Bajke Ivane Brlić-Mažuranić i suvremene bajke: komparativni pristup

U ovom diplomskom radu govori se o bajci, podijeli na klasičnu i modernu bajku, te povijesnom pregledu svjetskih i hrvatskih bajki. Postoje različita tumačenja bajke, a jedno od njih opisuje bajku kao priču čudesnog sadržaja sa svojim kategorijama prostora, vremena i uzroka. Njezina posebnost je u tome što ističe čudesnost, fantastičnost i izmišljenost. U radu su predstavljene najpoznatije hrvatske književnice koje su pisale bajke. Ivana Brlić–Mažuranić hrvatska spisateljica koja je, pišući bajke, stekla zvučni naziv „hrvatskog Andersena“. Započevši svoj književni rad u privatnim okvirima, pišući prvenstveno za vlastitu djecu, i nastavljajući ga impresionističkom poezijom, Ivana Brlić–Mažuranić odabrala je otklon od književne matice uvodeći u ruho klasične bajke slavensku mitologiju, hrvatski folklor i kršćanski svjetonazor. Iz njenog pera proizašlo je najznamenitije djelo Priče iz davnine koje objedinjuje osam bajki. U hrvatskoj književnosti put prema (post)modernoj bajci utrle su književnice Sunčana Škrinjarić i Nada Iveljić. Sunčana Škrinjarić obogatila je suvremenu bajku brojnim svojim modernim bajkama. Rad se dotiče njenog stvaralaštva na podlozi bajke, ustroja književne zbilje u njemu, likova i sredstava koji su prepoznatljivi u modernoj bajci. Treća autorica koju analiziramo u radu je Nada Iveljić. Temeljem njezine zbirke Šestinski kišobran sagledava se autoričin doživljaj narodnih i umjetničkih bajki te, narodnog blaga i kulturnog naslijeđa uopće. Također, promatra se struktura i značenje njezinih bajki. U radu se govori i o utjecaju, povezanosti, sličnostima i razlikama u pisanju bajki triju književnica te se sagledavanjem sličnosti i razlika između njihovih poetika nastoji dobiti šira slika o položaju, tipu i funkciji bajke u kontekstu hrvatske (dječje) književnosti.This diploma thesis is about a fairy tale, about its classification to classic and modern fairy tale and the historical review of fairy tales worldwide as well as the Croatian ones. There are various explanations of what a fairy tale is and one of them describes it as a story which has miraculous content, with its own categories of space, time and cause. Its specialty is that it emphasizes wonder, fantasy and fictitiousness. The most famous Croatian women writers of fairy tales are presented in this thesis. Ivana Brlić-Mažuranić, a Croatian writer who acquired the name “Croatian Andersen” because of her fairy tales. She started her literary work on the private level, writing for her own children, and continuing it with impressionist poetry, Ivana Brlić-Mažuranić chose a different path, away from the literary mainstream introducing Slavic Mythology into the classic fairy tale frame as well as the Croatian folklore and Christian worldview. Her pen produced the most important work Croatian Tales of Long Ago which unites eight fairy tales. The way towards (post)modern fairy tale was paved by women writers Sunčana Škrinjarić and Nada Iveljić. Sunčana Škrinjarić enriched contemporary fairy tale with her numerous modern fairy tales. The thesis also looks into her work based on a fairy tale, into the structure of literary reality, characters and means which are recognizable in the modern fairy tale. The third author analysed in this thesis is Nada Iveljić. Her collection Šestinski kišobran is used to examine the author’s experience of folk a nd art fairy tales as well as the folk treasure and cultural heritage in general. The structure and the meaning of her fairy tales is also analysed. The thesis is also about the influence, connection, similarities and differences in writing fairy tales of the three women writers. Similarities and differences between their poetics is analysed in an effort to form a bigger picture of the position, type and function of a fairy tale in the context of Croatian (children’s) literature

Otpornost na acetilsalicilnu kiselinu u kasnom poslijeoperacijskom razdoblju nakon kirurške revaskularizacije miokarda [Aspirin resistance in late postoperative period after coronary artery bypass grafting]

