Effects of quinoline-arylamidine hybrids on LPS-induced inflammation in RAW 264.7 cells

Background and purpose: Inflammation is a common pathogenesis in infection, injury, cancer, and many chronic diseases. Macrophages are among the main cells involved in generation of inflammation. The aim of the present study was to investigate the effects of molecular hybrids with 7-chloroquinoline and arylamidine moieties joined through flexible a 2-aminoethanol linker, on the in vitro inflammatory responses to lipopolysaccharides (LPS) induced inflammation in the RAW 264.7&nbsp;cells. Materials and methods: To determine effects of seven quinoline-arylamidine hybrids on the growth of the murine macrophage-like (RAW 264.7) cells MTT assay was used. Inflammatory reactions in the RAW264.7 cells were induced using E. coli lipopolysaccharides (LPS). Levels of nitric oxide (NO) and malondialdehyde (MDA) were determined by spectrophotometry methods. Intracellular production of reactive oxygen species (ROS) was measured by flow cytometry. Antioxidant capacity of tested compounds was tested by 2,2\u27-azino-bis(3-ethybenzthiazoline-6-sulfonic acid (ABTS) radical cation method. Results: Tested hybrid compounds differentially influenced proliferation of non-stimulated and LPS-stimulated RAW 264.7 cells. The hybrid compounds have not presented ABTS radical-scavenger activity. In the LPS-stimulated RAW 264.7 cells 10 μM compounds slightly decreased production of NO and ROS and significantly modulated LPS-induced lipid peroxidation. Conclusions: Molecular hybrids with 7-chloroquinoline and arylamidine moieties joined through flexible 2-aminoethanol linker markedly decreased accumulation of lipid peroxidation products in the LPS-stimulated RAW 264.7 cells. Further studies are necessary to determine their mechanism of anti-inflammatory action in more details. &nbsp; Keywords: Hybrid molecules, 7-Chloroquinoline, Aromatic amidine, Anti-inflammatory activity in vitro</p

Artroskopsko liječenje ozljeda meniska u adolescenata: usporedba tehnike šivanja izvana-unutra i meniskealnih strelica

