Randomizirano dvostruko-slijepo ispitivanje učinkovitosti oktreotid acetata u sprječavanju abdominalne boli nakon terapijske endoskopske retrogradne kolangiopankreatografije

Abdominal pain is a complication of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST). The aim of this trial was to investigate the effects of octreotide acetate in the prevention of abdominal pain in patients undergoing therapeutic ERCP. A double-blind study was carried out in 209 subjects who were randomly allocated to two groups (A and B). Group A (104 patients) received 0.5 mg of octreotide acetate subcutaneously one hour prior to ERCP; and group B (105 patients) were given placebo. Patients were assessed 2 and 24 hours following endoscopy for the following parameters: presence and character of abdominal pain, requirements of analgetics. Thirty-nine (18%) patients complained of post-ERCP pain, i.e. ten in group A and 29 in group B, all of them treated with analgetics. Of the ten group A patients, symptoms of acute pancreatitis were identified in four (3.85%) patients versus ten (9.52%) patients in the control group B. The results obtained in the study seem to indicate that octreotide pretreatment significantly reduced the development of post-ERCP pain.Abdominalna bol je česta komplikacija endoskopske retrogradne kolangiopankreatografije (ERCP) i endoskopske sfinkterotomije (EST). Cilj ovoga ispitivanja bio je istražiti učinke oktreotid acetata u prevenciji abdominalne boli u bolesnika podvrgnutih ERCP-u. U ovu dvostruko-slijepu studiju bilo je uključeno 209 bolesnika koji su nasumce podijeljeni u dvije skupine (A i B). Bolesnici skupine A (n=104) primili su 0,5 mg oktreotid acetata supkutano jedan sat prije ERCP-a, dok su bolesnici skupine B (n=105) dobili placebo. Procjena kliničkih parametara (prisutnost i težina abdominalne boli te potreba za analgeticima) provedena je u bolesnika 2 i 24 sata nakon endoskopije. Ukupno se 39 (18%) bolesnika žalilo na bol nakon ERCP-a, tj. desetoro u skupini A i 29 u skupini B, a svi su oni liječeni analgeticima. Od desetoro bolesnika iz skupine A simptomi akutnog pankreatitisa zabilježeni su u četvoro (3,85%) bolesnika, u usporedbi s desetoro (9,52%) bolesnika u kontrolnoj skupini B. Rezultati ovoga ispitivanja pokazali su da je prethodno davanje oktreotida značajno smanjilo nastup abdominalne boli nakon ERCP-a

PERFORMANCE ASSESSMENT TOOL FOR QUALITY IMPROVEMENT IN HOSPITALS (PATH): FIRST EXPERIENCES IN CROATIA

PATH (Performance Assessment Tool for Quality Improvement in Hospitals), projekt Regionalnog ureda Svjetske zdravstvene organizacije (SZO) za Europu pruža bolnicama sveobuhvatan i standardiziran alat za vrednovanje vlastitih rezultata i razvoj mjera za unapređenje kvalitete. Program PATH pokrenut je 2008. godine i u Hrvatskoj, a od 2009. godine provodi se u bolnicama koje su se dobrovoljno odlučile u njega uključiti. U ovom radu prikazujemo prva iskustva probne faze uspostavljanja programa PATH, utemeljena na podacima koji su prikupljani u 22 hrvatske bolnice. Analiza prvih rezultata upozorila je na postojanje izraženih razlika među bolnicama, koje su se na primjeru postotka carskih rezova kretale od najmanje 1,1% do najviše 21,4% zabilježenih carskih rezova u pojedinim bolnicama tijekom razdoblja prikupljanja podataka. Stopa smrtnosti infarkta miokarda kretala se od 1,9 do 21,4%, dok se smrtnost moždanog udara kretala od 12,5 do 45,5%. Najviši postotak prijavljenih ubodnih ozljeda za liječnike iznosio je 16,2% osoblja tijekom jedne godine, 6,1% za medicinske sestre i 4,6% za spremačice. Ovo istraživanje upućuje na postojanje mnogih problema i ograničenja u prikupljanju pokazatelja na bolničkoj razini, njihovoj analizi i stvaranju preporuka za unapređenje kvalitete koje se moraju uzeti u obzir prilikom usporedbe bolnica na nacionalnoj ili međunarodnoj razini.PATH (Performance Assessment Tool for Quality Improvement in Hospitals), a project of the World Health Organization (WHO) for Europe offers hospitals a comprehensive and standardized tool (a set of indicators) to evaluate their own performance and development of measures for quality improvement. PATH Program was launched in Croatia in 2008, and it was conducted in 2009 in hospitals that have voluntarily decided to be involved. Here we present the results of the first phase of pilot experience of establishing the program, based on data collected in 22 Croatian hospitals. Analysis of the first results indicated the existence of marked differences among the hospitals that have taken the example of the percentage of cesarean sections ranging from 1.1% to 21.4%. The mortality rate of myocardial infarction ranged from 1.9 to 21.4%, while the mortality of stroke ranged from 12.5 to 45.5%. The highest percentage of needle-stick injuries reported for physicians was 16.2% of entire hospital staff in one year, 6.1% for nurses and 4.6% for the supportive staff. The result suggests the existence of many problems and limitations in data collection at hospital level, limitations in their analysis and creates recommendations for quality improvements, which must be taken into account when hospitals are compared on the national or international level

