Emocionalna kompetencija i simptomi posttraumatskoga stresnog poremećaja kod veterana Domovinskog rata

This study examined the relationship between four factors of posttraumatic stress disorder symptoms – re-experiencing, avoidance, dysphoria and hyperarousal – and particular domains of emotional competence and emotional regulation and control among 215 Croatian Homeland War veterans. Cross-sectionally, emotional competence subscales – perceiving and understanding emotions, expressing and labelling emotions, managing and regulating emotions – were associated with dysphoria symptom cluster only, while emotional regulation and control subscales – influence of emotion and mood on memory and emotional reaction control – were associated with dysphoria and re-experiencing symptom clusters. The results of this study are consistent with the view that successful recovery from trauma requires adaptive emotion competence skills and that therefore difficulties in dealing with emotions (understanding, expressing or regulating) are a risk factor for the development and/or maintenance of posttraumatic stress disorder symptoms. It appears that interventions organized toward improving emotional competence and regulation may be useful as complementary or independent treatments for combat-related posttraumatic stress disorder.U ovom istraživanju ispitivali smo povezanost četiriju faktora posttraumatskoga stresnog poremećaja – ponovno proživljavanje traume, izbjegavanje, disforija i pojačana pobuđenost – i određenih aspekata emocionalne kompetencije i emocionalne regulacije i kontrole na uzorku od 215 branitelja Domovinskog rata. Podskale emocionalne kompetencije – percipiranje i razumijevanje emocija, izražavanje i imenovanje emocija, upravljanje i reguliranje emocijama – povezane su sa simptomima faktora disforije, koji uključuju ograničeni afekt, poteškoće u spavanju, osjećaj uskraćene budućnosti, otežano koncentriranje i iritabilnost, dok su podskale emocionalne regulacije i kontrole – utjecaj emocija i raspoloženja na pamćenje i kontrola emocionalnih reakcija – povezane sa simptomima disforije i simptomima ponovnoga proživljavanja traume, npr. aktualna i intruzivna uznemirujuća prisjećanja, aktualni uznemirujući snovi, ponašanja ili osjećaji kao da se događaji ponovno zbivaju te intenzivni psihološki distres. Rezultati istraživanja sugeriraju da su poteškoće u procesiranju i reguliranju emocija mogući rizični faktor za razvoj i/ili održavanje simptoma posttraumatskoga stresnog poremećaja

Manifestations of tuberculosis that we rarely think about

Tuberculosis is a multi-system infectious disease caused by Mycobacterium Tuberculosis. Tuberculosis mostly affects lungs but it can spread in the form of extrapulmonary tuberculosis. Around 4.3% of patients experience ischemic stroke and 1.5-3.4% of them experience pulmonary embolism

COPING STRATEGIES IN WAR VETERANS 20 YEARS AFTER THE EXPOSURE TO EXTREME STRESS

Many soldiers encounter difficulties while transitioning from military to civilian life. Such severe traumatic events may also have long-term effects. Previous studies have shown a strong relationship between coping strategies and posttraumatic stress disorder (PTSD) symptoms. The aim of this study was to investigate how veterans who were exposed to war trauma 20 years ago now deal with everyday life stressors, and how their current coping strategies relate to the four-factor model of PTSD. A total of 220 male Croatian Homeland War Veterans between the ages of 38 and 75 participated. Questionnaires included Combat Exposure Scale, Posttraumatic Stress Disorder Checklist – Military Version and Ways of Coping Questionnaire. Results showed positive association between dysphoria and escape-avoidance coping strategy and negative association between dysphoria and positive reappraisal coping strategy. Given that dysphoria symptoms are associated with the chronicity of PTSD and poorer response to PTSD therapy treatment in war veterans, our results underscore the importance of treating dysphoria symptoms and promoting engagement coping strategies for this population

