Nutrition and lifestyle habits of patients with type 1 diabetes mellitus in the Republic of Croatia

Kontrola glikemije oboljelih od dijabetesa tipa 1 (DMT1) ključ je sprječavanja akutnih komplikacija, odgađanja pojave kroničnih komplikacija te utječe na ukupnu kvalitetu života. Edukacija o prehrani bazirana na dijabetičkim jedinicama neophodna je za regulaciju glikemije i sastavni je dio terapije. Cilj rada bio je procijeniti prehrambene i životne navike oboljelih od DMT1 u Republici Hrvatskoj (RH), utjecaj bolesti na kvalitetu života, razinu educiranosti i primjenu naučenih savjeta o prehrani. Opažajno istraživanje provedeno je na oboljelima od DMT1 s područja RH online upitnikom koji je kreiran specifično za potrebe ovog istraživanja. Anketu je ispunio 101 oboljeli prosječne starosti 25 ± 8,9 godina (6 do 50 godina, 22,8 % muškaraca, 77,2 % žena). Zadovoljavajuće vrijednosti HbA1c postiže 49,4 % ispitanika odrasle dobi i 60,0 % djece i adolescenata. Rezultati pokazuju da je s dobi regulacija glikemije lošija (r=-0,249) a istovremeno dolazi do pogoršanja kvalitete prehrane (r=-0,338). Od dijabetičke retinopatije boluje 10,9 % ispitanika, 7,9 % od neuropatije, a 2,0 % ima problema s bubrezima. 30,3 % ispitanika nije zadovoljno edukacijom i ima problema s postizanjem optimalnih vrijednosti HbA1c. Posljedično, ispitanici koji se pridržavaju brojanja jedinica imaju bolju kontrolu glikemije promatrano kroz vrijednost HbA1c (p=0,023). Zabilježen je negativan utjecaj bolesti na društveni život, psihofizičko zdravlje i sveukupnu kvalitetu života oboljelih. Rezultati jasno ukazuju na potrebu stručne i adekvatne edukacije s naglaskom na reedukaciju oboljelih od DMT1.Glycemic control in type 1 diabetic patients (DMT1) is the key to prevent acute complications, delay chronic conditions, and influences the overall quality of life. Nutritional education based on diabetic unit counting in necessary to achieve good glycemic control and represents integral part of the therapy. Main objectives of this research were to assess nutritional and lifestyle habits of DMT1 patients in the Republic of Croatia (RC), the degree of impact the disease has on the quality of life, education level and the application of dietary recommendations. An observational study was conducted on DMT1 patients in RC by on-line questionnaire created specifically for the purpose of the present research. Total of 101 DMT1 patients mean age 25 ± 8.9 years (6 to 50 years of age, 22.8 % male, 77.2 % women) completed the questionnaire. Recommended HbA1c is achived by 49.4 % of adult patients and 60.0 % of children and adolescents. Results indicate that with age, HbA1c worsens (r=-0.249) and at the same time, the quality of diet deteriorates (r=-0.338). Diabetic retinopathy is present in 10.9 % DMT1 patients, 7.9 % has neuropathy, and 2.0 % diabetic kidney disease. 30.3 % of DMT1 patients are not satisfied with education about diabetes and have problem achieveing good glycemic control. Consequently, patients that implemented the method of diabetic units counting have better HbA1c (p=0.023). DMT1 negatively affects patients' social life, mental and physical health and the overall quality of life. The results clearly indicate an urgent need for a professional and adequate education, with special emphasis on re-education of DMT1 patients

Nutrition and lifestyle habits of patients with type 1 diabetes mellitus in the Republic of Croatia

