43 research outputs found
OSTEOARTHROSIS OF THE KNEE - WITH REGARD TO COMPARATIVE EFFICIENCY OF DISTINC THERAPEUTIC TREATMENTS
Cilj istraživanja bio je usporediti i evaluirali uÄinkovitost terapijske prunJene
lasera i ultrazvuka na kliniÄke manifestacije osteoartroze zgloba koljena. Ispitivano
skupinu Äi nilo je 53 bolesnika s manifestnom artrozom zgloba koljena. Uvjet ukljuÄenja
u ispitivan u skupinu bio je da u zadnjih mjesec dana nije apliciran intraartikularni lijek.
Tijekom ispitivanja praÄeno je ll kliniÄkih pokazatelja. Njihovom usporedbom prije i
poslije fizikalne terapije utvrdili smo znaÄajno kliniÄko poboljÅ”anje, s tim da je
primjena ultrazvuka uÄinkovitija na jedan dio parametara, a terapijska primjena lasera
na drugi dio. Iz navedenih rezultata nameÄe se zakljuÄak o moguÄnosti kombiniranog
lijeÄenja osteoartroze koljena ultrazvukom i laserom. Äime bi se optimalno iskoristio
povoljan uÄinak oba oblika fizikalne terapije.This paper tries to compare and evaluate the therapeutic efficiency following the
application of laser and ultrasonics, as clinically manifested in patients with knee
osteoarthrosis. The group being tested consisted 53 patients with manifest arthrosis of
the knee joint. A month prior to testing no medicine was allowed to be applied
intraarticularly on the patients being tested. The testing comprised ll parameters being
observed before and after the therapeutic treatments. The comparision showed
significant clinical improvement which, as to some parameters, seemed more effective
after the ultrasonics treatment and, as to others, after the laser treatment. The conclusion
implies the possibility of treating the osteoarthrosis of the knee by combining the
application of both ultrasonics and laser therapy, which might bring about the best
results of both therapeutic treatments
Correlation of Chronological Age with Tooth Wear in Archaeological Populations
Knowing that attrition and abrasion are most common wear processes of dental hard tissue, which occurs along with aging, the aim of this paper is to determine the correlation between dental age and loss of dental hard tissue on archeological bone residues. For the purpose of this research, the collection of skeletal remains of the Croatian Academy of Sciences and Arts (HAZU) was used. The study includes 392 samples of the remains of both upper and lower jaws from 7 Croatian archaeological sites, whereas 4 of them from continental and 3 of them from coastal Croatia. The remains of bones belong to two different archeological periods, late antiquity and early Middle Ages. Visa Metrix computer system was used on digital photography of occlusal tooth surfaces to measure total exposed area of dental hard tissue and surface of dental hard tissues damaged by attrition and abrasion. Data provided were defined in sq. cm, and as such were inserted in excel table and processed statistically. In the statistical analysis of data, Shapiro-Wilk test, Mann-Whitney U test and Kruskal-Wallis test were used. There is a statistically significant correlation between the total teeth number and estimated chronological age (ĻĀ² = 46.3, ĘĀ² = 0.23, p <0.001). Total number of teeth negatively correlates with chronological age (r = ā0.41, p <0.001). The total surface area of the teeth available decreases with the estimated chronological age (r = ā0.39, p <0.001), while the proportion (%) of the total damaged area of the teeth in relation to the total available area increases with the estimated chronological age (r = 0.622, P <0.001). The proportion of damaged surface in overall teeth surface increases with the estimated chronological age (r = 0.686; p <0.001) both in males and females (r = 0.534; p <0.001). The lifelong loss of hard tooth tissue positively correlates with chronological age in both sexes despite of historical period. The loss of hard tooth tissue due to attrition and abrasive changes, and with usage of Vista Metrix Inc. computer system can now be used to determine age in forensic dentistry as well as forensic anthropology and archeology
