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Quantification and Predictors of Hemoglobin Drop, Hidden Blood Loss and Irrigation Fluid Retention in Shoulder Arthroscopy
No full textBackground: Shoulder arthroscopy is a common, minimally invasive surgery, but the resulting postoperative blood loss remains poorly understood. In this study, we quantified the intraoperative and postoperative blood loss, the hemoglobin (Hb) drop, and the effects of irrigation fluid retention, as well as the influence of solutions administered through infusions. Methods: A prospective observational study of 49 patients undergoing arthroscopic rotator cuff tear (RCT) repair was conducted. Their preoperative and postoperative Hb levels were measured, along with the intraoperative and postoperative blood loss. Irrigation fluid retention was analyzed, and multiple regression was used to assess the factors contributing to Hb drops. Results: The intraoperative blood loss amounted to 36.46 ± 20.34 mL, while the total blood loss reached 791.17 ± 280.96 mL, with 94.64% occurring postoperatively. The postoperative Hb drop (2.06 ± 0.74 g/dL) was significantly greater than the intraoperative Hb drop (0.11 ± 0.06 g/dL) (p < 0.001). An older age (p = 0.02) and male sex (p = 0.025) significantly predicted the postoperative Hb drop, while irrigation fluid retention and administration of crystalloids and colloids had no notable effects. Capsulotomy was associated with a small but significant increase in intraoperative blood loss (p < 0.01). Increased intraoperative blood loss correlated with greater irrigation fluid retention (r = 0.41, adjusted R2 = 0.152, p < 0.001). Conclusions: In shoulder arthroscopy, the postoperative blood loss and Hb drop are significantly greater than the intraoperative blood loss and Hb drop, as well as the fluid gain, emphasizing the need for careful monitoring, especially in high-risk patients. Future studies should investigate the potential impacts of low-molecular-weight heparin on postoperative bleeding after shoulder arthroscopy
Enhanced Recovery After Surgery Protocols in Cesarean Delivery in International Settings: A Clinical Review of Implementation in Turkey and Croatia
No full textBackground: Enhanced Recovery After Surgery (ERAS) protocols have become integral in improving postoperative outcomes in cesarean deliveries. Variations in protocol adherence and implementation practices can significantly impact maternal and neonatal health across different healthcare systems. Objective: To evaluate the implementation of ERAS protocols in cesarean deliveries across two countries—Croatia and Turkey—and highlight differences in the level of adherence to ERAS recommendations. Design: A comparative clinical review was conducted. The study employed qualitative assessments carried out by medical professionals at two hospitals: one in central Anatolia, Turkey, and the Clinical Hospital “Sveti Duh” in Zagreb, Croatia. Methods: Twenty perioperative ERAS recommendations were evaluated based on implementation levels, rated using a five-point Likert scale (from very low to very high implementation). Qualitative insights were also collected to understand challenges and adaptations in the implementation process. Results: In Croatia, 13 recommendations were implemented at a very high level, compared to 8 in Turkey. Conclusions: Croatia demonstrates higher and more consistent adherence to ERAS protocols compared to Turkey, which faces greater challenges in consistent implementation, particularly in preoperative and postoperative care
THE RELATIONSHIP OF EATING HABITS AND PHYSICAL ACTIVITY WITH THE DEVELOPMENT OF EXCESSIVE BODY WEIGHT IN PRE-SCHOOL CHILDREN
No full textSuvremeni način života, obilježen smanjenom tjelesnom aktivnošću i nepravilnim prehrambenim navikama, pridonosi sve češćoj pojavi prekomjerne tjelesne mase kod djece predškolske dobi.
Cilj ovog rada bio je ispitati prehrambene navike djece predškolske dobi i stupanj njihove tjelesne aktivnosti te koju ulogu način prehrane i tjelesna aktivnost imaju u prevenciji prekomjerne tjelesne mase.
