Platelet antigen and P-selectin gene polymorphisms in cerebrovascular disorders in children and adults

Cerebrovaskularni poremećaji (CVP) su značajan medicinski problem u djece i odraslih. Cilj istraživanja bio je ispitati razlike u učestalostima polimorfizama gena za HPA (-1, -2, -3, -5), PSEL (S290N, N562D, V599L, T715P), mutacija FV G1691A (FVL) i FII G20210A u bolesnika s CVP-om u odnosu na kontrolnu skupinu, te utvrditi njihovu povezanost s bolešću. Ukupno je ispitano 300 bolesnika s CVP-om (ishemijski moždani udar-iCVI, TIA) (djece-100, odraslih-200) i 200 ispitanika kontrolne skupine (djece-100, odraslih-100), uz podatke za odrasle o standardnim čimbenicima rizika. Polimorfizmi HPA genotipizirani su PCR-SSP-om i PCR-om u stvarnom vremenu, PSEL-a PCR-SSP-om, a FVL i FII G20210A PCR-RFLP-om. U Hrvata alelne učestalosti HPA odgovaraju podacima za Europljane. Multivarijantnom regresijskom analizom u odraslih potvrđena je povezanost anamneze, hipertenzije, šećerne bolesti i alkoholizma s CVP-om, ali ne s alelom HPA-2b. U djece značajno je učestaliji genotip HPA-5a/b i alel HPA-5b u oboljelih od TIA-e u odnosu na iCVI, a u djece s genotipom GA ili s alelom A FVL, 5 puta je veća vjerojatnost oboljenja od CVP-a. Značajno učestaliji genotip GA i alel A FVL dobiven je u djece u odnosu na odrasle s CVP-om, te iCVI-om. Pomoć u predviđanju CVP-a u odraslih imaju anamneza, hipertenzija, šećerna bolest i alkoholizam, a u djece FVL.Cerebrovascular disorders (CVD) are a significant medical problem in children and adults. The aim of this research was to examine differences in the frequency of gene polymorphisms for HPA (-1, -2, -3, -5), PSEL (S290N, N562D, V599L, T715P), FV G1691A (FVL) and FII G20210A mutations in patients with CVD as compared to the control group, and to determine their correlation with the disease. The research included 300 patients with CVD (ischemic stroke-iCVI, TIA) (children-100, adults-200), 200 control subjects (children-100, adult-100), as well as data for standard risk factors for adults. HPA polymorphisms were genotyped using PCR-SSP and real-time PCR, PSEL by PCR-SSP, and the FVL and FII G20210A by PCR-RFLP. The allelic frequencies of HPA in Croats correspond to the data for Europeans. Multivariate regression analysis in adults confirmed the correlation between family history, hypertension, diabetes and alcoholism with CVD, but not with the HPA-2b allele. In children, HPA-5a/b genotype and HPA-5b allele is significantly more frequent in patients with TIA as compared to iCVI, and in children with GA genotype or with A allele FVL, there is a 5 times higher likelihood of CVD disease. Significantly more frequent GA genotype and A allele FVL was obtained in children than in adults with CVD and iCVI. Help in predicting CVD in adults is provided by family history, hypertension, diabetes and alcoholism, and in children by FVL