Kontrola glikemije oboljelih od dijabetesa tipa 1 (DMT1) ključ je sprječavanja akutnih komplikacija, odgađanja pojave kroničnih komplikacija te utječe na ukupnu kvalitetu života. Edukacija o prehrani bazirana na dijabetičkim jedinicama neophodna je za regulaciju glikemije i sastavni je dio terapije. Cilj rada bio je procijeniti prehrambene i životne navike oboljelih od DMT1 u Republici Hrvatskoj (RH), utjecaj bolesti na kvalitetu života, razinu educiranosti i primjenu naučenih savjeta o prehrani. Opažajno istraživanje provedeno je na oboljelima od DMT1 s područja RH online upitnikom koji je kreiran specifično za potrebe ovog istraživanja. Anketu je ispunio 101 oboljeli prosječne starosti 25 ± 8,9 godina (6 do 50 godina, 22,8 % muškaraca, 77,2 % žena). Zadovoljavajuće vrijednosti HbA1c postiže 49,4 % ispitanika odrasle dobi i 60,0 % djece i adolescenata. Rezultati pokazuju da je s dobi regulacija glikemije lošija (r=-0,249) a istovremeno dolazi do pogoršanja kvalitete prehrane (r=-0,338). Od dijabetičke retinopatije boluje 10,9 % ispitanika, 7,9 % od neuropatije, a 2,0 % ima problema s bubrezima. 30,3 % ispitanika nije zadovoljno edukacijom i ima problema s postizanjem optimalnih vrijednosti HbA1c. Posljedično, ispitanici koji se pridržavaju brojanja jedinica imaju bolju kontrolu glikemije promatrano kroz vrijednost HbA1c (p=0,023). Zabilježen je negativan utjecaj bolesti na društveni život, psihofizičko zdravlje i sveukupnu kvalitetu života oboljelih. Rezultati jasno ukazuju na potrebu stručne i adekvatne edukacije s naglaskom na reedukaciju oboljelih od DMT1.Glycemic control in type 1 diabetic patients (DMT1) is the key to prevent acute complications, delay chronic conditions, and influences the overall quality of life. Nutritional education based on diabetic unit counting in necessary to achieve good glycemic control and represents integral part of the therapy. Main objectives of this research were to assess nutritional and lifestyle habits of DMT1 patients in the Republic of Croatia (RC), the degree of impact the disease has on the quality of life, education level and the application of dietary recommendations. An observational study was conducted on DMT1 patients in RC by on-line questionnaire created specifically for the purpose of the present research. Total of 101 DMT1 patients mean age 25 ± 8.9 years (6 to 50 years of age, 22.8 % male, 77.2 % women) completed the questionnaire. Recommended HbA1c is achived by 49.4 % of adult patients and 60.0 % of children and adolescents. Results indicate that with age, HbA1c worsens (r=-0.249) and at the same time, the quality of diet deteriorates (r=-0.338). Diabetic retinopathy is present in 10.9 % DMT1 patients, 7.9 % has neuropathy, and 2.0 % diabetic kidney disease. 30.3 % of DMT1 patients are not satisfied with education about diabetes and have problem achieveing good glycemic control. Consequently, patients that implemented the method of diabetic units counting have better HbA1c (p=0.023). DMT1 negatively affects patients' social life, mental and physical health and the overall quality of life. The results clearly indicate an urgent need for a professional and adequate education, with special emphasis on re-education of DMT1 patients

MAN – IMAGE OF GOD. THEOLOGICAL INTERPRETATION AND CONTEMPORARY CHALLENGES

Članak se bavi klasičnim pitanjem poimanja čovjeka – slike Božje u kontekstu odabranih pitanja suvremenih izazova. Polazište je biblijska antropologija kojoj je posvećen prvi dio članka u kojem se donose temeljne odrednice starozavjetnog i novozavjetnog poimanja čovjekove bogolikosti. Drugi dio članka posvećen je teološkoj interpretaciji čovjeka – slike Božje shvaćenog kao osobno biće kojem su svojstvene kvalitete jedinstva duše i tijela, racionalnosti i slobode, komunitarne dimenzije te stvaralaštva i prokreacije. U završnom dijelu članka promatra se odjek razmatranih teološko-antropoloških postavki u kontekstu odabranih pitanja suvremenih izazova: međureligijskoga dijaloga, dostojanstva ljudskoga života, ekološke krize te izazova suvremene znanosti.The article is dedicated to the classical question of man created in the image of God in the context of contemporary challenges. The first part of the article presents the key points of the biblical anthropology. The elementary Old and New Testamentary concepts of man’s creation in God’s image are outlined. The second part of the article is dedicated to the theological interpretation of man – as the image of God, considered as a personal being, having the qualities of uniqueness of body and of soul, rationality and freedom, the communitarian dimension, creativity and procreation. In the last part of the article the previous theological and anthropological propositions are considered in the light of some contemporary questions and challenges: interreligious dialogue, dignity of the human life, ecological crisis and the challenges of the modern science