Povezanost serumske koncentracije vitamina d i glaukoma kod žena

The aim of the study was to determine whether serum vitamin D level is lower in female patients with glaucoma as compared with control group. The mechanism by which vitamin D reduces intraocular pressure is not fully clarified. Almost all tissues possess vitamin D receptor (VDR). The mice lacking VDR (VDR knockout mice) have greatly contributed to the understanding of the general vitamin D physiologic function. VDR has been found in some ganglion layer cells, external and internal nuclear layers of retina, and in retinal pigment epithelium, while VDR epitopes have also been found in the ciliary body epithelium, pointing to the role of this protein in eye physiology. The 1,25(OH)2D3 modulates expression of the genes involved in the regulation of intraocular pressure in non-human primates. Extracellular matrix can be remodeled by 1,25(OH)2D3 treatment. Actin disruption can lead to cell morphology alteration, trabecular meshwork relaxation and intraocular pressure reduction. This observational cross-sectional study included 90 female glaucoma subjects aged 45-55 and 50 glaucoma free female subjects as control group. Results of a pilot study conducted in 20 glaucoma subjects and 20 control subjects are presented below. All study subjects underwent history taking, complete ophthalmologic examination and serum vitamin D determination. The mean serum vitamin D level was 32.31 nmol/L in glaucoma patients and 64.17 nmol/L in control subjects. Serum vitamin D level was statistically significantly lower in glaucoma patients as compared with control group (p<0.05).Cilj istraživanja bio je utvrditi je li kod ispitanica oboljelih od glaukoma snižena serumska koncentracija vitamina D u odnosu na kontrolnu skupinu. Mehanizam kojim vitamin D snižava očni tlak nije jasno poznat. Gotovo sva tkiva posjeduju receptor za vitamin D (VDR). Velik doprinos razumijevanju globalne fiziološke funkcije vitamina D dobiven je od miša kojemu nedostaje VDR (engl. knockout mice for VDR). VDR je pronađen u nekim stanicama ganglijskog sloja, u vanjskom i unutarnjem nuklearnom sloju mrežnice i u retinalnom pigmentnom epitelu. Epitopi za VDR su pronađeni i u epitelu cilijarnog tijela. To sve govori o važnosti tog proteina u fiziologiji oka. 1,25 (OH)2D3 modulira ekspresiju gena koji su uključeni u regulaciju očnog tlaka u nehumanih primata. Nakon liječenja pomoću 1,25(OH)2D3 može se remodelirati ekstracelularni matriks. Disrupcija aktina može dovesti do promjene stanične morfologije, relaksacije trabekularne mreže i sniženja očnog tlaka. Provedeno je opažajno presječno istraživanje s kontrolnom skupinom. U istraživanje je bilo uključeno 90 ispitanica oboljelih od glaukoma u dobi od 45-55 godina i 50 ispitanica u kontrolnoj skupini. Prikazuju se rezultati probnog ispitivanja u 20 ispitanica oboljelih od glaukoma i isto toliko u kontrolnoj skupini. Ispitanicama je uzeta anamneza i kompletan oftalmološki status te je određen vitamin D u serumu. Koncentracija vitamina D u serumu ispitanica s glaukomom bila je 32,31 nmol/L u odnosu na kontrolnu skupinu gdje je bila 64,17 nmol/L. U zaključku, kod ispitanica oboljelih od glaukoma bila je snižena serumska koncentracija vitamina D u odnosu na kontrolnu skupinu na statistički značajnoj razini od p<0,05

Naše iskustvo u dijagnostici spinalnog epiduralnog apscesa upotrebom novih dijagnostičkih metoda - kompjutorizirane tomografije i magnetske rezonancije