Study goals: In patients after coronary artery bypass grafting during the early postoperative stage there is a higher prevalence of aspirin resistance. Data concerning the issue of aspirin resistance in the late postoperative period are rare. Clinical impact of aspirin resistance has not yet been thoroughly investigated. The primary objective of this dissertation was to assess the prevalence of laboratorically defined aspirin resistance during the late postoperative period after CABG (1-6 months after the procedure) using the method of whole blood impedance aggregometry. Furthermore, by assessing primary and secondary endpoints, this study will attempt to show to which extent the laboratorically defined high on-aspirin platelet reactivity is clinically relevant with regard to major adverse cardiac events. Also we are addressing the impact of high aspirin dose on the prevalence of aspirin resistance as well as its clinical significance. Study design: Prospective monocentric randomized controlled study with 2 years follow-up period. Patients and methods: We enrolled 300 consecutive patients over 18 years old admitted to three week stationary cardiac rehabilitation after CABG meeting all the inclusion criteria: CABG 1-6 months prior to admission and antiaggregation monotherapy with ASK 100 mg daily (enteric or non-enteric form). To assess aspirin resistance we used whole blood impedance aggregometry with Multiplate® analizer (Multiple platelet function analyzer). Residual platelet activity on-aspirin treatment was measured with ASPI and TRAP test. With respect to impedance aggregometry results two groups of patients were formed: group 1 included patients with significantly depleted platelet function (aspirin sensitive patients) and group 2 included patients with high on-aspirin platelet reactivity (aspirin resistant patients). Group 2 patients were afterwards randomized in subgroup 2A (increased the dosage of ASK to 300 mg daily) and subgroup 2B (100 mg ASK daily) Upon discharge patients were contacted via telephone after a period of 6 months, one year and again after two years which was the overall follow-up period in this research. Primary end point of this study was cardiovascular death. Secondary end points were: recurrent myocardial infarction, progressive or new onset angina pectoris, recurrent myocardial revascularization (PCI or CABG), heart failure or arrhythmias which demanded hospitalization, complications of antiaggregation therapy which demanded hospitalization, stroke and overall mortality. Results: Prevalence of aspirin resistance in late postoperative phase after CABG was rather high 40, 3%. The value of ASPI test in late postoperative period in patients after CABG proved to be clinically non-significant in regard to major adverse cardiac events. Increasing the dose of ASA from 100 mg up to 300 mg daily we achieved significant reduction of repeated ASPI test values as expected (P<0,001). Repeated ASPI test values in 2B subgroup of patients at the end of cardiac rehabilitation were also significantly lower (P<0,001) in comparison with initial testing, although in absolute values still within the range of aspirin resistance. There were no statistically significant differences in aspirin resistance prevalence in regard to „on-pump“ CABG (P=0,192). In aspirin resistance group we have proven significantly higher prevalence of calcium channel blockers usage (P=0,020), NSTE myocardial infarction (P=0,007), dyslipidemia (P=0,029) statin usage (P=0,032), higher age (P=0,036) and higher BMI values (P=0,040). Statistically significant differences between two groups have also been proven in relation to number of grafts, platelet count, SDNN values and serum creatinine values. Conclusion: ASPI test results had no predictive value with respect to prevalence of major adverse cardiac events. The only independent predictor of major primary and secondary cardiovascular events was the result of TRAP test above the upper reference range limit (<151). The latter constitutes a significant scientific contribution taking into consideration the fact that there are so far no available data on TRAP test predictive value in aspirin resistant CABG patients. Patients’ compliance with respect to antiaggregation therapy is an imperative when addressing the topic of aspirin resistance prevalence. The results of our study did not reveal any significant differences in mortality or prevalence of major adverse cardiac events between two groups of patients. Whether or not to routinely test the platelet response to aspirin therapy still remains an unanswered question. Further studies including early and late postoperative period after CABG on greater number of patients using guidelines oriented antiaggregation therapy are needed in order to define more accurately the independent predictive factors of aspirin resistant CABG patients’ prognosis