The aim of this study was to evaluate clinical and subjective outcomes of the meniscal dart technique in patients having undergone arthroscopic meniscal repair by comparing it with the outside-in suturing technique. From January 2006 until June 2017, case records of 37 patients having undergone arthroscopic meniscal repair were retrospectively reviewed. The patients were divided into two groups based on the technique used for meniscal repair, as follows: 18 patients in suture technique group and 19 patients in meniscal dart group. Each patient was analyzed for the following parameters: age, gender, mechanism of injury, side of injury and injured meniscus, injury localization regarding anatomic position, injury type and associated injuries. The patients that underwent meniscal repair were analyzed for type of repair technique, operating results and results of follow-up (Lysholm and International Knee Documentation Committee (IKDC) score). There were no statistically significant differences between the groups according to clinical outcomes except for anatomic injury localization (p=0.035). Median of operation time was 62.5 min in suture technique group and 70 min in meniscal dart group (p=0.184); median of hospital stay was 2 days for both groups (p=0.951); median of Lysholm score was 86.5 and 84.5 (p=0.651); and median of IKDC score was 81.05 and 81.6, respectively (p=0.986). Understanding the harmful impact of meniscectomy, arthroscopic meniscal repair should be attempted whenever possible. Our data support arthroscopic repair of meniscal tears, since both the suture technique and the meniscal dart technique are safe and successful in meniscal repair in children, with good long-term results and without important complications.Cilj ovoga istraživanja je bio analizirati kliničke i subjektivne ishode liječenja u bolesnika operiranih zbog ozljeda meniska te usporediti dvije skupine bolesnika operiranih različitim tehnikama popravka meniska. Od siječnja 2006. do lipnja 2017. godine u studiju je uključeno 37 bolesnika koji su liječeni artroskopski zbog rupture meniska. Bolesnici su podijeljeni u dvije skupine ovisno o vrsti kirurškog zahvata: jednu skupinu skupinu činilo je 18 bolesnika u kojih je meniskus šivan tehnikom postavljanja šavova, a drugu 19 bolesnika u kojih su upotrebljene strelice za fiksaciju meniska. Svakom ispitaniku analizirani su sljedeći parametri: dob, spol, mehanizam nastanka ozljede, lateralizacija ozljede i meniska, anatomska lokalizacija ozljede i pridružene ozljede. Ispitanicima koji su podvrgnuti tehnikama popravka meniska analizirani su još i vrsta kirurške tehnike popravka meniska, rezultati subjektivne evaluacije 4 tjedna nakon operacije putem upitnika Lysholm i IKDC (International Knee Documentation Committee) te komplikacije nakon operacije. Između skupina bolesnika operiranih tehnikom postavljanja šavova i tehnikom fiksacije meniska strelicama nije bilo značajne razlike u promatranim ishodima liječenja, osim za anatomsku lokalizaciju ozljede (p=0,035). Medijani operacijskog vremena u skupini bolesnika operiranih tehnikom postavljanja šavova iznosio je 62,5 min, dok je u skupini fiksacije meniska strelicama medijan operacijskog vremena iznosio 70 minuta (p=0,184). Medijan duljine hospitalizacije bio je 2 dana za obje skupine (p=0,951). Medijan vrijednosti ljestvice Lysholm za promatrane skupine bio je 86,5 i 84,5 (p=0,651), a ljestvice IKDC 81,05 i 81,6 (p=0,986). Poznavajući štetne učinke meniskektomije, tehnika popravka meniska je dugoročnije bolji odabir i trebala bi se provoditi kadgod je to moguće. Obje tehnike (tehnika postavljanja šavova i tehnika fiksacije meniska strelicama) su sigurne i uspješne u liječenju ruptura meniska u djece, bez značajnijih komplikacija te s dobrim dugoročnim rezultatima

Reuse of single-use surgical equipment - Survey on current practice and attitudes in Croatia

Aims: To gain an insight into current practice and attitudes regarding the reuse of single-use surgical equipment among surgeons and surgical residents in Croatia. Methods: During May 2020, an online survey was shared among Croatian surgeons and surgical residents via email link. The survey included 10 questions seeking information on respondents’ current positions at their departments, real-life practice about reusing single-use instruments, personal attitudes and knowledge about the current law frame. Results: The majority of 53 participants reused single-use surgical equipment in their practice (92.5%). More than half of them reused many single-use devices such as harmonic scalpels, bipolar dissectors, staplers, single-use trocars, graspers, and scissors. The participants had divided opinions on safety issues, personal support of such practice and the necessity of disclosing to patients. However, the majority was inclined towards the use of new instruments if they found themselves with patients on the operating table (75.5%). Very few participants were aware of the current legal regulations and the law changes that would take effect in the near future (5.6%). Conclusion: Current practice shows widespread reuse of single-use surgical equipment in Croatia despite the concerns of the involved surgeons. It seems that they recognize the potential safety and ethical issues, but at the same time, they are not well informed about the legal regulations of the practice which is alarming and calls for further education and preparation for the upcoming legal changes

Testing of the Retinal Visual Acuity in High Myops with Cataracts

In the presence of the media opacities and extreme ametropia, especially in high myopia, often arises a question of expected visual acuity, e.g. after cataract extraction because of the possible degenerative changes of the choroid and retina. In the measurements were enrolled 15 patients between 45 and 60 years of age, 9 female and 6 male. We have tested preoperative retinal visual acuity by the interferometer. One month postoperatively visual acuity was measured by Snellen international charts at a distance of 6 m. Both measurements are calculated using log MAR scale. Measurements were paired and the differences are calculated and analyzed for the significance. No significance was found (p>0.05). It was concluded that measured differences were incidental and interferometer measurements are reliable in predicting post cataract visual acuity in high myopia

