In honour of Asclepius and Orpheus - ten years of activities on the popularization of connections between medicine and music

Umjetnost se definira kao ekspresija ili primjena ljudske kreativne vještine ili mašte u stvaranju djela koja se cijene ponajprije zbog svoje ljepote i emocionalne snage. Ars medica i ars musica dva su pojma koja se međusobno isprepleću još od antičkih vremena. Mnogi su vrhunski liječnici tijekom povijest pokazivali sklonosti prema stvaranju i izvođenju glazbe. Vođeni strašću prema medicini i glazbi, skupina studenata Medicinskog fakulteta Sveučilišta u Rijeci okuplja se od 2006. u okrilju Hrvatskoga znanstvenog društva za povijest zdravstvene kulture u neformalnu skupinu pod nazivom Asklepiju i Orfeju u čast u sklopu koje provode brojna zapažena glazbena događanja poput koncerata, prigodnih glazbenih izričaja i događanja, među kojima su najvažniji tradicionalni koncert hrvatskih studenata medicine i projekt Europski zbor i orkestar studenata medicine. Osim u Rijeci, nastupali su više puta u Ljubljani, Zagrebu, Puli, Karlovcu, Krku, Opatiji i Crikvenici. Skupina nastavlja svoj rad vođena motivom koji pokreće svakog liječnika-glazbenika – umjetnost.Art is defined as the expression or application of the human creative skill and imagination, producing works to be appreciated primarily for their beauty or emotional power. „Ars medica“ and „Ars musica“ represent two concepts which have been mutually intertwined since the ancient times. Through history, many extraordinary physicians have shown talent towards making and performing music. Guided by the passion for medicine and music, since 2006 the students from the University of Rijeka, Faculty of Medicine have founded an informal group named „In honour of Asclepius and Orpheus“ under the aegis of the Croatian Scientific Society for the History of Health Culture. The group organizes many musical activities such as concerts, musical recitals and events, among which are the most important - the traditional annual concert of Croatian medical students and the European Medical Students Orchestra and Choir project. Apart from Rijeka, they performed several times in Ljubljana, Zagreb, Pula, Karlovac, Krk, Opatija and Crikvenica. The members of this group plan their future work guided by the principles that motivate every physician-musician – art

Epidemiological Study of Visual Functions – Refractive Errors, Macular Degeneration and Glaucoma in Children in the Karst Area of Opatija

Authors of earlier studies examined the epidemiological characteristics of certain eye diseases: age-related macular degeneration (AMD), refractive errors and glaucoma in the area of Primorsko-goranska County (the island of Rab, Novi Vinodolski and Delnice). It was found that the occurrence of AMD is most common on the island of Rab, followed by Novi Vinodolski and it is least common in Gorski Kotar. This fact is associated with the intensity of solar radiation in the UV-A and UV-B fi elds. The highest percentage of the occurrence of glaucoma was also identifi ed on the island of Rab. In comparison to this study, it was found that in the karst area of Opatija (Mune, Brgud, Žejane, Brešca, Zvoneće, Pasjak, Šapjane and Zaluki) there is a very high incidence of glaucoma (27% suspected and 7% diagnosed glaucoma) within the indigenous population. Glaucoma does not appear among children whose parents migrated to the karst area of Opatija. Refractive errors are far less common among children of indigenous population than among the children whose parents migrated to this area. The occurrence of AMD was not found in any child that was born and lives in this area, regardless of whether their parents are indigenous or not. This statement is very important because it confi rms author’s earlier statement which claims that at low exposure to solar UV-A and UV-B there is no occurrence of AMD

Genetic analysis of Y-chromosome microdeletions in men with a clinical diagnosis of schizophrenia

