Trichomonas and Candida in the Light of Sexually Transmitted Diseases

Trichomonas vaginalis je bičaš koji inficira urogenitalni trakt. Infekcija uzrokuje vaginitis u žena te uretritis i balanopostitis u muškaraca. Glavni put prijenosa je spolni. Infekcija je asimptomatska uglavnom u muškaraca i u polovice inficiranih žena. Prijevremeni porod i niska porođajna težina moguće su komplikacije. Dijagnoza se rijetko potvrdi u muškaraca, dok je u žena nešto jednostavnija na temelju pregleda nativnog preparata, iako se kultura danas smatra pouzdanijom. Uspješna terapija provodi se peroralnom primjenom preparata metronidazola ili tinidazola u oba partnera. U svakom slučaju treba naglasiti pitanje rezistencije na azolske pripravke, što je danas sve veći terapijski problem. Gljive roda Candida (C.) bitan su patogeni agens za čovjeka, no istodobno su i dio fiziološke flore. Naseljavanje genitalne regije žena gljivama roda kandida, poglavito vrstom C. albicans, očituje se klinički kao vaginitis odnosno vulvovaginitis. Prijenos spolnim putem sa žene na muškarca je čest, a u muškaraca se očituje kao balanitis odnosno balanopostitis. Dijagnoza se potvrđuje mikološkom obradom (nativni pripravak i kultura). Terapija se provodi lokalnom primjenom preparata imidazola, kao i peroralnom primjenom azolskih pripravaka (flukonazol i itrakonazol). Racionalna primjena peroralne antimikotske terapije sve je značajnija u suvremenom konceptu liječenja genitalne kandidoze.Trichomonas vaginalis is a flagellated parasite which infects the urogenital tract. It causes vaginitis in women and urethritis and balanoposthitis in men. The main route of transmission is through sexual contact. In men and half of all women the infection usually appears to be asymptomatic. Complications might include the preterm birth and low-birth-weight infants. It is not always so easy to diagnose it in men, whereas the diagnosis in women seems to be easier with the use of the wet mount examination. However, cultivation methods including the molecular techniques are currently the "gold standard". The therapy of choice is oral metronidazole or tinidazole simultaneously administered to both partners. An increasing resistance to azole preparations appears to be a major problem nowadays. Candida species is at the same time the main pathogenic yeast for humans and part of the physiological flora. Genital involvement in women is mostly presented in the form of vaginitis and vulvovaginitis. In men, the infection with Candida is presented as balanitis or balanoposthitis. Diagnosis should be confirmed by mycological testing. Topical treatment with imidazole and/or oral therapy with fluconazole or itraconazole have proven to be very safe and effective. We have no right to neglect either trichomoniasis or genital candidosis in the light of sexually transmitted infections

Talking Culture, Crying Health, Hoping for Nothing: Surviving the Many Flyers above the Human Rights Global Cuckoo’s Nests

Today’s talk about any health issue is part of a wider web of neoliberal destructive processes of which all fall into the category of discriminating populations and their cultures, downgrading their right to life and violating their human dignity. Poor health, poverty stricken health systems and screaming epidemiological factors make just one more triangle of the successive visible consequences of destruction that equals to the violation of human dignity, to begin with. Yet no correction is possible since every problem is tied to the double standard perceivement of Human Rights. The author is engaged in presenting a need of a deeper auto-reflexive work-through of our human approachments and biological realities. This urgent stance is based on the new, set by Kalny (2009) and Baxi (2006), orientation towards a critical reading of the Human Rights and the advocacy toward differentiating between the politics for human rights and politics of human rights (the later being the politics of rights instrumentalization). Health and its un-sustainability is one of the most dramatic areas in which this differentiation of ones approaches is dramatically felt and needed. The end conclusions are envisioned to support the already existing field of a number of dedicated critical medical anthropologists, as well as authors across all fields, in their demand for, nothing more or less than, the dignity for the populations that they/we daily represent

Talking Culture, Crying Health, Hoping for Nothing: Surviving the Many Flyers above the Human Rights Global Cuckoo’s Nests