Molekularni mehanizmi depresije

Depresija je danas vrlo raširena bolest od koje obolijevaju i muškarci i žene, neovisno o dobi. Iz tog se razloga puno ulaže u istraživanja ove bolesti te razvoj prikladnog lijeka, a s obzirom da je riječ o složenom poremećaju, postoji puno različitih hipoteza koje nastoje objasniti molekularne mehanizme bolesti. Jedna od glavnih jest tzv. “monoaminska hipoteza”, prema kojoj se kao glavni uzrok depresije smatra smanjena količina i aktivnost monoamina u određenim regijama mozga, posebice hipokampusu, amigdali i prefrontalnom korteksu. Promjene u nekoj od ovih regija mozga usko su povezane s nastankom bolesti, odnosno mogu utjecati na razvoj bolesti i njezino liječenje. Postoje i teorije o uključenosti neurotrofnog čimbenika moždanog podrijetla (eng. brain-derived neurotrophic factor, BDNF), no njegova se uloga i dalje istražuje. Istražuju se i citokini koji povezuju depresiju i imunologiju, te neuroendokrine interakcije u kojima kortizol ima važnu ulogu, a jedna od novijih i sve popularnijih teorija govori o povezanom utjecaju genetike i epigenetike, tj. utjecaju okoline, kao ključnim faktorima za razvoj bolesti.Depression is a very common and wide-spread disease from which both men and women are affected, regardless of age. A lot of money is invested in the research of this disease to develop efficient treatments. Due to the complexity of the disease, there are many different hypothesis trying to explain the mechanisms of depression: one of the main is the “monoamine hypothesis”, supposing that the main cause of depression is the decreased amount and activity of monoamines in specific brain regions, in particular the hippocampus, amygdala and prefrontal cortex. Changes in one of these regions can affect the development of disease as well as its treatment. There are also theories about brain-derived neurotrophic factor (BDNF). However, its role in the disease is still under investigation. Furthermore, cytokines are also included in one of the theories, connecting depression and immunology. Neuroendocrine interactions in which cortisol plays an important role are also involved in depression. The recent theories include the interplay between genetics and epigenetics, i.e. environmental factors, as crucial for disease development

Molekularni mehanizmi depresije

Depresija je danas vrlo raširena bolest od koje obolijevaju i muškarci i žene, neovisno o dobi. Iz tog se razloga puno ulaže u istraživanja ove bolesti te razvoj prikladnog lijeka, a s obzirom da je riječ o složenom poremećaju, postoji puno različitih hipoteza koje nastoje objasniti molekularne mehanizme bolesti. Jedna od glavnih jest tzv. “monoaminska hipoteza”, prema kojoj se kao glavni uzrok depresije smatra smanjena količina i aktivnost monoamina u određenim regijama mozga, posebice hipokampusu, amigdali i prefrontalnom korteksu. Promjene u nekoj od ovih regija mozga usko su povezane s nastankom bolesti, odnosno mogu utjecati na razvoj bolesti i njezino liječenje. Postoje i teorije o uključenosti neurotrofnog čimbenika moždanog podrijetla (eng. brain-derived neurotrophic factor, BDNF), no njegova se uloga i dalje istražuje. Istražuju se i citokini koji povezuju depresiju i imunologiju, te neuroendokrine interakcije u kojima kortizol ima važnu ulogu, a jedna od novijih i sve popularnijih teorija govori o povezanom utjecaju genetike i epigenetike, tj. utjecaju okoline, kao ključnim faktorima za razvoj bolesti.Depression is a very common and wide-spread disease from which both men and women are affected, regardless of age. A lot of money is invested in the research of this disease to develop efficient treatments. Due to the complexity of the disease, there are many different hypothesis trying to explain the mechanisms of depression: one of the main is the “monoamine hypothesis”, supposing that the main cause of depression is the decreased amount and activity of monoamines in specific brain regions, in particular the hippocampus, amygdala and prefrontal cortex. Changes in one of these regions can affect the development of disease as well as its treatment. There are also theories about brain-derived neurotrophic factor (BDNF). However, its role in the disease is still under investigation. Furthermore, cytokines are also included in one of the theories, connecting depression and immunology. Neuroendocrine interactions in which cortisol plays an important role are also involved in depression. The recent theories include the interplay between genetics and epigenetics, i.e. environmental factors, as crucial for disease development

