Odnos između serumske razine malondialdehida i progresije kolorektalnog karcinoma

The purpose of the study was to assess the level of serum malondialdehyde (MDA) concentration and its association with the stage and histopathologic sizes of colorectal cancer (CRC). One hundred and two patients having undergone surgical treatment of CRC between January 2014 and December 2015 were included in this cross-sectional study. The patients were divided into four groups (stage I-IV) according to the TNM classification. Control group included 30 subjects with no signs of malignancy and inflammatory diseases. In each patient, preoperative blood samples were obtained for determination of MDA concentration by ELISA immunoassay. Serum levels of MDA were progressively increased in patients with CRC, reaching the highest value in the fourth stage of CRC. Serum concentrations of MDA were significantly higher in pT4 group as compared with pT3 and pT2 groups of CRC patients (p<0.01). Significantly higher levels of MDA were found in the N1 and N2 groups of CRC patients as compared with N0 group, as well as in patients with metastatic disease as compared with those without metastasis (p<0.001). In conclusion, the progression of CRC is associated with a significant increase in serum MDA levels.Cilj istraživanja bio je procijeniti razinu koncentracije malondialdehida (MDA) u serumu i njegove povezanosti sa stadijem i histopatološkom veličinom kolorektalnog karcinoma (CRC). Stotinu i dva bolesnika podvrgnuta kirurškom liječenju CRC između siječnja 2014. i prosinca 2015. godine bili su uključeni u ovu presječnu studiju. Bolesnici su bili podijeljeni u četiri skupine (stadiji I.-IV.) prema klasifikaciji TNM. Kontrolnu skupinu predstavljalo je 30 ispitanika bez znakova malignih i upalnih bolesti. U svakog bolesnika prijeoperacijski su uzeti uzorci krvi za određivanje koncentracije MDA pomoću imuno testa ELISA. Razine MDA u serumu su se postupno povećavale u bolesnika s CRC, dosegnuvši najvišu vrijednost u četvrtoj fazi CRC. Serumske koncentracije MDA bile su značajno više u skupini pT4 u odnosu na skupine pT3 i pT2 bolesnika s CRC (p<0,01). Utvrđene su značajno više razine MDA u skupinama N1 i N2 u odnosu na skupinu N0, kao i kod bolesnika s metastatskom bolešću u usporedbi s bolesnicima bez metastaza (p<0,001). U zaključku, napredovanje CRC povezano je sa značajnim porastom razine MDA u serumu

Assessment of gait in patients with fibromyalgia during motor and cognitive dual task walking: a cross-sectional study

Background: The aim of the study was to assess gait pattern of patients diagnosed with fibromyalgia (FM) while performing demanding motor and/or cognitive dual tasks while walking. Further, idea was to explore possible correlations of dual task gait pattern alterations to patients’ functional status and presence or absence of clinical symptoms associated with FM. Methods: Twenty-four female FM patients and 24 healthy female subjects performed a basic walking task, a dual motor, a dual mental (cognitive) and a combined, dual motor and cognitive task simultaneously. Quantitative spatial (stride length) and temporal (cycle time, swing time and double support time) gait parameters were measured using GAITRite walkway system and their variability was assessed. Patients underwent clinical examination including assessment of functional status, pain and fatigue level, psychiatric and cognitive manifestations. Results: The motor, cognitive and combined dual tasks affect gait performance in FM patients. Difference in tasks between FM and healthy subjects was found as double support time prolongation. Comparison of tasks showing that cycle time in FM was longer than controls and stride length was shorter in patients for all conditions, while no changes were found in any of the gait parameters variability. Further, mental/cognitive dual tasks had a larger effect than motor tasks. Correlations were also found between depression and functional status of the patients and the gait parameters. Conclusions: Gait is affected in FM patients while dual task walking. No changes in stride-to-stride variability point that patients preserve stability in complex walking situations. Analysis of gait may provide additional information for the FM identification based on presence of clinical features and cognitive status. Correlation of dual task gait alterations with occurrence of clinical symptoms and influence of cognitive changes on gait pattern could additionally define FM subgroups

