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

Antecedents and Consequences of Agentic and Communal Stressful Life Events in Adolescence

The relationships among frequency and intensity measures of agentic and communal stressful life events was examined on the sample of 265 subjects ranging in age from 11 to 14 years. Also, the relations of the two measures of agentic and communal stressful life events (intensity and frequency) with several antecedents (age, sex, personality traits) and consequences (coping styles and school grades) were examined. The results obtained show that intensity and frequency measures represent different aspects of stressful experience. The relationships among variables are different in boys and girls, especially with regard to the types of stressful life events (agentic and communal). The participants\u27 age is significantly positively related to the frequency of agentic stressful events and overall frequency. Boys have significantly higher scores on the frequency of agentic and the frequency of overall stressful life events than girls. Eysenck\u27s personality traits better predict agentic stressful events and frequency measures on the subsample of boys, whereas they better predict communal stressful events and intensity measures on the subsample of girls. Furthermore, the intensity and frequency measures of agentic and communal stressful life events are related to different coping styles. Girls demonstrate greater differentiation in utilizing certain coping styles under the influences of various stressful events. In both subsamples, the frequency of agentic stressors is prospectively negatively related to school grades

Burnout in dispositional context: the role of personality traits, social support and coping styles

Big five personality traits, social support and coping styles were examined as predictors of three dimensions of burnout on the sample of 214 nurses using hierarchical regression analyses. Personality traits were included into the first step of the analyses, three sources of social support (co-workers, family and friends support) in the second, and in the third step three coping styles (problem-focused coping, emotion-focused coping and avoidance coping). The results show that out of five personality traits neuroticism positively predicted exhaustion, while agreeableness negatively predicted reduced professional efficacy. Regarding three sources of social support, only co-worker support negatively predicted exhaustion as well as reduced professional efficacy. Regarding coping styles examined, only avoidance coping positively predicted depersonalization. The results obtained were explained by several mechanisms through which personality variables may exert their effects on burnout

Personality, organizational stress, and attitudes toward work as prospective predictors of professional burnout in hospital nurses

Aim To examine to what extent personality traits (extraversion, agreeableness, conscientiousness, neuroticism, and openness), organizational stress, and attitudes toward work and interactions between personality and either organizational stress or attitudes toward work prospectively predict 3 components of burnout. Methods The study was carried out on 118 hospital nurses. Data were analyzed by a set of hierarchical regression analyses, in which personality traits, measures of organizational stress, and attitudes toward work, as well as interactions between personality and either organizational stress or attitudes toward work were included as predictors, while 3 indices of burnout were measured 4 years later as criteria variables. Results Personality traits proved to be significant but weak prospective predictors of burnout and as a group predicted only reduced professional efficacy (R2 = 0.10), with agreeableness being a single negative predictor. Organizational stress was positive, affective-normative commitment negative predictor, while continuance commitment was not related to any dimension of burnout. We found interactions between neuroticism as well as conscientiousness and organizational stress, measured as role conflict and work overload, on reduced professional efficacy (βNRCWO = -0.30; ßcRCWO = -0.26). We also found interactions between neuroticism and affective normative commitment (β = 0.24) and between openness and continuance commitment on reduced professional efficacy (β = -0.23), as well as interactions between conscientiousness and continuance commitment on exhaustion. Conclusion Although contextual variables were strong prospective predictors and personality traits weak predictors of burnout, the results suggested the importance of the interaction between personality and contextual variables in predicting burnout

Experiences obtained in 4 years of work of the Clinical department of child and adolescent psychiatry in Osijek

