Factores de riesgo de la flebitis: un estudio con cuestionario de la percepción de las enfermeiras

Objetivos:avaliar a percepção de enfermeiros sobre os fatores de risco para desenvolvimento de flebite, com enfoque especial na percepção sobre os potenciais causadores de flebite de alguns medicamentos e soluções.Método:estudo transversal com questionário, que incluiu uma amostra de 102 enfermeiros.Resultados:os enfermeiros reconheceram alguns fatores que podem reduzir a incidência de flebite; no entanto, mais da metade dos enfermeiros ignorava que o material e o diâmetro do cateter poderiam afectar a taxa de incidência de flebite. Além disso, a doença de base e alto pH dos medicamentos ou soluções foram identificados como potenciais fatores de risco, porém o pH baixo e baixa osmolaridade não foram identificados. Os enfermeiros identificaram a Vancomicina e Benzilpenicilina como os antibióticos com o mais forte potencial flebitico. Entre outros medicamentos e fluidos intravenosos, foram identificados aminofilina, cloridrato de amiodarona e cloreto de potássio 7,4% como potencialmente causadores de flebite.Conclusão:os enfermeiros identificaram fatores predisponentes para flebite relacionados aos pacientes e à terapia administrada, enquanto alguns fatores de risco relacionados ao cateter, particularmente, suas propriedades físico-químicas e tempo para a substituição, não foram totalmente percebidos.Objetivo:evaluar cómo perciben las enfermeras los factores de riesgo en el desarrollo de la flebitis, con atención especial a la percepción del potencial flebítico de algunos medicamentos y soluciones intravenosas.Método:un cuestionario transversal en el que se incluyó una población muestra de 102 enfermeras.Resultados:las enfermeras reconocieron algunos de los factores que pueden reducir la incidencia de la flebitis; sin embargo, más de la mitad de las enfermeras obviaron el hecho de que el material y el diámetro de la cánula pueden influir en la tasa de incidencia. De igual manera, las enfermedades subyacentes y el pH alto de los medicamentos y soluciones se identificaron como factores de riesgo potenciales, al contrario de un pH bajo y una baja osmolalidad. Las enfermeras identificaron que los antibióticos como la vancomicina y la bencilpenicilina tenían el mayor potencial flebítico. La aminofilina, el clorhidrato de amiodarona y el cloruro de potasio 7.4%, entre otros medicamentos y líquidos intravenosos, se identificaron como posibles causantes de la flebitis.Conclusión:Las enfermeras identificaron los factores de predisposición para la flebitis con relación a los pacientes y con las terapias administradas; mientras que algunos factores de riesgo relacionados con las cánulas no fueron apreciados en su totalidad, en particular aquellos relacionados a las propiedades fisicoquímicas y a los tiempos de remplazo de las cánulas.Objectives: to assess nurses' perceptions of risk factors for the development of phlebitis, with a special focus on the perception of phlebitic potentials of some infusion medications and solutions.Method: a cross-sectional questionnaire study, which included a sample of 102 nurses.Results: Nurses recognized some factors that may reduce the incidence of phlebitis; however, more than half of the nurses were unaware that the material and diameter of the cannula can affect the incidence rate of phlebitis. Furthermore,underlying disease and high pH of medications or solutions were identified as potential risk factors, whereas low pH and low osmolality were not. Nurses identified Vancomycin and Benzylpenicillin antibiotics with the strongest phlebitic potential. Among other medications and intravenous fluids, Aminophylline, Amiodaronehydrochloride and Potassium chloride 7.4% were identified as potentially causing phlebitis.Conclusion: predisposing factors for phlebitis relating to patients and administered therapy were identified by nurses, while some cannula related risk factors, in particular its physicochemical properties and the time for cannula replacement, were not fully perceived

