Syphilis Today

Sifilis je spolno prenosiva zarazna bolest uzrokovana spirohetom Treponema pallidum. Prenosi se ponajprije spolnim putem, a u rijetkim slučajevima moguć je i transplacentarni prijenos. Bolest zahvaća različita tkiva i organske sustave, u prvom redu kožu, kardiovaskularni, koštani i središnji živčani sustav. Sifilis danas nije jedan od vodećih javnozdravstvenih problema, međutim, prisutan je, a posljednjih godina zamijećen je i blagi porast zaraženih "de novo", kao i udruženost s drugim spolno prenosivim infekcijama (klamidije, HIV). Ovaj porast bilježi se i u nama susjednim zemljama u kojima se broj oboljelih povećava tijekom posljednja dva desetljeća. Prema trajanju bolesti sifilis se dijeli na rani i kasni sifilis, a na temelju kliničke slike bolest se dijeli u tri stadija. Sifilis je prozvan "velikim imitatorom" ubrzo nakon njegova otkrića zbog raznolikosti kliničkih slika kojima se očituje. Stoga je poznavanje različitosti kliničkih slika u raznim stadijima sifilisa važno, kako u okviru rane dijagnostike sifilisa tako i u diferencijalnoj dijagnostici različitih bolesti, osobito onih koje se pojavljuju na koži. Dijagnoza sifilisa temelji se na anamnezi, kliničkoj slici te laboratorijskim testovima. Lijek izbora za terapiju sifilisa je penicilin koji se u različitim stadijima i fazama bolesti primjenjuje u različitoj dozi. U slučaju preosjetljivosti na penicilin terapija se može provesti doksiciklinom ili azitromicinom. Nakon provedene terapije nužno je redovito kontrolirati bolesnika te na taj način utvrditi je li terapija uspješno provedena.Syphilis is a sexually transmitted disease caused by the spirochetal bacterium Treponema pallidum. The route of transmission of syphilis is almost always through sexual contact. Transplacental transmission has been also recorded although rarely. This disease affects various tissues and organ systems, primarily skin, and cardiovascular, skeletal and central nervous systems. Although syphilis does not represent a major public health problem, it is still present and it has even recorded a mild increase over the last years and has occurred in combination with other sexually transmitted infections (chlamydiae, HIV). This increase has been also recorded in neighboring countries over the last two decades. According to its duration, syphilis can be either early or late. On the basis of its clinical picture, it can be divided into three stages. The disease was dubbed the "Great Imitator" soon after its discovery due to the diversity in its clinical picture. Therefore, the knowledge of its clinical picture in early stages of the disease is important both for its diagnosis and for the differential diagnosis of various diseases, particularly skin diseases. The diagnosis of syphilis is based on anamnesis, clinical picture and laboratory tests. The drug of choice for the treatment of syphilis is penicillin, which is given in different doses in different stages of the disease. In hypersensitivity to penicillin, doxycycline or azithromycin may be used. Follow-up is necessary to verify whether the therapy has been successful

Uloga pušenja i uzimanja alkoholnih pića u razvoju i ponavljanju plućne tuberkuloze

