Clinical course and prognosis of patients with rapidly progressive glomerulonephritis

Brzoprogresivni glomerulonefritis (BPGN) je klinički i patološki entitet koji obilježava progresivno zatajenje bubrežne funkcije unutar razdoblja od nekoliko tjedana do nekoliko mjeseci. Uzrokovan je različitim patofiziološkim mehanizmima koji upalom u glomerulima uzrokuju stvaranje polumjeseca i posljedično zatajenje bubrežne funkcije ukoliko se rano ne prepozna i intervenira primjenom imunosupresivne terapije. Cilj ove studije je istražiti utjecaj kliničkih i laboratorijskih parametara pri inicijalnoj prezentaciji na ishod bubrežne funkcije retrospektivno, analizirajući sve bolesnike liječene zbog brzoprogresivnog glomerulonefritisa u KBC Zagreb, Referentnom centru za glomerulopatije od 1983.-2017. Kompletna remisija je definirana kao oporavak bubrežne funkcije, s proteinurijom < 0,25 g/dU i negativnim sedimentom urina. Parcijalna remisija je definirana proteinurijom između 0,25 – 3,5 g/dU, negativnim sedimentom urina s 50% smanjenjem inicijalne vrijednosti kreatinina. Uzrok bolesti je u 29 (36,7%) bolesnika bio mikroskopski poliangitis, kod 17 (21,5%) MPGN, SLE i bolesti odlaganja imunokompleksa, u 12 (15,2%) granulomatoza s poliangitisom, 8 (10,1%) IgA nefropatija, 7 (8,9%) Goodpasturov sindrom, 4 (5,1%) FSGS, te HUS i eozinofilna granulomatoza s poliangitisom s po jednim bolesnikom (1,3%). Trideset i sedam bolesnika (37%) bilo je ANCA pozitivno, a 32 (32%) je imalo afekciju pluća. Četvero (4,3%) je bilo ANA pozitivno. Medijan praćenja je 16 (3,5 – 42,5) mjeseci unutar kojeg je 17 (3,8%) bolesnika bilo u totalnoj remisiji, 33 (31,4%) u parcijanoj remisiji, 7 (6,7%) bez remisije, a 44 (41,9%) u terminalnom zatajenju bubrežne funkcije (ESRD), koji su inicijalno bili viših razina SCr (522,5(340,7-673) vs. 311(182,5-60,2); p<0,01), višeg postotka polumjeseca (80(46,2-90) vs. 25,5(0,4-71,2); p<0,01) i većom potrebom za liječenjem hemodijalizom pri prezentaciji (33(82,5) vs. 10(17,9); p<0,01). Tijekom praćenja opažen je značajan pad proteinurije (0,7(0,3-1,8) vs. 2,3(1,1-5); p<0,01). Bolesnici koji su se inicijalno prezentirali proteinurijom nefrotskog ranga su bili mlađi (p<0,01), viši (p<0,05), veće tjelesne težine (p<0,05), viših vrijednosti sistoličkog i dijastoličkog tlaka (p<0,01), te s većim udjelom polumjeseca u bioptatu bubrega (p<0,05). Ovo istraživanje potvrđuje važnost rane dijagnoze i ranog početka imunosupresivnog liječenja ovog hitnog stanja, koje će direktno utjecati na ishod bolesti, tj. bubrežno preživljenje.Rapidly progressive glomerulonephritis (RPGN) is a clinical and pathological entity which is represented by progressive faliure of kidney function in a span of a few weeks to several months. It is caused by different pathophysiological mechanisms which cause the creation of crescents via inflammation, which leads to consequential failure of renal function if not early recognised and intervened by applying immunosuppresive therapy. The goal of this study is to explore the influence of clinical and laboratory paramethers on initial presentation on the outcome of renal function retrospectively, analysing patients diagnosed with rapidly progressive glomerulonephritis in CHC Zagreb, the Croatian Refferal Centre for Glomerulopathy in the period from 1983. – 2017. Complete remission was defined as recovery of renal function, proteinuria < 0,25 g/dU and negative urine sediment. Parcial remission was defined as proteinuria range 0,25 – 3,5 g/dU, negative urine sediment and 50% reduction of the initial creatinine value. Cause of the disease was microscopic poliangitis in 29 (29%), MPGN, SLE and immunocomplex disease in 17 (21,5%), granulomatosis with poliangitis in 12 (15,2%), IgA nephropaty in 8 (10,1%), Goodpasture syndrome in 7 (8,9%), FSGS, HUS and eosinophilic granulomatosis with poliangitis with 1 (1,4%) each. Thirty-seven (37%) were ANCA positive, 32 (32%) had lung affection. Four (4,3%) were ANA positive. Mean time of follow up was 16 (3,5-42,5) months in which 17 (3,8%) were in total remission, 33 (31,4%) in partial remission, 7 (6,7%) without remission, and 44 (41,9%) had developed terminal renal function faliure (ESRD), whom initially presented with higher SCr values (522,5(340,7-673) vs. 311(182,5-60,2); p<0,01), higher percentage of crescent formations (80(46,2-90) vs. 25,5(0,4-71,2); p<0,01) and higher need for urgent HD (33(82,5) vs. 10(17,9); p<0,01). During the follow up significant reduction in proteinuria was observed (0,7(0,3-1,8) vs. 2,3(1,1-5); p<0,01). Patients initially presented with nephrotic range proteinuria were younger (p<0,01), taller (p<0,05), heavier (p<0,05), had higher systolic and diastolic pressure values (p<0,01), higher percentage of crescent formations (p<0,05). This study confirmes the importance of early diagnosis and early start of immunosuppresive therapy of this urgent condition, which directly influences the outcome, i.e. kidney survival

