Injuries of the tarsometatarsal joints: treatment and outcome [Lisfrancova ozljeda]

Between January 2005 and May 2009, a total of 26 patients, 21 males and 5 females, were admitted for treatment of Lisfranc lesion. All patients were radiologically evaluated and classified according to the criteria proposed by Myerson: 5 (19.2%) patients had a type A injury, 2 patients (7.7%) presented with a type B1 injury, 17 (65.4%) sustained the most common type B2 injury and 1 (3.8%) patient suffered from a type C1 and C2 injury. Taking radiological and clinical findings in account, fifteen patients were elected for operative treatment and eleven patients were treated conservatively. According to type of fracture we established three groups; in group I metatarsal fracture was found in fourteen (53.9%) patients, group II with phalangeal fracture in three (11.5%) cases, whereas in group III nine (34.6%) patients sustained combined metatarsal, navicular and, most commonly, a cuneiform fracture. Using the American Orthopedic Foot and Ankle Society (AOFAS) midfoot scoring scale and SF-36 questionnaire, the functional outcome was assessed. The mean value for age distribution was 42.7 +/- 13.2 years and the mean follow up was 27.9 +/- 12.4 months. A p value < 0.005 was regarded as statistically significant for the analysis of the results. We found by means of SF 36 questionnaire a statistically significant difference in the role limitation due to existence of pain (p = 0.04) and poor general health (p = 0.013) in the group of patients that sustained combined foot fracture. The purpose of this study is to assess the treatment of Lisfranc injuries in our patients, according to SF36 and AOFAS criteria, clinical outcome was evaluated. In the group I the mean AOFAS score was 74.0 +/- 9.1 and in the group II it reached 72.0 +/- 5.2 signifying fair outcome! Poor outcome was present in the group III with mean AOFAS score 67.1 +/- 9.0. All unstable injuries require surgery. Clinical outcome is highly dependent on the restoration of normal anatomic alignment

Early Christian Glass Lamps

Staklene svjetiljke važan su dio materijalne kulture starokršćanskih lokaliteta. Predstavljaju gotovo neizostavan dio liturgijskog namještaja crkvenih prostora od druge polovice 4. stoljeća o čijoj važnosti svjedoče brojni tekstovi i likovni prikazi. Osim oko crkvenih objekata, svjetiljke su čest nalaz i na nekropolama, gdje su osim funkcionalnog mogle imati i simbolički karakter. Unutar istraživanja javljaju se različiti oblici koji se mogu podijeliti u pet osnovnih oblika: svjetiljke u obliku šalice/zdjelice (Uboldi I), konične svjetiljke (Uboldi II), svjetiljke koje završavaju dnom s ispupčenjem (Uboldi III), svjetiljke u obliku lijevka (Uboldi IV) te svjetiljke u obliku kaleža (Uboldi V), uglavnom datiranih od kraja 4. do 8. stoljeća. Staklene svjetiljke sastojale su se od staklenog recipijenta punjenog vodom i slojem ulja na kojem je mogao plutati fitilj. U odnosu na glinene i metalne uljanice, staklene su predstavljale znatan napredak jer su s istom količinom ulja omogućavale dvostruko više svjetla. Rezultat je to prozirnih stjenki kroz koje se sjaj plamena lako širio. Paralelno s širenjem uporabe staklenih svjetiljki razvijaju se i dijelovi koji su zajedno sa staklenim recipijentima činili dio rasvjetnog uređaja. Osim staklenih dijelova, elementi rasvjetnog uređaja bili su i držači fitilja te metalni elementi (monokandila i polikandila) koji su omogućavali vješanje svjetiljki.Glass lamps are important element of Early Christian material culture. They are almost inevitable part of liturgical furnishings of church interiors from the second half of the fourth century onwards. Their significance is attested by numerous historical sources and visual depictions. They are common find in the churches and necropolae where they can have simbolic meaning also. Their typology can be divided into five basic forms: cup/bowls (Uboldi I), conical lamps (Uboldi II), lamps with base knob (Uboldi III), funnel-shaped lamps (Uboldi IV), chalice-shaped lamps (Uboldi V), mostly dated from the end of the 4th century to the 8th century. Glass lamps consisted of glass vessels filled with water and oil layer with a floating wick which could be made of flax or cotton fibres or obtained from some other plant fibres. They represented a technological advancement in comparison to clay and metal oil lamps since oil and water, together with transparent vessel, enabled much stronger light with the same amount of oil used. In addition to glass parts, elements of lighting device also comprised wick holders and metal elements (monocandela and polycandela) that enabled suspension of lamps