U radu je prikazana struktura i organizacija Kliničkog odjela dječje i adolescentne psihijatrije od njezina početnog rada, početne strukture i sadašnje organizacije, te djelokruga rada u tijeku četverogodišnjeg funkcioniranja. U sadašnjem obliku timski su djeca u organiziranom angažmanu terapeuta. Broj hospitalizirane djece u prosjeku je godišnje oko 250, razvrstanih u najizrazitije dijagnostičke grupe, gdje je prve dvije godine najveća zastupljenost mlađe dobne skupine sa simptomom noćne enureze, a posljednje dvije godine adolescentna dob s adolescentnim kriznim odrastanjem.Clinical section for child and adolescent psychiatry treata school children by means of team observation. The members of the team are: a psychiatrist, professors of psychiology and nurses, a therapist and a music therapist. The metods used are group and individual psychotherapy, group and individual pedagogical treatment, music therapy and ocupational wark therapy. The everyday life at the clinic is organized by principles of a therapy communion. The population diverses in sex, age and diagnostic categorries, which has a certain meaning for the psycotherapeutical process. The major point at such a climic is constant and direct observation of the children, with clinical and pedagogical orientation and the study of the object relationships between a child and its environment. This kind of stationary psychotherapy is of a multidimensional apprech. Because of time limitations it is characterised by the use of facus psychotherapy the clinic as a »peaceful casis« for the therapy, constant observation of the nurses who spend 24 hour a day with the children, and the combination of different therap techiques and different therapists

Procjena genotoksičnih učinaka irinotekana i cisplatina na zdrave mišje stanice primjenom alkalnog komet testa

The purpose of cytostatic agents is to act exclusively upon tumor cells, and to inhibit growth or induce tumor cell death by impairing their cell cycle progression. However, the majority of these agents are not specific in their action, and subsequently produce toxic effects on healthy tissues causing significant adverse events in both patients and health professionals exposed to these drugs. Various cytogenetic and molecular biology assays play an important role in the assessment of genotoxic effects related to antineoplastic drugs. Within a short period after exposure to a potentially genotoxic agent, these assays are able to assess the level of cellular DNA damage and/or to monitor the dynamics of DNA repair. Sensitive techniques, such as alkaline comet assay, are of special importance in the detection of primary DNA damage occurring in individual cells regardless of the cell cycle phase. The aim of the study was to assess and compare DNA damage that irinotecan and cisplatin induce in peripheral leukocytes, and normal kidney, liver and brain cells of Swiss albino mice. The results show that both cytostatics produce statistically significant DNA damage in normal cells compared to the control group. Compared to irinotecan, cisplatin has a significantly more potent genotoxic effect on these cells, which may be attributed to various mechanisms of action of the studied drugs.Po svojoj namjeni citostatici bi trebali djelovati isključivo na tumorske stanice, te narušavanjem njihovog staničnog ciklusa spriječiti rast ili izazvati smrt tih stanica. Međutim, većina ovih lijekova je u svom djelovanju nespecifična, zbog čega se toksične posljedice odražavaju i na stanicama zdravih tkiva, a rezultat toga su značajne nuspojave u bolesnika i osoba koje su profesionalno izložene tim lijekovima. U procjeni genotoksičnih učinaka antineoplastičnih lijekova značajnu ulogu imaju različiti citogenetični i molekularno-biološki testovi. Pomoću njih u kratkom vremenskom razdoblju nakon izlaganja nekom potencijalno genotoksičnom agensu, možemo procijeniti razinu oštećenja stanične DNA i/ili pratiti dinamiku njenog popravka. Posebnu važnost imaju tehnike poput alkalnog komet testa koje omogućavaju osjetljivo otkrivanje primarnih oštećenja DNA u pojedinačnim stanicama, neovisno o fazi staničnog ciklusa. Cilj našeg istraživanja je bio ustanoviti i usporediti oštećenja DNA koja izazivaju irinotekan i cisplatina na leukocitima periferne krvi, na zdravim stanicama bubrega, jetre i mozga Swiss albino miševa. Sukladno rezultatima istraživanja oba citostatika dovode do statistički značajnih oštećenja DNA spomenutih zdravih stanica u odnosu na kontrolnu skupinu. Međusobno uspoređujući irinotekan i cisplatinu možemo zamijetiti da cisplatina ima statistički značajno jači genotoksični učinak od irinotekana na spomenute stanice, što pripisujemo različitim mehanizmima djelovanja promatranih citostatika

Experiences obtained in 4 years of work of the Clinical department of child and adolescent psychiatry in Osijek