Nurses' role in patient triage in the United emergency admission unit at the Zadar general hospital

Trijažu mogu raditi svi zdravstveni djelatnici na hitnom prijemu koji su položili tečaj trijaže. Primarni cilj trijaže je brza identifikacija bolesnika u stanju neposredne životne ugroženosti. Medicinska sestra mora znati odrediti u koju trijažnu kategoriju će smjestiti pacijenta. Njezina komunikacija s pacijentom i obitelji/ pratnjom bitna je za daljnju suradnju. Zbog toga medicinska sestra na trijaži ne smije imati poteškoće s komunikacijom i mora biti dovoljno educirana kako bi prepoznala pacijentove tegobe. Cilj rada: Prikazati važnost uloge medicinske sestre pri trijaži pacijenata na Objedinjenom hitnom bolničkom prijemu, na osnovi dobivenih rezultata iz 2017. godine. Materijali i metode: Prikupljanje i obrada podataka o prijemu pacijenata ispunjavanjem obrasca za trijažu elektronskim putem, te liječnička dokumentacija ispunjena također elektronskim putem. Korišteni su ovi kriteriji: broj pacijenata prema trijažnim kategorijama, sveukupni broj trijažiranih pacijenata tijekom 2017. godine, prosječno vrijeme čekanja na početak pregleda liječnika (min), prosječno ukupno vrijeme boravka u hitnom prijemu (min) i učinkovitost. Ispitanici su pacijenti zaprimljeni na OHBP Zadar tijekom 2017. godine, neovisno o dobi, spolu i dijagnozi po prijemu. Zaključak: Zbog povećanja broja pacijenata, zahtjeva i složenosti medicinske skrbi, odjeli hitne medicine suočeni su s problemom preopterećenosti i slabijom učinkovitošću rada. Trijažna medicinska sestra/ tehničar je prva osoba koju bolesnik susreće pri dolasku u OHBP. Njezina profesionalnost, kvalitetna educiranost i široki spektar poznavanja bolesnikovih tegoba od izuzetne je važnosti za ispravno i kvalitetno obavljanje trijaže u odjelima hitne medicine.Triage can be done by all health workers at the emergency who passed the course in triage. The primary goal of triage is fast identification of a patient in a state of immediate life threat. A nurse has to be able to decide in which triage category she will put the patient. Her communication with a patient and his family /accompaniment is important for further cooperation. Due to that, a nurse in triage must not have difficulties in communication and has to be educated enough to recognize patient´s ailments. The goal of graduate thesis: To demonstrate the importance of the nurse´s role in patient triage in the United emergency admission unit, based on the results from 2017. Materials and methods: Collection and processing of data on reception of patients by filling the form for triage electronically, as well as medical documentation filled electronically. The above criteria were used: number of patients according to the categories of triage, total number of triage patients during 2017., average waiting time for the beginning of doctor's examination (min), average total duration of stay in the emergency admission unit (min) and its effectiveness. The respondents are the patients who were received in the United emergency admission unit Zadar during 2017., independent of age, sex and diagnosis on reception. Conclusion: Due to the increase of the number of the patients, demands and complexity of medical care , emergency departments are faced with the problem of overwork and poor efficiency of work itself. A triage nurse/technician is the first person that a patient meets when coming to the United emergency admission unit. Her professionalism, quality education and wide spectrum of knowledge for the patient's ailments is extremely important for correct and quality triage performance in the emergency department