Emergencies in psychiatry

Svrha i cilj rada su hitna stanja u psihijatriji. U radu se govori o statističkom istraživanju psihijatrijskih pacijenata na području grada Vrbovca i bliže okolice u vremenskom periodu od 01.07.2018 do 01.07.2019. godine. Do konačnog broja podataka dolazi se iz programa E-hitna Zavoda za hitnu medicinu Zagrebačke županije, koje je odobrilo Etičko povjerenstvo. (U prilogu). Izvanbolnička hitna medicinska služba predstavlja organiziranu, timsku djelatnost čija je osnovna zadaća zbrinjavanje pacijenata na mjestu intervencije te njihov što brži i sigurniji transport u najbližu zdravstvenu ustanovu. Skrb za pacijente pružaju posebno educirani i vješti djelatnici hitne medicinske pomoći koji svoje sposobnosti i vještine prikazuju u najrazličitijim situacijama te pritom paze na svoju vlastitu sigurnost i sigurnost samoga pacijenta. Cilj rada je istražiti najčešće „F“ dijagnoze u gradu Vrbovcu i bližoj okolici, pošto sam i sama zaposlenik Zavoda za hitnu medicinu Zagrebačke županije – ispostava Vrbovec. Istraživanje je rađeno razdoblju od jedne godine, odnosno od 01.07.2018 do 01.07.2019. godine. U radu je ispitana dobna i spolna struktura pacijenta, mjeseci u godini u kojima ima najviše hitnih psihijatrijskih intervencija, najčešće F dijagnoze, zatim su obrađene sve F intervencije s kojima smo se susreli u tom vremenskom periodu, potreba za transportom ili način na koji smo zbrinuli pacijente. Najviše F intervencija se nalazi pod dijagnozom F10 koja označava mentalni poremećaj i poremećaj ponašanja uzrokovanih upotrebom alkohola. Najveći broj psihijatrijskih pacijenata bio je u dobi iznad 60 godina starosti. Najstariji ispitanik rođen je 1929. godine što nam govori da je imao 90 godina. U istraživanju se dolazi do podatka da imamo 107 muškaraca, a 88 žena od sveukupnog boja hitnih psihijatrijskih intervencija. Većina ispitanih pacijenata po dolasku hitnog tima je nakon razgovora sa liječnikom iz hitne medicinske pomoći ostalo kod kuće, malo manji broj je vožen T2 odnosno sanitetskim prijevozom koji se sastoji od medicinske sestre i vozača u najbližu bolnicu, nešto pacijenata nakon obavljene intervencije savjetuje se da se vlastitim prijevozom javi liječniku obiteljske medicine, najmanji broj vožen je T1 odnosno timom sa liječnikom, a preostali dio pacijenata smješten je u jedinicu za zadržavanje MUP-a. Medicinska sestra ravnopravni je član tima hitne medicinske pomoći te sudjeluje u svim koracima zbrinjavanja pacijenta od prvoga kontakta sa pacijentom, brigom tijekom transporta pa sve do njegove predaje u najbližu bolnicu. U suradnji sa liječnikom koji je vođa tima te vozačem koji je zadužen za što hitniji i sigurniji transport pacijenta u bolnicu djeluju kao tim. 32 Svaki član tima je veoma važan i ima bitnu ulogu u zbrinjavanju pacijenata te je svaki član tima neizostavan jer se ne bi moglo doći do što kvalitetnijeg i što bržeg zbrinjavanja pacijenta

Early Sexual Intercourse and Risk Factors in Croatian Adolescents

Sexual behaviour in adolescence is a sensitive issue and has possible immediate and long term medical and psychical consequences. The aim of the study was to examine whether early sexual intercourse varies by gender and how is associated with unhealthy behaviour and factors of psycho-social well-being. 773 boys and 857 girls of 15.5 years old, included in a representative national school-based survey, conducted in Croatia in 2006, were invited to fill in anonymous questionnaires. Sexual experience before the age of 16 years was reported by 28.6% of the boys and 16.5% of the girls. Early sexual experience in boys was associated with smoking, drinking of alcohol, marijuana taking, physical fighting, and bullying other. The odds ratio was highest for smoking. (OR:8.1; CI:5.4–12.1). For girls the same variables were associated with the early sexual intercourse, marijuana use being the strongest independent predictor (OR:8.0; CI:5.0–12.6). While controlled for other behaviours, daily smoking remained the strongest predictor for both genders. Girls who had early sexual experience were more prone to be dissatisfied with their health (OR:2.9; CI:2.0–4.2), with their life (OR:2.1; CI:1.4–3.0), communication with father and mother (OR:1.9; CI:1.2–2.8 and OR:1.7; CI:1.1–2.6) and reported more psychosomatic symptoms (OR:2.9; CI:2.0–4.3). For both genders odds were higher if they had good communication with the friend of the opposite gender. Evenings spent out with friends were associated to early sexual experience in boys and girls as well as poorer school achievement. Early menarche was associated with the probability of being engaged in the early sexual intercourse and with smoking, marijuana use and psychosomatic symptoms. Early sexual intercourse is associated with unhealthy behaviour such as smoking, substance abuse, aggressiveness and lower psychosocial well-being. Preventive educational programmes should follow multi-facet approaches and recognize differences between boys and girls. Human papillomavirus (HPV) vaccination could be part of a comprehensive approach and is not to be viewed as an isolated activity