BIOKEMIJSKI I HEMATOLOŠKI POKAZATELJI I INDEKS TJELESNE KONDICIJE KRAVA HOLSTEINSKE PASMINE S OBZIROM NA OCJENU DOBROBITI

Animal welfare (AW) is a term denoting how the animals are coping with the conditions in which they live. A precise welfare assessment assumes a multidisciplinary approach, and modern evaluation protocol incorporates both the animal-based and non-animal-based measures. Due to the different welfare score classes, this study’s objective was to determine the variability of biochemical and hematological parameters, as well as the body condition score. The study was conducted involving 145 Holstein cows, randomly chosen from the six commercial dairy cow farms. The dairy cows’ welfare assessment checklist consisted of seventy items, pursuant to the CReNBA protocol. The biochemical parameters in blood and the milk plasma were determined using the Beckman Coulter AU400 (Beckman Coulter, FRG) automatic clinical chemistry analyzer. The obtained results indicate that the lower albumin, triglyceride, iron, and calcium values were detected in the cows bred on the farms that were ranked lower concerning the farm management and farm infrastructure levels. In the milk plasma, the concentration of albumins was higher (P<0.05) on the farms that were ranked lower concerning the farm management, infrastructure level, and total score scale. Iron concentration was higher (P<0.05) in the cows from the farms ranked lower concerning farm infrastructure and on the farms that were ranked higher concerning the animal level. The erythrocyte sedimentation rate was higher on the farms with worse marks on the farm infrastructure level and total AW score.Dobrobit životinja predstavlja procjenu stanja životinja kojima reagiraju na podražaje iz okoline. Precizna procjena dobrobiti podrazumijeva multidisciplinaran pristup, a suvremen evaluacijski protokol uključuje mjerenja na životinjama i mjerenja koja uključuju smještaj, hranidbu i upravljanje farmom. Svrha ovoga istraživanja bila je odrediti varijabilnost biokemijskih i hematoloških pokazatelja, kao i tjelesnu kondiciju, s obzirom na različite bodovne razrede dobrobiti. Istraživanje je provedeno na 145 krava holsteinske pasmine, nasumično odabranih na šest komercijalnih farma mliječnih krava. Kontrolni popis procjene dobrobiti mliječnih krava sastojao se od 70 pitanja prema protokolu CReNBA. Biokemijski pokazatelji u krvi i mliječnoj plazmi određeni su automatskim kemijskim analizatorom Beckman Coulter AU400 (Beckman Coulter, SRNj). Dobiveni rezultati ukazuju da niže koncentracije albumina, triglicerida, željeza i kalcija u krvi imaju krave na lošije ocijenjenim farmama s obzirom na menadžment farme i infrastrukturu. S obzirom na pokazatelje infrastrukturnih karakteristika farme, menađmenta i ukupnu ocjenu farme, koncentracija albumina u mliječnom serumu bila je veća (P<0.05)u krava s lošijom ocjenom. Sedimentacija eritrocita bila je brža na lošije ocijenjenim farmama s obzirom na infrastrukturu farme i ukupnu ocjenu dobrobiti

The importance of nutrition education for diabetics – type 1 versus type 2 diabetics

Nutrition education is an integral part of the diabetic therapy that aims at achieving good glycaemic control to prevent complications. This is very important for type 1 diabetics (DMT1), where nutrition and insulin therapy must be matched. The aims of the study were: the evaluation of differences in nutrition education between DMT1 and type 2 diabetics (DMT2), the influence of education on glycaemic control and diet quality, and the self-assessment of health-related quality of life. A descriptive study was conducted on patients with DMT1 (n=101) and DMT2 (n=90) from Croatia using a study-specific questionnaire. Diet quality did not differ significantly between DMT1 and DMT2 patients. However, 18.0% of DMT1 and 20.0% of DMT2 patients do not possess adequate knowledge of the diabetic diet, nor stick to relating nutritional guidelines. Poor glycaemic control had 48.5% of DMT1 and 73.5% of DMT2 patients (p<0.001). Psychophysical health is better among the DMT2 patients (p<0.001), while the DMT1 patients have a better social life (p=0.015) and the overall quality of life (p<0.001). The results show that diabetics have poor nutrition knowledge, clearly showing the need for professional, continuous nutrition education. Education would help diabetics in improving their quality of life and glycaemia control, which decreases disease complications

The influence of the addition of dietary selenium on the haematological and biochemical parameters in fallow deer (Dama dama L.)