Clinical course and prognosis of patients with rapidly progressive glomerulonephritis

Brzoprogresivni glomerulonefritis (BPGN) je klinički i patološki entitet koji obilježava progresivno zatajenje bubrežne funkcije unutar razdoblja od nekoliko tjedana do nekoliko mjeseci. Uzrokovan je različitim patofiziološkim mehanizmima koji upalom u glomerulima uzrokuju stvaranje polumjeseca i posljedično zatajenje bubrežne funkcije ukoliko se rano ne prepozna i intervenira primjenom imunosupresivne terapije. Cilj ove studije je istražiti utjecaj kliničkih i laboratorijskih parametara pri inicijalnoj prezentaciji na ishod bubrežne funkcije retrospektivno, analizirajući sve bolesnike liječene zbog brzoprogresivnog glomerulonefritisa u KBC Zagreb, Referentnom centru za glomerulopatije od 1983.-2017. Kompletna remisija je definirana kao oporavak bubrežne funkcije, s proteinurijom < 0,25 g/dU i negativnim sedimentom urina. Parcijalna remisija je definirana proteinurijom između 0,25 – 3,5 g/dU, negativnim sedimentom urina s 50% smanjenjem inicijalne vrijednosti kreatinina. Uzrok bolesti je u 29 (36,7%) bolesnika bio mikroskopski poliangitis, kod 17 (21,5%) MPGN, SLE i bolesti odlaganja imunokompleksa, u 12 (15,2%) granulomatoza s poliangitisom, 8 (10,1%) IgA nefropatija, 7 (8,9%) Goodpasturov sindrom, 4 (5,1%) FSGS, te HUS i eozinofilna granulomatoza s poliangitisom s po jednim bolesnikom (1,3%). Trideset i sedam bolesnika (37%) bilo je ANCA pozitivno, a 32 (32%) je imalo afekciju pluća. Četvero (4,3%) je bilo ANA pozitivno. Medijan praćenja je 16 (3,5 – 42,5) mjeseci unutar kojeg je 17 (3,8%) bolesnika bilo u totalnoj remisiji, 33 (31,4%) u parcijanoj remisiji, 7 (6,7%) bez remisije, a 44 (41,9%) u terminalnom zatajenju bubrežne funkcije (ESRD), koji su inicijalno bili viših razina SCr (522,5(340,7-673) vs. 311(182,5-60,2); p<0,01), višeg postotka polumjeseca (80(46,2-90) vs. 25,5(0,4-71,2); p<0,01) i većom potrebom za liječenjem hemodijalizom pri prezentaciji (33(82,5) vs. 10(17,9); p<0,01). Tijekom praćenja opažen je značajan pad proteinurije (0,7(0,3-1,8) vs. 2,3(1,1-5); p<0,01). Bolesnici koji su se inicijalno prezentirali proteinurijom nefrotskog ranga su bili mlađi (p<0,01), viši (p<0,05), veće tjelesne težine (p<0,05), viših vrijednosti sistoličkog i dijastoličkog tlaka (p<0,01), te s većim udjelom polumjeseca u bioptatu bubrega (p<0,05). Ovo istraživanje potvrđuje važnost rane dijagnoze i ranog početka imunosupresivnog liječenja ovog hitnog stanja, koje će direktno utjecati na ishod bolesti, tj. bubrežno preživljenje.Rapidly progressive glomerulonephritis (RPGN) is a clinical and pathological entity which is represented by progressive faliure of kidney function in a span of a few weeks to several months. It is caused by different pathophysiological mechanisms which cause the creation of crescents via inflammation, which leads to consequential failure of renal function if not early recognised and intervened by applying immunosuppresive therapy. The goal of this study is to explore the influence of clinical and laboratory paramethers on initial presentation on the outcome of renal function retrospectively, analysing patients diagnosed with rapidly progressive glomerulonephritis in CHC Zagreb, the Croatian Refferal Centre for Glomerulopathy in the period from 1983. – 2017. Complete remission was defined as recovery of renal function, proteinuria < 0,25 g/dU and negative urine sediment. Parcial remission was defined as proteinuria range 0,25 – 3,5 g/dU, negative urine sediment and 50% reduction of the initial creatinine value. Cause of the disease was microscopic poliangitis in 29 (29%), MPGN, SLE and immunocomplex disease in 17 (21,5%), granulomatosis with poliangitis in 12 (15,2%), IgA nephropaty in 8 (10,1%), Goodpasture syndrome in 7 (8,9%), FSGS, HUS and eosinophilic granulomatosis with poliangitis with 1 (1,4%) each. Thirty-seven (37%) were ANCA positive, 32 (32%) had lung affection. Four (4,3%) were ANA positive. Mean time of follow up was 16 (3,5-42,5) months in which 17 (3,8%) were in total remission, 33 (31,4%) in partial remission, 7 (6,7%) without remission, and 44 (41,9%) had developed terminal renal function faliure (ESRD), whom initially presented with higher SCr values (522,5(340,7-673) vs. 311(182,5-60,2); p<0,01), higher percentage of crescent formations (80(46,2-90) vs. 25,5(0,4-71,2); p<0,01) and higher need for urgent HD (33(82,5) vs. 10(17,9); p<0,01). During the follow up significant reduction in proteinuria was observed (0,7(0,3-1,8) vs. 2,3(1,1-5); p<0,01). Patients initially presented with nephrotic range proteinuria were younger (p<0,01), taller (p<0,05), heavier (p<0,05), had higher systolic and diastolic pressure values (p<0,01), higher percentage of crescent formations (p<0,05). This study confirmes the importance of early diagnosis and early start of immunosuppresive therapy of this urgent condition, which directly influences the outcome, i.e. kidney survival

