Breast Reconstruction after Mastectomy

Results of our analysis show as that breast reconstruction become a standard part of the care of female patients with breast cancer. We will analyse the factors that are important for the primary or secondary breast reconstruction after mastectomy, and also take a closer look on the most recent scientific advances on breast reconstruction and on the protocols regarding them. The breast is the most common site of cancer in Croatia women. Breast cancer is the first leading cause of cancer death among women today. The incidence of female breast cancer in Croatia estimates that approximately 2.200 news cases of female breast will be diagnosed every year. We retrospectively analysed data of 101 female patients undergoing reconstructive surgery for breast reconstruction after mastectomy at Division of Plastic Surgery and Burns, University Hospital Center Split and University Clinic of Plastic and Reconstructive Surgery, Innsbruck, Austria, between 1998 and 2008. For the purpose of outcome assessment, we performed the tree different type of questionnaire: (1) Personal/medical profile (Table 1), (2) Aesthetic assessment (Table 2), and (3) Psychosocial assessment (Table 3). The occurrence of main complications during breast reconstruction (partial necrosis of flap, hernia of donor site, pulmonary embolism, deep venous thrombosis, infection rate, hemathoma and seroma formation, and extrusion of expander/implant) during hospitalisation and follow up period until 6 post operatively were analysed with respect to use different type of reconstructive methods for breast reconstruction. The difference in complication between patients groups was evaluated by c2-test. The level of significance was set up at p=0.05. Mann-Whitney test was used to compare the time from mastectomy to breast reconstruction, due to asymmetrical data distribution. The three main variables of this study were to identify significant risk factors, asses the aesthetic outcome, and patient satisfaction with performed different methods for breast reconstruction (LD flap with or without tissue expander and implant, pedicle and free TRAM flaps, and expander /implants only. These variables determined the current guidelines for early and late breast reconstruction after mastectomy such as patient data, age and own decision, relation ship between reconstruction and radiotherapy, and chemotherapy, and finally about breast preserving operation. The result should confirm that breast reconstruction after mastectomy is justified, especially in young women, as well as how essential is team work involved in breast cancer operation and breast reconstruction after mastectomy

Breast Reconstruction after Mastectomy

Results of our analysis show as that breast reconstruction become a standard part of the care of female patients with breast cancer. We will analyse the factors that are important for the primary or secondary breast reconstruction after mastectomy, and also take a closer look on the most recent scientific advances on breast reconstruction and on the protocols regarding them. The breast is the most common site of cancer in Croatia women. Breast cancer is the first leading cause of cancer death among women today. The incidence of female breast cancer in Croatia estimates that approximately 2.200 news cases of female breast will be diagnosed every year. We retrospectively analysed data of 101 female patients undergoing reconstructive surgery for breast reconstruction after mastectomy at Division of Plastic Surgery and Burns, University Hospital Center Split and University Clinic of Plastic and Reconstructive Surgery, Innsbruck, Austria, between 1998 and 2008. For the purpose of outcome assessment, we performed the tree different type of questionnaire: (1) Personal/medical profile (Table 1), (2) Aesthetic assessment (Table 2), and (3) Psychosocial assessment (Table 3). The occurrence of main complications during breast reconstruction (partial necrosis of flap, hernia of donor site, pulmonary embolism, deep venous thrombosis, infection rate, hemathoma and seroma formation, and extrusion of expander/implant) during hospitalisation and follow up period until 6 post operatively were analysed with respect to use different type of reconstructive methods for breast reconstruction. The difference in complication between patients groups was evaluated by c2-test. The level of significance was set up at p=0.05. Mann-Whitney test was used to compare the time from mastectomy to breast reconstruction, due to asymmetrical data distribution. The three main variables of this study were to identify significant risk factors, asses the aesthetic outcome, and patient satisfaction with performed different methods for breast reconstruction (LD flap with or without tissue expander and implant, pedicle and free TRAM flaps, and expander /implants only. These variables determined the current guidelines for early and late breast reconstruction after mastectomy such as patient data, age and own decision, relation ship between reconstruction and radiotherapy, and chemotherapy, and finally about breast preserving operation. The result should confirm that breast reconstruction after mastectomy is justified, especially in young women, as well as how essential is team work involved in breast cancer operation and breast reconstruction after mastectomy

Zajednički poslijediplomski doktorski studij zdravstvenih znanosti

Ovaj doktorski studij omogućio bi studentima potrebnu razinu znanja, vještina i stavova temeljenih na interdisciplinarnom pristupu u poimanju javnog zdravlja, što bi u konačnici moglo značajno pridonijeti istraživanju prevencije, promocije i zaštite zdravlja stanovništva u XXI. stoljeću

