotein (LDL)-cholesterol, total LDL particles and triglycerides, but also with plasma levels of antiatherogenic high-density lipoprotein (HDL)-cholesterol, total HDL particles and small HDL particles. In the MetS group, EL plasma levels were positively correlated with triglyceride and small LDL-particle levels, and significantly negatively correlated with plasma levels of large HDL particles as well as with LDL- and HDL-particle size, respectively. EL- and lipid/lipoprotein- plasma levels were different in the no-MetS patients, compared to MetS patients. The association of EL with atherogenic lipid profile is altered in AHF and additionally modified by MetS, which strongly modulates EL- and lipid/lipoprotein-plasma levels in AHF
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