Quality of the blood sampled from surgical drainage after total hip arthroplasty

Several methods have been found to be successful in reducing the need for allogeneic transfusion among the patients undergoing total hip replacement. The purpose of this prospective study was to analyse the quality and evaluate the effect of postoperative autotransfusion on the need for allogeneic transfusion following total hip replacement. The prospective study was performed in two groups of patients undergoing total hip replacement. Before the operative procedure all patients in both groups predonated two doses of autologous blood. In GROUP 1. the system for postoperative collection and transfusion of shed blood was used. In GROUP 2. the patients underwent total hip replacement without blood salvage system. Standard suction collection sets were used postoperatively. In this group shed blood was not transfused to the patients. The samples of preoperative donated autologus blood, allogeneic blood and postoperative collected autologous blood were analysed for number of red cells, hemoglobin, hematocrit, platelets, white blood cells, values of potassium, sodium, free hemoglobin and acid base status. The postoperatively blood salvage significantly reduced the use of allogeneic transfusion among patients managed with total hip replacement (allogeneic transfusion received 12% patients in Group 1 and 80% patients in Group 2; p<0.001). The values of red blood cells are significantly lower in postoperative collected autotransfusion blood compared with preoperative collected autologous blood and allogeneic blood (p<0.001). The values of potassium and acid base status were in normal range in postoperatively collected autotransfusion blood. These values in preoperatively collected autologous blood and allogeneic blood were out of normal range; (p<0.001). In addition to reducing the risk of complications that are associated with allogeneic transfusion, postoperative blood salvage may offer benefits including reducing the need for allogeneic blood. Our study confirmed that postoperative collection and transfusion of drainaged blood is simple and safe method that significantly reduce the need for allogeneic transfusion in patients underwent total hip replacement. The blood collected and transfused postoperatively has lower values of red blood cells and normal values of potassium and acid base balance. The transfusion of this blood caused no complications in our patients

The beginning of the end or the end of the beginning? A framework for understanding youth unemployment in Croatia

“Youth unemployment in Croatia did not simply explode during the Crisis: it was there all the time, it is structural in nature and was systematically ignored.” Nikola Buković of the Croatian Youth Network lays out a framework to understand and tackle this monumental problem via three dimensions – governance (policy-makers), labour market supply (education) and labour market demand (economy)

The prevalence of cardiovascular disease risk factors in patients from Croatian Zagorje County treated at Department of Medicine, Zabok General Hospital from 2000 to 2006

The aim of the study was to assess the prevalence of risk factors for cardiovascular disease in patients treated for coronary heart disease (CHD) at Department of Medicine, Zabok General Hospital during the 2000-2006 period. Cardiovascular diseases are a group of diseases that occur due to arterial. The risk factors that lead to the development and occurrence of cardiovascular disease are hypertension, cigarette smoking, hyperholesterolemia, hypertriglyceridemia, diabetes mellitus and positive family history. Additional factors favoring the occurrence of cardiovascular disease include overweight, inadequate physical activity, and emotional stress. Data on all patients hospitalized and diagnosed with CHD at Department of Medicine, Zabok General Hospital during the 2000-2006 period were analyzed for the prevalence of risk factors for CHD, i.e. hypertension, cigarette smoking, hypercholesterolemia, hypertriglyceridemia, diabetes mellitus and positive family history of cardiovascular disease. Hypercholesterolemia was defined by a cholesterol level higher than 5.1 mmol/L, hypertension from history data and blood pressure measurement on admission greater than 140/90 mmHg, diabetes mellitus from history data, and hypertriglyceridemia by a triglyceride level greater than 1.7 mmol/L. Information on heredity and cigarette smoking was collected from history and a questionnaire filled out on admission. All laboratory values were determined on patient admission to the hospital. Analysis of the risk factors for CHD recorded in patients from Zagorje County during the 2000-2006 period revealed hypertension to be the most common risk factor in our patients. According to sex, CHD was found to show a male preponderance. According to age at admission, CHD predominated in the > 70 age group, which accounted for one third of all patients, followed by a comparable proportion of the 50-60 and 60-70 age groups, i.e. still active population groups. As CHD is one of the leading health threats worldwide, estimated to remain so at least by 2020, it is fully justified to invest all efforts in the study of cardiovascular disease. New research projects should be focused on the prevention and early detection of the disease, improvement of diagnosis procedures, introduction of novel therapeutic options, use of new concepts, and due survey of the measures taken. CHD poses great socioeconomic burden upon every community in industrialized societies because of the ever younger age at onset. Actions should be taken to improve awareness of the CHD risks and morbidity in the population at large, stimulating favorable lifestyle and dietary modifications, and one's own health awareness, in order to upgrade the control of risk factors for and morbidity of cardiovascular disease

