Traumatske hemolitične anemije: dva prikaza slučaja i pregled literature

Two patients with intravascular hemolysis are presented. One patient had traumatic hemolytic anemia after mechanical heart valve reimplantation, and the diagnosis was made rapidly and easily. In the other patient, the diagnosis was not so easy complex and time-consuming. This patient had both, traumatic hemolytic anemia caused by orthopedic prosthesis, and neutropenia. Fragmentation was caused by interaction of red blood cells with altered intravascular surfaces or by direct physical trauma to the cells due to excessive shear forces in the circulation. The following findings are seen in intravascular hemolysis: decreased hemoglobin, increased reticulocytes and lactic dehydrogenase, decreased serum haptoglobin, and presence of shizocytes in peripheral blood smear. Patients are considered to have intravascular hemolysis when lactic dehydrogenase is >460, along with the presence of two established criteria. If not causal, therapy is supportive.Prikazana su dvojica bolesnika s intravaskularnom hemolizom, od kojih je jedan imao hemolitičnu anemiju nakon ponovljene ugradnje mehaničkog srčanog zalistka i u kojega je dijagnoza bila brza i jednostavna. U drugoga je bolesnika postavljanje dijagnoze zahtijevalo dosta vremena i truda. Ovaj je bolesnik imao mehaničku hemolitičnu anemiju uzrokovanu ortopedskim protezama, ali i neutropeniju. Fragmentacija je bila izazvana interakcijom eritrocita s promijenjenom površinom žile ili izravnom fizikalnom traumom stanica u krvotoku. Kod intravaskularne hemolize prisutni su sljedeći nalazi: sniženi hemoglobin, povišeni retikulociti i laktat dehidrogenaza, sniženi haptoglobin u serumu, te prisutnost shizocita u razmazu periferne krvi. Smatra se da bolesnici imaju intravaskularnu hemolizu kada je laktat dehidrogenaza viša od 460, uz prisutnost dvaju utvrđenih kriterija. Ako nije etiološka, terapija je potporna

AROMATASE INHIBITORS (CYP19) : STRUCTURAL MODIFICATIONS AND IMPORTANCE IN THERAPY

Cilj ovog diplomskog rada je proučavanje mogućeg nastanka karcinoma dojke, uzrokovanog metaboličkim promjenama na estrogenim hormonima, a pod utjecajem enzimskih sustava koji u tim reakcijama sudjeluju. Prikazani su glavni metabolički putovi estrogenih hormona kao i metaboličke promjene lijekova koji se koriste u liječenju karcinoma dojke s posebnim naglaskom na inhibitore aromataze. Opisane su reakcije I. i II. faze biotransformacije kroz koje prolazi najpotentnija treća generacija inhibitora aromataze – anastrozol, letrozol i eksemestan. Anastrozol podliježe N-dealkilaciji, hidroksilaciji i glukuronidaciji. Letrozol podliježe N-dealkilaciji, te pod utjecajem enzima CYP ostaje produkt koji se zove karbinol koji potom podliježe procesu glukuronidacije. Eksemestan podliježe redukciji keto skupine u položaju 17, oksidaciji metilenske grupe u položaju 6, te glukuronidaciji. Opisane su i najvažnije interakcije anastrozola, letrozola i eksemestana.The aim of this graduate thesis is to study the possible emergence of breast cancer caused by metabolic changes on estrogen hormones and under the influence of the enzymatic systems involved in these reactions. The main metabolic pathways of estrogenic hormones have been described as well as the metabolic changes of the drugs used in the treatment of breast cancer with particular emphasis on aromatase inhibitors. The reactions of biotransformation of phases I and II of the most potent third generation of aromatase inhibitors - anastrozole, letrozole and exemestane have been described. Anastrozole is subjected to N-dealkylation, hydroxylation and glucuronidation. Letrozole is subjected to N-dealkylation, and under the influence of the CYP enzymes remains a product called carbinol which is then subjected to the glucuronidation process. The exemestane is subjected to reduction of the keto group at position 17, oxidation of the methylene group at position 6, and glucuronidation. The most important interactions of anastrozole, letrozole and exemestane are also described

