Organization of medical service of Bjelovar Medical centre during homeland\u27s war

Događanja u pakračko-daruvarskom, grubišno-poljskom, te bilogorskom kraju, u Medicinskom centru Bjelovar ispravno su procijenjena. Transformacija mirnodopskog zdravstva u ratni sanitet s odgovarajućim stručnim ljudskim potencijalom, donekle zaštićenim radnim prostorima, omogućili su nam da svoju glavnu ulogu, liječenje ranjenika, učinimo na najbolji mogući način, držeći se načela moderne medicinske znanosti.The war events in the Pakrac, Daruvar and Grubišno Polje region as well as in the Bilogora area are correctly estimated in Medical Centre Bjelovar. The transformation from civil to war medicine with appropriate expert teams working in relatively protected parts of the hospital has enabled us to provide adequate medical care and treatment of the wounded, according to the principles of the modern medicine

Develpment of endoscopy at the ward for ear, nose and throat disease of the Bjelovar general hospital

U radu je dan pregled razvoja endoskopije u djelatnosti za bolesti uha, nosa i grla Opće bolnice Bjelovar, od osnutka do današnjih dana. Prikazan je slijed nabavke endoskopskih instrumentarija, te mogućnosti endoskopskih pretraga koje se na odjelu rade. Zatim se govori o broju i vrsti endoskopskih zahvata koji su obavljeni u posljednjih šest godina. ORL odjel u Bjelovaru raspolaže suvremenim instrumentarijem za ezofagoskopiju, traheobronhoskopiju, s krutim i fleksibilnim instrumentima, a u posljednje dvije godine i instrumentarijem za funkcionalnu endoskopsku sinusnu kirurgiju. Godišnje se napravi u prosjeku 33 ezofagoskopije, 7 traheobronhoskopija s rigidnim traheobronhoskopom, a zadnje dvije godine 85 bolesnika operirano je prema načelima funkcionalne endoskopske sinusne kirurgije.The development of endoscopy at the Ward for ear, nose and throat diseases of the General Hospital in Bjelovar was reviewed from its foundation to these days. The sequence of endoscopic instruments\u27 acquisitions and possibilities of endoscopic examinations preformed at the wadr are presented. The Otolaryngological ward in Bjelovar has at its disposal modern instruments for oesophagoscopy, tracheobronchoscopy, solid and flexibile instruments and since two years ago, the instruments for functional endoscopic sinus surgery. Annually an average of 33 oesophagoscopies and 7 tracheobronchoscopies with rigid tracheobronchoscope are done and up to now 85 patients have been operated on according to the principles of functional endoscopic sinus surgery

The role of a family doctor concerning laryngeal cancer

Obiteljski liječnik, kao osoba prvog kontakta na relaciji liječnik bolesnik, ima izuzetnu ulogu ne samo u prevenciji raka grla, već i u njegovom ranom otkrivanju blago vremenim opažanjem onih simptoma koji će bolesnika na vrijeme dovesti do postavljanja prave dijagnoze i pravovremene terapije. Bolesnik sa rakom grla je specifičan ne samo zbog toga što ima malignu bolest, već i zbog toga što rak grla dovodi do gubitka, ili bar smanjenja, funkcija organa tako važnog u svakodnevnom životu čovjeka, a to je glas i govor. Bolesnik sa karcinomom grla postaje problem i sam sebi zbog teškoća u komunikaciji sa okolinom, ali i problem svojoj radnoj i obiteljskoj sredini koja ga takvog teže prihvaća. Gdje je tu mjesto obiteljskom liječniku?Family doctor as a person of the first contact between doctor and patient has an exceptional task not only in prevention but also in the early discovery of laryngeal cancer. Observation of symptoms will help make the right diagnosis timely and prescribe medical treatment for the patient. Such a patient is specific not only because of his malignant disease, but because laryngeal cancer affects the function of the speech organs, causing partial or complete loss of voice and speech. In everyday live a patient with laringeal cancer has difficulties in communication with other people. He becomes a burden to himself and to his family and working environment that accept him with difficulty. Where is there the place of the family doctor

Perioperative blood transfusion as a possible prognostic factor in laryngeal cancer

