Emerging infections

U radu su prikazane neke nadolazeće infekcije: Humani herpes virus tip 6 (HHV-6) je prvi put izoliran 1986., a 1988. je otkriveno daje uzročnik rozeole infantum. HHV-6 se povezuje sa encefalitisom, febrilnom bolešću sličnoj infekcijskoj mononukleozi, kao uzročnik mijelopatije, a spominje se i u patogenezi multiple skleroze. Prvi slučaj humane erlihioze u SAD-u je registriran 1987. g. Erlihije su male, gram negativne, obligatno intracelulame bakterije. Humanu monocitnu erlihiozu (HME) uzrokuje Ehrlichia chafeensis, a humanu granulocitnu erlihiozu (HGE) Ehrlichia phagocitophyla. Obje bolesti se stječu ubodom krpelja. Bolest mačjeg ogreba je prvi put spomenuta 1950. g. ali je uzročnik bolesti otkriven tek 1983. g. Očituje se benignom limfadenopatijom u djece i mladeži. Bacilama angiomatoza je prvi put opisana 1983. Obično se javlja u ljudi oboljelih od AIDS-a.The present paper describes some emerging infections. Human herpes virus-6 (HHV-6) was first isolated in 1986. In 1988, HHV-6 was identified as a causative agent of roseola infantum. HHV-6 has been associated with encephalitis, a mononucleosis-like febrile illnes, as a causative agent of myelophaty, and in the pathogenesis of multiple sclerosis. The first case of human ehrlichiosis in the United States was reported in 1987. Ehrlichiae are small, obligate intracellular bacteria with a gram-negative type cell wall. The causative agent of human monocytic ehrlichiosis (HME) is Ehrlichia chaffeensis, and the causative agent of human granulocytic ehrlichiosis (HGE) is Ehrlichia phagocythophila. Both HME and HGE are acquired by tick bite. Cat scratch disease was first reported in 1950, but causative organism has not been identified until 1983. Cat scratch disease is the most common cause of benign lymphadenopathy in children and young adults. Bacillary angiomatosis was originally described in 1983. It occurs most commonly in patients with AIDS

Emerging infections

U radu su prikazane neke nadolazeće infekcije: Humani herpes virus tip 6 (HHV-6) je prvi put izoliran 1986., a 1988. je otkriveno daje uzročnik rozeole infantum. HHV-6 se povezuje sa encefalitisom, febrilnom bolešću sličnoj infekcijskoj mononukleozi, kao uzročnik mijelopatije, a spominje se i u patogenezi multiple skleroze. Prvi slučaj humane erlihioze u SAD-u je registriran 1987. g. Erlihije su male, gram negativne, obligatno intracelulame bakterije. Humanu monocitnu erlihiozu (HME) uzrokuje Ehrlichia chafeensis, a humanu granulocitnu erlihiozu (HGE) Ehrlichia phagocitophyla. Obje bolesti se stječu ubodom krpelja. Bolest mačjeg ogreba je prvi put spomenuta 1950. g. ali je uzročnik bolesti otkriven tek 1983. g. Očituje se benignom limfadenopatijom u djece i mladeži. Bacilama angiomatoza je prvi put opisana 1983. Obično se javlja u ljudi oboljelih od AIDS-a.The present paper describes some emerging infections. Human herpes virus-6 (HHV-6) was first isolated in 1986. In 1988, HHV-6 was identified as a causative agent of roseola infantum. HHV-6 has been associated with encephalitis, a mononucleosis-like febrile illnes, as a causative agent of myelophaty, and in the pathogenesis of multiple sclerosis. The first case of human ehrlichiosis in the United States was reported in 1987. Ehrlichiae are small, obligate intracellular bacteria with a gram-negative type cell wall. The causative agent of human monocytic ehrlichiosis (HME) is Ehrlichia chaffeensis, and the causative agent of human granulocytic ehrlichiosis (HGE) is Ehrlichia phagocythophila. Both HME and HGE are acquired by tick bite. Cat scratch disease was first reported in 1950, but causative organism has not been identified until 1983. Cat scratch disease is the most common cause of benign lymphadenopathy in children and young adults. Bacillary angiomatosis was originally described in 1983. It occurs most commonly in patients with AIDS

