Atrioventrikularni blok srca trećeg stupnja u djece

Atrioventricular (AV) block is defined as a delay or interruption in the transmission of an impulse from the atria to the ventricles due to an anatomical or functional impairment in the conduction system. The conduction disturbance can be transient or permanent. In third degree AV block, also referred to as complete heart block, there is complete dissociation of the atrial and ventricular activity. Atrioventricular block is considered to be “congenital” when it occurs spontaneously in a fetus or young child. In children, the most common cause of permanent acquired complete AV block is surgery for congenital heart disease. Injury to fetal conduction tissues caused by transpla- cental exposure to maternal autoantibodies related to systemic lupus erythematosus or Sjogren’s syndrome is responsible for 60 to 90 percent of cases of congenital CHB overall1-3. As many as 40 percent of cases of congenital CHB do not present until later in childhood (mean age five to six years). Only rarely do these patients (5 percent) have proven autoimmune etiology. The increased risk of sudden death is associated with the onset of deep bradycardia or ventricular arrhythmia. A routine electrocardiogram is sufficient to diagnose the disease. A 15-year-old girl has been examined at the emergency pediatric outpatient clinic of the University Hospital Centre “Sestre Milosrdnice” for recurrent episodes of presyncope. Physical examination revealed no major devia- tions other than bradycardia. Her vital signs were within the reference range, with the exception of a pulse of about 44 beats per minute. The electrocardiogram showed atrioventricular dissociation consistent with third degree atrioventricular block. The echocardiogram showed a structurally normal heart except for sinus bradycardia. The girl underwent permanent epicardial pacemaker implantation after which there were no symptoms.Atrioventrikularni (AV) blok je definiran kao kašnjenje ili prekid u prijenosu impulsa iz atrija u ven- trikule zbog anatomskih ili funkcionalnih oštećenja u provodnom sustavu srca. Poremećaj provodl- jivosti može biti prolazan ili trajan. U AV bloku trećeg stupnja, koji se još naziva i kompletni srčani blok, dolazi do potpune disocijacije atrijske i ventrikularne aktivnosti. Atrioventrikularni blok se smatra “kongenitalnim” kada se pojavljuje spontano kod fetusa ili malog djeteta. Stečeni permanent- ni kompletni AV blok kod djece najčešće je posljedica kirurške korekcije prirođenih srčanih grešaka. Ozljeda fetalnog provodnog srčanog tkiva uzrokovana transplacentarnom izloženošću majčinim autoantitijelama povezanim sa sistemskim eritematoznim lupusom ili Sjogrenovim sindromom odgovorna je za 60 do 90 posto slučajeva kongenitalnog srčanog bloka1-3. Čak 40 posto slučajeva kongenitalnog srčanog bloka se javlja kasnije u djetinjstvu (prosječna dob od pet do šest godina). Od navedenih samo rijetki pacijenti (5 posto) imaju dokazanu autoimunu etiologiju. Povećan rizik iznenadne smrti se veže uz nastup duboke bradikardije ili ventrikulske aritmije. Za dijagnozu bolesti je dovoljan rutinski elektrokardiogram. Djevojčica od 15 godina je pregledana u hitnoj pedijatrijskoj ambulanti kliničkog bolničkog centra “Sestre Milosrdnice”, zbog ponavljajućih epizoda presinkopa. Tjelesnim pregledom se nije utvrdilo većih odstupanja, osim bradikardije. Njeni vitalni znakovi su bili unutar referentnog raspona, s izuzetkom pulsa koji je iznosio oko 44 otkucaja u minuti. Elektro- kardiogram je pokazao atrioventrikularnu disocijaciju u skladu s atrioventrikularnim blokom trećeg stupnja. Ehokardiogram je izuzev sinusne bradikardije pokazao strukturno normalno srce. Djevojka je podvrgnuta ugradnji trajnog epikardijalnog pacmakera nakon čega više nije imala simptoma i tegoba u budućnosti

Burden of non-communicable diseases among adolescents aged 10–24 years in the EU, 1990–2019: a systematic analysis of the Global Burden of Diseases Study 2019

