Primjena traneksamične kiseline u dermatologiji

Tranexamic acid is a synthetic derivative of the amino acid lysine, an antifibrinolytic that is primarily used to reduce bleeding in surgery, trauma, and dental procedures. Its anti-inflammatory and anti-angiogenic properties, as well as its ability to suppress melanogenesis have enabled it to be used in dermatology in the treatment of skin conditions such as melasma, acne, post-inflammatory hyperpigmentation, rosacea and angioedema. Tranexamic acid can be used by various routes of administration including oral, topical and intradermal injection, and in combination with other treatment methods. This review article presents evidence for the effectiveness of tranexamic acid in the treatment of various skin disorders.Traneksamična kiselina sintetski je derivat aminokiseline lizina, antifibrinolitika koji se prvenstveno rabi za smanjenje krvarenja u kirurškim zahvatima, traumi i stomatološkim zahvatima. Njegova protuupalna i antiangiogena svojstva, kao i njegova sposobnost suzbijanja melanogeneze omogućili su mu upotrebu u dermatologiji u liječenju kožnih stanja kao što su melazma, akne, poslijeupalna hiperpigmentacija, rozacea i angioedem. Traneksamičnu kiselinu moguće je primijeniti na različite načine: oralno, lokalno i intradermalno te u kombinaciji s drugim metodama liječenja. Ovaj pregledni članak prikazuje dokaze o učinkovitosti traneksamične kiseline u liječenju različitih kožnih poremećaja

Precipitirajući čimbenici i simptomi u bolesnika s dijabetičkom ketoacidozom

The aim of the study was to determine the most common precipitating factors and symptoms of diabetic ketoacidosis and the possible difference according to age, gender and severity of diabetic ketoacidosis. Medical records from January 1, 2017 until December 31, 2019 were reviewed and patients diagnosed with diabetic ketoacidosis were selected. The study included 52 patients, median age 34 (interquartile range 21-56) years. There was no statistically significant difference between male and female gender. The severity of diabetic ketoacidosis was moderate in the majority of cases (65.4%; p=0.005). The most common precipitating factor was infection (61.7%). In patients with moderate diabetic ketoacidosis, respiratory infections were more common, while gastrointestinal infections were more common in severe diabetic ketoacidosis (33% and 25%, respectively; p=0.03). Nausea (median age 32 years; p=0.004) and vomiting (median age 31 years; p=0.01) were more common in younger age groups, while altered mental status was more common in the older age group (median age 61 years; p=0.001). Infection was the most common precipitating factor. The most common symptoms in younger age groups were nausea and vomiting, and altered mental status in the older age group.Cilj istraživanja je bio utvrditi najčešće precipitirajuće čimbenike i simptome dijabetičke ketoacidoze te postoji li razlika s obzirom na dob, spol i stupanj dijabetičke ketoacidoze. Pregledana je medicinska dokumentacija od 1. siječnja 2017. do 31. prosinca 2019. godine te su izdvojeni bolesnici s dijagnozom dijabetičke ketoacidoze. U istraživanje je uključeno 52 bolesnika. Medijan dobi bio je 34 godine (interkvartilni raspon 21-56 godina). Nije postojala statistički značajna razlika muškog i ženskog spola. U najvećem broju slučajeva radilo se o umjerenom stupnju dijabetičke ketoacidoze (65,4%; p=0,005). Najčešći precipitirajući čimbenik bila je infekcija (61,7%). Kod umjerenog stupnja najčešće se radilo o respiracijskim infekcijama, a u teškom stupnju o gastrointestinalnim infekcijama (33% i 25%; p=0,03). U mlađim dobnim skupinama češće su se pojavljivale mučnina (medijan dobi 32 godine; p=0,004) i povraćanje (medijan dobi 31 godina; p=0,01), a u starijoj dobnoj skupini poremećaj svijesti (medijan dobi 61 godina; p=0,001). Infekcije su bile najčešći precipitirajući čimbenik dijabetičke ketoacidoze. Najčešći simptomi u mlađim dobnim skupinama bili su mučnina i povraćanje, a u starijoj dobnoj skupini poremećaj svijesti

Serum glucose, sodium and potassium concentrations in patients with diabetic ketoacidosis

