From foundation hospital to University hospital centre in Osijek

Početak razvoja Kliničkoga bolničkog centra u Osijeku vezanje uz Huttler Kohlhoffer Monspergerovu zakladnu bolnicu, osnovanu 1874. godine, koja je tada bila najmodernija bolnica na jugoistoku Europe. Naredbom Vlade 1895. godine postaje „Sveobća i javna Huttler Kohlhoffer-Monspergerova zakladna bolnica pod Zemaljskom upravom u Osieku“. U vrijeme Prvoga svjetskog rata Zakladna bolnica skrbi o ranjenima i bolesnima. Poslije Prvoga svjetskog rata otvaraju se novi bolnički odjeli. Osim Kirurgije i Interne medicine, novi su odjeli Oftalmologija, Otorinolaringologija, Dermatovenerologija, Epidemiološkohigijenski zavod i Dispanzer za tuberkulozu. Daljnji razvoj prekinuo je Drugi svjetski rat. U teškim prilikama razvijen je poseban način medicinskoga rada, osobito u pogledu zbrinjavanja ranjenika i bolesnika, poduzimanja protuepidemijskih mjera, medicinskog opskrbljivanja i si. Nakon Drugoga svjetskog rata obnavlja se Opća bolnica Osijek i započinje moderan ustroj kao temelj razvoja buduće kliničke bolnice. U razdoblju 1980. - 1990. godine provode se stručna usavršavanja na svim područjima, objavljuju se brojni znanstveni i stručni radovi, razvija izdavačka djelatnost, što pridonosi stvaranju obrazovno nastavne djelatnosti i znanstveno-istraživačkoga rada. Posebno treba istaknuti razdoblje Domovinskoga rata u kojem je bolnica časno izvršila sve svoje zadaće u liječenju ranjenih i bolesnih. Stoga joj je dodijeljena nagrada „Medicina . Godine 1992. stekla je naslov Klinička bolnica Osijek. Daljnjim razvojem, izgradnjom, opremanjem i napredovanjem djelatnika u znanstvena, nastavna, znanstveno nastavna i stručna zvanja, 2009. godine postaje Klinički bolnički centar. Klinike i odjeli Kliničkoga bolničkog centra u Osijeku nastavna su baza Medicinskoga fakulteta Sveučilišta J. J. Strossmayera u Osijeku.Beginnings of the University Hospital Centre in Osijek were related to Huttler Kohlhoffer Monsperger Foundation Hospital, which was founded in 1874 and was the most modern hospital in the south-east Europe at the time. By the Government legislation in 1895 it became "General and public Huttler Kohlhoffer Monsperger Foundation Hospital under Country\u27s management in Osiek". Foundation hospital was taking care of the wounded and sick during the World War 1. New hospital departments were opened after the World War I. Apart from Surgery and Internal Department; new departments were Ophthalmology, Otorhinolaryngology, Dermatovenereology, Epidemiological and Hygienic Institute and Tuberculosis Clinic. Further development was interrupted by the World War II. A special way of performing medical work developed in those hard times, especially regarding taking care of the wounded and sick, taking epidemic precaution measures, medical supplying, etc. After the World War II General Hospital Osijek was renovated and modern organization began, which was a basis for development of the future university hospital. In the period 1980 - 1990 professional educations in all areas were implemented, many scientific and professional papers were published, publishing developed, what contributed to creating educational and teaching activities, as well as scientific and research work. Period of the War for Croatian Independence, in which the hospital honourably performed all its duties regarding treating wounded and sick, especially needs to be pointed out. For those activities it was rewarded with "Medicine" reward. In 1992 it became University Hospital Osijek. By further development, construction, and equipment and by promoting its employees to scientific, teaching, scientific teaching and professional titles, it became University Hospital Centre in 2009. Clinics and Departments of the University Hospital Centre in Osijek are the teaching base of the Faculty of Medicine, Josip Juraj Strossmayer University of Osijek