THE EFFICIENCY OF LASER TREATMENT IN TREA TING SPORT INJURIES
OcjenjujuÄi uÄ inkovi tost lijeÄenja laserom nakon dijagnosticirane sportske
ozljede u -B aktivnih sportaÅ”a, ustanovili srno da tijekom lijeÄenja dolazi do znaÄajnog
smanjenja boli u ispitanika, do zna Äajnog smanjenja otekline te nestanka krepitacija i
znaÄajne redukcije posljediÄnih kontraktura. Na temelju dobivenih rezultata, miÅ”ljenja
smo da laser spada u vrlo uÄinkov ite oblike fizikalne terapije za lijeÄenje sportskih
ozljeda.The laser treatment of sport injuries has been applied on 43 professional
sportsmen. The research proved the pain considerably relived during the treatment. It
also showed the swelling considerably decreasing, the crepitations disappearing and
the contractures resulting from injuries considerably reduced. On the basis of these
results the authors fmd laser treatment one of the most useful physioterapeutic means
in trcating sport injuries
THE CHARACTERISTICS OF THE URINARY BLADDER WALL IN INFANTS DURING THE FIRST 6 MONTHS OF
Cilj: Odrediti ultrazvukom normalne vrijednosti debljine stijenke mokraÄnog mjehura zdrave dojenÄadi u prvih 6 mjeseci života i utvrditi postoje li razlike s obzirom na spol. Ispitanici i metode: Obavljen je ultrazvuÄni probir mokraÄnog mjehura 416-ero zdrave donoÅ”ene dojenÄadi (216 muÅ”ke i 200 ženske) u dobi od 0,5 do 6 mjeseci života. Debljine stijenke mokraÄnog mjehura analizirane su ultrazvuÄnim aparatom Siemens Sonoline Prima, semikonveksnom sondom od 5,0 MHz i linearnom sondom od 7,5 MHz. Rezultati: ProsjeÄna vrijednost debljine stijenke iznosila je 2,32 0,542 mm (95% indeks povjerenja: 2,27 ā 2,37). Najmanja zabilježena debljina stijenke je bila 1 mm, a najveÄa 4 mm. ProsjeÄna vrijednost debljine stijenke mokraÄnog mjehura u muÅ”ke dojenÄadi iznosila je 2,42 0,56 mm, a prosjeÄna vrijednost za žensku dojenÄad iznosila je 2,21 0,50 mm. Studija je pokazala da postoji statistiÄki znaÄajna razlika u smislu neÅ”to veÄih vrijednosti debljine stijenke mokraÄnog mjehura u muÅ”ke dojenÄadi nego u ženske (t=3,97, p=0,00009, p0,01). ZakljuÄak: Ovakvi bi se rezultati mogli oÄekivati jer mokraÄni mjehur muÅ”kog djeteta mora proizvesti neÅ”to veÄi tlak da bi izbacio urin kroz znaÄajno dulju i užu uretru, nego mjehur ženskog djeteta. Takva relativna hiperfunkcija mokraÄnog mjehura muÅ”kog dojenÄeta rezultira relativnim zadebljanjem njegove stijenke, Å”to pridonosi fizioloÅ”koj razliÄitosti meÄu spolovima.Objectives: to determine by ultrasonograph the normal values of bladder wall thickness in healthy infants in the first 6 months of life and to observe the possible differences between sexes. Patients and Methods: Ultrasonograph screening was performed in 416 healthy term infants (216 males and 200 females) aged between 0.5 and 6 months. Bladder wall thicknesses were analyzed using a Sonoline Prima ultrasound machine with semi convex probe of 5.0 MHz, and linear probe of 7.5 MHz. Results: The mean bladder wall thickness was 2.32 0.542 mm (95% confidence interval: 2.27-2.37). The minimal bladder wall thickness was 1.0 mm, and maximal 4.0 mm, respectively. The average bladder wall thickness was 2.42 0.56 mm in males, and 2.21 0.50 mm in females. We found a statistically significant difference between bladder wall thickness of male and female infants in the first 6 months of life. The bladder wall in the male infants was thicker than in female infants (t=3.97, p=0.00009, p<0.01). Conclusion: These results might be expected because the male urinary bladder needs somewhat higher pressure to expel the urine via the significantly longer and narrower urethra than the bladder in female infants. That relative hyperfunction of the male bladder results in a relatively thicker bladder wall, what contributes to physiologic variances between sexes in infancy
TREA TING OSTEOARTHROSIS OF THE KNEE JOINT BY SHORTWAVE THERAPY
Cilj istraživanja je bio utvrditi i dokazati uÄinkovitost kratkovalne dijatennije kod
manifestne osteoartroze koljena (gonartroza) u 40 bolesnika prosjeÄne životne dobi 64,43 godine.
