Smjernice za dijagnostiku i liječenje bolesnika s vratoboljom – 1. dio

Vratobolja je jedna od najčešćih mišićnokoštanih bolesti koja rezultira značajnom boli i nesposobnosti te ima velik utjecaj na individualnoj razini, kao i na zdravstveni sustav i društvo u cjelini. Uzroci vratobolje su različiti, a etiološki prevladavaju oni mehanički povezani s degenerativnim promjenama vratne kralješnice. Svjedočimo raznim dijagnostičkim i terapijskim pristupima za ove bolesnike. Hrvatsko vertebrološko društvo Hrvatskoga liječničkog zbora predstavlja sveobuhvatni narativni pregled i smjernice za dijagnozu i liječenje bolesnika s vratoboljom, s naglaskom na najčešće uzroke. Smjernice su rezultat konsenzusa stručnjaka različitih specijalnosti, a temelje se na najboljim dokazima. Ovaj prvi dio odnosi se na dijagnostiku, a drugi njemu komplementarni dio odnosi se na terapiju. Dijagnostički dio smjernica (1. dio) obuhvaća: klinička obilježja i evaluaciju (uključivo strukturirane upitnike), laboratorijsku dijagnostiku, slikovne metode, neurofiziološko testiranje i minimalno invazivne dijagnostičke postupke. Dio smjernica o liječenju (2. dio) uključuje: farmakološko liječenje, tjelesne medicinske vježbe, trakciju, manualnu terapiju, metode fizikalne terapije, primjenu ortoza, minimalno invazivne terapijske intervencije, kirurško liječenje, rehabilitaciju nakon kirurških zahvata i psihijatrijski pristup. Ovo su prve hrvatske smjernice za vratobolju primarno namijenjene liječničkoj profesionalnoj zajednici

Determination of ecotoxicity of xenobiotics present in the environment

U današnje vrijeme, zbog brzog rasta broja stanovništva dolazi i do sve veće ljudske potražnje za brojnim organskim i anorganskim tvarima. Velika proizvodnja farmaceutika, pesticida, proizvoda za osobnu njegu i dr. zahtjeva zbrinjavanje velike količine otpadnih tvari. Iako postoje uspješni načini zbrinjavanja otpada, uslijed rada metabolizma živih bića te nekontrolirane ljudske aktivnosti, u okoliš svakodnevno dospijevaju brojne sintetske tvari u vrlo niskim koncentracijama. Budući da u okoliš dospijevaju antropogenim putem, te tvari nazivamo ksenobioticima. Nažalost, zbog toga što se u okolišu i nalaze u vrlo malim koncentracijama, često se dugo zadržavaju u okolišu, a mogu imati jaki ekotoksičan učinak na pojedine članove ekosustava. Ovim se radom ispituje upravo njihov negativan učinak na pojedine mikroorganizme, kako bi se utvrdila njihova prava štetnost i kako bi se potencijalno našao način njihova zbrinjavanja. Ksenobiotici ispitivani u ovom radu su farmaceutici diklofenak i pantoprazol radnih koncentracija od 0,125 mg L^-1, 0,5 mg L^-1, 2 mg L^-1, 8 mg L^-1 i 16 mg L^-1. Ispitivane su i njihove smjese u omjerima diklofenaka i pantoprazola 1:1, 1:2 i 2:1 kako bi se odredilo njihovo međudjelovanje. Mikroorganizmi na kojima su se testovi provodili su morska bakterija Vibrio fischeri, bakterija Pseudomonas putida, mikroalga Chlorella sp. i kvasac Saccharomyces cerevisiae. Rezultati su pokazali kako čisti ksenobiotici, kao i njihove smjese imaju snažan ekotoksikološki utjecaj na Vibrio fischeri i Saccharomyces cerevisiae, dok čisti diklofenak negativno utječe na samo 5% populacije Pseudomonas putida s efektivnom koncentracijom od 9,3 mg L^-1 te na 5% populacije Chlorella sp. s efektivnom koncentracijom od 0,8 mg L^-1.Nowadays, due to the rapid growth of the population, there is an increasing human demand for numerous organic and inorganic substances. Large-scale production of pharmaceuticals, pesticides, personal care products and the like requires the disposal of a large amount of waste. Although there are successful ways of disposing the waste, as a result of the metabolism of living beings, as well as the uncontrolled human activity, numerous synthetic substances in very low concentrations reach the environment every day. Since they reach the environment anthropogenically, these substances are called xenobiotics. Unfortunately, due to the fact that they are found in the environment in very small concentrations, they often remain in the environment for a long time, and can have a strong ecotoxic effect on individual members of the ecosystem. This study examines their negative effect on individual microorganisms, in order to determine their true harmfulness and to potentially find a way of their disposal. The xenobiotics tested in this work are pharmaceuticals diclofenac and pantoprazole, with working concentrations of 0.125 mg L^-1, 0.5 mg L^-1, 2 mg L^-1, 8 mg L^-1 and 16 mg L^-1. Their mixtures were also tested in diclofenac and pantoprazole ratios of 1:1, 1:2 and 2:1 to determine their interaction. The microorganisms on which the tests were carried out were marine bacteria Vibrio fischeri, bacteria Pseudomonas putida, microalgae Chlorella sp. and yeast Saccharomyces cerevisiae. The results showed that pure xenobiotics, as well as their mixtures, have a strong ecotoxicological impact on Vibrio fischeri and Saccharomyces cerevisiae, while pure diclofenac has a fatal effect on only 5% of the population of Pseudomonas putida with an effective concentration of 9.3 mg L^-1 and on 5% of the population Chlorella sp. with an effective concentration of 0.8 mg L^-1