THE ORIGINS, GENESIS AND NATURE OF THE SECESSIONIST RHETORIC IN THE REPUBLIC OF SRPSKA

Bosna i Hercegovina (BiH) je složena državna zajednica sastavljena od dva entiteta i tri konstitutivna naroda. Ta činjenica je posljedica građanskog rata 1992-95. godine, koji je promijenio etničku strukturu BiH. U institucionalnom smislu entitetima je u Dejtonu dat vrlo visok nivo političke samostalnosti. Tzv. “entitetski veto” je nastao u Dejtonu i primjenjuje se u mnogim ključnim tijelima – od Doma naroda, Predstavničkog doma Parlamentarne skupštine BiH, do Predsjedništva BiH. Pored toga, tvrdi se da BiH nema tzv. unutrašnje priznanje i mnogi od aktera na političkoj sceni zagovaraju radikalne ustavne promjene koje bi narušile ili čak potpuno promijenile “Dejtonsku” arhitekturu BiH. Imajući u vidu ove faktore, ne iznenađuje prisutnost secesionističke retorike u političkom prostoru BiH. U ovom radu analiziraćemo secesionističku retoriku u Republici Srpskoj (RS) i pokušaćemo da opišemo moguću secesionističku strategiju u njenim glavnim linijama. Cilj nam je utvrditi da li se može reći da secesionistički argumenti, retorika i eventualno politike predstavljaju integralnu strategiju i koherentnu političku platformu ili su motivisane dnevnopolitičkim razlozima. Takođe ćemo pokušati utvrditi koliko je ova secesionistička retorika institucionalizovana, tj. koliko je zastupljena u zvaničnim dokumentima institucija RS i/ili glavnih političkih stranaka, a koliko ostaje na nivou društvenih pokreta i/ili pojedinačnih političkih subjekata.Bosnia and Herzegovina (BiH) is a complex state union composed of two entities and three constituent peoples. This fact is a consequence of the 1992-95 civil war, which changed the ethnic structure of BiH. From the institutional perspective, the two entities were given in Dayton a high level of political autonomy. The so-called “entity veto” was created in Dayton, and it is implemented by many key political bodies – from the House of Peoples and the House of Representatives of the Parliamentary Assembly of BiH to the Presidency of Bosnia and Herzegovina. Beside that, it is argued that BiH lacks the “internal recognition” and many of the political actors advocate radical constitutional changes which would disrupt or even completely change the “Dayton” architecture of BiH. Because of that it is not surprising that secessionist rhetoric exists in BiH’s political sphere. The secessionist rhetoric in the Republic of Srpska (RS) will be analysed in this paper and possible secessionist strategy will be described. The aim of this paper is to determine whether secessionist arguments, rhetoric and possibly politics represent an integral strategy and coherent political platform, or whether they are just generated for daily political purposes. Authors will also try to determine whether this secessionist rhetoric is “institutionalised”, i.e. whether it is present in official documents of RS institutions and/or major political parties, or just in the activities of social movements and/or individual political subjects

Our Experience with Virtual Endoscopy of Paranasal Sinuses

The main goal of our work was to evaluate advantages and disadvantages of virtual endoscopy (VE) techniques in routinely diagnostic and preoperative management of patients with various sinus diseases or head traumas in our practice. Fly-through algorithm was performed using an Xeon based workstation on data sets created from axial CT images acquired from 320 patients with various paranasal sinus disorders. Images were created using Siemens Somatom Emotion 16 continiously rotating helical CT scanner and archived in DICOM format. In comparison with real endoscopy, the VE has several advantages. It is completely non-invasive. It is possible to repeat the same procedure several times, therefore it may be a valuable tool for training. Interactive control of all virtual camera parameters, including the field- -of-view is possible. Endoscopic viewing as opposed to real endoscopy is not restricted to the spaces defined by inner surfaces. The viewer may penetrate the walls and see the extent of lesions within and beyond the wall as well as the adjacent anatomic structures. Virtual endoscopy also has a potential to stage tumors by determining the location and the extent of transmural extension

Tracheoesophageal puncture and placement of voice prosthesis: a surgical method for postlaryngectomy speech rehabilitation

