Hernioplasty in one-day surgery

Hernija označava izbočenje sadržaja kroz prirođeni ili stečeni defekt. Najučestalije su ingvinalne hernije. Zbrinjavaju se kirurški, na dva temeljna načina; herniorafijom ili hernioplastikom. Zahvati se izvode u sklopu višednevnog bolničkog programa ili u okviru jednodnevne kirurgije. Jednodnevna kirurgija označava pružanje kirurških postupaka bez potrebe za hospitalizacijom. Hernioplastike su jedna od najčešće izvođenih operacija u jednodnevnoj kirurgiji (30% do 80%). Ovaj diplomski rad analizira više kriterija predoperativnog odabira bolesnika, te uspoređuje njihovu sigurnost prema pojavi postoperativnih komplikacija. Obuhvaćeno je 590 bolesnika kojima je tijekom 2015. godine urađena hernioplastika na KBC-u Zagreb. Na Zavodu za jednodnevnu kirurgiju operirano je 226 bolesnika, dok je 354 bilo liječeno u okviru višednevnog bolničkog programa. Većina bolesnika dječje dobi (0-18), te starije dobi (>74), operirana je u bolničkim uvjetima. Bolesnici između 19-49 godina su dominantno operirani u jednodnevnoj kirurgiji. Bolesnici operirani u jednodnevnoj kirurgiji su najvećim djelom bili ASA I (53%), dok su bolnički operirani bolesnici većinom bili ASA II statusa (51.7%). Većina bolesnika s ASA III je zbrinjavana u bolničkom programu (20.7%). U skupini bolnički operiranih, najzastupljenija je bila opća anestezija (94.6%), a u skupini jednodnevne kirurgije lokalna anestezija (68%). Vrijeme čekanja do operacije je bilo kraće za bolesnike jednodnevne kirurgije (63% bolesnika je čekalo do 5 tjedana). Učestalost poslijeoperativne infekcije (2 %) i boli (8%) je bila vrlo niska u obje skupine, te nije postojala statistički značajna razlika između njih. Recidiv se s neznatnom razlikom nešto češće pojavljivao u skupini bolnički liječenih (8.7%). Hematomi i seromi pojavljivali su se po istom obrascu; vrlo rijetko (1-1.5 %) i bez razlika između skupina. Podjednako mali broj ranih komplikacija i recidiva govori kako su obje skupine liječene na siguran način, a izbor načina liječenja je bio primjeren.Hernia is a protrusion of an internal part of the body through the defect in the muscle or tissue wall. Inguinal hernias are the most common type. Treatment is surgical. There are two main methods; herrnioraphy and hernioplasty. Procedures can be done in inpatient or one-day surgery. One-day surgery is a surgery that does not require an overnight hospital stay. Hernia repairs are one of the most frequent procedures that are performed in one day-surgery (30% to 80%). The aim of this study was to evaluate the criteria for preoperative patient selection and compare safety in the manner of postoperative complications. Five hundred and ninety patients who underwent surgical repair of inguinal hernia at the University Hospital Centre Zagreb in 2015 were analyzed. 226 of them were treated at the Department of One-day Surgery, and 354 were treated at the main Surgical Department. Most patients of child age (0-18), as well as elderly patients (>74) were treated at Surgical Department. Patients between 19 and 49 years were dominantly managed at the Department of One-day Surgery. Hospitalized patients were mainly ASA II (51.7%), while one-day surgery patients were ASA I (53%). The ones with ASA III were mostly treated at main Surgical Department (20.7%). The greatest number of patients at the Surgical Department underwent surgery under general anesthesia (94.6%). In contrast, patients from one-day surgery underwent surgery mostly under local anesthesia (68%). The percentage of patients with postoperative wound infection was 2 %, and the incidence of postoperative pain was 8 %. The results didn’t statistically differ between the groups. The recurrence rate was slightly higher in the inpatient group (8.7%). Hematomas and seromas had the same incidence pattern; they were rarely present and without differences between groups. The inguinal hernia repair was associated with low postoperative complications and low recurrence rate. Therefore it is considered that both groups were treated in a safe manner and patient selection was adequate

