Intraductal papillary neoplasm of the bile duct (IPNB) as an uncommon cause of abdominal pain and cholangitis

INTRODUCTION/OBJECTIVES: Intraductal papillary neoplasm of the bile duct (IPNB) is a relatively new entity characterized by dilation of bile ducts filled with papillary neoplasms, which represents premalignant lesion of cholangiocarcinoma, with common malignant transformation

Extrahepatic Manifestations of Hepatitis C Virus Infection

Chronic hepatitis C virus (HCV) infection causes progressive liver fibrosis, cirrhosis, liver failure, and hepatocellular carcinoma. Additional to liver damage, HCV infection causes a variety of systemic disorders, some of which sometimes bear more severe morbidity than the liver disease itself. These extrahepatic manifestations represent a wide spectrum of disorders, ranging from the presence of a variety of clinically insignificant autoantibodies to diseases affecting a variety of organ systems. Mixed cryoglobulinemia is a common manifestation, and associated vasculitis can affect many organs (kidney, skin, and joints). The skin can also be affected by porphyria cutanea tarda and lichen planus. Other common extrahepatic manifestations include autoimmune disorders, lymphoproliferative disorders, and a number of neurological and neuropsychiatric disorders such as fatigue, depression, or cognitive impairment. Insulin resistance, diabetes mellitus, accelerated atherosclerosis, and increased cardiovascular disease morbidity and mortality have also been associated with chronic HCV infection. The existence and severity of extrahepatic manifestations do not correlate with the severity of liver disease, and the mainstay of treatment is HCV eradication. Patients with systemic manifestations of HCV infection should be prioritized for treatment, especially in the era of new interferon-free therapies with fewer side effects

Forensic analysis of bones and teeth

Kosti su važne za mnoge životne funkcije kao što su potpora, pokretljivost, zaštita, proizvodnja krvih stanica, endokrina regulacija i mnoge druge. Stanje kostiju može forenzičaru reći mnogo o životu žrtve pa se tako pomoću njih u najboljem slučaju može odrediti spol, dob, etnička pripadnost i još neke karakteristike kao što su visina i izgled lica. Zubi su također dobar materijal za identifikaciju žrtvi čija se tijela pronađu u lošem stanju zato što je jedna komponenta zuba, zubna caklina, najtvrđi dio ljudskog tijela te se i u slučaju kada je tijelo zapaljeno pomoću nje se može mnogo toga otkriti. U ovom radu je izložen kratak pregled najvažnijih karakteristika kostiju i zubi koje forenzičarima mogu poslužiti pri identifikaciji osoba, a sadrži i osvrt na rad hrvatskih forenzičara tijekom identifikacije žrtava Domovinskog rata.Bones are important for many life functions such as support, mobility, protection, production of blood cells, endocrine regulation, and many others. Condition of bones can tell much about victim's life and that is why they are the source of informations like gender, age, height and face features. Teeth are also good material for identification of the victims whose bodies are found in poor conditions because of enamel, the hardest substance in the human body that protects teeth even at high temperatures. This work presents a brief overview of the most important characteristics of bones and teeth that forensics can use in identification process and it also includes information about identification process of victims of Croatian war of Independence