A 69-year-old woman, a diabetic, presented to emergency unit for severe back pain that occurred three weeks of her having sustained a fall and blow in the back. Upon admission, she developed elevated body temperature, urinary retention and severe paraparesis of lower extremities. Laboratory testing showed increased levels of erythrocyte sedimentation rate (93 mm/h), leukocyte count (18.3x103/ mL), C-reactive protein (246.5 mg/L) and liver enzymes, and abundant bacteria in urine sediment. Penicillin-resistant Staphylococcus aureus was isolated in blood culture. Antibiotic therapy according to the antibiotic sensitivity report was introduced. Magnetic resonance of thoracic spine revealed epidural liquid collection compressing the spinal medulla from Th2 to Th7. The patient was transferred to neurosurgery for posterior laminectomy and decompression, along with antibiotic therapy. Microbiology confirmed Staphylococcus aureus in the intraoperative tissue specimen. The patient was discharged from the hospital with mild paraparesis and continuing antibiotic therapy recommended.Bolesnica u dobi od 69 godina sa šećernom bolešću javila se na hitnu pomoć zbog jakih bolova u leđima tri tjedna nakon pada i udarca u leđa. Kod prijma je zabilježena visoka temperatura, zadržavanje mokraće i teška parapareza donjih udova. Laboratorijski nalazi su pokazali povišene vrijednosti sedimentacije (93 mm/h), leukocita (18,3x10³/µL), C-reaktivnog proteina (246,5 mg/L), jetrenih enzima te dosta bakterija u mokraći. Iz kemokulture izoliran je Staphylococcus aureus rezistentan na penicilin pa je bolesnici uvedena antibiotska terapija prema antibiogramu. Magnetska rezonancija torakalne kralježnice pokazala je epiduralnu nakupinu tekućeg sadržaja koji je izazivao pritisak na medulu spinalis od Th2 do Th7. Na neurokirurgiji je izvedena stražnja laminektomija i dekompresija te je nastavljena antibiotska terapija. Mikrobiološka analiza operacijskog uzorka potvrdila je Staphylococcus aureus. Bolesnica je otpuštena u poboljšanom stanju, s blagom paraparezom i preporukom za daljnju antibiotsku terapiju

How deep is a problem of second victims for medical staff? A pilot study in Croatia

Adverse events lead to the emergence of several groups of victims, among which the second victims are medical staff involved in them. The suffering of second victims can lead to new adverse events and new victims. This study describes the cycle of an adverse event and its victims. Using the example of the largest Croatian hospital centre, authors try to understand how deep medical staff experience adverse events, and how different groups of medical staff (by profession, gender, qualification, and position) perceive adverse events. With the help of a special survey using the Bonferroni method from ANOVA, it was established that males feel more mental stress after adverse events than females. The results indicate that medical staff of different professions perceive adverse events differently, e.g. they are the least painful for psychiatrists and microbiologists and the most stressing for emergency and intensive care workers. In addition, nurses are more vulnerable to adverse events and experience various types of mental disorders more deeply than doctors. However, qualifications do not seem to affect the extent to which medical staff perceive adverse events. The results of this study differ from previous data for other countries and suggest new implications.peer-reviewe

Uticaj hrane na resorpciju lekova - osnovna razmatranja i mogućnost in vitro simulacije

Oral drug absorption is, generally, influenced by a number of factors related to drug substance/dosage form characteristics and gastrointestinal (GIT) conditions. Administration of a drug product with food, sometimes suggested in order to achieve better patient's compliance, may result in altered bioavailability as well as impaired therapeutic efficacy of the administered drug due to the significant postprandial changes in the gastrointestinal environment. Drug absorption may be accelerated, delayed, decreased, increased or not affected by the concomitant food intake. Although a number of factors with complex interrelationships may be responsible for the observed effect, they can be classified as physiologically and/or physicochemically based. Furthermore, they may be drug substance or dosage form (i.e. formulation) related. Although data obtained from the in vivo studies performed in volunteers represent a basis for further investigations, there is a great interest for in vitro simulation of such an interactions as the in vitro predictive methodology would considerably contribute drug development process and shorten the time and expenses for bringing drug products to the market. Such tests would be a useful tool in the development of formulations that would not be susceptible to the influence of co-administered meal and, furthermore, facilitate regulatory decision on the necessity to conduct food effect studies in vivo.Resorpcija lekova posle peroralne primene rezultat je brojnih i složenih interakcija koje zavise od karakteristika lekovite supstance, primenjenog lekovitog oblika i uslova koji vladaju u gastrointestinalnom traktu (GIT). S obzirom da se lekovi često uzimaju uz obrok sa ciljem poboljšanja komplijanse, promene u GIT-u, nastale kao posledica prisustva hrane, mogu uticati na biološku raspoloživost lekovite supstance i dovesti do varijacija u terapijskoj efikasnosti. Resorpcija lekova uzetih uz obrok može biti ubrzana, odložena, smanjena ili povećana usled fizioloških promena, kao i usled fizičkih i/ili hemijskih interakcija, kako lekovite supstance, tako i lekovitog oblika sa komponentama hrane. Mada je in vivo ispitivanje uticaja hrane najpouzdaniji način da se utvrdi mogućnost ispoljavanja lek-hrana interakcija, činjenica da se radi o dugotrajnim i skupim ispitivanjima, dovela je do intenzivnog rada na razvoju metodologije koja bi omogućila procenu uticaja hrane na osnovu podataka dobijenih in vitro. Identifikacija i procena uticaja pojedinačnih faktora koji mogu dovesti do promena u bioraspoloživosti lekova datih uz obrok predstavlja osnov za razvoj formulacija koje bi u manjoj meri bile podložne uticaju hrane. Razvoj odgovarajućih in vitro metoda bi, takođe, omogućio da se identifikuju preparati kod kojih postoji rizik od ispoljavanja lek - hrana interakcija odnosno, potreba za izvođenjem in vivo ispitivanja uticaja hrane