U istraživanju je sudjelovalo 243 djece predškolske dobi iz vrtićkih ustanova s područja grada Poreča i okolnih općina. Za procjenu prehrambenih navika korišten je MEDAS upitnik, dok je za procjenu tjelesne i sedentarne aktivnosti korišten NPAQ upitnik. Djeci su pomoću dobi, tjelesne visine i tjelesne mase izračunate z-vrijednosti ITM-a te su na temelju standarda Svjetske zdravstvene organizacije klasificirana kao: normalno uhranjena, pothranjena, preuhranjena (prekomjerne tjelesne mase) i pretila.
Rezultati istraživanja ukazuju da je većina djece bila normalne tjelesne mase, dok su prekomjerna tjelesna masa i pretilost zabilježene kod 16,05% djece. Potvrđena je hipoteza o većem udjelu prekomjerne tjelesne mase i pretilosti među dječacima (20%) u odnosu na djevojčice (11,5%). Statistički značajna povezanost utvrđena je između stupnja uhranjenosti i razine sedentarnosti, dok povezanost stupnja uhranjenosti s tjelesnom aktivnošću i adherencijom mediteranskoj prehrani nije utvrđena.
Dobiveni rezultati ukazuju na važnost praćenja prehrambenih i životnih navika u predškolskoj dobi, s posebnim naglaskom na smanjenje sedentarnosti i prevenciju prekomjerne tjelesne mase u djece.Modern lifestyles, characterized by reduced physical activity and unhealthy dietary habits, contribute to the increasing prevalence of overweight among preschool-aged children.
The aim of this study was to examine the dietary habits and physical activity levels of preschool children, and to explore the role of nutrition and physical activity in the prevention of excessive body weight.
The research included 243 preschool children attending kindergartens in the city of Poreč and surrounding municipalities. Dietary habits were assessed using the MEDAS questionnaire, while the NPAQ questionnaire was used to evaluate physical and sedentary activity. Using age, height, and weight, BMI z-scores were calculated for each child and classified according to World Health Organization standards as: normal weight, underweight, overweight, or obese.
The results showed that the majority of children had normal body weight, while overweight and obesity were identified in 16,05% of the sample. The hypothesis of a higher proportion of overweight and obese boys (20%) compared to girls (11,5%) was confirmed. A statistically significant correlation was found between nutritional status and the level of sedentary behavior, whereas no significant association was observed between nutritional status and physical activity or adherence to the Mediterranean diet.
These findings highlight the importance of monitoring dietary and lifestyle habits in early childhood, with a particular emphasis on reducing sedentary behavior and preventing excess body weight in children
CRYOTHERAPY IN ACUTE INJURIES: THERAPEUTIC VALUE OR POTENTIAL OBSTACLE TO RECOVERY?
No full textKrioterapija se tradicionalno koristi kao terapijska metoda u liječenju akutnih ozljeda zbog svog učinka na smanjenje boli, otekline i upale. Ovaj rad istražuje terapijsku vrijednost i potencijalne prepreke krioterapije kroz sustavni pregled znanstvene literature. Korištenjem pretraživanja baze podataka PubMed i primjenom MeSH termina, pronađeno je dvadeset radova, od kojih je devet uključeno u detaljnu analizu temeljem relevantnosti i metodološke kvalitete. Fokus je stavljen na tri ključna područja: utjecaj krioterapije na regeneraciju tkiva, utjecaj krioterapije smanjenje boli i utjecaj krioterapije na smanjenje otekline. Brojna recentna istraživanja sugeriraju da, iako krioterapija učinkovito smanjuje bol i edem, može negativno utjecati na upalni odgovor, angiogenezu i proliferaciju stanica, čime se potencijalno usporava regeneracija tkiva. Istraživanja potvrđuju da krioterapija pozitivo utječe na smanjenje boli i edema. Ograničenja uključuju malu veličinu uzoraka, heterogenost metoda i nedostatak dugoročnih studija. Unatoč širokoj primjeni, rezultati ukazuju na potrebu za individualizacijom krioterapijskih protokola i oprez pri njihovom korištenju u ranim fazama ozljede.Cryotherapy has traditionally been used as a therapeutic method in the treatment of acute injuries due to its effect on reducing pain, swelling, and inflammation. This paper explores the therapeutic value and potential limitations of cryotherapy through a systematic