Today’s talk about any health issue is part of a wider web of neoliberal destructive processes of which all fall into the category of discriminating populations and their cultures, downgrading their right to life and violating their human dignity. Poor health, poverty stricken health systems and screaming epidemiological factors make just one more triangle of the successive visible consequences of destruction that equals to the violation of human dignity, to begin with. Yet no correction is possible since every problem is tied to the double standard perceivement of Human Rights. The author is engaged in presenting a need of a deeper auto-reflexive work-through of our human approachments and biological realities. This urgent stance is based on the new, set by Kalny (2009) and Baxi (2006), orientation towards a critical reading of the Human Rights and the advocacy toward differentiating between the politics for human rights and politics of human rights (the later being the politics of rights instrumentalization). Health and its un-sustainability is one of the most dramatic areas in which this differentiation of ones approaches is dramatically felt and needed. The end conclusions are envisioned to support the already existing field of a number of dedicated critical medical anthropologists, as well as authors across all fields, in their demand for, nothing more or less than, the dignity for the populations that they/we daily represent

LIST OF DIAGNOSTIC TESTS AND PROCEDURES IN LEG ULCER

Brojni su uzroci nastanka ulkusa na donjim ekstremitetima. Najčešći je venski ulkus u bolesnika s kroničnom venskom insuficijencijom. rjeđa je pojava arterijskog ulkusa, koji je posljedica periferne okluzivne bolesti arterija, najčešće ateroskleroze. Dio ulkusa posljedica je kombinacije periferne okluzivne bolesti arterija i kronične venske insuficijencije. u sklopu dijabetesa melitusa i dijabetičke neuropatije javlja se ulcus neurotrophicus. Posljedica je distalne, simetrične neuropatije i periferne okluzivne bolesti arterija. osim u vaskularnih, neuropatskih i metaboličkih bolesti ulkus se pojavljuje i u sklopu hematoloških, autoimunih, genetskih, infektivnih i primarnih bolesti kože, neoplazmi, kod primjene nekih lijekova, terapijskih postupaka i djelovanja drugih vanjskih čimbenika. Pri utvrđivanju etiologije koristimo se anamnezom, inspekcijom, palpacijom, testovima kojima utvrđujemo vensku insuficijenciju i perifernu okluzivnu bolest arterija. ulkusi različite etiologije mogu imati istu ili sličnu kliničku sliku te je potrebno provesti dodatne dijagnostičke pretrage: iz krvi, uzorka tkiva [mikrobiološka, mikološka analiza, patološko histološke analize (PHD), direktna imunofluorescentna pretraga (DIF)]. koriste se pretrage uz uporabu medicinskih aparata: mjerenje gležanjskog indeksa (ankle brachial pressure indeks - AbPI), ultrazvučne pretrage, pletizmografija, MSCT i Mr angiografija, digitalna supstracijska angiografija (DSA), arteriografija, venografija, limfoscintigrafija, radiološka pretraga te kapilaroskopija. osim mikrobiološke analize rane ne postoje pretrage koje bi mogle dati točnu informaciju o statusu same rane.Many factors contribute to the pathogenesis of leg ulcer. Most patients have venous leg ulcer due to chronic venous insufficiency. Less often, patients have arterial leg ulcer resulting from peripheral arterial occlusive disease, the most common cause of which is arteriosclerosis. Leg ulcer may be of a mixed arteriovenous origin. In diabetic patients, distal symmetric neuropathy and peripheral vascular disease are probably the most important etiologic factors in the development of diabetic leg ulcer. Other causes of chronic leg ulcers are hematologic diseases, autoimmune diseases, genetic defects, infectious diseases, primary skin diseases, cutaneous malignant diseases, use of some medications and therapeutic procedures, and numerous exogenous factors. Diagnosis of leg ulcer is based on medical history, inspection, palpation of skin temperature, palpation of arteries, fascia holes, presence and degree of edema, firm painful cords, and functional testing to assess peripheral occlusive arterial disease or identify superficial and deep venous reflux of the legs. Knowledge of differential diagnosis is essential for ensuring treatment success in patients with leg ulcer. There are many possible etiologic factors of leg ulcers and sometimes, clinical findings are similar. Additional testing should be performed, e.g.,serologic testing such as blood count, C-reactive protein, HBA1c, erythrocyte sedimentation rate, differential blood count, total proteins, electrolytes, coagulation parameters, circulating immune complex, cryoglobulins, homocysteins, AT, PAI-1, APC resistance, proteins C and S, paraproteins, ANA, ENA, ANCA, dsDNA, antiphospholipid antibodies, urea, creatinine, blood lipids, vitamins and trace elements. Also, biopsy of the lesion for histopathology, direct immunofluorescence, bacteriology and mycology should be included. Other tests are Raynaud (cold stimulation) test and pathergy test. Device-based diagnostic testing should be performed for future clarification. Ankle brachial pressure index, color duplex sonography, plethysmography, MSCT and MR angiography, digital subtraction angiography, phlebography, angiography, x-ray, and capillaroscopy in lupus erythematosus are indicated. Except for bacteriologic analyses of wound biopsies, there is no test to provide specific information on the wound condition

