Molecular phylogenetics of spiders from the genus Nesticus (Arachnida, Araneae, Nesticidae)

Molekularna filogenetika je grana filogenije koja analizira srodstvene razlike na molekularnoj razini, uglavnom se obazirući na DNA i RNA sekvence, kako bi dobila informacije o evolucijskom odnosu organizama i njihovoj evolucijskoj povijesti. Svrha molekularne filogenije je izraditi filogenetičko stablo od prikupljenog skupa podataka preko sekvenci gena poznatih kao molekularnih biljega. Cilj ovog rada je opisati primjerom kako teče proces molekularno filogenetskog istraživanja. U ovom radu je proces opisan primjerom dokazivanja nove vrste špiljskog pauka Nesticus baeticus López-Pancorbo & Ribera, 2011 i njegovog uspoređivanja po filogeniji sa ostalim vrstama roda Nesticus koje su endemične za prostor Pirinejskog poluotoka kako bi ustvrdili njihovu srodnost. Za izradu stabla korištena je metoda najveće štedljivosti (Maximum parsimony) gdje su koristili vrstu iz roda Nesticus Thorell, 1869 sa područja Kine kao vanjsku grupu te je bootstrap-testom provjerena pouzdanost svakog čvora. Kod analize gotovog stabla došlo se do zaključka da vrste roda Nesticus sa Pirinejskog poluotoka nisu unutar jedne monofiletičke grupe te se pretpostavlja da su nezavisno tri puta kolonizirali Pirinejski poluotok. Kako bi se pretpostavka potvrdila ili odbacila, treba se napraviti molekularno filogenetska analiza svih mediteranskih pauka iz porodice Nesticidae za bolji prikaz evolucijskih događaja i kako bi se testirao molofiletički status trenutnog roda.Molecular phylogenetics is a branch of phylogenetic analyzes of kinship differences at the molecular level, largely considering the DNA and RNA sequences, in order to obtain information about the evolutionary relationship of organisms and their evolutionary history. The purpose of the molecular phylogeny is to draw design a phylogenetic tree of the collected data set of sequences of genes known as molecular markers. The objective of this paper is to describe an example of the procedure of a study in molecular phylogenetics. In this paper, the procedure is described by how to prove a new species of cave spiders - Nesticus baeticus López-Pancorbo & Ribera, 2011 and its comparison in phylogeny with the other species of the genus Nesticus that are endemic to the area of the Iberian Peninsula. To create a tree they used the method of Maximum parsimony where they used a species form the genus Nesticus which is located in China as an outgroup and with the bootstrap test they checked the reliability of each node. In the final analysis of the tree, they came to the conclusion that all the species from genus Nesticus located on the Iberian Peninsula are not within the same monophyletic group and it is assumed that they colonized the Iberian Peninsula independently three times. To confirm or reject the hypothesis, the future research should be focused on resolving the philogeny of the Mediterranean Nesticidae and will include most of the Mediterranean species to test the molophyletic status of current genera

Surgical anatomy of microsurgical 3-level anterior cervical discectomy and fusion C4–C7

Anterior cervical discectomy and fusion (ACDF) is one of the most common spinal procedures, frequently used for the treatment of cervical spine degenerative diseases. It was first described in 1958. Interestingly, to our knowledge, 3-level ACDF has not been previously published as a peer-reviewed video case with a detailed description of intraoperative microsurgical anatomy. In this video, we present the case of a 33-year-old male who presented with a combination of myelopathy (hyperreflexia and long tract signs in the upper and lower extremities) and bilateral radiculopathy of the upper extremities. He had been previously treated conservatively with physical therapy and pain management for 6 months without success. We performed 3-level microsurgical ACDF from C4 to C7. All 3 levels were decompressed, and bone allografts were placed to achieve intervertebral body fusion. A titanium plate was utilized from C4 to C7 for internal fixation. The patient was discharged home on the first postoperative day. His pain, numbness and tingling resolved, as well as his myelopathy. No perioperative complications were encountered. Herein we present the surgical anatomy of our operative technique including ertain technical tips. Written consent was obtained directly from the patient. VIDEO https://vimeo.com/user128225853 VIDEO ANNOTATIONS 01:13 — opening the surgery site 02:29 — positioning of retractors 03:02 — start of 3-level discectomy 06:04 — allograft placement and fixation 08:20 — drain placement and closur