During a two-year period (2001-2003), 464 patients were treated for tuberculosis at Jordanovac Department for Lung Diseases in Croatia. Besides pulmonary tuberculosis in 97.7% of patients, patients were also treated for tuberculous pleurisy (0.9%), tuberculous laryngitis (0.6%), tuberculous meningitis (0.2%), tuberculous pericarditis (0.2%) and urogenital tuberculosis (0.4%). Out of the total number of patients, 57.3% declared themselves to be active smokers (men were predominant and made up to 80.8%) and 20.9% to be active alcohol consumers. Both risk factors, i.e. smoking and alcohol consumption, were present in 15.1% of all patients. The most common comorbidities were diabetes mellitus (30.4%), cardiac diseases (11.2%) and chronic obstructive pulmonary disease (8.0%). Lung carcinoma was the most common malignant disease (n=51), with Mycobacterium tuberculosis isolated in 33% of them. Seventy-two of 464 (15.5%) patients had recurrences of tuberculosis. Of these, 30.5% had one of the risk factors (20.8% were smokers and 9.7% consumed alcohol), while 32.5% of patients had both risk factors. In conclusion, cigarette smoking was proved to be the most significant risk factor for development of pulmonary tuberculosis and its recurrence.Tijekom dvije godine (2001.-2003.) u Klinici za plućne bolesti “Jordanovac”, Zagreb, Hrvatska, od tuberkuloze je liječeno 464 bolesnika. Osim najčešće plućne tuberkuloze u 97,7% bolesnika, oboljeli su liječeni i od eksudativnog tuberkuloznog pleuritisa (0,9%), laringealne tuberkuloze (0,6%), tuberkuloznog meningitisa (0,2%), perikardijalne tuberkuloze (0,2%) te tuberkuloze koja je zahvatila urogenitalni sustav (0,4%). Od ukupnog broja bolesnika 57,3% ih se izjasnilo kao aktivni pušači (muškarci 80,8%), dok je 20,9% deklarirano kao aktivni konzumenti alkohola. Ukupno je 15,1% bolesnika imalo oba rizična čimbenika u anamnezi, tj. i aktivno pušenje cigareta i konzumaciju alkohola. Od komorbiditeta najčešća je bila šećerna bolest u 30,4% bolesnika, od srčanih bolesti bolovalo je 11,2% bolesnika, dok je kronična opstruktivna plućna bolest bila prisutna u 8% bolesnika. Karcinom pluća bio je najčešće zastupljen među malignim bolestima. Od ukupnog broja oboljelih od karcinoma pluća (51 bolesnik), Mycobacterium tuberculosis izolirali smo u 33% bolesnika. Recidivi tuberkuloze su zabilježeni u 72 (15,5%) bolesnika. Jedan rizični čimbenik imalo je 30,5% bolesnika: pušača je bilo 20,8%, dok je alkohol konzumiralo 9,7% bolesnika, a 32,5% bolesnika imali su oba rizična čimbenika. Zaključno, pušenje cigareta pokazalo se kao najznačajniji rizični čimbenik za razvoj plućne tuberkuloze, kao i za pojavu recidiva tuberkuloze

Morfološka i kemijska analiza introduciranih sorti nektarine u Hercegovini

A 2-year study was done to compare fruit morphological and chemical composition of three nectarine cultivars grown in south Hercegovinia conditions. A high variability among and within cultivars was found and significant differences were observed among them in all properties analyzed. On the basis of evaluated data, the best fruit performance was registered in ‘Caldesi 2000’ and ‘Venus’ grown in the condition of this part of the Mediteran. This evaluation may help to select a set of nectarine cultivars with better fruit quality attributes, which in our growing conditions might be indicated in ‘Caldesi 2000’ and somewhat in ‘Venus’. The highest average of fruit width (61.18 mm) and fruit weight (148.24 g) was found in cultivar Caldesi 2000. As for friut thickness, also cultivar Caldesi 2000 had the highest value (55.39 mm). The results for the highest fruit length (60.48 mm) had Venus cultivar also fruit stone weight length, width and thickness. The contents sugars (glucose, fructose) total soluble dry matter, and total acids in fruits were found in cultivar Venus, but pH and sucrose were found in cultivar Sun Grand.Provedeno je dvogodišnje istraživanje kako bi se usporedio morfološki i kemijski sastav plodova tri sorte nektarine uzgojene u južnohercegovačkim uvjetima. Utvrđena je velika varijabilnost između i unutar sorti te su uočene značajne razlike među njima u svim analiziranim svojstvima. Na temelju procijenjenih podataka najbolji učinak ploda zabilježen je kod sorti \u27Caldesi 2000\u27 i \u27Venus\u27 uzgojenih u uvjetima ovog dijela Mediterana. Ova procjena može pomoći u odabiru niza sorti nektarina s boljim svojstvima kvalitete ploda, što bi u našim uvjetima uzgoja moglo biti označeno kao \u27Caldesi 2000\u27 i donekle \u27Venus\u27. Najveći prosjek širine ploda (61,18 mm) i mase ploda (148,24 g) ima sorta Caldesi 2000. Što se tiče debljine ploda, također je sorta Caldesi 2000 imala najveću vrijednost (55,39 mm). Rezultati za najveću duljinu ploda (60,48 mm) imala je sorta Venus kao i težinu, širinu i debljinu koštice ploda. Sadržaj ukupne topljive suhe tvari, šećera (glukoza, fruktoza) i ukupnih kiselina u plodovima utvrđen je kod sorte Venus, a pH i saharoza kod sorte Sun Grand