Application of the Amniotic Membrane Extract (AMX) for the Persistent Epithelial Defect (PED) of the Cornea

A lot of pathological conditions could provoke damaging of the innervations of the cornea and lead to persistent epithelial defect (PED). AMX is lyophilized preparation of amniotic membrane (AM), which contains biological components and efficacy of AM for treatment of the corneal surface defects. In processing all the substances essential for biological effects of AM are preserved (growth factors, neutrophins, interleukins, receptors, fibronectins and different types of collagen). A patient can apply AMX as eye drops by himself in his home, thus avoiding surgical procedure. We presented two patients with PED; we treated them with eye drops of AMX, 2 drops every hour during day time. There was observed healing effect by reducing epithelial defect. Almost after a second day of application, and after 1-2 week period PED that persisted for weeks healed completely

Usporedba debljine kompleksa ganglijskih stanica i živčanih vlakana mrežnice u dijagnostici glaukoma

The aim was to compare retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thicknesses in patients with primary open angle glaucoma (POAG), ocular hypertension (OH) and healthy subjects, and to investigate the role of GCC parameters in glaucoma diagnosis. Eighty-one patients were divided into four groups according to Hodapp-Parrish-Anderson classification: 26 OH, 22 early POAG, 10 moderate to advanced POAG, and 23 healthy subjects. All patients underwent RNFL and GCC thickness measurement using SOCT Copernicus HR. All RNFL and GCC parameters were significantly lower in POAG than in OH and healthy subjects, especially Average RNFL, RNFL Superior and Inferior, GCC Average, and GGC Inferior. Of all RNFL parameters, the highest area under the receiver operating characteristic curve (AUC) was recorded for Average RNFL, 0.906. GCC Average, and GCC Superior and Inferior had the overall highest AUCs (0.957, 0.955 and 0.946, respectively) with 100% specificity. The RNFL Average and Inferior and GCC Average, Superior and Inferior were identified as the main predictors for development of glaucoma (p=0.015 and p=0.014 vs. p=0.002, p=0.002 and p=0.003, respectively). In conclusion, GCC parameters showed a slightly better glaucoma discriminating ability and were found to be better predictors for development of glaucoma as compared with RNFL.Cilj je bio usporediti debljinu sloja živčanih vlakana mrežnice (RNFL) i kompleksa ganglijskih stanica (GCC) u bolesnika s primarnim glaukomom otvorenog kuta (POAG), okularnom hipertenzijom (OH) i u zdravih ispitanika te istražiti ulogu parametara GCC u dijagnostici glaukoma. Ispitanici su bili podijeljeni u četiri skupine prema Hodapp-Parrish-Andersonovoj klasifi kaciji: 26 ispitanika s OH, 22 s ranim POAG-om, 10 s umjerenim do uznapredovalim POAG-om i 23 zdrava ispitanika. Svim ispitanicima je izmjerena debljina RNFL-a i GCC-a primjenom SOCT Copernicus HR. Ispitanici s POAG-om imali su značajno niže vrijednosti debljine GCC i RNFL nego ispitanici s OH i zdravi ispitanici, osobito vrijednosti prosječnog RNFL-a te RNFL-a u gornjem i donjem kvadrantu. Od svih parametara RNFL najveće područje ispod krivulje (AUC) pripadalo je prosječnom RNFL-u, 0,906. Prosječni GCC te GCC u gornjem i donjem kvadrantu imali su ukupno najveće vrijednosti AUC-a sa 100% specifičnošću. Glavni prediktori za razvoj glaukoma su bili prosječni RNFL, RNFL u donjem kvadrantu, prosječni GCC te GCC u gornjem i donjem kvadrantu (p1=0,015 i p2=0,014 prema p3=0,002, p4=0,002 i p5=0,003). U zaključku, parametri GCC su bolje razlikovali glaukomske od neglaukomskih bolesnika te su se pokazali kao bolji prediktori razvoja glaukoma u odnosu na parametre RNFL