Flora poluprirodne močvare Savica, suburbanog dijela grada Zagreba (Hrvatska)

The flora of Savica, a suburban part of the town Zagreb with remnants of alluvial forests and vegetation of still waters, was surveyed mainly during 2006 with some later additions. In total 289 vascular plant species and subspecies were recorded. Regarding the spectrum of chorological types the flora of Savica is similar to other areas of NW Croatia, but with higher ratio of Euro-Asiatic chorotypes (48.3%), adventive species (13.2%) and Mediterranean chorotypes (9.7%) as consequence of anthropogenic influence and the ruderalisation of habitats. The same process is reflected in its relatively high ratio of therophytes (19.1%). Indicators of anthropogenic changes show that the flora of Savica is more influenced by archaeophytes than by neophytes. Among them, 25 species (8.6%) are invasive alien species. The life-form spectrum is almost the same as for other areas of NW Croatia, suggesting that the flora has a structure well adapted to general climate of North-Western Croatia. A special value of the flora of Savica consists of stands of tree species representing the last remnants of alluvial forests along the Sava River, as well as hydrophytes and helophytes in and around small lakes.Flora Savice, suburbanog dijela grada Zagreba s ostacima poplavnih šuma i vegetacijom stajačica, istraživana je mahom 2006. s nekoliko kasnijih dodataka. Ukupno je zabilježeno 289 vrsta i podvrsta vaskularnog bilja. S obzirom na spektar horoloških tipova, flora Savice slična je nekim drugim područjima SZ Hrvatske s time da se s većom učestalošću ističu biljke eurazijskog elementa (48,3%), adventivne vrste (13,2%) i biljke mediteranskog elementa (9,7%), što je posljedica antropogenog utjecaja i posljedične ruderalizacije staništa. Taj proces se ogleda i u razmjerno visokom udjelu terofita (19,1%). Pokazatelji antropogene promjene pokazuju da je flora Savice više utjecana arheofitima nego neofitima. Među njima nalazi se 25 vrsta (8,6%) invazivnih stranih vrsta. Spektar životnih oblika gotovo je isti kao za druga područja SZ Hrvatske, što upućuje da je flora dobro prilagođena općoj klimi SZ Hrvatske. Osobita vrijednost flore Savice su sastojine drvenastih vrsta koje predstavljaju posljednje ostatke poplavne vegetacije uz rijeku Savu, kao i hidrofiti i helofiti prisutni u jezercima i oko njih

Preliminarni popis invazivnih stranih biljnih vrsta (IAS) u Hrvatskoj

In this paper a preliminary check-list of invasive alien plant species (IAS) in Croatia is presented. It has been created on the basis of the literature and of field observations. The list consists of 64 taxa, with family, life-form and geographic origin assigned to each IAS. Analyses according to family affiliation, life-form and origin were made. Out of 27 families the majority (24 families) belong to the dicotyledons. The most numerous family is Asteraceae, and genera with the highest number of IAS are Conyza, Erigeron and Impatiens. Life-form analysis showed the predominance of therophytes but also presence of hemicryptophytes, phanaerophytes and geophytes. In the origin analysis, IAS from the Americas predominated, followed by those from Asia and Africa.U radu je predstavljen preliminarni popis invazivnih stranih biljnih vrsta (IAS) u Hrvatskoj. Izrađen je na temelju literaturnih podataka i opažanja na terenu. Popis se sastoji od 64 svojte, kojima je pridružena pripadajuća porodica, životni oblik i geografsko podrijetlo. Izvršene su analize prema pripadnosti porodicama, životnom obliku i podrijetlu. Od 27 porodica većina (24 porodice) pripada dvosupnicama. Najbrojnija porodica je porodica Asteraceae dok su rodovi Conyza, Erigeron i Impatiens zastupljeni s najvećim brojem svojti. Analiza životnih oblika pokazala je dominaciju terofita, ali i prisutnost hemikriptofita, fanerofita i geofita. Po podrijetlu dominiraju invazivne svojte iz obiju Amerika, a slijede ih one iz Azije te Afrike

'Bois noir' phytoplasma induces significant reprogramming of the leaf transcriptome in the field grown grapevine