Analysis of Brown Bear Damages in Croatia in the Period from 2004 until 2009

Jedan od najvažnijih elemenata modernog gospodarenja smeđim medvjedima je sukob između medvjeda i ljudi, a ekonomski gubitci su čimbenik koji najviše doprinosi negativnim stavovima javnosti prema smeđem medvjedu. U Hrvatskoj je populacija od oko 1 000 medvjeda gotovo dosegla biološki i socijalni kapacitet. Medvjed je u Hrvatskoj divljač, zaštićena lovo­stajem i odstrijelnim kvotama koje se propisuju godišnjim Akcijskim plano­vima. Plan gospodarenja smeđim medvjedom u Republici Hrvatskoj i Zakon o lovstvu reguliraju naknadu štete koju počini medvjed. Na područjima gdje je medvjed stalno prisutan i njime se gospodari, štetu nadoknađuje ovlaštenik prava lova, dok na područjima gdje nisu ustanovljena lovišta štetu nadokna­đuje osoba koja upravlja zemljištem. Cilj rada je prikazati i analizirati poda­tke o štetama koje je smeđi medvjed počinio u Hrvatskoj u prvih 6 godina (2004–2009) provođenja Plana gospodarenja smeđim medvjedom tj. prvih šest godina organiziranog prikupljanja takvih podataka. U tom razdoblju pri­javljeno je ukupno 227 slučajeva šteta (prosječno 37,8 slučaja godišnje), od čega većina (54,2 %) na poljoprivrednim kulturama. Prijavljeno je 23,8 % na­pada na domaće životinje, te 8,8 % slučajeva štete na pčelinjacima. Nije zabi­lježen niti jedan napad na čovjeka. Materijalna šteta koju smeđi medvjed počini u Hrvatskoj niska je glede veličine populacije od 1 000 grla.One of the most important elements of a modern brown bear management is human – bear conflict. Economic losses are one of the key factors influencing negative public attitudes towards brown bears. In Croatia a population of 1000 bears has almost reached its biological and social capa­city. Brown bear in Croatia is a game species, protected by a closed hunting season and hunting quotas defined by yearly Action plans. National Brown bear Management Plan and Hunting Act regulate compensation of damage caused by brown bears. In areas where bears are permanently present and hunted damage compensation is paid by hunting unit leaseholders, whereas in national parks, areas where bears are not hunted and in areas with only acci­dental presence of bears compensation is paid from the state budget. The goal of this paper was to present and analyze data about brown bear damages in Croatia during the first 6 years (2004–2009) of the Management Plan imple­mentation, in other words the first 6 years of organized data collection. Totally 227 damage cases have been reported in this period (on average 37.8 cases per year). Most of the damage has been done on agricultural goods (54.2%), attacks on domestic animals (23.8%) and apiaries (8.8%). During this period attacks on humans have not been registered. Considering the population size of 1000 animals, brown bears cause low material damage in Croatia

Epicardial Fat Tissue and Coronary Artery Disease

Epikardijalno masno tkivo (EMT) ekstraabdominalno je visceralno masno tkivo smješteno između miokarda i visceralnog lista perikarda s kojima je embriološki, anatomski i funkcionalno povezano. Debljina epikardijalnoga masnog tkiva danas je prepoznata kao nezavisni rizični čimbenik koronarne bolesti srca (KBS), o čemu svjedoči sve veći broj kliničkih studija. Povećani volumen epikardijalnoga masnog tkiva povezan je s kroničnom upalom i povećanim lučenjem proupalnih citokina koji pogoduju i promoviraju proces aterogeneze. Standardiziranim postupkom ultrazvučnog mjerenja debljine epikardijalnoga masnog tkiva lateralnog zida desnog ventrikula može se s velikom sigurnošću predvidjeti postojanje KBS-a, a uz pomoć kompjutorizirane tomografije ili magnetske rezonancije predvidjeti i rizik od mogućega koronarnog događaja. Povezanost debljine i upale epikardijalnoga masnog tkiva s KBS-om nameće ideju o potencijalnim terapijskim intervencijama radi usporavanja procesa aterogeneze.Epicardial fat tissue is extraabdominal visceral fat tissue located between the myocardial muscle and the visceral pericard and connected to it embryonally and functionally. A large number of clinical studies support the claim that the epicardial adipose tissue thickness is an independent risk factor for coronary disease. The enlarged volume of the epicardial fat tissue is connected to chronical inflammation and strong production of anti inflammatory cytokines which entice the atherogenesis. Coronary disease can be predicted by standard measurement of the epicardial fat thickness of the right ventricle lateral wall. Thus it is possible to predict the risk of a coronary incident by conducting a CT or MR scan. The correlation between epicardial fat thickness and inflammation of the fat tissue suggests the possibility of potential therapeutical interventions with the aim to delay aterogenesis

INFLUENCE OF DIETARY PATTERN AND METHYLENTETRAHYDROFOLATE REDUCTASE C677T POLYMORPHISM ON THE PLASMA HOMOCYSTEINE LEVEL AMONG HEALTHY VEGETARIANS AND OMNIVORES

