Treatment of Barrett's Esophagus with radiofrequency ablation

Introduction: Barrett’s esophagus (BE) represents the distal esophageal epithelium changes that carry a high risk of developing esophageal adenocarcinoma. One of the most challenging aspects of diagnosing BE by endoscopy is precisely discerning between normal epithelium and BE changes, which is essential for therapy success. The objectives of this study were to compare the success of radio-frequency ablation (RFA) therapy to conservative treatment with proton pump inhibitor (PPI) drugs between the clinical presentation and endoscopy findings of BE at 2, 6, 12, and 24 months after administered therapy. Material and methods: Seventy-five subjects were divided into two groups (RFA and PPI) based on the BE treatment regimen in this case-control study to compare the quality of treatments applied over a 24-month follow-up. Subjects who received RFA therapy were further divided into groups: those who received focal HALO 90 and those who received circumferential HALO 360, based primarily on EGDS findings or endoscopist experience. Results: The results show that using the RFA therapeutic modality in the treatment of BE is more effective (by 94.2% in the second month of follow-up, i.e., by 99% at the final visit after 24 months) than using PPI therapy alone. Re-RFA therapy was given to 15% of the subjects, mostly applied in the same therapeutic modality (HALO 90). Conclusions: Our findings show that RFA and re-RFA therapy have a high efficacy and safety profile, with no registered worsening of histology findings, the occurrence of esophageal adenocarcinoma, or adverse effects of the therapy

The Church in Croatia and Political Traces (1989 - 2007)

Politička traganja Crkve u Hrvatskoj od 1989. do 2007. možemo promatrati na nekoliko razina. Na temelju Ustava RH, koji jamči slobodu vjeroispovijesti, ali i odvojenost vjerskih zajednica od države, te potpisivanjem ugovora između Svete Stolice i Republike Hrvatske, nakon više desetljeća komunističke vladavine pravno je reguliran odnos Crkve i države u duhu demokratskih standarda i postavljen okvir za njezino djelovanje. Na razni političkog govora Crkve, ispunjavajući svoje poslanje u zauzimanju za čovjeka i opće dobro, ističu se prigodne izjave biskupa i tijela HBK te promišljanja hrvatskih teologa. Na praktičnoj razini uočava se, pak, određeno (ne)snalaženje klera i vjernika laika u novim uvjetima društveno-političkog i socijalno-gospodarskog života. Povijesno gledajući, uočavamo stoga tri razdoblja političkog traganja Crkve u Hrvatskoj. U vremenu od 1990. do 1995., solidarno podnoseći patnje i stradanja u Domovinskom ratu, Crkva se zalaže za mir, ali i evanđeoskom jasnoćom brani pravo hrvatskog naroda na slobodu, obranu od agresora u svjetlu prava na zakonitu obranu i osuđuje svaki zločin. U razdoblju od 1995. do 2000. godine, Crkva se suočava s negativnim posljedicama rata, osobito s naslijeđenim mentalitetom i sve većim raslojavanjem hrvatskog društva te naglašava važnost socijalnog nauka Crkve u cilju stvaranja novih društvenih struktura. Međutim, zbog nedovoljnog zaživljavanja socijalnog nauka Crkve izostao je snažniji angažman vjernika i značajniji pomaci na planu društveno-socijalnog djelovanja. Treći period političkog traganja, od 2000. do danas, obilježava potreba novog pozicioniranja Crkve u društvu i suočavanje s novim izazovima pluralnog društva u duhu liberalne ideologije. Zbog društvene situacije nastale promjenom vlasti početkom 2000. godine, ali i u duhu smjernica tri pastoralna pohoda Svetoga Oca Republici Hrvatskoj, Crkva u ovom vremenu čini odmak od pozicije narodnog tribuna prema Crkvi koja ukazuje na socijalne probleme, ali i opasnost sekularnog fundamentalizma. Kao izazov trenutka nameće se potreba snažnijeg razvoja socijalnog pastorala koji zahtijeva osobnu izgradnju vjernika u duhu socijalnog nauka Crkve i snažniji angažman laičkih udruga u civilnom društvu.According to the last Population Census, more than 87% of the population in Croatia expressed themselves as Catholics and we can safely say that this characterised Croatian society on the social-political plan from 1989 to this day and in a certain way is reflected on the Church in Croatia itself. We can therefore observe its political traces from the first multi-party elections and the founding of the Croatian State to current endeavours of accessing Euro-Atlantic integrations at several levels. Pursuant to the Croatian Constitution which guarantees the freedom of religious confession but also the division of religious communities from the State and the signing of the Agreement with the Holy See, after several decades of communist rule, relations between the Church and State have finally been regulated in the spirit of democratic standards setting a legal framework for the Church\u27s activities. At the level of the Church\u27s political talk, while fulfilling its mission to advocate for humanity and common good, we have relevant statements by bishops and bodies of the Croatian Conference of Bishops and of course the thoughts of Croatian theologians. On a practical level however, we see a certain (lack of) adaptation of the clergy and laity in new social-political conditions and social-economic life. Observed historically, the Church\u27s stance for the common good of Croatian society and its being faced with various challenges occurred in three varying social contexts. Issues imposed by the Homeland War and its repercussions that faced Croatian society (1991—1995), particularly the question of the legality of defence and forgiveness as well as the hardships faced by displaced persons featured the first era of the Church\u27s political traces in Croatia. Bishops and priests called for the spirit of the Gospel for peace and forgiveness. They condemned any crime and shared the fate of their people in solidarity. The second period (1996-2000), which encompasses post-war renewal and encountering an inherited mentality while creating a democratic, economic and social structure within Croatian society required changes in the Church and its relations towards political structures and greater social advocacy in the spirit of the Second Vatican Council and the Social Teachings of the Church. Church representatives clearly pointed out the negative aspects of Croatian society and the danger of an inherited mentality but also, the lack of putting into practise the principles of the social teachings of the Church which meant an absence of greater involvement of the faithful or any significant progress in its social activities. The third period from 2000 to this day, featured with continuing democratisation of society and more or less successful development of a social State according to European standards required the Church to encounter new challenges in a plural society particularly one in the spirit of liberal ideologies. In that regard, due to the social situation which emerged with the change of government in 2000 but also in the spirit of the directives of three pastoral visits by the Holy Father to Croatia, the Church took a step back from being a national tribune to being a Church that points out social problems and the danger of secular fundamentalism. However, matters move slowly and the challenges of the time impose the need for greater development of social pastoral work which requires above all various forms of studies, seminars, lectures in particular on a diocesan and parish level with the aim of personal development in the spirit of the social teachings of the Church in order to overcome inherited mentality. At the start of the third millennium, in its political activities, the Church is called upon to put emphasis on promoting fundamental human and Christian values with the aim of protecting common good and national wealth. An important role relies on the laity requiring more serious involvement in social pastoral work on the social plan with concrete practical projects. In that regard, it is necessary to create better coordination of activities particularly on the diocesan level and subsidiary assistance in educating and training qualified staff. The Church therefore is required to take a step back from theory and move towards the practical; to step back from certain formality towards sincere social pastoral work that is able to contribute to the development of democracy in Croatia and a true transformation of public institutions in the spirit of the Social Teachings of the Church and in particular a stronger presence of Christians in civil society. In other words, clear social dialogue is required that will be supported by social action and educating the faithful to act socially in the civil sector

