Probiotici i prebiotici kod arterijske hipertenzije

There is growing evidence that a disturbed microbiota, a complex ecosystem, is associated with the development of numerous diseases, including arterial hypertension. This complex cardiovascular disease is the result of not sufficiently clear role that genetic and environmental factors play in it. Not only does the treatment of hypertension include a drug therapy, but also it includes a variety of non-pharmacological measures based on dietary intervention. Probiotics and prebiotics are besides the nutrition the most commonly used substances that are aimed at maintaining a healthy microbiome or restoring the balance in case of disturbed bacterial homeostasis in disease. Although many studies have confirmed the effects of an imbalance in the gut microbiota (dysbiosis) in the last decade, the benefits of dietary intervention with probiotics in people with hypertension need to be supported by stronger evidence and further clinical trials in order to be ultimately confirmed.Sve je više dokaza da je narušen sustav ljudske mikrobiote, kompleksnog eko sistema, povezan s patogenezom brojnih bolesti, među ostalim i arterijske hipertenzije (AH). Ova kompleksna kardiovaskularna bolest rezultat je još uvijek nepotpuno jasne uloge genetskih i okolišnih čimbenika. Liječenje AH pored medikamentnog liječenja obuhvaća i višestruke nefarmakološke mjere čiji temelj predstavljaju dijetalne intervencije. Najčešće korištene tvari kojima se nastoji održati zdrav mikrobiom ili uspostaviti ravnoteža pri poremećenoj bakterijskoj homeostazi u bolesti su, osim prehrane, probiotici i prebiotici. Iako mnoga istraživanja u zadnjem desetljeću potvrđuju učinak disbalansa crijevne mikrobiote (tzv. disbioze), za definitivnu potvrdu dobrobiti dijetalne intervencije probioticima kod osoba s AH, potrebni su snažniji dokazi te daljnja klinička istraživanja

Treatment Cost of Patients with Maxillofacial Fractures at the University Hospital in Mostar 2002–2006

The aim of this study was to establish the costs structure of medical treatment for the patients with maxillofacial fractures, to perform a treatment cost evaluation, describe the factors which considerably influence the costs and discover the ways of achieving financial savings in treated patients. The study group consisted of patients with maxillofacial fractures who were admitted and treated at the Department of Maxillofacial Surgery of the University Hospital Mostar in the period from January 2002 until December 2006. Data for the study were collected from the patients’ databases, case histories and data obtained on the basis of individual payments for the treatment that was collected by Finance Department of the University Hospital of Mostar. Most patients in this study were men (83%), of average age 34±19 years. Zygomatic bone fracture was the commonest injury. Open surgical procedure was performed in 84.7% of treated cases. The costs for the open procedure were considerably higher than conservative treatment. Medication cost made up a total of 37.9% and cost of hospital accommodation 27.3% out of total hospital charge. Cost reduction in treated patients with maxillofacial fractures should be achieved through protocols of urgent treatment of maxillofacial trauma patients immediately after sustaining an injury and with earlier discharge of the patients when postoperative complications are not expected

RECENT ADVANCES IN DIAGNOSIS, MANAGEMENT AND PREVENTION OF RH IMMUNISATION

Rh imunizacija kroz hemolitičku bolest fetusa i novorođenčeta (HBFN) najčešći je uzrok fetalne anemije tijekom trudnoće. Amniocenteza je godinama korištena kao metoda probira kroz određivanje OD 450 uz pomoć Lileyeva dijagrama, no u novije je vrijeme zamijenjena neinvazivnim određivanjem maksimalne brzine protoka u središnjoj moždanoj arteriji fetusa. Napredak je postignut i u liječenju HBFN gdje je konzervativno liječenje zamijenjeno intrauterinom intravaskularnom fetalnom transfuzijom. Također, učinjene su brojne promjene u profilaksi bolesti, ponajviše kroz davanje profilaktičkih anti D imunoglobulina svim Rh negativnim trudnicama. Ta tri postupka smanjila su perinatalnu smrtnost i pobol vezan uz HBFN.Rh immunization and hemolytic disease of the fetus and newborn (HDFN) are one of the most common causes of fetal anemia in pregnancy. Traditionally used amniocentesis and determination of OD 450 using Liley diagram is nowadays replaced by measurements of the peak systolic velocity of the blood flow in the middle fetal cerebral artery. Further advances are obtained in the treatment of HDFN where conservative treatment is completely replaced by intrauterine intravascular blood transfusion. As well as that, there is a marked improvement obtained by adapting the prophylactic protocol, with the most important, administration of anti D immunoglobulin to all Rh negative women. These three procedures resulted in reduction of perinatal mortality and morbidity related to HDFN