Povišena razina homocisteina u plazmi (Hcy) povezana je s fiziološkim i prehrambenim čimbenicima, kao i genetskim defektom enzima koji su uključeni u metabolizam Hcy. Ciljevi ove studije bili su (1) utvrditi razlike između zdravih vegetarijanca i omnivora u odnosu na biokemijske parametare, prevalenciju MTHFR genotipa i razinu Hcy, i (2) utvrditi učinke polimorfizma metilentetrahidrofolat reduktaze (MTHFR) C677T i načina prehrane na razinu Hcy u plazmi. U 47 vegetarijanaca i 53 omnivora izmjerena je razina Hcy, folata, vitamina B12, glukoze, ukupnog kolesterola, triglicerida, HDL i LDL kolesterola i kreatinina u plazmi. Polimorfizam MTHFR C677T analiziran je pomoću PCR-RFLP metode. Dobiveni rezultati su pokazali da su vegetarijanci imali niži vitamin B12, ukupni kolesterol, LDL-kolesterol i status kreatinina. Razina Hcy u plazmi bila je veća kod vegetarijanaca u usporedbi s omnivorima (14,10 ± 6,69 vs 10,49 ± 2,41 μmol/L) i negativno je korelirala sa statusom vitamina B12 i folatom. Razina plazme Hcy nije bila različita u odnosu na genotipove MTHFR C677T, ni među vegetarijancima ni omnivorima. Za razliku od MTHFR C677T polimorfizma, potvrđen je utjecaj načina prehrane na razinu Hcy u plazmi. Može se zaključiti da vegetarijanci obično imaju niži status vitamina B12 i višu razinu Hcy u plazmi. Polimorfizam MTHFR C677T nema utjecaja na razinu Hcy plazme, za razliku od prehrambenog uzorka koji ukazuje na važnost adekvatnog vitamina B12 i statusa folata u zaobilaženju mutacije.Elevated total plasma homocysteine level (Hcy) is associated with physiological and dietary factors as well as the genetic defect of enzymes involved in Hcy metabolism. The objectives of the study were to examine (1) differences between healthy vegetarian and omnivorous subjects in relation to biochemical parameters, prevalence of the MTHFR (methylentetrahydrofolate reductase) T/T genotype, and the plasma Hcy level, and (2) the effects of the MTHFR C677T polymorphism and dietary pattern on the plasma Hcy level. In 47 vegetarian and 53 omnivorous subjects the plasma level of Hcy, folate, vitamin B12, glucose, total cholesterol, triglycerides, HDL and LDL-cholesterol and creatinine were measured. MTHFR C677T polymorphisms were analyzed using the PCR-RFLP method. Obtained results have shown that vegetarians had lower vitamin B12, total cholesterol, LDLcholesterol and creatinine status. The plasma Hcy level was higher among vegetarians compared with omnivore subjects (14.10±6.69 vs. 10.49±2.41 μmol/L) and negatively correlated with vitamin B12 status and folate. The plasma Hcy level did not differ between the given MTHFR C677T genotypes among either vegetarians or omnivores. Unlike the MTHFR C677T polymorphism, the effect of dietary pattern on plasma Hcy level was confirmed. It could be concluded that vegetarians tend to have lower vitamin B12 status and a higher plasma Hcy level. The MTHFR 677C/T polymorphism has no effect on plasma Hcy level, in contrast to dietary pattern which indicates the importance of adequate vitamin B12 and folate status in bypassing the mutation

INFLUENCE OF DIETARY PATTERN AND METHYLENTETRAHYDROFOLATE REDUCTASE C677T POLYMORPHISM ON THE PLASMA HOMOCYSTEINE LEVEL AMONG HEALTHY VEGETARIANS AND OMNIVORES

