Optimalno vrijeme kirurške korekcije anomalija u djece

Autori opisuju glavne osobitosti prirođenih mana odnosno novorođenačke kirurgije.  Navode se značajne prirođene mane koje vitalno ugrožavaju novorođenče i ulaze u područje hitnih stanja. Opisuju se pojedine mane s glavnim dijagnostičkim i terapeutskim postupcima, a naglašava se vrijeme kada je potrebno učiniti operaciju.Također se navode prirođene mane u širem smislu, od veće važnosti radi učestalosti, i vrijeme kada se preporuča operativno liječenje

CROADA – our experience in fight against doping in sport

Podliježući različitim pritiscima, od vlastitog samodokazivanja do utjecaja roditelja, trenera i šire društvene zajednice radi slave i novca, sportaši se često nalaze u iskušenju da koriste zabranjena sredstva u svrhu poboljšanja rezultata. Ta sredstva djeluju na povećanje mišićne snage i mase, otklanjaju umor, maskiraju druga zabranjena sredstva prilikom testiranja, dovode do bržeg oporavka, ali imaju niz drugih učinaka, vrlo često štetnih po zdravlje. Primjena zabranjenih sredstava u suprotnosti je s tjelesnim i mentalnim integritetom sportaša i sportskom etikom. Poznatiji naziv za primjenu zabranjenih sredstava je doping i predstavlja jedan od najvećih problema u sportu. U zabranjena sredstva ubrajamo zabranjene supstancije i zabranjene metode. Da bi se neko sredstvo našlo na popisu zabranjenih sredstava potrebno je zadovoljiti dva od tri sljedeća kriterija: poboljšanje izvedbe, štetnost po zdravlje ili nespojivost s duhom sporta. Borba protiv dopinga u sportu već je dugi niz godina strateški važna, kako na nacionalnom tako i na globalnom nivou. Države, Međunarodni olimpijski odbor, međunarodne sportske federacije, nacionalni sportski savezi te različita vladina tijela i nevladine udruge uključeni su u kreiranje politike i strategije za borbu protiv dopinga u sportu. Rezultat tih nastojanja je osnivanje svjetske agencije za borbu protiv dopinga u sportu (WADA) 1999. i po uzoru na nju nacionalnih agencija za borbu protiv dopinga u sportu. Hrvatska agencija za borbu protiv dopinga u sportu (HADA) osnovana je 2007. s ciljem promicanja sporta bez dopinga i zaštite sportaša od neželjenih posljedica.Athletes are often tempted to take prohibited agents with the aim of performance enhancing because of diff erent pressures they face, including self-affi rmation, the infl uence of moneyand glory-driven parents, coaches and community members. Th ese agents increase body mass and power, relieve fatigue, mask other prohibited substances during testing, lead to faster recovery and have many other adverse eff ects on health. Th e use of prohibited agents, commonly known as doping, is detrimental to the mental and physical health of athletes and violates the rules of ethical conduct. The prohibited agents include prohibited substances and prohibited methods. For a substance or a method to be included on the Prohibited List published by the World Anti-Doping Agency (WADA) it has to meet at least two of the following three criteria: it enhances sport performance, it represents an actual or potential health risk to athlete or it violates the spirit of sport. The fight against doping has, for a long time, been a strategic goal at both national and global level. Countries, the International Olympic Committee, international sport federations, national sport associations and various government and non-governmental organizations have been making considerable efforts in creating policies and strategies for the fi ght against doping in sport. In 1999 these efforts resulted in the establishment of the World Anti-Doping Agency (WADA). Subsequently, many of the national anti-doping agencies were founded. Croatian Anti-doping Agency (CROADA) was founded in 2007 with the aim of promoting doping-free sport and protecting athletes from adverse health effects

Surgical treatment of hypospadias by poljugan procedure -presentation of the original four-stage technique

Poljuganova metoda je izvorna operacijska tehnika u četiri akta za primarnu i za "salvage" korekciju penoskrotalne, te proksimalne i srednje penilne hipospadije. Operacijski je postupak danas sažet u tri akta, od kojih prvi predstavlja jednodnevni mali kirurški zahvat u trajanju od nekoliko minuta. Za rekonstrukciju uretre Poljugan koristi poprečni, dvoobrazni prepucijalni režanj s peteljkom, karakteriziran kožom bez dlaka. Operacija uključuje fenestraciju prepucija i formiranje režnja, transpoziciju mobiliziranog režnja na ventralnu stranu penisa i formiranje tubusa nove uretre ušivanjem režnja na uretralnu ploču, od meatusa do vrha glansa. Kirurški postupak je krajnje jednostavan i podudarnog je, ili kraćeg, ukupnog trajanja u usporedbi s tehnikama u jednom aktu. U protekla četiri desetljeća u nas je ovom metodom operacijski tretirano 1.048 bolesnika, s vrlo dobrim, ali epidemiološki neprocijenjenim ishodom, što predstavlja najveću seriju u Republici Hrvatskoj i u bivšoj Jugoslaviji.Poljugan procedure is an original four-stage technique for primary and salvage repair of penoscrotal and also proximal and mid-penile hypospadias. This procedure has recently been reduced to three stages, the first of which comprises an outpatient minor one-day surgery, lasting for a few minutes. The transverse double-faced hairless pedicle preputial flap is used for the reconstruction. The procedure incorporates fenestration of the prepuce with flap formation, transposition of the mobilized pedicle flap to the ventral side of the penis and neourethral construction by onlaying the flap to the urethral plate from the meatus to the top of the glans. The surgical technique is extremely simple, with the total duration the same or less than single-stage procedures. In the past four decades 1048 patients underwent this procedure with very good, although epidemiologically unassessed outcome, representing the largest series in Croatia and former Yugoslavia

