35 research outputs found
Eozinofilni kolitis
Zbog nedefiniranih kriterija dijagnostike i velikog broja sekundarnih uzroka eozinofilije kolona, ova je bolest Äesto kasno prepoznata. Bolesnici se prezentiraju s nespecifiÄnim simptomima, kao Å”to su abdominalna bol, proljev i gubitak na težini, a kliniÄka slika ponajviÅ”e ovisi o dubini infiltracije stijenke eozinofilima. Eozinofilni kolitis ima bimodalnu dobnu distribuciju s najÄeÅ”Äom pojavnosti u novoroÄenÄadi i mlaÄoj odrasloj populaciji. ToÄan uzrok ove bolesti nije poznat. Dok je u novoroÄenÄadi to najÄeÅ”Äe IgE posredovan odgovor na kravlje mlijeko i proteine soje, u odraslih je najÄeÅ”Äe rezultat CD4 Th2 odgovora. Endoskopskim pregledom zamijeÄene promjene stijenke kolona nespecifiÄne su, uslijed Äega je potrebna biopsija za potvrdu dijagnoze i iskljuÄenje drugih moguÄih bolesti. Upalne bolesti crijeva, lijekovi, paraziti, autoimune bolesti vezivnoga tkiva, te idiopatski hipereozinofilni sindrom, mogu stvoriti sliÄnu kliniÄku i histoloÅ”ku sliku bolesti, zbog Äega je eozinofilni kolitis primarno dijagnoza iskljuÄenja. U djece je bolest nakon uvedene dijete samolimitirajuÄa, dok je u odraslih potrebno dugotrajno lijeÄenje s obzirom na to da je bolest kroniÄna tijeka s razdobljima remisije i relapsa. NajuÄinkovitijom se pokazala kortikosteroidna terapija, a u sluÄaju teÅ”kih refraktornih stanja i razvoja steroidne ovisnosti, uvodi se imunosupresivna terapija
First Case of Q Fever Endocarditis in Croatia and a Short Review
We present a 70-year-old man from Dalmatia, Croatia, with a history of prolonged high fever diagnosed as Q fever endocarditis. As far as we know, this is the first case of chronic Q fever in Croatia. The treatment was started as for culture-negative endocarditis, but was without clinical response. After significantly high anti-phase I IgG plus IgA antibodies titers to Coxiella burnetii were shown, the initial treatment with doxycycline was changed and ciprofloxacin was started with good clinical response
Potencijalni rizici farmakoloŔki izazvane hipoklorhidrije
Inhibitori protonske pumpe (IPP) trenutno su najdjelotvorniji lijekovi u regulaciji luÄenja želuÄane kiseline. Postali su terapija izbora u lijeÄenju gastroezofagealne refluksne bolesti, peptiÄkih ulkusa, Zollinger-Ellisonova sindroma (ZOS), funkcionalne dispepsije, lezija uzrokovanih nesteroidnim antireumaticima (NSAR), eradikacije Helicobacter pylori i ostalih hipersekretornih stanja. Na tržiÅ”tu se nalazi pet lijekova iz ove skupine: omeprazol, esomeprazol, lansoprazol, te rabeprazol za oralnu i pantoprazol za oralnu i intravensku upotrebu. Glavni mehanizam njihova djelovanja je inhibicija protonske pumpe parijetalnih stanica želuca i smanjenje stvaranja želuÄane kiseline. Visoka uÄinkovitost, jednostavna primjena, prihvatljiva cijena i rijetke nuspojave dovele su do pretjeranog propisivanja IPP-a u bolniÄkih i ambulantnih bolesnika. Zbog toga dolazi do poveÄane izloženosti bolesnika potencijalnim rizicima. Dugotrajna terapija IPP-ima uzrokuje hipoklorhidriju, hipergastrinemiju i proliferaciju parijetalnih stanica. Potencijanlo nepovoljno djelovanje može se odraziti na metabolizam vitamina B12, željeza i magnezija, regulaciju kalcija i nastanak osteoporotiÄnih fraktura, pojavnost enteralnih infekcija, posebice Clostridium difficile kolitisa i izvanbolniÄke pneumonije, promjenu sluznice želuca stvaranjem benignih polipa ili malignih promjena, nastanak demencije i pogorÅ”anje bolesti srca i bubrega. Racionalnom primjenom IPP-a, kontrolom i evaluacijom stanja bolesnika, te njihovom edukacijom, moguÄe je smanjiti pojavnost rizika i stanja do kojih dovodi neprimjereno lijeÄenje
Dermatoglyphics in Patients with Hypothyreosis
About 15% of all females and 3% of all males suffers from hypothyreosis. The thyroid disease is the most frequent
cause of hypothyreosis, and among people in Croatia who are suffering from that disease 90% have been affected by its
autoimmune form. The thyroid diseases are supposed to be caused by the influence of various genetic and external factors
