4 research outputs found
Effects of anesthetics on liver function in children
Jetra je najveÄi neparni parenhimni organ i najveÄa žlijezda u tijelu koja prosjeÄno Äini oko 5% tjelesne mase u novoroÄenÄeta. Razvija se iz primitivnog crijeva, a njezina se osnova pojavljuje sredinom 3. tjedna kao izboÄenje endodermalnog epitela na distalnom kraju prednjeg crijeva. RijeÄ je o organu koji obavlja brojne funkcije u organizmu, koje meÄutim nisu u potpunosti razvijene u novoroÄenaÄkoj i djeÄjoj dobi. Jedna od njih je i metabolizam lijekova koji se poglavito odvija preko dviju vrsta biokemijskih reakcija (reakcije faze I. i II.). Naime, djeca razliÄite dobi razliÄito metaboliziraju lijekove. Lijekovi koji se primjenjuju u djece za postizanje anestezije istovrsni su onima u odraslih. Razvitkom farmakoloÅ”ke industrije anestezioloÅ”ki lijekovi s veÄim brojem neželjenih nuspojava nadomjeÅ”taju se novim, sigurnijim sredstvima za bolesnika. Npr. prijaÅ”nji najÄeÅ”Äe koriÅ”teni inhalacijski anestetik halotan, zbog svog hepatotoksiÄnog uÄinka, danas je potisnut primjenom sevoflurana, koji se smatra najboljim inhalacijskim anestetikom za primjenu u djece. Ipak, ni jedan anestetik nije u potpunosti siguran, pa tako ni sevofluran, Å”to potvrÄuju i brojna istraživanja u kojima je dokazan Å”tetan uÄinak navedenog lijeka na jetru, uglavnom u obliku blagog porasta aminotrasferaza. TakoÄer su zabilježeni i sluÄajevi u kojima je sevofluran doveo do izraženije jetrene disfunkcije, ali i fulminantnog hepatitisa te jetrene nekroze. U danaÅ”nje vrijeme cilj je anestezirati malog bolesnika tehnikom i lijekovima u potrebnom i zadanom vremenskom trajanju sa Å”to manje neželjenih uÄinaka.The liver is the largest odd parenchymal organ and the largest gland in the body, which on average accounts for about 5% of body weight in the newborn. It develops from the primitive gut, and her foundation appears mid third week as the projection of the endodermal epithelium at the distal end of the anterior intestine. It is the organ that performs many functions in the body, which, however, are not fully developed in the neonatal and childhood. One of them is the metabolism of drugs that are mainly carried out through two kinds of biochemical reactions (reaction phase I and II.). Specifically, children of different ages metabolize drugs differently. Drugs used in children to achieve anesthesia are the same as those that apply to adults. With development of pharmacological industry, anesthetic drugs with a number of unwanted side effects are replaced by new, more secure means for patients. For example, previously the most commonly used inhaled anesthetics halothane, because of its hepatotoxic effect, today is suppressed by using sevoflurane, which is considered the best inhaled anesthetics for use in children. However, there is no completely safe anesthetic. Even sevoflurane has been confirmed by numerous studies as a drug with detrimental effect to the liver, mainly in the form of a slight increase of aminotransferases. As well, there have been cases in which sevoflurane led to pronounced liver dysfunction and fulminant hepatic necrosis and hepatitis. At the present time, the target is to anesthetize small patient with technique and drugs that in the necessary and given time duration have less side effects
Effects of anesthetics on liver function in children
Jetra je najveÄi neparni parenhimni organ i najveÄa žlijezda u tijelu koja prosjeÄno Äini oko 5% tjelesne mase u novoroÄenÄeta. Razvija se iz primitivnog crijeva, a njezina se osnova pojavljuje sredinom 3. tjedna kao izboÄenje endodermalnog epitela na distalnom kraju prednjeg crijeva. RijeÄ je o organu koji obavlja brojne funkcije u organizmu, koje meÄutim nisu u potpunosti razvijene u novoroÄenaÄkoj i djeÄjoj dobi. Jedna od njih je i metabolizam lijekova koji se poglavito odvija preko dviju vrsta biokemijskih reakcija (reakcije faze I. i II.). Naime, djeca razliÄite dobi razliÄito metaboliziraju lijekove. Lijekovi koji se primjenjuju u djece za postizanje anestezije istovrsni su onima u odraslih. Razvitkom farmakoloÅ”ke industrije anestezioloÅ”ki lijekovi s veÄim brojem neželjenih nuspojava nadomjeÅ”taju se novim, sigurnijim sredstvima za bolesnika. Npr. prijaÅ”nji najÄeÅ”Äe koriÅ”teni inhalacijski anestetik halotan, zbog svog hepatotoksiÄnog uÄinka, danas je potisnut primjenom sevoflurana, koji se smatra najboljim