U radu je prikazana struktura i organizacija Kliničkog odjela dječje i adolescentne psihijatrije od njezina početnog rada, početne strukture i sadašnje organizacije, te djelokruga rada u tijeku četverogodišnjeg funkcioniranja. U sadašnjem obliku timski su djeca u organiziranom angažmanu terapeuta. Broj hospitalizirane djece u prosjeku je godišnje oko 250, razvrstanih u najizrazitije dijagnostičke grupe, gdje je prve dvije godine najveća zastupljenost mlađe dobne skupine sa simptomom noćne enureze, a posljednje dvije godine adolescentna dob s adolescentnim kriznim odrastanjem.Clinical section for child and adolescent psychiatry treata school children by means of team observation. The members of the team are: a psychiatrist, professors of psychiology and nurses, a therapist and a music therapist. The metods used are group and individual psychotherapy, group and individual pedagogical treatment, music therapy and ocupational wark therapy. The everyday life at the clinic is organized by principles of a therapy communion. The population diverses in sex, age and diagnostic categorries, which has a certain meaning for the psycotherapeutical process. The major point at such a climic is constant and direct observation of the children, with clinical and pedagogical orientation and the study of the object relationships between a child and its environment. This kind of stationary psychotherapy is of a multidimensional apprech. Because of time limitations it is characterised by the use of facus psychotherapy the clinic as a »peaceful casis« for the therapy, constant observation of the nurses who spend 24 hour a day with the children, and the combination of different therap techiques and different therapists

Procjena genotoksičnih učinaka irinotekana i cisplatina na zdrave mišje stanice primjenom alkalnog komet testa

The purpose of cytostatic agents is to act exclusively upon tumor cells, and to inhibit growth or induce tumor cell death by impairing their cell cycle progression. However, the majority of these agents are not specific in their action, and subsequently produce toxic effects on healthy tissues causing significant adverse events in both patients and health professionals exposed to these drugs. Various cytogenetic and molecular biology assays play an important role in the assessment of genotoxic effects related to antineoplastic drugs. Within a short period after exposure to a potentially genotoxic agent, these assays are able to assess the level of cellular DNA damage and/or to monitor the dynamics of DNA repair. Sensitive techniques, such as alkaline comet assay, are of special importance in the detection of primary DNA damage occurring in individual cells regardless of the cell cycle phase. The aim of the study was to assess and compare DNA damage that irinotecan and cisplatin induce in peripheral leukocytes, and normal kidney, liver and brain cells of Swiss albino mice. The results show that both cytostatics produce statistically significant DNA damage in normal cells compared to the control group. Compared to irinotecan, cisplatin has a significantly more potent genotoxic effect on these cells, which may be attributed to various mechanisms of action of the studied drugs.Po svojoj namjeni citostatici bi trebali djelovati isključivo na tumorske stanice, te narušavanjem njihovog staničnog ciklusa spriječiti rast ili izazvati smrt tih stanica. Međutim, većina ovih lijekova je u svom djelovanju nespecifična, zbog čega se toksične posljedice odražavaju i na stanicama zdravih tkiva, a rezultat toga su značajne nuspojave u bolesnika i osoba koje su profesionalno izložene tim lijekovima. U procjeni genotoksičnih učinaka antineoplastičnih lijekova značajnu ulogu imaju različiti citogenetični i molekularno-biološki testovi. Pomoću njih u kratkom vremenskom razdoblju nakon izlaganja nekom potencijalno genotoksičnom agensu, možemo procijeniti razinu oštećenja stanične DNA i/ili pratiti dinamiku njenog popravka. Posebnu važnost imaju tehnike poput alkalnog komet testa koje omogućavaju osjetljivo otkrivanje primarnih oštećenja DNA u pojedinačnim stanicama, neovisno o fazi staničnog ciklusa. Cilj našeg istraživanja je bio ustanoviti i usporediti oštećenja DNA koja izazivaju irinotekan i cisplatina na leukocitima periferne krvi, na zdravim stanicama bubrega, jetre i mozga Swiss albino miševa. Sukladno rezultatima istraživanja oba citostatika dovode do statistički značajnih oštećenja DNA spomenutih zdravih stanica u odnosu na kontrolnu skupinu. Međusobno uspoređujući irinotekan i cisplatinu možemo zamijetiti da cisplatina ima statistički značajno jači genotoksični učinak od irinotekana na spomenute stanice, što pripisujemo različitim mehanizmima djelovanja promatranih citostatika