Platelet count monitoring in burn patients

Uvod: Kod bolesnika s opeklinama dolazi do bitnog narušavanja hemostatskog i imunološkog odgovora u kojem trombociti imaju značajnu ulogu. Cilj ispitivanja bio je praćenje broja trombocita u bolesnika s opeklinama, ovisno o težini opeklinske ozljede (postotak opečene površine tijela bolesnika - %TBSA) i ishodu bolesti (preživljenje/smrt). Materijali i metode: Ukupno smo ispitali 68 bolesnika: skupina A (32 bolesnika s lakšim opeklinama, ≤ 10% TBSA) i skupina B (36 bolesnika s umjerenim/težim opeklinama, > 10% TBSA). Broj trombocita odredili smo na hematološkom brojaču Sysmex XT-1800i, 1., 4., 7., 14., 21. i 28. dana nakon ozljede, ovisno o dužini boravka bolesnika u Klinici. Rezultati: Broj trombocita 4. i 7. dana u bolesnika s obzirom na težinu ozljede značajno se razlikovao između skupina A i B, a niži su bili u skupini B (P < 0,001; P = 0,045). U objema skupinama 4. u odnosu na 1. dan došlo je do pada broja trombocita, ali značajan pad bio je prisutan samo u skupini B. Značajan porast broja trombocita u objema skupinama zabilježen je 7. u odnosu na 4. dan, kao i 14. u odnosu na 7. dan. S obzirom na ishod bolesti preživjelo je 56, a umrlo 12 bolesnika. U bolesnika sa smrtnim ishodom, u usporedbi s preživjelima tijekom cijelog perioda praćenja, dobivena je značajna razlika u broju trombocita (P < 0,05). U umrlih je bolesnika bio značajno niži broj trombocita svih dana praćenja, osim prvoga dana kada su bili značajno viši u odnosu na preživjele bolesnike. Zaključak: Dobivene značajne razlike u broju trombocita 4. i 7. dana između skupina prema težini opeklinske ozljede, kao i značajan pad trombocita 4. u odnosu na 1. dan u skupini umjerenih/težih opeklina, upućuje na potrebu uvođenja učestalijeg praćenja broja trombocita u tom periodu radi pravovremenog određivanja pada njihovog broja. U bolesnika sa smrtnim ishodom u odnosu na preživjele značajno su bile niže vrijednosti trombocita tijekom cijelog perioda praćenja, osim prvoga dana kada su bile značajno više. Usprkos prisutnim razlikama prema ishodu bolesti, ali sličnoj dinamici trombocita (porast i pad) u objema skupinama te malog broja umrlih ispitanika, potrebna su dodatna istraživanja.Introduction: Platelets play an important role in severe hemostasis disorders and immune response impairments in burn patients. The aim of this study was platelet count monitoring in burn patients in relation to the severity of burn injury (percentage of total body surface area burned - %TBSA) and disease outcome (survival/death). Materials and methods: We investigated a total of 68 patients: group A (32 patients with mild burns, ≤ 10% TBSA) and group B (36 patients with moderate/severe burns, > 10% TBSA). Platelet count was determined on Sysmex XT-1800i automated hematology analyzer on the 1st, 4th, 7th, 21st and 28th day after burn injury, depending on the length of hospital stay. Results: Platelet count was significantly different on the 4th and 7th day comparing group A and B according to the severity of injury; platelet count was lower in group B (P < 0.001; P = 0.045). When the 4th day was compared to the 1st day, a platelet count decrease was observed in both groups, but was significant only in group B. In both groups, a significant increase in platelet count was observed on the 7th day compared to the 4th day, and on the 14th compared to the 7th day. In relation to disease outcome, 56 patients in our study group survived and 12 died. Comparison between surviving and non-surviving patients showed a significant difference throughout the whole period of observation (P < 0.05). Conclusion: The significant between-group differences observed in platelet count on the 4th and 7th day in relation to severity of injury, as well as the significant decrease in platelet count on the 4th day as compared to the 1st day in patients with moderate/severe burns, suggest the need to increase the frequency of platelet count monitoring in this particular period in order to timely identify the decrease in platelet count. Comparing surviving and deceased patients, a significantly lower platelet count was observed in the group of patients with lethal outcome throughout the whole period of observation, with the exception of the 1st day when platelet count was higher in this group. Despite the between-group differences in platelet count in relation to disease outcome (but similar time-dependent changes in, i.e. increase and decrease) and because of a low number of the examined deceased patients, additional investigations are needed

