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Seawater quality and the presence of Staphylococcus aureus on selected Rijeka beaches
No full textKakvoća morske vode u Republici Hrvatskoj ima izniman javnozdravstveni značaj, osobito tijekom turističke sezone. Sustavno praćenje provodi se u skladu s Uredbom o kakvoći mora za kupanje (NN 73/2008), koja je usklađena s Direktivom 2006/7/EZ Europske unije. U okviru ovog diplomskog rada provedena je analiza mikrobioloških pokazatelja kvalitete morske vode na četiri riječke plaže (Kantrida, 3. maj, Nogometno igralište i Ploče) tijekom tri sezone kupanja (2021.–2023.), na ukupno 12 mjernih točaka. Uzorci su prikupljani tjedno te su analizirani fizikalno-kemijski parametri (temperatura zraka, temperatura mora, salinitet) i mikrobiološki pokazatelji (Escherichia coli, crijevni enterokoki, Staphylococcus aureus, Pseudomonas aeruginosa, Clostridium perfringens, UBB22 i UBB37). Poseban naglasak stavljen je na prisutnost bakterije Staphylococcus aureus, koja nije uključena u važeću zakonsku regulativu, ali sve češće ulazi u znanstvenu raspravu kao potencijalni pokazatelj antropogenog onečišćenja. Ukupno je analizirano 900 uzoraka, pri čemu je S. aureus detektiran u 17 % slučajeva, s najvećom učestalošću na plaži Kantrida. Veća prisutnost zabilježena je u jutarnjim terminima, uključujući i uzorke ocijenjene kao „izvrsne“. Većina uzoraka (64 %) svrstana je u kategoriju izvrsne kakvoće, dok su preostali raspoređeni u kategorije dobra, zadovoljavajuća i nezadovoljavajuća. Statističkom obradom potvrđene su prostorne i vremenske razlike u prisutnosti mikroorganizama te su uočene korelacije između fizikalno-kemijskih i mikrobioloških parametara, osobito između saliniteta i prisutnosti fekalnih pokazatelja. Rezultati rada ukazuju na kompleksnost ocjene sanitarne ispravnosti morske vode te doprinose raspravi o mogućnosti proširenja skupa mikrobioloških parametara u sustavu monitoringa.Bathing water quality in the Republic of Croatia is of great public health importance, particularly during the summer tourist season. The monitoring system is implemented in accordance with the Regulation on Bathing Water Quality (NN 73/2008), which aligns with the Directive 2006/7/EC of the European Parliament and Council. This thesis presents an analysis of microbiological indicators of seawater quality at four urban beaches in the city of Rijeka (Kantrida, 3. maj, Nogometno igralište, and Ploče) over three consecutive bathing seasons (2021–2023), across a total of 12 sampling points. Samples were collected weekly and analyzed for physical-chemical parameters (air and sea temperature, salinity) and microbiological indicators: Escherichia coli, intestinal enterococci, Staphylococcus aureus, Pseudomonas aeruginosa, Clostridium perfringens, and total heterotrophic bacteria (UBB22 and UBB37). Special attention was given to Staphylococcus aureus, a bacterium not currently included in legal monitoring frameworks but increasingly discussed in the scientific community as a potential indicator of anthropogenic contamination. A total of 900 samples were analyzed, with S. aureus detected in 17 % of them, most frequently at the Kantrida beach. Higher detection rates were recorded in morning sampling sessions, even among samples rated as "excellent." Overall, 64 % of all samples were categorized as having excellent bathing water quality, while the remainder were classified as good, sufficient, or poor. Statistical analysis confirmed spatial and temporal variability in microbiological contamination, as well as correlations between physical-chemical and microbiological parameters-particularly a negative correlation between salinity and fecal indicators. The results highlight the complexity of assessing bathing water quality and support the ongoing discussion on expanding the set of microbiological indicators used in routine monitoring programs
Streptococcus pneumoniae - microbiology and pathogenesis of infection
No full textInfekcije uzrokovane bakterijom S. pneumoniae predstavljaju prijetnju ljudskom zdravlju.
Polisaharidna kapsula pneumokoka je glavni čimbenik virulencije, omogućavajući bakteriji
izbjegavanje imunološkog odgovora. Do sada je opisano više od 100 različitih kapsularnih
serotipova. Kapsula utječe na sposobnost pojedinog soja da uzrokuje bolest. Iako pneumokoki
uzrokuju teške invazivne infekcije s ponekad smrtonosnim ishodom, često samo koloniziraju
sluznice gornjih dišnih putova zdrave djece, odakle se mogu proširiti na osjetljive osobe putem
respiratornih kapljica. Pneumokoki najčešće uzrokuju infekcije gornjih dišnih putova, poput
otitisa i sinusitisa, te teže bolesti, uključujući upalu pluća (s ili bez bakterijemije) i meningitis.
