Uloga mikrobiološke dijagnostike ejakulata u dijagnostici sindroma kroničnoga prostatitisa [The role of semen microbiological diagnostics in the diagnosis of chronic prostatitis syndrome]

The aim of this study was to investigate how often etiology of chronic prostatitis syndrome is proved if the presence of the traditional prostatitis causitive pathogens is investigated with 'four glass test' plus the semen microbiological diagnostics. It also was to determine the frequency of traditional causitive pathogens of prostatitis in EPS and / or VB3 and the semen of patients with chronic bacterial prostatitis. The study included 107 adult male patients older than 20 years who came with chronic prostatitis to the 'Ambulance for urogenital infections and sexually transmitted disease' of the 'Clinics for Infectious Diseases' "Dr. Fran Mihaljevic" in the period from 2009 to 2013, and in whom the diagnosis of chronic bacterial prostatitis was confirmed by proving the causitive pathogens in EPS and / or VB3 and / or semen. The study was designed so that patients were control to each other. The experiment was carried out as a 'five glass test' in all subjects, and the analysis is done as it is in the same subjects performed the 'two glass test' and 'four glass test'. The most common traditional pathogens proven in EPS and / or VB3 and semen were Enterococcus faecalis (detected in 45 patients or 42.05%) and Escherichia coli (demonstrated in 42 patients or 39.25%). All other proven traditional pathogens - Proteus mirabilis, Klebsiella pneumoniae, Streptococcus agalactiae, coagulase - negative staphylococci - were isolated in EPS and / or VB3 and semen in 20 patients or 18.7%. Examining that samples it was determined that in 62 (57.94%) patients the pathogen was detected in EPS and / or VB3 and in the semen, in 18 (16.82%) patients the cause was found only in EPS and / or VB3, and in 27 (25.23%) patients the cause was found only in the semen. The etiology was confirmed in the significantly higher percentage of patients in EPS / VB3 and semen compared to the patients where etiology was demonstrated only in EPS / VB3 (Fischer exact test, p <0.00001), or only in the semen (Fischer exact test; p = 0.0012). There were no statistically significant differences in the percentage of patients in whom the etiology was demonstrated only in EPS / VB3 or only in the semen (Fischer's exact test, p = 0.1454). Since the results of this study indicate that a large proportion of patients with chronic prostatitis have causitive pathogen that is only proven by semen dijagnostics, not by EPS and / or VB3 (ie. 'four glass test' or 'two glass test'), we conclude that the semen microbiological diagnostics in these patients could constitute a valuable supplement to existing methods (making it a 'five glass test')

Wound dehiscence

Dehiscencija rane je rezultat oštećenja procesa cijeljenja rane. Čimbenici koji oštećuju proces cijeljenja rane mogu biti lokalni i opći. Infekcija rane je jedan od najvažnijih uzroka dehiscencije. Aseptički uvjeti rada i atraumatska kirurška tehnika bitno smanjuje mogućnost nastanka infekcije. Liječenje kirurških infekcija predstavlja hitnu indikaciju, kako bi se spriječile dodatne komplikacije sepsa). Prijeoperacijska primjena antibiotika ima strogu indikaciju.Wound dehiscence is a result of damage during healing. The factors that influence wound healing could be divided into local and systemic. Wound infection is the most important cause dehiscence. Aseptic conditions and atraumatic surgical techniques reduce wound infections significantly. The appropriate treatment of surgical infections is critical in preventing additional complications. Selective use of antiobiotics has an important place in perioperative management

Determining soil freezing depth under the pavement structures

Opisuje se istraživanje za određivanje indeksa smrzavanja zraka. Praktični doprinos ovoga rada jest izrađena karta kontura indeksa smrzavanja zraka (ISZ) za područje Hrvatske. Metodologija određivanja dubine smrzavanja ispod ceste na osnovi vrijednosti ISZ, koje su ustanovljene ovim istraživanjem, ima dvostruku inženjersku primjenu: za provjeru osjetljivosti na smrzavanje projektirane konstrukcije i za ocjenjivanje otpornosti na smrzavanje postojećih kolničkih konstrukcija.The research carried out to determine the air freezing index is described. The practical output of this research is the contour map with air freezing indices (AFI) for the territory of Croatia. The methodology for determining freezing depth under roadways, based on AFI values defined in this research, has two engineering applications: to check susceptibility to freezing of a designed structure, and to estimate freezing resistance of existing pavement structures