Aktualno sagledavanje Potterove globalne bioetike kao mosta između kliničke (personalizirane) i javnozdravstvene etike

In the context of modern scientific and technological developments in biomedicine and health care, and the potential consequences of their application on humans and the environment, Potter’s global bioethics concept resurfaces. By actualizing Potter’s original thoughts on individual bioethical issues, the universality of two of his books, which today represent the backbone of the world bioethical literature, “Bioethics – Bridge to the Future” and “Global Bioethics: Building on the Leopold Legacy”, is emphasized. Potter’s global bioethics today can legitimately be viewed as a bridge between clinical personalized ethics on the one hand and ethics of public health on the other.U kontekstu suvremenih znanstveno-tehnoloških dostignuća u biomedicini i zdravstvu i potencijalnih posljedica primjene za čovjeka i okoliš na površinu isplivava Potterov globalni bioetički koncept. Aktualizirajući izvorne Potterove misli na pojedine bioetičke teme ukazuje se na svevremenost dviju njegovih knjiga koje i danas predstavljaju okosnicu svjetske bioetičke literure: “Bioethics – Bridge to the Future” te “Global Bioethics: Building on the Leopold Legacy”. Potterova globalna bioetika danas se legitimno može promatrati kao most između kliničke personalizirane etike s jedne strane odnosno etike javnog zdravstva s druge

Prijelomi dijafize humerusa: liječenje antegradnim usidrenim endomedularnim čavlom s primjenom neutralizacijskih vijaka kroz frakturnu pukotinu

The aim of this study was to compare union time between two different nail designs for the treatment of humeral shaft fracture, i.e. antegrade interlocking intramedullary nail with and without additional interlocking neutralization screws. The retrospective study included 51 patients treated with antegrade humeral intramedullary nailing between January 2015 and December 2017. The inclusion criteria of the study were proximal and middle third humeral shaft fractures. Fifty-one patients met the inclusion criteria; 23 patients were treated with antegrade intramedullary nail with additional interlocking neutralization screws through fracture site (group A) and 28 patients were treated with antegrade intramedullary nail without additional interlocking neutralization screws (group B). Medical documentation and radiographic images taken preoperatively and postoperatively were reviewed. Radiological union was defined as cortical bridging of at least three of four cortices in two-plane radiographs, with disappearance of the fracture gap. There were no significant differences in union time between the groups (p>0.05). To our knowledge, this is the first report of antegrade interlocking humeral nailing with additional interlocking neutralization screws through fracture site. Hypothetical advantages of fracture gap reduction by additional interlocking neutralization screws to promote union were not confirmed by this first clinical trial.Cilj ovoga istraživanja bio je usporediti vrijeme cijeljenja prijeloma dijafize humerusa pri liječenju s dva različita dizajna intramedularnog čavla: antegradni ukotvljeni intramedularni čavao s dodatnim ukotvljenim neutralizacijskim vijcima i bez njih. Retrospektivna studija obuhvatila je 51 bolesnika liječenog antegradnim humeralnim intramedularnim čavlima između siječnja 2015. i prosinca 2017. godine. Kriteriji uključenja u studiju bili su prijelomi proksimalne i srednje trećine dijafize humerusa. Pedeset i jedan bolesnik je ispunio kriterije uključenja: 23 bolesnika su liječena antegradnim intramedularnim čavlom s dodatnim ukotvljenim neutralizacijskim vijcima kroz mjesto prijeloma (skupina A), a 28 bolesnika je liječeno antegradnim intramedularnim čavlom bez dodatnih ukotvljenih neutralizacijskih vijaka (skupina B). Analizirana je medicinska dokumentacija i radiološke slike učinjene prije i poslije operacije. Radiološko cijeljenje prijeloma definirano je kao kortikalno premošćivanje najmanje tri od četiri korteksa u dvoprofilnim radiografima, s nestankom frakturne pukotine. Nije bilo značajne razlike u vremenu cijeljenja prijeloma između skupina (p>0,05). Prema našim spoznajama, ovo je prva studija o liječenju prijeloma humerusa antegradnim intramedularnim čavlom s dodatnim ukotvljenim neutralizacijskim vijcima kroz mjesto prijeloma. Hipotetsku prednost redukcije prijelomne pukotine s dodatnim ukotvljenim neutralizacijskim vijcima u svrhu poticanja cijeljenja nije potvrdila ova prva klinička studija

Trebamo li liječiti bol u starijih palijativnih onkoloških bolesnika drukčije?