AROMATASE INHIBITORS (CYP19) : STRUCTURAL MODIFICATIONS AND IMPORTANCE IN THERAPY

Cilj ovog diplomskog rada je proučavanje mogućeg nastanka karcinoma dojke, uzrokovanog metaboličkim promjenama na estrogenim hormonima, a pod utjecajem enzimskih sustava koji u tim reakcijama sudjeluju. Prikazani su glavni metabolički putovi estrogenih hormona kao i metaboličke promjene lijekova koji se koriste u liječenju karcinoma dojke s posebnim naglaskom na inhibitore aromataze. Opisane su reakcije I. i II. faze biotransformacije kroz koje prolazi najpotentnija treća generacija inhibitora aromataze – anastrozol, letrozol i eksemestan. Anastrozol podliježe N-dealkilaciji, hidroksilaciji i glukuronidaciji. Letrozol podliježe N-dealkilaciji, te pod utjecajem enzima CYP ostaje produkt koji se zove karbinol koji potom podliježe procesu glukuronidacije. Eksemestan podliježe redukciji keto skupine u položaju 17, oksidaciji metilenske grupe u položaju 6, te glukuronidaciji. Opisane su i najvažnije interakcije anastrozola, letrozola i eksemestana.The aim of this graduate thesis is to study the possible emergence of breast cancer caused by metabolic changes on estrogen hormones and under the influence of the enzymatic systems involved in these reactions. The main metabolic pathways of estrogenic hormones have been described as well as the metabolic changes of the drugs used in the treatment of breast cancer with particular emphasis on aromatase inhibitors. The reactions of biotransformation of phases I and II of the most potent third generation of aromatase inhibitors - anastrozole, letrozole and exemestane have been described. Anastrozole is subjected to N-dealkylation, hydroxylation and glucuronidation. Letrozole is subjected to N-dealkylation, and under the influence of the CYP enzymes remains a product called carbinol which is then subjected to the glucuronidation process. The exemestane is subjected to reduction of the keto group at position 17, oxidation of the methylene group at position 6, and glucuronidation. The most important interactions of anastrozole, letrozole and exemestane are also described

Alternative and complementary therapies in children with chronic diseases

Uvod: Pedijatrijski reumatološki bolesnici često koriste komplementarne i alternativne metode (KAM). Unatoč tome, još uvijek se ne zna dovoljno o njihovim koristima i štetnostima. ----- Cilj: Cilj ovog istraživanja je bio utvrditi učestalost i osobitosti uporabe KAM-a u djece s kroničnim reumatološkim bolestima u KBC Sestre milosrdnice, Zagreb, Republika Hrvatska. ----- Ispitanici i metode: Provedeno je presječno istraživanje putem upitnika na roditeljima djece oboljele od kroničnih bolesti u sklopu dogovorenih liječničkih kontrolnih pregleda. ----- Rezultati: 63 roditelja (63%) su koristili najmanje jednu vrstu KAM-a u liječenju kronične bolesti svoje djece. Najčešće upotrijebljeni KAM-ovi su bile tvari biljnog porijekla (30,49%) i ortomolekularna terapija (25%). Primijećeno je da roditelji često koriste više skupina KAM-a. 4 ispitanika (6%) primijetili su nuspojave vezane za korištenje KAM-a. 43 ispitanika (68,25%) nisu obavijestili liječnika o korištenju KAM-a. Ova studija je pokazala da su jači simptomi bolesti povezani s češćim korištenjem KAM-a (p<0,05). ----- Zaključak: Veliki udio pedijatrijskih reumatoloških bolesnika u KBC Sestre milosrdnice koristi komplementarne i alternativne metode (KAM). Većina roditelja ne obavještava liječnika o njihovom korištenju.Introduction: Complementary and alternative methods (CAM) are commonly used by pediatric rheumatology patients. Nonetheless, their advantages and disadvantages still remain unclear. ----- Aim: The aim of this study was to assess the prevalence and patterns of CAM use in children with rheumatic chronic diseases at The University Hospital Center “Sestre milosrdnice”, Zagreb, Croatia. ----- Subjects and methods: A cross-sectional questionnaire study was conducted with parents of children with chronic diseases during routine pediatric rheumatology clinic visits. ----- Results: Sixty-three parents (63%) had used at least one CAM in management of the child’s chronic disease. The most commonly used CAM included herbal remedies (30.49%) and orthomolecular therapies (25%). It was observed that combinations of therapies were used too. Only four CAM users (6%) reported any side effects. Forty-three (68.25%) did not mention CAM use to their doctors. Stronger symptoms were associated with CAM use (p<0.05). ----- Conclusion: A large proportion of pediatric rheumatology patients in UHC “Sestre milosrdnice” are using complementary and alternative methods (CAM). Most respondents are still not discussing their CAM use with pediatric rheumatology specialist

Optimization of phenol removal on activated carbon by batch process : diploma thesis