Ossifying Fibroma of the Orbit

Osificirajući fibrom glave i vrata rijedak je tumor koji najčešće zahvaća gornju i donju čeljust. Javlja se u trećem i četvrtom desetljeću života. Lezija je obično solitarna, dobro ograničena. Postupnim rastom stanjuje okolno zdravo koπtano tkivo. Radiološka slika ovisi o trajanju bolesti. U ranome stadiju prikazuje se kao oštro ograničeno prosvjetljenje s pojedinačnim nakupinama kalcifikata. U daljnjem tijeku, uz oštro ograničenu zonu prosvjetljenja na periferiji, središnje smještene nakupine kalcifikata postaju gušće. Histološku sliku karakterizira fibrozno tkivo isprepleteno koštanim trabekulama lamelarne kosti koje su obrubljene osteoblastima i mjestimice miksomatoznom stromom. Terapija je kirurška i sastoji se u potpunoj resekciji tumora, koja jedino može spriječiti pojavu lokalnoga recidiva. U radu smo prikazali rijedak slučaj osificirajućeg fibroma orbite koji je zahvatio zigomatičnu kost i proširio se preko velikoga krila sfenoida do optičkoga kanala. Specifičnost terapije u naše bolesnice jest u tome što je unatoč doticaja tumora s prednjom lubanjskom bazom nije upotrijebljen neurokirurški pristup.Ossifying fibroma of the head and neck is a rare tumour which most frequently involves the upper and lower jaw. It occurs during the third and fourth decade of life. The lesion is usually solitary and well circumscribed. It grows slowly, thinning the surrounding healthy bone tissue. Radiographic appearance depends on the duration of the disease. In the early stage it presents as a sharply circumscribed zone of translucency with single accumulations of calcification. During the further course, with the sharply circumscribed zone of translucency on the periphery, the centrally located accumulations of calcification become denser. The histological appearance is characterised by fibrous tissue, interwoven with bony trabeculae of lamellar bones, which are bordered with osteoblasts and scattered myxomatous stroma. Therapy is surgical and consists of total resection of the tumour, which is the only way to prevent the occurrence of a local recurrence. In this paper we present a rare case of ossifying fibroma of the orbit which involved the zygomatic bone and spread/extended via the large branch of the sphenoid up to the optic canal. The specificity of the therapy in our female patient was that in spite of contact of the tumour with the frontal base of the skull, a neurosurgical approach was not used

Istraživanje mehaničkih oštećenja stabala jele i drugih vrsta tijekom eksploatacije – Slučaj Šumarije „Glamoč“

