Topics on Crises in Electronic Media in Croatia

One of the most important elements in emergency situations and catastrophes is information. It often stands in a very small number, particularly when there is the highest need for it. Mass media is the main link of services responding to emergency situations and disasters to general public. To survivors, to public and even to those enabling help, television, radio and newspapers are most often very crucial sources of information about areas hit by disasters. The interest of media, or their lack of interest, in emergency situations and disasters, can affect on the help arriving. The news is creating a »referential frame« which turns events into phenomenon discussed by the public and that way it is, at the same time, the recorder and the product of social realities. Whether the news will be published or not depends on criteria of efficiency, social context, human, political or social interests, news and regularities, all of these things determine the importance of the story or some of its parts to a particular media, and also determine the way in which it will be processed and context in which it will be aired in public

Uloga omjera E2/P u etiologiji fibrocistične bolesti dojke, mastalgije i mastodinije

The aim of the study was to assess the role of the estradiol and progesterone relationship during the late luteal phase and the occurrence of fibrocystic breast disease (FBD). The concentration of estradiol/progesterone was measured in the group of women with FBD as study group (n=50) and control group of women without FBD (n=40). All women had regular ovulation cycles. Blood samples for estradiol (E2), progesterone (P) and prolactin determination were obtained in the morning at 8 am on days 21 and 24 of menstrual cycle. Significant mastalgia and mastodynia history in women with FBD was obtained with yes or no questionnaire. FBD diagnosis was confirmed with ultrasound (size and number of simple cysts). In the control group, a reduced E2/P ratio was noticed from day 21 to day 24 of the cycle (from 14.8±11.5 pg/mL to 9.1±6.1 pg/mL; p<0.05), which was not recorded in the group of women with FBD (study group). Even the slightest disturbance of the E2/P ratio may contribute to the occurrence of FBD with clinical manifestations of mastalgia and mastodynia.Namjera rada je bila ispitati ulogu odnosa estradiola i progesterona za vrijeme lutealne faze ciklusa u pojavljivanju fibrocistične bolesti dojke (FBD). Koncentracija odnosa estradiol/progesteron je bila mjerena u skupini žena s FBD (n=50) (studijska skupina) i u kontrolnoj skupini žena bez FBD (n=40) (kontrolna skupina). Sve su žene imale redovite ovulacijske cikluse. Krvni uzorci estradiola (E2), progesterona (P) i prolaktina određivali su se u 8 h ujutro 21. i 24. dana menstruacijskog cikusa. Određivanje značajnosti mastalgije i mastodinije bila je ispitana upitnikom da/ne. Dijagnoza FBD je bila potvrđena ultrazvukom dojke (veličina i broj jednostavnih cista). U kontrolnoj skupini smanjen odnos E2/P zabilježen je od 21. do 24. dana ciklusa (od 14,8±11,5 pg/mL do 9,1±6,1 pg/mL; p<0,05), za razliku od žena studijske skupine gdje ta promjena nije bila zapažena. Čak i mala promjena odnosa E2/P može doprinijeti nastanku FBD s kliničkim manifestacijama mastalgije i mastodinije

Individualizacija magistralnog hormonskog liječenja kod bolesnice s kemoterapijom induciranom prijevremenom insuficijencijom jajnika i smanjenom jetrenom funkcijom: prikaz slučaja

