Učestalost mišićno-koštanih i očnih simptoma kod rada s računalom

Computer users most often complain of the eye and locomotor system disorders. The goal of this paper was to find out the frequency and relation between musculoskeletal and eye symptoms among computer workers. The data on musculoskeletal and eye symptoms were provided by two questionnaires. Forty-nine workers were included in the study. Their mean age was 41 years and average length of service 16 years. The average amount of time they spent in front of computers was 6.73 hours per day. Women spent more time working at a computer per day than men (P=0.025). The most frequent complaint in the past year referred to the upper back pain (30.6 % of the workers). Every fourth worker, i.e. 24.5 % of them experienced neck pain in the past year; women more often than men (P=0.024). A health problem which reduced the range of motion and prompted the workers to ask for sick leave was lower back pain. The relation between eye symptoms and the upper back pain experienced in the past year (P=0.004), and in the last week (P=0.031) was statistically signifi cant. Proper exercises for stretching musculoskeletal system, ergonomic computer equipment, and artificial tears could decrease muscular and eye problems, which in turn could enhance productivity and reduce sick leaves.tegoba očiju i mišićno-koštanoga sustava kod radnika koji rade s računalom i njihovu povezanost. Pomoću upitnika uzeti su podaci o mišićno-koštanim i očnim simptomima kod rada s računalom. U ispitivanju je sudjelovalo 49 radnika (27 žena i 22 muškarca) prosječne životne dobi od 41 godina i prosječnog trajanja radnog staža od 16 godina koji dnevno rade za računalom u prosjeku 6,73 sata. Žene su značajno duže dnevno radile na računalu od muškaraca (P=0,025). Najviše se radnika žalilo na bolove u gornjem dijelu leđa u zadnjih godinu dana (30,6 %). Svaki četvrti radnik, tj. 24,5 % radnika imalo je bol u vratu u zadnjoj godini i to statistički značajno češće žene (P=0,024). Tegobe koje ograničavaju aktivnost i mogu zahtijevati bolovanje bili su bolovi u donjem dijelu leđa. Statistički je bila značajna povezanost pojave očnih simptoma i bolova u gornjim leđima u zadnjoj godini (P=0,004) i u zadnjem tjednu (P=0,031). Odgovarajuće vježbe rasterećenja mišićno-koštanoga sustava uz ergonomsku opremu za rad s računalom te smanjenje očnih tegoba upotrebom umjetnih suza potrebno je provoditi radi smanjenja mišićnih i očnih tegoba, što zajedno povećava produktivnost i smanjuje bolovanja

Važnost početne hipokloremije za razvitak hiponatrijemije i ishoda bolesti u bolesnika s akutizacijom kroničnog srčanog zatajenja [The importance of initial hypochloremia in developing hyponatremia and adverse outcome in patients with acute heart failure]

Introduction: Heart failure (HF) is a major public health issue currently affecting more than 23 million patients worldwide. Hyponatraemia has been shown to be a predictor of poor outcome in patients with acute and chronic HF. Therefore, we aimed at finding a marker for early detection of patients at risk for developing hyponatraemia. To this end, the present study investigated the relationship between initial serum chloride and follow-up sodium levels in acute heart failure (AHF) patients. Patients and methods: The present study was performed as a prospective, single-centre, observational research with a total of 152 hospitalised AHF patients in The teaching hospital Sisters of Charity. Patients have been divided in four groups depending on values of sodium and chloride. Patients were monitored on the second, third and seventh day of hospitalisation and follow up was done after three months. Results: Compared to patients with initial normochloraemia, patients with initial hypochloraemia had a statistically significant higher incidence of hyponatraemia after a 3- months follow-up [P < 0.001; odds ratio (OR) = 27.08, CI: 4.3 - 170.7]. A similar finding was obtained upon exclusion of patients with initial hyponatriaemia with Fishers test [P = 0,034; odds ratio (OR)=15.5,CI:1.7–140.6]. Binary logistic regression revealed a significantly increased in-hospital mortality in the hypochloraemic/normonatriaemic (OR=4.08,CI:1.08 – 15.43,P=0.039),but not in the hypochloraemic/hyponatraemic, normochloraeamic/ hyponatraemic or normonatriaemic/normochloraemic patients. Ejection fraction (EF) at admission was significantly higher in hypochloraemic/normonatriaemic, compared to normonatriaemic/normochloraemic patients, but similar to EF in both hypochloraemic/hyponatraemic and normochloraeamic/hyponatraemic patients. The Nterminal precursor Brain Natriuretic Peptide (NT-proBNP) levels at admission were significantly lower in hypochloraemic/normonatriaemic compared to hypochloraemic/hyponatraemic and normonatriaemic/normochloraemic patients, respectively. As an interesting fact study showed that there is positive correlation between chloride and low-density lipoprotein (LDL), high-density lipoprotein cholesterol (HDL) and total cholesterol both predictors of mortality in heart failure. Recent studies have showed that hypochloraemia is strongly and independently associated with mortality in patients with heart failure. Also, there are studies showing that the higher cholesterol levels are associated with better outcomes in patients with heart failure. Until now, those two variables have not been linked before. Conclusion: Chloride, a long forgotten electrolyte, emerges as a possible predictor for the development of hyponatraemia in patients with AHF. Our study showed that initial low serum chloride concentration is predictive of developing hyponatraemia and associated with increased in-hospital mortality in AHF patients. Chloride could be used to start appropriate therapy early enough to prevent development of hyponatraemia and thereby associated complications and poor outcome of AHF patients. The main advantage of that chloride-status based diagnostics is its wide availability and practicability

