Idiopathic hypoparathyreoidism, reversible cardiomyopathy and nephrogenic diabetes insipidus - case report

We are presenting a case of a 36-year-old patient with idiopathic hypoparathyroidism and reversible dilated cardiomyopathy as a result of hypocalcaemia. Twelve years later, the patient presented a picture of nephrogenic diabetes insipidus, which according to available literature has so far not yet been described

Atypical clinical presentation of an acute abdomen

Prikazali smo slučaj šezdesetogodišnjeg bolesnika s atipičnom kliničkom slikom akutnog abdomena. Bio je bezbolnog trbuha, uz očuvano, spontano pražnjenje crijeva. Atipičnoj prezentaciji akutnog abdomena kod našeg bolesnika mogli su pridonijeti prethodno preboljeli moždani udar i šećerna bolest.We have presented a case of a sixty-year-old patient with atypical clinical manifestations of acute abdomen: the abdomen was painless with preserved spontaneous bowel movement. Stroke and diabetes could contribute to such an atypical presentation

Glycemic Index in Diabetes

The Glycemic Index (GI) is a rating system that ranks carbohydrate-containing foods according to their postprandial blood glucose response relative to the same quantity of available carbohydrate of a standard such as white bread or glucose. The concept of GI was first introduced in the early 80’s by Jenkins and coworkers. Since then, numerous trials have been undertaken, many indicating benefits of a low GI diet on glycemic control, as well as lipid profiles, insulin and C-peptide levels, inflamatory and thrombolytic factors, endothelial function and regulation of body weight. As a result, a low-GI diet may prevent or delay the vascular complications of diabetes. However, despite many studies supporting the benefits of the Glycemic Index as part of the treatment of diabetes mellitus, several areas of controversy have been raised in the literature and are addressed here. Clinicians treating diabetic patients should be aware of the potential benefits of low-GI foods in the prevention and treatment of diabetes and its complications

Glycemic Index in Diabetes

The Glycemic Index (GI) is a rating system that ranks carbohydrate-containing foods according to their postprandial blood glucose response relative to the same quantity of available carbohydrate of a standard such as white bread or glucose. The concept of GI was first introduced in the early 80’s by Jenkins and coworkers. Since then, numerous trials have been undertaken, many indicating benefits of a low GI diet on glycemic control, as well as lipid profiles, insulin and C-peptide levels, inflamatory and thrombolytic factors, endothelial function and regulation of body weight. As a result, a low-GI diet may prevent or delay the vascular complications of diabetes. However, despite many studies supporting the benefits of the Glycemic Index as part of the treatment of diabetes mellitus, several areas of controversy have been raised in the literature and are addressed here. Clinicians treating diabetic patients should be aware of the potential benefits of low-GI foods in the prevention and treatment of diabetes and its complications

Correlation of Endothelin-1 Concentration and Angiotensin-Converting Enzyme Activity with the Staging of Liver Fibrosis

Increased serum angiotensin-converting enzyme (SACE) activity and serum concentration of endothelin-1 (ET-1) were found in liver cirrhosis. We investigated a correlation between the different stages of liver fibrosis and SACE activity and serum ET-1 concentration. Seventy patients with pathohistologically established chronic liver disease were divided in three groups according to Ishak criteria for liver fibrosis: minimal fibrosis (Ishak score 0–1, n=20), medium fibrosis (Ishak score 2–5, n=20) and cirrhosis (Ishak score 6, n=30). SACE activity and ET-1 concentration were determined using commercial ELISA kits. SACE activity and ET-1 concentrations were proportional to the severity of disease, the highest being in patients with liver cirrhosis. Maximal increase in SACE activity was found between minimal and medium fibrosis while maximal increase in ET-1 concentration was revealed between medium fibrosis and cirrhosis. The analysis of the Receiver Operating Characteristic (ROC) curve for SACE activity suggested a cut-off value to separate minimal from medium fibrosis at 59.00 U/L (sensitivity 100%, specificity 64.7%). The cut-off value for serum ET-1 concentration to separate medium fibrosis from cirrhosis was 12.4 pg/mL (sensitivity 96.8%, specificity 94.4%). A positive correlation between SACE activity and ET-1 concentration was registered (Spearman’s ñ=0.438, p=0.004). Both SACE activity and ET-1 concentration were increased in all stages of liver fibrosis. Cut-off points for SACE activity and ET-1 concentration could be a biochemical marker for the progression of fibrosis. Positive correlation between SACE activity and ET-1 concentration might indicate their interaction in the development of liver cirrhosis