Retrospektivno je istraživan značaj perioperativne transfuzije krvi na tijek i ishod bolesti u 116 bolesnika koji su zbog raka grkljana operirani u Klinici za bolesti uha, nosa, grla i cervikofacijalnu kirurgiju Kliničkog bolničkog centra u Zagrebu u razdoblju od 1985. do 1990. godine. U istraživanu skupinu uključeni su bolesnici s karcinomima II. do IV. stupnja bolesti, jer među bolesnicima I. stupnja karcinomske bolesti nije zapažen ni jedan recidiv, niti je u bilo kojeg bolesnika tog stupnja primijenjena transfuzija krvi. Recidiv je zapažen u 73 bolesnika (62,9%), i to: u 42 (70%) od 60 bolesnika koji su perioperativno primili transfuziju krvi; te u 31 (55,4%) od 56 bolesnika koji nisu primili transfuziju krvi. Uočena razlika nije statistički značajna. U prvoj godini praćenja registrirano je u skupini osoba koje su perioperativno dobile transfuziju krvi 33 (45,2%) recidiva od 73 recidiva zapažena u obje skupine (ili 78,6% od 42 osobe koje su perioperativno primile transfuziju krvi te dobile recidiv u cijelom trogodišnjem razdoblju praćenja; preostalih 9 recidiva zapaženo je u drugoj godini praćenja). U skupini osoba koje nisu primile transfuziju krvi, recidivi su raspodijeljeni tako da je 15 recidiva zapaženo u prvoj godini, te 16 u drugoj i trećoj godini praćenja. U skupini osoba koje su primile transfuziju krvi statistički je značajno zapažanje ranije pojave recidiva (x2 12,379; DF2;P<0.001).A retrospective study was conducted on the influence of perioperative blood transfusion on the course and outcome of the disease with 116 patients on whom a surgical proce­dure had been performed at the ENT department, Zagreb University Hospital, in the period from 1985 to 1990. The group under research in cluded only the patients with laryngeal cancer in the 2nd do 4th stage, be cause patients in the 1st stage of the disease had neither received blood transfusion nor had a recurrence. Recurrence, however, was noted in 73 (62.9 %) patients i.e. in 42 (70 %) patients who received blood transfusion perioperatively and in 31 (55.4 %) patients who did not received blood transfusion. The difference was not statistically significant. During the first post-operative year 73 recurrences occurred, 33 (45.2%) of which in the group that received perioperative blood transfusion (i.e., 78.6% of the 42 persons who received perioperative blood transfusion and had a recurrence in the three-year observation period; the remaining 9 recurrences occurred during the 2nd year of the observation), and 16 during the remaining two years of the observation. Earlier recurrences in the patients who received perioperative blood transfusion are statistically significant (x2 12.379; DF 2; P<0.001)

Reconstruction of ala nasi defect in patients with facial and trigeminal nerve paralysis caused by trigeminal trophic syndrome

Nosno krilo predstavlja važan izražajni detalj ljudskog lica čija rekonstrukcija predstavlja pravi izazov za kirurga. U radu se željelo prikazati mogućnosti rekonstrukcije potpunog defekta nosnog krila kod bolesnika s paralizom ličnog i trigeminalnog živca u sastavu trigeminalnog trofičkog sindroma. Pri rekonstrukciji se koristio otočasti transpozicijski režanj kože zdrave strane čela na subkutanoj peteljci koji posjeduje vlastitu vaskularizaciju i inervaciju, čije preživljenje ne ovisi o primajućoj regiji. Ovaj režanj pokazao se izuzetno pogodnim prilikom rekonstrukcije defekata nosnog krila u bolesnika s paralizom ličnog i trigeminalnog živca, jer donosi zdravo tkivo u neurološki mrtvu regiju.Ala nasi represents a significant expressive detail of human face, whose reconstruction represents a real challenge for a surgeon. The intention of the paper was to present the options for reconstruction of total ala nasi defect in patients with facial and trigeminal nerve paralysis in the pattern of the trigeminal trophic syndrome. During the reconstruction, the insular transposition flap was used from the healthy side of the forehead on the subcutaneous stalk, which possesses its own vascularization and innervation, and whose survival does not depend on the recipient area. This flap proved itself extremely suitable during the reconstruction of the ala nasi defects in patients with facial and trigeminal nerve paralysis, because it brings healthy tissue in the neurologically dead area