Uvođenje pneumokoknih konjugiranih cjepiva u program cijepljenja djece u mnogim zemljama
dovelo je do značajnog smanjenja teških invazivnih pneumokoknih bolesti kod djece. Međutim,
u necijepljenoj populaciji starijih osoba se povećao broj invazivnih infekcija uzrokovanih
serotipovima koji nisu uključeni u cijepiva. Rastuća otpornost pneumokoka na antibiotike,
osobito na penicilin, dodatno ugrožava učinkovito liječenje.Infections caused by S. pneumoniae pose a serious threat to human health. The polysaccharide
capsule is a major virulence factor, mediating pneumococcal evasion of immune responses. To
date, more than 100 different capsular serotypes have been identified. The capsule influences a
strain’s ability to cause disease. Although these bacteria can cause severe invasive infections
with potentially lethal outcome, they are also common colonizers of the upper respiratory tract
in healthy children, from where they may spread to susceptible persons via respiratory droplets.
Pneumococci most commonly cause mild respiratory tract infections, such as otitis media and
sinusitis, but can also lead to more serious diseases, including pneumonia (with or without
bacteremia) and meningitis. The introduction of pneumococcal conjugate vaccines into
childhood immunization programs in many countries has led to a significant reduction in severe
invasive pneumococcal disease in children. However, infections caused by non-vaccine
serotypes have increased, resulting in invasive pneumococcal disease in unvaccinated
populations, such as older adults. Additionally, emerging resistance to penicillin threatens the
effectiveness of current therapies
Treatment approaches for patients with multiple sclerosis during pregnancy and breastfeeding
No full textMultipla skleroza (MS) autoimuna je neurodegenerativna bolest koja najčešće pogađa žene u reproduktivnoj dobi. Tradicionalno se trudnoća smatrala rizičnim razdobljem za žene s MS-om, no novija istraživanja pokazuju kako trudnoća u većini slučajeva ima povoljan učinak na tijek bolesti. Tijekom trudnoće dolazi do prirodne imunosupresije, što smanjuje rizik od relapsa. Nasuprot tome, postpartalno razdoblje karakterizira porast rizika od ponovnog aktiviranja bolesti.
Liječenje MS-a u trudnoći i tijekom dojenja izazov je zbog ograničenih podataka o sigurnosti lijekova koji modificiraju tijek bolesti (DMT). Lijekovi kao što su interferon beta i glatiramer acetat imaju najviše podataka o sigurnosti, dok se visoko učinkoviti lijekovi poput natalizumaba i anti-CD20 protutijela mogu koristiti u žena s agresivnijim oblicima bolesti uz oprez i individualiziran pristup.
Planiranje trudnoće kod žena s MS-om uključuje procjenu bolesti, prilagodbu terapije i pravovremenu edukaciju. Isključivo dojenje potencijalno smanjuje rizik od postpartalnih relapsa, iako su rezultati još uvijek nedovoljno jasni. Cilj ovog rada bio je prikazati trenutno dostupne spoznaje o liječenju žena s MS-om u trudnoći i dojenju te naglasiti važnost interdisciplinarne suradnje i potrebu za dodatnim istraživanjima u ovoj specifičnoj populaciji bolesnica.Multiple sclerosis (MS) is a chronic autoimmune disease that primarily affects women of reproductive age. While pregnancy was once discouraged in women with MS, current evidence suggests that pregnancy is generally safe and may even reduce disease activity due to natural immunosuppressive mechanisms. However, the postpartum period is associated with an increased risk of relapses. Managing MS during pregnancy and breastfeeding is complex due to limited safety data on disease-modifying therapies (DMTs). Interferon beta and glatiramer acetate have the most established safety profiles, while highly effective treatments such as natalizumab and anti-CD20 monoclonal antibodies may be considered for women with highly active disease, provided a case-by-case evaluation is done.
Family planning, preconception counseling, and timely treatment adjustments are essential to reduce risks for both mother and child. Exclusive breastfeeding may provide some protective effect against postpartum relapses, though further research is needed to confirm this association.
