Chronic Critical Patient: A challenge for modern Critical Care Medicine

Introduction: Cronic critical patients need long term care and multidiscilinary approach. Aim: To show clinical features of chronic critical illness and possible solutions for long term care. Materials and methods: Electronic searches of literature using words related to critical illness, chronic disease, physiotherapy. Results: Most of critically ill patients need prolonged mechanical ventilation and/or tracheostomy. Agressive intensive care treatment, advanced age and comorbidities are major risk factors for development of chronic critical illness. Chronic critical illness except prolonged mechanical ventilation and/or tracheostomy includes severe complications in almost all organs and organ systems (severe neuromyopathy, metabolic disorders, generalized oedema, pressure sores, reccurent infections, hormonal changes, emotional changes, etc.). Prolonged specialized care is associated with high costs for medical equipment and consumable medical supplies. Also, prolonged critical care is a burden for their families due to economic and emotional issues. Conclusion: Chronic critical illness becomes a real problem in the all developed world including Croatia. Multidisciplinary approach is a cornerstone of the care for the chronic critical ill patient and respiratory physiotherapist should be a team leader in that team. Regular early physiotherapy can improve fi nal outcome and decrease the number of complications. National service for prolonged critical care treatment out of acute hospitals and clear guidelines might improve the care for these patients. Long term home treatment is the best way of care, so it is very important to involve family members early at the beginning of intensive care treatment, educate and train them for the taking care of sick family member. Ensuring fi nancial, medical and technical support to the family is important also

Synthesis, characterization and bioactivity of selected metal complexes with imine ligands

The chemistry of complex compounds containing imine ligands is attracting significant attention from researchers today. In this work, complexes of selected transition metals (Cu, Co, Ni and Fe) with imines based on ninhydrin and amino acids methionine and cysteine were synthesized. FTIR and UV/VIS spectroscopy were used for structural characterization. Antioxidant activity of the complex was analyzed by the FRAP method. The synthesized compounds showed a significant reducing ability, ranging from 221.94 to 756.30 µmol/L. In vitro antimicrobial activity was tested on strains from the ATCC collection. Inhibitory activity against the tested microorganisms was recorded, and the zones of inhibition ranged from 10-24 mm. Preliminary research shows that these compounds have biological potency, but more detailed in vitro and in vivo studies are required for their use.</p

Muscle progenitor cells in skeletal muscle

Iako su malobrojne, satelitske stanice u skeletnom mišiću mogu u slučaju ozljede proizvesti velik broj mioblasta koji će daljnjim procesom regenerativne miogeneze dovesti do obnove mišićnog tkiva. Ove stanice su matične stanice specifične za mišićno tkivo. Njihovom aktivacijom pokreće se slijed u ekspresiji miogenetskih regulacijskih čimbenika i time program miogeneze. Satelitskim je stanicama svojstvena sposobnost samoobnavljanja. One predstavljaju heterogenu skupinu stanica s obzirom na funkciju i na markere kojima se dokazuju. Pored satelitskih stanica izolirane su i druge matične stanice u mišiću koje u eksperimentalnim uvjetima pridonose miogenezi. Miogenetski potencijal ovih stanica pokušava se iskoristiti u terapeutske svrhe u nekim oblicima mišićnih oboljenja.Although not numerous, satellite cells in skeletal muscle are capable to generate a large number of myoblasts upon injury. A further process of regenerative myogenesis leads to the muscle regeneration. Satellite cells are stem cells specific to skeletal muscle tissue. Their activation initiates the sequence of expression in myogenic regulatory factors and thus myogenic program. Besides the ability to provide new myoblasts, these cells also have selfrenewing capacity. Satellite cells are a heterogeneous group of cells considering their function and distinction markers. Several other types of stem cells with myogenic ability (in experimental conditions) have been isolated from the skeletal muscle. Therapeutic approaches to treat some forms of muscular diseases have been based on myogenic potential of both groups of stem cells

Biodegradable polymers: production, properties and application in medicine

Biodegradable polymers (biopolymers) represent materials of new generation with application in different areas of human activity. Their production has recently reached a commercial level. They can be divided according to the origin (natural and synthetic), according to the chemical composition, methods of obtaining, application etc. The use of biopolymers in medicine depends on their biocompatibility, mechanical resistance, and sorptive char-acteristics. Today, they are the most commonly used as implants in vascular and orthopedic surgery, for the production of materials such as catheters, products for gynaecology and haemodialysis, tooth reconstruction, etc. In pharmacy, they are used as a medicine matrix-carrier to allow controlled release of drug within the body. Within this review paper, the properties and methods of production of certain biopolymers such as polyglycolic acid (PGA), polylactide acid (PLA), poly-ε-coprolactone (PCL) and polybutylene succinate (PBS) will be described in detail, as well as their application in medicine and pharmacy