Minimally invasive Nuss procedure for repair of pectus excavantum

Uvod: Pectus excavatum, stečeno ili kongenitalno udubljenje prednje stijenke prsnog koša, najčešći je deformitet stijenke prsnog koša. Ljevkasta prsa zajedno s kokošjim prsima najčešći su deformiteti prsnog koša (oko 90%) s učestalosti od 1:400 novorođene djece. Ti pacijenti doživljavaju bitne psihosocijalne poteškoće i moguće fiziološke poremećaje s kardiopulmonalne strane. Liječenje ljevkastih prsa može biti provedeno na dva načina: kiruškim pristupom i nekirurškim. Tradicionalna procedura popravka ljevkastog prsnog koša izvodi se velikom otvorenom operacijom po Ravitchu i njegovim modifikacijama. Od 1998. dr. Donald Nuss publicirao je minimalno invazivnu tehniku operacije ljevkastih prsa koja koristi torakoskopsku vizualizaciju s malim postraničnim rezovima i privremeno postavljanje modelirane metalne šipke iza prsne kosti. Ova tehnika je bila brzo prihvaćena od mnogih kirurga, što je rezultiralo značajnim porastom broja operacija. Minimalno invazivni pristup za popravak ljevkastih prsa prihvaćen je u mnogim centrima kao metoda izbora, prvenstveno zbog povećane svijesti pacijenta i dobroga dugoročnog ishoda. U početku je ova procedura pokazala moguće rizike i komplikacije te su napravljene važne tehničke modifikacije koje su umanjile rizik i poboljšale ukupni rezultat. Cilj ovog rada je prikazati metodu liječenja minimalno invazivne kiruške korekcije ljevkastih prsa u pedijatrijskih bolesnika po Nussovoj metodi. Kod nekirurškog liječenja ljevkastih prsa koristi se vakuum zvono koje se postavi na prednju stijenku prsnog koša i uz pomoć pumpice učini vakuum koji prednju stijenku prsnog koša izvlači prema naprijed. Zaključci: Procedura po Nussu je uspješna metoda kiruškog liječenja ljevkastih prsa u djece i odraslih. Operacijsko liječenje ljevkastih prsa po Nussovoj metodi daje uglavnom odlične estetske rezultate te subjektivno zadovoljstvo pacijenta.Introduction: Pectus excavatum, an acquired or congenital malformation of the anterior chest wall, is the most common deformity of the chest wall. Pectus excavatum together with pectus carinatum are the most common chest deformities (about 90%) with a frequency of 1:400 in the newborns. These patients experience significant psychosocial difficulties and possible physiological disturbances like cardiopulmonary malfunctions. The treatment of pectus excavatum can be carried out in two ways: surgical and non-surgical. The traditional procedure of funnel chest repair is performed by large open surgery according to Ravitch and his modifications. Since 1998, Dr. Donald Nuss has published a minimally invasive funnel chest surgery technique that uses thoracoscopic visualization with small side incisions in the axillary line and early placement of a modeled metal rod behind the sternum. This technique was quickly adopted by many surgeons, resulting in a significant increase in the number of operations. The minimally invasive approach for funnel chest repair is accepted in many centers as the method of choice, primarily due to increased patient awareness and good long-term outcome. Initially, this procedure showed possible risks and complications, so important technical modifications were made that reduced the risk and improved the overall result. The aim of this paper is to present the treatment method of minimally invasive surgical correction of pectus excavatum in pediatric patients according to the Nuss method. In the non-surgical treatment of funnelshaped chest, a vacuum bell is used, which is placed on the front wall of the chest and with the help of a pump creates a vacuum that pulls the front wall of the chest forward. Conclusions: The Nuss procedure is a successful method of surgical treatment for pectus excavatum in children and adults. Operative treatment of funnel-shaped chest according to the Nuss method gives mainly excellent aesthetic results and subjective satisfaction of the patient