DIFFERENTIAL DIAGNOSIS AND WORK UP OF CHRONIC LEG ULCERS

Brojni su uzroci nastanka ulkusa na donjim ekstremitetima. najčešći uzroci su kronična venska insuficijencija, periferna okluzivna bolest arterija i dijabetes. dio ulkusa miješane je etiologije: kronične venske insuficijencije i periferne okluzivne bolesti arterija. Ateroskleroza je glavni čimbenik nastanka periferne okluzivne bolesti arterija.U bolesnika oboljelih od dijabetesa najvažniji čimbenici nastanka ulkusa su distalna, simetrična europatija i periferna okluzivna bolest arterija. rjeđi uzroci nastanka kroničnog ulkusa na potkoljenici su hematološke, autoimune, genetske, infektivne i primarne bolesti kože, neoplazme, nuspojave primjene nekih lijekova, terapijskih postupaka, te posljedica djelovanja drugih vanjskih čimbenika. pri utvrđivanju etiologije koristimo se anamnezom, inspekcijom, palpacijom, testovima kojima utvrđujemo vensku insuficijenciju i perifernu okluzivnu bolest arterija. Koristimo se pretragama iz krvi, uzimanjem uzoraka tkiva za mikrobiološku, mikološku, patološko histološku analizu (pHd) i direktnu imunofluorescentnu pretragu (diF)). Ulkusi različite etiologije mogu imati istu ili sličnu kliničku sliku, te je potrebno provesti i pretrage uz uporabu medicinskih aparata. Dobro poznavanje široke diferencijalne dijagnoze ključno je za pravilan izbor terapije.Many factors contribute to the pathogenesis of leg ulcers. The main causes are chronic venous insufficiency, peripheral arterial occlusive disease (PAOD) and diabetes. Some leg ulcers are caused by combinations of these well-known etiologic factors. The most common cause of PAOD is arteriosclerosis. In diabetic patients, distal symmetric neuropathy and peripheral vascular disease are probably the most important etiologic factors in the development of leg ulcers. Less frequent causes of chronic leg ulcers are hematologic diseases, autoimmune diseases, genetic defects, infections, primary skin disease, cutaneous malignant diseases, use of some medications and therapeutic procedures, and numerous exogenous factors. Diagnosis of leg ulcer is made upon medical history, clinical picture, palpation of arteries, functional testing and serologic testing. Device-based diagnostic testing should be performed for additional clarification. Also, lesion biopsy should be taken for histopathology, direct immunofluorescence, bacteriology and mycology. The knowledge of differential diagnosis is essential for ensuring treatment success in a patient with leg ulcer

Neoliberales Gesundheitswesen, globale Krankheit und Volksmedizin nach den Grundsätzen von Andrija Štampar