Background Disability and mortality burden of non-communicable diseases (NCDs) have risen worldwide; however, the NCD burden among adolescents remains poorly described in the EU. Methods Estimates were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Causes of NCDs were analysed at three different levels of the GBD 2019 hierarchy, for which mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) were extracted. Estimates, with the 95% uncertainty intervals (UI), were retrieved for EU Member States from 1990 to 2019, three age subgroups (10–14 years, 15–19 years, and 20–24 years), and by sex. Spearman's correlation was conducted between DALY rates for NCDs and the Socio-demographic Index (SDI) of each EU Member State. Findings In 2019, NCDs accounted for 86·4% (95% uncertainty interval 83·5–88·8) of all YLDs and 38·8% (37·4–39·8) of total deaths in adolescents aged 10–24 years. For NCDs in this age group, neoplasms were the leading causes of both mortality (4·01 [95% uncertainty interval 3·62–4·25] per 100 000 population) and YLLs (281·78 [254·25–298·92] per 100 000 population), whereas mental disorders were the leading cause for YLDs (2039·36 [1432·56–2773·47] per 100 000 population) and DALYs (2040·59 [1433·96–2774·62] per 100 000 population) in all EU Member States, and in all studied age groups. In 2019, among adolescents aged 10–24 years, males had a higher mortality rate per 100 000 population due to NCDs than females (11·66 [11·04–12·28] vs 7·89 [7·53–8·23]), whereas females presented a higher DALY rate per 100 000 population due to NCDs (8003·25 [5812·78–10 701·59] vs 6083·91 [4576·63–7857·92]). From 1990 to 2019, mortality rate due to NCDs in adolescents aged 10–24 years substantially decreased (–40·41% [–43·00 to –37·61), and also the YLL rate considerably decreased (–40·56% [–43·16 to –37·74]), except for mental disorders (which increased by 32·18% [1·67 to 66·49]), whereas the YLD rate increased slightly (1·44% [0·09 to 2·79]). Positive correlations were observed between DALY rates and SDIs for substance use disorders (rs=0·58, p=0·0012) and skin and subcutaneous diseases (rs=0·45, p=0·017), whereas negative correlations were found between DALY rates and SDIs for cardiovascular diseases (rs=–0·46, p=0·015), neoplasms (rs=–0·57, p=0·0015), and sense organ diseases (rs=–0·61, p=0·0005)

Parabolic trough collector dynamics

Ovaj izvještaj opisuje stvaranje, verifikaciju i primjenu modela prijenosa topline koji je implementiran u softverskom paketu Simulink. Model procjenjuje performanse linearnog prijemnika u paraboličnom kolektoru za solarnu energiju. Izvještaj obuhvaća uključivanje jednadžbi prijenosa topline, termodinamičkih jednadžbi, optičkih svojstava i relevantnih parametara unutar modela. Također, obrađuje pretpostavke i ograničenja modela, kao i specifično ponašanje koje model pokazuje. U okviru modela, analiziran je utjecaj masenog protoka radnog medija kroz linearni prijemnik na njegovu temperaturu. Izvedena je simulacija puštanja u pogon tijekom jutarnjih sati kako bi se prikazalo vrijeme potrebno za zagrijavanje radnog medija na optimalnu temperaturu. Također, istražen je utjecaj naoblake na rad solarnog polja.This report presents the creation, verification, and application of a heat transfer model incorporated within Simulink. The model assesses the performance of a linear receiver in a parabolic trough solar collector. The report covers the inclusion of heat transfer equations, thermodynamic equations, optical properties, and relevant parameters within the model. Additionally, it addresses the assumptions and limitations of the model, as well as specific behaviors exhibited by the model. Within the model, the impact of the mass flow rate of the working fluid through the linear receiver on its temperature was analyzed. A simulation of the start-up during the morning hours was conducted to illustrate the time required to heat the working fluid to the optimal temperature. Additionally, the influence of cloud cover on the performance of the solar field was investigated

Parabolic trough collector dynamics

Ovaj izvještaj opisuje stvaranje, verifikaciju i primjenu modela prijenosa topline koji je implementiran u softverskom paketu Simulink. Model procjenjuje performanse linearnog prijemnika u paraboličnom kolektoru za solarnu energiju. Izvještaj obuhvaća uključivanje jednadžbi prijenosa topline, termodinamičkih jednadžbi, optičkih svojstava i relevantnih parametara unutar modela. Također, obrađuje pretpostavke i ograničenja modela, kao i specifično ponašanje koje model pokazuje. U okviru modela, analiziran je utjecaj masenog protoka radnog medija kroz linearni prijemnik na njegovu temperaturu. Izvedena je simulacija puštanja u pogon tijekom jutarnjih sati kako bi se prikazalo vrijeme potrebno za zagrijavanje radnog medija na optimalnu temperaturu. Također, istražen je utjecaj naoblake na rad solarnog polja.This report presents the creation, verification, and application of a heat transfer model incorporated within Simulink. The model assesses the performance of a linear receiver in a parabolic trough solar collector. The report covers the inclusion of heat transfer equations, thermodynamic equations, optical properties, and relevant parameters within the model. Additionally, it addresses the assumptions and limitations of the model, as well as specific behaviors exhibited by the model. Within the model, the impact of the mass flow rate of the working fluid through the linear receiver on its temperature was analyzed. A simulation of the start-up during the morning hours was conducted to illustrate the time required to heat the working fluid to the optimal temperature. Additionally, the influence of cloud cover on the performance of the solar field was investigated

