ANXIETY AND DEPRESSION IN ONCOLOGY PATIENTS IN THE MOSTAR UNIVERSITY CLINICAL HOSPITAL

Cilj: Utvrditi stupanj anksioznosti i depresivnosti u bolesnika hospitaliziranih na odjelu onkologije Sveučilišne kliničke bolnice Mostar te povezanost tog stupnja sa spolom, bračnim statusom, dobi i stupnjem naobrazbe. Ispitanici i metode: U istraživanje je bilo uključeno 160 bolesnika, koji su bili podijeljeni u dvije skupine: ispitnu i kontrolnu. Svakom bolesniku iz ispitne skupine bio je pridružen bolesnik iz kontrolne skupine prema dobi, spolu, stupnju naobrazbe i bračnom statusu. Ispitnu skupinu činilo je 80 bolesnika koji su se liječili na odjelu onkologije Sveučilišne kliničke bolnice Mostar od 1. siječnja 2010. godine do 31. ožujka 2010. godine. Kontrolnu skupinu činilo je 80 bolesnika koji su primljeni u ordinaciju obiteljske medicine Doma zdravlja Mostar od 1. ožujka 2010. godine do 31. ožujka 2010. godine. U istraživanju smo se koristili Beckovom ljestvicom anksioznosti i depresivnosti. Prikupljeni su se podaci testirali odgovarajućim statističkim metodama. Rezultati:Ispitanici hospitalizirani na odjelu onkologije imali su veći stupanj depresivnosti u odnosu prema kontrolnoj skupini (egzaktni test, P<0,001). Nismo pronašli značajnu razliku u stupnju anksioznosti između ispitne i kontrolne skupine (egzaktni test, P=0,143). U onkoloških bolesnika s blagim stupnjem anksioznosti najviše su bili zastupljeni bolesnici stariji od 60 godina, dok je u visokom stupnju anksioznosti najviše bila zastupljena dobna skupina od 25 do 40 godina (egzaktni test, P<0,001) te visoko obrazovani bolesnici (egzaktni test, P=0,024). U istraživanju se pokazalo da su u onkoloških bolesnika mlađe dobne skupine imale viši stupanj depresivnosti (egzaktni test, P<0,001). Usporedbom stupnja anksioznosti s obzirom na dob u kontrolnoj skupini pronašli smo statistički značajnu razliku, i to tako da su najviši stupanj anksioznosti imali ispitanici između 41 i 60 godina (egzaktni test, P<0,001). U kontrolnoj skupini u većem su postotku bile depresivnije žene (egzaktni test, P=0,034) i ispitanici stariji od 60 godina (egzaktni test, P=0,006). Zaključak: Ispitna je skupina pokazala statistički viši stupanj depresivnosti, dok za anksioznost nismo utvrdili statistički značajnu razliku između ispitne i kontrolne skupineObjective: To determine the degree of anxiety and depression in patients hospitalized at the Department of Oncology of the Mostar University Clinical Hospital and the relationship between the degree of anxiety and depression, sex, marital status, age, and education of the patients. Patients and methods: The study included 160 patients who were divided into two groups: a test and a control group. A patient from the test group was assigned a patient from the control group according to his/her age, gender, education level and marital status. The study population consisted of 80 patients who were treated at the Department of Oncology of the Mostar University Clinical Hospital from January 1, 2010 to March 31, 2010. The control group consisted of 80 patients who were admitted via the Family Medicine Office of the Mostar Community Health Center from March 1, 2010 to March 31, 2010. The Beck’s Anxiety and Depression scale was used. The appropriate statistical methods were used to test the collected data. Results: Patients hospitalized at the Department of Oncology had a greater degree of depression than the control group (exact test, P<0.001). A significant difference in the level of anxiety between the test and control groups was not found (exact test, P=0.143). A mild degree of anxiety was found in the cancer patients older than 60 and a high level of anxiety in the group aged 25–40 (exact test, P<0.001) and in highly educated patients (exact test, P=0.024). The research showed that the cancer patients from the younger age group had higher levels of depression (exact test, P<0.001). By comparing the degree of anxiety to the age in the control group, statistically significant difference was not found, so the highest level of anxiety was found in the patients aged between 41 and 60 (exact test, P<0.001). It was determined that a higher percentage of women (exact test, P=0.034) and patients over 60 years old (exact test, P=0.006) in the control group were more depressed. Conclusion: Although a statistically higher level of depression was determined for the test group patients, a statistically significant difference in the levels of anxiety between test and control groups was not found

Periurethral bulking agents in the treatment of female stress urinary incontinence