review of scientific literature. Using a PubMed database search and the application of MeSH terms, twenty studies were identified, nine of which were included in a detailed analysis based on relevance and methodological quality. The focus was placed on three key areas: the impact of cryotherapy on tissue regeneration, the effect of cryotherapy on pain reduction, and its influence on swelling reduction. Numerous recent studies suggest that while cryotherapy effectively reduces pain and edema, it may negatively affect the inflammatory response, angiogenesis, and cell proliferation, potentially slowing tissue regeneration. Research confirms that cryotherapy has a positive effect on reducing pain and edema. Limitations include small sample sizes, methodological heterogeneity, and a lack of long-term studies. Despite its widespread use, the results highlight the need for individualized cryotherapy protocols and caution in its application during the early stages of injury
Personal and perceived stigma towards postpartum depression
No full textUVOD: Poslijeporođajna depresija (PPD) javlja se kod majki i/ili očeva u prvoj godini nakon
poroda te može negativno utjecati na kvalitetu života obitelji i razvoj djeteta. Unatoč porastu
prevalencije, PPD često ostaje neprepoznata zbog osobne stigme (vlastita uvjerenja) i
percipirane (očekivanja od tuđih uvjerenja), koje otežavaju traženje pomoći. Na stigmatizaciju
mogu utjecati spol, dob, iskustvo s PPD, obrazovanje i roditeljski status.
CILJ: Cilj ovog istraživačkog rada bio je ispitati osobne stavove pojedinaca i njihova
očekivanja o stavovima drugih prema poslijeporođajnoj depresiji.
METODE: Istraživanje je provedeno u općoj populaciji od veljače do travnja 2025. godine,
putem online platformi. Uključeni su punoljetni ispitanici bez obzira na spol, dob, socijalni i
roditeljski status. Podatci su prikupljeni putem online upitnika koji se sastoji od
sociodemografskog dijela i modificirane Skale stigme prema depresiji (DSS).
REZULTATI: U istraživanju je sudjelovalo 212 ispitanika. Percipirana stigma bila je viša od
osobne, povezanost je bila pozitivna, ali slaba. Muškarci su iskazali višu osobnu stigmu od
žena, dok spol nije utjecao na razinu percipirane stigme. Ispitanici s osobnim iskustvom PPD
pokazali su nižu osobnu stigmu, a razlike u percipiranoj stigmi nisu bile statistički značajne ni
kod osobnog iskustva ni kod svjedočenja PPD. Povezanost dobi s razinom osobne i percipirane
stigme nije utvrđena.
ZAKLJUČCI: Rezultati istraživanja ukazuju na izraženiju percipiranu stigmu u odnosu na
osobnu stigmu prema PPD, posebno među muškarcima i osobama bez osobnog iskustva s PPD.
Ističe se važnost edukacije i destigmatizacije mentalnog zdravlja u poslijeporođajnom
razdoblju, kako bi se potaknulo razumijevanje i osigurala pravovremena podrška oboljelima.INTRODUCTION: Postpartum depression (PPD) occurs in mothers and/or fathers in the first
year after birth and can negatively impact quality of life and child development. Despite its
rising prevalence, PPD often remains unrecognized due to personal (own beliefs) and perceived
(others' beliefs) stigma, which makes it hard to seek help. Stigma can be influenced by gender,
age, PPD experience, education, and parenthood.
OBJECTIVE: The aim of this research paper was to examine the personal attitudes of
individuals and their expectations about the attitudes of others towards postpartum depression.
METHODS: The research was conducted in the general population from February to April
2025, via online platforms. Adult respondents were included regardless of gender, age, social
and parental status. Data were collected via an online questionnaire consisting of a
sociodemographic section and a modified Depression Stigma Scale (DSS).
RESULTS: The study included 212 respondents. Perceived stigma was higher than personal
stigma, the association was positive but weak. Men reported higher personal stigma than
women, while gender did not affect the level of perceived stigma. Respondents with personal
experience of PPD showed lower personal stigma, and differences in perceived stigma were not
statistically significant for either personal experience or testimony of PPD. The association of
age with the level of personal and perceived stigma was not established.