Impact of environmental factors on marijuana use in 11 European countries

AIM: To investigate the association between environmental factors (perceived availability of marijuana, perceived use among friends and siblings, use of alcohol and tobacco, family structure, parental control, school performance) and lifetime prevalence and frequent and early marijuana use in high school students. ----- METHODS: We used self-reported data from 15-16 years old participants of the 2003 European School Survey Project on Alcohol and Other Drugs (ESPAD) conducted in 11 countries: Denmark, Estonia, Norway, Croatia, Slovenia, Germany, Switzerland, Bulgaria, Czech Republic, Russian Federation, and Ukraine. Multivariate logistic regression was used for data analysis. ----- RESULTS: Countries varied according to lifetime prevalence (8.7%-47.8%) and frequent (8.7%-23.9%) and early (3.0%-13.0%) marijuana use. Daily tobacco smoking was most strongly associated with lifetime marijuana use for boys in 7 and for girls in 5 countries, with highest odds ratio (OR, 95% and confidence interval - CI) for boys in Denmark (OR, 13.52; 95% CI, 8.16-22.4), and for girls in the Czech Republic (OR, 21.21; 95% CI, 12.99-34.62). Perceived marijuana availability was most strongly associated with frequent marijuana use for boys in 4 countries (highest in Slovenia: OR, 19.28; 95% CI, 6.52-57.02) and girls in 5 (highest in Slovenia: OR, 19.05; 95% CI, 5.18-70.04). Perceived use of marijuana among friends was most strongly associated with frequent marijuana use in 5 countries, both for boys (highest in Norway: OR, 23.91; 95% CI, 4.16-137.48) and girls (highest in Denmark: OR, 75.42; 95% CI, 13.11-433.90). Perceived use of marijuana among friends was most strongly associated with early marijuana use in 8 countries for boys (highest in Norway: OR, 54.03; 95% CI, 3.34-875.19) and 3 countries for girls (highest in Denmark: OR, 7.29; 95%CI, 1.77-30.12). ----- CONCLUSION: In each country, marijuana use was associated with similar factors, regardless of marijuana use prevalence in that country.The influence of peer group and perceived availability of marijuana seemed more important than parental control and family structure