Rad od kuće i mišićno-koštani bol tijekom epidemije COVID-19 – pilot-istraživanje

One of the side-effects of the COVID-19 pandemic is a global change in work ergonomic patterns as millions of people replaced their usual work environment with home to limit the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection. The aim of our cross-sectional pilot study was to identify musculoskeletal pain that may have resulted from this change and included 232 telecommunications company workers of both genders [121 (52.2 %) men aged 23–62 (median 41; interquartile range 33–46 yrs.) and 111 (47.8 %) women aged 23–53 (median 40; interquartile range 33–44)] who had been working from home for eight months (from 16 March to 4 December 2020) before they joined the study. The participants were asked to fill in our web-based questionnaire by self-assessing their experience of hand, lower back, and upper back/neck pain while working at home and by describing their work setting and physical activity. Compared to previous work at the office, 90 (39.1 %) participants reported stronger pain in the lower back, 105 (45.7 %) in the upper back/neck, and 63 (27.2 %) in their hands. Only one third did not report any musculoskeletal problems related to work from home. Significantly fewer men than women reported hand, lower back, and upper back/neck pain (p=0.033, p=0.001 and p=0.013, respectively). Sixty-nine workers (29.9 %) reported to work in a separate room, 75 (32.4 %) worked in a separate section of a room with other household members, whereas 87 (37.7 %) had no separate work space, 30 of whom most often worked in the dining room. Ninety-five participants (40.9 %) had no office desk to work at, and only 75 (32.3 %) used an ergonomic chair. Of those who shared their household with others (N=164), 116 (70.7 %) complained about constant or occasional disturbances. Over a half of all participants (52 %) said that they worked longer hours from home than at work, predominantly women (p=0.05). Only 69 participants (29.9 %) were taking frequent breaks, predominantly older ones (p=0.006). Our findings clearly point to a need to inform home workers how to make more ergonomic use of non-ergonomic equipment, use breaks, and exercise and to inform employers how to better organise working hours to meet the needs of work from homePandemija izazvana širenjem koronavirusa teškog akutnog respiratornog sindroma 2 dovela je do značajnih promjena u globalnoj ergonomiji rada. Naime, tisuće zaposlenika iznenada su uobičajene radne prostore zamijenile kućnim prostorom ne bi li se smanjilo širenje virusa i obuzdala pandemija. Kako bi se opisale mišićno-koštane tegobe u uvjetima rada od kuće te analizirali novonastali uvjeti rada od kuće, ovo presječno pilot-istraživanje obuhvatilo je 232 zaposlenika telekomunikacijske tvrtke: 121 muškarca (52,2 %) u dobi od 23 do 62 godine i 111 žena (47,8 %) u dobi od 23 do 53 godine, koji su radili od kuće osam mjeseci, tj. od 16. 3. 2020. do 4. 12. 2020. Za potrebe ovog istraživanja autori su izradili virtualni upitnik u kojem su ispitanici samostalno procijenili intenzitet bolova u šakama, donjem dijelu leđa te u vratu i gornjem dijelu leđa tijekom rada od kuće, uvjete rada od kuće te razinu vlastite tjelesne aktivnosti. U odnosu na vrijeme prije rada od kuće, 90 ispitanika (39,1 %) prijavilo je jače bolove u donjem dijelu leđa tijekom rada od kuće, pri čemu je pogoršanje bola u vratu i gornjem dijelu leđa prijavilo 105 ispitanika (45,7 %), a bola u šakama njih 63 (27,2 %). Samo trećina zaposlenika nije prijavila mišićno-koštane tegobe tijekom rada od kuće. Muškarci su značajno rjeđe prijavili bol u šakama, donjem dijelu leđa te u vratu i gornjem dijelu leđa (p=0,033; p=0,001 odnosno p=0,013). Posebnu prostoriju za rad od kuće imalo je 69 ispitanika (29,9 %), odvojeni radni prostor njih 75 (32,4 %), a njih 87 (37,7 %) nije imalo radni prostor, pa su najčešće radili u blagovaonici (njih 30). Pisaći radni stol za rad nije imalo 95 ispitanika (40,9 %), a ergonomsku radnu stolicu imalo je njih tek 75 (32,3 %). Od ispitanika koji žive s ukućanima (N=164), njih 116 (70,7 %) smatralo je da ih ukućani ometaju u radu stalno ili povremeno. Više od polovice ispitanika (52 %) smatralo je da radi dulje kod kuće nego na poslu, i to značajno više žene (p=0,05). Samo je 69 ispitanika (29,9 %) uzimalo češće predahe, i to značajno češće stariji zaposlenici (p=0,006). Naši rezultati upućuju na to da, radi sprječavanja mišićno-koštanih tegoba, zaposlenike treba educirati o metodama i načinima prilagodbe neergonomske opreme, korištenju pauza, potrebi tjelovježbe, a poslodavce treba educirati o potrebi organizacije radnog vremena u novim uvjetima rada od kuće