and some forms of genetic influences have not yet been studied. Analysis of digito-palmar dermatoglyphics has been used
in the research of the role of genetic predisposition in many various diseases. We have analyzed correlation of qualitative
and quantitative traits between the group of 50 females suffering from hypothyreosis and a control group of 100 phenotypically
healthy females. Quantitative statistical analysis using t-test has indicated only few significantly different
variables, while the discriminant analysis has shown 76.9% correctly classified samples. The factor analysis has shown
a high percentage of total variance within patients suffering from hypothyreosis, as well as the different structure of individual
factors. Qualitative analysis has shown the heterogeneity between the two examined groups. The results of the research
have proved that the qualitative characteristics are more unstable than the quantitative ones and they have also
shown the instability of genes taking part in hypothyreosis development implying genetic predisposition of the disease
Azatioprin u lijeÄenju bolesnika s ulceroznim kolitisom
Ulcerozni kolitis kroniÄna je upalna bolest za koju su karakteristiÄne ulceracije sluznice debeloga crijeva
i kliniÄki tijek obilježen razdobljima remisije i relapsa bolesti. KliniÄki se ulcerozni kolitis najÄeÅ”Äe oÄituje
uÄestalim sluzavo-krvavim proljevima. Azatioprin je tiopurin koji imunosupresiju postiže putem svojih
aktivnih metabolita. Oni potiÄu apoptozu T-limfocita, te, inkorporirajuÄi se u replicirajuÄi lanac DNA i
blokirajuÄi de novo sintezu purina, smanjuju njihovu proliferaciju. Mjerenjem aktivnosti tiopurin Smetiltransferaze i praÄenjem metabolita tiopurina, uspjeÅ”no se postiže optimizacija terapije. Time se
poboljÅ”ava kliniÄka djelotvornost lijeÄenja, te sprjeÄava neuspjeh lijeÄenja uzrokovan Å”tetnim nuspojavama
azatioprina. UnatoÄ pretpostavkama da Äe u buduÄnosti, zbog razvoja uÄinkovitijih i sigurnijih lijekova, uloga
tiopurina u lijeÄenju bolesnika s ulceroznim kolitisom biti ograniÄenija, azatioprin i dalje ostaje neizostavan
lijek u lijeÄenju bolesnika s ulceroznim kolitisom
Dermatoglyphics in Patients with Hypothyreosis
About 15% of all females and 3% of all males suffers from hypothyreosis. The thyroid disease is the most frequent
cause of hypothyreosis, and among people in Croatia who are suffering from that disease 90% have been affected by its
autoimmune form. The thyroid diseases are supposed to be caused by the influence of various genetic and external factors
and some forms of genetic influences have not yet been studied. Analysis of digito-palmar dermatoglyphics has been used
in the research of the role of genetic predisposition in many various diseases. We have analyzed correlation of qualitative
and quantitative traits between the group of 50 females suffering from hypothyreosis and a control group of 100 phenotypically
healthy females. Quantitative statistical analysis using t-test has indicated only few significantly different
variables, while the discriminant analysis has shown 76.9% correctly classified samples. The factor analysis has shown
a high percentage of total variance within patients suffering from hypothyreosis, as well as the different structure of individual
factors. Qualitative analysis has shown the heterogeneity between the two examined groups. The results of the research
have proved that the qualitative characteristics are more unstable than the quantitative ones and they have also
shown the instability of genes taking part in hypothyreosis development implying genetic predisposition of the disease
Isolated Left Ventricular Non-Compaction Cardiomyopathy Associated with Ventricular Preexcitation: A Case Report
