Liječenje mladih žena s ranim stadijem raka dojke - važnost očuvanja plodnosti

Management of young women with breast cancer is complex and has several particularities, one of which is fertility preservation, a very important quality of life issue for young breast cancer survivors. Chemotherapy can be gonadotoxic and significantly reduce woman`s reproductive potential and cause premature ovarian insufficiency while endocrine therapy requires a delay of pregnancy and indirectly affects fertility. Therefore every woman of reproductive age diagnosed with breast cancer should be informed about potential gonadotoxic effect of cancer treatment, the risk of premature ovarian insufficiency and associated symptoms, available fertility preservation methods, delay of cancer treatment and chances of subsequent pregnancy. If interested in fertility preservation breast cancer patients should be referred as early as possible to a reproductive specialist to further discuss the risk of infertility and available fertility preservation options. Currently established methods for fertility preservation are embryo and oocyte cryopreservation, while ovarian tissue cryopreservation, cryopreservation of immature oocytes and ovarian suppression with gonadotropin-releasing hormone agonists are still considered experimental. The aim of this review is to highlight the importance of fertility preservation as an important quality of life issue for young breast cancer survivors.Liječenje mladih žena s rakom dojke je složeno i ima nekoliko posebnosti, jedna od kojih je očuvanje plodnosti, vrlo bitan čimbenik kvalitete života mladih žena koje su preboljele rak dojke. Kemoterapija može štetno utjecati na jajnike i značajno smanjiti reprodukcijski potencijal žene i uzrokovati prijevremenu ovarijsku insuficijenciju, dok endokrina terapija zahtijeva odgodu trudnoće i tako posredno utječe na plodnost. Stoga bi svaka žena, kojoj je rak dojke dijagnosticiran u reprodukcijskoj dobi, trebala biti informirana o mogućem gonadotoksičnom učinku antineoplastičke terapije, riziku prijevremene ovarijske insuficijencije i povezanim simptomima, dostupnim metodama očuvanja plodnosti, odgodi sustavne antineoplastičke terapije, kao i o mogućnostima ostvarenja trudnoće nakon provedenog liječenja. Ukoliko je bolesnica s rakom dojke zainteresirana za očuvanje plodnosti, treba je što ranije uputiti subspecijalistu humane reprodukcije, koji će joj dodatno objasniti rizike za neplodnost i dostupne metode očuvanja plodnosti. Krioprezervacija embrija i oocita su trenutno jedine etablirane metode očuvanja plodnosti, dok se krioprezervacija tkiva jajnika, krioprezervacija nezrelih oocita i ovarijska supresija još uvijek smatraju eksperimentalnima. Cilj ovoga preglednog rada je istaknuti važnost očuvanja plodnosti kao bitnog čimbenika kvalitete života mladih žena koje su preboljele rak dojke

Giant Aneurysm of Basilar Artery

In the article we showed the patient, a woman with unruptured giant aneurysm of basilar artery, we showed the done examinations, and therapy dilemmas about what to do in the given case. We found in literature a number of examples which suggest operation treatment, but of embolisation too, some suggest conservative treatment

Head Trauma and Posttraumatic Epilepsy in Slavonski Brod, East Croatia, 1988-2008

Posttraumatic epilepsy is result of head trauma. The aim of our research was to establish how many patients after head trauma developed posttraumatic epilepsy (PTE). Retrospectively we analyzed 50 patients with head trauma different severity in period from 1989. to 2008., which we werified radiological, electroenfephalographic, and psychical changes were established according pto psychiatric examination. From 50 patient with head trauma, 40 developed seizures (3 in the firs 24 hours and 6 after first 24 hours to the end of first week, 31 after first week). By introducing antiepileptic therapy (AETh), 30 patients were seizure free, 10 patients had 1-2 epileptic seizure monthly (EPA/CPA), 10 patients got prophylactic AETh in period 6-12 months. 14 patients developed psychical changes which were verified by psychiatrist. The experience and literature show that posttraumatic epilepsy is good for treating with 1 or 2 antiepileptic, and remission is more difficult in case psychiatric comorbidity