The ground-state energy of helium and spin-polarised hydrogen clusters

U ovom radu proučava se metodama kvantnog Monte Carla osnovno stanje kvantnih klastera helija i spin-polariziranog vodika te tekućina spin-polariziranog tricija (T↓). Određene su energije osnovnog stanja i struktura malih miješanih klastera helija koji su građeni maksimalno od osam atoma. Predviđeno je postojanje klastera 3He4 4He3, čije postojanje nije prethodnim teorijskim istraživanjima utvrđeno. Potvrđeno je da trimer (T↓)3 predstavlja primjer Borromeanovljeva stanja. Izračunate su energije osnovnog stanja čistih klastera T↓ koji su građeni maksimalno od 320 atoma. Utvrđene su granice stabilnosti malih miješanih klastera (T↓)n(D↓)m, za m ≥ 2 i n + m ≤ 10. Posebno je pokazano da klasteri (T↓)ND↓ tvore stabilne sustave, za N ≥ 3. Također je utvrđeno da ni 60 atoma T↓ nije dovoljno za formiranje stabilnog klastera (T↓)60H↓. Iz rezultata dobivenih simuliranjem tekućine T↓ određena je jednadžba stanja, spinodalna gustoća, energija po čestici pri ravnotežnoj gustoći, jedinični radijus i površina T↓ tekućine.The ground-state of the helium and spin-polarized hydrogen quantum clusters is investigated in this work using Quantum Monte Carlo methods, as well as the spin-polarized tritium (T↓) liquid. For small mixed helium clusters consisting of up to eight helium atoms the ground-state energy and structure have been obtained. Stability of the 3He4 4He3 cluster, which was previously considered unstable, is predicted. It is confirmed that tritium trimer (T↓)3 is an example of Borromean state. For pure large spin-polarized tritium clusters consisting of up to 320 atoms the ground-state energy is obtained. Stability limits have been investigated for small mixed (T↓)n(D↓)m clusters, for m ≥ 2 i n + m ≤ 10. Especially, it has been shown that all clusters (T↓)ND↓ are stable for N ≥ 3. It is also shown that even 60 T↓ atoms are not enough to form stable cluster (T↓)60H↓. Equation of state, spinodal density, energy per particle at the equilibrium density, unit radius and surface tension of the T↓ liquid have been determined using results obtained in the simulations of liquid phase

Insolvency prediction model of the company: the case of the Republic of Serbia

In this article, the authors analyse the existing foreign insolvency prediction models of the company and on the basis of the sample of solvent and insolvent companies they aim to develop a new model to predict insolvency of a company by binomial logistic regression (LR), which will be suitable for the business environment in the Republic of Serbia. The research seeks to determine statistically most important financial ratios in predicting insolvency of Serbian companies. As a result of research, a model for the prediction of bankruptcy was created, which accurately classifies 82.9% of solvent (‘healthy’) Serbian companies and 93.3% of Serbian companies which have undergone bankruptcy proceedings (Serbian insolvent companies), while the average (total) accuracy of the prediction model is 88.4% of the cases