Mechanisation used in forest utilisation has an impact on the occurrence of damage in stand and on forest land. The research in this work had the objective of determining damage on fir trees and other tree species during felling and processing of trees and their skidding using the forest cable-skidder. The research wasconducted in mixed beech and fir forests in the area of FMA “Glamočko”, M.U. “Hrbinje-Kujača”. The following data were gathered on damaged trees: tree type, breast height diameter, economic importance of the tree, amount of damage, location of damage, cause of damage, types of damage. Damage was recorded on a total of 305 trees, 133 trees of silver fir (Abies alba), 130 trees of European beech (Fagus sylvatica), 33 trees of European spruce (Picea abies), 8 trees of rowan/mountain-ash (Sorbusaucuparia) and one tree of sycamore (Acer pseudoplatanus). The overall damage intensity was 18.7%, but together with the old damages, the overall number of ‘wounds’ is 496. According to this, when the old damage isalso considered, then the intensity of damage amounts to 30.6%. The largest amount of damage is in the diameter sub-class ranging from 10 to 14.99 cm. According to the cause of damage, the largest amount of damage occurred during the wood extraction phase (217 trees), while during the felling phase, 88 trees or 29% were damaged. Since the wood extraction phase is divided into the winching and skidding phases, the total number of damaged trees during the winching phase amounted to 157 or 52%, while during the skidding phase, the number of damaged trees was 60 or 19%. To reduce damage to the trees during following operations in forest utilisation, it is necessary to perform more frequent training of all employees working on forest utilisation, to increase controls in execution of operations during forest utilisation, modernise machines used during forest exploitation, and in quality manner open compartments with forest road infrastructure.Mehanizacija koja se koristi u iskorištavanju šuma utječe na pojavu oštećenja u sastojini i na šumskom tlu. Istraživanja u ovom radu su imala za cilj utvrđivanje oštećenja na stablima jele i drugih vrsta drvća pri sječi i izradi drvnih sortimenata te privlačenju šumskim zglobnim traktorom.Istraživanja su obavljena u mješovitim šumama bukve i jele sa smrekom na području ŠGP „Glamočko”, G.J. „Hrbinje-Kujača“. Prikupljeni su sljedeći podaci o oštećenim stablima: vrsta drveća, prsni promjer stabla, privredna važnost stabla, broj oštećenja, mjesto oštećenja, uzrok oštećenja, vrsta oštećenja.Oštećenja su evidentirana kod ukupno 305 stabala, 133 stabala jele (Abies alba), 130 stabala bukve (Fagus sylvatica), 33 stabla smreke (Picea abies), osam stabala jarebike (Sorbus aucuparia) i jedno (1) stablo gorskog javora (Acer pseudoplatanus). Ukupan intenzitet oštećenja je iznosio 18,7%, a kad tome pridodamo i stara oštećenja, ukupan broj ozljeda iznosi 496. Prema tomu, kada se u obzir uzmu i stara oštećenja, tada intenzitet oštećenja iznosi 30,6%. Najveći broj oštećenja se nalazi u debljinskom stepenu od 10 do 14,99 cm.Prema uzroku oštećenja, najveći broj oštećenja je nastao prilikom faze privlačenja (217 stabala), dok je prilikom sječe oštećeno 88 ili 29% stabala. Kako je faza privlačenja podijeljena na fazu primicanja i privlačenja, ukupan broj oštećenih stabala tijekom faze primicanja iznosio je 157 ili 52%, dok je tijekom privlačenja broj oštećenih stabala iznosio 60 ili 19%.Da bi se prilikom sljedećih operacija iskorištavanja šuma smanjile štete na stablima, potrebna je češća edukacija svih djelatnika koji obavljaju poslove iskorištavanja šuma, potrebno je povećati kontrole obavljanja svih poslova prilikom iskorištavanja šuma, modernizirati strojeve koji se koriste prilikom eksploatacije šuma te na kvalitetan način otvoriti odjele šumskim komunikacijama

Possibilities of Nanotechnology Application in the Food Sector with Reference on its Consumers Acceptance

