TRANSPLANTATION PSYCHIATRY: AN OVERVIEW

Psychiatric consultation and evaluation is an important part of candidate selection for organ transplantation. Psychiatric assessment of patients undergoing transplantation procedure is done in pre- and post transplantation periods, each one having its specifics. In the pre-transplantation period it is crucial to assess the patient’s therapeutic adherence and the ability of understanding the treatment. The main prediction factor for short and long-term success is medical compliance for which thorough clarification of psychosocial support is needed. Symptoms of psychological exhaustion due to physical illness should be distinguished from psychiatric disorders. If a patient has a history of psychiatric illness, the risks of exacerbation or recurrence of a disease need to be evaluated. Pharmacokinetic and pharmacodynamics of psychotropic drugs resulting from to organ failure should be considered when deciding on treatment. Psychiatric assessment of the organ donor aims to clarify the psychological suitability and motivation. There are specific aspects of liver, kidney, heart and lung transplantation to keep in mind. Understanding psychosexual development is particularly important to children, before transplantation, as is the assessment of every family member. The consultation concludes with an overall evaluation of the patient\u27s psychosocial strengths and limitations and recommended interventions to optimize the candidacy for transplantation. In the post-transplantation period potential psychological problems or psychiatric disorders must be identified and treated accordingly, in addition to psychiatric side effects of immunosuppressive therapy. The use of psychotropic drugs in the post-transplantation period requires knowledge of medication interactions. Overall, psychiatrists perform multiple roles in the transplantation team. The psychiatrists’ goals are to meet the psychological needs of both patients and potential donors, evaluate candidates and to help other medical experts on the team with understanding underlying psychological mechanisms triggered by serious medical conditions and procedures. Finally, the most important purpose is optimal organ recruitment and recovery

New markers for following bone healing in patients with long-bone fracture

Transformirajući čimbenik rasta beta (TGF-β) pripada velikoj superobitelji čimbenika rasta koji imaju važnu ulogu u mnogim fiziološkim i patološkim stanjima organizma, a djeluje na stanicu preko svojih receptora. TGF-β ima značajnu ulogu u proliferaciji epitelnih, endotelnih i hematopoetskih stanica te staničnoj diferencijaciji, cijeljenju rana, upali, angiogenezi i tumorogenezi. Mutacija TGF-β i njegovih receptora bitna je u patogenezi bolesti, posebno karcinoma. Uloga TGF-β prilikom razvoja i pregradnje kosti prikazana je u mnogim istraživanjima gdje se navedena molekula kod prijeloma kostiju navodi kao jedan od prvih čimbenika koji se može detektirati u krvi pacijenata. TGF-β III receptor (TGFβrIII) jedan je od najzastupljenijih receptora koji sudjeluje u djelovanju TGF-β na stanice. U zdravih ljudi TGFβrIII nije detektiran u plazmi, ali je pronađen u pacijenata s prijelomom dugih kostiju. Cilj ove studije je pratiti koncentraciju solubilnog TGFβrIII prilikom prijeloma dugih kostiju u ljudi, te utvrditi njegovu potencijalnu ulogu kao biomarkera u procesu koštanog cijeljenja. Istraživanje uključuje 22 pacijenata starija od 18 godina s dijagnozom jednostrukog koštanog prijeloma duge kosti traumatske naravi te 9 zdravih ispitanika bez ozljede koštanog sustava. Uzroci plazme prikupljeni su u različitim vremenskim periodima od trenutka prijeloma te tijekom redovitih kontrola, a zdravim ispitanicima tijekom sistematskog pregleda. Koncentracija TGFβrIII u prikupljenim uzorcima plazme određena je pomoću ELISA metode, te analizirana pomoću metode ograničene najveće vjerojatnosti REML. Dobivena koncentracija solubilnog TGFβrIII u zdravih ispitanika iznosi Ẋ= 40±10.7 pg/mL. Koncentracija solubilnog TGFβrIII nakon prijeloma postepeno raste, doseže svoj plato između 12. i 14. tjedna te zatim postupno pada na svoju početnu razinu krajem 25. tjedna. Studija je pokazala kako postoji izražaj TGFβrIII u plazmi zdravih pacijenata, te kako se koncentracija TGFβrIII prilikom cijeljenja kosti parabolično mijenja. Stoga je za zaključiti kako TGFβrIII možemo smatrati potencijalnim biomarkerom u cijeljenju kosti.Transforming growth factor beta (TGF-β) belongs to a large growth factor superfamily having an important role in a number of physiologic and pathologic states of the organism, and it binds to the cell by means of its receptors. TGF-β has an important role in proliferation of epithelium, endothelium and hematopoietic cells and cell differentiation, wound healing, inflammation, angiogenesis and tumorigenesis. Mutation of TGF-β and its receptors is essential in pathogenesis of disease, especially carcinoma. The influence of TGF-β during bone formation and remodeling has been shown throughout many researches where the respective molecule in bone fracture is noted as one of primary factors able to be detected in patients’ blood. TGF-β III receptor (TGFβrIII) is among the most present receptors participating in action of TGF-β on cells. TGFβrIII is not detected in plasma of healthy people, but it has been found in patients with long bone fracture. The aim of this study is to monitor the concentration of soluble TGFβrIII during long bone fractures in humans and to determine its possible role as a biomarker in bone healing follow up. The study involved 22 patients aged 18 and above with the diagnosis of single long bone fracture induced by trauma and 9 healthy volunteers (no skeletal trauma). Plasma samples were taken in different temporal instants beginning with moment of fracture during regular control examinations and in healthy subjects during physical examination. TGFβrIII concentration in collected samples was determined using ELISA method, and was analyzed using REML method. Concentration of soluble TGFβrIII in healthy individuals amounts to Ẋ= 40±10.7 pg/mL. Concentration of soluble TGFβrIII after fracture rises steadily, reaching plateau between week 12 and 14, and then falls slowly to its initial value at the end of week 25. This study has shown that there is expression of TGFβrIII in plasma of healthy individuals and that concentration of TGFβrIII during bone healing exhibits parabolic change. It can be concluded therefore that TGFβrIII may be considered potential biomarker for bone healing