Use of Artificial Surfaces in Sports

Umjetne podloge na sportskim igralištima i terenima imaju sve veću primjenu posljednjih 20 godina. Razvoj modernih tehnologija izrađivanja takvih podloga je u konstantnom porastu te se na tržištu mogu pronaći različiti proizvođači koji plasiraju svoje proizvode u sportskoj industriji. Nogomet kao najrašireniji sport u svijetu je među prvima implementirao terene s umjetnom travom u sustav treninga i odigravanja utakmica. Danas je u upotrebi umjetna trava 4. generacije koja se postavlja na nogometne travnjake diljem svijeta te bi trebala zadovoljavati najveće europske standarde. Pregledom istraživanja na travnatim površinama uočeno je da je umjetna trava prve i druge generacije imala zabilježenu veću incidenciju ozljeda u odnosu na prirodne travnjake. Osobito treba pripaziti na toksičnost granulata koji je bio postavljan na umjetnu travu te su zabilježena kožna i respiratorna oboljenja na travnjacima starijih generacija. Tenis pripada sportovima gdje su se među prvima koristile umjetne podloge različitih karakteristika. Učestale promjene igranja na različitim teniskim podlogama dovele se do ozljeđivanja igrača koji nisu bili adekvatno fizički pripremljeni. Dvoranski sportovi poput rukometa, odbojke, futsala koriste višenamjenske umjetne podloge za svoja natjecanja. Istraživanja na ozljedama u dvoranskim sportovima pokazala su da postoje povećani rizici od ozljede kada se igra na umjetnim podlogama. Cilj ovoga stručnoga rada je potaknuti znanstvenu i sportsku zajednicu na važnost prevencije i dobre fizičke pripreme sportaša za igranje na različitim umjetnim podlogama. Konačan je zaključak da treba konstantno provoditi kontrolu proizvodnje umjetnih podloga te redovito pratiti incidenciju ozljeđivanja za vrijeme treninga i natjecanja, kako se ne bi povećala opasnost ozljeđivanja sportaša.Artificial surfaces on sports fields and terrains have been increasingly used for the last 20 years. The development of modern technologies for making such surfaces has been constantly increasing, and different manufacturers who place their products in the sports industry can be found on the market. Soccer is the most widespread sport in the world and was among the first to implement fields with artificial grass in the system of training and playing matches. Today, artificial grass of the 4th generation is used and placed on football pitches around the world with the highest European standards. The review of research on grass surfaces showed that artificial grass of the first and second generation had a higher incidence of injuries compared to natural lawns. Particular attention should be paid to the toxicity of the granulate that was placed on the artificial grass, because skin and respiratory di-seases have been recorded on the lawns of older generations. Tennis belongs to the sports where artificial surfaces with different characteristics were among the first to be used. Frequent changes of playing on different tennis surfaces led to injuries to players who were not adequately physically prepared. Indoor sports such as handball, volleyball, futsal use multipurpose artificial surfaces for their competitions. Research of injuries in indoor sports has shown that there is an increased risk of injury when playing on artificial surfaces. The goal of this professional work is to warn the scientific and sports community on the importance of prevention and good physical preparation of athletes for playing on different artificial surfaces. Also, it is necessary to constantly control the production of artificial surfaces and regularly monitor the incidence of injuries during training and competition, in order not to increase the risk of injury in athletes

European digital learning credentials at the University Department of Health Studies, University of Split

