Non-Financial Reporting as Part of Sustainability Accounting With the Examples of Good Practices

Doing business today for a conscious entrepreneur is not only focused on profit but also on the social, environmental, and economic aspects of doing business together with the sustainable development. Therefore, non-financial reporting for involved stakeholders is a new source of information based on which key decisions will be made related to the further development of the company itself. It contains information on relevant measures that affect the development of business and its results, the effects of business from the environmental and social aspect, the necessary tools to understand the development, business results and position of the company and the effects of its activities. In the European Union, non-financial reporting became mandatory from 1 January 2017 for all large publicinterest companies with more than 500 employees. The legal framework and the market are putting strong pressure on the development of sustainability accounting that is becoming more and more accepted in modern business practice

Rijetki intrakranijski multifokalni ne-germinomatozni tumor zametnih stanica kod 18-godišnjeg mladića: prikaz slučaja

Intracranial germ cell tumors are rare brain tumors that are distinguished based on their histology and selected tumor markers. Non-germinomatous germ cell tumors are a diverse group of such tumors having the poorest prognosis. Most commonly, they are located in the suprasellar and pineal regions. Since the exact treatment protocol has not yet been established, there is currently no standardized modality of management. We present a case of intracranial multifocal non-germinomatous germ cell tumor in an 18-year-old male, along with relevant literature review. We describe initial diagnostic and treatment procedures in a young adult presented with diplopia and ataxic gait. Neuroradiological findings and elevated alpha fetoprotein and beta chain of the human chorionic gonadotropin tumor markers indicated the possible mixed germ cell tumor. Chemotherapy regimen was adjusted accordingly, biopsy was not performed. The patient’s clinical condition improved significantly and his alpha fetoprotein values decreased remarkably after initiation of chemotherapy. In conclusion, initial evaluation with neuroimaging, tumor markers, and cytology from cerebrospinal fluid is important as guidance to further treatment and prognosis. In selected cases, biopsy may not be indicated to start adjuvant chemotherapy. We emphasize the importance of specific treatment modality selection based mainly on tumor markers, regardless of the precise histologic classification.Intrakranijski tumori zametnih stanica su rijetki tumori mozga koji se razlikuju na temelju histologije i tumorskih biljega. Ne-germinomatozni tumori zametnih stanica su raznolika podskupina tih tumora s najlošijom prognozom. Najčešće su locirani u supraselarnoj i pinealnoj regiji. S obzirom na to da točan protokol liječenja još nije utemeljen trenutno ne postoji standardizirani način liječenja. Predstavljamo slučaj intrakranijskog multifokalnog ne-germinomatoznog tumora zametnih stanica kod 18-godišnjeg mladića, popraćen relevantnim pregledom literature. Opisali smo početne dijagnostičke i terapijske postupke provedene kod mladića koji se prezentirao diplopijom i ataksičnim hodom. Neuroradiološki nalazi i povišeni tumorski biljezi, alfa fetoprotein te beta lanac humanog korionskog gonadotropina, upućivali su na mogući miješani tip tumora zametnih stanica. Propisana je odgovarajuća kemoterapija, a biopsija nije učinjena. Nakon početka kemoterapije bolesnikovo kliničko stanje se iznimno popravilo te su mu se vrijednosti alfa fetoproteina značajno snizile. Zaključno, početna neuroradiološka obrada, nalaz tumorskih biljega i citologija iz likvora važni su čimbenici u određivanju smjera liječenja i predviđanju prognoze. U određenim slučajevima biopsija ne mora biti indicirana kako bi se započelo s kemoterapijom. Naglašavamo važnost odabira specifičnog načina liječenja prvenstveno na temelju nalaza tumorskih biljega bez obzira na preciznu histološku klasifikaciju

Potpuno iščezavanje medika mentno tvrdokorne epilepsije temporalnog režnja nakon fenestracije arahnoidne ciste

Intracranial arachnoid cysts are congenital lesions that are frequently detected incidentally. About 30% of patients have a symptomatic epileptic seizure as the presenting symptom, occasionally with other focal neurologic signs. A case is presented of a young male patient with medically refractory temporal lobe epilepsy. Following his neurological examination, epileptic zone was defined in the right temporal lobe that correlated with the MRI-detected sylvian arachnoid cyst. Microneurosurgical cyst fenestration with volume reduction was performed, which resulted in a decremental but eventually complete seizure freedom. In conclusion, the arachnoid microsurgical cyst reduction is a safe procedure and may result in complete remission of symptomatic epileptic seizures and favorable outcomes, as reported in other studies.Intrakranijske arahnoidne ciste su prirođena oštećenja koja se često otkrivaju slučajno. U oko 30% bolesnika manifestiraju se simptomatskim epileptičnim konvulzijama, ponekad i uz druge žarišne neurološke znakove. Prikazuje se slučaj mladog muškog bolesnika s medicinski refraktornom epilepsijom temporalnog režnja. Nakon neurološkog pregleda epileptična zona je definirana u desnom temporalnom režnju, što je koreliralo s arahnoidnom cistom Sylvianove fisure otkrivenom magnetskom rezonancijom. Izvedena je mikroneurokirurška fenestracija ciste sa smanjenjem volumena, što je rezultiralo ublažavanjem i na kraju potpunim izostankom konvulzija. Zaključuje se kako je mikrokirurško smanjenje ciste siguran zahvat koji može dovesti do potpune remisije simptomatskih epileptičnih napadaja i dobrog ishoda, kao što izvještavaju i autori drugih studija