Gubitak verbalne komunikacije najteža je posljedica totalne laringektomije, a učinkovita je govorna rehabilitacija ključna za uspješno sprječavanje psihosocijalnih i ekonomskih posljedica afonije. Metode govorne rehabilitacije nakon laringektomije mogu se podijeliti u tri kategorije: ezofagealni govor, traheoezofagealni govor i korištenje pneumatskih ili elektronskih ručnih pomagala. Ezofagealni govor i ručna govorna pomagala još se koriste, no u posljednjih 15-ak godina traheoezofagealna punkcija i ugradnja govornih proteza postaje širom svijeta najpopularnija metoda. Autori predstavljaju vlastita iskustva u rehabilitaciji govora nakon totalne laringektomije ugradnjom govornih proteza.Deprivation of verbal communication is the most devastating outcome of total laryngectomy, and effective voice restoration is critical to the successful prevention of psychological, social and economic consequences of postlaryngectomy aphonia. The methods of voice rehabilitation after laryngectomy may be grouped into three categories: esophageal speech, tracheoesophageal speech and the use of pneumatic or electrical hand-held devices. Esophageal speech and external hand held devices are still useful for some patients, but in the past 15 years tracheoesophageal puncture and voice prosthesis placement has become worldwide the most popular method. Authors present their own experience in voice rehabilitation using voice prosthesis after total laryngectomy being performed

Incidence of Post-Tonsillectomy and Post-Adenotonsillectomy Hemorrhage in 5125 Patients Operated During the 1994-2005 Period at Department of ENT, Head and Neck Surgery, Osijek University Hospital in Osijek, Croatia

Cilj studije bio je utvrditi incidenciju krvarenja nakon tonzilektomije i adenotonzilektomije te procijeniti čimbenike rizika koji tom krvarenju doprinose. Ovo je bila retrospektivna studija 5125 bolesnika operiranih u općoj anesteziji na našem Odjelu od 1. siječnja 1994. do 31. prosinca 2005. godine. Poslijeoperacijsko krvarenje zabilježeno je u 169 (3,29%) bolesnika; kod 69 (40,82%) od njih bila je potrebna revizija zahvata u općoj anesteziji u operacijskoj sali. Incidencija krvarenja bila je najviša u dobnoj skupini od 20,01 do 30 godina. Primarno krvarenje (<24 h) je nastupilo u 39 (0,76%), a sekundarno krvarenje u 130 (2,53%) bolesnika. Najviša incidencija sekundarnog krvarenja poslije tonzilektomije i adenotonzilektomije zabilježena je između 6. i 7. dana od operacije. Nije bilo statistički značajne razlike u danu nastupa krvarenja između muških i ženskih bolesnika. U skupini bolesnika kod kojih je bila potrebna revizija zahvata pod općom anestezijom u operacijskoj sali 59 (85%) bolesnika nije imalo nikakve dodatne dijagnoze koje bi mogle doprinijeti poslijeoperacijskom krvarenju. Opisujemo dva slučaja prekomjernog krvarenja nakon tonzilektomije koji su zahtijevali ligaturu vanjske karotidne arterije šavovima. Krvarenje nakon tonzilektomije i adenotonzilektomije je rijetko i nastupa uglavnom 6 dana od operacije. Kod velike većine bolesnika nije potrebna revizija u operacijskoj sali. Utvrdili smo kako muški bolesnici u dobi od 20 do 30 godina imaju povećan rizik od poslijeoperacijskog krvarenja.The aim of this study was to determine the incidence of post-tonsillectomy and post-adenotonsillectomy hemorrhage, and to evaluate risk factors that contribute to this hemorrhage. It was a retrospective study including 5125 patients operated in general anesthesia at our Department between January 1, 1994 and December 31, 2005. A total of 169 (3.29 %) patients experienced postoperative bleeding; 69 (40.82%) of them required revision in operating room under general anesthesia. The incidence of bleeding was highest in the 20.01-30 age group. Primary bleeding (<24 h) occurred in 39 (0.76%) and secondary bleeding in 130 (2.53%) patients. The highest incidence of secondary post-tonsillectomy and post-adenotonsillectomy hemorrhage was between day 6 and day 7 of the operation. There was no statistical significance between men and women in the day when bleeding occurred. In the group of patients requiring revision in the operating room under general anesthesia, 59 (85%) patients had no additional diagnoses that may have contributed to postoperative hemorrhage. Two cases of excessive post-tonsillectomy bleeding requiring suture ligation of the external carotid artery are reported. Hemorrhage following tonsillectomy and adenotonsillectomy is rare and occurs mainly 6 days after surgery. A vast majority of patients do not need revision in the operating room. Male patients aged 20-30 were found to have an increased risk of postoperative hemorrhage