Morfološka i kemijska analiza introduciranih sorti nektarine u Hercegovini

A 2-year study was done to compare fruit morphological and chemical composition of three nectarine cultivars grown in south Hercegovinia conditions. A high variability among and within cultivars was found and significant differences were observed among them in all properties analyzed. On the basis of evaluated data, the best fruit performance was registered in ‘Caldesi 2000’ and ‘Venus’ grown in the condition of this part of the Mediteran. This evaluation may help to select a set of nectarine cultivars with better fruit quality attributes, which in our growing conditions might be indicated in ‘Caldesi 2000’ and somewhat in ‘Venus’. The highest average of fruit width (61.18 mm) and fruit weight (148.24 g) was found in cultivar Caldesi 2000. As for friut thickness, also cultivar Caldesi 2000 had the highest value (55.39 mm). The results for the highest fruit length (60.48 mm) had Venus cultivar also fruit stone weight length, width and thickness. The contents sugars (glucose, fructose) total soluble dry matter, and total acids in fruits were found in cultivar Venus, but pH and sucrose were found in cultivar Sun Grand.Provedeno je dvogodišnje istraživanje kako bi se usporedio morfološki i kemijski sastav plodova tri sorte nektarine uzgojene u južnohercegovačkim uvjetima. Utvrđena je velika varijabilnost između i unutar sorti te su uočene značajne razlike među njima u svim analiziranim svojstvima. Na temelju procijenjenih podataka najbolji učinak ploda zabilježen je kod sorti \u27Caldesi 2000\u27 i \u27Venus\u27 uzgojenih u uvjetima ovog dijela Mediterana. Ova procjena može pomoći u odabiru niza sorti nektarina s boljim svojstvima kvalitete ploda, što bi u našim uvjetima uzgoja moglo biti označeno kao \u27Caldesi 2000\u27 i donekle \u27Venus\u27. Najveći prosjek širine ploda (61,18 mm) i mase ploda (148,24 g) ima sorta Caldesi 2000. Što se tiče debljine ploda, također je sorta Caldesi 2000 imala najveću vrijednost (55,39 mm). Rezultati za najveću duljinu ploda (60,48 mm) imala je sorta Venus kao i težinu, širinu i debljinu koštice ploda. Sadržaj ukupne topljive suhe tvari, šećera (glukoza, fruktoza) i ukupnih kiselina u plodovima utvrđen je kod sorte Venus, a pH i saharoza kod sorte Sun Grand

The Effects of C 02 and Nd:YAG Lasers on Periodontal Tissue in the Furcations of Molars