Relationship between Polymorphonuclear Leukocyte Count in Bronchoalveolar Lavage Fluid and Bacterial Content in Gram’s Stain and Bacterial Content in Final Microbiological Report

Eighty samples of bronchoalveolar lavage fluid (BALF) were obtained from the total of 48 patients (22 females and 26 males) and analyzed. Eighteen of those patients were organ transplant recipients.The relationship between polymorphonuclear leukocyte (PMN) count in direct sample and semi quantitative Gram-positive and Gram-negative bacterial content were analyzed in BALF samples. PMN count in direct sample and Gram-positive and Gram-negative bacterial content of the final microbiological report was compared as well. On the total number of samples PMN count in direct samples of BALF was statistically significant regarding the presence of Gram-positive bacteria in the same sample; it was nearly significant regarding the presence of Gram-negative bacteria; and it was statistically significant for the total bacterial content. If BALF samples are divided into those obtained from organ-transplant and those obtained from non- -organ-transplant patients, positive, statistically significant relationship is found in the organ-transplant group, more specifically for the relationship between PMNs and total bacterial content. When PMN count in direct microbiological sample was compared with the results of the final microbiological report, statistically significant relationship was found neither with respect to all BALF samples, nor after dividing them into »organ-transplant« and »non-organ-transplant« group. We did not find differences caused by gender

Relationship between Polymorphonuclear Leukocyte Count in Bronchoalveolar Lavage Fluid and Bacterial Content in Gram’s Stain and Bacterial Content in Final Microbiological Report

Eighty samples of bronchoalveolar lavage fluid (BALF) were obtained from the total of 48 patients (22 females and 26 males) and analyzed. Eighteen of those patients were organ transplant recipients.The relationship between polymorphonuclear leukocyte (PMN) count in direct sample and semi quantitative Gram-positive and Gram-negative bacterial content were analyzed in BALF samples. PMN count in direct sample and Gram-positive and Gram-negative bacterial content of the final microbiological report was compared as well. On the total number of samples PMN count in direct samples of BALF was statistically significant regarding the presence of Gram-positive bacteria in the same sample; it was nearly significant regarding the presence of Gram-negative bacteria; and it was statistically significant for the total bacterial content. If BALF samples are divided into those obtained from organ-transplant and those obtained from non- -organ-transplant patients, positive, statistically significant relationship is found in the organ-transplant group, more specifically for the relationship between PMNs and total bacterial content. When PMN count in direct microbiological sample was compared with the results of the final microbiological report, statistically significant relationship was found neither with respect to all BALF samples, nor after dividing them into »organ-transplant« and »non-organ-transplant« group. We did not find differences caused by gender

Initial experiences of hemodialysis HeRO graft in University Hospital Dubrava – A report of two cases and review of literature

U Kliničkoj bolnici Dubrava u Zagrebu prvi je put u Hrvatskoj ugrađen novi sustav za krvožilni pristup kod bolesnika koji se liječi kroničnom hemodijalizom. Radi se o kombinaciji centralnoga venskog katetera i grafta engleskog naziva Hemodialysis Reliable Outflow (HeRO) device, skraćenog naziva HeRO-graft. Glavna je indikacija za primjenu ovoga krvožilnog pristupa okluzija ili značajna stenoza centralnih vena. Iz literature se doznaje da ovaj krvožilni pristup ima značajne prednosti u odnosu na tunelirani centralni venski kateter koji bi trebao biti zadnja opcija kod bolesnika koji zahtijevaju trajno nadomještanje izgubljene bubrežne funkcije. Za razliku od tuneliranih katetera ovaj je sustav u potpunosti smješten potkožno, što ga čini otpornijim na infekcije. Do sada su u Kliničkoj bolnici Dubrava ugrađena dva HeRO-grafta za hemodijalizu i prema prvim iskustvima potrebna je detaljna obrada kandidata za ovu proceduru. Potrebno je dobro poznavati indikacije i kontraindikacije te je nužna suradnja više timova: nefrološkog, anesteziološkog, radiološkog i kirurškog. Osobito je potrebno obratiti pažnju na stanje arterijske cirkulacije okrajine koja se koristi za ovaj krvožilni pristup kako bi se izbjegle moguće ishemijske komplikacije. Kod obaju naših bolesnika postupak ugradnje protekao je uredno te smo započeli s korištenjem HeRO-grafta za potrebe hemodijalize.A new vascular access system in patients undergoing chronic hemodialysis was implanted for the first time in Dubrava University Hospital in Zagreb. It is a combination of a central venous catheter and a graft known as Hemodialysis Reliable Outflow device (HeRO graft). The main indication for this vascular access is the occlusion or a significant stenosis of the central veins. Literature supports the significance of this type of vascular access over tunneled central venous catheters which should be the last option for patients requiring permanent renal replacement therapy. Unlike tunneled catheters, this system is completely located subcutaneously which makes it more resistant to infections. So far, two HeRO grafts for hemodialysis have been implanted in Dubrava University Hospital, and according to the first experiences, detailed workup on candidates is required before this procedure. It is necessary to be well aware of the indications and contraindications, and the cooperation of several specialties is required: nephrology, anesthesiology, radiology and surgery. It is especially important to pay attention to the condition of the arterial circulation of the arm used for this vascular access in order to avoid possible ischemic complications. In both of our patients, the implantation procedure had no immediate complications and we started using the HeRO graft