Chemical characteristics of the sweet cheery species (Prunus avium L.) from the island of Cres

Istraživanje je provedeno na sortama trešanja Stella, Creska, Van i Bing uzgojenim na lokalitetu otoka Cresa. Analizirana je kakvoća plodova preko parametara: suha tvar, ukupna kiselost, topljiva suha tvar, pH vrijednost i vitamin C. Dobiveni rezultati pokazuju da postoje signifikantne razlike između istraživanih sorata. Sorta Stella imala je najveću količinu vitamina C koja je iznosila 15,1 mg/100g dok su sorte Creska i Van imale najveću količinu suhe tvari koja je iznosila 16,49 do 16,6% i topljive suhe tvari koja je iznosila 16,0 do 16,4 °Brix-a. Sve dobivene vrijednosti bile su u zadovoljavajućim granicama. Možemo zaključiti da u uvjetima otoka Cresa navedene sorte daju dobru kakvoću plodova. .The research has been conducted upon the cheery species called Stella, Creska, Van and Bing that were raised on the island of Cres. The quality of the fruits was analysed by the following parameters: dry matter, total acidity, total soluble solid, pH and L-ascorbic acid. The purpose of this research was to establish if there were any differences in above parameters between the explored species. The given results show that there were significant differences between the sorts. The species Stella had the largest quantity of vitamin C which amounted to 15.1 mg/100g while the sort Creska and Van had a bigger amount of the soluble solid (from 16.49 to 16.6%) and total soluble solid (from 16.0 to 16.4 °Brix). All obtained values were within satisfactory limits. We can conclude that from the aspect of cultivation and climate conditions of the island of Cres the mentioned species have good quality fruits

Prevalence of Periodontal Diseases in Zagreb Population, Croatia, 14 Years Ago and Today

The aim of this study was to assess prevalence of periodontal diseases within Zagreb adult population in 2000. The sample comprised of 412 examinees of both sexes and all age groups. World Health Organization (WHO) methodology and Community Periodontal Index (CPI), (1997) were used. The data gained was statistically assorted and compared with the data from previously conducted research in 1986. Results showed relatively high prevalence of periodontal diseases. No healthy periodontium was recorded in the 45-and-above age group. Shallow periodontal pockets was registered in 12% of nineteen-year-olds, whereas this symptom was very evident in 45–54 age group (45.7%) and in older than 65 (48.2%). Over 90% of participants had insufficient oral hygiene and 80% required initial periodontal therapy. Approximately 20% needed complex periodontal treatment. Comparison of this data with the previous 1986 research showed improvement of periodontal status in up-to-44 age group due to more healthy persons and more subjects with the initial stages of disease. The possible reason for periodontal health improvement in the last 14 years, evident specially in younger age groups, were the effects of large preventive program measures conducted on schoolchildren in Croatia in 1980- -ties and terminated in 1990-ties when the war in Croatia started. Following studies are needed to monitor whether deterioration in oral health will occur regarding to absence of organized preventive programs since 1990-ties