The history of kidney transplantation in the Sušak hospital

Transplantacija bubrega najučinkovitija je metoda nadomještanja bubrežne funkcije. Iako prvi počeci transplantacije datiraju iz druge polovice 19. stoljeća, razvoj transplantacije seže u drugu polovicu 20. stoljeća. U bolnici na Sušaku prvi eksperimentalni kirurški postupci koji su prethodili zahvatima na ljudima počeli su 1966. godine. Razvoj transplantacije bubrega omogućilo je uvođenje dviju drugih metoda nadomještanja bubrežne funkcije – hemodijalize i peritonejske dijalize. Time su stečeni uvjeti za razvoj svih metoda nadomještanja bubrežne funkcije do danas. Prva transplantacija bubrega sa živog davatelja u bolnici na Sušaku izvršena je 31. siječnja 1971., a godinu dana kasnije i prva transplantacija bubrega s umrlog davatelja. Posljednjih 40 godina napredak transplantacijske medicine u Rijeci i Hrvatskoj rezultirao je činjenicom da je Rijeka i danas jedan od vodećih transplantacijskih centara u Hrvatskoj, a od 2003. godine Klinika za urologiju je Referentni centar Ministarstva zdravstva za transplantaciju bubrega. Daljnji razvoj transplantacije bubrega ali i dijalize u Rijeci neupitan je, temelji se na velikom iskustvu, stručnosti, znanstvenom radu brojnih naraštaja liječnika i medicinskih sestara, a osigurava se trajnom edukacijom mladih kroz brojne nastavne sadržaje na Medicinskom fakultetu Sveučilišta u Rijeci.Kidney transplantation is the most efficient method of renal replacement therapy (RRT). Although first surgical activities were performed in the 19th century, real development of the kidney transplantation occured in the second part of 20th century. In the Sušak hospital, first experimental surgical acts on the animal models started in year 1966. Development of kidney transplantation was possible after the introduction of two other methods for RRT – hemodialysis and peritoneal dialysis. The first kidney transplantation from living related donor in the Sušak hospital was performed on January 31st 1971, one year after first transplantation from cadaveric donor. In the last 40 years, development of transplantation medicine in Rijeka and Croatia was succesful and Rijeka is one of the top transplantation centers in Croatia today. From year 2003, Clinic for urology developed the Referrent center for kidney transplantation under auspicies of the national Ministry of Health. Development of both kidney transplantation and dialysis became possible on the base of the great experience, knowledge and scientific work of generations of doctors and nurses. Permanent education in the field of RRT of the young generation is a continuous process at the Faculty of Medicine, University of Rijeka

Bajke Ivane Brlić-Mažuranić i suvremene bajke: komparativni pristup

U ovom diplomskom radu govori se o bajci, podijeli na klasičnu i modernu bajku, te povijesnom pregledu svjetskih i hrvatskih bajki. Postoje različita tumačenja bajke, a jedno od njih opisuje bajku kao priču čudesnog sadržaja sa svojim kategorijama prostora, vremena i uzroka. Njezina posebnost je u tome što ističe čudesnost, fantastičnost i izmišljenost. U radu su predstavljene najpoznatije hrvatske književnice koje su pisale bajke. Ivana Brlić–Mažuranić hrvatska spisateljica koja je, pišući bajke, stekla zvučni naziv „hrvatskog Andersena“. Započevši svoj književni rad u privatnim okvirima, pišući prvenstveno za vlastitu djecu, i nastavljajući ga impresionističkom poezijom, Ivana Brlić–Mažuranić odabrala je otklon od književne matice uvodeći u ruho klasične bajke slavensku mitologiju, hrvatski folklor i kršćanski svjetonazor. Iz njenog pera proizašlo je najznamenitije djelo Priče iz davnine koje objedinjuje osam bajki. U hrvatskoj književnosti put prema (post)modernoj bajci utrle su književnice Sunčana Škrinjarić i Nada Iveljić. Sunčana Škrinjarić obogatila je suvremenu bajku brojnim svojim modernim bajkama. Rad se dotiče njenog stvaralaštva na podlozi bajke, ustroja književne zbilje u njemu, likova i sredstava koji su prepoznatljivi u modernoj bajci. Treća autorica koju analiziramo u radu je Nada Iveljić. Temeljem njezine zbirke Šestinski kišobran sagledava se autoričin doživljaj narodnih i umjetničkih bajki te, narodnog blaga i kulturnog naslijeđa uopće. Također, promatra se struktura i značenje njezinih bajki. U radu se govori i o utjecaju, povezanosti, sličnostima i razlikama u pisanju bajki triju književnica te se sagledavanjem sličnosti i razlika između njihovih poetika nastoji dobiti šira slika o položaju, tipu i funkciji bajke u kontekstu hrvatske (dječje) književnosti.This diploma thesis is about a fairy tale, about its classification to classic and modern fairy tale and the historical review of fairy tales worldwide as well as the Croatian ones. There are various explanations of what a fairy tale is and one of them describes it as a story which has miraculous content, with its own categories of space, time and cause. Its specialty is that it emphasizes wonder, fantasy and fictitiousness. The most famous Croatian women writers of fairy tales are presented in this thesis. Ivana Brlić-Mažuranić, a Croatian writer who acquired the name “Croatian Andersen” because of her fairy tales. She started her literary work on the private level, writing for her own children, and continuing it with impressionist poetry, Ivana Brlić-Mažuranić chose a different path, away from the literary mainstream introducing Slavic Mythology into the classic fairy tale frame as well as the Croatian folklore and Christian worldview. Her pen produced the most important work Croatian Tales of Long Ago which unites eight fairy tales. The way towards (post)modern fairy tale was paved by women writers Sunčana Škrinjarić and Nada Iveljić. Sunčana Škrinjarić enriched contemporary fairy tale with her numerous modern fairy tales. The thesis also looks into her work based on a fairy tale, into the structure of literary reality, characters and means which are recognizable in the modern fairy tale. The third author analysed in this thesis is Nada Iveljić. Her collection Šestinski kišobran is used to examine the author’s experience of folk a nd art fairy tales as well as the folk treasure and cultural heritage in general. The structure and the meaning of her fairy tales is also analysed. The thesis is also about the influence, connection, similarities and differences in writing fairy tales of the three women writers. Similarities and differences between their poetics is analysed in an effort to form a bigger picture of the position, type and function of a fairy tale in the context of Croatian (children’s) literature