Nanotehnologija je jedna od najnovijih tehnologija koja je našla svoju primjenu u raznim granama industrije, uključujući i prehrambenu industriju. Ona ima važan utjecaj na znanost o hrani od toga kako je hrana proizvedena pa sve do toga kako je zapakirana. Nanotehnologija nudi niz prednosti za industriju i potrošače, ali treba uzeti u obzir i moguće rizike. Dostupna literatura ukazuje da mnoge nejasnoće oko nanomaterijala još uvijek postoje, uključujući i mogućnost bioakumulacije pa tako i potencijalne opasnosti za ljudsko zdravlje. Dok je moguća primjena nanotehnologije zaista široka i raznolika, razvoj se suočio s određenim oprezom, a napredak može biti stopiran zbog nedostatnog financiranja projekata i zbog potencijalnih rizika. U ovom radu prikazani su aspekti primjene nanotehnologije u prehrambenoj industriji, zakonodavni okvir te mišljenje potrošača o pitanju korištenja nanotehnologije u hrani.Nanotechnology is one of the newest technologies that found its application in various fi elds, including food and beverage industry. It has an important impact on many aspects of food science, from the field of production to the fi eld of packaging. Although, nanotechnology offers many advantages for industry and consumers; the possible risks of its application should be taken into account. Available literature suggests that many uncertainties remain about nanomaterials, including the potential for bioaccumulation and potential human health risks. While proposed applications of nanotechnologies are wide and varied, developments are met with some caution, while progress may be stifled by lack of projects financial support and potential risks. This paper presents various possibilities of nanotechnology application in the food industry, the legislative framework and the opinion of consumers regarding the use of nanotechnology in food

Indication for the Closure of a Facial Defects by Second Intention Healing

Zatvaranje defekata u području glave i vrata sekundarnim cijeljenjem alternativa je primarnoj rekonstrukciji. Za dobar poslijeoperacijski estetski rezultat važno je odabrati veličinu i lokalizaciju kožnoga defekta te podučiti bolesnika o njezi rane i dužini liječenja. U pravilu su konkavni predjeli kože lica najpogodniji za sekundarno cijeljenje. Kod dobro postavljenih indikacija sekundarno je cijeljenje metoda s izvrsnim estetskim poslijeoperacijskim rezultatom. Ako je rezultat estetski neprihvatljiv, i dalje ostaju moguće sve druge kirurške metode rekonstrukcije.Closure of a defect in the head and neck area by second intention is an alternative to primary reconstruction. In order to achieve a satisfactory post-operational, aesthetic result it is important to choose the size and localisation of the dermal defect, and to educate the patient on care of the wound for the duration of treatment. As a rule the concave areas of the facial skin are the most suitable for healing by second intention. In cases of well-established indications healing by second intention is a method with excellent esthetical post-operational result. However, if the result is aesthetically unacceptable, the possibility of performing other surgical methods of reconstruction, remains

Kliničke karakteristike i liječenje lupusnog nefritisa - preliminarna analiza opservacijskih podataka Nacionalnog referentnog centra

