Karcinom dojke u Brodsko-Posavskoj županiji

Ovaj rad napisan je s namjerom da se čitatelju prikaže karcinom dojke sa njegovim čimbenicima uzroka, vrstama karcinoma, lokalizaciji karcinoma dojke, načinima ranog otkrivanja kroz Nacionalni program ranog otkrivanja i liječenje karcinoma suvremenim metodama u regionalnim zdravstvenim ustanovama. Kroz Nacionalni program ranog otkrivanja karcinoma dojke u Brodsko-posavskoj županiji, provedenom u razdoblju od 2006.-2012. godine, prikazani su rezultati istraživanja o oboljelima od karcinoma dojke u Novoj Gradišci i Slavonskom Brodu sa njihovom okolicom. Istraživanje je provedeno na svim ženama dobne skupine od 50-69 godina kroz omogućen besplatan mamografski pregled, kako bi se što ranije otkrio eventualni razvoj maligne bolesti koja je vodeći uzrok smrti žena u dobi od 35-69 godina u svijetu. Svjetska zdravstvena organizacija smatra da je svakoj 11. ženi u svijetu prijeti karcinom dojke, stoga je ovakav oblik prevencije, rano otkrivanje i liječenje od iznimno velike važnosti u unapređenju smanjenja broja oboljelih žena od karcinoma dojke, a posebno velik naglasak je stavljen na rano otkrivanje bolesti jer je u tom slučaju liječenje povoljnije. Spomenuvši ulogu medicinske sestre i obiteljskog liječnika, u ovom radu stavljen je naglasak na veliku važnost liječnika obiteljske medicine i medicinske sestre u provođenju mjera javnog zdravstva kroz dostupnost i upućivanje na preglede,podizanje razine svijesti o mogućim posljedicama uslijed neodazivanja na mamografski pregled, a osobito ako se radi o osobama koje pripadaju rizičnim skupinama koje su detaljno opisane u daljnjem tekstu. Zahvaljujući informatizaciji i dostatnom educiranom osoblju koje provodi sve navedene mjere omogućena je realizacija cilja ovog programa i nas pojedinaca, a to je smanjenje broja oboljelih žena od karcinoma dojke i otkrivanje istog u što ranijem stadiju.This paper was written with the intent to represent to the reader breast cancer with its causes factor, breast cancer types, localization of breast cancer, methods of early detection of breast cancer per National Programme of Early Detection, and treatment of cancer with contemporary methods in regional medical institutions. National Programme of Early Detection of Breast Cancer in Brod- Posavina County, conducted in the period of 2006 – 2014, displays the results of research of breast cancer diseased in Nova Gradiška and Slavonski Brod region. The research was conducted on all women ages 50 – 69 through free mammographic screening provided to detect, as early as possible, potential development of this malignant disease which is the leading cause of death of women ages 35 – 69 worldwide. World Health Organization presumes every eleventh woman in the world is in threat of breast cancer, therefore this type of prevention, early detection and treatment is extremely important for decrease of number of breast cancer diseased women. A particularly strong emphasis is placed on early detection of the disease because in this case the treatment is more favourable. By refering to roles of nurses and family physicians in this paper, an emphasis is placed on the importance of family physicians and nurses in implementation of the public health measurements. These imply accessability and sending patients to examinations. They also imply boosting levels of awareness about the possible consequences of not going to mammographic screening, especially if the person in question belongs to a risk group described thoroughly hereinafter. Owing to information systems and sufficiently educated staff which maintains above mentioned measurements, the aim of all programmes and us individually is decrease in the number of breast cancer diseased women and detection of aforesaid in the earliest possible stage

Rak dojke

Rak dojke je najčešća maligna bolest kod žena, a vrlo rijetko mogu oboljeti i muškarci. Rak dojke manifestira se pojavom nove tvorbe. Tumorske stanice se mogu odvojiti od tumora u dojci te putem krvi ili limfe dospjeti do udaljenih dijelova tijela. Tamo počinju daljnji rast i razmnožavanje te stvaraju novi tumor. Najčešća mjesta metastaza raka dojke su jetra, pluća, kosti, mozak te limfni čvorovi. Skoro polovica žena koje obole od raka dojke razviju metastatsku bolest. Oko trećinu svih malignih tumora kod žena čini upravo rak dojke. Rak dojke je multifaktorska bolest koja ovisi o vanjskim i unutarnjim čimbenicima. Vanjski čimbenici kao što su prehrana, navike i stil života osobe, ionizirajuće zračenje. Reproduktivna aktivnost, obiteljska sklonost i dob kao unutarnji čimbenici. Dijagnostika raka dojke sastoji se od samopregleda dojke i provođenjem redovitih dijagnostičkih metoda. Samopregledom se potiče liječenje i preživljavanje ovisi o stadiju bolesti pri otkivanju karcinoma dojke. Pojavnost raka dojke raste, dok je smrtnost konstantna što nam govori na povećanje uspješnosti u liječenju. Stoga je vrlo važno rano otkrivanje raka dojke kako bi se spriječilo te poboljšalo liječenje i ozdravljenje