AVAILABILITY OF ANTIDOTES IN EMERGENCY DEPARTMENT: WHICH ONE, HOW MUCH, WHY AND WHEN?

U Hrvatskoj ne postoji razvijena subspecijalizacija iz kliničke toksikologije, a samim time nije razvijena ni strategija ni mreža toksikoloških centara. Činjenica je da se u svakodnevnom radu susrećemo s otrovanjima, a postoji nejednaka dostupnost antidotima u hitnim prijmovima ili centralnim bolničkim ljekarnama. Svrha ovog preglednog članka je upoznavanje s literaturom o dostupnosti antidota u akutnim bolnicama, vremenske i količinske, ali i vlastitih iskustava o izgradnji takve prakse u OHBP-u KBC-a Zagreb, a s nadom da će u budućnosti postojati strategija koja će dati preporuke o tome koje antidote moramo imati uvijek u hitnom prijmu, kada ih dajemo, u kojim dozama, i kakve zalihe bolnice moraju uvijek imati u centralnim ljekarnama.In this paper, we will try to address a common problem in Croatian hospitals and emergency departments, which is the lack of strategy that determines availability of antidotes. Up to date, there is no specialization that involves clinical toxicology specifi cally, and furthermore, there is no strategy regarding regional toxicology centers. Some international data on stocking of antidotes in hospitals that provide emergency care will be presented in this paper, and some personal experience of building a system of stocking antidotes in emergency department and hospital pharmacies. Hopefully, in the future, we will be able to create an expert consensus on the subject of which antidotes do we need, how much of them, where they need to be, and how to use them effi ciently

The impact of zno nanoparticles application on yield components of different wheat genotypes

The properties of zinc oxide nanoparticles (ZnO NPs) and their use have been shown as prominent for application in agriculture since it can bring certain benefits in agricultural production. The objective of this study was to estimate the impact of seed priming with ZnO NPs on yield components, plant height and spike length on wheat. In order to estimate the effects of ZnO nanoparticles on yield component, four winter wheat genotypes namely, NS Pobeda, NS Futura, NS 40S and NK Ingenio were selected. Seeds of each wheat genotypes were primed with different concentrations of ZnO NPs (0, 10, 100 and 1000 mg l-1) for 48 h in dark box by continuous aeration. Primed seeds were after sown in soil pots with 60-70% moisture contents during the till maturity. Considerable improvement was observed in plant height and spike length which increased with rates of ZnO NPs compared to the control. At rates of 10 mg l-1 ZnO NPs, the greatest increases in plant height and spike length were observed for genotypes NS Pobeda and NS Futura. At 100 mg l-1 ZnO NPs, the greatest increase for both traits was observed for genotypes NS 40S and NK Ingenio. Maximum rates of ZnO nanoparticles reduced both observed traits of wheat. The result indicated that ZnO nanoparticles can significantly increase plant height and spike length of wheat, but also plant response to ZnO nanoparticles significantly depends on concentration of application, as well as from wheat genotype