Lupus nephritis (LN) is one of the most severe features of systemic lupus erythematosus (SLE). Data on LN is scarce in the Croatian population. We analysed the characteristics of LN patients diagnosed at our tertiary referral centre. In this retrospective study, we analysed the following features of patients with biopsy-proven LN diagnosed between 2011 and 2020: demographics, renal laboratory parameters, renal histopathology, and treatment. A total of 38 patients were included (30 females; mean age 39±15 years). The most common indication for kidney biopsy was proteinuria (89%). The proportion of LN classes was: class I (2.6%), II (5.3%), III (18.4%), IV (42.1%), V (13.2%), III+V (10.5%), IV+V (5.3%). The median time from SLE diagnosis to histologic confirmation of LN was 1.0 year. All patients were treated with methylprednisolone (MP), 68% received MP pulses. Induction treatment included intravenous (IV) cyclophosphamide (CYC) (71%) (15 patients treated per Euro-Lupus and 9 per the National Institutes of Health regimen), oral CYC (3%), or mycophenolate mofetil (11%). 79% of patients received antimalarials. While there is heterogeneity between different populations, our patient profile was similar to that from other European studies. Further follow-up of this group is necessary to assess outcomes in our population.Lupusni nefritis (LN) je česta i vrlo ozbiljna manifestacija sustavnog eritemskog lupusa (SLE). Još uvijek nema dovoljno podataka o karakteristikama bolesnika s LN u Hrvatskoj. Analizirali smo karakteristike bolesnika s LN koji su liječeni u referentnom centru naše tercijarne ustanove. U ovu retrospektivnu studiju uključili smo bolesnike s biopsijom potvrđenim LN u periodu od 2011. do 2020. godine, analizirali smo demografske podatke, parametre bubrežne funkcije, patohistološki nalaz bioptata bubrega i liječenje. U studiju je uključeno 38 bolesnika (30 žena, prosječna dob 39±15godina). Najčešća indikacija za biopsiju bubrega bila je proteinurija (89%). Raspodjela klasa LN bila je sljedeća: klasa I(2,6 %), II(5,3 %), III(18,4 %), IV(42,1 %), V(13,2 %), III+V(10,5 %), IV+V(5,3 %). Prosječno vrijeme od dijagnoze SLE do histološke potvrde LN bilo je 1,0 godina. Svi bolesnici su liječeni kortikosteroidima, 68 % liječeno je bolusima metilprednizolona. Indukcijska terapija uključivala je parenteralnu primjenu ciklofosfamida (CYC) (71 %) (15 bolesnika liječeno je prema Euro-lupus protokolu, 9 bolesnika prema protokolu Nacionalnog instituta za zdravlje (NIH)), peroralni CYC (3 %) ili mikofenolat mofetil (11 %). Antimalarike je primilo 79 % bolesnika. Unatoč heterogenosti između različitih populacija s LN, profil bolesnika uključen u ovu studiju sličan je ostalim europskim studijama. Daljnje praćenje potrebno je da bi se istražili ishodi u ovoj populaciji

Gastrointestinalni stromalni tumor koji oponaša ginekološku patologiju: prikaz slučaja

Diagnosis of gastrointestinal stromal tumors (GISTs) of the terminal part of the small intestine on ultrasound examination can be difficult because of their similarity in appearance to gynecological tumors. We present a case of a 49-year-old asymptomatic female patient with GIST of the small intestine, which presented as a pelvic mass, mimicking an ovarian tumor. Tumor was diagnosed during the control check up and ultrasound gynecological examination. Computed tomography (CT) showed tumor mass in the pelvis on the right and free fluid in the lesser pelvis. During the surgery, exploration of the abdominal cavity displayed tumor of the terminal part of the small intestine (ileum). The uterus and both adnexes were normal. The patient was treated by resection of the terminal part of the small intestine and termino-terminal anastomosis. Immunohistochemical evaluation demonstrated positive vimentin, positive CD117, and negative CD 34. In the presence of a pelvic mass, especially if other unusual anamnestic data are present, the possibility of other than a gynecologic tumor has to be considered.Dijagnozu gastrointestinalnih stromalnih tumora (GIST) završnog dijela tankog crijeva teško je postaviti ultrazvučnim pregledom jer su izgledom nalik ginekološkim tumorima. Opisujemo slučaj 49-godišnje asimptomatične bolesnice s GISTom tankog crijeva koji se prikazuje kao tvorba u zdjelici i oponaša tumor jajnika. Tumor je dijagnosticiran na kontrolnom i ultrazvučnom ginekološkom pregledu. Kompjutorizirana tomografija (CT) otkrila je tumorsku tvorbu u zdjelici i slobodnu tekućinu maloj zdjelici. Pretraživanjem trbušne šupljine tijekom operacije otkriven je tumor završnog dijela tankog crijeva (ileuma). Maternica i adneksi bili su zdravi. Bolesnici je napravljena resekcija završnog dijela tankog crijeva i termino-terminalna anastomoza. Imunohistokemijska analiza pokazala je pozitivnu reakciju na vimentin i CD117; te negativnu na CD 34. Kad je u zdjelici prisutna tvorba; osobito ako su i drugi anamnestički podaci neuobičajeni; treba uzeti u obzir mogućnost da je riječ o nekom drugom; a ne ginekološkom tumoru