<p>Abstract</p> <p>Background</p> <p>Phytoplasmas are bacteria without cell walls from the class <it>Mollicutes</it>. They are obligate intracellular plant pathogens which cause diseases in hundreds of economically important plants including the grapevine (<it>Vitis vinifera</it>). Knowledge of their biology and the mechanisms of their interactions with hosts is largely unknown because they are uncultivable and experimentally inaccessible in their hosts. We detail here the global transcriptional profiling in grapevine responses to phytoplasmas. The gene expression patterns were followed in leaf midribs of grapevine cv. 'Chardonnay' naturally infected with a phytoplasma from the stolbur group 16SrXII-A, which is associated with the grapevine yellows disease 'Bois noir'.</p> <p>Results</p> <p>We established an on field experimental system in a productive vineyard that allowed application of molecular tools in a plant natural environment. Global transcription profiles of infected samples were compared with the healthy ones using microarray datasets and metabolic pathway analysis software (MapMan). The two-year-long experiment revealed that plant genes involved in primary and secondary metabolic pathways were changed in response to infection and that these changes might support phytoplasma nutrition. A hypothesis that phytoplasmas interact with the plant carbohydrate metabolism was proven and some possibilities how the products of this pathway might be utilized by phytoplasmas are discussed. In addition, several photosynthetic genes were largely down-regulated in infected plants, whereas defense genes from the metabolic pathway leading to formation of flavonoids and some PR proteins were significantly induced. Few other genes involved in defense-signaling were differentially expressed in healthy and infected plants. A set of 17 selected genes from several differentially expressed pathways was additionally analyzed with quantitative real-time PCR and confirmed to be suitable for a reliable classification of infected plants and for the characterization of susceptibility features in the field conditions.</p> <p>Conclusion</p> <p>This study revealed some fundamental aspects of grapevine interactions with the stolbur 'Bois noir' phytoplasma in particular and some plant interactions with phytoplasmas in general. In addition, the results of the study will likely have an impact on grape improvement by yielding marker genes that can be used in new diagnostic assays for phytoplasmas or by identifying candidate genes that contribute to the improved properties of grape.</p

Alohtona flora Hrvatske: prijedlozi standarda u terminologiji, kriterija te baze podataka

As a result of the global problem of invasion, the number of studies dealing with plant invasion is increasing, thus causing increasing confusion about terminology used. As a part of the first national project about invasive Croatian flora in 2006, we prepared a proposal for a national standard terminology and criteria for the treatment of alien flora. This proposal includes regular terminology globally accepted in most botanical communities, but it is especially harmonized with European standards for alien flora treatment, particularly for invasive alien plant species (IAS). Special attention was paid to defining the criteria for status of plant species potentially invasive in Croatia, such as origin status, residence status and invasion status, for which a special module »Allochthonous plants« within Flora Croatica Database was prepared.Kako je problem invazivnih vrsta postao svjetski, porastao je broj studija o invazivnim biljnim vrstama, što je uzrokovalo porast terminološke konfuzije koja se nastoji prevladati uvođenjem općeprihvaćenih standarda. Stoga smo, kao dio prvog nacionalnog projekta o invazivnoj flori Hrvatske, provedenog 2006. godine, pripremili prijedlog nacionalnih standarda i kriterija za tretiranje alohtone flore. Taj prijedlog uključuje standardnu terminologiju, svjetski prihvaćenu od većine botaničara, ali i posebno usklađenu s europskim standardima za tretiranje alohtone flore, a naročito invazivnih biljnih vrsta. Posebna pažnja posvećena je definiranju kriterija za utvrđivanje statusa potencijalno invazivnih vrsta u Hrvatskoj, kao što su podrijetlo, datum i način unosa, te invazivni status, na temelju kojih je, za navedene svojte, unutar baze Flora Croatica priređen zaseban modul »Alohtone biljke«

Irritable Bowel Syndrome in Croatia

There are three epidemiological studies of irritable bowel syndrome (IBS) that were conducted in Croatia (in the area of Zagreb in 2002, Bjelovarsko-bilogorska County in 2008, and finally in Osječko-baranjska County in 2011). The aim of this study is to analyze the anthropometric, demographic and socioeconomic characteristics of IBS in Croatia comparing these three studies. The studies included a questionnaire based on Rome criteria. Study population matched the adult population of Croatia according last available census (1991, 2001 resp.). Studies showed a high prevalence of IBS and some common factors relevant for development of IBS were determined such as gender, body mass index and lower level of education. There is a need for further investigations in coastal Croatia applying a uniform questionnaire on anthropometric, demographic and socioeconomic characteristics of IBS and Rome III criteria, diagnostic questionnaires and scoring algorithm for functional gastrointestinal disorders developed by Rome Foundation applicable in clinical practice and population studies, regarding the significant high prevalence of IBS in our country