The craniovertebral venous system

Kraniovertebralni venski sustav čine kranijalne i kralježnične vene. Ove vene su međusobno povezane i nemaju zalistaka, što omogućava tok krvi u oba smjera. Kranijalnim venama pripadaju vene mozga, sinus tvrde moždane ovojnice, diploične i emisarne vene, dok kralježničnim venama pripada vanjski i unutarnji vertebralni splet te bazivertebralne vene. Iz kraniovertebralnog venskog sustava krv odvode vv. vertebrales, vv. intercostales postt., vv. lumbales i v. sacralis lat. u sustave gornje i donje šuplje vene izravno ili putem sustava vene azigos. Kraniovertebralni venski sustav s ostalim sustavima tvori brojne anastomoze koje u patološkim uvjetima predstavljaju kolateralni put krvi ka srcu i omogućuju izravno širenje neoplazmi iz prsne, trbušne i zdjelične šupljine u područje kranijuma i kralježnice. Osim toga, značajna je uloga kranijalnih vena i vena gornjih dijelova dišnog sustava u selektivnom rashlađivanju mozga, što je osobito značajno u hipertermiji.The craniovertebral venous system consists of cranial veins and veins of vertebral column. These veins are interconnected with no valves, allowing blood to flow freely in both directions. The veins of brain, dural venous sinuses, diploic veins and emissary veins belong to cranial veins. The veins of vertebral column consist of external and internal vertebral venous plexus and of basivertebral veins. The vertebral veins, posterior intercostals veins, lumbar veins and lateral sacral veins drain blood directly from craniovertebral venous system in azigos vein or in superior and inferior vena cava. The craniovertebral venous system with other venous systems are forming numerous anastomosis, which in pathological conditions represent a collateral pathway for blood to the heart and allow the direct spread of neoplasms of the thoracic, abdominal and pelvic cavity in the area of the cranium and spine. In addition, the significance of cranial veins and veins of the upper part of the respiratory system are part of the selective brain cooling mechanism which is particulary important in condition of hyperthermia

The craniovertebral venous system

Kraniovertebralni venski sustav čine kranijalne i kralježnične vene. Ove vene su međusobno povezane i nemaju zalistaka, što omogućava tok krvi u oba smjera. Kranijalnim venama pripadaju vene mozga, sinus tvrde moždane ovojnice, diploične i emisarne vene, dok kralježničnim venama pripada vanjski i unutarnji vertebralni splet te bazivertebralne vene. Iz kraniovertebralnog venskog sustava krv odvode vv. vertebrales, vv. intercostales postt., vv. lumbales i v. sacralis lat. u sustave gornje i donje šuplje vene izravno ili putem sustava vene azigos. Kraniovertebralni venski sustav s ostalim sustavima tvori brojne anastomoze koje u patološkim uvjetima predstavljaju kolateralni put krvi ka srcu i omogućuju izravno širenje neoplazmi iz prsne, trbušne i zdjelične šupljine u područje kranijuma i kralježnice. Osim toga, značajna je uloga kranijalnih vena i vena gornjih dijelova dišnog sustava u selektivnom rashlađivanju mozga, što je osobito značajno u hipertermiji.The craniovertebral venous system consists of cranial veins and veins of vertebral column. These veins are interconnected with no valves, allowing blood to flow freely in both directions. The veins of brain, dural venous sinuses, diploic veins and emissary veins belong to cranial veins. The veins of vertebral column consist of external and internal vertebral venous plexus and of basivertebral veins. The vertebral veins, posterior intercostals veins, lumbar veins and lateral sacral veins drain blood directly from craniovertebral venous system in azigos vein or in superior and inferior vena cava. The craniovertebral venous system with other venous systems are forming numerous anastomosis, which in pathological conditions represent a collateral pathway for blood to the heart and allow the direct spread of neoplasms of the thoracic, abdominal and pelvic cavity in the area of the cranium and spine. In addition, the significance of cranial veins and veins of the upper part of the respiratory system are part of the selective brain cooling mechanism which is particulary important in condition of hyperthermia

The craniovertebral venous system

Kraniovertebralni venski sustav čine kranijalne i kralježnične vene. Ove vene su međusobno povezane i nemaju zalistaka, što omogućava tok krvi u oba smjera. Kranijalnim venama pripadaju vene mozga, sinus tvrde moždane ovojnice, diploične i emisarne vene, dok kralježničnim venama pripada vanjski i unutarnji vertebralni splet te bazivertebralne vene. Iz kraniovertebralnog venskog sustava krv odvode vv. vertebrales, vv. intercostales postt., vv. lumbales i v. sacralis lat. u sustave gornje i donje šuplje vene izravno ili putem sustava vene azigos. Kraniovertebralni venski sustav s ostalim sustavima tvori brojne anastomoze koje u patološkim uvjetima predstavljaju kolateralni put krvi ka srcu i omogućuju izravno širenje neoplazmi iz prsne, trbušne i zdjelične šupljine u područje kranijuma i kralježnice. Osim toga, značajna je uloga kranijalnih vena i vena gornjih dijelova dišnog sustava u selektivnom rashlađivanju mozga, što je osobito značajno u hipertermiji.The craniovertebral venous system consists of cranial veins and veins of vertebral column. These veins are interconnected with no valves, allowing blood to flow freely in both directions. The veins of brain, dural venous sinuses, diploic veins and emissary veins belong to cranial veins. The veins of vertebral column consist of external and internal vertebral venous plexus and of basivertebral veins. The vertebral veins, posterior intercostals veins, lumbar veins and lateral sacral veins drain blood directly from craniovertebral venous system in azigos vein or in superior and inferior vena cava. The craniovertebral venous system with other venous systems are forming numerous anastomosis, which in pathological conditions represent a collateral pathway for blood to the heart and allow the direct spread of neoplasms of the thoracic, abdominal and pelvic cavity in the area of the cranium and spine. In addition, the significance of cranial veins and veins of the upper part of the respiratory system are part of the selective brain cooling mechanism which is particulary important in condition of hyperthermia