Selen je esencijalni element uključen u brojne fiziološke procese te je potrebno i u domaćih i u divljih životinja putem hrane osigurati njegov unos. Oblik selena utječe na njegovu bioraspoloživost i dostupnost u sintezi selenoproteina. Upravo je stoga neophodan, jer kao dio enzimskih sustava sudjeluje u metabolizmu štitaste žlijezde, ključan je u reprodukciji i dijelom je važnog antioksidacijskog sustava. Cilj istraživanja bio je ustvrditi utjecaj dodatka organskog oblika selena (Selplex®, Alltech, SAD) u krmnu smjesu za jelene u količini od 0,5 mg/ kg suhe tvari na hematološke i biokemijske pokazatelje u jelena lopatara. Istraživanje je provedeno na 40 jelena lopatara tijekom dvije godine istraživanja, na po dvadeset svake godine. Životinje smo podijelili na mlade (do 1 godine starosti) i odrasle (2-9 godina). Krmna smjesa ponuđena je tijekom 60 dana na kraju ljetnog perioda godine. Utvrđen je trend povećanja ukupnih proteina, globulina i imunoglobulina G klase u odraslih jedinki hranjenih s većim udjelom selena u hrani, ali bez statističke značajnosti. Koncentracija LDL kolesterola bila je značajno (P<0,05) veća u odraslih jelena hranjenih s većom koncentracijom selena. Pad koncentracije željeza u jelena kojima je dodavan selen znakom je da su životinje uistinu dobile veću količinu selena u obroku nego prve godine. S obzirom da nije bilo značajnih razlika u rezultatima hematoloških i biokemijskih pokazatelja, moguće je preispitati normative za potrebne koncentracije selena kao dodatka u krmnu smjesu za jelene.Selenium is an essential element that is involved in numerous physiological processes and accordingly, its inclusion in the feed of both domestic and game animals is advised. The form of selenium affects its bioavailability and the availability of seleno-aminoacids for the synthesis of selenoproteins. As part of the enzymatic system, it participates in thyroid gland metabolism, and plays an important role in the functioning of the antioxidation system. The aim this study was to determine the influence of organic selenium (Selplex®, Alltech, USA) in the amount of 0.5 mg/kg DM in feed mixture on the hematologic and biochemical indicators of fallow deer. The study was conducted on 40 deer over a two- year period. Animals were divided into two groups: young up to 2 years and adults 2-9 years old. The feed mixture was offered for 60 days at the end of the summer season. The trend of increasing the total protein, globulin and immunoglobulin G levels in adult deer fed with a selenium supplement was established, but without significance. The concentration of LDL cholesterol was significantly (P<0.05) higher in adult deer fed selenium supplement. The drop in iron concentrations in the second year is a sign that animals actually received a higher amount of selenium than in the first year. Given that there were no significant differences in the results of hematological and biochemical indicators, re-examination of the normative for the required selenium concentrations as a supplement in the feed mixture is recommended

Influence of micronized zeolite clinoptilolite supplementation on udder health, milk production and composition of Holstein cows in different lactations under robotic milking conditions