Nurses' role in patient triage in the United emergency admission unit at the Zadar general hospital

Trijažu mogu raditi svi zdravstveni djelatnici na hitnom prijemu koji su položili tečaj trijaže. Primarni cilj trijaže je brza identifikacija bolesnika u stanju neposredne životne ugroženosti. Medicinska sestra mora znati odrediti u koju trijažnu kategoriju će smjestiti pacijenta. Njezina komunikacija s pacijentom i obitelji/ pratnjom bitna je za daljnju suradnju. Zbog toga medicinska sestra na trijaži ne smije imati poteškoće s komunikacijom i mora biti dovoljno educirana kako bi prepoznala pacijentove tegobe. Cilj rada: Prikazati važnost uloge medicinske sestre pri trijaži pacijenata na Objedinjenom hitnom bolničkom prijemu, na osnovi dobivenih rezultata iz 2017. godine. Materijali i metode: Prikupljanje i obrada podataka o prijemu pacijenata ispunjavanjem obrasca za trijažu elektronskim putem, te liječnička dokumentacija ispunjena također elektronskim putem. Korišteni su ovi kriteriji: broj pacijenata prema trijažnim kategorijama, sveukupni broj trijažiranih pacijenata tijekom 2017. godine, prosječno vrijeme čekanja na početak pregleda liječnika (min), prosječno ukupno vrijeme boravka u hitnom prijemu (min) i učinkovitost. Ispitanici su pacijenti zaprimljeni na OHBP Zadar tijekom 2017. godine, neovisno o dobi, spolu i dijagnozi po prijemu. Zaključak: Zbog povećanja broja pacijenata, zahtjeva i složenosti medicinske skrbi, odjeli hitne medicine suočeni su s problemom preopterećenosti i slabijom učinkovitošću rada. Trijažna medicinska sestra/ tehničar je prva osoba koju bolesnik susreće pri dolasku u OHBP. Njezina profesionalnost, kvalitetna educiranost i široki spektar poznavanja bolesnikovih tegoba od izuzetne je važnosti za ispravno i kvalitetno obavljanje trijaže u odjelima hitne medicine.Triage can be done by all health workers at the emergency who passed the course in triage. The primary goal of triage is fast identification of a patient in a state of immediate life threat. A nurse has to be able to decide in which triage category she will put the patient. Her communication with a patient and his family /accompaniment is important for further cooperation. Due to that, a nurse in triage must not have difficulties in communication and has to be educated enough to recognize patient´s ailments. The goal of graduate thesis: To demonstrate the importance of the nurse´s role in patient triage in the United emergency admission unit, based on the results from 2017. Materials and methods: Collection and processing of data on reception of patients by filling the form for triage electronically, as well as medical documentation filled electronically. The above criteria were used: number of patients according to the categories of triage, total number of triage patients during 2017., average waiting time for the beginning of doctor's examination (min), average total duration of stay in the emergency admission unit (min) and its effectiveness. The respondents are the patients who were received in the United emergency admission unit Zadar during 2017., independent of age, sex and diagnosis on reception. Conclusion: Due to the increase of the number of the patients, demands and complexity of medical care , emergency departments are faced with the problem of overwork and poor efficiency of work itself. A triage nurse/technician is the first person that a patient meets when coming to the United emergency admission unit. Her professionalism, quality education and wide spectrum of knowledge for the patient's ailments is extremely important for correct and quality triage performance in the emergency department