U terapiji je koriŔten aparat "Oscilotenn 400 E" "Elektromedicine" iz Ljubljane, tijekom 10
terapijskih procedura po 20 minuta. PraÄeno je Å”est kliniÄkih pokazatelja (jutarnja zakoÄenost, bol
u mirovanju, izljev u koljenu, opseg pokreta, opseg koljena preko sredine patele, udaljenost vrŔka
pete i glutealnog nabora). Dokazano je da je nakon l O terapijskih procedura kratkovalnom
dijatennijom doÅ”lo do znaÄajnog poveÄanja funkcijskog kapaciteta koljena.The aim of this research was to observe and prove the efficiency of the short-wave therapy
("Oscilotenn 400 E" Elektromedicina Ljubljana) applied to 40 patients with manifested
osteoarthrosis of the knee joint. Their average age being 64,43 years. The treatment comprised l O
applications of 20 minutes each. The six eli ni cal parameters being observed (morning stiffuess of
the knee, the pain in the rest, the effusion of the knee, the motion range, the knee perimeter
circumference measured over the patella center, the distance between the heel tip and the gluteal
wrinkles) and their showed that functional capacity of the knee joint being significantly increased
after l O therapeutic procedures
Influence of war on quantitative and qualitative changes in drug-induced mortality in Split-Dalmatia County, Croatia
Aim To study drug-induced mortality and characteristics
of overdose deaths in the war (1991-1995), pre-war (1986-
1990), and post-war period (1996-2000) in Split-Dalmatia
County.
Methods We retrospectively searched through Databases
of the Department of Forensic Medicine, University Hospital
Split, the national register of death records, the archives
of the Split-Dalmatia County Police, and the Register of
Treated Drug Addicts of the Croatian National Institute of
Public Health, covering the period from 1986 to 2000, according
to drug poisoning codes IX and X of the International
Classification of Diseases. The indicators were statistically
analyzed.
Results There were 146 registered drug-induced deaths,
with 136 (93%) deceased being men. The median age of
all cases was 27 years (interquartile range 8). Most of them
were single (70.6%), unemployed (44.6%), and secondary
school graduates (69.2%). In the war period, there were 4.8
times more deaths than in the pre-war period (P = 0.014),
and in the post-war period there were 5.2 times more
deaths than in the pre-war period (P = 0.008). The most
common site of death was the deceased personās home.
The toxicological analyses showed that 59 (61%) deaths
were heroin related, alcohol use was found in 62 cases
(42.5%), and multi-substance use was found in more than
a half of the cases. In 133 (91.1%) cases, deaths were classified
as unintentional, whereas 13 (8.9%) were classified
as suicides.
Conclusion The war, along with other risk factors, contributed
to unfavorable developments related to drug abuse
in Split-Dalmatia County, including the increase in the
drug-induced mortality rate
Uloga gena nm23 u kolorektalnom karcinomu
The aim of this study was to investigate the correlation of immunohistochemical expression of nm23 gene in colorectal cancer cells with tumor stage according to Dukes, tumor differentiation, occurrence of distant metastases and patient survival. This retrospective study included 100 colorectal cancer patients who underwent surgical treatment. Both pathological and clinical data were analyzed according to sex, age, immunohistochemical expression of nm23, tumor stage, tumor differentiation, occurrence of distant metastases and patient survival. Overexpression of nm23 gene was related to both good tumor differentiation and Dukesā stage A, whereas no significant correlation was found between the occurrence of metastases and nm23 gene expression. There was no significant correlation between nm23 gene expression and 5-year survival of colorectal cancer patients either. Although the results of this study suggested that higher expression of nm23 gene correlated with an early stage of tumor and its good differentiation, this parameter cannot yet be taken as an independent and reliable prognostic indicator