Prirodni zeolit klinoptilolit je mikroporozni alumosilikatni mineral čvrste anionske rešetke, otvorene trodimenzionalne strukture u čijim porama su izmjenjivi kationi. Dodatak zeolita u obroku sve se više primjenjuje u hranidbi životinja. Cilj pokusa bio je ustanoviti utjecaj dodatka mikroniziranog zeolita klinoptilolita na zdravlje vimena i sastav mlijeka krava različitih laktacija u uvjetima robotizirane mužnje. Krave su hranjene parcijalnim obrokom za krave u mužnji (PMR) s dodatkom 200 g po kravi mikroniziranog zeolita klinoptilolita (Zeotex®, Mevex, Hrvatska) i koncentratom na robotskoj jedinici za hranjenje, tijekom 42 dana pokusa. Značajno (P0,05) smanjenje broja somatskih stanica nakon 42 dana primjene zeolita u obroku mliječnih krava potvrđuje sposobnost zeolita da pozitivno utječe na zdravlje vimena. Smanjenje broja somatskih stanica samo kod krava u 1. i 2. laktaciji daje naslutiti ograničenu sposobnost zeolita prema kroničnim infekcijama vimena kod krava viših laktacija. Značajno (P 0.05) reduction in the number of somatic cells after 42 days of zeolite application in the diet of dairy cows confirms the ability of zeolite to positively affect udder health. The decrease in the number of somatic cells in cows of only 1st and 2nd lactation suggests a limited ability of zeolites to chronic udder infections in higher lactating cows. Significant (P <0.05), but transient increase in urea in milk on day 21 of the experiment, is probably a reflection of the adaptation of the rumen micropopulation to the new feeding conditions with the addition of zeolite. The increase in the content of milk fat in cows in the first lactation speaks in favor of the positive effect of zeolite and the improvement of milk quality

Kraniofacijalni rast u adolescenciji i utjecaj na zbijenost mandibularnih sjekutića

Background: To analyze craniofacial growth during adolescence from the ages of 12 to 21 years and its relation to late mandibular incisor crowding. Methods: The study included 61 orthodontically untreated subjects (49% males). Lateral cephalograms were used to assess the jaw growth and inclination of the incisors. Little’s Irregularity Index and the anterior mandibular dental arch depth of mandibular dentition were measured. Results: A reduction of the skeletal class angle (ANB) was observed in both genders, although it was significant only in males (η2=0.188; p=0.015). The growth of the mandible was more prominent compared to that of the maxilla, and it was more prominent in males than in females. The skeletal vertical dimension, however, demonstrated a significant reduction in both genders (η2=0.527-0.593, p<0.001). The mandibular incisors tended to retrocline in both genders, while the maxillary ones tended to procline in males, and slightly retrocline in females. A decrease in the mandibular dental arch depth occurred in both genders (η2=0.259; p<0.05). An increase in the irregularity of incisors for 1.8±1.7 mm on average (95% CI 1.3-2.2; η2=0.520; p<0.001) was observed in both genders. A logistic regression revealed that less sagittal growth of maxilla (increase of SNA angle ≤2°) and reduction of convexity in skeletal sagittal interjaw relationship (reduction of ANB ≥1°) were significant predictors of the occurrence of crowding (Δ Little Irregularity Index ≥1mm) yielding odds ratios of 4.9 and 4.8. Conclusions: The differential growth of the maxilla and mandible is related to the occurrence of late crowding, mostly in smaller amounts in maxillary sagittal growth compared to the mandible.Cilj: Analizirati kraniofacijalni rast tijekom adolescencije u dobi od 12. do 21. godine i njegovu povezanost s kasnom zbijenošću mandibularnih sjekutića.Metode: U studiji je sudjelovao 61 ortodontski netretirani ispitanik (49 % muškaraca). Za procjenu rasta čeljusti i nagiba sjekutića korišteni je laterolateralni kefalogram. Izmjereni su Littleov indeks nepravilnosti i prednja dužina donjega zubnog luka.Rezultati: Uočeno je smanjenje kuta skeletne klase (ANB) kod oba spola, iako značajno samo kod muškaraca (η2 = 0,188; p = 0,015). Mandibula je rasla više od maksile i to više kod muškaraca negoli kod žena. No, skeletna vertikalna dimenzija pokazala je značajno smanjenje u oba spola (η2 = 0,527 – 0,593, p < 0,001). Mandibularni sjekutići imali su tendenciju retroinklinacije u oba spola, a maksilarni su bili skloni proklinaciji kod muškaraca te blažoj retroinklinaciji kod žena. Primijećeno je smanjenje prednje dužine donjega zubnog luka u oba spola (η2 = 0,259; p < 0,05). Povećanje nepravilnosti sjekutića u prosjeku je iznosilo 1,8 ± 1,7 mm (95 % CI 1,3 – 2,2; η2 = 0,520; p < 0,001), a uočeno je u oba spola. Logistička regresija otkrila je da su manji sagitalni rast maksile (povećanje kuta SNA ≤ 2°) i smanjenje konveksiteta sagitalnoga međučeljusnog odnosa (smanjenje ANB ≥ 1°) bili značajni prediktori nastanka zbijenosti (Δ Littleov indeks nepravilnosti ≥ 1 mm) dajući omjere izgleda od 4,9 i 4,8. Zaključci: Diferencijalni rast maksile i mandibule povezan je s pojavom kasne zbijenosti mandibularnih sjekutića uglavnom zbog manje količine sagitalnoga rasta maksile u odnosu na mandibulu