Surgical pathology

Kirurška patologija najznačajniji je i vremenski najzahtjevniji dio prakse većine patologa. Ima za cilj dati/isključiti definitivnu dijagnozu bolesti temeljeći se na uzorcima tkiva. Dva su glavna tipa tkivnih uzoraka za patološku analizu: biopsije i kirurške resekcije. Četiri su glavna dijela kirurške patologije koji se koriste u konačnoj dijagnostici tkivnih uzoraka: makroskopski pregled, patohistološki pregled koji se temelji na svjetlosnoj mikroskopiji, imunohistokemija i molekularne/citogenetske analize. Rezultat rada patologa je patohistološko izvješće. Ono sadrži makroskopski i mikroskopski opis lezije, dijagnozu ili diferencijalnu dijagnozu. Postoje situacije kada je potrebno dijagnozu postaviti za vrijeme kirurškog zahvata, dok je pacijent pod anestezijom. Tada se koristi hitna ili intraoperacijska biopsija, na smrznutim tkivnim rezovima. Hitna ili intraoperacijska biopsija je hitno stanje u patologiji koje zahtijeva dobru suradnju između kirurga i patologa te iskusnog i dobro educiranog patologa koji je svjestan mogućnosti, ali i ograničenja hitne biopsije. Resekcijski rubovi su rubovi ili površine koje je napravio kirurg. Udaljenost između tumora i resekcijskog ruba naziva se kirurški rub. Kirurški rubovi izuzetno su važni jer pozitivnost rubova korelira s recidivom bolesti. Definicija pozitivnog kirurškog ruba ovisi o vrsti tumora, njegovoj biologiji i lokalizaciji bolesti. Jedan od najvažnijih ciljeva kirurške patologije je dijagnostika malignih bolesti i procjena proširenosti bolesti, odnosno klasifikacija tumora, prema odrednicama Svjetske zdravstvene organizacije. Patološka klasifikacija (p) malignih bolesti označava se kao pTNM (primarni tumor – T, regionalni limfni čvorovi – N, udaljene metastaze – M). Ona se temelji na podacima dobivenim prije kirurškog liječenja uz modifikaciju proizašlu iz patohistološke analize tkiva.The most important part of pathology work is surgical pathology. Its goal is to diagnose or exclude the clinical diagnosis based on tissue samples. Two main types of tissue samples for pathohistologic analyses are biopsies and surgical resections. There are four main parts used in final diagnosis of tissue samples in surgical pathology: macroscopic exam, pathohistologic analysis, immunohistochemistry and molecular/cytogenetic analysis. The result of pathologists’ work is pathohistologic report, which contains macroscopic and microscopic description of a lesion, diagnosis or differential diagnosis. There are situations when diagnosis needs to be established during surgical procedure, while the patient is under anesthesia, so pathologist uses so called intraoperative biopsy or frozen tissue sections. This is an emergency in pathology practice and it requires good cooperation between surgeons and pathologists. The surgical margins are surfaces that were cut by the surgeon. The distance between the tumour and the margin is called surgical margin. Margins are important as an incompletely removed disease process may lead to reccurrence. What defines a positive surgical margin is dependent on the tumour and its biology; definitions of positive margin are dependent on the anatomical site. One of the most important goals of surgical pathology is diagnosis of malignant diseases and assessment of extent of disease, and not less important, tumour classification, defined by World Health Organization. Pathological classification (p) of malignant diseases (or postsurgical pathohistologic classification) is defined as pTNM (T – tumour, N – lymph node, M – distant metastasis). It is based on presurgical clinical data modified by pathohistological data analysis