Myocarditis following COVID – 19 mRNA vaccine administration

Development of effective vaccines marked the beginning of the end for COVID-19 pandemic. Even though they represent key factor in combatting the disease, adverse events were reported following the administration of Pfizer-BioNTech and Moderna mRNA vaccines and among them myocarditis. The aim of this review was to present key points of myocarditis following the administration of Pfizer-BioNTech and Moderna mRNA vaccines like: epidemiological characteristics, clinical features, investigation and treatment

Vertebrobasilar insufficiency due to subclavian-vertebral artery steal

Subclavian-vertebral artery steal is an occurrence of a retrograde blood flow in the ipsilateral vertebral artery when an occlusion or hemodynamically significant stenosis of the subclavian artery proximal to the origination of the vertebral artery impair normal blood flow to the arm and the brainste

Cystic Fibrosis – results of CFTR modulators in Croatia

Cistična fibroza najčešća je nasljedna bolest, koja skraćuje životni vijek, a uzrokuje je defekt u genu za transmembranski regulator provodljivosti cistične fibroze (eng. cystic fibrosis transmembrane regulator – CFTR). Poremećena je homeostaza elektrolita, što se očituje simptomima u više organskih sustava. Plućne manifestacije, s kroničnim infekcijama, upalom i, na kraju, respiratornim zatajenjem, ostaju i dalje najvažnija prijetnja životnom vijeku bolesnika. Do prije jednog desetljeća bilo je dostupno samo simptomatsko liječenje. Od 2012. g. dostupno je liječenje tzv. modulatorima CFTR-proteina i njihovim kombinacijama za osobe s cističnom fibrozom koje nose različite varijante CFTR-gena. Pojavom tih lijekova uvelike se promijenila perspektiva i kvaliteta života ljudi s cističnom fibrozom, ali postavljeni i novi izazovi u vezi s dugoročnim komplikacijama, pitanje eventualnog smanjenja konvencionalnog liječenja, ali i financiranja terapije, koja je mnogim bolesnicima nedostupna. Iznesene su bazične spoznaje o cističnoj fibrozi i funkciji CFTR-proteina, klasifikaciji varijanata CFTR-gena, mogućnostima liječenja CFTR-modulatorima te osnovni ishodi liječenja bolesnika s cističnom fibrozom u Hrvatskoj, gdje se ta terapija primjenjuje od jeseni 2021. godine.Cystic fibrosis, the most frequent lifespan shortening hereditary disease in Caucasians, is caused by a defect in the CFTR (cystic fibrosis transmembrane regulator) gene. Disturbed electrolyte homeostasis leads to the development of different symptoms in multiple organs. Pulmonary manifestations with chronic infections and inflammation result in respiratory failure and remain the most important life-shortening factor. Until recently only symptomatic treatment was available. In year 2012. a new treatment approach with small molecules that modulate the CFTR protein was introduced. Different combinations of CFTR modulators are applicable to certain patients carrying different variants of the CFTR gene. CFTR modulators made a huge difference in the quality of life and perspectives of people with cystic fibrosis. At the same time, new challenges emerged regarding long term complications and possible reduction of conventional treatment options, as well as financial issues that are an obstacle to the use of these drugs for many patients. This paper brings basic insight into cystic fibrosis, the function of CFTR protein, the classification of CFTR gene variants and possibilities of treatment with CFTR modulators as well as basic outcomes of CFTR modulators treatment in Croatia, where this therapy was introduced in autumn 2021