HISTOLOGICAL TYPES OF LUNG CARCINOMA DIAGNOSED FROM 2010 UNTIL 2015 IN KBC SPLIT

Cilj istraživanja: Analizirati epidemiološke karakteristike pacijenata sa karcinomom pluća i utvrditi histološke tipove istih u razdoblju od 2010. do 2015. u KBC Split. Materijali i metode: Retrospektivno epidemiološko istraživanje. Uzorak pacijenata obuhvaća sve pacijente s dijagnozom karcinoma pluća na Odjelu za patologiju, sudsku medicinu i citologiju KBC–a Split. Pacijentima su određeni dob (godine), spol (muško/žensko), histološki tip karcinoma, imunohistokemijska bojanja korištena u dijagnostici i vrsta dijagnostičkog zahvata. Rezultati: Analizirano je ukupno 1344 pacijenta, od kojih je bilo 1008 muškaraca ( 75%), i 336 žena ( 25%). Prosječna dob muškarca iznosila je 66 godina, a za žene 65 godina, te nije bilo značajne razlike u dobi ispitanikan (P=0,0913). Najučestaliji histološki tip karcinoma pluća bio je adenokarcinom (39,4%), a drugi po učestalosti karcinom pločastih stanica (33,0%). Najučestaliji histološki tip karcinoma pluća kod muškaraca je bio karcinom počastih stanica, dok je na drugom mjestu adenokarcinom. Kod žena, najučestaliji histološki tip karcinoma pluća je bio adenokarcinom, dok je karcinom pločastih stanica na drugom mjestu. Najučestaliji podtip adenokarcinoma pluća kod muškaraca je bio solidni (51,3%), a kod žena acinarni podtip (42,86%). Najveći broj uzoraka, njih 1237 (92,03%), za patohistološku analizu je dobiven transbronhalne biopsije. Najčešće korištena primarna antitijela bila su CK 5/6, CK 7, TTF-1 i napsin. Zaključak: U KBC Split većina pacijenata sa dijagnozom malignog tumora pluća je muškog spola. U ovom razdoblju došlo je do povećanja dijagnosticiranih slučajeva te se pojavila promjena incidencije karcinoma pluća po spolu. Najzastupljeniji histološki tip je adenokarcinom. Učestalost histoloških tipova karcinoma pluća obzirom na spol je različita. U muškaraca najzastupljeniji je karcinom pločastih stanica, a u žena adenokarcinom. Uzorak za patohistološki analizu dobiven je transbronhalnom biopsijom u 92%, a najčešće korištena primarna antitijela su CK 5/6, CK 7, TTF-1 i napsin.Objectives: To analyze epidemiologic characteristics of patients with lung carcinoma and histological types of the former in KBC Split from 2010 till 2015. Materials and Methods: A retrospective epidemiologic research has been made. Patients’ samples included all patients diagnosed with lung carcinoma at the Department of pathology, forensic medicine and cytology KBC Split. Age (years), sex (male/female), histological type of carcinoma, immunohistochemistry and type of diagnostic procedure were determined. Results: Records of 1344 patients were analyzed. Study included 1008 men (75%) and 336 women (25%). Average age of men was 66 years and women 65 years which was statistically insignificant (P= 0, 0913). The most common histological type of lung carcinoma was adenocarcinoma (39, 4%) and the second most common was squamous cell carcinoma (33%). The most common histological type of lung carcinoma for men was squamous cell carcinoma while adenocarcinoma was on the second place. When talking about women the most common histological type of lung cancer was adenocarcinoma and squamous cell carcinoma was on the second place. The most common adenocarcinoma subtype for men was solid (51, 3%) and for women was acinar subtype (42, 86%). Most of samples, 1237 (92, 03%), for patohistological analysis were taken with transbronhial bronchoscopy. Most frequently used primary antibodies where CK 5/6, CK 7, TTF-1 and napsin. Conclusion: In KBC Split most of the patients with lung carcinoma were men. In this period the number of diagnosed cases increased and also some changes in incidence of lung carcinoma by sex happened. The most common histological type of lung carcinoma was adenocarcinoma. Incidence of histological types by sex is different. The most common histological type of lung carcinoma for men was squamous cell carcinoma, while in women it was adenocarcinoma. Most of samples for patohistological analises were taken with transbronhial bronhoskopy and most frequently used primary antibodies where CK 5/6, CK 7, TTF-1 and napsin

Hepatitis C Virus (HCV) Treatment in Croatia: Recent Advances and Ongoing Obstacles

The prevalence of hepatitis C virus (HCV) antibodies in Croatia is low in the general population (reported <1%), similar to the prevalence rates of many European countries, but is higher in the populations at risk, especially among intravenous drug users. With the development of new classes of direct-acting antiviral agents and interferon-free regimens, the landscape of HCV treatment has completely changed. Management of HCV infection in Croatia is in accordance with the European Association for the Study of the Liver (EASL) recommendations published in 2015, recently updated Croatian Guidelines (published in April 2016) and the recommendations of Croatian Health Insurance Fund (HZZO) which covers the costs of treatment. HZZO approved simeprevir at the beginning of 2015. By the end of the 2015 sofosbuvir, combination of sofosbuvir + ledipasvir and the combination of ombitasvir, paritaprevir and ritonavir ± dasabuvir became available. Although the drawback of these new highly effective treatments is their price, prioritization of patients on a national level offers equal opportunities to patients in need for treatment. Due to improvements in therapy and prevention, clinical care for patients with HCV in Croatia advanced significantly during the last two years