12. Poslovni sastanak Nacionalnih koordinatora Europske mreže škola koje promiču zdravlje

12. Poslovni sastanak Nacionalnih koordinatora Europske mreže škola koje promiču zdravlje održan je u Edinburghu, Škotska od 18. do 20. svibnja 2005. Budući je Nacionalni koordinator za Hrvatsku prim.dr.sc. Marina Kuzman bila spriječena, sastanku je prisustvovala Ivana Pavić Šimetin, dr.med. Bili su prisutni nacionalni koordinatori iz 40-tak europskih zemalja, predstavnice iz Azerbejdžana i Kosova, potencijalnih članica Mreže, te predstavnici iz Vijeća Europe, Europske komisije i Regionalnog ureda za Europu Svjetske zdravstvene organizacije. Prikazan je značaj prevencije pretilosti u populaciji školske djece i adolescenata te prihvaćeno to područje, uključujući zdravu prehranu i tjelesnu aktivnost, kao područje djelovanja unutar Mreže u slijedećem razdoblju

Age differences in the relationship between media use and attitudes about vaccination

IN ENGLISH: Theoretical approaches that analyze media effects can be divided into those which state that the impact is real, comprehensive and one-way, and those which state that there is a reversed causality, i.e. that values, characteristics and attitudes affect the way the media are used. In this paper, these approaches were developed on the example of the attitudes towards vaccination, a topic that has become an extremely important social and public health issue with the outbreak of the COVID-19 pandemic. The authors analyzed the data collected in a pilot study on attitudes towards vaccination conducted before the start of the COVID-19 pandemic on a convenience online sample of the Croatian population (N = 822). The results of the research study showed the lack of influence of television and the limited and uneven influence of the use of the Internet and Internet social networking sites on attitudes towards vaccination, i.e. on conspiracy beliefs in the field of vaccination. Namely, the research results revealed negative correlation between the Internet and SNSs use and conspiracy beliefs, which probably flows from the impact of social integration or the prevailing positive information that can be found about vaccination online. Furthermore, age was proven to be a significant moderator variable, given that the negative correlation between time spent online and conspiracy beliefs is much stronger among younger people, and the moderating impact of time spent on social media moved to the opposite direction. The results of the research therefore indicate a need to better understand the use of old and new media, their communicative differences, age differences in their use, and other background variables that can lead to unequal influences of the media on different social groups. --------------- IN CROATIAN: Teorijski pristupi koji analiziraju medijske učinke mogu se podijeliti na one koji smatraju da je taj utjecaj stvaran, sveobuhvatan i jednosmjeran te one koji smatraju da je riječ o obrnutom kauzalnom učinku, odnosno da vrijednosti, obilježja i stavovi osoba utječu na način upotrebe medija. U ovom se radu navedeni pristupi testiraju na primjeru stavova o cijepljenju, teme koja je izbijanjem COVID-19 pandemije postala iznimno važno društveno i javnozdravstveno pitanje. U radu autori analiziraju podatke prikupljene u pilot istraživanju o stavovima o cijepljenju napravljenom prije početka COVID-19 pandemije na prigodnom online uzorku stanovnika Hrvatske (N = 822). Rezultati istraživanja pokazali su nepostojanje utjecaja televizije te ograničen i nejednolik utjecaj upotrebe interneta i internetskih društvenih mreža na stavove o cijepljenju, odnosno na konspiracijska uvjerenja u području cijepljenja. Nasuprot pretpostavljenoj pozitivnoj korelaciji vremena provedenog na internetu i konspiracijskih uvjerenja, rezultati istraživanja pokazali su da je ova korelacija negativna, što vjerojatno održava utjecaj društvene integracije ili prevladavajuće pozitivne informacije koje se o cijepljenju mogu naći na internetu. Nadalje, dob se pokazala kao značajna moderatorska varijabla, s obzirom na to da je negativna korelacija vremena provedenog na internetu i konspiracijskih uvjerenja mnogo jača kod mlađih osoba, a moderatorski utjecaj vremena provedenog na društvenim mrežama suprotnog je smjera. Rezultati istraživanja stoga upućuju na potrebu da se bolje razumije način upotrebe starih i novih medija, njihove razlike te dobne razlike u upotrebi ili drugim pozadinskim varijablama koje mogu dovesti do nejednolikih utjecaja medija na različite društvene skupine

Enforcement of Contact Orders as a Predictor of Violation of Rigths from the Eeuropean Convention for the Protection of Human Rights and Fundamental Freedoms