Stress urinary incontinence (SUI) is a common type of urinary incontinence in women, affecting large proportion of women. Surgical methods, especially suburethral sling operations are the most important modes of the treatment of SUI. Bulking agents were created as an alternative to conventional surgical methods and may be the first line of therapy in certain patients. Periurethral bulking implies implantation of various biocompatible agents around the urethra in order to improve coaptation of the urethral walls during intra-abdominal pressure elevation. The rates of cure are lower with bulking methods as compared with surgical techniques but are associated with a lower prevalence of postoperative complications. Bovine collagen remains the most frequently injected agent worldwide, with cure rates of 53% at 12 months after procedure. Polyacrylamide hydrogel and silicone micro implants have showed promising results, with about 64% improvement rate at 18 to 24 months after procedure. Application of urethral bulking agents is minimally invasive procedure and is mostly applied outpatiently in local anesthesia. Urethral bulking agents are safe for clinical usage. Bulking agents should not be recommended as a method of final cure because they only lead to short-term improvement

PSYCHOLOGICAL ADJUSTMENT TO CHRONIC STRESS IN PARENTS OF CHILDREN WITH INTELLECTUAL DISABILITY

Cilj rada: Istražiti razlikuju li se majke i očevi djece s intelektualnim teškoćama, koja se liječe u Službi za psihofiziološke i govorne poteškoće Doma zdravlja u Mostaru, Centru za djecu s posebnim potrebama »Marija naša nada« u Širokom Brijegu te Centru »Nazaret« u Mostaru, u zaštitnim čimbenicima (suočavanje sa stresom, crte ličnosti i kvaliteta braka) i prilagodbi (izraženost psihičkih i tjelesnih simptoma te ugodnog i neugodnog raspoloženja). Ispitanici i metode: U istraživanju je sudjelovalo 30 bračnih parova, 30 majki i 30 očeva, roditelja djece s intelektualnim teškoćama, koja se liječe u Službi za psihofiziološke i govorne poteškoće Doma zdravlja u Mostaru, Centru za djecu s posebnim potrebama »Marija naša nada« u Širokom Brijegu te Centru »Nazaret« u Mostaru. Materijali su uručeni roditeljima prilikom dolaska djeteta na kontrolni pregled defektologu. Istraživanje je provedeno u razdoblju od 1. 9. 2010. do 1. 5. 2011. godine. U istraživanju je upotrijebljena anketa koja se sastojala od pet upitnika: standardizirani Upitnik suočavanja sa stresom, standardizirani Upitnik izraženosti subjektivnih zdravstvenih simptoma, standardizirani Upitnik kvalitete braka, standardizirani Upitnik ljestvice raspoloženja i Upitnik petofaktorskog modela ličnosti. Istraživanje je bilo anonimno. Prikupljeni su podaci testirani odgovarajućim statističkim metodama. Rezultati: Majke učestalije (P=0,005) i intenzivnije (P=0,005) doživljavaju subjektivne zdravstvene simptome nego očevi. Majke učestalije (P=0,043) i intenzivnije (P=0,033) doživljavaju gastrointestinalne simptome nego očevi. Sklonije su i učestalim (P=0,000) i intenzivnijim (P=0,001) pseudoneurološkim simptomima. Simptomi gripe su učestaliji (P=0,008) i intenzivniji (P=0,005) kod majki. Nisu pronađene statistički značajne razlike u učestalosti i intenzitetu muskuloskeletnih i alergijskih simptoma. Očevi su emotivno stabilniji od majki (P=0,000). U ostalim zaštitnim čimbenicima (model ličnosti, suočavanje sa stresom i kvaliteta braka) nisu pronađene statistički značajne razlike. Nije pronađena statistički značajna razlika u mjerama prilagodbe (ljestvica raspoloženja). Zaključak: S obzirom na mjere prilagodbe, majke i očevi djece s intelektualnim teškoćama razlikuju se u ukupnoj učestalosti i intenzitetu subjektivnih zdravstvenih simptoma. Ovdje se posebno ističu gastrointestinalni, pseudoneurološki simptomi i simptomi gripe. U pogledu zaštitnih čimbenika očevi su emocionalno stabilniji od majki.Aim: To investigate whether mothers and fathers of children with intellectual disability differ when it comes to resistance factors (deailing with stress, marital quality, personality traits) and adjustement (psychical symptoms and subjective health complaints, pleasant and unpleasant mood). Subjects and methods: The researchencompassed 30 married couples, 30 mathers and 30 fathers, all of wich are parents of children whit intellectual disability who treat in Service for psychophysical and speech difficulties in Mostar, Centre for special needs »Mary our hope« in Široki Brijeg and Centre »Nazareth« in Mostar. Materials are delivered to parents on arrival at chech-in to special education. The research was conducted from Semptebre 2010 to May 2011. The study used a survey that consisted of five questionnaires: the Standardizerd questionaire of coping with stress, Standardizerd questionaire severity of subjective health symptoms, Standardizerd questionaire of quality of marriage, Standardizerd questionaire of a mood and Standardizerd questionaire of five-factor model of personality. The survey was anonymus. The collected dana was tested with corresponding statistical methods.Results: Mothers frequently (P= 0,005) and intense (P= 0,005) perceived subjective health symptoms as compered to fathers. Mothers frequently (P= 0,043) and intense (P= 0,033) experienced gastrointestinal symptoms compared to fathers. They also more frequent (P= 0,000) and more intense (P= 0,001) experienced pseudoneurological symptoms. Flu symptoms are more frequent (P=0,008) and more intense (P= 0,005) in mothers. There is not statistically significant difference in the frequency and intensity of muscle and allergic symptoms. Fathers are emotionally stable than mothers (P= 0,000). In other protective factors we adid not find statistically significant differences in measures of adjustment. Conclusion: With regard to measures to adjustment, mothers and fathers of children with intellectual disability differ in overall frequency and intensity of subjective health symptoms. Here we hightlight the gastointestinal, pseudoneurological and flu symptoms. In termes of protective facrors fathers are emotionally stable than the mothers