inhalacijskim anestetikom za primjenu u djece. Ipak, ni jedan anestetik nije u potpunosti siguran, pa tako ni sevofluran, Å”to potvrÄuju i brojna istraživanja u kojima je dokazan Å”tetan uÄinak navedenog lijeka na jetru, uglavnom u obliku blagog porasta aminotrasferaza. TakoÄer su zabilježeni i sluÄajevi u kojima je sevofluran doveo do izraženije jetrene disfunkcije, ali i fulminantnog hepatitisa te jetrene nekroze. U danaÅ”nje vrijeme cilj je anestezirati malog bolesnika tehnikom i lijekovima u potrebnom i zadanom vremenskom trajanju sa Å”to manje neželjenih uÄinaka.The liver is the largest odd parenchymal organ and the largest gland in the body, which on average accounts for about 5% of body weight in the newborn. It develops from the primitive gut, and her foundation appears mid third week as the projection of the endodermal epithelium at the distal end of the anterior intestine. It is the organ that performs many functions in the body, which, however, are not fully developed in the neonatal and childhood. One of them is the metabolism of drugs that are mainly carried out through two kinds of biochemical reactions (reaction phase I and II.). Specifically, children of different ages metabolize drugs differently. Drugs used in children to achieve anesthesia are the same as those that apply to adults. With development of pharmacological industry, anesthetic drugs with a number of unwanted side effects are replaced by new, more secure means for patients. For example, previously the most commonly used inhaled anesthetics halothane, because of its hepatotoxic effect, today is suppressed by using sevoflurane, which is considered the best inhaled anesthetics for use in children. However, there is no completely safe anesthetic. Even sevoflurane has been confirmed by numerous studies as a drug with detrimental effect to the liver, mainly in the form of a slight increase of aminotransferases. As well, there have been cases in which sevoflurane led to pronounced liver dysfunction and fulminant hepatic necrosis and hepatitis. At the present time, the target is to anesthetize small patient with technique and drugs that in the necessary and given time duration have less side effects
Point prevalence of significant nutritional risk among cancer patients in Croatia ā research study of the Section of young oncologists, Croatian society for medical oncology of Croatian medical association
Cilj istraživanja: Utvrditi trenutaÄnu prevalenciju znatnoga nutritivnog rizika meÄu onkoloÅ”kim bolesnicima u Republici Hrvatskoj. Ispitanici i metode: Ova presjeÄna studija ugniježÄena je u prospektivnu kohortnu studiju Sekcije mladih onkologa HDIO-a HLZ-a, koja je provedena u Hrvatskoj tijekom 2017. godine na susljednom uzorku onkoloÅ”kih bolesnika biranome prema redoslijedu dolaska na lijeÄenje. Nutritivni probir proveli smo uporabom upitnika za procjenu nutritivnog rizika NRS-2002. Prema njemu, bolesnik se smatra nutritivno ugroženim ako je rezultat ā„ 3. Rezultati: U istraživanje je ukljuÄeno 275 bolesnika, medijana (interkvartilnog raspona) dobi od 61 godine (51 ā 68), meÄu kojima je bila 161 žena (58,5%). Bolesnici su lijeÄeni u jedanaest onkoloÅ”kih centara u Hrvatskoj. U 60 bolesnika (21,8%; 95%-tni CI 17,1 ā 27,2%) utvrÄen je znatan nutritivni rizik (NRS-2002 ā„ 3) koji indicira potrebu za nutritivnom intervencijom. Bilo kakvu nepovoljnu promjenu tijekom 30 dana prije ukljuÄivanja, dakle, gubitak tjelesne mase ili smanjen unos hrane, primijetilo je 127 (46,2%) sudionika. ZakljuÄak: NaÅ”e istraživanje potvrdilo je da znatan broj onkoloÅ”kih bolesnika u Hrvatskoj ima neki stupanj nutritivnog rizika te da je u viÅ”e od Äetvrtine potrebna nutritivna intervencija. Nutritivni probir prvi je korak u dugoroÄnoj kontroli komplikacija vezanih uz promijenjen
unos hrane i nutritivni rizik, kao i pri poboljŔanju kvalitete života onkoloŔkih bolesnika te prognoze ishoda bolesti pa bi ga, s obzirom na prikazane rezultate, trebalo rutinski provoditi.Objective of the Study: To determine the point prevalence of significant nutritional risk among cancer patients in Croatia. Subjects and Methods: This cross-sectional study was nested in the prospective cohort study of