CONCLUSIONS: The results of the study indicate a higher perceived stigma compared to
personal stigma towards PPD, especially among men and people without personal experience
with PPD. The importance of education and destigmatization of mental health in the postpartum
period is emphasized, in order to encourage understanding and ensure timely support for those
affected
THE IMPACT OF CHRONIC FATIGUE ON THE QUALITY OF LIFE OF PEOPLE WITH MULTIPLE SCLEROSIS
No full textUVOD: Multipla skleroza je kronična autoimuna bolest središnjeg živčanog sustava, karakterizirana različitim simptomima. Kronični umor predstavlja jedan od najčešćih i najtežih simptoma s značajnim utjecajem na kvalitetu života oboljelih.
CILJ ISTRAŽIVANJA: Ispitati utjecaj razine kroničnog umora na kvalitetu života osoba oboljelih od multiple skleroze. U obzir će biti uzeti različiti aspekti bolesti poput oblika multiple skleroze, duljine trajanja same bolesti i stupanj onesposobljenosti.
ISPITANICI I METODE: U istraživanju je sudjelovalo 80 ispitanika, članova društava multiple skleroze Krapinsko-zagorske, Grada Zagreba, Osječko-baranjske i Splitsko-dalmatinske županije. Podaci su prikupljeni putem online upitnika. Upitnik je obuhvaćao sociodemografske podatke, Upitnik težine umora (FSS) i upitnik za procjenu kvalitete života SF-36. Statistička analiza provedena je pomoću programskog jezika „R“ i programskog paketa „jamovi“. Korišten je Spearmanov koeficijent korelacije i neparametrijski Kruskal-Wallisov test.
REZULTATI: Viša razina kroničnog umora bila je statistički značajno povezana s nižom kvalitetom života u svim domenama (p < 0,001). Također utvrđena je povezanost između niže procjene općeg zdravlja i više razine umora (ρ = −0,544; p < 0,001). Nije utvrđena statistički značajna povezanosti između trajanja bolesti i kvalitete života, oblika bolesti i razine umora (p = 0,419), kao ni između EDSS-a i razine umora (p = 0,600).
ZAKLJUČAK: Rezultati istraživanja pokazuju negativan utjecaj umora na kvalitetu života osoba oboljelih od multiple skleroze. Također utvrđena je povezanost između niže samoprocjene zdravlja i više razine umora. S druge strane, oblik bolesti, duljina trajanja bolesti i EDSS nisu pokazali značajnu povezanost s razinom umora.INTRODUCTION: Multiple sclerosis is a chronic autoimmune disease of the central nervous system, characterized by various symptoms. Chronic fatigue is one of the most common and severe symptoms, with a significant impact on the quality of life of those affected.
RESEARCH OBJECTIVE: To examine the impact of chronic fatigue levels on the quality of life of individuals with multiple sclerosis. Various aspects of the disease will be considered, such as the type of multiple sclerosis, the duration of the disease, and the degree of disability.
RESPONDENTS AND METHODS: The study involved 80 participants, members of multiple sclerosis societies from Krapinsko-zagorje, City of Zagreb, Osječko-baranjska, and Splitsko-dalmatinska counties. Data were collected via an online questionnaire. The questionnaire included sociodemographic data, the Fatigue Severity Scale (FSS), and the SF-36 quality of life assessment questionnaire. Statistical analysis was performed using the "R" programming language and the "jamovi" software package. Spearman's correlation coefficient and the non-parametric Kruskal-Wallis test were used.
RESULTS: A higher level of chronic fatigue was statistically significantly associated with a lower quality of life in all domains (p < 0.001). A connection was also found between a lower assessment of general health and a higher level of fatigue (ρ = −0.544; p < 0.001). No statistically significant association was found between the duration of the disease and quality of life, the form of the disease and the level of fatigue (p = 0.419), nor between EDSS and the level of fatigue (p = 0.600).