Utjecaj nekih klimatskih elemenata na reprodukcijska svojstva romanovske ovce na području Bilogore

The study aimed to determine the influence of air temperature, amount of precipitation and sunlight duration on the reproductive traits of the Romanov sheep in the Bilogora region, Croatia.Animals were kept in a fenced rotating pasture with access to stables during the night. Sheep were naturally mated. During three consecutive years (2019-2021), reproductive performance data were collected for four sheep flocks (n=26-57). Data on air temperature, sunlight duration, and daily precipitation volumes were obtained from the Croatian Meteorological and Hydrological Service (CMHS), Zagreb, Croatia, from the nearest meteorological recording station, located within 5-15 km of farms. A total of 425 ewes were mated, of which 399 successfully conceived and 851 lambs were born, with an average litter size of 1.63. The average fertility during the study was 93.88%. Lambing distribution was not equally distributed throughout the year as 73% of all lambs were born during winter and spring (winter 51.88%; spring 21.31%; summer 13.53% and autumn 13.28%). Sexual activity was lowest from the end of March to May, while the peak of sexual activity was from the end of August to October. There was a positive or negative correlation (P<0.0001 (Kruskall-Wallis)) between air temperature, sunshine duration and amount of precipitation with certain reproductive traits (number of pregnant and non-pregnant ewes). Daily average air temperatures were highest in summer but drop suddenly at the start of the breeding season in early autumn. Also, the day begins to shorten, and night begins to become longer which is crucial for shortday breeder species such as sheep and goats. Other factors, such as relative humidity and rainfall, can also directly or indirectly impact sexual activity and significantly affect fertility. The results indicate that air temperature, amount of precipitation, and sunlight duration during different months or seasons could influence the reproductive traits of Romanov sheep in Bilogora region, Croatia.Cilj je istraživanja bio utvrditi utjecaj temperature zraka, količine dnevnih oborina i trajanja sunčeve svjetlosti na reprodukcijska svojstva romanovske ovce u području Bilogore, Hrvatska. Životinje su držane na ograđenom rotirajućem pašnjaku s pristupom stajama tijekom noći. Ovce su bile prirodno pripuštane. Tijekom 3 uzastopne godine (2019.-2021.) prikupljeni su podatci o reproduktivnoj učinkovitosti četiri stada ovaca (n=26-57). Temperaturu zraka, trajanje sunčeve svjetlosti i dnevne količine oborina prikupio je Hrvatski meteorološki i hidrološki zavod (CMHS), Zagreb, Hrvatska, u najbližoj meteorološkoj postaji za mjerenje, koja je udaljena nalazi unutar 5-15 km od farmi. Pripušteno je ukupno 425 ovaca, od kojih je 399 uspješno koncipiralo i ojanjilo 851 janje. Prosječna veličina legla bila je 1,63; prosječna plodnost tijekom istraživanja bila je 93,88 %. Rasprostranjenost janjenja nije bila tijekom cijele godine ravnomjerno raspoređena, jer je 73 % svih ovaca ojanjeno tijekom zime i proljeća (zimi 51,88 %, u proljeće 21,31 %, u ljeto 13,53 % i u jesen 13,28 %). Spolna aktivnost bila je najniža od kraja ožujka do svibnja, dok je vrhunac spolne aktivnosti bio od kraja kolovoza do listopada. Postojala je pozitivna ili negativna korelacija (P<0,0001 (Kruskall Wallis)) između temperature zraka, trajanja sunčeve svjetlosti i količine oborina s određenim reproduktivnim svojstvima (brojem gravidnih i negravidnih ovaca). Prosječne dnevne temperature najviše su ljeti, no početkom jeseni i početkom sezone razmnožavanja temperature zraka naglo padaju. Isto tako, dan postaje kraći, a noć postaje duža što je ključno za rasplodnju vrsta tzv. short day breeder kao što su ovce i koze. Osim temperature i sunčeve svjetlosti, drugi čimbenici, poput relativne vlažnosti i padalina, mogu izravno ili neizravno utjecati na spolnu aktivnost i znatno utjecati na plodnost. Možemo pretpostaviti da temperatura zraka, količina oborina i trajanje sunčeve svjetlosti tijekom različitih mjeseci ili godišnjih doba mogu utjecati na reproduktivne osobine romanovske ovce na Bilogori u Hrvatskoj

Sigurnost i djelotvornost azitromicina u liječenju infekcija donjih dišnih putova: međunarodna multicentrična ne-usporedna studija