Hernioplasty in one-day surgery

Hernija označava izbočenje sadržaja kroz prirođeni ili stečeni defekt. Najučestalije su ingvinalne hernije. Zbrinjavaju se kirurški, na dva temeljna načina; herniorafijom ili hernioplastikom. Zahvati se izvode u sklopu višednevnog bolničkog programa ili u okviru jednodnevne kirurgije. Jednodnevna kirurgija označava pružanje kirurških postupaka bez potrebe za hospitalizacijom. Hernioplastike su jedna od najčešće izvođenih operacija u jednodnevnoj kirurgiji (30% do 80%). Ovaj diplomski rad analizira više kriterija predoperativnog odabira bolesnika, te uspoređuje njihovu sigurnost prema pojavi postoperativnih komplikacija. Obuhvaćeno je 590 bolesnika kojima je tijekom 2015. godine urađena hernioplastika na KBC-u Zagreb. Na Zavodu za jednodnevnu kirurgiju operirano je 226 bolesnika, dok je 354 bilo liječeno u okviru višednevnog bolničkog programa. Većina bolesnika dječje dobi (0-18), te starije dobi (>74), operirana je u bolničkim uvjetima. Bolesnici između 19-49 godina su dominantno operirani u jednodnevnoj kirurgiji. Bolesnici operirani u jednodnevnoj kirurgiji su najvećim djelom bili ASA I (53%), dok su bolnički operirani bolesnici većinom bili ASA II statusa (51.7%). Većina bolesnika s ASA III je zbrinjavana u bolničkom programu (20.7%). U skupini bolnički operiranih, najzastupljenija je bila opća anestezija (94.6%), a u skupini jednodnevne kirurgije lokalna anestezija (68%). Vrijeme čekanja do operacije je bilo kraće za bolesnike jednodnevne kirurgije (63% bolesnika je čekalo do 5 tjedana). Učestalost poslijeoperativne infekcije (2 %) i boli (8%) je bila vrlo niska u obje skupine, te nije postojala statistički značajna razlika između njih. Recidiv se s neznatnom razlikom nešto češće pojavljivao u skupini bolnički liječenih (8.7%). Hematomi i seromi pojavljivali su se po istom obrascu; vrlo rijetko (1-1.5 %) i bez razlika između skupina. Podjednako mali broj ranih komplikacija i recidiva govori kako su obje skupine liječene na siguran način, a izbor načina liječenja je bio primjeren.Hernia is a protrusion of an internal part of the body through the defect in the muscle or tissue wall. Inguinal hernias are the most common type. Treatment is surgical. There are two main methods; herrnioraphy and hernioplasty. Procedures can be done in inpatient or one-day surgery. One-day surgery is a surgery that does not require an overnight hospital stay. Hernia repairs are one of the most frequent procedures that are performed in one day-surgery (30% to 80%). The aim of this study was to evaluate the criteria for preoperative patient selection and compare safety in the manner of postoperative complications. Five hundred and ninety patients who underwent surgical repair of inguinal hernia at the University Hospital Centre Zagreb in 2015 were analyzed. 226 of them were treated at the Department of One-day Surgery, and 354 were treated at the main Surgical Department. Most patients of child age (0-18), as well as elderly patients (>74) were treated at Surgical Department. Patients between 19 and 49 years were dominantly managed at the Department of One-day Surgery. Hospitalized patients were mainly ASA II (51.7%), while one-day surgery patients were ASA I (53%). The ones with ASA III were mostly treated at main Surgical Department (20.7%). The greatest number of patients at the Surgical Department underwent surgery under general anesthesia (94.6%). In contrast, patients from one-day surgery underwent surgery mostly under local anesthesia (68%). The percentage of patients with postoperative wound infection was 2 %, and the incidence of postoperative pain was 8 %. The results didn’t statistically differ between the groups. The recurrence rate was slightly higher in the inpatient group (8.7%). Hematomas and seromas had the same incidence pattern; they were rarely present and without differences between groups. The inguinal hernia repair was associated with low postoperative complications and low recurrence rate. Therefore it is considered that both groups were treated in a safe manner and patient selection was adequate

Povezanost sniženoga salivarnog melatonina i narušene kvalitete života u bolesnika s kroničnom spontanom urtikarijom - probno istraživanje

Chronic spontaneous urticaria (CSU) is a dermatological disorder accompanied by itching that greatly affects the quality of life and quality of sleep. Therefore, it is assumed that CSU patients consequently experience reduced melatonin secretion and lower values of serum or salivary melatonin. This pilot study included 20 patients with CSU (chronic urticaria of unknown etiology that lasts for more than 6 weeks) and 10 healthy controls. All subjects were examined by a dermatovenereologist-allergist, as well as an oral pathologist, to exclude oral pathological conditions. Salivary melatonin levels were determined by ELISA and all subjects completed a standardized Dermatology Life Quality Index questionnaire and Pittsburgh Sleep Quality Index on the same day they gave a saliva sample for analysis. According to our results, 86% of CSU patients had decreased values of salivary melatonin, and lower salivary melatonin values significantly correlated with a reduced quality of life in CSU patients. This study was the first to analyze melatonin in CSU patients, also suggesting a possible new therapeutic option for the treatment of CSU.Kronična spontana urtikarija (KSU) je bolest kože praćena intenzivnim subjektivnim osjećajem svrbeža koji snažno utječe na kvalitetu života i kvalitetu spavanja bolesnika. Pretpostavka je da bolesnici s KSU-om posljedično imaju smanjeno lučenje melatonina, kao i niže vrijednosti melatonina u serumu ili slini. Ovo probno istraživanje uključilo je 20 bolesnika s KSU-om (urtikarija koja traje dulje od 6 tjedana nepoznate etiologije) i 10 zdravih ispitanika. Svakog bolesnika je pregledao dermatovenerolog-alergolog, kao i oralni patolog koji je isključio bolesti usne šupljine koje bi mogle utjecati na razinu melatonina u bolesnika. Razina salivarnog melatonina određena je testom ELISA, a svi ispitanici su ispunili standardizirani dermatološki upitnik o kvaliteti života (Dermatology Life Quality Index, DLQI) i Pittsburški upitnik o kvaliteti sna (Pittsburgh Sleep Quality Index, PSQI) istoga dana kad im je uzet uzorak sline za analizu. Prema rezultatima ovog istraživanja 86% bolesnika s KSU-om imalo je snižene vrijednosti salivarnog melatonina koje značajno koreliraju s lošijom kvalitetom života u bolesnika s KSU-om. Ovo istraživanje je prvo istraživanje koje je analiziralo vrijednosti melatonina u bolesnika s KSU-om i koje predlaže novu terapijsku mogućnost u liječenju KSU-e