CONCLUSION: The research results indicate a negative impact of fatigue on the quality of life of individuals with multiple sclerosis. Additionally, a correlation between lower self-assessment of health and higher levels of fatigue was established. On the other hand, the form of the disease, the duration of the disease, and EDSS did not show a significant correlation with the level of fatigue
THE COVID-19 PANDEMIC AND THE APPEARANCE OF ALCOHOLIC LIVER CIRRHOSIS
No full textUvod: Alkoholna ciroza jetre predstavlja ozbiljan javnozdravstveni problem, kako u Hrvatskoj, tako i u svijetu. Globalno, alkoholna ciroza je jedan od vodećih uzroka smrtnosti povezanih s bolestima jetre. Pandemija COVID-19 značajno je utjecala na konzumaciju alkohola i posljedično povećala broj slučajeva alkoholne ciroze jetre.
Cilj: usporediti broj pacijenata koji su hospitalizirani zbog alkoholne ciroze jetre u razdoblju pandemije COVID-a 19 te u razdobljima prije i nakon završetka pandemije.
Metode: retrospektivna analiza medicinske dokumentacije bolesnika u tri vremenska razdoblja, prije, tijekom i nakon COVID-pandemije.
Rezultati: Statistički značajno najveći broj hospitalizacija zbog alkoholne ciroze jetre bio je prije pandemije COVID-19 (χ² = 16,658, p = 0,001). Udio hospitalizacija zbog alkoholne ciroze bio je najveći u razdoblju pandemije (8,8%). Nije pronađena statistički značajna razlika u broju hospitalizacija između muškaraca i žena (χ²=5,748, p=0,056) kao ni u broju hospitalizacija u odnosu na dob bolesnika (χ²=0,050, p=0,975). Psihijatrijski komorbiditeti prisutni su kod 36,1% bolesnika, 22,65% bolesnika ima pridružen samo jedan psihijatrijski komorbiditet. Žene s alkoholnom cirozom jetre češće imaju pridružene psihijatrijske komorbiditete (52,2%) u odnosu na muškarce (33,3%), ali bez statistički značajne razlike.
Zaključak: Iako je iz rezultata našeg istraživanja pokazala vidljivo smanjenje stope hospitalizacija oboljelih od alkoholne ciroze jetre tijekom i nakon pandemije prava slika posljedica prekomjerne konzumacije alkohola na incidenciju ciroze jetre tek će se vidjeti u budućnosti. Prisutnost psihijatrijskih komorbiditeta kod oboljelih naglašava potrebu za multidisciplinarnim pristupom ovim bolesnicima integrirajući hepatološku i psihijatrijsku skrb u svrhu držanja bolesti pod kontrolom i jačanja mentalnog zdravlja.Introduction: Alcoholic cirrhosis of the liver is a serious public health problem, both in Croatia and worldwide. Globally, alcoholic cirrhosis is one of the leading causes of death related to liver diseases. The COVID-19 pandemic has significantly affected alcohol consumption and consequently increased the number of cases of alcoholic cirrhosis of the liver.
Objective: The aim of this study is to compare the number of patients hospitalized for alcoholic cirrhosis of the liver during the COVID-19 pandemic and in the periods before and after the end of the pandemic.
Methods: retrospective analysis of medical records of patients in three time periods, before, during and after the COVID-19 pandemic.
Results: Statistically significant, the highest number of hospitalizations for alcoholic cirrhosis of the liver was before the COVID-19 pandemic (χ² = 16.658, p = 0.001). The proportion of hospitalizations due to alcoholic cirrhosis was the highest during the pandemic (8.8%). No statistically significant difference was found in the number of hospitalizations between men and women (χ²=5.748, p=0.056) or in the number of hospitalizations in relation to the age of the patient (χ²=0.050, p=0.975). Psychiatric comorbidities were present in 36.1% of patients, 22.65% of patients had only one psychiatric comorbidity. Women with alcoholic liver cirrhosis had psychiatric comorbidities more often (52.2%) than men (33.3%), but without a statistically significant difference (p=0.068).
Conclusion: Although the results of our study showed a visible decrease in the rate of hospitalizations of patients with alcoholic liver cirrhosis during and after the pandemic, the true picture of the consequences of excessive alcohol consumption on the incidence of liver cirrhosis will only be seen in the future. The presence of psychiatric comorbidities in patients emphasizes the need for a multidisciplinary approach to these patients, integrating hepatological and psychiatric care in order to keep the disease under control and strengthen mental health.