Opioids are considered the cornerstone of pain management in palliative care. Available data suggest that older patients use different analgesics and lower opioid doses compared to younger patients. However, it has not been elucidated yet whether such dosing is associated with worse pain levels or shorter survival in the palliative care setting. We evaluated the relationship among pain scores, quality of life, opioid dose, and survival in palliative care cancer patients in a hospice setting. A total of 137 palliative care cancer patients were analyzed prospectively. We divided patients into two groups using the age of 65 as a cut-off value. Younger patients exhibited significantly higher pain ratings (5.14 vs. 3.59, p=0.01), although older patients used almost 20 mg less oral morphine equivalent (OME) on arrival (p=0.36) and 55 mg OME/day less during the last week (p=0.03). There were no differences in survival between the two groups (17.36 vs. 17.58 days). The elderly patients also used nonsteroidal analgesics less often and paracetamol more often. Hence, using lower opioid doses in older palliative care cancer patients does not result in worse pain rating, and could be a plausible approach for pain management in this patient group.Opioidi se smatraju jednim od osnovnih lijekova u liječenju boli u palijativnoj skrbi. Dostupni podaci ukazuju na to da stariji bolesnici uzimaju drukčije analgetike uz niže doze opioida u usporedbi s mlađim bolesnicima. Međutim, nije razjašnjeno utječe li takvo doziranje opioida na lošije liječenje razine boli ili kraće preživljenje u uvjetima palijativne skrbi. Analizirali smo odnos razine boli, kvalitete života, doze opioida i preživljenja u palijativnih onkoloških bolesnika koji su bili hospitalizirani u hospiciju. Ukupno je 137 palijativnih bolesnika analizirano prospektivno. Bolesnici su podijeljeni u dvije skupine pri čemu se dob od 65 godina uzimala kao granica između skupina. Mlađi bolesnici su izražavali višu razinu boli prilikom dolaska u hospicij (5,14 prema 3,59, p=0,01), iako su stariji bolesnici koristili gotovo 20 mg manje oralnog morfij ekvivalenta (OME) na dan dolaska te čak 55 mg OME manje na dan tijekom zadnjeg tjedna (p=0,03). Nije bilo razlika u preživljenju između dviju skupina bolesnika (17,36 prema 17,58 dana). Starija skupina bolesnika također je nesteroidne antireumatike uzimala rjeđe, a paracetamol češće od mlađe skupine. Uzimanje nižih doza opioida u starijih onkoloških bolesnika u palijativnoj skrbi nije rezultiralo lošijom razinom boli pa bi to mogao biti razuman pristup liječenju boli u ovoj skupini bolesnika