EVOLUTIONARY-SYNERGETIC APPROACH TO THE PROBLEM OF SOCIAL SUSTAINABILITY

Relevance. The social dimension of the concept of sustainable development is recognized as the most relevant but least developed. Ensuring social sustainability requires effective interdisciplinary cooperation based on a modern evolutionary-synergetic picture of the world. Objective. To formulate the concept of social system sustainability within the framework of evolutionary-synergetic paradigm. Materials and Methods. The philosophical and methodological analysis of the works of foreign and domestic authors in the field of social philosophy, sociology and synergetics was carried out. Results. The notions of sustainability in synthetic evolution of G. Spencer are considered. The role of division of labor in ensuring the social sustainability from the position of the concept of social solidarity of E. Durkheim is revealed. The mechanism of ensuring the sustainability of civilizations in the theory of historical evolution A. Toynbee is described. The prevailing role of sociocultural metaevolution in increasing of adaptive sustainability of society is noted. The paper analyzes the principles of the antifragile strategy proposed by N.N. Taleb to increase sustainability in conditions of nonlinearity and uncertainty.The applicability of synergetic methodology to the study of the problem of social sustainability is substantiated. The role of personality in the formation of a sustainable social system in the synergetic concept of S.P. Kurdyumov and E.N. Knyazeva is established. Discussion. The problem of the balance between chaos and order in sustainable society, as well as the mechanisms of self-organization of the social system in the studies of the Russian school of synergetics is considered. Conclusion. From the standpoint of evolutionism and synergetics, the sustainability of society is a property of purposeful increase in the efficiency of social processes as it moves towards the at-tractor of social justice along the optimal trajectory with minimal controlling influence

Ishod starijih bolesnika s ANCA glomerulonefritisom liječenih imunosupresivnom terapijom

The most common cause of rapidly progressive glomerulonephritis in elderly, antineutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN), demands immunosuppressive therapy (IS) regimen in a multi-morbid disease burdened population. Our aim was to assess outcome differences in two age groups. The study included a total of 38 ANCA-GN renal limited patients (18 men) treated from 1990 to 2018, of which 11 were 65 years of age and older (median 70, min. - max. 66 - 79 years), and 27 younger than 65 (median 55, min. - max. 23 - 64 years). All patients were treated with mono/combination of IS. Most commonly applied IS in elderly was combination of IV cyclophosphamide and corticosteroids (CS) (in 9 [81.8%]), while in younger it was a combination of CS and cyclophosphamide or rituximab (59.2%). Older patients had comparable mortality (3, [14.8%] vs. 4, [27.3%]; P = 0.369), malignancies (1, [3.7%] vs. 1, [9.1%]; P = 0.5) and infectious complications (10, [46.7%] vs. 7, [63.6%]; P = 0.388). Ten patients at the end of the follow up were at renal replacement therapy (RRT ), with no difference between age groups (6, [22.2%] vs. 4, [36.4%]; P = 0.369). Interestingly, from initial need for RRT , half of the younger and older patients recovered with IS. Our findings give more credit to the current paradigm to treat elderly ANCA-GN patients with IS therapy due to the similar outcome of elderly as younger ones.Najčešći uzrok brzoprogresivnog glomerulonefritisa u starijih je glomerulonefritis s antineutrofilnim citoplazmatskim protutijelima (ANCA-GN, od eng. antineutrophil cytoplasmic antibody related glomerulonephritis), a s obzirom na komorbiditete predstavlja izazov u odluci oko primjene imunosupresivne terapije (IS). Cilj ovog istraživanja je usporediti razlike u ishodu dvije dobne skupine bolesnika. Istraživanje je obuhvatilo slučajeve ANCA-GN ograničenih na bubrege, liječene od 1990. do 2018. godine, njih 38 (18 muških), od kojih 11 ima 65 ili više godina (medijan 70, min.-max. 66 - 79 godina) a 27 mlađih (medijan 55, min. - max. 23 - 64 godina). Svi bolesnici su liječeni monoterapijom ili kombinacijom IS-a. Najčešće primjenjena IS u starijoj populaciji bila je kombinacija intravenskog ciklofosfamida i kortikosteroida (KS) (u 9 (81,8%)), u mlađoj kombinacija KS s ciklofosfamidom ili rituksimabom (59,2%). Stariji pacijenti imali su sličnu učestalost smrtnosti (3, 14,8% vs 4, 27,3%; P = 0.369), zloćudnih bolesti (1, 3,7% vs 1, 9,1%; P = 0.5) i infektivnih komplikacija (10, 46,7% vs 7, 63,6%); P = 0.388). Deset bolesnika je na kraju praćenja bila ovisno o nadomještanju bubrežne funkcije (NBF) bez razlike u dobnoj skupini (6, 22,2% vs 4, 36,4%; P = 0.369). Međutim, od inicijalne potrebe NBF-om se uz IS oporavila polovica starijih i mlađih bolesnika. Naši rezultati su u skladu trenutačnim stajalištima koja podupiru primjenu IS terapije kod starijih bolesnika sa ANCA-GN zbog usporedivih ishoda i rizika komplikacija kao u mlađih bolesnika