Quality of the Blood Sampled From Surgical Drainage after Total Hip Arthroplasty

Several methods have been found to be successful in reducing the need for allogeneic transfusion among the patients undergoing total hip replacement. The purpose of this prospective study was to analyse the quality and evaluate the effect of postoperative autotransfusion on the need for allogeneic transfusion following total hip replacement. The prospective study was performed in two groups of patients undergoing total hip replacement. Before the operative procedure all patients in both groups predonated two doses of autologous blood. In GROUP 1. the system for postoperative collection and transfusion of shed blood was used. In GROUP 2. the patients underwent total hip replacement without blood salvage system. Standard suction collection sets were used postoperatively. In this group shed blood was not transfused to the patients. The samples of preoperative donated autologus blood, allogeneic blood and postoperative collected autologous blood were analysed for number of red cells, hemoglobin, hematocrit, platelets, white blood cells, values of potassium, sodium, free hemoglobin and acid base status. The postoperatively blood salvage significantly reduced the use of allogeneic transfusion among patients managed with total hip replacement (allogeneic transfusion received 12 % patients in Group 1 and 80% patients in Group 2; p<0.001). The values of red blood cells are significantly lower in postoperative collected autotransfusion blood compared with preoperative collected autologous blood and allogeneic blood (p<0.001). The values of potassium and acid base status were in normal range in postoperatively collected autotransfusion blood. These values in preoperatively collected autologous blood and allogeneic blood were out of normal range; (p<0.001). In addition to reducing the risk of complications that are associated with allogeneic transfusion, postoperative blood salvage may offer benefits including reducing the need for allogeneic blood. Our study confirmed that postoperative collection and transfusion of drainaged blood is simple and safe method that significantly reduce the need for allogeneic transfusion in patients underwent total hip replacement. The blood collected and transfused postoperatively has lower values of red blood cells and normal values of potassium and acid base balance. The transfusion of this blood caused no complications in our patients

Review on Prostaglandin and Oxytocin Activity in Preterm Labor

The principal difference between term and preterm labor is how they are activated. It has been proposed that term labor results from physiological activation of the common terminal pathway, whereas preterm labor is a pathological condition caused by multiple etiologies that activate one or more of the components of this pathway. Increased uterine contractility at preterm labor results from activation and stimulation of the myometrium. Myometrium is stimulated by increased concentrations of prostaglandins and oxytocin. Increased production of stimulatory prostaglandins by intrauterine tissues is generally considered a central component of the cascade of events leading to preterm parturition. Prostaglandins act to mediate cervical ripening and to stimulate uterine contractions and indirectly to increase fundally dominant myometrial contractility by up regulation of gap junctions, oxytocin and arginine vasopressin receptors and synchronizations of contractions. The authors tried to explain the role and influence of oxytocin in human parturition, as well as the novel therapy in inhibiting the contractions in preterm labor. The selective oxytocin inhibitor was tested in vitro on human myometrium and decidua by the author of this article among the first in the world

Mechanical ventilation in chronic obstructive pulmonary disease patients, noninvasive vs. invasive method (randomized prospective study) [Usporedba neinvazivne i invazivne umjetne ventilacije kod bolesnika s kroničnom opstruktivnom plućnom bolesti: prospektivna randomizirana studija]

Acute respiratory failure due to chronic obstructive pulmonary disease (COPD) presents an increasing problem throughout the world. The aim of this study was to compare invasive and non-invasive mechanical ventilation (MV) for patients with COPD. A prospective, randomized trial was performed in a multidisciplinary intensive care unit for the period of 36 months and included 156 patients with COPD. MV procedure was performed using standard methods, and was applied as either invasive MV (IMV) or noninvasive MV (NIMV). Patients were randomized in two groups for application of MV using closed, nontransparent envelops. Comparison was made based on patient characteristics, objective parameters on admission and 1h, 4h, 24h, and 48h after admission and based on treatment outcome. We have confirmed that NIMV method is superior to IMV for patients with COPD. MV duration NIMV:IMV was 94:172 hours, p<0.001, time spent in Intensive Care Unit 120:223 hours, p<0.001. Ventilator associated pneumonia 5(6%):29(37%), p<0.001.The advantage of NIMV in COPD patients, especially in the early stages was confirmed