Interakcija inhalacijskih anestetika i citostatika

Inhaled anesthetics are often used for inducing or maintaining anesthesia in cancer patients as the length and complexity of the surgical procedure cannot be predicted for it depends on intraoperative surgical and pathohistological findings, and as often as not requires repeated operations for removal or reduction of the primary tumor, regional metastases, recurrence, pathological fractures, or surgery complications. These are easily volatile liquids that enter the body through inhalation, and then, by diffusion through the aleveolocapillary membrane, they are transferred into the blood stream to be transported to all other organs and the central nervous system. Most of the inhaled anesthetics are eliminated from the body through respiration; a portion of them, however, metabolizes in the liver via the cytochrome P450 oxidase family and is excreted via the kidneys, so the issue of their toxicity has always attracted a considerable interest from investigators. Cancer patients receiving cytostatic agents during the perioperative period increase in number every day. Aside from their planned surgery, cancer patients receiving cytostatics also undergo emergency surgery either for their disease complication or for another reason. It is important to understand the pharmacology of cytostatics, their interaction with anesthetics, pharmacokinetics and toxic reactions. Cytostatics and general anesthetics act immunosuppressively and thus compromise the patient’s immune status. In addition, cytostatics depress the myocardium and damage lung function, which can cause serious problems during anesthesia. Each anesthesia as well as each surgery produce stress on the body, and the anesthetics themselves alter the cell immunity so the patients receiving cytostatics during their perioperative period can experience serious general and organ-specific side effects. It would be worth knowing whether any of the most commonly used anesthetics today show an advantage in treating patients withcancer, especially patients receiving chemotherapy, and whether the inhaled anesthetics combined with cytostatics increase, enhance or even suppress the individual effect on various types of cells, above all on tumor cells that can become resistant to therapy for developing the so-called „multidrug resistance“.Inhalacijski anestetici često se primjenjuju za uvod u anesteziju ili za održavanje anestezije kod onkoloških bolesnika zbog toga što se kod uvoda u anesteziju dužina i opseg operacijskog zahvata često ne mogu predvidjeti i ovise o intraoperacijskom kirurškom i patohistološkom nalazu, a nerijetko su potrebne ponavljane operacije zbog uklanjanja ili redukcije primarnog tumora, regionalnih metastaza, recidiva bolesti, udaljenih metastaza, patoloških fraktura ili zbog komplikacija same operacije. To su lako hlapljive tekućine koje u organizam ulaze udisanjem, a zatim difuzijom kroz alveolokapilarnu membranu prelaze u krvotok, krvotokom se dopremaju do svih ostalih organa i do središnjeg živčanog sustava. Veći dio inhaliranih anestetika se eliminira iz organizma respiracijom, me|utim jedan dio metabolizira se u jetri putem obitelji citokrom oksidaza P450 i izlučuje putem bubrega te je pitanje njihove toksičnosti oduvijek izazivalo veliki interes istraživača. Svakodnevno se povećava broj onkoloških bolesnika koji u periperacijskom periodu primaju citostatike. Osim planiranih operacijskih zahvata onkološki bolesnici koji primaju citostatike podvrgavaju se i hitnim operacijskim zahvatima, bilo zbog komplikacija bolesti ili zbog nekog drugog razloga. Važno je razumjeti farmakologiju citostatika, interakciju s anesteticima, farmakokinetiku i toksične reakcije. Citostatici i opći anestetici djeluju imunosupresivno na bolesnika te kompromitiraju njegov imunološki status. Osim toga, citostatici deprimiraju miokard i oštećuju plućnu funkciju, što može izazvati ozbiljne probleme u anesteziji. Svaka anestezija i operacija predstavlja stres za organizam, a sami anestetici mijenjaju staničnu imunost, te bolesnici koji primaju citostatike u perioperacijskom periodu mogu imati ozbiljne opće i organ specifične nuspojave. Bilo bi dobro znati ima li neki od danas najčešće upotrebljavanih anestetika prednost u primjeni kod onkoloških bolesnika, osobito ako ti bolesnici primaju citostatike te da li inhalacijski anestetici i citostatici u kombinaciji povećavaju, potenciraju ili čak suprimiraju pojedinačni učinak na različite vrste stanica, osobito tumorskih stanica koje mogu postati rezistentne na terapiju zbog tzv. „multidrug resistance“