U ovom se radu kroz protokole kritične antropološke analize mapiraju, definiraju i iscrtavaju osnovni pojmovi u današnjoj politici globalne medicine. Specifično ishodište ovog rada jest analiza lokalnoga slučaja hrvatskoga zdravstva u sferi neoliberalne matrice komodifikacije svih područja života, s najdramatičnijim posljedicama u području zdravlja, bolesti, socijalne pravde i ekološke održivosti. U drugom dijelu rada zagovara se danas toliko spominjana sintagma štamparovske medicine, no ne kao mjesto sjećanja i slavljenja, nego kao izvor novih reinterpretacija kritične štamparovske osviještenosti, toliko potrebne u današnjem uklizavanju u gipsane odljevke neoliberalne neodrživosti, posebno opasne u području "zdravlja" i zdravstva.In this paper, by means of the protocols of critical anthropological analysis, mapped, defined and outlined are the main concepts present in today’s policy of global medicine. A specific starting point for this paper is an analysis of the case of Croatian health care in the sphere of the neoliberal matrix of commodification of all areas of life, with the most dramatic consequences in the fields of health, illness, social justice and ecological sustainability. In the second part of the paper the author supports the concept of "[tampar medicine", so frequently mentioned nowadays, not for the purpose of remembering and celebrating, but as a source of new reinterpretations of critical "[tampar" awareness so much needed in the current reality of sliding into plaster casts of neoliberal unsustainability, which can be especially perilous in the field of health and health care.In der vorliegenden Arbeit werden anhand einer kritischen anthropologischen Analyse die Grundbegriffe der gegenwärtigen globalen Gesundheitspolitik ermittelt und definiert. Der spezifische Ausgangspunkt dieser Arbeit ist eine Fallstudie des kroatischen Gesundheitswesens vor dem Hintergrund der neoliberalen Matrix der Kommodifizierung aller Lebensbereiche, die dramatische Folgen im Bereich der Volksgesundheit, der sozialen Gerechtigkeit sowie ökologischen Nachhaltigkeit nach sich zieht. Der zweite Teil der Arbeit widmet sich der heute wieder viel erwähnten Volksmedizin nach den Grundsätzen des kroatischen Sozialmediziners Andrija [tampar (1888–1958), nicht jedoch im Sinne einer feierlichen Reminiszenz, sondern als Versuch, die kritischen Ansichten [tampars neu zu interpretieren. Dies ist heutzutage ganz besonders vonnöten, da die Gesellschaften Gefahr laufen, in den Bahnen neoliberaler Unnachhaltigkeit, die zumal im Bereich der Volksgesundheit und des Gesundheitswesens gefährlich sind, festzufahren

Novi pogled na "hrvatske odselidbe"

U povodu knjige Ivana Rogića i Ivana Čizmića Modernizacija u Hrvatskoj i hrvatska odselidba, Institut društvenih znanosti Ivo Pilar, Biblioteka Studije, Zagreb, 2011., 471 st