Neuroslikovne pretrage u djece s kroničnom glavoboljom u kliničkoj praksi

In daily practice, neuroimaging studies are frequently performed for the management of childhood headache. The aim of this study was to determine whether there is significant discrepancy between clinical practice and clinical practice guidelines on the indications for neuroimaging studies. Medical records of children with chronic headache, aged 2 to 18 years and treated at Rijeka University Hospital Center, Kantrida Department of Pediatrics, were retrospectively reviewed. Indications for brain magnetic resonance imaging and computed tomography (MRI/CT) scanning were reviewed and compared with clinical practice guidelines. Brain imaging was performed in 164 (76.3%) of 215 children, MRI in 93 (56.7%) and CT in 71 (43.3%) children. Indications for brain MRI/CT were as follows: anxiety and/or insistence by the child’s family (71.3%), presence of associated features suggesting neurologic dysfunction (13.4%), age under 5 years (12.8%) and abnormal neurologic examination (2.4%). The majority of children (71.4%) had normal neuroimaging findings. In the rest of imaging studies (28.1%), MRI/CT revealed different intracerebral/extracerebral findings not influencing changes in headache management. Only one (0.60%) patient required change in headache management after MRI/CT. Study results proved that, despite available evidence- based clinical guidelines, brain imaging in children with chronic headaches is overused, mostly in order to decrease anxiety of the family/patient.Cilj rada bio je utvrditi postoji li značajan nesrazmjer između kliničke prakse i kliničkih smjernica u svezi indikacija za provođenje neuroslikovnih pretraga u djece s kroničnom glavoboljom. Analizirana je medicinska dokumentacija djece s kroničnom glavoboljom u dobi od 2 do 18 godina liječene u Kliničkom bolničkom centru Rijeka, Klinika za pedijatriju “Kantrida”. Indikacije za provođenje magnetske rezonancije i kompjutorizirane tomografije (MR/CT) mozga uspoređene su s indikacijama preporučenim u smjernicama. MR je učinjen u 93 (56,7%) djece, a CT u 71 (43,3%) djeteta, ukupno u 164 (76,3%) od 215 djece. Indikacije za MR/CT mozga bile su: tjeskoba i/ili inzistiranje obitelji (71.3%), prisutnost pridruženih simptoma koji su ukazivali na neurološki poremećaj (13.4%), djeca mlađa od 5 godina (12,8%) i promijenjen neurološki status (2,4%). U većine djece (71,4%) nalaz MR/CT bio je uredan. U ostalim MR/CT nalazima opisane su intra-/ekstracerebralne promjene koje nisu utjecale na promjene u terapijskom pristupu (28,1%). U samo jednog djeteta (0,60%) promijenjen je terapijski pristup nakon provedene neuroslikovne pretrage. Ovo ispitivanje dokazuje da se, unatoč dostupnim kliničkim smjernicama, neuroslikovne pretrage mozga u djece s kroničnim glavoboljama prekomjerno provode, uglavnom s ciljem umanjivanja tjeskobe roditelja i/ili zbog njihovog inzistiranja da se iste učine

Neuroslikovne pretrage u djece s kroničnom glavoboljom u kliničkoj praksi

In daily practice, neuroimaging studies are frequently performed for the management of childhood headache. The aim of this study was to determine whether there is significant discrepancy between clinical practice and clinical practice guidelines on the indications for neuroimaging studies. Medical records of children with chronic headache, aged 2 to 18 years and treated at Rijeka University Hospital Center, Kantrida Department of Pediatrics, were retrospectively reviewed. Indications for brain magnetic resonance imaging and computed tomography (MRI/CT) scanning were reviewed and compared with clinical practice guidelines. Brain imaging was performed in 164 (76.3%) of 215 children, MRI in 93 (56.7%) and CT in 71 (43.3%) children. Indications for brain MRI/CT were as follows: anxiety and/or insistence by the child’s family (71.3%), presence of associated features suggesting neurologic dysfunction (13.4%), age under 5 years (12.8%) and abnormal neurologic examination (2.4%). The majority of children (71.4%) had normal neuroimaging findings. In the rest of imaging studies (28.1%), MRI/CT revealed different intracerebral/extracerebral findings not influencing changes in headache management. Only one (0.60%) patient required change in headache management after MRI/CT. Study results proved that, despite available evidence- based clinical guidelines, brain imaging in children with chronic headaches is overused, mostly in order to decrease anxiety of the family/patient.Cilj rada bio je utvrditi postoji li značajan nesrazmjer između kliničke prakse i kliničkih smjernica u svezi indikacija za provođenje neuroslikovnih pretraga u djece s kroničnom glavoboljom. Analizirana je medicinska dokumentacija djece s kroničnom glavoboljom u dobi od 2 do 18 godina liječene u Kliničkom bolničkom centru Rijeka, Klinika za pedijatriju “Kantrida”. Indikacije za provođenje magnetske rezonancije i kompjutorizirane tomografije (MR/CT) mozga uspoređene su s indikacijama preporučenim u smjernicama. MR je učinjen u 93 (56,7%) djece, a CT u 71 (43,3%) djeteta, ukupno u 164 (76,3%) od 215 djece. Indikacije za MR/CT mozga bile su: tjeskoba i/ili inzistiranje obitelji (71.3%), prisutnost pridruženih simptoma koji su ukazivali na neurološki poremećaj (13.4%), djeca mlađa od 5 godina (12,8%) i promijenjen neurološki status (2,4%). U većine djece (71,4%) nalaz MR/CT bio je uredan. U ostalim MR/CT nalazima opisane su intra-/ekstracerebralne promjene koje nisu utjecale na promjene u terapijskom pristupu (28,1%). U samo jednog djeteta (0,60%) promijenjen je terapijski pristup nakon provedene neuroslikovne pretrage. Ovo ispitivanje dokazuje da se, unatoč dostupnim kliničkim smjernicama, neuroslikovne pretrage mozga u djece s kroničnim glavoboljama prekomjerno provode, uglavnom s ciljem umanjivanja tjeskobe roditelja i/ili zbog njihovog inzistiranja da se iste učine