Christian Charity and Social Policy

Polazeći od teološkog promišljanja dr. Vilka Anderlića (1882.-1957.), đakovačkog profesora i pisca prve katoličke sociologije na hrvatskom jeziku, članak želi ukazati na suvremenu društveno-socijalnu problematiku i doprinos kršćanske dobrotvornosti u rješavanju socijalnih problema. U prvom dijelu rada, polazeći od nastanka korporativnoga uređenja države tijekom prve polovice 20. stoljeća te na temelju analize djela dr. Anderlića, ukazuje se na razlikovanje karitativnog djelovanja od područja socijalne politike. Ističe se kako kršćanska dobrotvornost mora učiniti odmak od puke pomoći siromašnima i aktivno se uključiti u proces socijalne politike, uklanjajući uzroke siromaštva i preuzimajući svoj dio odgovornosti u društvu. Polazeći od pojma socijalne politike i nastanka socijalno osjetljive države nakon Drugoga svjetskog rata, u drugom se dijelu rada raspravlja o današnjim modelima države blagostanja, s posebnim naglaskom na nastanak socijalne države na europskom kontinentu. Analizira se model države blagostanja u anglosaksonskim zemljama te skandinavski model kao i njemački model socijalne države i austrijsko socijalno partnerstvo. Ukazujući na prednosti i nedostatke ovih modela pažnja se pridaje i tzv. Trećem putu Tonyja Blaira. Na kraju, u svjetlu enciklike Centesimus annus, članak ukazuje da socijalnu politiku treba provoditi ne samo država nego i sve udruge i ustanove društva, uključujući i gospodarstvo. Današnja socijalna politika nije samo briga države, nego je odraz sustava vrijednosti u jednom društvu i plod je suradnje i odgovornosti svih članova civilnog društva. Karitativno djelovanje, nadahnuto kršćanskim poimanjem solidarnosti, u tome zauzima značajno mjesto.Opening with thoughts of Dr. Vilko Anderlić (1882-1957), professor in Ðakovo and the author of the first Catholic Sociology in Croatian, this article points to current social issues and to contribution by Christian charity to solution of social problems. The first section based on the analysis of work by Dr. Anderlić shows that Anderlić made distinction between charity work and the area of work covered by social policy. Further on the article describes the existing types of a social state in European countries, with an emphasis on the establishment of a social state. First the basic difference between the concept of a minimal state and the welfare state, then different types of an assistant state are described. The article analyses the Scandinavian model, or so called Swedish model designed by the Social Democratic Party, then the type of a social state according to the example of the German model and Austrian social partnership. Pointing to the advantages and disadvantages of these models, the article also takes into consideration The Third Way by Tony Blair. In the light of Centecimus annus by John Paul II, the article makes clear that there is a need to move from a welfare state towards a solidarity society. This means that social policy should be conducted not only by a state, but also by all the social institutions, including economy. In accordance with Dr. Anderlić’s reflections the article reveals that Christian charity must stop merely helping the poor. It should be actively engaged in the process of social policy, remove the causes of poverty and take on its part of responsibility in the society