C 02 i Nd:YAG laseri najčešće su rabljeni laseri u stomatologiji i u medicini. Zbog atraumatskog i djelotvornoga rezanja mekih tkiva laser se može, između ostalog, rabiti za pulpotomiju mliječnih i trajnih mladih zuba. Svrha rada bila je istražiti učinak tih dvaju lasera, čije su energetske vrijednosti dostatne za ablaciju mekih tkiva, na parodontno tkivo tijekom pulpotomije laserom. Eksperiment je izvršen na psima mješancima teškim oko 25 kg. Životinje su anestezirane pentobarbitalom, trepanirane su pulpne komore molara, a pulpno tkivo je uklonjeno ekskavatorom te učinjena namjerna trepanacija dna pulpne komore. Parodontno tkivo u furkacijskom području obasjano je C 02 (2 W /1 0 ms / 5x/s) i Nd.YAG (2W / 20 pps) laserskom zrakom tijekom 3 s. Na histološkim pripravcima, učinjenim 30 odnosno 45 dana nakon obradbe, vidi se površinska nekroza kosti, upalna infiltracija, fragmentacija koštanih lamela. Prvi znakovi cijeljenja koštane strukture javljaju se kod C 02 lasera 45 dana nakon obasjavanja stvaranjem novoga koštanog matriksa, osteoida. Nd.YAG laser dublje prodire u tkivo i uzrokuje opsežnije promjene te i 45 dana nakon obradbe tim laserom nije opazeno da parodontna rana zacjeljuje.CO2 and Nd. YAG lasers are the most commonly used in medicine and dentistry. Due to atraumatic and efficient cutting of the soft tissue they can be used for pulpotomy o f deciduous and young permanent teeth. The aim of this study was to evaluate the effect of these two lasers with energy parameters used for abblation o f soft tissues on the incidently irradiated periodontal tissue during pulpotomy.Mixed breed dogs weighing 25 kg were used for experiments. The animals were anesthetized with pentobarbital. Pulp chambers of molars were opened and pulp tissues removed with a sharp spoon. The floor of the pulp chamber was penetrated intentionally with a water cooling low speed steel bur. Periodontal tissue of the furcation region was irradiated with C 02 (2 W / 1 0 ms / 5x/s) i Nd. YAG (2W/ 20 pps) lasers for 3 s. Histological analysis made 30 and 45 days after treatment revealed superficial necrosis of bone, inflammatory infiltration and fragmentation of bone trabeculae. The first signs of bone healing appeared 45 days after treatment with the C 02 laser as formation of new bone matrix, osteoid. Nd. YAG laser penetrates deeper into bone tissue and causes more severe changes. Thus 45 days after lasing the bone with it there were no signs of healing

Utjecaj zračnog prijevoza na kvalitetu uzoraka krvi

The aim of this study was to establish the impact of air transport on blood samples packaged with and without cooling elements and effect of outdoor temperature on sample quality. Venous samples from 38 blood donors in winter and 36 in summer were tested for hemolysis and complete blood count. One tube per subject was kept in controlled conditions at +4 °C. Two sets of tubes were sent by plane from Zagreb to Brussels, one with and one without cooling elements, and another two sets were sent to London following the same principle. Packages with cooling elements were stored in controlled warehousing conditions at airports (+2 °C to +8 °C), whereas packages without cooling elements were stored in ambient warehouse conditions. Data loggers were used for temperature monitoring. Our research revealed statistically significant differences in several hematologic parameters when comparing the samples stored in controlled laboratory conditions and those transported by plane. These differences were more pronounced in the samples transported during the summer. Transport conditions without cooling elements had additional negative impact on the sample quality. Transport of samples using cooling elements and controlled warehousing conditions at airports are sometimes not sufficient to maintain laboratory storage conditions.Cilj ovog istraživanja bio je utvrditi utjecaj zračnog prijevoza na uzorke krvi pakirane s rashladnim elemenatima i bez njih, kao i utjecaj vanjske temperature na kvalitetu uzorka. U venskim uzorcima 38 darivatelja krvi tijekom zime i njih 36 tijekom ljeta određeni su stupanj hemolize i kompletna krvna slika. Jedan uzorak po ispitaniku ostavljen je u kontroliranim uvjetima na +4 °C. Dva seta uzoraka poslana su zrakoplovom iz Zagreba u Bruxelles, jedan s rashladnim elemenatima i jedan bez njih, a druga dva seta poslana su u London po istom načelu. Pakovanja s rashladnim elementima čuvana su u kontroliranim skladišnim uvjetima u zračnim lukama (+2 °C do +8 °C), dok su pakovanja bez rashladnih elemenata čuvana u ambijentnim skladišnim uvjetima. Uređaji za kontinuirano mjerenje temperature korišteni su za nadzor temperature tijekom transporta. Naše istraživanje otkrilo je statistički značajne razlike u nekoliko hematoloških parametara kada se uspoređuju uzorci pohranjeni u kontroliranim laboratorijskim uvjetima i oni koji se transportiraju zračnim prijevozom. Te su razlike bile izraženije u uzorcima transportiranim tijekom ljeta. Uvjeti transporta bez rashladnih elemenata imali su dodatni negativni utjecaj na kvalitetu uzoraka. Transport uzoraka pomoću rashladnih elemenata i kontrolirani uvjeti skladištenja u zračnim lukama ponekad nisu dovoljni za održavanje laboratorijskih uvjeta skladištenja