Determination of ecotoxicity of xenobiotics present in the environment

U današnje vrijeme, zbog brzog rasta broja stanovništva dolazi i do sve veće ljudske potražnje za brojnim organskim i anorganskim tvarima. Velika proizvodnja farmaceutika, pesticida, proizvoda za osobnu njegu i dr. zahtjeva zbrinjavanje velike količine otpadnih tvari. Iako postoje uspješni načini zbrinjavanja otpada, uslijed rada metabolizma živih bića te nekontrolirane ljudske aktivnosti, u okoliš svakodnevno dospijevaju brojne sintetske tvari u vrlo niskim koncentracijama. Budući da u okoliš dospijevaju antropogenim putem, te tvari nazivamo ksenobioticima. Nažalost, zbog toga što se u okolišu i nalaze u vrlo malim koncentracijama, često se dugo zadržavaju u okolišu, a mogu imati jaki ekotoksičan učinak na pojedine članove ekosustava. Ovim se radom ispituje upravo njihov negativan učinak na pojedine mikroorganizme, kako bi se utvrdila njihova prava štetnost i kako bi se potencijalno našao način njihova zbrinjavanja. Ksenobiotici ispitivani u ovom radu su farmaceutici diklofenak i pantoprazol radnih koncentracija od 0,125 mg L^-1, 0,5 mg L^-1, 2 mg L^-1, 8 mg L^-1 i 16 mg L^-1. Ispitivane su i njihove smjese u omjerima diklofenaka i pantoprazola 1:1, 1:2 i 2:1 kako bi se odredilo njihovo međudjelovanje. Mikroorganizmi na kojima su se testovi provodili su morska bakterija Vibrio fischeri, bakterija Pseudomonas putida, mikroalga Chlorella sp. i kvasac Saccharomyces cerevisiae. Rezultati su pokazali kako čisti ksenobiotici, kao i njihove smjese imaju snažan ekotoksikološki utjecaj na Vibrio fischeri i Saccharomyces cerevisiae, dok čisti diklofenak negativno utječe na samo 5% populacije Pseudomonas putida s efektivnom koncentracijom od 9,3 mg L^-1 te na 5% populacije Chlorella sp. s efektivnom koncentracijom od 0,8 mg L^-1.Nowadays, due to the rapid growth of the population, there is an increasing human demand for numerous organic and inorganic substances. Large-scale production of pharmaceuticals, pesticides, personal care products and the like requires the disposal of a large amount of waste. Although there are successful ways of disposing the waste, as a result of the metabolism of living beings, as well as the uncontrolled human activity, numerous synthetic substances in very low concentrations reach the environment every day. Since they reach the environment anthropogenically, these substances are called xenobiotics. Unfortunately, due to the fact that they are found in the environment in very small concentrations, they often remain in the environment for a long time, and can have a strong ecotoxic effect on individual members of the ecosystem. This study examines their negative effect on individual microorganisms, in order to determine their true harmfulness and to potentially find a way of their disposal. The xenobiotics tested in this work are pharmaceuticals diclofenac and pantoprazole, with working concentrations of 0.125 mg L^-1, 0.5 mg L^-1, 2 mg L^-1, 8 mg L^-1 and 16 mg L^-1. Their mixtures were also tested in diclofenac and pantoprazole ratios of 1:1, 1:2 and 2:1 to determine their interaction. The microorganisms on which the tests were carried out were marine bacteria Vibrio fischeri, bacteria Pseudomonas putida, microalgae Chlorella sp. and yeast Saccharomyces cerevisiae. The results showed that pure xenobiotics, as well as their mixtures, have a strong ecotoxicological impact on Vibrio fischeri and Saccharomyces cerevisiae, while pure diclofenac has a fatal effect on only 5% of the population of Pseudomonas putida with an effective concentration of 9.3 mg L^-1 and on 5% of the population Chlorella sp. with an effective concentration of 0.8 mg L^-1