APPROACH TO PATIENTS WITH GASTROINTESTINAL BLEEDING

U razvijenim zemljama zapadnog svijeta unatoč akumulaciji znanja o uzrocima i načinu liječenja gastrointestinalnog krvarenja, iskustvu gastroenterologa endoskopičara, upotrebi sofi sticiranih endoskopskih uređaja, broj hospitalizacija i stopa smrtnosti nisu se očekivano smanjili. Moguća objašnjenja su starenje populacije, povećanje prevalencije gastroezofagealne refl usne bolesti, debljina, antibiotska rezistencija Helicobacter pylori, upotreba antiagregacijskih, antikoagulantnih lijekova te ekscesivno korištenje nesteroidnih antireumatika. Cilj ovog preglednog rada je prikazati incidenciju, defi nirati najčešće znakove i simptome krvarenja, pokazati inicijalnu kliničku evaluaciju, dijagnostičke metode, osnovne uzroke krvarenja i endoskopske metode zaustavljanja krvarenja te algoritme liječenja krvarenja iz gornjeg i donjeg gastrointestinalnog sustava. Koristeći baze podataka MEDLINE i Ovid tražili smo meta analize i sistemske preglede objavljene na engleskom jeziku u razdoblju od 2005.-2015. godine. Meta analize su uključivale rezultate randomiziranih, dvostruko slijepih istraživanja na odraslim bolesnicimaliječenima zbog gastrointestinalnog krvarenja. Uključene su smjernice Europskog i Američkog društva za gastroenterološku endoskopiju kao i recentni radovi stručnjaka. Donosimo najaktualnije spoznaje o krvarenju iz gastrointestinalnog sustava, novu podjelu na krvarenja iz gornjeg, srednjeg i donjeg dijela gastrointestinalnog trakta, kontroverze o plasmanu nazogastrične sonde, upotrebi prokinetika i inhibitora protonske pumpe u akutnim krvarenjima iz gornjeg dijela gastrointestinalnog trakta, restriktivnoj transfuzijskoj strategiji, boljoj kliničkoj stratifi kaciji težine krvarenja, hospitalizaciji te kliničkom ishodu na osnovi upotrebe dijagnostičkih zbrojeva, gastroprotekciji u bolesnika s visokim rizikom nastanka peptičnih ulkusa, važnosti inicijalne ezofagogastroduodenoskopije u procjeni variksa u bolesnika s novootkrivenom cirozom jetre, primarnoj i sekundarnoj profi laksi varicealnog krvarenja, novim endoskopskim metodama hemostaze (Hemospray), radiološkom i kirurškom zaustavljanju krvarenja. Smatramo da bi edukativna narav ovog teksta mogla poslužiti kao temelj stvaranju hrvatskih smjernica za krvarenja iz gastrointestinalnog sustava.In the developed Western countries, despite the accumulation of knowledge about the causes and treatment of gastrointestinal bleeding, as well as the experience of gastroenterologists-endoscopists using sophisticated endoscopic devices, the number of hospitalizations and mortality rates has not declined as expected. The most likely explanations are the following: aging population, increased prevalence of alcoholic liver cirrhosis, gastroesophageal refl ux disease and obesity, Helicobacter pylori antibiotic resistance, using dual anti-aggregation therapy, anticoagulants, and excessive use of nonsteroidal anti-infl ammatory drugs. The aim of this paper is to show the incidence and the most common signs and symptoms of gastrointestinal bleeding. The aim is also to present initial clinical evaluation, diagnostic methods, the main causes of gastrointestinal bleeding, endoscopic hemostatic modalities and treatment of bleeding from the upper and lower gastrointestinal tract. Using the MEDLINE and Ovid databases, we searched the meta-analyses and systematic reviews published in English during the 2005-2015 period. Meta-analyses included results of randomized, double-blind studies on adults treated for gastrointestinal bleeding. Included were guidelines of the European and American Society of Gastroenterological Endoscopy, as well as recent expert work. In this review, we bring the state-of-the-art on gastrointestinal bleeding, new classifi cation of gastrointestinal bleeding from the upper, mid and lower gut, controversy of nasogastric tube placement, use of prokinetic agents and inhibitor proton pumps in acute gastrointestinal bleeding from the upper tract, restrictive transfusion strategy, useful clinical stratifi cation of the severity of bleeding, indications for hospitalization and outcome of using the clinical bleeding score, proper use of gastroprotection in patients at a high risk of peptic ulcer, the need of initial endoscopy, variceal assessment in newly diagnosed liver cirrhosis, primary and secondary prophylaxis of variceal bleeding, new endoscopic hemostatic modality, and radiological and surgical treatment of gastrointestinal bleeding. The educational nature of this review could serve for establishing Croatian guideline for the management of gastrointestinal bleeding