Potrošnja antibiotika u bolnicama i stopa otpornosti bakterija Klebsiella pneumoniae i Escherichia coli u Crnoj Gori

Inappropriate use of antibiotics leads to an increase in antibiotic resistance. Infections caused by antibiotic-resistant gram-negative bacteria are a serious threat to public health. This study aimed to compare data on inpatient antibiotic consumption with antimicrobial resistance (AMR) rate of Klebsiella pneumoniae and Escherichia coli invasive strains in Montenegro and provide targets for improving antibiotic use. We used the national data on antibiotic consumption from 2009 to 2015, Point Prevalence Survey data on inpatient antibiotic consumption from 2015, and national AMR data on 79 Klebsiella pneumoniae and 68 Escherichia coli isolates collected from 8 hospitals from 2016 to 2018. The most commonly used antibiotics were third-generation cephalosporins with a median annual consumption of 0.66 DDD/1000/day. Ceftriaxone was the most frequently prescribed antibiotic in the treatment of community/hospital acquired infections and surgical/medical prophylaxis. The highest resistance rates were recorded for Klebsiella pneumoniae to ceftriaxone, ceftazidime and gentamicin (93.59%, 90.79% and 89.87%, respectively), and Escherichia coli to aminopenicillins, ceftriaxone and ceftazidime (89.06%, 70.15% and 61.54%, respectively). High consumption of broadspectrum antibiotics in Montenegro is accompanied by the high rate of resistance of Klebsiella pneumoniae and Escherichia coli to these agents. Antibiotic misuse demands the introduction of an antimicrobial stewardship program in Montenegrin hospitals.Neodgovarajuća upotreba antibiotika dovodi do povećanja otpornosti na antibiotike. Infekcije uzrokovane gram-negativnim bakterijama otpornima na antibiotike ozbiljna su prijetnja javnom zdravlju. Ovo istraživanje imalo je za cilj usporediti podatke o potrošnji antibiotika u bolnicama sa stopom antimikrobne rezistentnosti (AMR) invazivnih sojeva Klebsiella pneumoniae i Escherichia coli u Crnoj Gori i osigurati ciljeve za poboljšanje upotrebe antibiotika. Rabili smo nacionalne podatke o potrošnji antibiotika od 2009. do 2015. godine, podatke iz studije presjeka o potrošnji antibiotika u bolnicama u 2015. godini i nacionalne podatke AMR za 79 izolata Klebsiella pneumoniae i 68 izolata Escherichia coli prikupljena iz 8 bolnica od 2016. do 2018. godine. Najčešće primijenjeni antibiotici bili su cefalosporini treće generacije s medijanom godišnje potrošnje od 0,66 DDD/1000/dan. Ceftriakson je najčešće propisivani antibiotik u liječenju izvanbolničkih i bolničkih infekcija te u kirurškoj/medicinskoj profilaksi. Stopa otpornosti Klebsiella pneumoniae bila je najviša na ceftriakson, ceftazidim i gentamicin (93,59%, 90,79% odnosno 89,87%), a Escherichia coli na aminopeniciline, ceftriakson i ceftazidim (89,06%, 70,15% odnosno 61,54%). Visoka potrošnja antibiotika širokog spektra u Crnoj Gori praćena je visokom stopom otpornosti Klebsiella pneumoniae i Escherichia coli na njih. Zlouporaba antibiotika zahtijeva uvođenje programa antimikrobnog upravljanja u crnogorskim bolnicama

Head Trauma and Posttraumatic Epilepsy in Slavonski Brod, East Croatia, 1988-2008

Posttraumatic epilepsy is result of head trauma. The aim of our research was to establish how many patients after head trauma developed posttraumatic epilepsy (PTE). Retrospectively we analyzed 50 patients with head trauma different severity in period from 1989. to 2008., which we werified radiological, electroenfephalographic, and psychical changes were established according pto psychiatric examination. From 50 patient with head trauma, 40 developed seizures (3 in the firs 24 hours and 6 after first 24 hours to the end of first week, 31 after first week). By introducing antiepileptic therapy (AETh), 30 patients were seizure free, 10 patients had 1-2 epileptic seizure monthly (EPA/CPA), 10 patients got prophylactic AETh in period 6-12 months. 14 patients developed psychical changes which were verified by psychiatrist. The experience and literature show that posttraumatic epilepsy is good for treating with 1 or 2 antiepileptic, and remission is more difficult in case psychiatric comorbidity