in colorectal cancer.Cilj ovoga rada bio je istražiti povezanost izmeÄu promjene ekspresije gena nm23 u stanicama kolorektalnog karcinoma sa stadijem tumora po Dukesu, diferenciranosti tumora, pojavom udaljenih metastaza i petogodiÅ”njim preživljenjem. U ovom istraživanju obraÄeno je 100 bolesnika oboljelih od karcinoma debelog crijeva koji su operirani u Klinici za kirurgiju KBC Split. PatohistoloÅ”ki i kliniÄki podaci analizirani su prema spolu, dobi, imunohistokemijskoj ekspresiji gena nm23, stadiju tumora po Dukesu, stupnju histoloÅ”ke diferenciranosti tumora, pojavi udaljenih metastaza i petogodiÅ”njem preživljenju. UtvrÄeno je da dobro diferencirani karcinomi pokazuju statistiÄki znaÄajnu prekomjernu ekspresiju gena nm23. Isto tako, naÄena je prekomjerna ekspresija gena nm23 u stadiju tumora Dukes A. Nije naÄena povezanost izmeÄu promjene ekspresije gena nm23 i pojave udaljenih metastaza ni petogodiÅ”njeg preživljenja. Promjena ekspresije gena nm23, prema rezultatima ovoga istraživanja, ne može se rabiti za predviÄanje pojave metastaza i procjenu petogodiÅ”njeg preživljenja, ali povezanost prekomjerne ekspresije gena nm23 s ranim kliniÄkim stadijem (Dukes A) i dobrom diferencijacijom tumora upuÄuje na moguÄnost zaÅ”titnog djelovanja gena nm23 u ranom procesu tumorigeneze
Early and final outcome of patients suffered from muscle weakness aquired in COVID Intensive Care Unit ā How precise we can be about eary and final outcome of patients at the time of the end of mechanical ventilation?
Pojam kritiÄne bolesti odnosi se na Å”irok spektar medicinskih stanja opasnih po život koja obiÄno zahtijevaju lijeÄenje u jedinici intenzivnog lijeÄenja (JIL). Prema dostupnoj literaturi, u prosjeku 50ā80% bolesnika lijeÄenih u JIL-u zbog kritiÄne bolesti razvije miÅ”iÄnu slabost steÄenu u jedinici intenzivnog lijeÄenja (eng. Intensive care unit ā aquired weakness, ICUAW) koja se definira kao difuzna, generalizirana slabost koja se može objasniti iskljuÄivo kritiÄnom bolesti. Neuspjeh odvajanja od respiratora Äesto je povezan s ovim stanjem te dovodi do duljeg lijeÄenja i boravka u bolnici, Å”to stvara dodatnu patnju za bolesnika, optereÄuje medicinsko osoblje i stvara troÅ”kove za sustav koji bi se mogli izbjeÄi ili barem umanjiti i zato je ova stanja važno prepoznati, prevenirati i lijeÄiti. Cilj studije / istraživanja: Utvrditi uÄestalost razvoja ICUAW-a u bolesnika lijeÄenih u COVID JIL-u te promatrati
ishode bolesnika u skupini bolesnika koji su imali zadovoljavajuÄu miÅ”iÄnu snagu i skupine bolesnika sa ICUAW-om. Rani ishod oznaÄava ponovnu potrebu bolesnika za mehaniÄkom ventilacijom, a konaÄan ishod bolesnika oznaÄava preživljenje ili smrtni ishod. Metode: Istraživanje je provedeno u COVID JIL-u Klinike za anesteziologiju, reanimatologiju i intenzivno lijeÄenje. UkljuÄeni su svi bolesnici koji su lijeÄeni mehaniÄkom ventilacijom najmanje 48 h te odvojeni od mehaniÄke ventilacije tijekom veljaÄe 2022. godine, a iskljuÄni kriterij za bolesnike je bio od ranije postojanje neuroloÅ”ke i miÅ”iÄne bolesti. Bolesnici su pregledani nakon iskljuÄena analgosedacije i nakon odvajanja bolesnika od mehaniÄke ventilacije. Dijagnoza je postavljena kliniÄki po testu VijeÄa za medicinska istraživanja (eng. Medical Research Council test, MRC). Rezultati: Tijekom veljaÄe 2022. u COVID JIL-u lijeÄeno je 77 bolesnika. Od navedenih 77 bolesnika, 36 je uspjeÅ”no odvojeno od mehaniÄke ventilacije na period duži od 24 h, u 12 (33%) bolesnika je kliniÄki postavljena dijagnoza ICUAW-a, jednog bolesnika zbog poremeÄaja svijesti nije bilo moguÄe procijeniti. Dokazali smo da izmeÄu bolesnika koji su zadovoljavajuÄe miÅ”iÄne snage postoji znaÄajna razlika u duljini mehaniÄke ventilacije, potrebi za reintubacijom, traheotomijom, smrtnom ishodu za