The aim of this study was to describe clinical effectiveness of azithromycin in the management of lower respiratory tract infections in daily clinical practice, to examine duration of symptoms after therapy initiation, and to record any possible adverse effects of azithromycin treatment. A total of 153 patients were included in the analysis of the effectiveness of azithromycin: 94 patients with community acquired pneumonia (CAP) and 59 with acute exacerbation of chronic bronchitis (AECB). Clinical effectiveness was assessed as improvement, cure or failure after three-day treatment with azithromycin. The assessment was based on a calculation of clinical score for each diagnosis before treatment and on days 4, 10 and 28 after treatment initiation. Clinical effectiveness of azithromycin was 93.6% in CAP group and 94.9% in AECB group. Azithromycin led to relief of symptoms within three days in 88.6% of CAP patients and 77.2% of AECB patients. Overall, 15 adverse events were reported in 14 (9.1%) patients. The most common adverse events were abdominal pain, diarrhea and vomiting, each reported in four (2.6%) patients. Accordingly, azithromycin was found to have high clinical effectiveness and a small number of adverse events in the treatment of lower respiratory tract infections. ISRCTN38391551.Ciljevi ove studije bili su opisati kliničku djelotvornost azitromicina u liječenju infekcija donjih dišnih putova u kliničkoj praksi, ispitati trajanje simptoma nakon početka terapije te prikupiti podatke o neželjenim događajima. Uispitivanje su bila uključena 153 bolesnika: 94 bolesnika s pneumonijom iz opće populacije te 59 bolesnika s akutnom egzacerbacijom kroničnog bronhitisa. Klinička djelotvornost je ocijenjena kao poboljšanje, izlječenje ili neuspjeh liječenja trodnevnom terapijom azitromicinom. Procjena se osnivala na izračunu kliničkog indeksa za svaku dijagnozu prije početka terapije te nakon 4, 10 i 28 dana. Uovom ispitivanju klinička djelotvornost azitromicina bila je 93,6% u skupini bolesnika s pneumonijom iz opće populacije te 94,9% u bolesnika s akutnom egzacerbacijom kroničnog bronhitisa. Azitromicin je doveo do olakšanja simptoma unutar 3 dana kod 88,6% bolesnika s pneumonijom i 77,2% bolesnika s akutnom egzacerbacijom kroničnog bronhitisa. Zabilježeno je 15 neželjenih događaja kod 14 (9,1%) bolesnika. Najčešći neželjeni događaji su bili dijareja i povraćanje, od kojih je svaki zabilježen u 4 (2,6%) bolesnika. Rezultati ispitivanja pokazuju da azitromicin ima visoku djelotvornost u liječenju infekcija donjih dišnih putova i izaziva mali broj nuspojava. ISRCTN38391551

E-Learning for physicians and pharmacists

Uvođenjem novih tehnologija, posebice interneta, otvorile su se nove mogućnosti trajne medicinske edukacije u obliku e-učenja. U preglednom radu opisane su mogućnosti e-učenja u Hrvatskoj. Pravilnik o trajnoj edukaciji i mogućnostima e-učenja izrađuje i objavljuje Hrvatska liječnička i ljekarnička komora. U posljednjih desetak godina objavljeno je nekoliko e-tečajeva za liječnike i jedan za ljekarnike. Kontinuitet etečajeva prisutan je jedino na PLIVAmed.net portalu na kojem se tečajevi rade u suradnji sa stručnim društvima, nastavnicima medicinskog i farmaceutskog, fakulteta te Komorom. U Hrvatskoj treba detaljnije istražiti potrebe zdravstvenih djelatnika za ovim oblikom edukacije, utvrditi njihov stav i dosadašnja iskustva, kako bi se što više iskoristile mogućnosti moderne tehnologije u modelu cjeloživotnog učenja.The introductions of new technologies, especially the Internet, have opened up new possibilities for continuing medical education (CME) in the form of e-learning. This review article describes the opportunities for CME e-learning. CME regulations and e-learning options have been developed by the Croatian Medical Chamber and the Croatian Chamber of Pharmacists. In the past decade several e-learning courses for physicians and one for pharmacists have been posted online. However, only the PLIVAmed.net Internet portal has maintained the continuity of e-courses. These courses are run in collaboration with professional societies, professors from schools of medicine and pharmacy and experts from the relevant chambers. Further investigations are needed in Croatia to determine e-learning needs, attitudes and experiences and thus use the advantages of modern technologies in lifelong learning