Takotsubo cardiomyopathy after the first electroconvulsive therapy regardless of adjuvant beta-blocker use: a case report and literature review

Takotsubo cardiomyopathy (TC) is a rare complication of electroconvulsive therapy (ECT), an effective and safe treatment for severe cases of depression and psychosis. There are reports on 16 patients who developed TC after ECT, and these were predominantly female patients treated with antidepressants for depressive disorder. We describe a case of a 40-year-old male patient, with a history of schizophrenia and heavy caffeine and nicotine use, treated for acute psychotic episode with haloperidol and clozapine. Propranolol was administered because of clozapine-induced tachycardia. After 8 weeks without therapeutic response, the patient was referred for standard ECT procedure, which included premedication and bifrontotemporal stimulation. Two hours later, the patient experienced gastric pain and had increased troponin and natriuretic peptide levels and ST-elevation. After inotrope and anticoagulant treatment and replacement of antipsychotics, the patient remained stable. Contrary to common opinion, previous adrenergic blockade in this patient did not prevent TC occurrence. TC pathophysiology remains unclear although it has been related to the burst of norepinephrine neurons. Psychosis has also been associated with catecholamine dysfunction, and excessive psychological stress with long-term norepinephrine dysfunction. Animal models have shown that ECT, clozapine, and nicotine and caffeine use could considerably increase catecholamine levels. Clinical understanding of rare cardiac ECT complications could improve early recognition of patients at risk for TC and ensure safe ECT protocols

PHANTOM EARTHQUAKE SYNDROME - A PILOT STUDY AFTER ZAGREB AND BANOVINA 2020 EARTHQUAKE

Impact of earthquake on mental health is well-documented globally. A number of earthquake survivors after Zagreb and Banovina earthquake in the year 2020 reported a phenomenon of phantom earthquake. Telephone pilot study on phantom earthquake symptoms was conducted with semi-structured interview in earthquake survivors. Phantom earthquake is manifested as a false sense of earthquake-motion, accompanied with vegetative and motor symptoms with psychological distress and behavioral change that interfere with expected daily functioning. We propose an operational model for the phantom earthquake syndrome and discuss possible underlying neurobiological mechanisms to be further investigated in studying of the phantom earthquake syndrome

Effect of sex and age on physical parameters of mouflon (Ovis ammon musimon Pal.) meat

Cilj ovog diplomskog rada bio je utvrditi fizikalna svojstva mesa muflona te utjecaj spola i dobi na navedena svojstva. U tu svrhu uzorkovano je 36 uzoraka (18 muških i 18 ženskih jedinki različite dobi) dugog leđnog mišića (m. longissimus dorsi) muflona na kojima je provedeno mjerenje pH vrijednosti, pokazatelja boje mesa (L*, a* i b*), kala kuhanja, kala odmrzavanja i otpora presijecanju. Prosječna pH vrijednost iznosila je 5,55±0,08, kalo kuhanja iznosio je 30,37±3,73 %, kalo odmrzavanja 9,59±3,81 %, a otpor presijecanju 51,28±21,21 N. Parametri boje imali su sljedeće vrijednosti: L*60 = 32,64±1,79, a*60= 17,09±1,36, b*60= 5,92±0,93. Spol i dob nisu imali značajan utjecaj na većinu analiziranih svojstava. Ipak, značajno (p<0,05) veći kalo odmrzavanja i manja vrijednost a60*su utvrđene u mesu ženki u odnosu na mužjake. Ujedno, u mesu mladih jedinki je utvrđen značajno (p<0,05) manji otpor presijecanju te manja vrijednosti L60* u odnosu na srednjodobne i stare jedinke.The aim of this thesis was to determine the physical properties of mouflon meat and effect of sex and age of analyzed traits. For this purpose, 36 samples (18 male and 18 female of different age) od longissimus dorsi were collected and used to determine pH value, meat color parameters (L*, a* and b*), cooking loss, thawing loss and shear force. The average pH value was 5.55± 0.08, the cooking loss was 30.37±3.73%, the thawing loss 9.59±3.81%, and the shear force was 51.28±21.21 N. The color parameters after 60 minutes were as follows: L*60 = 32,64±1.79, a*60= 17.09±1.36, b*60= 5.92±0.93. Sex and age did not have significant effect on majority of analyzed traits. However, significantly (p<0.05) thawing loss and lower a*60 value were found in meat of females than male mouflon. Also, meat of young mouflons had significantly (p<0.05) lower shear force and L*60 value than middle-aged or old individuals

Office information systems

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Office information systems

U radu se govori o pojmovno određenju i razvoju ureda, nadalje o informacijsko sustavu i izgradnji istog u poslovanju. Objasnit će se pojam i razvoj uredskih informacijskih sustava i na kraju uredski informacijski sustavi budućnosti