vrijeme hospitalizacije, vremenu hospitalizacije i duljini lijeÄenja bolesnika u JIL-u. ZakljuÄak: ICUAW je Äesta komplikacija lijeÄenja bolesnika u JIL-u. BuduÄi da navedeno komplicira tijek i produljuje lijeÄenje bolesnika navedeno bitno je Å”to ranije prepoznati i lijeÄiti. Daljnja istraživanja Äe biti potrebna kako bi se utvrdila toÄna etiopatogeneza i na taj naÄin navedeno uspjeÅ”nije lijeÄilo, a po moguÄnosti i preveniralo.Critical illness refers to all medical life-threatening condition that should be treated in Intesive care unit (ICU). According to literature, about 50ā80 % patients treated in ICU because of critical illness develop Intensive care unit ā aquired weakness, ICUAW. It is defined as diffused, generalised muscle weakness that could only be explained by critical illness. Unsuccessful weaning from ventilator is very often associated with this condition and it causes more complications, prolonges hospitalization and increases health-care related costs. Considering all of this, ICUAW is very important to notice, prevent and treat. Aim of the study: Define the ICUAW incidence of ICU patients and compare the early and final outcome of patients who had sufficient muscle strenght to those who developed ICUAW. Eary outcome refers to need to reintubation of patient and final outcome refers to survival
or death outcome. Material and methods: The research was done in COVID ICU Clinic of anesthesia, reanimatology and intensive care during the February 2022. All pateint that were mechanicaly ventilated more than 48 h, and weaned from ventilator successfuly were included. All patient that had a muscle or neurologic disorder were excluded. The patients were examined after abolition of analgosedation and after weaning from ventilator. The diagnosis was made clinically by Medical Research Council test (MRC test). Results: During the February 2022 in COVID ICU, 77 patients were treated. In this group 36 patients were successfully weaned from ventilator in a period longer than 24 hours and 12 patients developed ICUAW, one patient becuase of impared consciousness was not able to be examined. We determined that group that develop ICUAW needed prolonged mechanical ventilantion, there was more need for reintubation and there was a higher probability of mortal outcome. Conclusion: ICUAW is very often complication of patient treated in ICU. Considering the fact that it prolonges mechanical ventilation, hospitalization and increases healtcare cost it is very important to prevent and treat this condition. Further investigation will be needed to define the exact etiopathogenesis in order to prevent ICUAW and treat propertly
Uloga gena nm23 u kolorektalnom karcinomu
The aim of this study was to investigate the correlation of immunohistochemical expression of nm23 gene in colorectal cancer cells with tumor stage according to Dukes, tumor differentiation, occurrence of distant metastases and patient survival. This retrospective study included 100 colorectal cancer patients who underwent surgical treatment. Both pathological and clinical data were analyzed according to sex, age, immunohistochemical expression of nm23, tumor stage, tumor differentiation, occurrence of distant metastases and patient survival. Overexpression of nm23 gene was related to both good tumor differentiation and Dukesā stage A, whereas no significant correlation was found between the occurrence of metastases and nm23 gene expression. There was no significant correlation between nm23 gene expression and 5-year survival of colorectal cancer patients either. Although the results of this study suggested that higher expression of nm23 gene correlated with an early stage of tumor and its good differentiation, this parameter cannot yet be taken as an independent and reliable prognostic indicator in colorectal cancer.Cilj ovoga rada bio je istražiti povezanost izmeÄu promjene ekspresije gena nm23 u stanicama kolorektalnog karcinoma sa stadijem tumora po Dukesu, diferenciranosti tumora, pojavom udaljenih metastaza i petogodiÅ”njim preživljenjem. U ovom istraživanju obraÄeno je 100 bolesnika oboljelih od karcinoma debelog crijeva koji su operirani u Klinici za kirurgiju KBC Split. PatohistoloÅ”ki i kliniÄki podaci analizirani su prema spolu, dobi, imunohistokemijskoj ekspresiji gena nm23, stadiju tumora po Dukesu, stupnju histoloÅ”ke diferenciranosti tumora, pojavi