Povezanost meteoroloških varijabla sa subarahnoidnim krvarenjem: iskustvo jednog centra

Spontaneous subarachnoid hemorrhage (SAH) can occur unexpectedly and independently of the classic risk factors. Several different factors could affect intracranial aneurysm (IA) rupture, such as morphological and hemodynamic factors. The aim of this study was to establish the potential association of meteorological data such as temperature, atmospheric pressure, and humidity, and the onset of clinical symptoms preceding hospital admission of patients with acute SAH due to IA rupture. This retrospective study included 130 consecutive patients admitted for non-traumatic SAH with a determinable onset of SAH symptoms. The effects of meteorological parameters of atmospheric pressure, ambient temperature, and relative air humidity on the day of acute SAH onset and 24 hours prior to the onset of symptoms were recorded and analyzed in each patient. Spearman rank correlation analysis was used to assess the risks of incident SAH on the basis of daily meteorological data. Seasonal incidence of acute SAH showed the peak incidence in winter and a trough in summer, with monthly incidence peak in January and December. The circadian rhythm analysis showed the peak incidence of SAH in the forenoon, followed by the evening. Acute SAH incidence showed moderate positive association with daily atmospheric pressure (p<0.05), while no association was found with ambient temperature and relative air humidity. Our results suggested no significant association of changes in ambient temperature and relative humidity with the risk of SAH. Increases in atmospheric pressure were weakly associated with a higher SAH risk. Additional studies are needed to establish in detail both meteorological and morphological factors important to predict IA rupture and SAH.Spontano subarahnoidno krvarenje (SAH) može nastati neočekivano i neovisno o klasičnim čimbenicima rizika. Nekoliko različitih čimbenika može utjecati na rupturu intrakranijske aneurizme (IA), poput morfoloških i hemodinamskih čimbenika. Cilj ovoga istraživanja bio je utvrditi potencijalnu povezanost meteoroloških podataka kao što su temperatura, atmosferski tlak i vlažnost te pojave kliničkih simptoma prije prijma u bolnicu bolesnika s akutnim SAH-om zbog rupture IA. Ova retrospektivna studija uključila je 130 uzastopnih bolesnika primljenih zbog netraumatskog SAH-a s vidljivim početkom simptoma SAH-a. Za svakog bolesnika zabilježeni su i analizirani učinci meteoroloških parametara atmosferskog tlaka, temperature okoline i relativne vlažnosti zraka na dan nastanka akutnog SAH-a i 24 sata prije pojave simptoma. Korelacijska Spearmanova analiza primijenjena je za procjenu rizika od incidentnog SAH-a na temelju dnevnih meteoroloških podataka. Sezonska incidencija akutnog SAH-a pokazala je vrhunac incidencije zimi i pad ljeti, s mjesečnim vrhom incidencije u siječnju i prosincu. Analiza cirkadijanog ritma pokazala je vrhunac incidencije SAH-a u prijepodnevnim satima, a zatim navečer. Učestalost akutnog SAH-a pokazala je umjereno pozitivnu povezanost s dnevnim atmosferskim tlakom (p<0,05), dok nije nađena povezanost s temperaturom okoline i relativnom vlagom zraka. Naši rezultati ukazuju na to da nema značajne povezanosti promjena u temperaturi okoline i relativnoj vlažnosti s rizikom od SAH-a. Povećanje atmosferskog tlaka slabo je povezano s većim rizikom od SAH-a. Potrebne su dodatne studije kako bi se detaljno utvrdili meteorološki i morfološki čimbenici važni za predviđanje rupture IA i SAH-a