Key words: alcoholic liver cirrhosis, hospitalization, COVID-19 pandemi
The Relationship Between Pain Intensity and Disability with the Cross-Sectional Area of the Psoas Major Muscle in Patients with Chronic Low Back Pain
No full textCilj: Veliki slabinski mišić (VSM) ima važnu stabilizacijsku ulogu lumbalnog dijela kralješnice, a s obzirom na to da on puno manje podliježe atrofičnim promjenama tijekom križobolje od ostale paravertebralne muskulature, cilj ovog istraživanja bio je ispitati povezanost intenziteta boli i onesposobljenosti zbog boli s površinom poprečnog presjeka (engl. Cross-sectional area; CSA) VSM-a u osoba s kroničnom križoboljom i utvrditi njegov pozitivan utjecaj na stabilizaciju lumbalne kralješnice u osoba s navedenim poremećajem. Ispitanici i metode: Istraživanje je provedeno na 42 ispitanika (24 muškaraca i 18 žena). Na MR snimkama određivan je CSA velikog slabinskog mišića u razini intervertebralnih diskova L3/L4, L4/L5 i L5/S1. Ispitanici su ispunili upitnike za utvrđivanje intenziteta boli (vizualna analogna skala boli) i onesposobljenosti zbog boli (upitnici Roland-Morris i Oswestry Disability Index). Ispitivana je povezanost između CSA velikog slabinskog mišića i intenziteta boli te onesposobljenosti zbog boli, a za određivanje povezanosti između pojedinih čimbenika unutar skupina korišten je Spearmanov koeficijent korelacije ranga. Razina statističke značajnosti određena je na razini P < 0,05. Rezultati: Rezultati istraživanja pokazali su negativnu povezanost između CSA velikog slabinskog mišića i intenziteta boli te onesposobljenosti zbog boli što znači da povećanjem CSA mišića dolazi do smanjenja intenziteta boli i onesposobljenosti zbog boli u osoba s kroničnom križoboljom. Zaključci: Veći CSA velikog slabinskog mišića može dovesti do smanjenja intenziteta boli i onesposobljenosti zbog boli u osoba s kroničnom križoboljom.Aim: Psoas major muscle (PM) has an important stabilizing role of the lumbar spine, and given that it is much less subject to atrophic changes during low back pain syndrome (LBS) than other paravertebral muscles, the aim of this study was to examine the relationship between pain intensity and disability with the cross-sectional area (CSA) of the PM in people with chronic LBS and determine its impact on the stabilization of the lumbar spine in patients with the mentioned syndrome. Patients and methods: The research was conducted on 42 patients (24 men and 18 women). CSA of the PM was determined on MRI scans at the level of L3/L4, L4/L5 and L5/S1 intervertebral discs. Patients completed questionnaires to determine pain intensity (Visual Analogue Scale) and disability (Roland-Morris and Oswestry Disability Index questionnaires). The relationship between CSA of the PM and pain intensity and disability was examined using Spearman’s rank correlation coefficient. The level of statistical significance was determined at the
Etiopathogenetic mechanism of sleep apnea: review
No full textApneja tijekom spavanja se može razviti uslijed kompleksnih međudjelovanja anatomskih, fizioloških, metaboličkih, neuroloških i upalnih čimbenika koji dovode do ponavljanih epizoda djelomične ili potpune opstrukcije gornjih dišnih puteva. Patofiziološki mehanizmi obuhvaćaju smanjen tonus mišića gornjih dišnih puteva u snu, prvenstveno u REM fazi, posljedično dovodeći do kolapsa dišnih puteva i nestabilnost ventilacijskog pogona. Ponavljajuće epizode uzrokuju intermitentnu hipoksiju, fragmentaciju sna i pojačanu aktivaciju simpatikusa, te kardiovaskularnih i metaboličkih komplikacija. Klasifikacija apneja tijekom spavanja uključuje tri glavna oblika: opstruktivna apneja u snu (OSA), karakterizirana ponavljanim epizodama djelomične ili potpune opstrukcije gornjih dišnih puteva unatoč očuvanom respiratornom naporu. Najčešći etiopatogenetski razlozi uključuju: anatomske anomalije gornjih dišnih puteva, pretilost i smanjen mišićni tonus tijekom spavanja. Centralna apneja u snu (CSA) se razvija uslijed izostanka respiratornog impulsa iz središnjeg živčanog sustava, i prestankom ventilacijske aktivnosti bez pokušaja disanja. Često se razvija u bolesnika s ishemijskom srčanom bolesti, moždanim udarom i/ili tijekom terapije opioidima. Treći oblik predstavlja mješovita apneja, koja obično započinje kao centralna bez respiratornog napora, a završava s izraženom opstruktivnom komponentom i čini prijelaz iz centralne u opstruktivnu apneju. Kompleksni sindrom apneje u snu (CompSAS) je poseban klinički entitet kada se u bolesnika s prethodno dijagnosticiranom OSA-om nakon započinjanja CPAP terapije razvija centralna apneja zbog poremećaja u ravnoteži između stimulacije i supresije respiratornog centra.