EINFLUB DER MIGRATIONEN AUF DIE BEVOLKERUNGSSTRUKTUR DER MITTELDALMATINISCHEN INSELN

Istraživanje opisano u ovom radu dio je antropoloških istraživanja biološke i kulturne (mikro)diferencijacije izoliranih seoskih populacija istočnog Jadrana. Korišteni su migracijski podaci prikupljeni od ispitanika i u župnim knjigama otoka Brača, Hvara, Korčule i poluotoka Pelješca. Primjenom temporalne migracijske analize proučene su migracijske karakteristike parentalnog i ancestrainog podrijetla ispitanika. Dobiveni rezultati potvrdili su pretpostavku da je utjecaj (mikro)evolucijskih trendova izraženih kroz migraciju (alela) djelovao različitim intenzitetom kroz četiri analizirane vremenske kohorte, na svakom od otoka i na poluotoku. Iako postoje sličnosti u migracijskim kretanjima stanovništva u smislu vrlo velike zatvorenosti populacija otoka, s obzirom na općenito velike vrijednosti endogamija i male vrijednosti unutarotočnih i izvanotočnih migracija, brzina je promjena obrazaca migriranja jedinstvena na svakom od otoka i na poluotoku.The study is part of a wider anthropological study devoted to the biological and cultural (micro)differentiation among isolated village populations in the Eastern Adriatic. The migration data are collected from lntervlews and from the church registers of each island\u27s and peninsula parish. Using a well established methodology of temporal migration analysis conducted on the island of Brač, parental and ancestral origin of proposed populations of the Eastern Adriatic and their migrational characteristics were investigated. All results clearly confirm our presumption of the existence of various forms of (micro)evolutionary trends for each island and the peninsula, which are expressed through the migration of alleles on each of the islands and peninsula. Although similar/ties can be observed in migrational movements over the region in the sense of high endogamies and small values of within-island and off-island migrations, the change of migrational patterns for every island and the peninsula is unique.Die in dieser Arbeit durchgefUhrte Forschung stellt einen Teil der anthropologischen Forschungen der biolog ischen und kulturellen (Mikro) Differenzierung der isolierten Dorfpopulationen der Ostadria dar. Es wurden die von den Befragten und aus den PfarrbOchern der Insel Brač, Hvar, Korčula und der Halbinsel Pelješac gesammelten Angaben gebraucht. Mit der Anwendung der temporalen migratorischen Analyse wurden die migratorischen Charakteristiken des parentalen und ancestralen Ursprungs der Befragten erforscht. Die erzielten Resultate haben die Voraussetzung nachgeprOft, daB der EinfluB der (Mikro)Evolutionstrends, die durch die Migration ausgedrOckt sind, mit unterschiedlicher lntensitat durch vier analysierten Zeitkohorten, auf jeder von den Insein und auf der Halbinsel gewirkt hat. Obwohl es gewisse Ahnlichkeiten bei den Migrationsbewegungen der Bev61kerung im Sinne der sehr groBen Geschlossenheit der Inselbev61kerung im Hinblick auf den allgemein groBen Wert der Endogamie und den kleinen Wert der inneninsularen und auBerinsularen Migrationen gibt, ist die Geschwindigkeit der Anderung der Migrationsmuster auf jed er von den Insein und auf der Halbinsel einzigartig

ANTHROPOLOGICAL – JUNGIAN ANALYSIS OF THE PARADOX OF THE SPECIFICITY OF PODGORJE: ACCORDING TO AN ARCHETYPAL READING OF CROATIAN LIVING COSMOLOGIES