Ovrha u obiteljskim stvarima „sjecište“ je pravnih rješenja obiteljskog i ovršnog prava te kompleksno pravno područje čije je uređenje velik izazov i za zakonodavca i za praktičare. U radu smo nastojali prikazati specifičnosti postupaka ishođenja ovršne isprave u obiteljskim stvarima, zatim specifičnosti postupaka ovrhe u tim stvarima s posebnim naglaskom na ovrhu osobnih odnosa roditelja i djece da bismo u konačnici prikazali tijek razvoja problema koji su se u navedenim postupcima javljali usporednom primjenom Ovršnog zakona i Obiteljskog zakona iz 2003., odnosno Obiteljskog zakona iz 2015. te nastojanja zakonodavca da za navedene probleme pronađe odgovarajući odgovor u novim zakonskim rješenjima. Posljednje poglavlje rada posvećeno je analizi relevantnih odluka Europskog suda za ljudska prava jer su problemi da se pojedini roditelji s kojima djeca stanuju ne pridržavaju ovršnih sudskih odluka te nemogućnosti države da osigura provedbu ovrhe osobnih odnosa djece i roditelja s kojim ne stanuju doveli u pitanje ostvarenje konvencijskog prava na poštivanje obiteljskog života potonjeg roditelja te otvorili put pokretanju postupaka najprije pred Ustavnim sudom Republike Hrvatske, a u konačnici i pred Europskim sudom za ljudska prava.Since the enforcement of orders in family law cases is a complex legal area and its regulation represents a great challenge both for the legislator and for practicioners, the purpose of this paper is to analyse the specific features of procedures for obtaining enforceable title in family law cases, as well as special characteristics of enforcement procedure in those cases, especially the enforcement of contact orders, legal regulation and practical problems concerning the application of relevant rules of law. Special attention is paid to legislative changes introduced by the Family Law Act of 2015. In the final part of the paper relevant case law of the European Court of Human Rights is analysed since noncompliance with an enforceable order by a parent who lives with the child as well as the impossibility of the State to secure enforcement of that order can present a violation of the Convention rights

EUROPEAN IDENTITY: MEDIA AND CULTURE

Nacija predstavlja oblik političke organizacije povezan s modernosti. Nacionalne države su gradile standardne jezike i obrazovne sustave kako bi se formirala nacionalna identifikacije, budući da država teško može postojati bez nekog oblika kulturne bliskosti među svojim građanima. Bez zajedničkog identiteta, društvo je često podijeljeno i nedostaje mu solidarnosti. Europska unija je izgrađena na ekonomskim i političkim temeljima; no pokušava krivotvoriti osjećaj zajedničke pripadnosti i identiteta. Kao u slučaju nacionalne integracije, postoje dvije mogućnosti - europski identitet na temelju zajedničke kulture i europski identitet temeljen na zajedničkim političkim načelima. Prvi tip identiteta je teško krivotvoriti, s obzirom na europske kulturne i jezične raznolikosti. Drugi tip identiteta teško može biti osnova političke zajednice, a također se teško može postići zbog nepostojanja europskog medijskog prostora i zajedničkog javnog mnijenja. Stoga, autori ovog rada zaključuju da se Europska unija temelji na nestabilnim osnovama.Nation represents a form of political organization connected with modernity. National states had been building standard languages and educational systems in order to form national identification, since a state can hardly exist without some form of cultural closeness between its citizens. Without a common identity, a society is often divided and lacks solidarity. European Union was built on economical and political grounds; however it tries to forge a sense of common belonging and identity. As in the case of national integration, there are two possibilities – European identity based on the common culture, and European identity based on common political principles. The first type of identity is hard to forge, due to European cultural and linguistic diversity. The second type of identity can hardly form a basis of spolitical community, and also can hardly be achieved due to non-existence of European media space and common public opinion. Therefore, the authors of this paper conclude that European Union is based on unstable grounds