Molekularni mehanizmi depresije

Depresija je danas vrlo raširena bolest od koje obolijevaju i muškarci i žene, neovisno o dobi. Iz tog se razloga puno ulaže u istraživanja ove bolesti te razvoj prikladnog lijeka, a s obzirom da je riječ o složenom poremećaju, postoji puno različitih hipoteza koje nastoje objasniti molekularne mehanizme bolesti. Jedna od glavnih jest tzv. “monoaminska hipoteza”, prema kojoj se kao glavni uzrok depresije smatra smanjena količina i aktivnost monoamina u određenim regijama mozga, posebice hipokampusu, amigdali i prefrontalnom korteksu. Promjene u nekoj od ovih regija mozga usko su povezane s nastankom bolesti, odnosno mogu utjecati na razvoj bolesti i njezino liječenje. Postoje i teorije o uključenosti neurotrofnog čimbenika moždanog podrijetla (eng. brain-derived neurotrophic factor, BDNF), no njegova se uloga i dalje istražuje. Istražuju se i citokini koji povezuju depresiju i imunologiju, te neuroendokrine interakcije u kojima kortizol ima važnu ulogu, a jedna od novijih i sve popularnijih teorija govori o povezanom utjecaju genetike i epigenetike, tj. utjecaju okoline, kao ključnim faktorima za razvoj bolesti.Depression is a very common and wide-spread disease from which both men and women are affected, regardless of age. A lot of money is invested in the research of this disease to develop efficient treatments. Due to the complexity of the disease, there are many different hypothesis trying to explain the mechanisms of depression: one of the main is the “monoamine hypothesis”, supposing that the main cause of depression is the decreased amount and activity of monoamines in specific brain regions, in particular the hippocampus, amygdala and prefrontal cortex. Changes in one of these regions can affect the development of disease as well as its treatment. There are also theories about brain-derived neurotrophic factor (BDNF). However, its role in the disease is still under investigation. Furthermore, cytokines are also included in one of the theories, connecting depression and immunology. Neuroendocrine interactions in which cortisol plays an important role are also involved in depression. The recent theories include the interplay between genetics and epigenetics, i.e. environmental factors, as crucial for disease development

Application of edible coatings enriched with extracts from olive and nettle leaves for potato frying

Cilj ovog istraživanja bio je ispitati utjecaj jestivih filmova od karboksimetil celuloze ili gume arabike obogaćenih s ekstraktima lišća masline ili koprive [u koncenteracijama od 0,5 i 1,5 % (m/v)] na senzorska svojstva (prije i nakon prženja), te smanjenje udjela masti u prženom krumpiru. Vrsta polimera značajano je utjecala na boju sirovih krumpira, dok primjenom ekstrakata dolazi do značajnijeg posmeđivanja i sirovog i prženog krumpira. Korištenjem premaza neovisno o sastavu dolazi do promjene mirisa i okusa, dok se pri višim koncentracijama ekstrakta primjećuje niža razina zauljenosti. Udio ukupnih fenola viši je u uzorcima s ekstraktom lista masline u odnosu na uzorke s ekstraktom lista koprive. Iako se udio masti smanjio u premazanim uzorcima, značajnije razlike obzirom na vrstu ekstrakta nije bilo, ukazujući da ekstrakti lista koprive ili masline u primjenjenim koncentracijama nemaju ulogu u redukciji masti u odnosu na premaze bez ekstrakta. Ovo istraživanje ukazuje kako korištenje premaza može biti djelotvoran način smanjenja apsorpcije masti u krumpirima prženim u ulju.The aim of this work was to investigate application of edible coatings made from carboxymethyl cellulose or gum arabic enriched with extract of olive or nettle leaves [in concentrations of 0,5 and 1,5 % (w/v)] on sensory properties (before and after frying) and oil content in fried potatoes. Type of polymers significantly influenced colour of raw samples, while used extracts had a significant impact on the browning of raw and fried potatoes. Independently of the formulations, coatings had an impact on odour and taste, while oiliness was reduced in samples with extracts. Total phenolic content was higher in olive leaves extract samples when compared to samples with nettle leaves extract. Even though the content of oil was reduced in coated samples, there was no significant difference between extracts used, indicating that olive or nettle leaves extracts used in applied concentrations did not have a significant impact on oil reduction in comparison with samples without extracts. This work shows that using edible coatings might be a useful and alternative way in fat reduction in deep fat fried potatoes