udaljenih metastaza i petogodiÅ”njem preživljenju. UtvrÄeno je da dobro diferencirani karcinomi pokazuju statistiÄki znaÄajnu prekomjernu ekspresiju gena nm23. Isto tako, naÄena je prekomjerna ekspresija gena nm23 u stadiju tumora Dukes A. Nije naÄena povezanost izmeÄu promjene ekspresije gena nm23 i pojave udaljenih metastaza ni petogodiÅ”njeg preživljenja. Promjena ekspresije gena nm23, prema rezultatima ovoga istraživanja, ne može se rabiti za predviÄanje pojave metastaza i procjenu petogodiÅ”njeg preživljenja, ali povezanost prekomjerne ekspresije gena nm23 s ranim kliniÄkim stadijem (Dukes A) i dobrom diferencijacijom tumora upuÄuje na moguÄnost zaÅ”titnog djelovanja gena nm23 u ranom procesu tumorigeneze
ZnaÄenje kvantitativnog scintigrama kosti u prognostici zaraÅ”tanja prijeloma
Studies of fracture healing are aimed at differentiating normal from delayed bone union. Delayed union, nonunion with the development of pseudarthrosis, and infection are complications of fracture healing. In the present study, quantitative analysis by three-phase bone scintigraphy was evaluated in the early prognosis of the course of fracture healing, to assess its potential in the early detection and therapy of healing complications. In 105 patients with long bone fractures, three-phase bone scintigraphy was performed early (day 4-7), and 3 weeks, 3 months and 6 months of injury. Based on clinical, laboratory and radiological findings, patients were retrospectively divided into four groups of normal healing, pseudarthrosis, delayed union, and healing with infection. The region of interest method was used to analyze all three scintigraphy phases, i.e. perfusion, vascular space image, and static scintigram at 3 h of injection. Comparison of impulse count in the fracture area with the contralateral, intact side produced a relative index for each step of three-phase scintigraphy. Infection at the fracture site can be suspected on the basis of perfusion index in the earliest stages following injury. Delayed bone union can also be predicted very early, within three weeks of injury, by use of perfusion index. Quantitative analysis of the vascular space phase and late static scintigrams can contribute to the diagnosis of complications, however, only in later stages of disease, which in part limits their clinical relevance. Three-phase bone scintigraphy is a valuable study when expecting problems in the process of bone union.Ispitivanje zarastanja prijeloma ima za cilj razlikovanje normalnog od usporenog zarastanja kosti. Odloženo zarastanje, nezarastanje s razvojem pseudoartroze te infekcija komplikacije su zarastanja prijeloma. S ciljem Å”to ranijeg otkrivanja, a time i ranije terapije komplikacija, željeli smo ispitati moguÄnosti kvantitativne analize troetapne scintigrafije kosti u ranoj prognozi tijeka zarastanja prijeloma. U 105 ispitanika s prijelomima dugih kostiju uÄinjena je troetapna scintigrafija kosti neposredno nakon traume (4.-7. dan nakon traume), te 3 tjedna, 3 i 6 mjeseci nakon traume. Ispitanici su na osnovi kliniÄkih, laboratorijskih i radioloÅ”kih nalaza retrospektivno podijeljeni u Äetiri skupine: normalno zarastanje, pseudoartroza, odloženo zarastanje i zarastanje uz infekciju. Metodom regije interesa (ROI) analizirali smo sve tri faze scintigrama: perfuziju, snimku vaskularnih prostora, te statiÄki scintigram 3 sata nakon injiciranja. UsporeÄujuÄi broj impulsa podruÄja frakture s kontralateralnom, zdravom stranom dobili smo relativne indekse (RI) za svaku fazu troetapne scintigrafije. U najranijim stadijima nakon povrede moguÄe je, na temelju indeksa perfuzije, posumnjati na infekciju na mjestu frakture. Odloženo zarastanje takoÄer se može predskazati indeksom perfuzije vrlo rano, unutar tri tjedna od prijeloma. Kvantitativna analiza faze vaskularih prostora i kasnih statiÄkih scintigrama može doprinijeti dijagnostici komplikacija, ali u kasnim fazama bolesti, Å”to donekle umanjuje njihovo kliniÄko znaÄenje. Troetapna scintigrafija kosti vrijedna je pretraga u sluÄajevima kada se oÄekuju problemi zarastanja kosti