GUIDELINES FOR INTERVENTIONAL AND INVASIVE TREATMENT IN PATIENTS WITH MECHANICAL BACK PAIN

Križobolja kao posljedica primarno mehaničkih poremećaja najčešći je tip križobolje, a obično se javlja u osoba mlađe i srednje životne dobi odnosno radno sposobne populacije. Zbog toga se smatra da je križobolja jedan od najvećih javnozdravstvenih pro¬blema. Liječenje bolnog sindroma kralješnice ovisi o brojnim čimbenicima, a općenito uključuje konzervativne i invazivne metode. Relativna indikacija za intervencijske i kirurške postupke je i dugotrajna križobolja, koja svojim simptomima, a ponajprije bolovi¬ma značajno onemogućava bolesnika u obavljanju aktivnosti svakodnevnoga života. Invazivno/kirurško liječenje primjenjuje se nakon najmanje 3 mjeseca konzervativnog liječenja, ako ono nije uspješno. Invazivni i kirurški postupci obuhvaćaju široki spektar intervencija od interventnih i poluinvazivnih postupaka, minimalno invazivnih operacija sve do opsežnih, invazivnih operacija koje uključuju instrumentaciju. Odabir intervencije temelji se na kliničkoj slici, trajanju i jačini bolova i drugih tegoba te na nalazima dijagnostičke obrade. Unatoč preporukama temeljenih na rezultatima kliničkih studija, individualizirani pristup svakom bolesniku i dalje ostaje glavni preduvjeti uspješnog liječenja.Back pain caused primarily by mechanical disorders is the most common type of back pain and it is usually found in young and middle-aged population, i.e. active population. This is why back pain is one of the most important public health problems. Tre¬atment of pain syndrome affecting spine depends on a variety of factors and generally includes conservative and invasive met-hods. Relative indication for interventional and surgical procedures is long lasting back pain, the symptoms of which, predomi¬nantly pain, cause significant problems for the patient on performing everyday activities. Invasive/surgical treatment is applied after minimally 3 months of unsuccessful conservative treatment. Invasive and surgical procedures comprise a wide spectrum of interventions, from interventional and semi-interventional procedures, minimally invasive procedures to extensive, invasive ope¬rations that include instrumentation. The choice of intervention is based on clinical findings, duration and severity of pain and other symptoms, as well as on diagnostic reports. Despite recommendations based on the results of clinical studies, individual approach to each patient is the main principle of successful treatment

Rare Intracranial Multifocal Non-Germinomatous Germ Cell Tumor in an 18-Year-Old Male: A Case Report

Intracranial germ cell tumors are rare brain tumors that are distinguished based on their histology and selected tumor markers. Non-germinomatous germ cell tumors are a diverse group of such tumors having the poorest prognosis. Most commonly, they are located in the suprasellar and pineal regions. Since the exact treatment protocol has not yet been established, there is currently no standardized modality of management. We present a case of intracranial multifocal non-germinomatous germ cell tumor in an 18-year-old male, along with relevant literature review. We describe initial diagnostic and treatment procedures in a young adult presented with diplopia and ataxic gait. Neuroradiological findings and elevated alpha fetoprotein and beta chain of the human chorionic gonadotropin tumor markers indicated the possible mixed germ cell tumor. Chemotherapy regimen was adjusted accordingly, biopsy was not performed. The patient’s clinical condition improved significantly and his alpha fetoprotein values decreased remarkably after initiation of chemotherapy. In conclusion, initial evaluation with neuroimaging, tumor markers, and cytology from cerebrospinal fluid is important as guidance to further treatment and prognosis. In selected cases, biopsy may not be indicated to start adjuvant chemotherapy. We emphasize the importance of specific treatment modality selection based mainly on tumor markers, regardless of the precise histologic classification

Sphenoid sinus aspergilloma in trans-sphenoidal surgery for pituitary adenomas

Background: Simultaneous appearance of sphenoid sinus aspergilloma and pituitary adenoma is a very rare finding. Methods: Retrospective analysis of patients with sellar and sphenoid sinus mass lesions who underwent trans-sphenoidal surgery was performed. Demographic data, medical history, predisposing factors, clinical picture, neurological status and radiological findings were reviewed. All patients underwent a trans-sphenoidal microsurgical treatment, and acquired specimens underwent both histopathological and microbiological analysis. Results: Sphenoid sinus aspergilloma was encountered in seven patients. Three patients had an isolated sphenoid sinus aspergilloma and four patients with pituitary macroadenoma had a sphenoid aspergilloma as an incidental finding. Conclusions: Sphenoid sinus aspergilloma can be found during trans-sphenoidal surgery for pituitary adenomas. Sphenoid sinus extirpation followed by adenomectomy is the treatment of choice unless invasive aspergilloma is encountered requiring additional antifungal therapy