MOTORCYCLE EMERGENCY MEDICAL SERVICE

Nastavni zavod za hitnu medicinu u suradnji s Gradom Zagrebom provodi probni projekt Hitna medicinska pomoć na motociklu od 2016. godine kada su nabavljena dva motocikla za pružanje medicinske pomoći. U 2019. godini projekt je proširen nabavom dvaju novih snažnijih motocikla. T3 timovi, medicinski tehničari na motociklima interveniraju od travnja do listopada kao tri tima raspoređena na tri lokacije: Centar, Jarun i Dubrava. Ciljevi projekta su skratiti vrijeme dolaska timova hitne medicinske pomoći na mjesto intervencije, smanjiti mortalitet kardiorespiratornog aresta, učinkovitije rasporediti raspoložive resurse (timovi na terenu) te podići standard hitne medicinske pomoći u Gradu Zagrebu. Njihova prednost je što brže i lakše stižu do unesrećenih na gradskim prometnicama, osobito u vrijeme prometnih gužvi. Hitnoj pomoći na motociklu treba prosječno 5,18 minuta za dolazak na mjesto intervencije, dok je za isto standardnom timu s kombijem potrebno oko 10,45 minuta. U 2019. godini ukupan broj intervencija HMP na motociklu iznosi 807, od toga 253 samostalne i 554 zajedno s vozilom HMP. Započeto je 11 reanimacija od medicinskog tehničara na motociklu, a vrijeme dolaska za prvi stupanj hitnosti iznosi 4,57 minuta. Medicinska oprema na motociklu sastoji se od AVD, kisika, opreme za zbrinjavanje dišnog puta, glukometra, iv. kanile, infuzija, zavojnih materijala, ovratnika, udlaga i START trijaža seta. Neka od ograničenja hitne pomoći na motociklu su vremenski uvjeti, visoka rizičnost rada, oprema – prostor na motoru, fi nanciranje timova na motociklu i brojnost članova tima hitne medicinske službe. U budućnosti je cilj dodatno educirati medicinske tehničare i povećati broj postupaka na terenu, standardizirati kadar, povećati broj timova te obnoviti vozni park.Emergency Medicine Service, in cooperation with the City of Zagreb, has been implementing the pilot project Medical Emergency Motorcycle Assistance since 2016, with two motorcycles provided to enable emergency medical assistance. In 2019, the project was expanded with the acquisition of two new more powerful motorcycles. The T3 teams, motorcycle medical technicians, intervene from April to October as three teams deployed at three locations, i.e. Center, Jarun and Dubrava. The aim of the project is to shorten the time of emergency medical (EM) team arrival to the site of intervention, reduce the cardiac arrest mortality, provide more effi cient allocation of available resources (teams in the fi eld), and raise the standard of EM care in Zagreb. Their advantage is that they get to casualties on city roads as quickly and easily as possible, especially during traffi c jams. It takes the mean of 5.18 minutes for a motorcycle ambulance to arrive to the intervention site versus 10.45 minutes needed for the standard ambulance team to arrive. In 2019, the total number of motorcycle EM interventions was 807, of which 253 were standalone and 554 together with the EM team. Eleven resuscitations were started by a medical technician on the motorcycle and the mean arrival time for high-risk emergency was 4.57 minutes. Motorcycles are equipped with an automatic external defi brillator, oxygen, respiratory care equipment, glucometer, IV cannulas, infusions, bandages, collars, splints and START triage sets. Some of the limitations of a motorcycle ambulance are the weather, highrisk work, equipment (limited space on the motorcycle), fi nancing the motorcycle teams, and number of EM team members. The goal in the future is to further educate the teams and increase the number of interventions, standardize staff, increase the number of teams, and renew the existing equipment