Although the use of commercially manufactured hormone therapy (HT) to treat menopausal symptoms has declined during the past 12 years, the use of custom compounded HT seems to have increased. A 39-year-old woman with refractory anemia sustained premature ovarian insufficiency following allogeneic stem cell transplantation. After systemic biologic treatment (azacitidine) and corticosteroid therapy, besides extreme climacteric symptoms (Green Climacteric Scale, 59) and impaired quality of life, she also had elevated liver enzymes. Therefore, she was not a candidate for oral HT. Treatment was started with 17-beta estradiol patch 0.5 mg (Climara) together with micronized progesterone intravaginally, 2x100 mg (Utrogestan) for 3 months. She was not satisfied, so the custom compound HT started with 17-beta estradiol 0.5 mg gel 2x/day and micronized progesterone in liposomal gel 100 mg/daily. She was much better but she complained of low libido, decreased sex drive and emotional instability, so 1% testosterone gel was added. Now she was completely satisfied, Green Climacteric Scale was 8 and liver enzymes were normal. In conclusion, custom compound HT has the possibility of tailoring and adjusting therapy to the individual need, which has been the everlasting goal in menopause medicine and should be a good option for special clinical cases.Premda je upotreba komercijalno pripravljene hormonske terapije u liječenju klimakteričnih simptoma u posljednjih 12 godina u padu, čini se da je upotreba magistralnih hormonskih pripravaka u porastu. Žena u dobi od 39 godina s refraktornom anemijom doživjela je prijevremenu insuficijenciju jajnika nakon transplantacije matičnih stanica. Nakon sistemskog biološkog liječenja azacitidinom i kortikosteroidima, uz izrazite klimakterične tegobe (Greenov indeks 59) i smanjenu kvalitetu života imala je povišene jetrene enzime. Zbog toga nije bila kandidat za oralnu hormonsku terapiju. Započeto je liječenje 17-beta estradiolom u obliku naljepka od 0,5 mg (Climara) zajedno s mikroniziranim progesteronom intravaginalno 2x100 mg (Utrogestan) kroz 3 mjeseca. Nije bila zadovoljna terapijom pa su joj propisani magistralno pripravljeni hormoni. Započelo se s primjenom 17-beta estradiola u obliku 0,5 mg gela 2x/dan i mikroniziranog progesterona u liposomalnom gelu 100 mg/dnevno. Bolje se je osjećala, ali još uvijek se žalila na smanjeni libido i emocionalnu nestabilnost pa je dodan 1% testosteron. Sad je bila potpuno zadovoljna terapijom, Greenova klimakterijska ljestvica bila je 8, a jetreni enzimi su se normalizirali. U zaključku, magistralni hormonski pripravci pružaju mogućnost titracije i prilagođavanja terapije individualnim potrebama, što je stalni cilj u menopauzalnoj medicini i mogao bi biti dobra mogućnost za posebne slučajeve

Croatian Cartographic Data Model, Creation and Implementation

Hrvatski projekt “Izradba kartografskog modela podataka” (KMP) izrađen je u okviru izradbe projekta STOKIS (DGU, 1995, Službeni topografski i kartografski informacijski sustav). Kartografski model podataka izrađen je potpuno konformno s CROTIS-om (Hrvatski Topografski Informacijski Sustav). Omogućeno je generiranje kartografskih podataka iz topografskih podataka. Klasifikacija podatka je uslijedila iz logičkog grupiranja objekata sadržanih u kartografiji ovisno o geometriji, kategoriji, tipu i svojstvu svakog objekta. Kartografski model podataka opisuje strukturu kartografske baze podataka i sve atribue, kategorije, tipove i polja. Opis geometrije i prijenos podataka napravljen je u skladu s ISO-normama, preporučenih od strane tehničkog odbora ISO/TC211, zaduženog za geografske informacije i geomatiku te OpenGIS konzorcija. Sljedeći korak je direktna implementacija vektorskog modela koji sadrži grafičke i alfanumeričke elemente. Kartografski ključ ostao je identičan TK25 i kartama ostalih mjerila.Croatian project Cartographic Data Model (KMP) has been started as a component of the STOKIS (SGA, 1995, Official Topographic and Cartographic Information System) project. The cartographic data model conforms to CROTIS (Topographic Information System of the Republic of Croatia). It enables the generation of the cartographic database from topographic one. Classification of data is performed by logical grouping of objects and depends on geometry, type and properties of features. The cartographic data model describes structure of cartographic database and all attributes, categories, types and fields. Description of geometry and exchange of data is performed according to the specification of ISO Standards, adapted by Technical Committee ISO/TC 211, Geographic information/Geomatics and OpenGIS Consortium. Creation of the cartographic data model is the basis for the creation of cartographic database. The next step is direct implementation of vector model that contains graphic and alphanumeric elements. The cartographic key must stay identical to TK25 and maps of other scales

NEW ASPECTS IN DIAGNOSIS AND TREATMENT OF OSTEOPOROSIS

Background. Osteoporosis is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. In prevention and treatment of osteoporosis, the issue of main interest is prevention of fractures, especially prevention of the first fracture. In recent years, especially after the result of the randomised control trial of Women’s Health Initiative (WHI) was published in the literature, attitudes toward prevention and treatment of osteoporosis have been changed. Hormonal replacement therapy (HRT) use is no longer recommended as a first line treatment, but only a possibility for treatment perimenopausal and early-postmenopausal women with climacteric symptoms and increased risk for fracture, only when therapy benefits outweigh the risks. Today, independent risk factors are taken into account in treatment of osteoporosis, with or without BMD measurement, but including the 10-years risk probability (FRAX – fracture risk assessment tool). There are new possibilites for treatment including a Osteoprotegerin (OPG)/ Receptor Activator of Nuclear factor kappa B (RANK) / Receptor Activator of Nuclear factor kappa B ligand (RANKL) remodelation bone model. Conclusions. Treatment of osteoporosis is going to be a complex task including all fracture risk factors, polypragmazia which is very common in elderly patents, adherence problems, and last but not least, the economic aspects