Terestrički laserski skeneri

Ovaj članak opisuje relativno novu tehnologiju snimanja prostora i objekata u njemu i njezinu upotrebu stvarnom životu. Također, opisana je razlika između pojedinih tipova terestričkih laserskih skenera, koje su im bitne karakteristike i na što treba obratiti pozornost pri odabiru instrumenta za pojedini projekt

Poboljšanje spolne i reprodukcijske funkcije u muškaraca s oštećenjem kralježnične moždine

The aim of the review is to establish sexual and reproductive functions in men with spinal cord lesion (SCL). Many sexual and reproductive dysfunctions may be found in these patients including individual’s low self-esteem, delay of orgasm, erectile or ejaculatory disorder and abnormalities of semen, which are characterized by lower sperm motility or viability. Owing to improvements in physical medicine and rehabilitation, the focus has been shifted from keeping patients alive towards ensuring the quality of life and improvements of sexual dysfunctions and later reproduction. Erectile dysfunction can be treated by using phosphodiesterase-5 inhibitors, intracavernosal injections, vacuum devices and penile prostheses. Semen can be retrieved from anejaculatory patients by medically assisted methods utilizing penile vibratory stimulation, electroejaculation, prostate massage, or surgically. Although there is low chance for pregnancy in natural way in most of SCL patients, fatherhood is possible through the introduction of assisted medical management. By use of various medical, technical and surgical procedures for sperm retrieval combined with assisted reproductive methods, high pregnancy rates have been reported comparable to those in able-bodied subfertile patients. Nevertheless, future studies are needed to improve semen quality and methods of assisted ejaculation in patients with SCL.Svrha ovoga preglednog članka je analizirati spolne i reprodukcijske funkcije u muškaraca s oštećenjem kralježnične moždine (OKM). Mnoge spolne i reprodukcijske funkcije u ovih bolesnika mogu biti oštećene uključujući vlastitu podcjenjenost, nedostatak spolnog zadovoljstva, erekcijsku i ejakulacijsku disfunkciju te nepravilnosti spermiograma koje karakteriziraju slabija pokretljivost i vijabilnost. Zahvaljujući napretku u fizikalnoj medicini i rehabilitaciji pomiče se glavna usmjerenost na omogućavanje preživljenja takvih bolesnika prema osiguranju kvalitete života, poboljšanju spolne disfunkcije i kasnije reprodukcije. Erekcijska disfunkcija može se liječiti primjenom inhibitora fosfodiesteraze-5, intrakavernoznih injekcija, vakumskih uređaja i proteza za penis. U većine muškaraca s anejakulacijom sjeme se može dobiti postupkom medicinski pomognute ejakulacije primjenom vibracijske stimulacije penisa, elektroejakulacije, masaže prostate ili kirurških zahvata. Premda većina muškaraca s OKM ne uspijeva postići trudnoću na prirodan način, stvaranje potomstva ipak je moguće uvođenjem specijalističkog medicinskog liječenja. Primjenom raznih medicinskih, tehničkih i kirurških tehnika za dobivanje spermija u kombinaciji s metodama za pomognutu oplodnju postignute su zavidne stope trudnoća slično kao u subfertilnih osoba bez tjelesnih oštećenja. Ipak, potrebna su daljnja istraživanja za poboljšanje kvalitete sjemena i metoda za pomognutu ejakulaciju u bolesnika s OKM