Nova platforma Europass-a (https://europa.eu/europass/hr) od srpnja 2020. godine dostupna je kao besplatni online instrument za prikazivanje postignutih ishoda učenja, planiranje ili pripremu karijere u Europi, te služi kao potpora građanima Europske unije kako bi lakše prolazili kroz svoj profesionalni razvoj. Kroz platformu Europass-a korisnici mogu izraditi svoj profil, jednostavno pretraživati različite mogućnosti za učenje ili zapošljavanje diljem Europe, primati individualne prijedloge obrazovnih programa ili poslova koji odgovaraju njihovom profilu i interesima, izrađivati, uređivati i pohranjivati životopise, motivacijska pisma i prijave za posao, pohranjivati digitalne vjerodajnice, dijeliti svoj profil s poslodavcima, obrazovnim ustanovama ili karijernim savjetnicima, te koristiti brojne druge usluge. Od navedenih mogućnosti korištenja platforme Europass-a posebno se ističu Europske digitalne vjerodajnice za učenje (Europass Digital Credentials for learning, EDC), odnosno digitalne datoteke koje pojedincima dodjeljuje odgovarajuće obrazovne ustanova, primjerice sveučilišta, kako bi se potvrdio i pružio dokaz o postignutim ishodima učenja. Europske digitalne vjerodajnice za učenje mogu se koristiti za postignuća kroz sve oblike učenja, formalna, neformalna i informalna. Digitalne vjerodajnice imaju jednaku pravnu vrijednost kao potvrde, diplome i druge vjerodajnice u papirnatom obliku, a visokoškolskim ustanovama omogućuju besplatno i sigurno izdavanje. Platforma Europass-a omogućuje sigurnu pohranu i dijeljenje digitalnih vjerodajnica. Besplatnim i sigurnim sustavom Europskih digitalnih vjerodajnica za učenje upravlja Europska komisija. Ideja o uključivanju Sveučilišta u Splitu u procese razvoja i provedbe platforme za Europske digitalne vjerodajnice za učenje javila se u vrijeme jasnog interesa rektora, prof. dr. sc. Dragana Ljutića, i njegovih suradnika za jačanje internacionalizacije, relevantnosti i kvalitete studijskih programa i znanstvenih istraživanja. U suradnji s partnerskim sveučilištima Europskog sveučilišta mora (European University of the Seas, SEA-EU), razvijene su projektne aktivnosti za testiranje i provedbu za neformalna i informalna učenja, kao i za dodjelu diploma stečenih kroz sveučilišne preddiplomske, diplomske i poslijediplomske studije. Kroz aktivnosti Europskog sveučilišta mora, Europske digitalne vjerodajnice za učenje povezuju se s drugim europskim inicijativama u visokom obrazovanju, kao što su osiguravanje kvalitete i automatsko priznavanje visokoškolskih kvalifikacija i dijela studiranja. Prednosti Europskih digitalnih vjerodajnica za učenje proizlaze iz brzog i pouzdanog izdavanja diploma i drugih vjerodajnica, njihovog pregleda, pohrane i dijeljenja s poslodavcima i drugim pojedincima i institucijama. Glavna prednost za sva sveučilišta, pa tako i za Sveučilište u Splitu, povezana je s potencijalnim povezivanjem s mjerljivim pokazateljima provedbe osiguravanja kvalitete u Europskom prostoru visokog obrazovanja, tj. povezivanjem s Bazom podataka rezultata vanjskog osiguravanja kvalitete (DEQAR). Visokoškolskim ustanovama, posebno sveučilištima u okviru Europskih sveučilišta mora, Europske digitalne vjerodajnice za učenje donose niz prednosti koje se mogu koristiti za olakšavanje mobilnosti studenata, izgradnji fleksibilnijeg učenja usmjerenog na studente, poticanju cjeloživotnog učenja, stvaranju snažnijih veza s poduzetnicima i izgradnji boljih veza između obrazovanja, istraživanja i inovacija. Tijekom 2021. godine, Sveučilište u Splitu uspješno je dodijelilo nekoliko stotina pojedinačnih Europskih digitalnih vjerodajnica za sudjelovanja u nekoliko neformalnih i informalnih aktivnosti, čime je postalo prvo visokoškolsko učilište koje je uspješno koristilo platformu Europass-a za dodjelu Europskih digitalnih vjerodajnica za učenje.The new Europass platform (https://europa.eu/europass/en) is available as a free online tool from July 2020 for documenting learning outcomes, planning and career preparation in Europe, and serves to support the citizens of the European Union in managing their professional development. Through the Europass platform, users can create their own profile, easily search for different learning or employment opportunities across Europe, receive proposals for educational programmes or jobs that match their profile and interests, create, edit, and store CVs, cover letters and job applications, store digital credentials, share their profile with employers, educational institutions, or career counsellors, and use many other services. Among the mentioned possibilities of using the Europass platform, European digital learning credentials stand out (Europass Digital Credentials for learning, EDC), i.e., digital files assigned to individuals by appropriate educational institutions, such as universities, to validate and provide evidence of learning outcomes. Europass digital learning credentials can be used for achievements in all forms of learning, formal, non-formal and informal. Digital credentials have the same legal value as certificates, diplomas and other credentials in paper form, and allow higher education institutions to issue them free and securely. The Europass platform enables secure storage and sharing of digital credentials. The free and secure Europass Digital Learning Credentials system is managed by the European Commission. The idea of involving the University of Split in the processes of development and implementation of the platform for Europass digital learning credentials arose at a time of a strong interest of the Rector, prof. Dragan Ljutić, PhD, and his associates in strengthening the internationalization, relevance and quality of study programmes and scientific research. In collaboration with the partner universities of the European University of the Sea (European University of the Seas, SEA-EU) the project activities for testing and implementation for non-formal and informal learning have been developed, as well as for the award of diplomas obtained in university undergraduate, graduate, and postgraduate study programmes. Through the activities of the European University of the Sea, European digital learning credentials are linked to other European initiatives in higher education, such as quality assurance and automatic recognition of higher education qualifications and periods of study. The benefits of European digital learning credentials stem from the rapid and reliable issuing diplomas and other credentials, their review, storage and sharing with employers and other individuals and institutions. The main advantage for all universities, including the University of Split, is related to the potential association with measurable indicators of quality assurance implementation in the European Higher Education Area, i.e., connection with the External Quality Assurance Results Database (DEQAR). For higher education institutions, especially the European Maritime Universities, the Europass Digital Credentials for Learning bring many benefits that can be used to facilitate student mobility, build more flexible student-centred learning, foster lifelong learning, build stronger links with entrepreneurs, and build better links between education, research, and innovation. During 2021 the University of Split successfully issued several hundred Europass Digital Credentials to participants in several informal and informal activities, making it the first higher education institution to successfully use the Europass platform to issue Europass Digital Credentials for Learning