Cilj: Stopa plodnosti bolesnika s dijagnozom shizofrenije značajno je niža negoli u općoj populaciji. Smanjenoj stopi plodnosti pridonose spol, bračni status, reproduktivna dob, socioekonomski, kulturni, ali i genetički čimbenici. U ovom smo radu pretpostavili genetičku povezanost shizofrenije i smanjene plodnosti muških bolesnika. Ispitanici i metode: U uzorku od 105 muškaraca s kliničkom dijagnozom shizofrenije (prema DSM-IV) i 100 kontrolnih muškaraca ispitali smo prisutnost mikrodelecija područja čimbenika azoospermije (AZF) kromosoma Y kako bismo utvrdili pridonose li spomenute mikrodelecije riziku i/ili smanjenoj plodnosti muških bolesnika. Ispitivani STS-biljezi (engl. sequence tagged sites) AZF područja jesu: sY86, sY134, sY255, te sY84, sY127, sY254 koji su analizirani dvjema multipleks lančanim reakcijama polimeraze. Kao kontrolni lokusi korišteni su STS-biljeg sY14 (Yp) i presudoautosomni lokus ZFX/ZFY. Rezultati: Mikrodelecije kromosoma Y nismo pronašli niti u uzorku bolesnika niti u kontroli. Zaključak: Mikrodelecije AZF područja kromosoma Y ne pridonose riziku niti smanjenoj plodnosti muškaraca oboljelih od shizofrenije.Aim: Fertility rate of patients with schizophrenia is lower than in the general population. The contributing factors are sex, marital status, reproductive age, socioeconomic, cultural, and genetic factors. In this work, we tested the possible genetic association between schizophrenia and lower fertility rate of male patients. Patients and methods: DNA samples taken from 105 male patients with clinical diagnosis of schizophrenia (according to DSM-IV criteria) and 100 control men were analysed for the presence of chromosome Y azoospermia factor (AZF) microdeletions. Six sequence tagged sites (STS) spanning AZFa-c region were analysed using two multiplex polymerase chain reactions: sY84, sY127, sY254, and sY86, sY134, sY255. STS-marker sY14 (Yp) and pseudoautosomal locus ZFX/ZFY were used as control loci in both reactions. Results: No evidence of AZF-microdeletions were found in both groups. Conclusion: Microdeletions of the chromosome Y AZF-region do not contribute to the risk or reduced fertility rate in males with schizophrenia

Presentation and development of Cochrane systematic review of interventions

Sustavni pregledni radovi se danas smatraju dijelom relevantne znanstvene i stručne literature koja postaje neizostavni dio svakodnevne medicinske prakse i važan element u donošenju odluka. Radi se o znanstvenom istraživanju koje temeljem sustavne i strogo definirane metodologije pretrage, odabira i analize dostupnih znanstvenih dokaza daje odgovor na točno definirano znanstveno pitanje. Cochrane kolaboracija je svjetska neprofitna organizacija čiji je cilj stvaranje kvalitetnih sustavnih preglednih radova kroz detaljnu, razrađenu i rigoroznu metodologiju. Kroz različite znanstvene grupe, autori publiciraju Cochrane sustavne preglede intervencija i dijagnostičkih testova koji se objavljuju u Cochrane bazi sustavnih preglednih članaka. Cochrane sustavni pregledni rad se razvija u nekoliko koraka: formulacija pitanja, odabir Cochrane skupine, registracija naslova, izrada i objava protokola, te izrada, objava i održavanje sustavnog preglednog rada. Ovim radom želimo prikazati metodologiju razvoja sustavnog pregleda u sklopu Cochrane kolaboracije kao općeniti uvid u kompleksnost njegove izrade.Systematic review articles are considered today as part of relevant scientific and professional literature which is becoming an infallible part of everyday medical practice and a vital part in decision making. This scientific work is based on systematic and strictly defined methodology of search, selection and analysis of available medical evidence which provides and answer to a specific scientific question. The Cochrane Collaboration is a world non-profit organizaton whose goal is to publish high qualitiy systematic reviews through detailed and rigorous methodology. Through different scientific groups, authors publish Cochrane systematic reviews of interventions and diagnostic tests which are published in the Cochrane Database of Systematic Reviews. These reviews are developed through several steps: question formulation, Cochrane group selection, title registration, writing and publishing a protocol and writing, publishing and updating a systematic review. In this article we wish to present the methodology of Cochrane systematic review development as a general insight into its complexity