Bilateral Synchronous Breast Cancer

We report a rare case of synchronous bilateral breast cancer in 79-year old female patient treated at our hospital. The tumors were discovered one year ago after a complete clinical and radiological (mammography, US) examination with cytopunction of tumor masses. Results came back and showed carcinomas of both breasts. Patient underwent surgical removal of the both breasts with bilateral axillary lymphadenectomy. Later histological examination confirmed earlier diagnosis of invasive ductal carcinoma in both breasts in a G3 stage. After surgical removal of the tumors patient was also treated with radiotherapy. One year after bilateral mastectomy and axillary lymphadenectomy, clinical and radiological examination that included mammography and ultrasound of breast with tumor marker C15-3 which was 2.8, we did not found recurrence of the tumor

Orbitalni kavernozni hemangiom

The aim of this case report was to present a patient with a benign orbital tumor, cavernous hemangioma, who presented with symptoms of compressive orbital mass: unilateral axial proptosis, with motility restriction and sudden vision loss in the left eye. Ophthalmologic examination (visual acuity, applanation tonometry, Goldmann tonometer, visual field) and radiologic examination diagnosed a benign, well circumscribed, vascular, intraconal tumor that compresses the optic nerve. Treatment was operative: lateral orbitectomy Krönlein procedure and the tumor was removed. Pathologic and pathohistologic examination confirmed the previous diagnosis. Follow up examination, visual field and MRI of the orbit showed considerable improvement. Surgical treatment was also the final treatment and no adjuvant therapy was necessary. Prognosis for visual acuity and life is excellent.Cilj ovog rada bio je prikazati slučaj pacijentice s benignim tumorom orbite, kavernoznim hemangiomom, koji se javlja sa simptomima kompresivne tvorbe u orbiti: unilateralnom proptozom, smetnjama motiliteta te naglim gubitkom vida lijevog oka. Oftalmološkom obradom (ispitivanje vidne oštrine, aplanacijska tonometrija, ispitivanje vidnog polja po Goldmannu) te radiološkom obradom (MR, MSCT, MSCT angiografija) postavlja se dijagnoza benigne, dobro ograničene, vaskularne tvorbe u konusu koja pritišće očni živac. Pristupilo se operativnom zahvatu, napravila se lateralna orbitektomija po Krönleinu i odstranio tumor u cijelosti. Patološka i patohistološka pretraga potvrđuju raniju dijagnozu. Postoperativni tijek protiče uredno te se na nalazu kontrolnog vidnog polja i kontrolnim snimkama MR-a utvrđuje značajno poboljšanje. Kod pacijentice je kirurško liječenje bilo i konačno te nije bila potrebna dodatna terapija. Prognoza za vidnu oštrinu i život je odlična

Head and Neck Cancer Patients’ Survival According to HPV Status, miRNA Profiling, and Tumour Features—A Cohort Study

Head and neck cancers (HNC) are a heterogeneous group of tumours mainly associated with tobacco and alcohol use and human papillomavirus (HPV). Over 90% of all HNC are squamous cell carcinomas (HNSCC). Sample material from patients diagnosed with primary HNSCC (n = 76) treated with surgery as primary treatment at a single centre were assessed for HPV genotype, miR-9-5p, miR-21-3p, miR-29a-3p and miR-100-5p expression levels. Clinical and pathological data were collected from medical records. Patients were enrolled between 2015 and 2019 and followed-up until November 2022. Overall survival, disease-specific survival and disease-free survival were assessed and correlated with clinical, pathological, and molecular data. Kaplan-Meier and Cox proportional hazard regression was used to assess different risk factors. In the study, male gender, HPV-negative HNSCC (76.3%) mostly located in the oral region (78.9%) predominated. Most patients had stage IV cancer (47.4%), and the overall survival rate was 50%. HPV was found not to affect survival, indicating that in this population, classic risk factors predominate. The presence of both perineural and angioinvasion was strongly associated with survival in all analyses. Of all miRNAs assessed, only upregulation of miR-21 was consistently shown to be an independent predictor of poor prognosis and may thus serve as a prognostic biomarker in HNSCC

Manual versus rigid intraoperative maxillo-mandibular fixation in the surgical management of mandibular fractures:A European prospective analysis