A Fruit Tree as an Identification Element of Ornamental Gardens Shaping in Croatia- Istria Ornamental Gardens Case

A fruit tree has always been a determinant of an ornamental garden shaping in Croatia. From the 13th century onward an organized planting of fruit trees has been recorded. A total of 100 gardens in Istria have been analysed, 50 of which were examined in the Istria interior, and 50 in the coastal area. Due to the shape and architectural style, 8 different types of gardens were determined and classified, by the location, into three climatic-relief areas A, B and C. There were 7 types of ornamental gardens with a fruit tree as a primary determinant of the garden, except one without it. Out of the 23 recorded fruit tree species, Prunus avium (L.) L., sweet cherry, Ficus carica L., fig tree, Vitis vinifera L. vine and Olea europeaea L., olive tree and vine have been the most commonly used in the Istria interior whereas olive trees, Eriobotrya japonica (Thunb.) Lindl., Japanese loquat, fig trees and vine have been known in the Istria coas

The Overall Health-Status of Dental Patients

Svrha istraživanja bila je procijeniti opće-zdravstveni status opulacije stomatoloških pacijenata, nakon obrade podataka iz ispunjenih Upitnika o zdravlju FDI-a koje je preporučila Hrvatska stomatološka komora. Podaci iz 2045 upitnika koje su ispunili pacijenti Zavoda za endodonciju i restaurativnu stomatologiju tijekom godine 2005. uneseni su u kompjutorsku bazu podataka te statistički obrađeni. Obrada podataka pokazala je da 30,1% stomatoloških pacijenata boluje od neke bolesti, a najčešće su kardiovaskularne (14,7%). Česte su i alergije bolesti (13,1%). U upitnicima je registrirano i 1,5% pacijenata s virusnim hepatitisom te 0,6% s TBC-om. Razmjerno malo pacijenata upisalo je HIV-seropozitivnost (0,2%) i izloženost virusu HIV-a (0,5%). Transfuziju je primilo 12% pacijenata. Stomatološki pacijent iznad 75 godina u prosjeku uzima 2,16 lijekova. Vrlo česte sistemske bolesti kod stomatoloških pacijenata te povećana potrošnja lijekova kod pacijenata starije dobi, upućuje na to da je potrebna dodatna izobrazba stomatologa kako bi se s takvim bolesnicima moglo odgovarajuće postupati.The purpose of the study was to evaluate the general health condition i.e. overall health-status of the dental patients population by processing the data obtained from the FDI health-questionnaires which was recommended by the Croatian Dental Chamber. The data which was collected from a total of 2045 individual medical history questionnaires - personally filled in by the patients who attended this Department of Endodontics and Restorative Dentistry during the year of 2005 - was loaded into a computer data-base and statistically analyzed. The analysis showed presence of some kind of a disease in 30.1% of patients; topping the list by incidence were cardiovascular diseases (14.7%). Also, highly represented were various allergic diseases (13.1%). A 1.5% had developed a viral hepatitis, whereas 0.6% of the patients had even had TBC. A comparatively small percentage of patients (0.2%) had admitted to HIV seropositivity resp. exposure to the HIV virus (0.5%). A total of 12% of the group had received a blood-transfusion at some point. Typically, a dental patient above 75 years of age was taking in average 2.16 different types of medicinal drugs. High incidence of systemic diseases in dental patients and an increased consumption of medicinal drugs in the elderly dental patients indicates the need for an enhanced education of the dentist in order to enable his/her proper attitude toward such patients