This thesis aimed to present current knowledge on MS treatment during pregnancy and lactation, emphasizing the importance of individualized care and the urgent need for more clinical research to inform treatment decisions in this population
The role of PET/CT in colorectal cancer diagnosis
No full textKolorektalni karcinom (CRC) postaje sve veći javnozdravstveni problem širom svijeta. Jedan je od vodećih uzroka morbiditeta i mortaliteta povezanih s malignim bolestima. Kolorektalni karcinom često je sporadičan i povezan s čimbenicima rizika kao što su dob, spol, rasa, prehrana i životne navike, no postoje i nasljedni oblici bolesti. Rano otkrivanje i točno određivanje stadija bolesti ključni su za planiranje optimalnih strategija liječenja, koje mogu uključivati operaciju, kemoterapiju, radioterapiju, ciljanu molekularnu terapiju i imunoterapiju. Dijagnostičke pretrage imaju važnu ulogu u postavljanju dijagnoze, utvrđivanju stadija i praćenju pacijenata oboljelih od CRC-a. Prema smjernicama, glavnu ulogu ima standardna kolonoskopija dopunjena različitim dostupnim dijagnostičkim modalitetima; kompjutoriziranom tomografijom (CT-om) i magnetskom rezonancom (MR-om). Uloga pozitronske emisijske tomografije s kompjutoriziranom tomografijom (PET/CT) još nije jasno definirana u svjetskim smjernicama, no svakako predstavlja važan dijagnostički postupak u onkologiji. U slučaju kolorektalnog karcinoma, 18F-FDG PET/CT je važna metoda dijagnostičke procjene. Fluorodeoksiglukoza (FDG) je analog glukoze koji se nakuplja u metabolički aktivnim tkivima, uključujući i tumorske stanice, omogućujući stvaranje funkcionalne slike koja nadopunjuje anatomske informacije dobivene CT-om. 18F-FDG PET/CT je važan dijagnostički modalitet u procjeni proširenosti bolesti, otkrivanju udaljenih metastaza, praćenju učinka liječenja i prognoze bolesti, planiranju daljnjih terapijskih protokola te sveukupnom praćenju pacijenata s malignom bolešću. Unatoč svojim prednostima, 18F-FDG PET/CT ima i neke nedostatke. Lažno negativni i lažno pozitivni nalazi mogu biti rezultat brojnih fizioloških i benignih patoloških stanja što predstavlja izazov u interpretaciji nalaza i može dovesti do pogrešne dijagnoze.Colorectal carcinoma (CRC) is an increasingly significant public health issue worldwide. It is one of the leading causes of morbidity and mortality related to malignant diseases. Colorectal carcinoma is often sporadic and associated with risk factors such as age, gender, race, diet, and lifestyle habits, although hereditary forms of the disease also exist. Early detection and accurate staging of the disease are crucial for planning optimal treatment strategies, which may include surgery, chemotherapy, radiotherapy, targeted molecular therapy, and immunotherapy. Diagnostic procedures play a significant role in establishing diagnosis, staging, and monitoring patients with CRC. According to current guidelines, colonoscopy remains the gold standard, supported by various available imaging modalities-computed tomography (CT) and magnetic resonance imaging (MRI). The role of positron emission tomography with computed tomography (PET/CT) in CRC is not yet clearly defined in international guidelines, but it is nevertheless considered a valuable diagnostic tool in oncology. In colorectal carcinoma, 18F-FDG PET/CT is an important diagnostic assessment method. Fluorodeoxyglucose (FDG) is a glucose analog that accumulates in metabolically active tissues, including tumor cells, enabling the generation of functional images that complement the anatomical information obtained from CT. 18F-FDG PET/CT is a significant diagnostic modality for evaluating disease extent, detecting distant metastases, monitoring treatment response and disease prognosis, planning further therapeutic protocols, and conducting comprehensive follow-up of cancer patients. Despite its advantages, 18F-FDG PET/CT has certain limitations. False-negative and false-positive results may occur due to various physiological, benign pathological conditions, which can pose challenges in interpretation and potentially lead to diagnostic errors
Autoimmune thyroiditis: pathogenesis, diagnosis and treatment
No full textAutoimuni tireoiditis najčešća je autoimuna bolest u ljudi, a uključuje dva glavna klinička entiteta – Hashimotov tireoiditis (HT) i Gravesovu bolest (GD). Riječ je o organski specifičnim poremećajima koje karakterizira limfocitna infiltracija i prisutnost autoantitijela usmjerenih na specifične komponente tireocita. Dok HT vodi do hipotireoze uslijed destrukcije žljezdanog parenhima, GD izaziva hipertireozu potaknutu stimulirajućim protutijelima na TSH receptor. Dijagnoza se temelji na laboratorijskim testovima, ultrazvuku i scintigrafiji štitnjače.
Patogeneza autoimunog tireoiditisa uključuje kompleksnu interakciju genetskih predispozicija (HLA, CTLA-4), okolišnih čimbenika (pušenje, unos joda) i disfunkcije imunološkog nadzora, osobito T limfocita i prirodnih stanica ubojica (NK). U kliničkoj slici dominiraju nespecifični simptomi – anksioznost, umor, promjene tjelesne mase – što otežava pravovremenu dijagnozu. Terapijski pristupi uključuju farmakološko liječenje (antitireoidni lijekovi, levotiroksin), radiojodnu terapiju i tireoidektomiju, ovisno o fenotipu bolesti.