Parabolic trough collector dynamics

Ovaj izvještaj opisuje stvaranje, verifikaciju i primjenu modela prijenosa topline koji je implementiran u softverskom paketu Simulink. Model procjenjuje performanse linearnog prijemnika u paraboličnom kolektoru za solarnu energiju. Izvještaj obuhvaća uključivanje jednadžbi prijenosa topline, termodinamičkih jednadžbi, optičkih svojstava i relevantnih parametara unutar modela. Također, obrađuje pretpostavke i ograničenja modela, kao i specifično ponašanje koje model pokazuje. U okviru modela, analiziran je utjecaj masenog protoka radnog medija kroz linearni prijemnik na njegovu temperaturu. Izvedena je simulacija puštanja u pogon tijekom jutarnjih sati kako bi se prikazalo vrijeme potrebno za zagrijavanje radnog medija na optimalnu temperaturu. Također, istražen je utjecaj naoblake na rad solarnog polja.This report presents the creation, verification, and application of a heat transfer model incorporated within Simulink. The model assesses the performance of a linear receiver in a parabolic trough solar collector. The report covers the inclusion of heat transfer equations, thermodynamic equations, optical properties, and relevant parameters within the model. Additionally, it addresses the assumptions and limitations of the model, as well as specific behaviors exhibited by the model. Within the model, the impact of the mass flow rate of the working fluid through the linear receiver on its temperature was analyzed. A simulation of the start-up during the morning hours was conducted to illustrate the time required to heat the working fluid to the optimal temperature. Additionally, the influence of cloud cover on the performance of the solar field was investigated

Acceptance and use of health information technology in Slovenian public health institutions

Izhodišča: Namen raziskave je bil oceniti sprejemanje in uporabo informacijske tehnologije (IT) med različnimi profili strokovnega osebja, zaposlenega v slovenskih javnih zdravstvenih ustanovah. Kljub dolgoletnemu procesu informatizacije slovenskega zdravstva taka raziskava, kolikor vemo, na nacionalni ravni še ni bila izvedena. Metode: Na podlagi metodologije Unified Theory of Acceptance and Use of Technology (UTAUT) smo sestavili anketni vprašalnik s 37 zaprtimi vprašanji. Na vprašanja so odgovarjali strokovni delavci, zaposleni v javnih zdravstvenih ustanovah v Sloveniji. K sodelovanju smo povabili 100 zdravstvenih ustanov. Z odgovori se jih je odzvalo 52. Prejeli smo 1575 veljavno rešenih vprašalnikov. Rezultate smo statistično analizirali na podlagi opisne statistike in logistične regresije. Mejo signifikantnosti smo postavili pri vrednosti p< 0,05. Rezultati: Ugotovili smo visoko stopnjo upora- be in pripravljenosti za uporabo IT med vsemi profili anketirancev. Kar 77 % jih računalniški sistem pri delu uporablja večkrat na dan. Naj- višja stopnja povezanosti s pogosto uporabo IT imajo večletne izkušnje z uporabo IT pri delu (p < 0,001). Anketiranci so visoko ocenili koristnost uporabe IT (4,50 od 5) in lastno znanje uporabe IT (4,28). Nekoliko manj so zadovoljni z delovanjem računalniških sistemov in dosegljivostjo tehnološke pomoči v primeru težav (oboje 3,57). Zaključki: Rezultati pričajo o splošni naklonjenosti IT med slovenskimi zdravstvenimi delavci in pogostosti uporabe. Rezultati so toliko bolj relevantni zato, ker je raziskava uspela zajeti vse profile zdravstvenih delavcev v vseh vrstah usta- nov po vsej Sloveniji.Introduction: The purpose of this study was to assess the use and acceptance of information technology (IT) in Slovenian public healthcare institutions. To our knowledge, this is the first national survey to estimate the willingness of employees to welcome new technology into their work routine. Methods: The survey was based on the Unified Theory of Acceptance and Use of Technology (UTAUT) methodology, according to which we designed a questionnaire. It consisted of 37 closed-ended questions and participants were asked to choose the single best answer to each. Out of one hundred public healthcare institutions across the country, 52 replied. We received 1,575 validly completed questionnaires. The results were statistically analyzed using descriptive statistics and logistic regression. Statistically significant value of p was set at < 0.05. Results: The data revealed a high degree of acceptance and use of IT among healthcare professionals. Health IT use showed the highest degree of coincidence with previous IT experience (p< 0.001). Respondents graded highly the usefulness of IT (4.50 of 5) and their own IT skills (4.28). They were slightly less content with the performance of their workplace IT and the avail- ability of technical help in case of difficulty (both 3.57). Conclusions: The results show a positive attitude toward IT among Slovenian healthcare professionals. These findings are especially relevant in view of the fact that all types of healthcare professionals from all kinds of public healthcare institutions across the country were included in the survey