Aim To investigate possible differences in serum glucose and sodium and potassium concentrations with respect to age, gender and severity of diabetic ketoacidosis. Methods Medical records from 1 January 2017 to 31 December 2019 were reviewed and patients with the diagnosis of diabetic ketoacidosis were selected. Results The study included 52 patients. Glucose concentration was significantly higher in the age group of 25-44 and >65 years compared to the group of 18-24 years (p=0.02). Sodium concentration was significantly higher in the age group 18-24 and >65 years compared to groups 25-44 and 45-65 years (p=0.002). Females had significantly higher sodium concentration than males (p=0.002). Potassium concentration was significantly higher in the age group 25-44 years compared to other groups (p=0.01). Males had significantly higher potassium concentration (p =0.01). Conclusion This study showed that significant differences exist in electrolyte concentration between specific age groups, male and female gender as well as DKA severity. Knowing these differences could help clinicians to promptly recognize and treat electrolyte derangements, leading to better outcome of patients with DKA

Maternal outcomes in gestational diabetes

Uvod: Gestacijski dijabetes mellitus (GDM) je najčešći metabolički poremećaj u trudnoći, a definira se kao netolerancija na glukozu otkrivena tijekom trudnoće, najčešće u drugom i trećem trimestru. Ukoliko bolest nije dobro kontrolirana moguća je pojava različitih nepovoljnih ishoda trudnoće kao što su arterijska hipertenzija, preeklampsija, polihidroamnion, oligohidroamnion, porod carskim rezom i prijevremeni porod. Ustroj studije: presječna studija s povijesnim podatcima Cilj: Ispitati povezanost majčinskih ishoda s terapijom, vremenom OGTT-a, prethodnim GDM-om, ukupnim dobitkom na tjelesnoj masi tijekom trudnoće i majčinim ITM-om. Metode i ispitanici: Pacijentice liječene u KBC Osijek pod dijagnozom GDM, u razdoblju od 2016. do 2020. Veličina uzorka je 400 ispitanica. Podaci su prikupljeni iz Bolničkog informacijskog sustava. Rezultati su prikazani tablicama, apsolutnim i relativnim frekvencijama, a značajnost razlika hi-kvadrat testom s 95 % intervalom pouzdanosti. Statistička značajnost će biti prihvaćena uz p < 0,05. Rezultati: Nisu pokazane statistički značajne razlike između promatranih ishoda trudnoće i terapije, vremena provođenja OGTT-a i prethodnog GDM-a. Majke koje su tijekom trudnoće dobile više od 15 kg značajno su više imale arterijsku hipertenziju u odnosu na majke koje su dobile manje od 15 kg (P < 0,001). Zaključak: U prikazanom ispitivanju terapija GDM nije značajno utjecala na majčinske ishode trudnoće, kao niti vrijeme učinjenog OGTT-a ili prisutvo prethodnog GDM-a u anamnezi. Pojava arterijske hipertenzije bila je češća u bolesnica s ukupnim dobitkom na tjelesnoj masi većim od 15 kg. Arterijska hipertenzija, preeklampsija i porod carskim rezom bili su češći u majki s viskom ITM-om.Introduction: Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnancy, and is defined as glucose intolerance detected during pregnancy, most commonly in the second and third trimesters. If the disease is not well controlled, various adverse pregnancy outcomes such as arterial hypertension, preeclampsia, polyhydroamnion, oligohydroamnion, cesarean delivery and premature birth are possible. Study structure: cross-sectional study with historical data Objective: To examine the association of maternal outcomes with therapy, time of OGTT, previous history of GDM, and weight gain during pregnancy Methods and subjects: Women treated at Clinical Hospital Center Osijek under the diagnosis of GDM, in the period from 2016. to 2020. The sample size is 400 respondents. Data were collected from patients medical histories. The results are shown in tables, absolute and relative frequencies, and the significance of the differences by the chi-square test with a 95 % confidence interval. Statistical significance will be accepted with p < 0.05. Results: There were no statistically significant differences between the observed outcomes of pregnancy and therapy, the time of OGTT and previous GDM. Mothers who gained more than 15 kg during pregnancy had significantly more arterial hypertension compared to mothers who gained less than 15 kg (P < 0.001). Conclusion: In this study, GDM therapy did not significantly affect maternal pregnancy outcomes, nor did the time of OGTT performed or the presence of a history of previous GDM. The occurrence of arterial hypertension was more common in patients with a total weight gain greater than 15. Arterial hypertension, preeclampsia, and cesarean delivery were more common in mothers with high BMI