Examining Vibrations in Dental Procedures

Dugogodišnjim radom mogu se zbog djelovanja vibracija i u stomatologa i u zubnih tenhičara pojaviti određene zdravstvene poteškoće. Svrha rada bila je izmjeriti i usporediti neke parametare u vezi s vibracijama koje utječu na zdravlje stomatologa i zubnih tehničara i to vibracija koje proizvode tehnicki mikromotori sa svrdlima različitih oblika i materijala pri različitim brojevima okretaja. Vibracije su mjerene akcelerometrom postavljenim na tehničkom mikromotoru te na određenim dijelovima tijela ispitanika, uređajem koji se sastoji od piezosenzora, pojačala, filtara i prijenosnog uređaja za snimanje. Dobiveni signali analizirani su računalnim programom SpectraLAB i uspoređeni sa sadašnjim međunarodnim standardima. Statistička raščlamba podataka izvedena je s pomoću programskih paketa: STATISTICA for Windows, Release 5.5 H i SPSS for Windows. Temeljni čimbenik koji utječe na vibraciju jest broj okretaja kojim se služimo tijekom obradbe protetskoga rada. Dobiveni rezultati pokazuju da su vrijednosti ubrzanja vibracija unutar vrijedećih standarda, premda su vrijednosti vibracija radom na 40000 okretaja/min. vrlo blizu gornjoj granici tih standarda. Spektrografska raščlamba vibracija pokazala je da broj okretaja određuje na kojim će frekvencijama biti izražene vršne vrijednosti. Budući da postoje dokazane vibracijske bolesti stomatologa i zubnih tehničara preporučuje se upozoravati osobe koje rukuju takvim alatima na moguće posljedice, a dobiveni rezultati mogu biti korisni da bi se prevenirale takve bolesti i upotrebljavale brzine okretaja koje proizvode najmanje vibracija.Certain health problems may appear both in dentists and dental technicians due to long periods of exposure to vibrations. The aim of the study was to measure and compare some factors related to vibrations which affect the health of dentists and dental techicians, particularly those produced by mocromotors with drills of different shapes, made of different materials rotating at different speeds. Vibrations were measured by an accelerometre which was placed an the technical micromotor and on various body parts of subjects. The device consists of a piezosensor, an amplifier, a filter and mobile recording device. The obtained signals were analysed by the SpectraLAB computer programme and consequently compared with presently valid international standards. Statistical data analysis was carried out by PC software, STATISTICA for Windows, Release 5.5 H and SPSS for Windows, Release 7.5. The main factor that effects vibration is the rotation number used in the course of prosthetic replacement processing. The obtained results point to the fact that the vibration acceleration values are within accepted standards, although the vibration values at 40000 rotations per minute approach the maximum limit of these standards. The spactral analysis of vibration revealed that the rotation number determined the frequencies of the maximum values. Since there is strong evidence to support vibration related illnes in dentists and dental technicians, it is recommended that individuals who use such devices be warned about the possible harmful effects. The obtained results may be used in prevention of such illness. They are also recommended to use rotation speeds which produce the least vibrations

Measurement of the Electromagnetic Field in Dentistry

The aim of this study was to measure the magnetic field in dentistry together with simultaneous substraction of direct ground component of the magnetic field. The research instrument used to measure the power of the magnetic field was of our own design. It measures the magnetic field by the Hall sensor that is powered with 5 to 10 V and is integrated in one chip together with preamplifier. The sensor output is differential (Q1-Q2) and proportionate to measurement values of magnetic induction. As the values of alternate fields in a laboratory setting are small the differential output voltage should be increased by about 100 times. Our study samples consisted of instruments currently available in dentistry: halogen lamps, polymerizing lamps, amalgam mixers, micromotors and dental chairs. On the basis of our study results and statistical analysis the following conclusions are made magnetic field spreads through space in ISOTROPIC manner. The greatest frequency obtained at the smallest distance was 100 kHz. The sensitivity of the measurement instrument was 0.0001 μT and the majority of instruments produce magnetic radiation higher than 4o G. The power of the magnetic field decreases with increasing distance from the source. The investigated instruments produce a relatively mild magnetic field. The instruments with stronger magnetic fields are located far enough from the persons on whom they act. The newly produced instrument acts on their environment by smaller magnetic fields

Institutional Development of Croatian Vocational Education Policy

Zbog nepostojanja odgovarajuće teorijsko-konceptualne podloge relevantna analiza institucionalnih odrednica hrvatske politike strukovnog obrazovanja zahtijeva razvoj zasebnog, prilagođenog eksplanatornog modela. Stoga autor, uz odgovarajuće modifikacije, koristi široko prihvaćen okvir političke ekonomije razvoja vještina za stvaranje kodne liste koju primjenjuje na sve normativne i strateško-programske dokumente koji su uređivali hrvatski sustav strukovnog obrazovanja od neovisnosti do danas. Rezultati kvalitativne analize ukazuju kako je postojeći sustav hrvatskog strukovnog obrazovanja moguće opisati kao „državni s elementima krnje kolektivnosti u području obrazovanja za obrte“; dok je ključni mehanizam njegova stvaranja i održavanja prikladno nazvati „slojevanjem bez promjene institucionalne jezgre”. Empirijsko testiranje ovog mehanizma može bitno produbiti razumijevanje hrvatske politike strukovnog obrazovanja, ali i predstavljati osnovu ambicioznijeg komparativnog istraživanja politike strukovnog obrazovanja u postkomunističkim društvima.The absence of an adequate theoretical and conceptual framework dictates that any relevant institutional analysis of Croatian vocational education policy requires a separate, tailor-made explanatory model. Consequently, elements of the political economy of skill formation, a broadly acclaimed conceptual framework, were modified for coding all policy documents governing Croatian vocational education system since the country’s independence. Results of such qualitative analysis indicate that the existing vocational education system is best described as “statism with elements of partial collectivism in training for crafts”; while the dominant mechanism behind it as “layering without affecting the institutional core”. Testing this mechanism could pave the way to a deeper understanding of Croatian vocational education policy; but also, more ambitious comparative research within the context of post-communist societies