Isolated left ventricular non-compaction (ILVNC) is one of the most misclassified cardiomyopathies. It is caused by failure of normal embryonic development of the myocardium from loosely arranged muscle fibers to the mature compacted form of myocardium, but it seems that etiology is not exclusively congenital. Diagnosis of ILVNC is mostly missed because of lack of awareness and knowledge. The recognition of the disease is mandatory, because of its high mortality and morbidity due to the progressive heart failure, thromboembolic events and lethal arrhythmias. We report of a family in which two adult members were found to have ILVNC. A literature review about ILVNC pathogenesis, diagnosing, and treatment was discussed
Potencijalni rizici farmakoloŔki izazvane hipoklorhidrije
Inhibitori protonske pumpe (IPP) trenutno su najdjelotvorniji lijekovi u regulaciji luÄenja želuÄane kiseline. Postali su terapija izbora u lijeÄenju gastroezofagealne refluksne bolesti, peptiÄkih ulkusa, Zollinger-Ellisonova sindroma (ZOS), funkcionalne dispepsije, lezija uzrokovanih nesteroidnim antireumaticima (NSAR), eradikacije Helicobacter pylori i ostalih hipersekretornih stanja. Na tržiÅ”tu se nalazi pet lijekova iz ove skupine: omeprazol, esomeprazol, lansoprazol, te rabeprazol za oralnu i pantoprazol za oralnu i intravensku upotrebu. Glavni mehanizam njihova djelovanja je inhibicija protonske pumpe parijetalnih stanica želuca i smanjenje stvaranja želuÄane kiseline. Visoka uÄinkovitost, jednostavna primjena, prihvatljiva cijena i rijetke nuspojave dovele su do pretjeranog propisivanja IPP-a u bolniÄkih i ambulantnih bolesnika. Zbog toga dolazi do poveÄane izloženosti bolesnika potencijalnim rizicima. Dugotrajna terapija IPP-ima uzrokuje hipoklorhidriju, hipergastrinemiju i proliferaciju parijetalnih stanica. Potencijanlo nepovoljno djelovanje može se odraziti na metabolizam vitamina B12, željeza i magnezija, regulaciju kalcija i nastanak osteoporotiÄnih fraktura, pojavnost enteralnih infekcija, posebice Clostridium difficile kolitisa i izvanbolniÄke pneumonije, promjenu sluznice želuca stvaranjem benignih polipa ili malignih promjena, nastanak demencije i pogorÅ”anje bolesti srca i bubrega. Racionalnom primjenom IPP-a, kontrolom i evaluacijom stanja bolesnika, te njihovom edukacijom, moguÄe je smanjiti pojavnost rizika i stanja do kojih dovodi neprimjereno lijeÄenje
Child injuries in traffic accidents
Uvod ā Djeca su Äesto žrtve u prometnim nezgodama, obiÄno kao pjeÅ”aci ili suputnici u automobilu.
PoveÄanjem inteziteta prometa poveÄao se broj stradale djece, Å”to predstavlja znaÄajan javnozdravstveni problem.
Metode ā Retrospektivno su analizirani podaci o stradanju djece u prometu u vremenskom razdoblju od 5. do 9. mjeseca 2010. na podruÄju Zadarske županije.
Rezultati ā Dobiveni podaci pokazuju da u prometnim nezgodama Äesto sudjeluju djeca, a najteže ozljede zadobila su djeca pjeÅ”aci i biciklisti. Kraniocerebralne ozljede i prijelomi ekstremiteta najÄeÅ”Äe su teÅ”ke ozljede. NajviÅ”e stradavanja bilo je za vrijeme ljetnih mjeseci kada je zbog turistiÄke sezone, najguÅ”Äi promet.
ZakljuÄak ā Edukacijom djece o ponaÅ”anju u prometu, koriÅ”tenjem autosjedalica, sigurnosnog pojasa i biciklistiÄkih kaciga može se izbjeÄi ili umanjiti težina ozljede.Introduction ā A lot of children are hurt in traffic accidents, in most cases as a companion-traveller in cars.The number of children hurt in such accidents has increased by the growth of traffic which represents a ignificant public health problem.
Methods ā The data on children who were hurt in traffic during the period of 5 months in 2003 are analyzed retrospectively.
Results ā Children with the worst injuries were those who were hurt in traffic as bicycle riders and pedestrians. Craniocerebral injuries and limb fractures are the most frequent serious injuries. Most calamities were during the summer period when the traffic is most frequent because of the tourist season. Children pedestrians are especially brought into danger at the beginning of the school year when there is no parent control near big traffic.
Conclusions ā Teaching children on traffic behaviour, the use of baby car chairs, safety belts and bike helmets can help in avoiding or decreasing the seriousness of injuries