Nutritional assessment in patients with cirrhosis and inflammatory bowel disease

Nutritivni status pruža informacije o općem stanju i uhranjenosti pojedinca. Svako odstupanje od normalnog nutritivnog statusa naziva se malnutricija. Malnutricija je veoma učestala pojava u pacijenata koji boluju od bolesti kroničnog tijeka. Može biti zamijećena u svim stadijima bolesti te se često povezuje s nepovoljnim ishodom i višim mortalitetom. Nešto veća prevalencija malnutricije zabilježena je kod pacijenata s Crohnovom bolesti, u odnosu na ulcerozni kolitis. Malnutricija se također ubraja u najučestalije komplikacije kompenzirane i dekompenzirane ciroze jetre. U pacijenata s upalnim crijevnim bolestima ključni faktori koji utječu na nutritivni status su smanjeni unos hrane, aktivna upala, smanjena apsorpcija i gubitak nutrijenata za vrijeme aktivne faze bolesti. U cirozi jetre poremećaju nutritivnog statusa doprinose još i hormonski disbalans, disbioza crijevnog mikrobioma, malapsorpcija te konzumacija alkohola. Zbog tolike učestalosti, precizno i brzo određivanje nutritivnog statusa pacijenta je od iznimne važnosti za kliničku primjenu i osiguravanje odgovarajuće skrbi i nutritivne potpore. Niti jedna postojeća metoda procjene nije dovoljno pouzdana kako bi postala zlatnim standardom, stoga se najtočnija procjena statusa dobiva kombiniranjem više različitih metoda. Sama procjena nutritivnog statusa može biti subjektivna i objektivna, a glavne skupine metoda procjene su dijetetičke metode, antropometrijske metode, biokemijske metode te klinički pregled. Danas su u kliničkoj uporabi razni alati za procjenu nutritivnog statusa, kojima se služimo za pokušaj predviđanja toka bolesti te procjene utjecaja nutritivne intervencije na pacijenta. Primjer takvog alata je NRS-2002 (engl. Nutritional Risk Screening - 2002) upitnik. Kombinacija procjene nutritivnog statusa antropometrijskim mjerenjima, NRS2002-upitnikom i laboratorijskim parametrima, prikazana u ovom radu precizniji je način određivanja nutritivnog statusa nego korištenjem svake od navedenih metoda zasebno.Nutritional status provides information about the general condition and nutrition of an individual. Any deviation from normal nutritional status is called malnutrition. Malnutrition is a very common condition in patients suffering from chronic diseases. It can be observed at all stages of the disease and is often associated with an unfavorable outcome and higher mortality. A slightly higher prevalence of malnutrition was observed in patients with CD compared to UC. Also, malnutrition is among the most common complications of compensated and decompensated liver cirrhosis. In patients with inflammatory bowel disease, key factors affecting nutritional status are reduced food intake, active inflammation, and nutrient loss during the active phase of the disease. In liver cirrhosis, hormonal imbalance, intestinal microbiome dysbiosis, malabsorption and alcohol consumption also contribute to nutritional status disorders. Because of this frequency, accurate and rapid determination of a patient’s nutritional status is of utmost importance for clinical application and the provision of appropriate care and nutritional support. No existing assessment method is reliable enough to become the gold standard of assessment, so the most accurate status assessments are obtained by combining several different methods. The assessment of nutritional status itself can be subjective and objective, and the main groups of assessment methods are dietary methods, anthropometric methods, biochemical methods, and clinical examination. Today, various tools are used to assess nutritional status, with purpose to try to predict the course of the disease and assess the impact of nutritional intervention on the patient. An example of such a tool is the NRS-2002 (Nutritional Risk Screening - 2002) questionnaire. The combination of nutritional status assessment by anthropometric measurements, NRS2002-questionnaire, and laboratory parameters, presented in this paper are a more precise way of determining nutritional status than using each of the above methods separately

Movement and dance stories in the curriculum of natural and social sciences

This bachelor's degree thesis with a title “Movement and Dance Stories in the Curriculum of Natural and Social Sciences” is separated into two parts, theoretical part and empirical part. Theoretical part consists of the dance theory or creative movement. I have explained what exactly embodied cognition is and what have other pedagogues and scientists written about it. Because one cannot find a big plethora of professional literature on this topic, I have decided to explore how to connect dance and movement stories with natural and social science in the kindergarten. Empirical part consists of six dance and movement activities which are connected to the different topics within the natural or social science. The main point behind my thesis was to find out whether children are capable of using different dancing elements when expressing themselves through dance and movement and if I would have been able to meet the educational goal within the curriculum of natural or social science. At the end of the activity, I checked the level of acquired knowledge from the area of natural or social science through a drawing about a certain topic that was previously re-enacted through their body movement. Every child was able to communicate their understanding of the story and their feelings regarding the story with me. Since I have four foreign language children in my kindergarten group, I was intrigued by how will they connect with the dance and movement stories, how will their knowledge of the language progress and which will be easier for them to express with, movement, drawing or storytelling. The children really enjoyed the dance and movement stories; they were relaxed and spontaneous as were their movements and whilst all this was happening, they were coming up with new and new dance elements. From time to time whilst they were listening to the stories, they used the outside encouragement which elevated their creative movement. Children have assimilated the knowledge about the natural and social science concepts with the help of the dance and movement stories since they used their bodies to re-enact them. All of the concepts were later drawn by them and trough their drawings, one could realise that they understood the point which proves the main goal of the thesis. Foreign language children were not always present when we were doing the dance and movement stories, but when they were, they watched and imitated the other children. It was much easier for them to express themselves through drawings than through speaking or through movement, since the understanding was not sufficient. With the participation in the dance and movement stories they showed their well being and content since they had a chance to be a part of a group activity which made them feel that they are a part of their kindergarten group