Assessment of the influence of intrinsic environmental and geographical factors on the bacterial ecology of pit latrines

Funding Information: This research received financial support from the Bill and Melinda Gates Foundation (grant number OPP52641). AWW and JP were supported by the Wellcome Trust [grant number 098051]. AWW and the Rowett Institute of Nutrition and Health, University of Aberdeen, receive core funding support from the Scottish Government Rural and Environmental Science and Analysis Service (RESAS). UZ is funded by Natural Environment Research Council (NERC) Independent Research Fellowship (NE/L011956/1). CQ is funded through an Medical Research Council fellowship (MR/M50161X/1) as part of the MRC Cloud Infrastructure for Microbial Bioinformatics consortium (MR/L015080/1).Peer reviewedPublisher PD

Microbial CO₂ fixation and sulfur cycling associated with low-temperature emissions at the Lilliput hydrothermal field, southern Mid-Atlantic Ridge (9°S)

Lilliput was discovered in 2005 as the southernmost known hydrothermal field along the Mid-Atlantic Ridge. It is exceptional in that it lacks high-temperature venting probably because of a thickened crust. The absence of thermophilic and hyperthermophilic prokaryotes in emissions supports the argument against the presence of a hot subsurface at Lilliput, as is typically suggested for diffuse emissions from areas of high-temperature venting. The high phylogenetic diversity and novelty of bacteria observed could be because of the low-temperature influence, the distinct location of the hydrothermal field or the Bathymodiolus assemblages covering the sites of discharge. The low-temperature fluids at the Lilliput are characterized by lowered pH and slightly elevated hydrogen (16 nM) and methane (∼2.6 μM) contents compared with ambient seawater. No typical hydrogen and methane oxidizing prokaryotes were detected. The higher diversity of reverse tricarboxylic acid genes and the form II RubisCO genes of the Calvin Benson-Bassham (CBB) cycle compared with the form I RubisCO genes of the CBB cycle suggests that the chemoautotrophic community is better adapted to low oxygen concentrations. Thiomicrospira spp. and Epsilonproteobacteria dominated the autotrophic community. Sulfide is the most abundant inorganic energy source (0.5 mM). Diverse bacteria were associated with sulfur cycling, including Gamma-, Delta- and Epsilonproteobacteria, with the latter being the most abundant bacteria according to fluorescence in situ hybridization. With members of various Candidate Divisions constituting for 25% of clone library sequences we suggest that their role in vent ecosystems might be more important than previously assumed and propose potential mechanisms they might be involved in at the Lilliput hydrothermal field

Clinical genetics and breast cancer

Geneti čki čimbenici već su dugo poznati kao važni rizični čimbenici kod raka dojke. Procjenjuje se da je oko 5 do 10 % slučajeva raka dojke posljedica monogenske geneti čke predispozicije. U medicinskoj obradi raka dojke važno je prepoznati one žene i obitelji kod kojih postoji velika mogućnost monogenske geneti čke predispozicije, kako bi im se omogućila primjerena genetička i klinička obrada. Naime, osobama s visokim rizikom može se ponuditi mogućnost otkrivanja genetičkim testom (dijagnosti čko ili presimptomatsko testiranje) i drugačiju razinu medicinske obrade u smislu rane prevencije i liječenja u usporedbi s općom populacijom.It is known that geneti c factors play an important role as risk factors in breast cancer. 5 to 10% of breast cancer is of monogenetic predispositi on. In the process of clinical evaluati on of pati ents with breast cancer it is very importnat to identify those pati ents with high probability of having cancer predisposing mutati ons and to provide them relevant and professional genetic and clinical management. This can lead to the identification of genetic etiology of breast cancer and allow earlier and more efficient prevention, screening and treatment of breast cancer

Socio-economic status over the life-course and depressive symptoms in men and women in Eastern Europe

Objective: Research into social inequalities in depression has studied western populations but data from non-western countries are sparse. In this paper, we investigate the extent of social inequalities in depression in Eastern Europe, the relative importance of social position at different points of the life-course, and whether social patterning of depression differs between men and women.Method: A cross-sectional study examined 12,053 men and 13,582 women in Russia, Poland and the Czech Republic. Depressive symptoms (16 or above on the CESD-20) were examined in relation to socio-economic circumstances at three phases of the life-course: childhood (household amenities and father's education); own education; current circumstances (financial difficulties and possession of household items).Results: Pronounced social differences in depression exist in men and women throughout Eastern Europe. Depression was largely influenced by current circumstances rather than by early life or education, with effects stronger in Poland and Russia. Odds ratios in men for current disadvantage were 3.16 [95% CI: 2.57-3.89], 3.16 [2.74-3.64] and 2.17 [1.80-2.63] in Russia, Poland and the Czech Republic respectively. Social variables did not explain the female excess in depression, which varied from 2.91 [2.58-3.27] in Russia to 1.90 [1.74-2.08] in Poland. Men were more affected by adult disadvantage than women, leading to narrower sex differentials in the presence of disadvantage.Limitations: Cross-sectional data with recall of childhood conditions were used.Conclusion: Current social circumstances are the strongest influence on increased depressive symptoms in countries which have recently experienced social changes. (C) 2007 Elsevier B.V. All rights reserved