Razina i percepcija suradljivosti u održavanju higijene leća među nosiocima tvrdih plinopropusnih leća - pilot studija

The aim was to estimate compliance rate among rigid gas permeable lens wearers (RGPLW) in lens system care, identify procedures in lens care process with poorest compliance levels, and assess concordance between participant reported practices and their subjectively perceived compliance. The study included outpatient RGPLW managed at Zagreb University Hospital Center in Zagreb, Croatia. They filled out a questionnaire that included demographic data, duration of lens wear, self-evaluation compliance grade, and 14 lens care procedures and wearing habits indicative of compliance. There were 50 patients (mean age 34.6 years, 68% female). Full compliance was found in a single patient. The mean number of non-compliant procedures was 5.48, with 32% of participants non-compliant in more than 50% of the compliance criteria. Critical procedures of the lens care process were infrequent lens case exchange (74%), using tap water for lens (70%), and improper case cleaning (68%). The mean lens case replacement time was 9.8 months (SD 6.76), with only 26% of patients replacing lens case at least once in 3 months. Excessive daily lens wear was associated with greater total number of non-compliant procedures (p<0.0008). RGPLW were aware of their inappropriate lens care only when achieved non-compliance in almost 50% of the procedures. In conclusion, lens wearers were not aware of their extremely low compliance rate in several aspects of lens and lens case maintenance. Study results indicated the key procedures the practitioners should focus on when evaluating subjective and objective compliance and reinforcing care and hygiene education of RGPLW.Cilj je bio ispitati razinu suradljivosti nosilaca tvrdih plinopropusnih leća (NTPL) u održavanju higijene leća, utvrditi koji su koraci u postupku higijene leća kojih se najmanje pridržavaju i procijeniti povezanost između objektivne i vlastite subjektivne procjene o suradljivosti NTPL u održavanju higijene leća i kutijica za leće. Uključeni su ambulantno kontrolirani NTPL u Kliničkom bolničkom centru Zagreb, Zagreb, Hrvatska. Ispitanici su ispunili upitnik koji je sadržavao demografske podatke, dužinu nošenja leća, ocjenu za samoprocjenu suradljivosti u održavanju leća i 14 koraka i navika nošenja leća koji su važni za procjenu suradljivosti. Uključili smo 50 bolesnika (srednja dob 34,6 godina, 68% bolesnika ženskog spola). Potpuna suradljivost utvrđena je u samo jednog bolesnika. Srednji broj nesuradljivih koraka je bio 5,48, a 32% ispitanika je bilo nesuradljivo u više od 50% kriterija suradljivosti. Najkritičniji koraci nepridržavanja odgovarajuće higijene leća bili su neredovita zamjena kutijica za leće (74%), uporaba tekuće vode za ispiranje leća (70%) i nepravilno čišćenje posudica za leće (68%). Srednje vrijeme zamjene kutijica za leće bilo je 9,8 mjeseci (SD 6,76), a samo 26% bolesnika mijenjalo je kutijice u preporučenom roku od 3 mjeseca. Prekomjerno nošenje leća u danu povezano je s većim ukupnim brojem koraka nesuradljivosti (p<0,0008). NTPL postali su svjesni svoje neprimjerene higijene leća tek kada bi postali nesuradljivi u gotovo 50% koraka za procjenu održavanja higijene leća. U zaključku, NTPL nisu bili svjesni svoje iznimno niske razine suradljivosti u nekoliko aspekata održavanja leća i kutijica za leće. Rezultati ove studije pokazali su ključne korake na koje bi se liječnici trebali usredotočiti kada procjenjuju subjektivnu i objektivnu razinu suradljivosti bolesnika i potiču na izobrazbu NTPL o pravilnoj brizi za leće