U ovom radu je provedena optimizacija vezivanja fenola na aktivnom ugljenu. Određen je utjecaj pH, S/L omjera, vremena kontakta i početne koncentracije fenola na učinkovitost vezivanja fenola na aktivnom ugljenu. Rezultati su pokazali najveću učinkovitost uklanjanja fenola na aktivnom ugljenu pri pH o =5,01-9,01, S/L=4 te vrijeme kontakta od 300 minuta za početnu koncentraciju fenola od 990,933 mg/L. Temeljem ravnotežnih rezultata izvršena je optimizacija mase aktivnog ugljena primjenom dvostupanjskog šaržnog procesa.In this paper, the optimization of phenol removal on activated carbon is performed. The influence of pH, S/L ratio, contact time and initial phenol concentration on the sorption efficiency of phenol removal on activated carbon is determined. The results showed the highest phenol removal efficiency of activated carbon is achieved at pH o =5.01-9.01, S/L=4 and a contact time of 300 minutes for an initial phenol concentration of 990.933 mg/L. Based on the equilibrium results, the mass of activated carbon is optimized using a two-stage batch process

Photovoltaic Panels: A Review of the Cooling Techniques

In this paper, current advances in cooling techniques and temperature control of photovoltaic (PV) panels in general, are analyzed and discussed. Namely, it is well known that a decrease in the panel temperature will lead to an increase in electrical efficiency, so in recent years different cooling techniques have been proposed and tested experimentally. The efficiency drops with the rise in temperature, with a magnitude of approximately 0.5 %/°C. Several cooling techniques have been tried, mostly based on active water and air cooling, as these are the simplest techniques. Other cooling techniques include conductive cooling, phase-change material cooling, etc. Increase in electrical efficiency depends on cooling techniques, type and size of the module, geographical position and the season of the year, and usually corresponds with a rise of 3-5 % in overall efficiency. Finally, a perspective on the other cooling techniques for PV panels will be also elaborated on and discussed in this paper

The land of milk and honey?: young Croatians’ identities and perceptions as drivers of migration desire

IN ENGLISH: Taking up the Croatian case and the gap in the literature concerning non-economic, micro-level drivers of migration, this article explores young peoples’ identity, and the perceptions of their country and the European Union. Survey data is analysed by means of hierarchical linear regression, aiming to answer the question to what extent the selected non-economic variables play a role in youth migration desire. Overall, the results show that these drivers do play a certain role. While perception of the EU seems to be irrelevant for young people’s migration desire, perception of Croatia is associated with it. Likewise, a stronger national identity acts as an inhibiting force. When comparing the EU and Croatia, young people do not demonstrate a defined vision of the EU, seeing it as a place where almost everything is better. In contrast, their opinion on Croatia is more nuanced, which makes variables connected to their local context more relevant. --------------- IN CROATIAN: Istražujući slučaj Hrvatske, u radu se propituju mikro pokretači migracijskih želja mladih. Rad je usmjeren na identitet i percepciju vlastite zemlje i Europske unije. Koristeći podatke iz ‘Friedrich Ebert Stiftung (FES) Youth Studies Southeast Europe 2018’ istraživanja, hijerarhijskom linearnom regresijom pristupa se glavnom istraživačkom pitanju - igraju li odabrani mikro-pokretači ulogu u jačini namjere odlaska mladih? U okviru uzorka na kojem je rađeno istraživanje, 32.5% mladih iskazalo je želju za odlaskom, a najveći ih je broj kao glavnu motivaciju naveo poboljšanje standarda života ili bolje zaposlenje. Unatoč tome, rezultati statističke analize općenito pokazuju da spomenuti mikro pokretači imaju određenu ulogu. Povjerenje EU i europski identitet čine se nevažni za odlučivanje mladih o migracijama. Percepcija Hrvatske je, međutim, povezana s njom, na način da veće iskazano povjerenje i veći osjećaj zastupljenosti interesa mladih u nacionalnoj politici smanjuje želju za odlaskom. Isto tako, snažniji nacionalni identitet može djelovati kao inhibitor želje za odlaskom. Uspoređujući EU i Hrvatsku, razlika između dvoje također pokazuje vezu s jačinom namjere odlaska. Mladi ne pokazuju definiranu viziju EU, već je vide kao mjesto gdje je gotovo sve bolje. Nasuprot tome, njihovo je mišljenje o Hrvatskoj nijansiranije, što zaključujemo s obzirom na veće razlike u odgovorima mladih na pitanja koja se odnose na ne-ekonomsko stanje u državi. Ostali čimbenici koji su bili kontrolirani pokazali su statističku povezanost, i to spol, razina obrazovanja, važnost Boga, financijska situacija kućanstava i postojeće transnacionalno iskustvo