Maternal outcomes in gestational diabetes

Uvod: Gestacijski dijabetes mellitus (GDM) je najčešći metabolički poremećaj u trudnoći, a definira se kao netolerancija na glukozu otkrivena tijekom trudnoće, najčešće u drugom i trećem trimestru. Ukoliko bolest nije dobro kontrolirana moguća je pojava različitih nepovoljnih ishoda trudnoće kao što su arterijska hipertenzija, preeklampsija, polihidroamnion, oligohidroamnion, porod carskim rezom i prijevremeni porod. Ustroj studije: presječna studija s povijesnim podatcima Cilj: Ispitati povezanost majčinskih ishoda s terapijom, vremenom OGTT-a, prethodnim GDM-om, ukupnim dobitkom na tjelesnoj masi tijekom trudnoće i majčinim ITM-om. Metode i ispitanici: Pacijentice liječene u KBC Osijek pod dijagnozom GDM, u razdoblju od 2016. do 2020. Veličina uzorka je 400 ispitanica. Podaci su prikupljeni iz Bolničkog informacijskog sustava. Rezultati su prikazani tablicama, apsolutnim i relativnim frekvencijama, a značajnost razlika hi-kvadrat testom s 95 % intervalom pouzdanosti. Statistička značajnost će biti prihvaćena uz p < 0,05. Rezultati: Nisu pokazane statistički značajne razlike između promatranih ishoda trudnoće i terapije, vremena provođenja OGTT-a i prethodnog GDM-a. Majke koje su tijekom trudnoće dobile više od 15 kg značajno su više imale arterijsku hipertenziju u odnosu na majke koje su dobile manje od 15 kg (P < 0,001). Zaključak: U prikazanom ispitivanju terapija GDM nije značajno utjecala na majčinske ishode trudnoće, kao niti vrijeme učinjenog OGTT-a ili prisutvo prethodnog GDM-a u anamnezi. Pojava arterijske hipertenzije bila je češća u bolesnica s ukupnim dobitkom na tjelesnoj masi većim od 15 kg. Arterijska hipertenzija, preeklampsija i porod carskim rezom bili su češći u majki s viskom ITM-om.Introduction: Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnancy, and is defined as glucose intolerance detected during pregnancy, most commonly in the second and third trimesters. If the disease is not well controlled, various adverse pregnancy outcomes such as arterial hypertension, preeclampsia, polyhydroamnion, oligohydroamnion, cesarean delivery and premature birth are possible. Study structure: cross-sectional study with historical data Objective: To examine the association of maternal outcomes with therapy, time of OGTT, previous history of GDM, and weight gain during pregnancy Methods and subjects: Women treated at Clinical Hospital Center Osijek under the diagnosis of GDM, in the period from 2016. to 2020. The sample size is 400 respondents. Data were collected from patients medical histories. The results are shown in tables, absolute and relative frequencies, and the significance of the differences by the chi-square test with a 95 % confidence interval. Statistical significance will be accepted with p < 0.05. Results: There were no statistically significant differences between the observed outcomes of pregnancy and therapy, the time of OGTT and previous GDM. Mothers who gained more than 15 kg during pregnancy had significantly more arterial hypertension compared to mothers who gained less than 15 kg (P < 0.001). Conclusion: In this study, GDM therapy did not significantly affect maternal pregnancy outcomes, nor did the time of OGTT performed or the presence of a history of previous GDM. The occurrence of arterial hypertension was more common in patients with a total weight gain greater than 15. Arterial hypertension, preeclampsia, and cesarean delivery were more common in mothers with high BMI