Movement and dance stories in the curriculum of natural and social sciences

Diplomsko delo Gibalno-plesne zgodbe v povezavi z naravo in družbo je razdeljeno na dva dela: teoretičnega in empiričnega. V teoretičnem delu sem opredelila ples oz. ustvarjalni gib. Pojasnila sem, kaj pomeni utelešena kognicija in kaj so o tej temi že ugotovili drugi znanstveniki oziroma pedagogi. Ker še ni veliko raziskav o pričujoči temi, sem se odločila, da raziščem, kako lahko gibalno-plesne zgodbe povežem s področjem narave in družbe v vrtcu. V empiričnem delu je predstavljenih šest gibalno-plesnih dejavnosti, ki se povezujejo z različnimi temami pri naravi in družbi. Bistvo diplomskega dela je bilo ugotoviti, ali bodo otroci ob gibalno-plesnem izražanju uporabljali različne plesne elemente in ali jim bom lahko na takšen način približala vzgojni cilj s področja narave in družbe. Na koncu dejavnosti sem preverjala pridobljeno znanje, tako da so otroci narisali pojem s področja narave ali družbe, ki so ga prej uprizorili z ustvarjalnim gibom. Ob tem sem izvedla kratek pogovor, v katerem je otrok pripovedoval o svojem razumevanju zgodbe in tudi o svojem počutju. Ker imamo v naši skupini tudi štiri tujejezične otroke, me je zanimalo, kako se bodo vključili v gibalno-plesne dejavnosti, kako bo napredoval njihov govor in ali se bodo lažje izražali z gibom, risbo ali s pripovedovanjem. V gibalno-plesnih dejavnostih so otroci neizmerno uživali, izvajali sproščene in spontane gibe, in si izmišljali nove plesne elemente. Ob poslušanju gibalno-plesnih zgodb so včasih uporabljali zunanje spodbude, ki so popestrile njihovo ustvarjalno gibanje. Otroci so usvojili naravoslovne in družboslovne pojme z gibalno-plesnimi zgodbami, saj so jih s svojim telesom uprizorili oziroma utelesili. Pojme so tudi narisali in iz njihovih risb je bilo razvidno, da so pojme razumelis tem je bil zastavljen cilj diplomskega dela dosežen. Tujejezični otroci niso bili prisotni v vseh gibalno-plesnih dejavnostih, ko pa so bili, so opazovali in posnemali sovrstnike. Veliko lažje se jim je bilo izražati z risbo kot s pogovorom ali z gibom, saj včasih niso vsega razumeli. Pri sodelovanju v gibalno-plesnih dejavnostih so izražali dobro počutje, saj so se počutili v skupini sprejete in so imeli možnost skupinskega sodelovanja.This bachelor\u27s degree thesis with a title “Movement and Dance Stories in the Curriculum of Natural and Social Sciences” is separated into two parts, theoretical part and empirical part. Theoretical part consists of the dance theory or creative movement. I have explained what exactly embodied cognition is and what have other pedagogues and scientists written about it. Because one cannot find a big plethora of professional literature on this topic, I have decided to explore how to connect dance and movement stories with natural and social science in the kindergarten. Empirical part consists of six dance and movement activities which are connected to the different topics within the natural or social science. The main point behind my thesis was to find out whether children are capable of using different dancing elements when expressing themselves through dance and movement and if I would have been able to meet the educational goal within the curriculum of natural or social science. At the end of the activity, I checked the level of acquired knowledge from the area of natural or social science through a drawing about a certain topic that was previously re-enacted through their body movement. Every child was able to communicate their understanding of the story and their feelings regarding the story with me. Since I have four foreign language children in my kindergarten group, I was intrigued by how will they connect with the dance and movement stories, how will their knowledge of the language progress and which will be easier for them to express with, movement, drawing or storytelling. The children really enjoyed the dance and movement storiesthey were relaxed and spontaneous as were their movements and whilst all this was happening, they were coming up with new and new dance elements. From time to time whilst they were listening to the stories, they used the outside encouragement which elevated their creative movement. Children have assimilated the knowledge about the natural and social science concepts with the help of the dance and movement stories since they used their bodies to re-enact them. All of the concepts were later drawn by them and trough their drawings, one could realise that they understood the point which proves the main goal of the thesis. Foreign language children were not always present when we were doing the dance and movement stories, but when they were, they watched and imitated the other children. It was much easier for them to express themselves through drawings than through speaking or through movement, since the understanding was not sufficient. With the participation in the dance and movement stories they showed their well being and content since they had a chance to be a part of a group activity which made them feel that they are a part of their kindergarten group