TREATMENT GUIDELINES FOR PATIENTS WITH GENOTYPE 1 CHRONIC HEPATIS C INFECTION

Standard liječenja kroničnog hepatitisa C genotipa 1 do 2011. godine bila je kombinacija pegiliranog interferona-alfa 2a ili 2b (PEG IFN-α2) i ribavirina. Slijedom odobrenja novih, učinkovitijih lijekova tzv. prve generacije inhibitora virusnih proteaza boceprevira i telaprevira za kliničku primjenu u Europi i SAD-u 2011. g., postoji potreba osuvremenjivanja nacionalnih smjernica za liječenje kroničnog hepatitisa C genotipa 1 u Hrvatskoj. Pri donošenju novih preporuka za liječenje kroničnog hepatitisa C genotipa 1 u Hrvatskoj uzeli smo u obzir rezultate registracijskih studija za boceprevir i telaprevir, postojeće nacionalne smjernice u EU (Velika Britanija, Švedska, Njemačka, Francuska i Italija), preporuke EASL i AASLD te vlastita iskustva u dosadašnjem liječenju bolesnika s kroničnim hepatitisom C genotipa 1 dvojnom terapijom. U tekstu su navedene preporuke za prethodno neliječene kao i liječene bolesnike prema vrsti prethodnog virološkog odgovora. Kod neliječenih bolesnika s niskim stadijem fibroze, te povoljnim prediktorima virološkog odgovora preporuča se nadalje liječenje dvojnom terapijom. Liječenje trojnom terapijom preporuča se za neliječene bolesnike s visokim stadijem fibroze (F3 i F4), kao i one s umjerenim stadijem fibroze (F2) i kombinacijom nepovoljnih prediktora za izliječenje dvojnom terapijom (stariji >40 godina, non-CC IL28B genotip, non-RVR). U skupini prethodno liječenih bolesnika trojna terapija se preporuča za relapsere bez obzira na stadij fibroze, parcijalne respondere s visokim stadijem fibroze (F3 i F4), te individualni pristup u primjeni trojne terapije za nul-respondere.Dual therapy based on the combination of pegylated interferon-alpha 2a or 2b (PEG IFN-α2) and ribavirin has been considered standard-of-care treatment for chronic hepatitis C genotype 1 up to 2011. The first generation of protease inhibitors, boceprevir and telaprevir, have been approved for clinical use in Europe and USA since 2011. Therefore, national guidelines for the treatment of chronic hepatitis C genotype 1 have been updated to include new and more efficient therapeutic options. Croatian guidelines are based on the results of registration clinical trials for boceprevir and telaprevir, national guidelines of several EU countries (United Kingdom, Sweden, Germany, France and Italy), EASL and AASLD recommendations, as well as on the results of chronic hepatitis C genotype 1 treatment with dual therapy at the national level. The Croatian guidelines include recommendations for treatment-naïve and treatment-experienced patients (based on the type of virologic response to the first-line treatment). In treatment-naïve patients with mild fibrosis and favorable predictors of treatment outcome, dual therapy is the recommended treatment option. In treatment-naïve patients with advanced fibrosis (F3 and F4) as well as in patients with moderate fibrosis (F2) and unfavorable predictors of treatment outcome (age >40 years, non-CC IL-28B genotype, non-RVR), triple therapy is recommended. Triple therapy is also recommended for relapsers (irrespective of fibrosis stage) and partial responders with advanced fibrosis (F3 and F4). Lead-in treatment strategy during triple therapy is recommended for null-responders

Dynamic analysis of cable-stay and suspension bridges

Dinamička ispitivanja zavješenih i visećih mostova prikazana su na primjerima Mosta Franja Tuđmana u Dubrovniku i pješačkog mosta u Osijeku. Kako je utjecaj dinamičkih djelovanja na zavješene i viseće mostove veći nego na druge tipove mostova veća je i potreba za njihovu eksperimentalnu verifikaciju. Prikazani su rezultati eksperimentalno određenih dinamičkih parametara (vlastitih frekvencija i prigušenja) prikupljenih u različitim vremenskim intervalima te njihove usporedbe.The dynamic analysis of cable-stay and suspension bridges is presented through case studies of the Franjo Tuđman Bridge in Dubrovnik, and the pedestrian bridge in Osijek. As the impact of dynamic actions on cable-stay and suspension bridges is greater when compared to other bridge types, the need for their experimental verification is also greater. The results of experimentally defined dynamic parameters (eigenfrequency and damping), measured at various time intervals, are presented and compared