One-pot synthesis of biocompatible NaYF4:Yb,Er nanoparticles for cell labeling

In modern medical research, great attention has been focused to the development of the new biomarkers which include up-converting nanoparticles (UCNPs). Their optical response is triggered by NIR radiation that achieves deeper tissue penetration when compared with traditionally used fluorophores. In this work, biocompatible NaYF4: Yb, Er nanoparticles were synthesized by polymer assisted one-pot solvothermal processing using chitosan or poly(lacticco- glycolic acid). X-ray powder diffraction and electron microscopy results revealed differences in crystal arrangement and morphology of the as-synthesized particles. Fourier transform infrared spectroscopy confirmed the presence of corresponding polymers moiety on UCNPs surface providing their biocompatibility and low cytotoxicity towards human gingival fibroblasts (HFG). As a consequence of efficient up-conversion, prominent green emission (between 512-533nm and between 533-560nm) as well as red emission (630-690nm) were recorded in the particles photoluminescence spectra, and these are applied further in the visualization of the HFG using the laser scanning microscopy with a NIR laser source

Ispitivanje kvaliteta kafe različitim metodama

The results obtained by the analysis of the samples of coffee mostly consumed on our market showed that the coffee quality corresponds to the values as given in the Law of Health Food. It was not found that any of the parameters which determine food quality exceeded permitted values. Content of heavy metals and aflatoxines is below permitted values. The least content of caffeine was determined in a coffee sample roasted in the private roaster’s shop, and only in it the presence of coffee surrogates/substitutes was not proved. The obtained results of the coffee analysis showed that the coffees of most popular producers are very equal, and results of caffeine analysis are even more equal. This indicates the most probable fact that coffee is of the same origin, and that later, on during production, a different mixture was made, which affects the final product and gives aroma and taste to the liquid.Dobijeni rezultati ispitivanja kvaliteta kafa koje se najčešće konzumiraju na našem tržištu pokazali su da kvalitet kafe odgovara vrednostima koje su preporučene Zakonom o zdravstvenoj ispravnosti namirnica. Ovim ispitivanjima utvrđeno je da nisu prekoračene dozvoljene granice nijednog od parametra koji utiču na kvalitet namirnica. Sadržaj teških metala i aflatoksina je ispod dozvoljenih vrednosti. Najmanji sadržaj kofeina određen je u uzorku kafe koja je proizvedena u privatnoj pržionici, a takodje jedino u njoj nije dokazano prisustvo surogata kafe. Dobijeni rezultati ispitivanja kafe ukazuju da su kafe najpoznatijih proizvođača veoma ujednačene, a rezultati ispitivanja kofeina čak i izjednačeni. To ukazuje na verovatnu činjenicu da je kafa istog porekla, a da je kasnije u pogonima pravljena različita mešavina, koja i utiče na konačni proizvod i koja daje aromu i ukus napitku

Effect of Gd3+ introduction on YF3: Yb, Er structural, morphological and optical properties

Monosized up-converting nanoparticles (UCNPs) with a spherical shape and biocompatible surface have a wide application in biomedicine as new cell markers or light-triggered drug delivery agents. The synthesis of the hexagonal β-NaYF4:Yb/Er phase is of a great interest, because of its most efficient up-conversion luminescence. Beside it, synthesis of the UCNPs based on YF3:Yb/Er phase is also attractive due to its orthorhombic phase arrangement and fact that higher concentration of dopants could be introduced in such crystal lattice. In this work the synthesis of pure and Gd-doped YF3:Yb/Er phases were performed through hydro/solvo thermal method using a biocompatible chitosan as a surfactant. The XRD analysis showed that independently of the gadolinium content formation of the orthorhombic phase is achieved, but intensity of the green emission due to the (2H11/2, 4S3/2) → 4I15/2 electronic transitions was highest for un-doped YF3:Yb/Er sample