Usporedba masenih koncentracija PAU-a u lebdećim česticama zraka priobalnog područja srednjeg Jadrana i središnje Hrvatske

Polycyclic aromatic hydrocarbons (PAHs) are considered priority pollutants due to their distribution, persistence, bioaccumulation, and adverse effects on human health. The aim of this study was to obtain the first insight into PAHs mass concentrations bound to airborne particulate matter (PM) in the mid Adriatic coast area of Croatia, and compare them with the PAH levels in Croatia’s urban central area. Relatively low values of PAH mass concentrations were measured in the coastal area, compared to the continental urban region of Croatia impacted by increased emissions due to intensive traffic, industry, and residential heating. A high PM10 contribution of four-ring PAHs (Flu and Pyr) at Martinska site indicated that wood burning heating as well as open fire events, including waste incineration, could be important emission sources of PAHs in the mid Adriatic coast region. This work is licensed under a Creative Commons Attribution 4.0 International License.Policiklički aromatski ugljikovodici (PAU) zbog rasprostranjenosti, postojanosti, bioakumulacije i štetnih utjecaja na zdravlje ljudi te biljnog i životinjskog svijeta smatraju se prioritetnim onečišćujućim tvarima. Cilj istraživanja je po prvi put dobiti uvid u masene koncentracije specifičnih PAU-a u lebdećim česticama u zraku priobalnog područja srednjeg Jadrana te napraviti usporedbu s razinama PAU-a urbanog područja središnje Hrvatske. Koncentracije PAU-a u priobalnom području bile su relativno niske u odnosu na koncentracije u urbanoj središnjoj Hrvatskoj, gdje se i očekuju njihove povišene emisije uslijed znatno jačeg intenziteta prometa, industrije te izgaranja biomase uslijed loženja u kućanstvima. Veća zastupljenost PAU-a četirima aromatskim prstenovima (Flu i Pyr) u ukupnoj masi PM10 čestica na mjernoj postaji Martinska upućuju na to da izgaranje drvne biomase uslijed grijanja kućanstava te uslijed požara otvorenog tipa mogu biti važan izvor PAU-a na obalnom dijelu srednjeg Jadrana. Ovo djelo je dano na korištenje pod licencom Creative Commons Imenovanje 4.0 međunarodna

Kirurško liječenje preponske kile: ambulantno ili bolnički [Inguinal hernioplasty: day surgery or hospital surgery procedure]

Inguinal hernia repair is a surgical procedure that can be done in inpatient or one-day surgery. Adequate patient selection is not a simple task. There are more than several selection criteria, but the main objective is a patient safety. This study analyzes the patient selection criteria and compares safety in the manner of postoperative complications between the two groups of patients. There were 590 patients who underwent surgical repair of inguinal hernia at the University Hospital Centre Zagreb in 2015. 226 (38.3%) of them were treated in one-day surgery, and 364 (61.7%) were treated at the main Surgical department; 69 of those had an emergent presentation. Most patients of child age (0–18) were treated at the inpatient department. ­Patients in the age groups between 19 and 39 years, as well as those between 35 and 49 were dominantly managed at the Department of one-day surgery. Those patients were mainly ASA I and ASA II (only three of them were ASA III), while hospitalized patients were mostly ASA II (52.2%). In the hospitalized, inpatient group, frequency of ASA I was 24%, ASA II 21% and ASA IV 3%. The greatest number of one-day surgery patients underwent surgery under local anesthesia (68%). In contrast, only 8% of the inpatient group had a surgery under local anesthesia. The percentage of patients with post­operative wound infection was 2%, and the incidence of pain after surgery was 8%. The results didn’t statistically differ between the groups. The recurrence rate was slightly more frequent in the inpatient group. Hematomas and seromas had the same incidence pattern; they were rarely present and without differences between the groups. 7 of 226 ambulatory patients (3%) were hospitalized. The main causes for three of them were nausea, weakness and hypotension; two patients had tachycardia and stenocardia, one patient had neurasthenia, and also one had scrotal hematoma. The hernia repair in both groups was associated with low postoperative complications, low recurrence rate, and low percentage of unplanned hospital ­admissions. Therefore it is considered that both groups were treated in a safe manner and patient selection was adequate