Relevant Sonographic Parameters of a Painful Shoulder in Symptomatic Dialyzed Patients versus Asymptomatic Dialyzed and Healthy Volunteers

The aim of this study is to find dialysis relevant sonographic parameters of painful shoulder of the symptomatic dialyzed patients comparing them with parameters in asymptomatic dialyzed patients and healthy volunteers. Significant difference in all metric parameters (thickness of supraspinatus tendon, diameter of biceps tendon sheet and capsula-bone distance) were noticed between all groups and the symptomatic had the highest values. Asymptomatic had the higher values then volunteers. Inhomogenicity of the tendon and biceps tendon sheet effusion in the symptomatic patients were the most often occurred. Subdeltoid effusion, deposits and tendon rupture were found only in symptomatic patients. No difference in presence of calcifications between symptomatic and asymptomatic was found. Metric parameters are relevant and associated with dialysis, as well as biceps tendon effusion tendon inhomogenicity, deposits and subdeltoid effusion. Tendon ruptures are relatively rare and nonspecific

Relevant Sonographic Parameters of a Painful Shoulder in Symptomatic Dialyzed Patients versus Asymptomatic Dialyzed and Healthy Volunteers

The aim of this study is to find dialysis relevant sonographic parameters of painful shoulder of the symptomatic dialyzed patients comparing them with parameters in asymptomatic dialyzed patients and healthy volunteers. Significant difference in all metric parameters (thickness of supraspinatus tendon, diameter of biceps tendon sheet and capsula-bone distance) were noticed between all groups and the symptomatic had the highest values. Asymptomatic had the higher values then volunteers. Inhomogenicity of the tendon and biceps tendon sheet effusion in the symptomatic patients were the most often occurred. Subdeltoid effusion, deposits and tendon rupture were found only in symptomatic patients. No difference in presence of calcifications between symptomatic and asymptomatic was found. Metric parameters are relevant and associated with dialysis, as well as biceps tendon effusion tendon inhomogenicity, deposits and subdeltoid effusion. Tendon ruptures are relatively rare and nonspecific

Laboratory and Sonographic Findings in Dialyzed Patients with Bilateral Chronic Knee Pain versus Dialyzed Asymptomatic Patients

The aim of this study is to evaluate connection of plasma level of b2-microglobulin, C-reactive protein and uric acid as well as sonographic parameters like thickness of synovial membrane, thickness of femoral condylar cartilage and presence of joint effusion and Baker’s cysts with bilateral knee pain in dialyzed patients, comparing them with parameters in asymptomatic dialyzed patients. Plasma levels of b2-microglobulin and C-reactive protein were significantly higher in symptomatic patients while uric acid level showed no difference among the groups. In symptomatic patients synovial membrane was thicker and in those patients there were more knee effusions and Baker’s cysts. Thickness of femoral condylar cartilage showed no difference between groups. That suggests that inflammatory mechanisms developing from b2-microglobulin accumulation could be important factor in bilateral knee pain in dialyzed patients even in shorter duration dialysis