the Section of Young Oncologists of the Croatian Society for Medical Oncology, Croatian Medical Association, conducted in Croatia during 2017 on the consecutive sample of cancer patients selected by the order of their arrival to the exam.Nutritional screening was performed using the NRS-2002, According to NRS-2002, the patient is considered to be at significant nutritional risk if the result is ā„3. Results: We included 275 patients treated at eleven cancer centers in Croatia. In 60 patients (21.8%, 95% CI 17.1% -27.2%) we identified the significant
nutritional risk (NRS-2002 ā„3) what indicates the need for the nutritional intervention. Any change during 30 days prior to screening, such as loss of body weight or reduced intake of food, was expressed by 127 (46.2%) participants. Conclusion: Our study has confirmed that a significant number of cancer patients in Croatia are in some degree at nutritional risk, and that more than one quarter need nutritional intervention. Nutritional screen poing is the first step in the long-term control of complications associated with altered food intake and nutritional risk, as well as in improving the overall quality of life of cancer patients and the prognosis of disease outcomes, so
regarding the presented results, it should be routinely implemented
Effects of anesthetics on liver function in children
Jetra je najveÄi neparni parenhimni organ i najveÄa žlijezda u tijelu koja prosjeÄno Äini oko 5% tjelesne mase u novoroÄenÄeta. Razvija se iz primitivnog crijeva, a njezina se osnova pojavljuje sredinom 3. tjedna kao izboÄenje endodermalnog epitela na distalnom kraju prednjeg crijeva. RijeÄ je o organu koji obavlja brojne funkcije u organizmu, koje meÄutim nisu u potpunosti razvijene u novoroÄenaÄkoj i djeÄjoj dobi. Jedna od njih je i metabolizam lijekova koji se poglavito odvija preko dviju vrsta biokemijskih reakcija (reakcije faze I. i II.). Naime, djeca razliÄite dobi razliÄito metaboliziraju lijekove. Lijekovi koji se primjenjuju u djece za postizanje anestezije istovrsni su onima u odraslih. Razvitkom farmakoloÅ”ke industrije anestezioloÅ”ki lijekovi s veÄim brojem neželjenih nuspojava nadomjeÅ”taju se novim, sigurnijim sredstvima za bolesnika. Npr. prijaÅ”nji najÄeÅ”Äe koriÅ”teni inhalacijski anestetik halotan, zbog svog hepatotoksiÄnog uÄinka, danas je potisnut primjenom sevoflurana, koji se smatra najboljim inhalacijskim anestetikom za primjenu u djece. Ipak, ni jedan anestetik nije u potpunosti siguran, pa tako ni sevofluran, Å”to potvrÄuju i brojna istraživanja u kojima je dokazan Å”tetan uÄinak navedenog lijeka na jetru, uglavnom u obliku blagog porasta aminotrasferaza. TakoÄer su zabilježeni i sluÄajevi u kojima je sevofluran doveo do izraženije jetrene disfunkcije, ali i fulminantnog hepatitisa te jetrene nekroze. U danaÅ”nje vrijeme cilj je anestezirati malog bolesnika tehnikom i lijekovima u potrebnom i zadanom vremenskom trajanju sa Å”to manje neželjenih uÄinaka.The liver is the largest odd parenchymal organ and the largest gland in the body, which on average accounts for about 5% of body weight in the newborn. It develops from the primitive gut, and her foundation appears mid third week as the projection of the endodermal epithelium at the distal end of the anterior intestine. It is the organ that performs many functions in the body, which, however, are not fully developed in the neonatal and childhood. One of them is the metabolism of drugs that are mainly carried out through two kinds of biochemical reactions (reaction phase I and II.). Specifically, children of different ages metabolize drugs differently. Drugs used in children to achieve anesthesia are the same as those that apply to adults. With development of pharmacological industry, anesthetic drugs with a number of unwanted side effects are replaced by new, more secure means for patients. For example, previously the most commonly used inhaled anesthetics halothane, because of its hepatotoxic effect, today is suppressed by using sevoflurane, which is considered the best inhaled anesthetics for use in children. However, there is no completely safe anesthetic. Even sevoflurane has been confirmed by numerous studies as a drug with detrimental effect to the liver, mainly in the form of a slight increase of aminotransferases. As well, there have been cases in which sevoflurane led to pronounced liver dysfunction and fulminant hepatic necrosis and hepatitis. At the present time, the target is to anesthetize small patient with technique and drugs that in the necessary and given time duration have less side effects