Screening with Mammography Organized by Family Physicians Teams: What Have We Learnt?

The mammography, recommended as standard method for screening on breast cancer, can reveal suspicious lesions early enough to anable cancer elimination in entirely. Experience with women of the target population, 50–69 years old, included in the mass screening programs, show the reduction in the specific mortality by 30%. One of the main problem in organizing the preventive programs is how to increase responsiveness of subjects to screening. In the study, based on the large sample of over 1000 of subjects and 20 family medicine practices, included in the investigation, we showed that it is possible, by a pro-active involvement of family physicians teams and intensive educational and motivational activities, to achieve high level of over 80% of responsiveness to mammography screening. Analysis of the reasons of nonresponsiveness can contribute to better understanding of the mental processes included in a self-decision making. This, as the final aim, can help family physicians in their efforts to overcome many hidden barriers which obstruct their patients to accept the mammography screening

Epidemiologic Data of Malignant Melanoma in Osijek-Baranya County (Eastern Croatia) During the Period of 2000–2008

During the past several decades there has been a substantial increase in the incidence of malignant melanoma worldwide. The highest incidences were reported in New Zealand and Australia. In Europe the northern countries generally have a higher incidence. The aim of this retrospective study was to provide the incidence and mortality for all patients with malignant melanoma diagnosed in Osijek-Baranya County, Eastern Croatia, during 2000–2008. In the past 30 years in the Republic of Croatia the incidence of melanoma increased by 337%. During the period of 2000–2006 in Osijek-Baranja County, the incidence of melanoma increased by 13%. The incidence of melanoma increases with age, but in past decades melanoma is more often diagnosed in people aged 25–40. The mortality between 2000 and 2008 increased by 18%. The incidence of melanoma generally increases equally in men and women. The most common localization of skin melanoma in males was trunk and in females the lower extremities. Presently, in Osijek-Baranya County melanoma is 15th on the list of malignant tumors and represent 2% of all malignant tumors. In New Zealand, Australia and European northern countries mortality is reduced, as result of earlier diagnosis and education of risk groups. Unfortunately, in Osijek-Baranya County, in a comparison with these countries, the mortality is higher although incidence is the same or lower

Epidemiology of Laryngeal Cancer in Osijek-Baranja County (Eastern Croatia)

The aim of this retrospective study was to provide the incidence and mortality rate for all patients with laryngeal carcinoma diagnosed in Osijek-Baranja County, during the period of 1999 – 2008. In this period, there were 329 registered patients, from which 301 (91.5%) males, and 28 (8.5%) females. Age-standardized rate (ASR World) laryngeal cancer incidence was 6.4/100,000 (13.4/100,000 for males and 0.9/100,000 for females). In the same period, 238 people, including 224 (94.1%) men and 14 (5.9%) women died of laryngeal carcinoma. Age-standardized rate (ASR World) laryngeal cancer mortality was 4.4/100,000 (9.8/100,000 for males and 0.5/100 000 for females). There is a significant decline in mortality in males and increased mortality in females. Laryngeal carcinoma is a significant public health problem in the Osijek-Baranja county. Although the study period shows a tendency to decrease in the number of new cases and deaths, in the times ahead it is important to focus the emphasis on prevention and early detection with the goal of reducing incidence and mortality