Effects of Visual Stimuli from Media on the Perception of Dentofacial Esthetics

Cilj: Autori studije istražili su mogu li televizijske reklame mijenjati percepciju vlastite dentofacijalne privlačnosti te je li taj proces pod utjecajem osobina ličnosti.Materijal i metode: Uzorak su činila 83 ispitanika u dobi od 19 do 27 godina. Eksperimentalna skupina (N = 42) gledala je reklame u kojima su sudjelovali poznati mladi ljudi s visokom estetikom osmijeha, svijetlim zubima i bez vidljivih malokluzija, a kontrolnoj skupini (N = 41) prezentirane su neutralne reklame (bez ljudi ili vidljivih zuba). Percepcija estetike vlastita lica i osmijeha te njezini psihološki učinci procijenjeni su mjesec dana prije gledanja reklama te odmah nakon toga. Procijenjeni su i intenzitet malokluzije ispitanika te osobine ličnosti (ekstraverzija, savjesnost, ugodnost, neuroticizam, intelekt, samopoštovanje i perfekcionizam).Rezultati: U svojem drugom iskazu ispitanici su imali tendenciju navoditi manje psihosocijalnih utjecaja uz male razlike (prosječno u rasponu od 0 do 3 skalarna boda) te manje značajne promjene u aktivnoj skupini negoli u neutralnoj (2 od 7 vs. 5 od 7 aspekata). Vrsta vizualnog podražaja bila je značajan prediktor samo promjene koja se odnosi na psihološki utjecaj dentalne estetike (p = 0,045; r = 0,221). Intelekt je kao supresor oblikovao percepciju estetike osmijeha nakon gledanja reklama s naglašenim lijepim osmijesima (ΔR 2 = 0,076; p = 0,005; ukupni model R 2 = 0,347; p = 0,033). Kod osoba s većim intelektom je povećanje intenziteta samoopažene malokluzije izazvalo manji pad psihološkog utjecaja dentalne estetike u usporedbi s onima s manjim intelektom.Zaključak: Psihosocijalni utjecaji malokluzije nisu stabilni i imaju tendenciju smanjivati se tijekom vremena. No, izlaganje visokoj estetici osmijeha drugih ljudi može kočiti taj proces kod osoba s većom malokluzijom i većim intelektom.Objectives: The study explored whether television commercials change the perception of one’s own dentofacial attractiveness and to identify if it is influenced by personality traits. Material and methods: The sample included 83 participants, aged 19-27 years. The experimental group (N=42) watched commercials portraying famous young individuals with high smile esthetics, bright teeth and no visible malocclusions, while the control group (N=41) watched neutral commercials (without people or visible teeth). The perception of subjects` own orofacial esthetics and its psychosocial effects were assessed a month before the exposure and immediately after it. The subjects` malocclusion severity and personality characteristics (extraversion, conscientiousness, agreeableness, neuroticism, in-tellect, self-esteem and perfectionism) were assessed. Results: In their second report, respondents were inclined to report less psychosocial impacts with small differences (ranging from 0-3 scalar points on average) and less significant in the active group compared to neutral group (2 out of 7 vs. 5 out of 7 aspects). Types of visual stimuli were a significant predictor only of changes pertaining to psychological impact of dental esthetics (p=0.045; r=0.221). The intellect moderated perception of smile esthetics, after having been exposed to commercials, accentuated beautiful smiles as a suppressor (ΔR 2 =0.076; p=0.005; total model R 2 =0.347; p=0.033). In subjects with higher cognitive abilities, an increase in the self-perceived malocclusion level induced a smaller decrease in psychological impact of dental esthetics as compared to those with lower intellect. Conclusion: Psychosocial influences of malocclusion are not stable and tend to decrease during time. However, the exposure to a high smile esthetic of other individuals can inhibit that process in persons with more severe mallocclusion and higher cognitive abilities