State total microcirculation in patients with hemophilia

The paper presents the results of the study total microcirculation in patients with hemophilia, obtained using laser Doppler flowmetry. Revealed asymmetric reduction of perfusion, increase the maximum amplitude of violations of microcirculation

Laser Doppler velocimeter for laboratory training

ABSTRACT The laser Doppler velocimeter was developed specially for students laboratory training. The experimental kit consists of the classic dual beam laser Doppler system and the set of the dynamic objects such as moving phase screen and scattering flows. Signal processing and data analysis is performed using personal computer that allows for flexible training

Evaluation of anemia syndrom in haemophilia

In work risk factors of development of an anemia at patients with a hemophilia are analyzed. The anemia met more often at the heavy form of disease, at persons with A (II) group of blood (40%)

Development and transformation of Zagreb's city district Trešnjevka-sjever

Trešnjevka-sjever zagrebačka je gradska četvrt koja je omeđena željezničkom prugom na sjeveru, Ljubljanskom i Zagrebačkom avenijom na jugu, Savskom cestom na istoku te Zagrebačkom cestom na zapadu. Gradnja željezničke pruge na njezinoj sjevernoj granici i elektrane 1907. godine započela je razvoj ove gradske četvrti koja je do sredine 20. stoljeća bila je zapuštena periferija seoskog karaktera s neuređenom komunalnom infrastrukturom i pretežito ilegalnom gradnjom gdje je živjelo pretežito radničko stanovništvo. Sredinom 20. stoljeća dolazi do značajnijeg urbanog razvoja, izgradnje planskih naselja i razvoja prometne mreže i centralnih funkcija koje trebaju zadovoljiti sve veći broj stanovnika ove četvrti. Najveći urbani razvoj događa se nakon Drugog svjetskog rata kada su osim novih stambenih zgrada izgrađeni brojni sportsko-rekreacijski i kulturni centri. Privatizacijom 1990-ih dolazi do promjena prostorne strukture zbog stihijske gradnje i propada industrijskih pogona. Danas Trešnjevka-sjever ima maleni udio zelenih površina te se njezin karakterističan izgled s malim kućama s vrtovima u 20. stoljeću danas pretvorio u područje kontrasta stare niskogradnje i nove stihijske visokogradnje.Trešnjevka-sjever is a city district of Zagreb that is bounded by the railway line in the north, Ljubljanska and Zagrebačka avenues in the south, Savska road in the east and Zagrebačka road in the west. The construction of the railway on its northern border and the power plant in 1907 started the development of this city district, which until the middle of the 20th century was a neglected suburb of a rural character with unorganized communal infrastructure and mostly illegal construction where the majority of the working class population lived. In the middle of the 20th century, significant urban development took place, the construction of planned settlements and the development of the transport network and central functions that tried to satisfy the increasing number of inhabitants of this district. The biggest urban development took place after the Second World War when, in addition to new residential buildings, numerous sports-recreational and cultural centers were built. Privatization in the 1990s led to changes in the spatial structure due to uncontrolled construction and the collapse of industrial facilities. Today, Trešnjevka-sjever has a small share of green areas, and its characteristic appearance with small houses with gardens in the 20th century has today turned into an area of contrast between old low-rise buildings and new uncontrolled high-rise building