ANALIZA GLOBALNIH KRETANJA NA TRŽIŠTU PRIRODNOGA PLINA

An accurate prediction of energy indicators is critical for orientation in the energy market, and it could give direction for policymakers and market participants. The aim of this research was to examine the accuracy of projections of natural gas market indicators. This paper presents a comparative analysis of historic predictions and actual global natural gas movements in several segments, namely production, consumption, and regional import dependence, as well as forecasted and actual price movements. The goal of this paper is to compare projected and actual natural gas market indicators. Predictions of market movements 20 years into the future are very useful, but they do have certain limitations. Those limitations especially apply to goods whose prices are regional and linked to price movements of another good, as is the case with natural gas. External influences have a direct impact on production and consumption, and it is rather clear that changes in one of the fundamental factors entails and magnifies the error of further predictions. Despite that, predictions of global production and consumption have proven to be very accurate. Based on the research results, it could be emphasized that for strategical planning and policy-making purposes, the predictions of natural gas production, consumption, or even import independence could be considered with great certainty, while price assumptions in the case of natural gas have shown significant mismatching, therefore, should be very carefully perceived.Točno predviđanje energetskih pokazatelja presudno je za određivanje smjera energetskih politika tržišnih sudionika. Ovaj rad predstavlja komparativnu analizu prethodnih predviđanja i stvarnih globalnih kretanja u sektoru prirodnoga plina u nekoliko segmenata, odnosno u proizvodnji, potrošnji i regionalnoj ovisnosti o uvozu, kao i u prognoziranim i stvarnim kretanjima cijena. Cilj istraživanja bila je analiza podudaranja predviđenih i ostvarenih kretanja tržišnih pokazatelja. Projekcije su dobivene iz predviđanja predstavljenih u referentnome scenariju World Energy Outlook 2000 (WEO) Međunarodne energetske agencije (IEA), a obuhvaćaju razdoblje od 1997. do 2020. Referentni scenarij ne uzima u obzir politike koje su trebale biti provedene do 2020. godine. Stvarna kretanja prirodnoga plina na globalnome tržištu (proizvodnja, potrošnja, regionalna ovisnost o uvozu i cijene) temelje se na podatcima koje je objavio British Petroleum (podatci dostupni do 2018. godine) i odvojeni su u iste četiri kategorije kao i u predviđanju IEA-e. Predviđanja kretanja na tržištu 20 godina u budućnosti vrlo su korisna, ali imaju određena ograničenja. Ta se ograničenja posebno odnose na robu i dobra čija je cijena regionalna i povezana je s kretanjem cijena drugoga dobra, kao što je slučaj s prirodnim plinom. Vanjski utjecaji izravno utječu na proizvodnju i potrošnju i prilično je jasno da promjene u jednome od temeljnih čimbenika povlače i povećavaju pogrešku daljnjih predviđanja. Unatoč tome, predviđanja globalne proizvodnje i potrošnje pokazala su se vrlo preciznima. Na temelju rezultata istraživanja moguće je zaključiti da bi se za potrebe strateškoga planiranja i kreiranja politika s velikom sigurnošću mogla uzeti u obzir predviđanja proizvodnje, potrošnje, pa čak i ovisnosti o uvozu prirodnoga plina, dok su pretpostavljena kretanja cijena u slučaju prirodnoga plina pokazala znatna odstupanja od realnih cijena te treba biti pažljiv prilikom njihova sagledavanja

Utjecaj Strategije niskougljičnog razvoja Republike Hrvatske na energetski sektor nafte i plina

Rusko-ukrajinska kriza bila je prekretnica u energetskoj politici Europske unije koja se do tad oslanjala na energiju iz fosilnih goriva. Nakon krize, a poglavito nakon Konferencije UN-a o klimatskim promjenama u Parizu počinju zaokreti u energetskim politikama europskih zemalja, koje se sve više usmjeravaju na povećanje udjela obnovljivih izvora energije u energetskom miksu. Ciljevi predviđeni Strategijom energetskog razvoja Republike Hrvatske donesene 2009. godine većinom nisu ostvareni zbog nepostojanja provedbenog plana same strategije. U lipnju 2017. je predstavljen prijedlog Strategije niskougljičnog razvoje Republike Hrvatske za razdoblje do 2030. s pogledom na 2050. godinu. Utjecaj odredbi Strategije na poslovanje naftnog i plinskog sektora razmatra se u ovom radu kako bi se ujedno pripremile i smjernice za izradu nove strategije energetskog razvoja Hrvatske, osigurala sigurnost opskrbe energentima u državi, ali i realno sagledali izazovi s kojima će se naftni i plinski sektor u Hrvatskoj suočiti na putu društva prema niskougljičnom razvoju

Utjecaj Strategije niskougljičnog razvoja Republike Hrvatske na energetski sektor nafte i plina

Rusko-ukrajinska kriza bila je prekretnica u energetskoj politici Europske unije koja se do tad oslanjala na energiju iz fosilnih goriva. Nakon krize, a poglavito nakon Konferencije UN-a o klimatskim promjenama u Parizu počinju zaokreti u energetskim politikama europskih zemalja, koje se sve više usmjeravaju na povećanje udjela obnovljivih izvora energije u energetskom miksu. Ciljevi predviđeni Strategijom energetskog razvoja Republike Hrvatske donesene 2009. godine većinom nisu ostvareni zbog nepostojanja provedbenog plana same strategije. U lipnju 2017. je predstavljen prijedlog Strategije niskougljičnog razvoje Republike Hrvatske za razdoblje do 2030. s pogledom na 2050. godinu. Utjecaj odredbi Strategije na poslovanje naftnog i plinskog sektora razmatra se u ovom radu kako bi se ujedno pripremile i smjernice za izradu nove strategije energetskog razvoja Hrvatske, osigurala sigurnost opskrbe energentima u državi, ali i realno sagledali izazovi s kojima će se naftni i plinski sektor u Hrvatskoj suočiti na putu društva prema niskougljičnom razvoju