INGUINAL HERNIOPLASTY: DAY SURGERY OR HOSPITAL SURGERY PROCEDURE

Hernioplastika preponske kile kirurški je zahvat koji se može izvoditi u bolnici ili dnevnoj bolnici. Odabir ­bolesnika u jedan od ova dva načina liječenja nije jednostavan. Postoji više kriterija probira, no ponajprije se misli na ­sigurnost bolesnika. Ovaj rad analizira kriterije odabira te uspoređuje sigurnost bolesnika s pojavnošću komplikacija nakon operacije dviju skupina bolesnika (ukupno 590) kojima je načinjena hernioplastika preponske kile tijekom 2015. godine u KBC-u Zagreb. U prvoj je 226 (38,3%) pacijenata operiranih u dnevnoj bolnici, a u drugoj njih 364 (61,7%) bolnički liječena (69 hitno i 295 elektivno). Većina bolesnika dječje dobi (0 – 18 godina) operirana je bolnički. Bolesnici dobnih skupina 19 – 34 i 35 – 49 godina golemom su većinom operirani u jednodnevnoj kirurgiji, a stariji od 74 godine u bolničkim uvjetima. Bolesnici jednodnevne kirurgije bili su statusa ASA I ili II (samo troje bolesnika ASA III). Većina bolnički ­operiranih bolesnika bila je statusa ASA II (52,2%). ASA I bilo je 24%, ASA III 21%, a ASA IV 3% bolesnika. Lokalna anestezija bila je dominantan izbor kod pacijenata dnevne bolnice (68%), a u bolnički liječene skupine rijetko (8%). Učestalost poslijeoperacijske infekcije (2%) i boli (8%) bila je vrlo niska u obje skupine, a razlika između njih nije statistički značajna. Hematomi i seromi pojavljivali su se jednakim obrascem: vrlo rijetko i bez razlika između skupina. Recidiv se s neznatnom razlikom nešto češće pojavljivao u skupini pacijenata višednevne kirurgije. Od ukupno 226 bolesnika dnevne bolnice njih sedmero (3,0%) primljeno je na bolničko liječenje. Troje zbog mučnine, slabosti i hipotenzije, dvoje bolesnika zbog tahikardije i stenokardije, jedan zbog neurastenije, jedan zbog skrotalnog hematoma. Podjednako malen broj ranih komplikacija, recidiva i neplaniranih produžetaka liječenja bolesnika dnevne bolnice govori da su obje skupine liječene na siguran način, a probir bolesnika bio je primjeren.Inguinal hernia repair is a surgical procedure that can be done in inpatient or one-day surgery. Adequate patient selection is not a simple task. There are more than several selection criteria, but the main objective is a patient safety. This study analyzes the patient selection criteria and compares safety in the manner of postoperative complications between the two groups of patients. There were 590 patients who underwent surgical repair of inguinal hernia at the University Hospital Centre Zagreb in 2015. 226 (38.3%) of them were treated in one-day surgery, and 364 (61.7%) were treated at the main Surgical department; 69 of those had an emergent presentation. Most patients of child age (0–18) were treated at the inpatient department. ­Patients in the age groups between 19 and 39 years, as well as those between 35 and 49 were dominantly managed at the Department of one-day surgery. Those patients were mainly ASA I and ASA II (only three of them were ASA III), while hospitalized patients were mostly ASA II (52.2%). In the hospitalized, inpatient group, frequency of ASA I was 24%, ASA II 21% and ASA IV 3%. The greatest number of one-day surgery patients underwent surgery under local anesthesia (68%). In contrast, only 8% of the inpatient group had a surgery under local anesthesia. The percentage of patients with post­operative wound infection was 2%, and the incidence of pain after surgery was 8%. The results didn’t statistically differ between the groups. The recurrence rate was slightly more frequent in the inpatient group. Hematomas and seromas had the same incidence pattern; they were rarely present and without differences between the groups. 7 of 226 ambulatory patients (3%) were hospitalized. The main causes for three of them were nausea, weakness and hypotension; two patients had tachycardia and stenocardia, one patient had neurasthenia, and also one had scrotal hematoma. The hernia repair in both groups was associated with low postoperative complications, low recurrence rate, and low percentage of unplanned hospital ­admissions. Therefore it is considered that both groups were treated in a safe manner and patient selection was adequate