Nutritional assessment in patients with cirrhosis and inflammatory bowel disease

Nutritivni status pruža informacije o općem stanju i uhranjenosti pojedinca. Svako odstupanje od normalnog nutritivnog statusa naziva se malnutricija. Malnutricija je veoma učestala pojava u pacijenata koji boluju od bolesti kroničnog tijeka. Može biti zamijećena u svim stadijima bolesti te se često povezuje s nepovoljnim ishodom i višim mortalitetom. Nešto veća prevalencija malnutricije zabilježena je kod pacijenata s Crohnovom bolesti, u odnosu na ulcerozni kolitis. Malnutricija se također ubraja u najučestalije komplikacije kompenzirane i dekompenzirane ciroze jetre. U pacijenata s upalnim crijevnim bolestima ključni faktori koji utječu na nutritivni status su smanjeni unos hrane, aktivna upala, smanjena apsorpcija i gubitak nutrijenata za vrijeme aktivne faze bolesti. U cirozi jetre poremećaju nutritivnog statusa doprinose još i hormonski disbalans, disbioza crijevnog mikrobioma, malapsorpcija te konzumacija alkohola. Zbog tolike učestalosti, precizno i brzo određivanje nutritivnog statusa pacijenta je od iznimne važnosti za kliničku primjenu i osiguravanje odgovarajuće skrbi i nutritivne potpore. Niti jedna postojeća metoda procjene nije dovoljno pouzdana kako bi postala zlatnim standardom, stoga se najtočnija procjena statusa dobiva kombiniranjem više različitih metoda. Sama procjena nutritivnog statusa može biti subjektivna i objektivna, a glavne skupine metoda procjene su dijetetičke metode, antropometrijske metode, biokemijske metode te klinički pregled. Danas su u kliničkoj uporabi razni alati za procjenu nutritivnog statusa, kojima se služimo za pokušaj predviđanja toka bolesti te procjene utjecaja nutritivne intervencije na pacijenta. Primjer takvog alata je NRS-2002 (engl. Nutritional Risk Screening - 2002) upitnik. Kombinacija procjene nutritivnog statusa antropometrijskim mjerenjima, NRS2002-upitnikom i laboratorijskim parametrima, prikazana u ovom radu precizniji je način određivanja nutritivnog statusa nego korištenjem svake od navedenih metoda zasebno.Nutritional status provides information about the general condition and nutrition of an individual. Any deviation from normal nutritional status is called malnutrition. Malnutrition is a very common condition in patients suffering from chronic diseases. It can be observed at all stages of the disease and is often associated with an unfavorable outcome and higher mortality. A slightly higher prevalence of malnutrition was observed in patients with CD compared to UC. Also, malnutrition is among the most common complications of compensated and decompensated liver cirrhosis. In patients with inflammatory bowel disease, key factors affecting nutritional status are reduced food intake, active inflammation, and nutrient loss during the active phase of the disease. In liver cirrhosis, hormonal imbalance, intestinal microbiome dysbiosis, malabsorption and alcohol consumption also contribute to nutritional status disorders. Because of this frequency, accurate and rapid determination of a patient’s nutritional status is of utmost importance for clinical application and the provision of appropriate care and nutritional support. No existing assessment method is reliable enough to become the gold standard of assessment, so the most accurate status assessments are obtained by combining several different methods. The assessment of nutritional status itself can be subjective and objective, and the main groups of assessment methods are dietary methods, anthropometric methods, biochemical methods, and clinical examination. Today, various tools are used to assess nutritional status, with purpose to try to predict the course of the disease and assess the impact of nutritional intervention on the patient. An example of such a tool is the NRS-2002 (Nutritional Risk Screening - 2002) questionnaire. The combination of nutritional status assessment by anthropometric measurements, NRS2002-questionnaire, and laboratory parameters, presented in this paper are a more precise way of determining nutritional status than using each of the above methods separately