Causal Connection of Non-Specific Low Back Pain and Disc Degeneration in Children with Transitional Vertebra and/or Spina bifida occulta: Role of Magnetic Resonance – Prospective Study

The problem of low back pain (LBP) in children is very common and many specialists are dealing with it in everyday practice. The cause for low back pain often is not found and classified under the diagnosis of non specific low back pain. The objective of this prospective study is to determine wether children with non specific low back pain and existence of anomalies in LS spine (transitional vertebra- TV and/or Spina bifida occulta SBO) also have the degeneration of the intervertebral disc (DD) L4-L5 and/or L5-S1. This prospective study included 69 patients from 8 to 16 years of age (X 12.81) of whom 40 were male (57.97%), and 29 female (42.03%). They all were examinated in University of Zagreb, »Sestre milosrdnice« University Hospital Center, Zagreb Children’s Hospital, Department of Orthopaedic, Zagreb, Croatia. The reason of their visit was non specific low back pain. Pain was measured by visual analog scale (VAS) and mean score was three, duration of pain was between two and four weeks. Also, pain was sporadic, during daytime and not connected with level of physical activity. They all have undergone an algorithm of radiological examinations. Standard AP and LL radiographs (RTG) were made, as well as magnetic resonance (MR) of LS spine and sacrum in sagittal and transversal plane in T1 and T2 weighted sequence. The anomalies of L5 and S1 were found in 65 patients: transitional vertebra classified according to Castellvi et al. and SBO. In MRI in T2 weighted sequence DD was found in 61 patients which was classified modified from Pearce. Data analysis and comparison showed that 56 patients with TV and/or SBO have changes on vertebral dynamic segment L5-S1 (VDS) and that means DD. In 13 patients only DD or spinal anomaly (TV and/or SBO) were found. Correlation between anomalies and DD in those patients was established by McNemar analysis and has shown significant difference (p=0.581) in favour of the patients with anomaly and DD. This has established that all of 56 patients with spinal anomaly could have DD as known cause of LBP

Ultrazvuk probavnoga sustava u pedijatriji: revijalni rad

Modern sonography techniques are increasingly used for the evaluation of gastrointestinal tract in pediatric age. High-resolution real-time scanners, graded compression technique, along with color-flow and power Doppler, represent non-invasive, accurate and reliable diagnostic methods. Sonography can easily be performed for the diagnostic evaluation of acute abdominal pain, gastrointestinal inflammatory diseases and congenital anomalies. Current applications of modern sonography techniques in the evaluation and treatment of pediatric gastrointestinal diseases are presented.Ultrazvučna dijagnostika sve se više rabi u dijagnostici probavnoga trakta u dječjoj dobi. Ultrazvuk visoke razlučivosti, tehnika dozirane kompresije, uz obojeni i Power Dopler, neinvazivna je i pouzdana dijagnostička metoda. Pretraga je tehnički jednostavna za izvođenje, te se najčešće izvodi pri evaluaciji akutne abdominalne boli, upalnih bolesti probavnoga trakta i urođenih anomalija. U radu je prikazan današnji doseg ultrazvuka u dijagnostici i terapiji bolesti probavnog trakta u dječjoj dobi

Joint Observation of the Galactic Center with MAGIC and CTA-LST-1

MAGIC is a system of two Imaging Atmospheric Cherenkov Telescopes (IACTs), designed to detect very-high-energy gamma rays, and is operating in stereoscopic mode since 2009 at the Observatorio del Roque de Los Muchachos in La Palma, Spain. In 2018, the prototype IACT of the Large-Sized Telescope (LST-1) for the Cherenkov Telescope Array, a next-generation ground-based gamma-ray observatory, was inaugurated at the same site, at a distance of approximately 100 meters from the MAGIC telescopes. Using joint observations between MAGIC and LST-1, we developed a dedicated analysis pipeline and established the threefold telescope system via software, achieving the highest sensitivity in the northern hemisphere. Based on this enhanced performance, MAGIC and LST-1 have been jointly and regularly observing the Galactic Center, a region of paramount importance and complexity for IACTs. In particular, the gamma-ray emission from the dynamical center of the Milky Way is under debate. Although previous measurements suggested that a supermassive black hole Sagittarius A* plays a primary role, its radiation mechanism remains unclear, mainly due to limited angular resolution and sensitivity. The enhanced sensitivity in our novel approach is thus expected to provide new insights into the question. We here present the current status of the data analysis for the Galactic Center joint MAGIC and LST-1 observations

Updating the approaches to define susceptibility and resistance to anti-tuberculosis agents: implications for diagnosis and treatment

11 páginas, 2 figuras, 1 tablaInappropriately high breakpoints have resulted in systematic false-susceptible AST results to anti-TB drugs. MIC, PK/PD and clinical outcome data should be combined when setting breakpoints to minimise the emergence and spread of antimicrobial resistance.I. Comas was supported by PID2019-104477RB-I00 from the Spanish Science Ministry and by ERC (CoG 101001038)Peer reviewe

MAGIC and H.E.S.S. detect VHE gamma rays from the blazar OT081 for the first time: a deep multiwavelength study

https://pos.sissa.it/395/815/pdfPublished versio