Povišena razina homocisteina u plazmi (Hcy) povezana je s fiziološkim i prehrambenim čimbenicima, kao i genetskim defektom enzima koji su uključeni u metabolizam Hcy. Ciljevi ove studije bili su (1) utvrditi razlike između zdravih vegetarijanca i omnivora u odnosu na biokemijske parametare, prevalenciju MTHFR genotipa i razinu Hcy, i (2) utvrditi učinke polimorfizma metilentetrahidrofolat reduktaze (MTHFR) C677T i načina prehrane na razinu Hcy u plazmi. U 47 vegetarijanaca i 53 omnivora izmjerena je razina Hcy, folata, vitamina B12, glukoze, ukupnog kolesterola, triglicerida, HDL i LDL kolesterola i kreatinina u plazmi. Polimorfizam MTHFR C677T analiziran je pomoću PCR-RFLP metode. Dobiveni rezultati su pokazali da su vegetarijanci imali niži vitamin B12, ukupni kolesterol, LDL-kolesterol i status kreatinina. Razina Hcy u plazmi bila je veća kod vegetarijanaca u usporedbi s omnivorima (14,10 ± 6,69 vs 10,49 ± 2,41 μmol/L) i negativno je korelirala sa statusom vitamina B12 i folatom. Razina plazme Hcy nije bila različita u odnosu na genotipove MTHFR C677T, ni među vegetarijancima ni omnivorima. Za razliku od MTHFR C677T polimorfizma, potvrđen je utjecaj načina prehrane na razinu Hcy u plazmi. Može se zaključiti da vegetarijanci obično imaju niži status vitamina B12 i višu razinu Hcy u plazmi. Polimorfizam MTHFR C677T nema utjecaja na razinu Hcy plazme, za razliku od prehrambenog uzorka koji ukazuje na važnost adekvatnog vitamina B12 i statusa folata u zaobilaženju mutacije.Elevated total plasma homocysteine level (Hcy) is associated with physiological and dietary factors as well as the genetic defect of enzymes involved in Hcy metabolism. The objectives of the study were to examine (1) differences between healthy vegetarian and omnivorous subjects in relation to biochemical parameters, prevalence of the MTHFR (methylentetrahydrofolate reductase) T/T genotype, and the plasma Hcy level, and (2) the effects of the MTHFR C677T polymorphism and dietary pattern on the plasma Hcy level. In 47 vegetarian and 53 omnivorous subjects the plasma level of Hcy, folate, vitamin B12, glucose, total cholesterol, triglycerides, HDL and LDL-cholesterol and creatinine were measured. MTHFR C677T polymorphisms were analyzed using the PCR-RFLP method. Obtained results have shown that vegetarians had lower vitamin B12, total cholesterol, LDLcholesterol and creatinine status. The plasma Hcy level was higher among vegetarians compared with omnivore subjects (14.10±6.69 vs. 10.49±2.41 μmol/L) and negatively correlated with vitamin B12 status and folate. The plasma Hcy level did not differ between the given MTHFR C677T genotypes among either vegetarians or omnivores. Unlike the MTHFR C677T polymorphism, the effect of dietary pattern on plasma Hcy level was confirmed. It could be concluded that vegetarians tend to have lower vitamin B12 status and a higher plasma Hcy level. The MTHFR 677C/T polymorphism has no effect on plasma Hcy level, in contrast to dietary pattern which indicates the importance of adequate vitamin B12 and folate status in bypassing the mutation

INFLUENCE OF DIETARY PATTERN AND METHYLENTETRAHYDROFOLATE REDUCTASE C677T POLYMORPHISM ON THE PLASMA HOMOCYSTEINE LEVEL AMONG HEALTHY VEGETARIANS AND OMNIVORES

Povišena razina homocisteina u plazmi (Hcy) povezana je s fiziološkim i prehrambenim čimbenicima, kao i genetskim defektom enzima koji su uključeni u metabolizam Hcy. Ciljevi ove studije bili su (1) utvrditi razlike između zdravih vegetarijanca i omnivora u odnosu na biokemijske parametare, prevalenciju MTHFR genotipa i razinu Hcy, i (2) utvrditi učinke polimorfizma metilentetrahidrofolat reduktaze (MTHFR) C677T i načina prehrane na razinu Hcy u plazmi. U 47 vegetarijanaca i 53 omnivora izmjerena je razina Hcy, folata, vitamina B12, glukoze, ukupnog kolesterola, triglicerida, HDL i LDL kolesterola i kreatinina u plazmi. Polimorfizam MTHFR C677T analiziran je pomoću PCR-RFLP metode. Dobiveni rezultati su pokazali da su vegetarijanci imali niži vitamin B12, ukupni kolesterol, LDL-kolesterol i status kreatinina. Razina Hcy u plazmi bila je veća kod vegetarijanaca u usporedbi s omnivorima (14,10 ± 6,69 vs 10,49 ± 2,41 μmol/L) i negativno je korelirala sa statusom vitamina B12 i folatom. Razina plazme Hcy nije bila različita u odnosu na genotipove MTHFR C677T, ni među vegetarijancima ni omnivorima. Za razliku od MTHFR C677T polimorfizma, potvrđen je utjecaj načina prehrane na razinu Hcy u plazmi. Može se zaključiti da vegetarijanci obično imaju niži status vitamina B12 i višu razinu Hcy u plazmi. Polimorfizam MTHFR C677T nema utjecaja na razinu Hcy plazme, za razliku od prehrambenog uzorka koji ukazuje na važnost adekvatnog vitamina B12 i statusa folata u zaobilaženju mutacije.Elevated total plasma homocysteine level (Hcy) is associated with physiological and dietary factors as well as the genetic defect of enzymes involved in Hcy metabolism. The objectives of the study were to examine (1) differences between healthy vegetarian and omnivorous subjects in relation to biochemical parameters, prevalence of the MTHFR (methylentetrahydrofolate reductase) T/T genotype, and the plasma Hcy level, and (2) the effects of the MTHFR C677T polymorphism and dietary pattern on the plasma Hcy level. In 47 vegetarian and 53 omnivorous subjects the plasma level of Hcy, folate, vitamin B12, glucose, total cholesterol, triglycerides, HDL and LDL-cholesterol and creatinine were measured. MTHFR C677T polymorphisms were analyzed using the PCR-RFLP method. Obtained results have shown that vegetarians had lower vitamin B12, total cholesterol, LDLcholesterol and creatinine status. The plasma Hcy level was higher among vegetarians compared with omnivore subjects (14.10±6.69 vs. 10.49±2.41 μmol/L) and negatively correlated with vitamin B12 status and folate. The plasma Hcy level did not differ between the given MTHFR C677T genotypes among either vegetarians or omnivores. Unlike the MTHFR C677T polymorphism, the effect of dietary pattern on plasma Hcy level was confirmed. It could be concluded that vegetarians tend to have lower vitamin B12 status and a higher plasma Hcy level. The MTHFR 677C/T polymorphism has no effect on plasma Hcy level, in contrast to dietary pattern which indicates the importance of adequate vitamin B12 and folate status in bypassing the mutation