TREATMENT GUIDELINES FOR PATIENTS WITH GENOTYPE 1 CHRONIC HEPATIS C INFECTION

Standard liječenja kroničnog hepatitisa C genotipa 1 do 2011. godine bila je kombinacija pegiliranog interferona-alfa 2a ili 2b (PEG IFN-α2) i ribavirina. Slijedom odobrenja novih, učinkovitijih lijekova tzv. prve generacije inhibitora virusnih proteaza boceprevira i telaprevira za kliničku primjenu u Europi i SAD-u 2011. g., postoji potreba osuvremenjivanja nacionalnih smjernica za liječenje kroničnog hepatitisa C genotipa 1 u Hrvatskoj. Pri donošenju novih preporuka za liječenje kroničnog hepatitisa C genotipa 1 u Hrvatskoj uzeli smo u obzir rezultate registracijskih studija za boceprevir i telaprevir, postojeće nacionalne smjernice u EU (Velika Britanija, Švedska, Njemačka, Francuska i Italija), preporuke EASL i AASLD te vlastita iskustva u dosadašnjem liječenju bolesnika s kroničnim hepatitisom C genotipa 1 dvojnom terapijom. U tekstu su navedene preporuke za prethodno neliječene kao i liječene bolesnike prema vrsti prethodnog virološkog odgovora. Kod neliječenih bolesnika s niskim stadijem fibroze, te povoljnim prediktorima virološkog odgovora preporuča se nadalje liječenje dvojnom terapijom. Liječenje trojnom terapijom preporuča se za neliječene bolesnike s visokim stadijem fibroze (F3 i F4), kao i one s umjerenim stadijem fibroze (F2) i kombinacijom nepovoljnih prediktora za izliječenje dvojnom terapijom (stariji >40 godina, non-CC IL28B genotip, non-RVR). U skupini prethodno liječenih bolesnika trojna terapija se preporuča za relapsere bez obzira na stadij fibroze, parcijalne respondere s visokim stadijem fibroze (F3 i F4), te individualni pristup u primjeni trojne terapije za nul-respondere.Dual therapy based on the combination of pegylated interferon-alpha 2a or 2b (PEG IFN-α2) and ribavirin has been considered standard-of-care treatment for chronic hepatitis C genotype 1 up to 2011. The first generation of protease inhibitors, boceprevir and telaprevir, have been approved for clinical use in Europe and USA since 2011. Therefore, national guidelines for the treatment of chronic hepatitis C genotype 1 have been updated to include new and more efficient therapeutic options. Croatian guidelines are based on the results of registration clinical trials for boceprevir and telaprevir, national guidelines of several EU countries (United Kingdom, Sweden, Germany, France and Italy), EASL and AASLD recommendations, as well as on the results of chronic hepatitis C genotype 1 treatment with dual therapy at the national level. The Croatian guidelines include recommendations for treatment-naïve and treatment-experienced patients (based on the type of virologic response to the first-line treatment). In treatment-naïve patients with mild fibrosis and favorable predictors of treatment outcome, dual therapy is the recommended treatment option. In treatment-naïve patients with advanced fibrosis (F3 and F4) as well as in patients with moderate fibrosis (F2) and unfavorable predictors of treatment outcome (age >40 years, non-CC IL-28B genotype, non-RVR), triple therapy is recommended. Triple therapy is also recommended for relapsers (irrespective of fibrosis stage) and partial responders with advanced fibrosis (F3 and F4). Lead-in treatment strategy during triple therapy is recommended for null-responders

Operator’s whole body vibrations dependent of agrotechnical surface, speed of movement and seat upholstery

The paper presents the recorded vibrations that affect the operator’s body when an agricultural tractor moves along three types of agrotechnical surfaces, i.e. asphalt, an alfalfa field, and a field path, and when seven different tractor seat upholsteries are used. The research was performed in accordance with the HRN ISO 2631-1 and HRN ISO 2631-4 standards. The tractor used in the research was an IMT 560 and the duration of the measurement was 30 minutes, which was repeated three times for every tractor seat upholstery type. The research was exploitative. The measurements were performed using an MMF VM30 meter. The paper reveals a different level of vibrations in dependence with different surfaces and seat upholsteries. The fewest vibrations were produced by asphalt, and the best upholsteries are memory foam and sponge