Thomas Aquinas on finality

Pitanje o svrsi vlastitoga života i postoji li svrha uopće čovjek si postavlja od pamtivijeka. Možemo reći da je pitanje o svrsi jedno od egzistencijalno najvažnijih pitanja s kojima se čovjek suočava. Na tom tragu autora ovog rada na pitanje o svrsi i svrhovitosti svega što jest nalazi u nauku Tome Akvinskog, jednog od velikana filozofske misli. No, da bi izložili Akvinčevo poimanje svrhovitosti bilo je nužno iznijeti nekoliko preliminarnih napomena o teleologiji i njezinim počecima. Štoviše, bilo je nužno izložiti i Aristotelov nauk o četiri uzroka. Naime, Aristotelov teleološki nauk prihvatio je i produbio Toma Akvinski kod kojeg nalazimo vezu između prvog uzroka pisanog maili i Prvog uzroka pisanog velikim slovom. Akvinac je jedini, kako se smatra, nauk o svrhovitosti izložio cjelovito. Drugim riječima, nauk o svrhovitosti Tome Akvinskog obuhvaća cjelokupnu stvarnost što u sebi uključuje prirodu koja nas okružuje, ali i čovjeka sa svim njegovim dimenzijama. Značaj ovako shvaćene svrhovitosti je velik jer, s jedne strane, odgovara na pitanja o ljudskoj svrsi, a samim time odgovara na specifično ljudsku potragu za srećom. S druge pak strane, objašnjava smisao, svrhu i djelovanje cjelokupne prirode koja je svrhovita. Za Tomu Akvinskog ključ svrhovitosti nalazi se u Bogu koji se razumije kao izvor života, ali i kao konačno i potpuno ispunjenje sviju svrhovitih težnji svega što djeluje prema nekom cilju, odnosno svega što jest i što bivstvuje.The question of the purpose of one's own life and is there a purpose at all the man is asking since ancient times. We can say that the question of purpose is one of the existentially most important issues that man faces. At that trail, the author of this paper, the question of the purpose and purpose of all that is, found in the teaching of Thomas Aquinas, one of the great philosophical thinkers. However, in order to exhibit the Aquinar's concept of purposes, it was necessary to present several preliminary notes about teleology and its beginnings. Moreover, it was necessary to expose Aristotel's doctrine of four causes. Namely, Aristotle's teleological doctrine has accepted and deepened Tom Aquinas, at which we find the link between the first cause and Fist cause. Aquinas is the only one, as it is considered, that exposed complete the doctrine of the purpose. In other words, the doctrine of the purposefulness at Aquinas covers the entire reality that involves the nature that surrounds us, but also a man with all his dimensions. The significance of this kind of purpose is great because, on the one hand, it answers questions about human purpose, and therefore responds to a specific human quest for happiness. On the other hand, it explains the meaning, purpose and action of the entire nature that is purposeful. For the Aquinas's key of purpose is in God that is understood as a source of life, but also as a final and fulfilment of all the purposeful aspirations of everything that acts according to some goal, or everything that is and what is being in existence

Thomas Aquinas on finality

Pitanje o svrsi vlastitoga života i postoji li svrha uopće čovjek si postavlja od pamtivijeka. Možemo reći da je pitanje o svrsi jedno od egzistencijalno najvažnijih pitanja s kojima se čovjek suočava. Na tom tragu autora ovog rada na pitanje o svrsi i svrhovitosti svega što jest nalazi u nauku Tome Akvinskog, jednog od velikana filozofske misli. No, da bi izložili Akvinčevo poimanje svrhovitosti bilo je nužno iznijeti nekoliko preliminarnih napomena o teleologiji i njezinim počecima. Štoviše, bilo je nužno izložiti i Aristotelov nauk o četiri uzroka. Naime, Aristotelov teleološki nauk prihvatio je i produbio Toma Akvinski kod kojeg nalazimo vezu između prvog uzroka pisanog maili i Prvog uzroka pisanog velikim slovom. Akvinac je jedini, kako se smatra, nauk o svrhovitosti izložio cjelovito. Drugim riječima, nauk o svrhovitosti Tome Akvinskog obuhvaća cjelokupnu stvarnost što u sebi uključuje prirodu koja nas okružuje, ali i čovjeka sa svim njegovim dimenzijama. Značaj ovako shvaćene svrhovitosti je velik jer, s jedne strane, odgovara na pitanja o ljudskoj svrsi, a samim time odgovara na specifično ljudsku potragu za srećom. S druge pak strane, objašnjava smisao, svrhu i djelovanje cjelokupne prirode koja je svrhovita. Za Tomu Akvinskog ključ svrhovitosti nalazi se u Bogu koji se razumije kao izvor života, ali i kao konačno i potpuno ispunjenje sviju svrhovitih težnji svega što djeluje prema nekom cilju, odnosno svega što jest i što bivstvuje.The question of the purpose of one's own life and is there a purpose at all the man is asking since ancient times. We can say that the question of purpose is one of the existentially most important issues that man faces. At that trail, the author of this paper, the question of the purpose and purpose of all that is, found in the teaching of Thomas Aquinas, one of the great philosophical thinkers. However, in order to exhibit the Aquinar's concept of purposes, it was necessary to present several preliminary notes about teleology and its beginnings. Moreover, it was necessary to expose Aristotel's doctrine of four causes. Namely, Aristotle's teleological doctrine has accepted and deepened Tom Aquinas, at which we find the link between the first cause and Fist cause. Aquinas is the only one, as it is considered, that exposed complete the doctrine of the purpose. In other words, the doctrine of the purposefulness at Aquinas covers the entire reality that involves the nature that surrounds us, but also a man with all his dimensions. The significance of this kind of purpose is great because, on the one hand, it answers questions about human purpose, and therefore responds to a specific human quest for happiness. On the other hand, it explains the meaning, purpose and action of the entire nature that is purposeful. For the Aquinas's key of purpose is in God that is understood as a source of life, but also as a final and fulfilment of all the purposeful aspirations of everything that acts according to some goal, or everything that is and what is being in existence