Perkutana aspiracijska trombektomija u Paget-Schroetterovu sindromu – prikaz bolesnika

SUMMARY We report the case of a younger, physically active patient who presented at the emergency department with swelling, pain, and bluish discoloration of the left arm, with clinical examination identifying effort-induced deep vein thrombosis of the arm (Paget-Schroetter syndrome). After unsuccessful medication treatment with a therapy dose of low-molecular-weight heparin, the patient was treated with an endovascular procedure – percutaneous aspiration thrombectomy. The procedure was successful, with the establishment of peripheral flow through the subclavian, axillary, and cephalic vein despite some thrombotic masses remaining. Before discharge, the patient was placed on peroral anticoagulation treatment with rivaroxaban. Additional imaging was performed during treatment of the superior thoracic aperture, confirming the diagnosis. Expanded laboratory testing showed values within normal limits. Follow-up showed regression of the symptoms. Color Doppler ultrasound and clinical examination verified maintenance of peripheral flow through the affected veins, with residual small thrombi and the development of collaterals. The patient was subsequently considered for decompression therapy by removing the first rib as a permanent solution for the symptoms.SAŽETAK Prikazujemo slučaj mlađeg, fizički aktivnog bolesnika u kojeg su se pri hitnom prijemu manifestirali oteklina, bolnost i plavičasta diskoloracija lijeve ruke te mu je obradom ustanovljena naporom inducirana duboka venska tromboza ruke (Paget-Schroetterov sindrom). Nakon neuspješna medikamentnog liječenja terapijskom dozom niskomolekularnog heparina liječen je endovaskularnim zahvatom – perkutanom aspiracijskom trombektomijom. Postupak je protekao uredno uz uspostavu rubnog protoka kroz potključnu, pazušnu te cefaličnu venu usprkos ostatnim trombotskim masama. Prije otpusta uvedena je peroralna antikoagulantna terapija rivaroksabanom. U sklopu obrade sindroma gornje torakalne aperture provedena je dodatna slikovna obrada kojom je dijagnoza potvrđena. Nalazi proširene laboratorijske obrade bili su u granicama normale. Na kontrolnim pregledima praćena je regresija tegoba. Color Doppler ultrazvukom te klinički verificiran je i dalje održan rubni protok kroz zahvaćene vene uz rezidualne male trombe te razvoj kolaterala. U bolesnika se razmatra dekompresijsko liječenje resekcijom prvog rebra kao konačno rješenje uzroka tegoba

Refractive Errors in Children of Primorsko-Goranska County – Epidemiological study

Three institutions: Teaching Institute of Public Health of Primorsko-Goranska County, Croatian Association »Albert Einstein« and Eye Clinic »Dr B.Vojnikovi}« Rijeka agreed a five-year project to study children´s health status of vision at Primorsko-Goranska County. Main task was the study of damage of vision in children due to prolonged sun exposure. Examination were conducted on a three locations, with the assumption of varying insolation: Island of Rab, Novi Vinodolski and Delnice. The study included children aged between 9 to 14 years. The study included 189 children. Except routine ophthalmologic examinations in addition were preformed biomicroscopic examination of the anterior segment of the eye, intraocular pressure and eye fundus. In a certain number of children with suspect of a specific disease (macular degeneration, glaucoma and refractive error), additional tests were performed: glaucoma treatment, field of vision, optical coherence tomography (OCT) of the eye and detailed eye refraction. This study specifically addressed of refractive error at that three different regions. It was found that the most difficult situation was at the Novi Vinodolski where as many as 40% of children have a refractive error, followed by Island of Rab with 17% and Delnice with 9%. Especially like to mention that on the island of Rab, 50–60 years ago, it was a very rare occurrence of some refractive errors in children