Accounting and tax treatment of depreciation and value adjustment of long-term tangible assets

Poduzeće ne može poslovati ukoliko ne posjeduje određena sredstva, a osim vlastitih, koristi i tuđa sredstva. Svakodnevno se spominje pojam imovine koji podrazumijeva sredstva poduzeća kojim ono upravlja i koja koristi za svoj rad. Sredstva poduzeća se, s obzirom na to koliko se dugo koriste, dijele na dugotrajnu (stalnu) i kratkotrajnu (tekuću) imovinu. Dok se pod dugotrajnom imovinom podrazumijevaju stalna, pod kratkotrajnom se podrazumijevaju obrtna sredstva. I jedna su i draga važna za poslovanje poduzeća jer imaju doprinos u ostvarivanju njegovih rezultata. S aspekta računovodstva, imovinu je moguće vrednovati prema gotovini koja se ulaže u njeno nabavljanje. Računovodstvenom evidencijom pribavljanja imovine moguće je stvoriti logičnu povezanost među imovinom, s jedne, te obveza i kapitala vlasnika, s druge strane. Pod dugotrajnom se imovinom poduzeća podrazumijevaju njegova sredstva koja upotrebljava u razdoblju dužem od godine dana, a njena je glavna karakteristika njena unovčivost. Korištenjem se imovina troši što se naziva amortizacijom, a počinje onog trenutka kada je imovina spremna za korištenje i kada počinje njena upotreba u poslovanju. Završetkom amortizacije smatra se trenutak kada je istekao vijek njenog korištenja na temelju čega se je i amortizirala. Za obračun amortizacije poduzeće ima na raspolaganju različite metode, a svakako je najjednostavnija linearna. Međutim, koju god metodu poduzeće odabere, važno je da realno i istinito odražava stanje i položaj poduzeća što često u praksi i nije slučaj. Poduzeća često pribjegavaju izračunavanju privremenih razlika te u godini u kojoj se one ukidaju računovodstvena se dobit smanjuje za iznos privremenih razlika te se u bilanci poduzeća iskazuje smanjenje vrijednosti stroja. Uslijed smanjenja njegove vrijednosti smanjuje se i ukupna aktiva, ali i ukupna pasiva poduzeća. Iz svega navedenoga u radu može se zaključiti da obračun amortizacije uvelike utječe na financijske izvještaje poduzeća.The company cannot operate unless it has certain funds, and in addition to its own, it also uses other people's funds. The term property is mentioned every day, which means the funds of the company that it manages and that it uses for its work. Company assets are divided into longterm (permanent) and short-term (current) assets, depending on how long they are used. While long-term assets are fixed assets, short-term assets are working capital. Both are important for the business of the company because they contribute to the achievement of its results. From an accounting perspective, assets can be valued according to the cash invested in their acquisition. With accounting records of the acquisition of assets, it is possible to create a logical connection between assets, on the one hand, and the owner's liabilities and capital, on the other. The longterm assets of a company mean its funds that it uses for a period longer than a year, and its main characteristic is its liquidity. Through use, the asset is consumed, which is called depreciation, and it begins at the moment when the asset can be used and when its use in business begins. The end of amortization is considered the moment when its useful life has expired, on the basis of which it was amortized. For the calculation of depreciation, the company has different methods at its disposal, and the simplest is certainly the linear one. However, whatever method the company chooses, it is important that it realistically and truthfully reflects the state and position of the company, which is often not the case in practice. Companies often resort to the calculation of temporary differences, and in the year in which they are abolished, the accounting profit is reduced by the amount of the temporary differences, and the company's balance sheet shows a decrease in the value of the machine. As a result of the decrease in its value, the total assets, as well as the total liabilities of the company decrease. From everything stated in the paper, it can be concluded that the calculation of depreciation greatly affects the company's financial statements