Sindikalna dejavnost v policiji

Diplomsko delo obravnava delovanje sindikatov v policiji. Kot vsi vemo, je PSS nastal že v času osamosvojitve in je pred kratkim praznoval 20-letnico svojega delovanja, medtem ko je SPS nastal v času mandata Pahorjeve vlade oziroma takratne ministrice za notranje zadeve gospe Katarine Kresal. S tem, ko je nastal še en sindikat, ki ga je takratno ministrstvo podpiralo in po zadnjih dogodkih tudi sedanje, pa so se začeli problemi tudi med zaposlenimi. V nekaterih sredinah so člani SPS izvajali pritiske na člane PSS, kaj počnejo v tem starem sindikatu (PSS) ipd. Tudi zadnji dogodki kažejo, da je vladi in MNZ všeč, ker sta PSS in SPS skregana med seboj in le redko sodelujeta. Analiza statističnih podatkov nadalje pokaže, da tudi policisti in policistke niso zadovoljni s tem, da obstajata dva delujoča sindikata. Prav tako je bilo iz analize ugotovljeno, da je kar 42.7 % anketirancev mnenja, da sindikata med seboj slabo sodelujeta. Če na kratko povzamemo celotno nalogo, lahko zapišemo, da je sindikat organizacija v katerem so včlanjeni člani, ki imajo določene pravice, kot so pravica do stavke, koalicijska svoboda, delavski boj, soodločanje, pogajanja in kolektivno pogodbo. Glavna naloga sindikata je, da se bori za pravice policistov, s čimer se je strinjajo tudi 72,5 % anketirancev. Glede na pravice in ugodnosti, ki jih pridobijo člani sindikata, je bilo iz analize ugotovljeno, da je kar 85.5 % policistk in policistov včlanjenih v sindikat. Vsak sindikat ima tudi svojega sindikalnega zaupnika, ki deluje na območju celotne regije ali pa na določeni policijski postaji. Naloga sindikalnega zaupnika je, da obvešča svoje člane o trenutnem dogajanju. Pri tem je statistična analiza pokazala, da se kar 34,5 % anketirancev poprečno strinjajo s tem, da sindikalni zaupniki dobro opravljajo svoje delo. Prav tako je bilo iz analize ugotovljeno, da se 33,6 % anketirancev prav tako povprečno strinjajo s tem, da sindikalni zaupniki obveščajo člane o trenutnih dogodkih. 35,5 % pa je vseh tistih, ki so mnenja, da sindikat povprečno zastopa interese svojih članov. Lahko rečemo, da sindikat in sindikalni zaupniki dobro opravljajo svoje delo.This thesis discusses activity of trade unions in the police. Like we all know PSS was formed during the time of independence and has recently celebrated the twentieth anniversary of its operation, while SPS was formed during the mandate of Pahor government and the then Minister of Interior Mrs. Katarina Kresal. When another trade union in police was founded it was suported by the then Ministry and after recent events also from the current Ministry. This has caused problems between employees. In some environments the members of SPS exert pressure on the members of PSS saying what they are doing in this old trade union (PSS) etc. Last events show that Government and MNZ like the fact PSS and SPS are at odds with each other and rarely cooperate. The analysis of statistical data further shows that police officers are not satisfied with the fact that there are two functioning trade unions. Analysis shows that 42.7% of respondents thinks that cooperation between trade unions is not good. If we briefly summarize the entire task we can say that the trade union is organisation in which they are members, which have certain rights, such as the right to strike,freedom coalition, aworking class fight, co-decision, negotiations and collective agreement. The main task od the trade union is to fight for the rights of the police officers. With that agree72.5% of the respondents. Depending on the rights and benefits, which acquire trade union members from the analysis is found that as many as 85.5% of policeofficers are members of a trade union. Each trade union ha salso his labor confidant which works in the area of the entire redion or at a particular police station. The task of the labor confident is to inform its members about the current events. The statistical analysis shows that 34,5% of respondents agree that trade union representatives are good at their work. It was also found from the analysis that 33,6% of the respondents agree that trade union representatives infrom members abaut current events. There is 35,5% of all those who share the opinion that the trade union on average represents the interests of its members. We can say that the trade union and trade union representatives are good at their work

Precipitating Factors and Symptoms in Patients with Diabetic Ketoacidosis

The aim of the study was to determine the most common precipitating factors and symptoms of diabetic ketoacidosis and the possible difference according to age, gender and severity of diabetic ketoacidosis. Medical records from January 1, 2017 until December 31, 2019 were reviewed and patients diagnosed with diabetic ketoacidosis were selected. The study included 52 patients, median age 34 (interquartile range 21-56) years. There was no statistically significant difference between male and female gender. The severity of diabetic ketoacidosis was moderate in the majority of cases (65.4%; p=0.005). The most common precipitating factor was infection (61.7%). In patients with moderate diabetic ketoacidosis, respiratory infections were more common, while gastrointestinal infections were more common in severe diabetic ketoacidosis (33% and 25%, respectively; p=0.03). Nausea (median age 32 years; p=0.004) and vomiting (median age 31 years; p=0.01) were more common in younger age groups, while altered mental status was more common in the older age group (median age 61 years; p=0.001). Infection was the most common precipitating factor. The most common symptoms in younger age groups were nausea and vomiting, and altered mental status in the older age group