Kolesterol i kloridi u akutnom zatajivanju srca

Detecting predictors of poor outcome is crucial for understanding the underlying pathophysiology of heart failure (HF) and thus creating new therapeutic concepts. It is well established that low serum lipid levels are associated with unfavorable outcomes in HF patients. Several studies examined the association between serum lipids and established predictors of mortality in HF patients. The aim of the present study was to examine the association of serum lipid and chloride concentrations, as well as their impact on survival in acute heart failure (AHF). The present study was performed as a prospective, single-centre, observational research. The study included 152 patients with AHF. Spearman’s correlation coefficient revealed a significant positive correlation of serum chloride levels with serum levels of total cholesterol (ρ 0.221, p=0.006), low-density lipoprotein cholesterol (LDL-c) (ρ 0.187, p=0.015) and high-density lipoprotein-cholesterol (HDL-c) (ρ 0.169, p=0.038). Binary logistic regression revealed a significant association of chloride, total cholesterol and LDL-c serum levels measured at admission with hospital survival (OR 1.077, CI 1.01-1.154, p=0.034), (OR 1.731, CI 1.090-2.748, p=0.020) and (OR 1.839, CI 1.033-3.274, p=0.038), respectively, as well as with 3-month survival (OR 1.065, CI 1.002-1.131, p=0.042), (OR 1.625, CI 1.147-2.303, p=0.006) and (OR 1.711, CI 1.117-2.622, p=0.014), respectively. In conclusion, positive statistical association between serum cholesterol (total cholesterol, LDL-c and HDL-c) and chloride levels may suggest their similar modulation by AHF pathophysiology. Serum levels of total cholesterol, LDL-c and chloride contribute to patient survival.Otkrivanje pokazatelja lošijeg ishoda u bolesnika s akutnim zatajivanjem srca je od velike važnosti za razumijevanje njegove patofiziologije, a time i za otkrivanje novih terapijskih pristupa. Poznato je da su niske koncentracije lipida u serumu povezane s lošijim ishodom u bolesnika s akutnim zatajivanjem srca. Brojne studije su pokušale utvrditi vezu između koncentracije lipida u serumu i ostalih prediktora lošijeg ishoda u bolesnika s akutnim zatajivanjem srca. Cilj istraživanja bio je istražiti povezanost koncentracije lipida i klorida u serumu kod bolesnika sa zatajivanjem srca te njihov utjecaj na preživljenje. Studija je provedena u obliku prospektivnog opservacijskog istraživanja u jednom bolničkom centru. U istraživanje je bilo uključeno 157 bolesnika s akutnim zatajivanjem srca. Spearmanovi koeficijenti korelacije su pokazali značajnu pozitivnu povezanost koncentracije klorida i ukupnog kolesterola (ρ 0,221, p=0,006), lipoproteina male gustoće (LDL-c) (ρ 0,187, p=0,015) i lipoproteina velike gustoće (HDL-c) (ρ 0,169, p=0,038). Binarnom logističkom regresijom je uočena statistički značajna povezanost koncentracije klorida, ukupnog kolesterola i LDL-c u bolesnika s akutnim zatajivanjem srca prilikom prijma bolesnika u bolnicu i unutarbolničkog preživljenja (OR 1,077, CI 1,01-1,154, p=0,034), (OR 1,731, CI 1,090-2,748, p=0,020) i (OR 1,839, CI 1,033-3,274, p=0,038), kao i preživljenja nakon tri mjeseca (OR 1,065, CI 1,002-1,131, p=0,042), (OR 1,625, CI 1,147-2,303, p=0,006) i (OR 1,711, CI 1,117-2,622, p=0,014). Zaključno, pozitivna statistička povezanost između koncentracije kolesterola u serumu (ukupni kolesterol, LDL-c i HDL-c) i koncentracije klorida može ukazivati na njihovu sličnu ulogu u patofiziologiji akutnog zatajivanja srca. Koncentracija ukupnog kolesterola, LDL-c i klorida u serumu sudjeluju u preživljenju bolesnika

Genotype x Environment Interaction for Wheat Yield Traits Suitable for Selection in Different Seed Priming Conditions