Accounting and tax treatment of depreciation and value adjustment of long-term tangible assets

Poduzeće ne može poslovati ukoliko ne posjeduje određena sredstva, a osim vlastitih, koristi i tuđa sredstva. Svakodnevno se spominje pojam imovine koji podrazumijeva sredstva poduzeća kojim ono upravlja i koja koristi za svoj rad. Sredstva poduzeća se, s obzirom na to koliko se dugo koriste, dijele na dugotrajnu (stalnu) i kratkotrajnu (tekuću) imovinu. Dok se pod dugotrajnom imovinom podrazumijevaju stalna, pod kratkotrajnom se podrazumijevaju obrtna sredstva. I jedna su i draga važna za poslovanje poduzeća jer imaju doprinos u ostvarivanju njegovih rezultata. S aspekta računovodstva, imovinu je moguće vrednovati prema gotovini koja se ulaže u njeno nabavljanje. Računovodstvenom evidencijom pribavljanja imovine moguće je stvoriti logičnu povezanost među imovinom, s jedne, te obveza i kapitala vlasnika, s druge strane. Pod dugotrajnom se imovinom poduzeća podrazumijevaju njegova sredstva koja upotrebljava u razdoblju dužem od godine dana, a njena je glavna karakteristika njena unovčivost. Korištenjem se imovina troši što se naziva amortizacijom, a počinje onog trenutka kada je imovina spremna za korištenje i kada počinje njena upotreba u poslovanju. Završetkom amortizacije smatra se trenutak kada je istekao vijek njenog korištenja na temelju čega se je i amortizirala. Za obračun amortizacije poduzeće ima na raspolaganju različite metode, a svakako je najjednostavnija linearna. Međutim, koju god metodu poduzeće odabere, važno je da realno i istinito odražava stanje i položaj poduzeća što često u praksi i nije slučaj. Poduzeća često pribjegavaju izračunavanju privremenih razlika te u godini u kojoj se one ukidaju računovodstvena se dobit smanjuje za iznos privremenih razlika te se u bilanci poduzeća iskazuje smanjenje vrijednosti stroja. Uslijed smanjenja njegove vrijednosti smanjuje se i ukupna aktiva, ali i ukupna pasiva poduzeća. Iz svega navedenoga u radu može se zaključiti da obračun amortizacije uvelike utječe na financijske izvještaje poduzeća.The company cannot operate unless it has certain funds, and in addition to its own, it also uses other people's funds. The term property is mentioned every day, which means the funds of the company that it manages and that it uses for its work. Company assets are divided into longterm (permanent) and short-term (current) assets, depending on how long they are used. While long-term assets are fixed assets, short-term assets are working capital. Both are important for the business of the company because they contribute to the achievement of its results. From an accounting perspective, assets can be valued according to the cash invested in their acquisition. With accounting records of the acquisition of assets, it is possible to create a logical connection between assets, on the one hand, and the owner's liabilities and capital, on the other. The longterm assets of a company mean its funds that it uses for a period longer than a year, and its main characteristic is its liquidity. Through use, the asset is consumed, which is called depreciation, and it begins at the moment when the asset can be used and when its use in business begins. The end of amortization is considered the moment when its useful life has expired, on the basis of which it was amortized. For the calculation of depreciation, the company has different methods at its disposal, and the simplest is certainly the linear one. However, whatever method the company chooses, it is important that it realistically and truthfully reflects the state and position of the company, which is often not the case in practice. Companies often resort to the calculation of temporary differences, and in the year in which they are abolished, the accounting profit is reduced by the amount of the temporary differences, and the company's balance sheet shows a decrease in the value of the machine. As a result of the decrease in its value, the total assets, as well as the total liabilities of the company decrease. From everything stated in the paper, it can be concluded that the calculation of depreciation greatly affects the company's financial statements