The role of computerized tomography in the diagnosis of acute abdomen

Cilj: Cilj ovog retrospekti vnog istraživanja bio je ispitati dijagnosti čku vrijednost kompjutorizirane tomografi je (CT) kod neoperiranih pacijenata koji su se prezenti rali kliničkom slikom akutnog abdomena u procjeni potrebe kirurškog liječenja te u detekciji uzroka nastanka kliničke slike. Ispitanici i metode: Retrospekti vno istraživanje obuhvati lo je neoperirane pacijente starije od 18 godina koji su upućeni na CT pretragu s kliničkom slikom i uputnom dijagnozom akutnog abdomena u razdoblju od 31. 10. 2014. do 31. 10. 2015. godine. Isključeni su pacijenti s laparotomijom ili laparoskopijom učinjenom unutar 30 dana prije CT pretrage te pacijenti koji su preminuli ti jekom hospitalizacije bez učinjenog kirurškog zahvata. Osim operacijskog nalaza, referentna metoda je bila kliničko praćenje ti jekom 30 dana nakon CT-a u neoperiranih pacijenata. CT nalaze neovisno su analizirala dva radiologa s više od 5 godina iskustva s abdominalnim CT pretragama, a nesuglasja su rješavana konsenzusom. Rezultati : Od ukupno 81 pacijenta (dobni raspon od 19 do 91 god., medijan 69 godina, omjer muškaraca i žena 45/36), 51 pacijent podvrgnut je hitnom kirurškom liječenju. Perforacija duodenalnog/želučanog ulkusa, diverti kuliti s i apendiciti s s komplikacijama, perforacija crijeva i komplikacija akutne upale žučnog mjehura bile su najčešće indikacije za operaciju. Osjetljivost i specifi čnost CT pretrage u ispiti vanoj skupini iznosila je 94,6 % i 84,0 %, dok su poziti vna i negati vna predikti vna vrijednost bile 93,0 % i 87,5 %. U stvarno poziti vnih nalaza CT-om smo uspješno procijenili uzrok nastanka kliničke slike u 83 % pacijenata. Zaključak: CT pretraga abdomena i zdjelice u pacijenata s kliničkom slikom akutnog abdomena pouzdana je dijagnosti čka metoda u procjeni indikacije za kirurško liječenje i detekciji uzroka nastanka kliničke slike.Aim: The aim of this retrospecti ve study was to determine the diagnosti c value of computerized tomography (CT) in pati ents without prior surgery who presented with clinical signs and symptoms of acute abdomen with the goal of assessment of the need for surgery and the detecti on of causes of acute abdomen. Pati ents and methods: This retrospecti ve study included all adult pati ents without prior surgery who were referred to perform abdominal CT scan with the diagnosis of acute abdomen in the period from October 31st 2014 ti ll October 31st 2015. Pati ents who had laparotomy of laparoscopy performed within 30 days prior to CT examinati on and those who died during hospitalizati on aft er the CT examinati on and without surgery were excluded. Reference standards in this study were surgery report and hospital observati on during 30 days aft er CT exam in pati ents who had no surgery. CT exams were independently analysed by two radiology specialists with more than 5 years of experience in abdominal CT imaging and all disagreements were sett led with consensus. Results: Out of 81 pati ents (age 19-91, median 69 years, male/female rati o 45/36) 51 had emergency surgery. Duodenal/gastric ulcer perforati on, diverti culiti s and appendiciti s with complicati ons, bowel perforati on and complicati ons of acute cholecysti ti s were the most common causes for surgery. Sensiti vity and specifi city of abdominal CT were 94.6% and 84.6%, while positi ve and negati ve predicti ve values were 93.0% and 87.5%, respecti vely. In pati ents with true positi ve results, CT successfully assessed the localizati on of the cause of acute abdomen in 83% of pati ents. Conclusion: Abdominal CT examinati on in pati ents with signs and symptoms of acute abdomen is a reliable diagnosti c method in the assessment of indicati on for surgery and the detecti on of causes of acute abdomen