Između primorskih padina Velebita, južno od Senja, prostire se Podgorje koje bi se u svjetskim razmjerima usporedbi slobodno moglo opisivati kao podnožje hrvatskog Tibeta. Štoviše, naš prerano preminuli etnolog i antropolog, Tomo Vinšćak, koji je pohodio oba nebeska doticališta ustvrdio je da su Kailash i Velebit planinski srodnici – himalajski i hrvatski Olimp (1991). U ovom će se radu progovarati iz (iskustvom) prizemnijih uvida, no s jednakom upornošću zagovarati potreba smislenijeg upoznavanja specifičnosti ovog kraja i njegovih ljudi. Pa ako je podnožje hrvatskog Olimpa naizgled (nedostatkom iskustvene usporedbe) moguće definirati kao pretencioznom idealizacijom, ostaje faktografija mnogih disciplina, koje sinergijski presložene omogućavaju manje depresivno tumačenje kraja po njegove ljude. U ovom radu se takvo znanstveno združivanje pokušava doseći ispreplitanjem upotrebe antropoloških perspektiva (emsko-etsko) i Jungijanske analize iskustvene arhetipske sekvence koja povezuje autoricu s ovim krajem. Kraj je to čestog kolektivnog zaborava svih historiografskih činjenica koje potvrđuju da unatoč surovosti prirode koja se kroz buru i sušu stoljećima tu slijevala, te opisa da se iz toga kraja \u27samo\u27 bježalo i nestajalo zbog težine života, on ostao stjecište brojnih naroda i populacija. Sidrište mnogobrojnih kulturalnih, sakralnih i imaginativnih dimenzija za Hrvate, baš kao i jedna od konačnih destinacija najvećih hrvatskih migracijskih tijekova. U današnjim doslovnim i otrcanim postmodernističkim tumačenjima – kraj multikulturalnih susretišta unatoč in loco teških narativa života. Slijedom iste površnosti on postaje i kraj za kratkotrajno navraćanje u maniri sasvim ritualnog oblika pohoda na izazov divljine – od turistički brendiranog bazanja po Velebitu, pod geslom očuvanja neobuzdane prirode, do sasvim planiranog doživljaja išibanosti burom na senjskoj rivi. Kako sve navedeno ne bi ostalo samo na eko(nomsko)historijskoj potrazi simbolike, metafora i brikolaže mitova ovdje valja proširiti tumačenje specifičnosti lokaliteta i pridodati realitet biokulturalne povijesti. Tako, doprinosi istraživanja viševrsnih disciplina u području medicine već više dekada ukazuju na svojevrsni, rekli bismo, paradoks podgorske specifičnosti koji se ogleda u kontrastu mjesta teškog za življenje naspram poželjnog mjesta za doživjeti duboku starost, ili ako se hoće kozmološki i manje antropocentrično, starost neusmjerenu uživanju i ugodi. Konačni cilj analize ovog rada je (pre)usmjeravanje mogućih interesa za Podgorje s turistički-egzotično-isplativih kolonijalnih matrica na kozomološki-etičko shvaćanje, u kojem sprega čovjeka, prirode i povijesti zaslužuje puno šire sagledavanje njegove \u27izdrživosti\u27 u mjestu \u27održivosti\u27 ili \u27revitaliziranosti\u27. Kozmološkim pristupom rečeno, svaka jednadžba neoliberalne ugode je ovdje neprimjenjiva, baš sasvim suprotno, obrnuto je proporcionalna povijesnim i biokulturalnim dokazima. Ustvrditi je – ništa začuđujuće u odnosu na mogućnost tumačenja tog kraja kao podnožja hrvatskog Olimpa.Between the littoral slopes of Velebit, south of Senj, stretches Podgorje, which in global dimensions could freely be described as the foothill of the Croatian Tibet. Moreover, our prematurely departed ethnologist and anthropologist, Tomo Vinšćak, who visited both heaventouching points, claimed that Kailash and Velebit were mountain relatives – the Himalayan and Croatian Olympus (1991). In this paper the need of a coherent familiarisation of the specificity of this region and its people will be brought up and also argued for with the same persistence from ground level insights (with experience). So if it is seemingly possible to define the foothill of the Croatian Olympus (with a lack of empirical comparison) as a pretentious idealisation, it remains the factography of many disciplines, which synergistically rearranged allow a less depressing interpretation of the region by its people. In this paper such a scientific association is sought to be reached with the intertwining of the use of anthropological perspectives (emic-etic) and a Jungian analysis of an empirical archetypal sequence that links the author with this region. This is a region of the frequent collective forgetfulness of all the historiographic facts, which confirm that despite the harshness of nature which has poured the \u27bura\u27 and drought down here over the centuries, and the description that from this region people just escaped and disappeared because of the difficulty of life, it has remained a junction of numerous peoples and populations. The anchor point of many cultural, sacral and imaginative dimensions for Croats, just like one of the final destinations of the largest Croatian migratory flows. In today’s literal and trite post modernistic interpretations – a region of multicultural encounters despite the in loco of the difficult narratives of life. Following the same superficiality, it also becomes a region for a brief drop by in the manner of an altogether ritual form of an expedition at the challenge of the wilderness – from the touristic branding of wandering through Velebit, under the motto of the preservation of untameable nature, to the altogether planned experience of being beaten by the \u27bura\u27 on the quayside of Senj. In order that everything mentioned is not left to just an eco(nomic)historical search of symbolism, metaphors and bricolages of myths, it would be good here to widen the interpretation of the specificity of the locality and to add the reality of bio-cultural history. Thus, the contributions of the research of many kinds of disciplines in the area of medicine have for decades already pointed to a kind of, let’s say, paradox of the Podgorje specificity,which is reflected in the contrast of a place of hard living compared to a desired place to live out old age or if wanted cosmologically and less anthropocentrically, an old age of open-ended enjoyment and comfort. The final aim of the analysis of this paper is the (re)direction of the possible interests for Podgorje with the touristic-exotic-profitable colonial matrices onto a cosmological-ethical understanding in which the interconnection of man, nature and history deserves a much wider perception of its \u27endurance\u27 instead of \u27sustainability\u27 or \u27revitalisation\u27. With the cosmological approach said, each equation of neoliberal comfort here is inapplicable, quite the opposite, it is reversely proportionate to the historical and biocultural evidence. To conclude – nothing surprising in relation to the possibility of the interpretation of this region as the foothill of the Croatian Olympus