Risk factor for phlebitis: a questionnaire study of nurses' perception

AbstractObjectives: to assess nurses' perceptions of risk factors for the development of phlebitis, with a special focus on the perception of phlebitic potentials of some infusion medications and solutions.Method: a cross-sectional questionnaire study, which included a sample of 102 nurses.Results: Nurses recognized some factors that may reduce the incidence of phlebitis; however, more than half of the nurses were unaware that the material and diameter of the cannula can affect the incidence rate of phlebitis. Furthermore,underlying disease and high pH of medications or solutions were identified as potential risk factors, whereas low pH and low osmolality were not. Nurses identified Vancomycin and Benzylpenicillin antibiotics with the strongest phlebitic potential. Among other medications and intravenous fluids, Aminophylline, Amiodaronehydrochloride and Potassium chloride 7.4% were identified as potentially causing phlebitis.Conclusion: predisposing factors for phlebitis relating to patients and administered therapy were identified by nurses, while some cannula related risk factors, in particular its physicochemical properties and the time for cannula replacement, were not fully perceived

Epicardial Fat Tissue and Coronary Artery Disease

Epikardijalno masno tkivo (EMT) ekstraabdominalno je visceralno masno tkivo smješteno između miokarda i visceralnog lista perikarda s kojima je embriološki, anatomski i funkcionalno povezano. Debljina epikardijalnoga masnog tkiva danas je prepoznata kao nezavisni rizični čimbenik koronarne bolesti srca (KBS), o čemu svjedoči sve veći broj kliničkih studija. Povećani volumen epikardijalnoga masnog tkiva povezan je s kroničnom upalom i povećanim lučenjem proupalnih citokina koji pogoduju i promoviraju proces aterogeneze. Standardiziranim postupkom ultrazvučnog mjerenja debljine epikardijalnoga masnog tkiva lateralnog zida desnog ventrikula može se s velikom sigurnošću predvidjeti postojanje KBS-a, a uz pomoć kompjutorizirane tomografije ili magnetske rezonancije predvidjeti i rizik od mogućega koronarnog događaja. Povezanost debljine i upale epikardijalnoga masnog tkiva s KBS-om nameće ideju o potencijalnim terapijskim intervencijama radi usporavanja procesa aterogeneze.Epicardial fat tissue is extraabdominal visceral fat tissue located between the myocardial muscle and the visceral pericard and connected to it embryonally and functionally. A large number of clinical studies support the claim that the epicardial adipose tissue thickness is an independent risk factor for coronary disease. The enlarged volume of the epicardial fat tissue is connected to chronical inflammation and strong production of anti inflammatory cytokines which entice the atherogenesis. Coronary disease can be predicted by standard measurement of the epicardial fat thickness of the right ventricle lateral wall. Thus it is possible to predict the risk of a coronary incident by conducting a CT or MR scan. The correlation between epicardial fat thickness and inflammation of the fat tissue suggests the possibility of potential therapeutical interventions with the aim to delay aterogenesis