Novelties in etiopathogenesis, diagnosis and treatment of patients with lumbar intevrertebral disc degeneration

Križobolja je jedan od najčešćih uzroka fizičke nesposobnosti, čije je najčešće izvorište degeneracija intervertebralnog diska. Nemogućnost točnog utvrđivanja potjecišta boli jest ograničavajući čimbenik u učinkovitijoj prevenciji i liječenju. Nova saznanja, napose u područjima genetike i analize proteina primjenom spektrometrije masa, bacaju novo svjetlo u razumijevanju etiopatogeneze degenerativne bolesti diska. Novim slikovnim metodama kao što je CEST magnetska rezonancija ili ADC magnetska rezonancija mogu se detektirati rane degenerativne promjene. Napredak je ostvaren glede razjašnjenja uloge fizičkog opterećenja, kao i tipa vježbi koje mogu imati utjecaj kako na razvoj tako i na liječenje bolesnika s degenerativnim promjenama diska. Na kraju, značajan napredak je ostvaren u kirurškom liječenju tih bolesnika, s naglaskom na minimalno invazivne tehnike. Ostali kirurški modaliteti liječenja su pokazali napredak koji ohrabruje, kao što su totalna zamjena diska i liječenje mezenhimalnim matičnim stanicama. Uz navedeno, i ostale novosti u dijagnostici i liječenju degenerativne bolesti vertebralnog diska raspravljene su u ovom članku.Low-back pain is one of the most common causes of physical disability, most often originating from intervertebral disc degeneration. Lack of pinpointing the exact source of pain is the limiting factor in more efficient prevention and treatment. New findings, especially in the fields of genetics and mass spectometry based protein analysis, shed a new light to the understanding of etiopathogenesis of disc degenerative disease. New imaging methods like chemical exchange saturation transfer (CEST)MRI or apparent diffusion coefficient (ADC)MRI can detect early degenerative changes. Advances have been made regarding elucidating the role of physical load, as well as the type of exercise that can have an impact on the development and treatment of patients with degenerative disc disease. Finally, a significant progress has been made in the surgical treatment ecouraging of these patients, with an emphasis on minimally invasive techniques. Other surgical modalities have also shown improvement, like total disc replacement and mesenchymal stem cells treatments. These, and other novelties in the diagnosis and treatment of degenerative disc disease of lumbar spine are discussed in this article

Stenoza spinalnog kanala slabinske kralježnice – od epidemiologije do rehabilitacije [Lumbar spinal stenosis – from epidemiology to rehabilitation]

Lumbar spinal stenosis (LSS) is becoming an increasingly prevalent condition due to trends of aging population. That is because, although etiologically heterogenous, it is most often the consequence of degenerative changes of the spine. There is no generally accepted classification of LSS. To make the diagnosis of LSS it is crucial to interrelate history, clinical examination and imaging alongside with neurophysiological findings. The treatment of patients with LSS may be conservative (pharmacological and non-pharmacological) and surgical, and in this respect in the latter minimally invasive techniques are preferred lately. In this paper we comprehensively present a state-of-the-art view on LSS