Nutritional assessment in patients with cirrhosis and inflammatory bowel disease

Nutritivni status pruža informacije o općem stanju i uhranjenosti pojedinca. Svako odstupanje od normalnog nutritivnog statusa naziva se malnutricija. Malnutricija je veoma učestala pojava u pacijenata koji boluju od bolesti kroničnog tijeka. Može biti zamijećena u svim stadijima bolesti te se često povezuje s nepovoljnim ishodom i višim mortalitetom. Nešto veća prevalencija malnutricije zabilježena je kod pacijenata s Crohnovom bolesti, u odnosu na ulcerozni kolitis. Malnutricija se također ubraja u najučestalije komplikacije kompenzirane i dekompenzirane ciroze jetre. U pacijenata s upalnim crijevnim bolestima ključni faktori koji utječu na nutritivni status su smanjeni unos hrane, aktivna upala, smanjena apsorpcija i gubitak nutrijenata za vrijeme aktivne faze bolesti. U cirozi jetre poremećaju nutritivnog statusa doprinose još i hormonski disbalans, disbioza crijevnog mikrobioma, malapsorpcija te konzumacija alkohola. Zbog tolike učestalosti, precizno i brzo određivanje nutritivnog statusa pacijenta je od iznimne važnosti za kliničku primjenu i osiguravanje odgovarajuće skrbi i nutritivne potpore. Niti jedna postojeća metoda procjene nije dovoljno pouzdana kako bi postala zlatnim standardom, stoga se najtočnija procjena statusa dobiva kombiniranjem više različitih metoda. Sama procjena nutritivnog statusa može biti subjektivna i objektivna, a glavne skupine metoda procjene su dijetetičke metode, antropometrijske metode, biokemijske metode te klinički pregled. Danas su u kliničkoj uporabi razni alati za procjenu nutritivnog statusa, kojima se služimo za pokušaj predviđanja toka bolesti te procjene utjecaja nutritivne intervencije na pacijenta. Primjer takvog alata je NRS-2002 (engl. Nutritional Risk Screening - 2002) upitnik. Kombinacija procjene nutritivnog statusa antropometrijskim mjerenjima, NRS2002-upitnikom i laboratorijskim parametrima, prikazana u ovom radu precizniji je način određivanja nutritivnog statusa nego korištenjem svake od navedenih metoda zasebno.Nutritional status provides information about the general condition and nutrition of an individual. Any deviation from normal nutritional status is called malnutrition. Malnutrition is a very common condition in patients suffering from chronic diseases. It can be observed at all stages of the disease and is often associated with an unfavorable outcome and higher mortality. A slightly higher prevalence of malnutrition was observed in patients with CD compared to UC. Also, malnutrition is among the most common complications of compensated and decompensated liver cirrhosis. In patients with inflammatory bowel disease, key factors affecting nutritional status are reduced food intake, active inflammation, and nutrient loss during the active phase of the disease. In liver cirrhosis, hormonal imbalance, intestinal microbiome dysbiosis, malabsorption and alcohol consumption also contribute to nutritional status disorders. Because of this frequency, accurate and rapid determination of a patient’s nutritional status is of utmost importance for clinical application and the provision of appropriate care and nutritional support. No existing assessment method is reliable enough to become the gold standard of assessment, so the most accurate status assessments are obtained by combining several different methods. The assessment of nutritional status itself can be subjective and objective, and the main groups of assessment methods are dietary methods, anthropometric methods, biochemical methods, and clinical examination. Today, various tools are used to assess nutritional status, with purpose to try to predict the course of the disease and assess the impact of nutritional intervention on the patient. An example of such a tool is the NRS-2002 (Nutritional Risk Screening - 2002) questionnaire. The combination of nutritional status assessment by anthropometric measurements, NRS2002-questionnaire, and laboratory parameters, presented in this paper are a more precise way of determining nutritional status than using each of the above methods separately