Liječenje apneje u snu zahtijeva multimodalni pristup i obuhvaća promjene životnog stila, upotrebu CPAP terapije, korištenje oralnih udlaga i kirurških zahvata, te selektivne farmakološke i eksperimentalne terapije. Rana dijagnostika i liječenje apneje u snu donosi mnogostruke dobrobiti: poboljšanje kvalitete života, povećavanje kognitivnih funkcija, smanjenje dnevne pospanosti, i smanjenje kardiovaskularnih i metaboličkih poremećaja. Neophodno je povećati svijest opće populacije o posljedicama i mogućnostima liječenja ove često zanemarene bolesti.Sleep apnea can develop due to a complex interactions of anatomical, physiological, metabolic, neurological and inflammatory factors that lead to repeated episodes of partial or complete obstruction of the upper airway. Pathophysiological mechanisms include decreased upper airway muscle tone during sleep, primarily during REM sleep, resulting in airway collapse and ventilatory drive instability. Recurrent episodes cause intermittent hypoxia, sleep fragmentation and increased sympathetic activation, as well as, cardiovascular and metabolic complications. The classification of sleep apnea includes three main forms: obstructive sleep apnea (OSA), characterized by repeated episodes of partial or complete upper airway obstruction despite preserved respiratory effort. The most common etiopathogenetic reasons include: anatomical anomalies of the upper airway, obesity and decreased muscle tone during sleep. Central sleep apnea (CSA) develops due to the absence of respiratory impulses from the central nervous system, and the cessation of ventilatory activity without an attempt to breathe. It often develops in patients with ischemic heart disease, stroke and/or during opioid therapy. The third form is mixed apnea, which usually begins as central apnea without respiratory effort, and ends with a pronounced obstructive component and makes a transition from central to obstructive apnea. Complex sleep apnea syndrome (CompSAS) is a separate clinical entity when a patient with previously diagnosed OSA develops central apnea after starting CPAP therapy due to a disturbance in the balance between stimulation and suppression of the respiratory center.