Different seed priming treatments are widely used in order to improve the nutritional status of wheat, as well as to improve its grain yield and yield- related traits. The present study aimed to evaluate the impact of seed priming with zinc oxide nanoparticles (ZnO NPs) on the yield related traits, such as, field emergence, plant height, spike length and grain yield per plant of four winter wheat genotypes (Triticum aestivum L.) during two vegetation seasons of 2018/2019 and 2019/2020. The seeds of each wheat genotypes were primed with different concentrations of ZnO NPs (0 mg L-1, 10 mg L-1, 100 mg L-1 and 1000 mg L-1) for 48 h in a dark box by continuous aeration and were sown in soil pots with 60-70% moisture content until full maturity. The additive main effects and multiplicative interaction (AMMI) models were used to study the genotype environment effects. The results indicated that the plants response to ZnO nanoparticles significantly increased all of the observed traits of the wheat, while its maximum rates reduced the traits of the wheat. The AMMI analysis revealed the very complex nature of the variation observed in the trial and showed the significant effect of the GxE interaction, in which the first main component was significant for all components

Serum concentrations of free fatty acids are associated with 3-month mortality in acute heart failure patients

Background: Plasma free fatty acids (FFA) are higher in heart failure (HF) patients compared to healthy controls. Considering that the extent of FFA elevation in HF might mirror the severity of HF, we hypothesized that the serum levels of FFA may be a useful prognostic indicator for 3-month mortality in acute heart failure (AHF). ----- Methods: We analyzed the serum samples of AHF patients obtained at admission to the emergency department. Serum levels of FFA were analyzed using an enzymatic reagent on an automatic analyzer. ----- Results: Out of 152 included AHF patients that were originally included, serum samples of 132 patients were available for the quantification of FFA. Of these, 35 (26.5%) died within 3 months of onset of AHF. These patients had significantly higher serum levels of FFA compared to AHF patients who were alive 3 months after onset of AHF. Univariable logistic regression analyses showed a significant positive association of FFA levels with 3-month mortality (odds ratio [OR] 2.76 [95% confidence interval 1.32-6.27], p = 0.010). Importantly, this association remained significant after adjusting for age and sex, as well as for further clinical and laboratory parameters that showed a significant association with 3-month mortality in the univariate analyses. ----- Conclusions: We conclude that the admission serum levels of FFA are associated with 3-month mortality in AHF patients. Therefore, measurements of circulating FFA levels may help identifying high-risk AHF patients

Serum concentrations of Citrate, Tyrosine, 2- and 3- Hydroxybutyrate are associated with increased 3-month mortality in acute heart failure patients

Considering the already established relationship between the extent of the metabolic dysfunction and the severity of heart failure (HF), it is conceivable that the metabolomic profile of the serum may have a prognostic capacity for 3-month mortality in acute heart failure (AHF). Out of 152 recruited patients, 130 serum samples were subjected to the metabolomic analyses. The 3-month mortality rate was 24.6% (32 patients). Metabolomic profiling by nuclear magnetic resonance spectroscopy found that the serum levels of 2-hydroxybutyrate (2-HB), 3-hydoxybutyrate (3-HB), lactate, citrate, and tyrosine, were higher in patients who died within 3 months compared to those who were alive 3 months after onset of AHF, which was confirmed by univariable logistic regression analyses (p = 0.009, p = 0.005, p = 0.008, p<0.001, and p<0.001, respectively). These associations still remained significant for all tested metabolites except for lactate after adjusting for established prognostic parameters in HF. In conclusion, serum levels of 2-HB, 3-HB, tyrosine, and citrate measured at admission are associated with an increased 3-month mortality rate in AHF patients and might thus be of prognostic value in AHF

Metabolic syndrome modulates association between endothelial lipase and lipid/lipoprotein plasma levels in acute heart failure patients

We hypothesised that the established association of endothelial lipase (EL) plasma levels with atherogenic lipid profile is altered in acute heart failure (AHF) and additionally affected by overlapping metabolic syndrome (MetS). We examined the association of EL plasma levels and lipid/lipoprotein plasma levels in AHF patients without and with overlapping MetS. The study was performed as a single-centre, observational study on 152 AHF patients, out of which 85 had overlapping MetS. In the no-MetS group, EL plasma levels were significantly positively correlated with plasma levels of atherogenic lipids/lipoproteins, including total cholesterol, low-density lipoprotein (LDL)-cholesterol, total LDL particles and triglycerides, but also with plasma levels of antiatherogenic high-density lipoprotein (HDL)-cholesterol, total HDL particles and small HDL particles. In the MetS group, EL plasma levels were positively correlated with triglyceride and small LDL-particle levels, and significantly negatively correlated with plasma levels of large HDL particles as well as with LDL- and HDL-particle size, respectively. EL- and lipid/lipoprotein- plasma levels were different in the no-MetS patients, compared to MetS patients. The association of EL with atherogenic lipid profile is altered in AHF and additionally modified by MetS, which strongly modulates EL- and lipid/lipoprotein-plasma levels in AHF