Guidelines for diagnosis and treatment of patients with neck pain – Part 1

Neck pain is one of the most prevalent musculoskeletal diseases which results in considerable pain and disability, and has a great impact on individual level, as well as on health-care system, and overall society. Causes of neck pain are different, and prevailing aetiology are mechanical reasons associated with degenerative changes of cervical spine. We are witnessing various diagnostic and therapeutic approaches for these patients. The Croatian Society for Vertebrology of the Croatian Medical Association is presenting a comprehensive narrative review and guidelines for the diagnosis and treatment of neck pain, focusing on the most prevalent causes. The guidelines are the result of consensus of experts of different background, based on the best available evidence. This part (Part 1) relates to diagnosis, while the complementary part (Part 2) relates to treatment. For the diagnostic part (Part 1) the guidelines encompass: clinical features and evaluation (including questionnaires), laboratory tests, imaging, neurophysiology tests, and minimally invasive diagnostic procedures. The management part (Part 2) includes: pharmacology treatment, physical exercise, traction, manual therapies, physical therapy modalities, orthotics, minimally invasive therapeutic interventions, surgical treatment, rehabilitation after surgical procedures, and psychiatric approach. These are the first Croatian guidelines for neck pain intended in the first place for the physicians’ professional community.Vratobolja je jedna od najčešćih mišićnokoštanih bolesti koja rezultira značajnom boli i nesposobnosti te ima velik utjecaj na individualnoj razini, kao i na zdravstveni sustav i društvo u cjelini. Uzroci vratobolje su različiti, a etiološki prevladavaju oni mehanički povezani s degenerativnim promjenama vratne kralješnice. Svjedočimo raznim dijagnostičkim i terapijskim pristupima za ove bolesnike. Hrvatsko vertebrološko društvo Hrvatskoga liječničkog zbora predstavlja sveobuhvatni narativni pregled i smjernice za dijagnozu i liječenje bolesnika s vratoboljom, s naglaskom na najčešće uzroke. Smjernice su rezultat konsenzusa stručnjaka različitih specijalnosti, a temelje se na najboljim dokazima. Ovaj prvi dio odnosi se na dijagnostiku, a drugi njemu komplementarni dio odnosi se na terapiju. Dijagnostički dio smjernica (1. dio) obuhvaća: klinička obilježja i evaluaciju (uključivo strukturirane upitnike), laboratorijsku dijagnostiku, slikovne metode, neurofiziološko testiranje i minimalno invazivne dijagnostičke postupke. Dio smjernica o liječenju (2. dio) uključuje: farmakološko liječenje, tjelesne medicinske vježbe, trakciju, manualnu terapiju, metode fizikalne terapije, primjenu ortoza, minimalno invazivne terapijske intervencije, kirurško liječenje, rehabilitaciju nakon kirurških zahvata i psihijatrijski pristup. Ovo su prve hrvatske smjernice za vratobolju primarno namijenjene liječničkoj profesionalnoj zajednici

Ružička days : International conference 19th Ružička Days “Today Science – Tomorrow Industry” : Proceedings

Dear colleagues, we are extremely honoured to present to you the Proceedings of the international conference 19th Ružička Days, which was successfully held on September 21–23, 2022, in Vukovar, Croatia, in the hometown town of our famous Croatian scientist and first Nobel laureate, professor Leopold (Lavoslav) Ružička. The main goals of the Conference were to promote excellence, originality and innovation of interdisciplinary scientific research as well as the practical application of the obtained results through collaboration with industry, emphasizing thus the recognizable slogan of the Ružička Days conference: "Today Science – Tomorrow Industry". In addition, the Conference gave the opportunity for meetings, exchanging the ideas, opinions, experiences and cooperation among participants from different working surroundings. It is also important to point out that since 2008, within the international conference Ružička Days, Meeting of Young Chemists has also been held, where high school students, with the help of their mentors, present papers in the field of chemistry, with the aim to direct students and young people to the technical and natural sciences, especially chemistry. In its seventh issue (2011, 2013, 2015, 2017, 2019, 2021) the Proceedings publishes scientific and professional full papers of high quality in the following sections: Chemical analysis and synthesis (10), Chemical and biochemical engineering (3), Food technology and biotechnology (4), Chemistry in agriculture and forestry (1), Environmental protection (9) and 8th Meeting of Young Chemists (3). Full-length papers were subjected to an international review procedure done by eminent experts from the corresponding fields, to whom we express our gratitude, but they were not subjected to linguistic proofreading. On behalf of the Scientific and Organizing Committee of the 19th Ružička Days we cordially thank all the authors, reviewers, participants, lecturers, organizers, especially the international organizers EuCheMS and EHEDG, auspices and sponsors, and all the others who, in any way, supported the Conference and contributed to the preparation of the Proceedings, especially to our highly skilled and committed associates, who have put a lot of effort in the preparation of these Proceedings. At the very end, special thanks to our young, future scientists and their mentors who are faithful participants of the Meeting of Young Chemists of the Ružička Days conference. Enjoy the extremely interesting scientific and professional papers contained in these Proceedings, until the next 20th jubilee of Ružička Days in 2024! We are looking forward to meeting you again in Vukovar! Yours sincerely, Chief Editors Jurislav Babić Vesna Ocelić Bulatović Dajana Kučić Grgi