Treatment of sleep apnea requires a multimodal approach and includes lifestyle changes, the use of CPAP therapy, the use of oral splints and surgical procedures, and selective pharmacological and experimental therapies. Early diagnosis and treatment of sleep apnea brings multiple benefits: improved quality of life, increased cognitive function, reduced daytime sleepiness, and reduced cardiovascular and metabolic disorders. It is necessary to increase awareness among the general population about the consequences and treatment options of this often neglected diseas
Physical activity of Medical school graduates in Rijeka
No full textU današnjim uvjetima života i rada sve je prisutnija zabrinutost o tome koliko mladi sudjeluju u tjelesnoj aktivnosti i na koji način provode svoje slobodno vrijeme. Tehnološki napredak omogućuje ljudima da obavljaju svakodnevne zadatke iz udobnosti svojih domova. Mladi često usvajaju i oponašaju takvo ponašanje, ne prepoznajući važnost alternativnih oblika provođenja vremena. To stvara problem jer djeca sve više preferiraju pasivan način života, zbog čega ih je iznimno teško motivirati na bavljenje sportom ili aktivnim igrama. Prema Svjetskoj zdravstvenoj organizaciji, tjelesna aktivnost obuhvaća sve vrste kretanja u svakodnevnom životu, uključujući radne obaveze, rekreaciju i sportske aktivnosti. U kontekstu razvoja, smatra se da odgovarajuća tjelesna aktivnost kod djece i mladih povoljno utječe na njihov rast i razvoj, čineći ovo područje iznimno važnim za istraživanje i intervencije. Važno je da tjelesna aktivnost postane svakodnevna navika od najranije dobi, jer se u tom razdoblju oblikuju temelji za životne navike, a kvalitetne navike pozitivno utječu na cjelokupni razvoj pojedinca. Cilj ovog istraživanja je analizirati razinu tjelesne aktivnosti i navike vježbanja maturanata Medicinske škole u Rijeci, te utvrditi promjene u količini tjelesne aktivnost tijekom priprema za maturu. Također, ispitalo se i povećanje razine stresa i anksioznosti tijekom razdoblja državne mature. Uzorak ispitanika čine učenici i učenice Medicinske škole u Rijeci što je kriterij za uključenje u istraživanje. Anketirani su maturanti i maturantice koji pohađaju četverogodišnju školu za medicinska zanimanja: fizioterapeutski tehničar/ka, dentalni tehničar/ka, medicinski tehničar/ka, tehničar nutricionist, farmaceutski tehničar/ka te sanitarni tehničar/ka.Za prikupljanje podataka korištena je anonimna online anketa, dok su za provjeru hipoteza korišteni T-test te Hi-kvadrat test neovisnosti. Utvrđeno je kako maturanti koji pohađaju smjer Fizioterapeutski tehničar nisu tjelesno aktivniji od maturanata općeg medicinskog smjera, dok nam rezultati ukazuju da se količina tjelesne aktivnosti svih maturanata Medicinske škole u Rijeci za vrijeme državne mature uvelike smanjila. Unatoč izazovima, većina maturanata izražava pozitivan stav prema važnosti redovite tjelesne aktivnosti i pravilne prehrane. Također, velik broj njih prepoznaje dobrobiti koje dolaze nakon fizičke aktivnosti, kako u vidu poboljšanog raspoloženja, tako i osjećaja ispunjenosti.In today’s living and working conditions, there is growing concern about how much young people engage in physical activity and how they spend their free time. Technological progress enables people to carry out everyday tasks from the comfort of their homes. Young people often adopt and imitate such behavior, failing to recognize the importance of alternative ways of spending time. This creates a problem, as children increasingly prefer a passive lifestyle, making it extremely difficult to motivate them to participate in sports or active games. According to the World Health Organization, physical activity encompasses all types of movement in daily life, including work-related tasks, recreation, and sports activities. In the context of development, it is considered that appropriate physical activity in children and young people positively influences their growth and development, making this area particularly important for research and intervention. It is essential that physical activity becomes a daily habit from an early age, as this is the period when the foundations for lifelong habits are formed, and healthy habits have a positive effect on overall individual development. The aim of this research is to analyze the level of physical activity and exercise habits of final-year students at the Medical School in Rijeka, and to determine changes in the amount of physical activity during preparations for the final exam. Furthermore, the study will examine the increase in stress and anxiety levels during the state graduation exam period. The sample consists of male and female students of the Medical School in Rijeka, which was the inclusion criterion for the research. The surveyed students are final-year pupils attending a four-year program in medical professions: physiotherapy technician, dental technician, medical technician, nutrition technician, pharmaceutical technician, and sanitary technician. Data were collected using an anonymous online survey, while the T-test and Chi-square test of independence were used to test the hypotheses. It was established that final-year students in the physiotherapy technician program are not more physically active than those in the general medical program. Results also indicate that the amount of physical activity among all final-year students of the Medical School in Rijeka decreased significantly during the state graduation exam period. Despite the challenges, most students express a positive attitude toward the importance of regular physical activity and proper nutrition. Moreover, many recognize the benefits that follow physical activity, both in terms of improved mood and a sense of fulfillment