Značenje polimorfizma 4g/5g pai-1 gena i dijagnostička vrijednost biočimbenika u bolesnika s alergijskim i nealergijskim fenotipovima astme

Asthma is a chronic inflammatory disease that is characterized by reversible obstruction of airways, bronchial hyper-reactivity and airway remodeling. The etiology of asthma is multifactorial, with in-heritance playing an important role. The aim of our study was to investigate the importance of biomarkers of asthma and the role of plasminogen activator inhibitor-1 (PAI-1) gene as a genetic factor that could be involved in the pathogenesis of asthma. The research was conducted at Jordanovac University Department for Lung Diseases and Croatian Institute of Transfusion Medicine. The research included 149 patients with asthma and 89 healthy individuals. We collected demographic data of both study groups, determined asthma severity using GINA guidelines, and the values of biomarkers and PAI-1 by using laboratory techniques. Based on the results, we concluded that patients with allergic phenotype of asthma were younger, had better lung function and higher levels of IgE. By observing FeNO values, we were not able to distinguish asthmatic patients that had been diagnosed with obstruction of airways from asthmatic patients with normal lung function because FeNO indicates the inflammatory component of disease. The 4G/5G polymorphism of PAI-1 gene did not show any statistically significant difference in the distribution of 4G/4G, 4G/5G and 5G/5G between the group of asthmatic patients and control group.Astma je kronična upalna bolest koju obilježava reverzibilna opstrukcija dišnih putova, bronhalna hiperreaktibilnost te remodelacija dišnih putova. Etiologija astme je multifaktorska, gdje nasljeđe ima važnu ulogu. Cilj našega rada bio je ispitati važnost biočimbenika astme i ulogu gena za inhibitor aktivatora plazminogena 1 (PAI-1) kao genetskog čimbenika koji bi mogao biti uključen u patogenezu astme. Istraživanje je provedeno u Klinici za plućne bolesti “Jordanovac” i Hrvatskom zavodu za transfuzijsku medicinu. U istraživanju je sudjelovalo 149 bolesnika sa stabilnom astmom i 89 zdravih davatelja krvi. Prikupili smo demografske podatke obiju skupina, odredili stupanj težine bolesti koristeći smjernice GINA te laboratorijskim tehnikama odredili vrijednosti biomarkera (FeNO, IgE) i PAI-1 4G/5G polimorfizma. Temeljem dobivenih rezultata zaključili smo da su osobe s alergijskim fenotipom astme mlađe dobi, imaju bolju plućnu funkciju i više vrijednosti ukupnog IgE. Prema vrijednostima FeNO nismo mogli razlučiti astmatičare koje imaju dokazanu opstrukciju dišnih putova u odnosu na astmatičare s urednom plućnom funkcijom, budući da je FeNO pokazatelj upalne komponente bolesti. Polimorfizam 4G/5G u promotorskoj regiji gena za PAI-1 kod bolesnika s astmom u usporedbi s ispitanicima kontrolne skupine pokazao je da ne postoji statistički značajna razlika u učestalosti genotipova 4G/4G, 4G/5G i 5G/5G između skupine oboljelih od astme i skupine zdravih ispitanika