Purpose: Intraoperative stabilisation of bony fragments with maxillo-mandibular fixation (MMF) is an essential step in the surgical treatment of mandibular fractures that are treated with open reduction and internal fixation (ORIF). The MMF can be performed with or without wire-based methods, rigid or manual MMF, respectively. The aim of this study was to compare the use of manual versus rigid MMF, in terms of occlusal outcomes and infective complications. Materials and methods: This multi-centric prospective study involved 12 European maxillofacial centres and included adult patients (age ≥16 years) with mandibular fractures treated with ORIF. The following data were collected: age, gender, pre-trauma dental status (dentate or partially dentate), cause of injury, fracture site, associated facial fractures, surgical approach, modality of intraoperative MMF (manual or rigid), outcome (minor/major malocclusions and infective complications) and revision surgeries. The main outcome was malocclusion at 6 weeks after surgery. Results: Between May 1, 2021 and April 30, 2022, 319 patients-257 males and 62 females (median age, 28 years)-with mandibular fractures (185 single, 116 double and 18 triple fractures) were hospitalised and treated with ORIF. Intraoperative MMF was performed manually on 112 (35%) patients and with rigid MMF on 207 (65%) patients. The study variables did not differ significantly between the two groups, except for age. Minor occlusion disturbances were observed in 4 (3.6%) patients in the manual MMF group and in 10 (4.8%) patients in the rigid MMF group (p &gt; .05). In the rigid MMF group, only one case of major malocclusion required a revision surgery. Infective complications involved 3.6% and 5.8% of patients in the manual and rigid MMF group, respectively (p &gt; .05). Conclusion: Intraoperative MMF was performed manually in nearly one third of the patients, with wide variability among the centres and no difference observed in terms of number, site and displacement of fractures. No significant difference was found in terms of postoperative malocclusion among patients treated with manual or rigid MMF. This suggests that both techniques were equally effective in providing intraoperative MMF.</p

TEMPERATURE MEASUREMENT BY KNX THROUGH RADIO FREQUENCIES

Pojava same ideje za KNX-om nastaje 1990.godine u Briselu u Belgiji gdje 15 najvećih proizvođača električne opreme osniva European Installation Bus Association tj. EIBA. Ideja je bila da se u budućnosti ostvari primjena električnih instalacija s sabirničkom topologijom. Nakon toga slijedi ubrzani razvoj te nastaje prvi računalni softver za korištenje samog EIB-a tzv. Engineering Tool Softver tj. ETS. Nakon uspješne prve verzije ETS-a došlo je do novijih verzija u budućnosti. Uspostavljaju se prvi treninzi za korištenje i implementaciju te nastaje prvi uređaj koji koristi sistem EIB. Nakon toga dolazi do udruženja EIB-a s još dva udruženja te se 2006.godine preimenuju u KNX. Danas KNX broji skoro 500 proizvođača diljem svijeta i ima konstantan razvoj gledano kako u broju korisnika tako i u unapređenju same opreme. Uređaji koji su napravljeni prije 25 godina i odmah stavljeni u proizvodnju koriste se još uvijek i danas što govori o visoko postavljenim standardima pri izradi KNX uređaja. Zbog tako visokog standarda potrebno je pratiti temperaturu pri procesu izrade samog uređaja. Temperatura kroz koju prolaze uređaji je vrlo visoka i ne može izmjeriti jednostavnim putem npr.termometrom. Uz mjerenje visoke temperature potrebno je slati podatke o trenutno temperaturi i stanje temperature je potrebno kasnije dokumentirati. Takav uređaj koji prolazi kroz cijeli proces izrade i šalje potrebne podatke putem radiofrekvencije je uređaj koji je opisan u ovome radu.The very idea for KNX originated in 1990 in Brussels, Belgium, where the 15 largest electrical equipment manufacturers founded the European Installation Bus Association, i.e. EIBA. The idea was to implement electrical installations with a bus topology in the future. This is followed by accelerated development and the first computer software for the use of the EIB itself, the so-called Engineering Tool Software i.e. ETS. After the successful first version of ETS, newer versions came in the future. The first trainings for use and implementation are established and the first device using the EIB system is created. After that, the EIB merged with two other associations and in 2006 they were renamed KNX. Today, KNX has almost 500 manufacturers worldwide and has a constant development in terms of both the number of users and the improvement of the equipment itself. Devices that were made 25 years ago and were immediately put into production are still used today, which speaks of high standards in the manufacture of KNX devices. Due to such a high standard, it is necessary to monitor the temperature during the manufacturing process of the device itself. The temperature through which the devices pass is very high and cannot be measured easily, e.g. with a thermometer. In addition to measuring high temperature, it is necessary to send data on the current temperature and the temperature condition must be documented later. Such a device that goes through the entire manufacturing process and sends the necessary data via radio frequency is the device described in this paper