Poseban naglasak stavljen je na važnost ranog prepoznavanja bolesti, individualizirani pristup liječenju i interdisciplinarnu suradnju. Istraživanja ukazuju i na povezanost autoimunog tireoiditisa s drugim autoimunim i onkološkim poremećajima, što zahtijeva kontinuirano praćenje bolesnika. Unatoč znatnom napretku, brojna pitanja o patogenezi i razvoju bolesti još uvijek ostaju otvorena.Autoimmune thyroiditis is the most common autoimmune disease in humans and includes two main clinical entities – Hashimoto’s thyroiditis (HT) and Graves’ disease (GD). These are organ-specific disorders characterized by lymphocytic infiltration and the presence of autoantibodies directed against specific components of thyrocytes. While HT leads to hypothyroidism due to the destruction of glandular parenchyma, GD causes hyperthyroidism triggered by stimulating antibodies to the TSH receptor. Diagnosis is based on laboratory tests, ultrasound, and thyroid scintigraphy. The pathogenesis of autoimmune thyroiditis involves a complex interaction of genetic predispositions (HLA, CTLA-4), environmental factors (smoking, iodine intake), and dysfunction of immune surveillance, especially T lymphocytes and natural killer (NK) cells. The clinical presentation is dominated by nonspecific symptoms – anxiety, fatigue, changes in body weight – which complicates timely diagnosis. Therapeutic approaches include pharmacological treatment (antithyroid drugs, levothyroxine), radioiodine therapy, and thyroidectomy, depending on the disease phenotype. Special emphasis is placed on the importance of early disease recognition, individualized treatment approaches, and interdisciplinary cooperation. Research also indicates an association between autoimmune thyroiditis and other autoimmune and oncological disorders, which requires continuous patient monitoring. Despite significant progress, many questions regarding the pathogenesis and development of the disease still remain unanswered
Prijavi se i postani ambasador ljepote
No full textZavršni rad u formi autorske predstave “Prijavi se i postani ambasador ljepote” bavi se utjecajem estetskih normi na tijelo mladih osoba. Kroz distopijski sustav Ministarstva Izgleda publika se aktivno uključuje u proces korekcije tijela izvođačica, čime se otvara prostor za propitivanje odgovornosti i društvenih mehanizama kontrole
Tanka granica
No full textOvaj radi bavi se opisom ispitne kazališne produkcije iz kolegija Laboratorij režije II pod nazivom "Tanka granica" autorice i studentice Sare Bunić od njegove ideje, režijskih i dramaturških rješenja, procesa na radu s tehnologijom i glumcima do finalnog produkta i javne izvedbe
S figom u džepu
No full textU završnom radu objašnjavam svoju režijsku ideju od vizije sve do realizacije, kroz detaljno opisivanje same teme u uvodu, zatim dramaturškog koncepta i režijskog pristup, kao i vizualni identitet te dizajn svjetla i zvuka. Potom, u zaključku osvrćem se na iskustvo, suradnju i uspjeh izvedbe
Mile Majke
No full textOvaj završni rad prati proces razvoja kazališne predstave, od začetne ideje do konačne izvedbe, s tematskim fokusom na majke djece s poremećajem iz spektra autizma i njihov često zanemaren, nevidljiv svijet. U radu su detaljno opisane probe, razrada autorskog koncepta, suradnja s izvođačicom te oblikovanje svjetla i zvuka u svrhu stvaranja cjelovite scenske kompozicije
Clinical strategies for managing acute intermittent porphyria : biochemical insights in targeting pain pathways and implementing them into clinical practice
No full textThis paper investigates clinical strategies for management and therapy of acute intermittent porphyria using a biochemical approach to understand and utilize the pathophysiology of the disease in special regard to its pain symptoms and pain pathways. Specifically, the thesis focuses on the toxicity of ALA (alpha aminolevulinic acid) as well as the biochemical implications of AIP regarding the heme biosynthesis disruption. Furthermore, literature regarding several treatment options with novel approaches were reviewed to connect and bridge the intricate pain pathophysiology of AIP with modern strategies of treatment. In exact, the genesis of several metabolic implications of AIP were explored. Studies regarding the interaction of the glucose metabolism and its connection to ALAS (alpha aminolevulnic acid synthase) as well as literature regarding experimental therapies with gene modification and vector associated enzyme delivery were revised to propose new ways of clinical AIP therapy with an emphasis on pain management