Radiofrequency as the New Opportunity in Treating Overactive Bladder and Urge Urinary Incontinence—A Single-Arm Pilot Study

Background and Objectives: Until now, overactive bladder (OAB) with or without urge urinary incontinence (UUI) has been treated mainly in two ways: with behavioral methods and patient education, or using antimuscarinic drugs and/or beta-3 adrenergic receptor agonists. Unfortunately, these drugs may cause side effects in some women or are insufficiently effective, so patients abandon them. Therefore, in this pilot study, radiofrequency was evaluated as a new option in the treatment of OAB and UUI. Materials and Methods: Nineteen patients were enrolled in this pilot study using radiofrequency (RF), where the level of OAB and UUI was assessed using the validated ICIQ-OAB questionnaire. RF was applied four times for 20 min, once a week. Two weeks after treatment, the level of OAB and UUI was reassessed and processed statistically and the treatment effect evaluated. Results: Using the ICIQ-OAB, the severity of OAB and UUI was assessed: 0–3 mild symptoms; 4–7 moderate symptoms; 8–11 severe symptoms; 12–16 very severe symptoms. Before treatment, 10.5% of patients had mild symptoms, 21.1% moderate symptoms, 63.2% severe symptoms and 5.3% very severe symptoms. After treatment, 42.9% had mild symptoms, 50% moderate symptoms and 7% severe OAB and UUI symptoms. All four main symptoms—frequency, nocturia, urgency and incontinence—decreased statistically significantly, with the best results being found in urgency (p = 0.002). Conclusions: Based on this pilot study, RF seems a very promising method in the treatment of OAB and UUI. To extend our initial findings, it is necessary to perform a prospective, randomized and placebo-controlled study in order to obtain reliable results and to determine for how long one set of treatment maintains the results obtained immediately after the end of that treatment. In this way, we may determine how often the treatment needs to be repeated, if necessary, and when

Laser Therapy in the Treatment of Female Urinary Incontinence and Genitourinary Syndrome of Menopause: An Update

Vaginal birth trauma is the leading cause of stress urinary incontinence (SUI) in women. Also, the process of ageing and hormonal deprivation in postmenopause alters the metabolism of connective tissues and decreases collagen production leading to pelvic floor dysfunction. Noninvasive treatment is recommended as first-line management of urinary incontinence (UI) in women. Surgical procedures are more likely to be implemented to cure UI but are associated with more adverse events. Sex hormone deficiency affects changes also in the lower urinary tract where estrogens are the main regulators of physiological functions of the vagina. In the last decade, laser treatment of SUI and of the genitourinary syndrome of menopause (GSM) has been shown a promising treatment method in peer-reviewed literature. This review’s aim is to present the evidence-based medical data and laser treatment of SUI and GSM in an outpatient setting to be a good treatment option, regarding short-term as well as long-term follow-ups. Long-term follow-up studies are needed to confirm that laser treatment is a good, painless outpatient procedure with no side effects in postmenopausal women

Genetska etiologija prijevremene insuficijencije jajnika

Primary premature ovarian insufficiency (PPOI) is characterized by hypergonadotropic amenorrhea and hypoestrogenism in women under 40 years of age. PPOI incidence is 1:10,000 in women aged 18-25, 1:1000 in women aged 25-30 and 1:100 in women aged 35-40. In 10%-28% of cases, PPOI causes primary and in 4%-18% secondary amenorrhea. The process is a consequence of accelerated oocyte atresia, diminished number of germinated cells, and central nervous system aging. Specific genes are responsible for the control of oocyte number undergoing the ovulation process and the time to cessation of the reproductive function. A positive family history of PPOI is found in 15% of women with PPOI, indicating the existing genetic etiology. Primary POI comprises genetic aberrations linked to chromosome X (monosomy, trisomy, translocation, deletion) or to autosomal chromosome. Secondary POI implies surgical removal of ovaries, chemotherapy and radiotherapy, and infections. Diagnostic criteria include follicle stimulating hormone level >40 IU/L and estradiol level <50 pmol/L.Primarna prijevremena insuficijencija jajnika (PPIJ) je sindrom koji je obilježen hipergonadotropnom amenorejom i hipoestrogenizmom. Incidencija PPIJ je 1:10.000 kod žena starosti 18-25 godina, 1:1000 kod žena starosti 25-30 godina i 1:100 kod žena starosti 35-40 godina. U 10%-28% slučajeva PPIJ je uzrok primarnih, a u 4%-18% sekundarnih amenoreja. Bolest nastaje kao posljedica ubrzanog procesa atrezije oocita, smanjenja broja germinativnih stanica i starenja središnjeg živčanog sustava. Specifični geni su odgovorni za kontrolu broja oocita koji prolaze proces ovulacije i vrijeme prekida reproduktivne funkcije. Pozitivna obiteljska anamneza PPIJ nađena je u oko 15% žena s PPIJ, što ukazuje na postojanje određene genetske etiologije. Primarna insufi cijencija jajnika (PIJ) dijeli se na primarnu i sekundarnu. U primarnu PIJ spadaju genetske aberacije vezane za kromosom X (monosomije, trisomije, translokacije, delecije) ili one vezane za autosomne kromosome. U sekundarnu PIJ spadaju kirurško odstranjenje jajnika, liječenje kemoterapijom i radioterapijom te infekcije. Simptomi su razdražljivost, nemir, gubitak libida, depresija, nesanica, dekoncentracija, napadaji vrućine, povišenje tjelesne težine, suhoća vagine i drugih sluznica. Kriteriji za dijagnozu su folikulostimulirajući hormon viši od 40 IJ/L i estradiol (E2) niži od 50 pmol/L kod žena mlađih od 40 godina