Burkittov limfom u probavnom traktu: prikaz 2 slučaja

Burkitt lymphoma, a type of non-Hodgkin B-cell lymphoma, is the fastest growing human cancer, presenting pathologically with a ‘starry sky’ pattern. It is most often found in the abdomen and the jaw, however, localization in the abdomen other than the ileocecal area is very rare and described only in a handful of cases. Standard treatment consists of initial tumor cytoreduction followed by intense chemotherapy. Most of the relapses occur within one year of the diagnosis, while the 5-year survival is around 80%. We present two cases which are specific for unusual location of Burkitt lymphoma in the colon and stomach, in immunocompetent patients with negative Epstein-Barr virus tests. Also, one of the patients presented is one of the oldest ever reported with abdominal Burkitt lymphoma, while the other patient is an example of diagnostic difficulties in distinguishing Burkitt lymphoma from similar lymphomas. Due to the rapidly growing tumors and urgent need for cytoreductive surgery, it is crucial to consider the diagnosis of Burkitt lymphoma even in atypical localizations or absence of the common risk factors associated with Burkitt lymphoma.Burkittov limfom spada u non-Hodgkin B-stanične limfome te je najbrže rastući tumor u ljudi, a patološki se prezentira uzorkom ‘zvjezdanog neba’. Najčešće je lokaliziran u trbuhu i u čeljusti, međutim, lokalizacija u trbuhu izvan ileocekalnog područja je izrazito rijetka i opisana samo u nekoliko slučajeva. Uobičajeno liječenje se sastoji od inicijalne citoredukcije tumora nakon čega slijedi intenzivna kemoterapija. Većina recidiva javi se unutar jedne godine od dijagnoze, dok je petogodišnje preživljenje oko 80%. U članku prikazujemo dva slučaja koja su specifična zbog rijetke lokalizacije Burkittova limfoma u debelom crijevu i želudcu, u imunokompetentnih bolesnika s negativnim testom na Epstein-Barrov virus. Također, jedan od opisanih bolesnika je jedan od najstarijih slučajeva abdominalnog Burkittova limfoma opisanih u literaturi, dok slučaj drugog bolesnika naglašava izazove u dijagnostici Burkittova limfoma, osobito u bolesnika kod kojih se isti ne očekuje. S obzirom na brz rast tumora i hitnu potrebu citoreduktivne operacije važno je uzeti u obzir dijagnozu Burkittova limfoma čak i u bolesnika s netipičnom lokalizacijom tumora i bez uobičajnih rizičnih čimbenika povezanih s Burkittovim limfomom

Mediterranean vineyards and olive groves in Croatia harbour some rare and endemic invertebrates

The Mediterranean is characterised by high biodiversity and numerous endemic species. These species are not only present in natural habitats, but also inhabit areas under human influence, such as agricultural lands. In the biodiversity assessment of Mediterranean vineyards and olive orchards within Zadar County, in Croatia, we identified eight endemic species with Mediterranean distribution, six with a Balkan Peninsula distribution, four with Dinaric Alps distribution and three species rare and endangered in Europe. Alongside these species, we have recorded five new species for Croatian fauna, many of those identified by combining morphological characteristics and the DNA barcoding tool. Araneae and Coleoptera contributed the highest number of endemic species and groups with new record were the following: Coleoptera, Diptera and Araneae. Compared to other sites, an olive orchard with ecological pest management (EPM), surrounded by natural ecosystems, had the highest ratio of endemic and rare species. Our findings emphasise that agricultural lands in the Mediterranean can be habitats for endemic and rare species and that future biodiversity research of these habitats is highly important, to monitor potential biodiversity changes and motivate future species and ecosystem conservation