Beta Blockers in Mental Retardation and Developmental Disorders

β-Adrenergic blockers appear to be effective in the management of verbal aggression, physical aggression, or self-injurious behavior associated with mental retardation and other developmental disorders. However, methodological limitations of the available studies make it difficult to judge the value of these treatments. Optimal doses for treating patients with mental retardation or developmental disorders appear lower than described in the general psychiatric literature, so low doses of β-blockers may be preferred in such patients with abnormal brain development. Children and adolescents with mental retardation or developmental disorders appear to respond to particularly low doses (e.g., below propranolol 150 mg daily). Propranolol is recommended for central blockade, and nadolol is recommended for peripheral blockade. Most β receptors in the brain (except cerebellum) seem to be β1 (cardiac type), but it is not clear that central blockade is required for psychotropic effects. Interim suggestions for empirical trials are offered, and rating scales and other measurement approaches are discussed. Since evidence supporting the efficacy of β-blockers in mental retardation or developmental disorders in children and adolescents is not definitive, the clinician is advised to consider designing an empirical trial for each patient, utilizing pre- and postmedication measures, when conventional treatments have been unsuccessful

Microbial diversity in heavy-metal polluted waters

Indigenious water microflora as well as the presence of metal- and xenobiotic biotransforming bacteria were investigated in waters near the KCM Pb-Zn smelter, South Bulgaria. Content of As, Hg, Cd, Mn, Pb, Cu and Zn exceeded in times the maximum permission standart. Absence of some microbial groups demonstrated a change in the microbial community structure in the region. Ecotoxicology test ISO/DIS 10712.2 displayed toxic environmental effect of the polluted waters, especially one of them which demonstrated 72 % of ecotoxicity. More than 20 ecologically relevant new bacteria were cultured. Three of them demonstrated tolerance to Cd, Cu and Mn and five- a tolerance to 2,4-dichlorphenoxyacetic acid. Our result revealed that the heavy metal pollutions reduced the microbial diversity in the studied waters, are ecotoxic as well as that some of newly isolated bacteria possess a capacity for a clean-up biotechnologies in the region. . 1, . 2, 2., 3, 3, .

High 16S rDNA bacterial diversity in glacial meltwater lake sediment, Bratina Island, Antarctica

The microbial diversity in maritime meltwater pond sediments from Bratina Island, Ross Sea, Antarctica was investigated by 16S rDNA-dependent molecular phylogeny. Investigations of the vertical distribution, phylogenetic composition, and spatial variability of Bacteria and Archaea in the sediment were carried out. Results revealed the presence of a highly diverse bacterial population and a significantly depthrelated composition. Assessment of 173 partial 16S rDNA clones analyzed by amplified rDNA restriction analysis (ARDRA) using tetrameric restriction enzymes (HinP1I 5'GVCGC3'and Msp I. 5'CVGG3', BioLabs) revealed 153 different bacterial OTUs (operational taxonomic units). However, only seven archaeal OTUs were detected, indicating low archaeal diversity. Based on ARDRA results, 30 bacterial clones were selected for sequencing and the sequenced clones fell into seven major lineages of the domain Bacteria; the a, c, and d subdivisions of Proteobacteria, the Cytophaga–Flavobacterium– Bacteroides, the Spirochaetaceae, and the Actinobacteria. All of the archaeal clones sequenced belonged to the group Crenarchaeota and phylogenetic analysis revealed close relationships with members of the deep-branching Group 1 Marine Archaea

Breast cancer metastasis to the conjunctiva

Introduction. Conjunctival metastasis is exceedingly rare, and it is, as a rule, a sign of advanced malignant disease with poor prognosis. We presented a female patient with breast cancer metastasis to the conjunctiva. Case report. A 45-yearold premenopausal female patient was presented with a solitary, yellowish, thin, demarcated lesion in the superior nasal quadrant of the bulbar conjunctiva of the left eye noted by chance a week earlier. There was no sign of irritation, and no pain, and no other functional or morphological problem in either eye or orbit. Five years before the appearance of conjunctival metastasis, breast carcinoma was diagnosed and the patient underwent chemotherapy, preoperative radiotherapy and radical mastectomy. Three years later, computed tomography scan showed metastasis in the left hepatic lobe with ascites and the patient underwent chemotherapy again. But, four months prior to the appearance of conjunctival lesion body scintigraphy showed multifocal sceletal lesions and nuclear magnetic resonance revealed diffuse hepatic metastases and bilateral ovarial tumors. Paliative radiotherapy and hormonal therapy (megestrol, 160 mg) were carried out. An excisional biopsy of the observed conjunctival lesion was performed under topical anesthesia and the material was subjected to histopathological (HP) examination. HP and immunohistochemical examinations established the presence of breast infiltrating lobular carcinoma metastatic to the conjunctiva. The patient showed rapid deterioration after intervention, and died after three weeks. Conclusion. A survival period less than one month after the appearance of conjunctival metastasis deserves attention because it is unexpected and has never been reported previously. It is not a rule that HP presentation of a metastatic lesion is so characteristic that it is possible to determine a primary tumor