Inkontinencija mokraće - od djetinjstva do starosti

Urinary incontinence (UI) is a condition that affects patients of all ages, starting with childhood. There are two peaks in its incidence, i.e., in childhood and another one in patients over 40 years of age, which increases continuously with patient age. It is a condition recognized by the World Health Organization as a set of diseases (International Classification of Diseases, ICD-10), and the International Classification of Functionality recognizes the associated extreme disablement. UI is a major health problem affecting the lives of an estimated 400 million persons worldwide. The global aging of the population will cause rise in the incidence of UI in the future. It is expected that UI itself will become a serious health and social burden for both patients and health service providers. UI can be an isolated problem, or it can be associated and/or aggravated by any associated disorder affecting the nervous system such as myelomeningoceles, Parkinson’s disease or stroke. UI often affects the patient daily life, and it can have repercussions on their physical, financial, social, and emotional well-being. At last, it has a negative influence on their sexual health.Inkontinencija mokraće (IM) je stanje koje pogađa osobe svih dobnih skupina počevši od djetinjstva. Postoje dva vrhunca incidencije i to u djetinjstvu, a drugi u bolesnika starijih od 40 godina, koji se stalno povećava s dobi bolesnika. To je stanje koje Svjetska zdravstvena organizacija prepoznaje kao skup bolesti (Međunarodna klasifikacija bolesti, MKB-10), a Međunarodna klasifikacija funkcionalnosti prepoznaje pridruženu ekstremnu onesposobljenost. IM glavni je zdravstveni problem koji utječe na živote oko 400 milijuna ljudi širom svijeta. Globalno starenje stanovništva uzrokovat će porast učestalosti IM u budućnosti. Očekuje se da će i sama IM postati ozbiljno zdravstveno i socijalno opterećenje za bolesnike i pružatelje zdravstvenih usluga. IM može biti izolirani problem ili može biti povezana s i/ili pogoršana bilo kojim povezanim poremećajem koji pogađa živčani sustav, kao što su mijelomeningocele, Parkinsonova bolest, moždani udar itd. IM često utječe na svakodnevni život bolesnika i može imati posljedice na njihovo fizičko, financijsko, socijalno i emocionalno stanje. Napokon ima negativan utjecaj na njihovo seksualno zdravlje

The Role of E2/P Ratio in the Etiology of Fibrocystic Breast Disease, Mastalgia and Mastodynia

The aim of the study was to assess the role of the estradiol and progesterone relationship during the late luteal phase and the occurrence of fibrocystic breast disease (FBD). The concentration of estradiol/progesterone was measured in the group of women with FBD as study group (n=50) and control group of women without FBD (n=40). All women had regular ovulation cycles. Blood samples for estradiol (E2), progesterone (P) and prolactin determination were obtained in the morning at 8 am on days 21 and 24 of menstrual cycle. Significant mastalgia and mastodynia history in women with FBD was obtained with yes or no questionnaire. FBD diagnosis was confirmed with ultrasound (size and number of simple cysts). In the control group, a reduced E2/P ratio was noticed from day 21 to day 24 of the cycle (from 14.8±11.5 pg/mL to 9.1±6.1 pg/mL; p<0.05), which was not recorded in the group of women with FBD (study group). Even the slightest disturbance of the E2/P ratio may contribute to the occurrence of FBD with clinical manifestations of mastalgia and mastodynia