Adjusted Blood Requirement Index as Indicator of Failure to Control Acute Variceal Bleeding

Aim: To estimate the clinical value of adjusted blood requirement index (ABRI) in relation to other criteria for failure of variceal bleeding control proposed at Baveno consensus workshops and to evaluate ABRI as an early predictor of occurrence of other Baveno criteria and identification of possible predictors of unfavorable ABRI. Methods: We retrospectively analyzed the data on 60 patients admitted to the hospital due to acute variceal bleeding. Number of treatment failures according to Baveno II-III and Baveno IV definitions and criteria was compared. We tested the ABRI’s predictability of other Baveno IV and Baveno II-III criteria. Logistic regression analysis was performed to ascertain independent variables that predict ABRI≥0.75. Results: Failure to control variceal bleeding occurred in 40 of 60 patients according to Baveno II-III criteria, and in 35 of 60 patients according to Baveno IV criteria. Excluding the criterion of “transfusion of 2 units of blood or more (over and above the previous transfusions)”and ABRI criterion, failure to control variceal bleeding was observed in 17 and 14 of 60 patients, respectively. Congruence of ABRI with other criteria was present in about two-thirds of the cases. ABRI≥0.75 was associated with increased risk of positive other Baveno criteria,particularly modified Baveno II-III (odds ratio [OR] 4.10; 95% confidence interval [CI], 1.11-15.05) and Baveno IV without ABRI (OR 4.37; 95% CI, 1.04-18.28). Independent predictors of ABRI≥0.75 identified in logistic regression analysis were male sex (P<0.001) and higher hematocrit values (P=0.004). Conclusion: We found low congruence between ABRI and other Baveno criteria. It seems that criteria related to the quantity of blood transfusions are not reliable indicators of treatment failure

Influence of an uneven surface on the vibration occurrence affecting the tractor operator

The paper presents a study of the influence of an uneven surface and number of tractor hours on vibration that is transmitted to the operator\u27s hand-arm system during operation. The study was conducted on the asphalt, gravel and grass traversal during 2015 and 2016. The results indicate that the movement of a tractor on different agrotechnical surfaces generates vibrations of varying intensity that affect the hand-arm system of the operator. The highest vibration values were recorded on the asphalt, while the least vibrations were measured on the grass. The measured maximum vibration values are lower than the permissible 5 m·s−2 in the direction of all three axes, making it possible to assume that they are not harmful to the health of the operator

Positive interaction of industrial and recycled steel fibres in fibre reinforced concrete

In line with current ”green” transport initiatives, Croatia plans to build over the next investment period a high speed railway line which will connect central Croatia and its capital with coastal regions of the country. According to design documents, the track system will be built using ballastless concrete solutions. In the scope of the project “Concrete track system – ECOTRACK”, researchers from the University of Zagreb - Faculty of Civil Engineering analysed a new material, i.e. the rubberized hybrid fibre reinforced concrete (RHFRC), in order to find out whether its properties are adequate for the proposed concrete track system. The RHFRC contains by-products from mechanical recycling of waste tyres (rubber and steel fibres). The study of fibre and rubber interaction and their contribution to mechanical properties of the fibre reinforced concrete is presented, as extensive research on positive interaction between industrial and recycled steel fibres has not as yet been made. The results show that the RHFRC is an innovative, sustainable and cost-effective concrete, which is fully compliant with criteria prescribed in relevant standards

STATIČKO I DINAMIČKO ISPITIVANJE BETONSKIH ŽELJEZNIČKIH PRAGOVA

Trajnost i mehanička otpornost pragova važan su čimbenik u održavanju željezničkih kolosijeka. Kako bi se osigurao očekivani vijek trajanja od otprilike 50 godina, pragovi moraju zadovoljiti stroge i opsežne zahtjeve ispitivanja propisane europskim normama. U radu su prikazana eksperimentalna ispitivanja betonskih željezničkih pragova tipa PB-85K koja su provedena prema normi HRN EN 13230-2:2016. Prikazani rezultati statičkih, dinamičkih i ispitivanja na zamor pokazuju to da ispitani pragovi imaju znatne rezerve u odnosu na uvjete tražene normom