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Autoimmune Thyroid Disease and Pregnancy: The Interaction Between Genetics, Epigenetics and Environmental Factors
No full textAutoimmune thyroid disease (AITD) is the leading cause of thyroid dysfunction globally, characterized primarily by two distinct clinical manifestations: Hashimoto’s thyroiditis (HT) and Graves’ disease (GD). The prevalence of AITD is approximately twice as high in women compared to men, with a particularly pronounced risk during the reproductive years. Pregnancy exerts profound effects on thyroid physiology and immune regulation due to hormonal fluctuations and immune adaptations aimed at fostering maternal–fetal tolerance, potentially triggering or exacerbating AITD. The impact of AITD on pregnancy outcomes is multifaceted. Both HT and GD have been associated with adverse obstetric and neonatal outcomes, including miscarriage, preterm delivery, preeclampsia and fetal growth restriction. Inadequately managed AITD can also affect fetal neurodevelopment due to disrupted maternal thyroid hormone availability during critical periods of brain maturation. This review explores the complex interplay between the genetic, epigenetic and environmental factors that drive AITD during pregnancy, highlighting their roles in disease development and impacts on pregnancy outcomes. Gaining a deeper understanding of these mechanisms is crucial for improving diagnostic tools, treatment options and preventive measures to enhance the health and well-being of both the mother and the newborn
Dizajn etiketa vinskih boca hrvatske autohtone sorte žlahtine: tekstno-lingvistička analiza
No full textIako je Hrvatska relativno mala sredozemna država, njezin položaj pruža plodnu klimu za uzgoj mnogih različitih sorti vinove loze. Vinogradarstvo i bogata vinarska tradicija duga više od 2500 godina rezultirali su popisom od 258 sorti vinove loze koje se danas smiju uzgajati na području Republike Hrvatske. Među njima je za analizu dizajna etikete vinske boce odabrana autohtona hrvatska vinska sorta žlahtina. Cilj ovog rada bio je proučiti vizualne kodove na vinskim bocama različitih proizvođača žlahtine, odnosno prednje i stražnje etikete. Budući da se etiketa vinske boce može definirati kao posebna tekstna vrsta, provedena je tekstno-lingvistička analiza odabranih etiketa. Etikete vinskih boca žlahtine analizirane su na trima različitim razinama: komunikacijsko-pragmatičkoj, tematskoj i jezično-stilističkoj razini. Fokus je analize na makrorazini s obzirom na to da ona uključuje analizu vizualnog elementa koji privlači pozornost potrošača. Dobiveni rezultati dali su podatke o karakteristikama tekstne vrste etiketa vinske boce na jezičnoj i semiotičkoj razini
Tetracyclines in Rheumatoid Arthritis: Dual Anti-Inflammatory and Immunomodulatory Roles, Effectiveness, and Safety Insights
No full textRheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent inflammation, joint pain, and progressive cartilage and bone erosion. Despite advancements in RA management with disease-modifying antirheumatic drugs (DMARDs) and biologics, some patients remain refractory to conventional treatments. Tetracyclines, such as minocycline and doxycycline, exhibit anti-inflammatory and immunomodulatory properties, making them potential supplementary treatments. This narrative review explores their effectiveness, mechanisms of action, safety profiles, and current challenges in RA care. Tetracyclines have demonstrated significant immunomodulatory effects, including the inhibition of pro-inflammatory cytokines and matrix metalloproteinases (MMPs), which are critical in RA pathology. Clinical trials, including double-blind, placebo-controlled studies, have shown efficacy in reducing RA symptoms, particularly in early and refractory cases. However, their use remains limited by inconsistent evidence, small sample sizes, and concerns about antimicrobial resistance. Current guidelines for RA management do not explicitly recommend tetracyclines due to these limitations, although off-label use may be considered in specific cases. The use of tetracycline for RA is restricted by drug interactions causing bacterial resistance alongside unpredictable patient responses, hence the necessity for prudence in its prescription within a clinical setting. To overcome these limitations, the development of safer compounds, in-depth in silico analyses, and integration with personalized medicine approaches are needed. Overall, tetracyclines show promise as adjunct therapies in RA management due to their dual anti-inflammatory and immunomodulatory actions. This review highlights the need for further research to address gaps in evidence, including the development of modified tetracyclines with reduced antimicrobial effects and improved safety profiles, as well as the integration of personalized medicine approaches to optimize patient outcomes
Features of inclusive subtitles in the children's film A Train in the Snow
No full textAudiovizualni sadržaj u Hrvatskoj često nije prilagođen osobama sa senzornim oštećenjima, odnosno osobama oštećena sluha i vida. Djelovanjem raznih udruga i platformi posljednjih godina se osobe s invaliditetom, uključujući i osobe sa senzornim oštećenjima, nastoji uključiti u društvene aktivnosti te osvijestiti zajednicu o preprekama s kojima se te osobe svakodnevno susreću, pa tako i na području kulture. Kako bi audiovizualni sadržaj postao dostupan svima, za slijepe i slabovidne osobe radi se audiodeskripcija, a gluhim i nagluhim osobama se određeni kulturni sadržaj prilagođava pomoću prevoditelja na znakovni jezik i inkluzivnih podslova. Upravo inkluzivni podslovi za osobe oštećena sluha u dječjem filmu Vlak u snijegu tema su ovog rada. Provedena je analiza inkluzivnih podslova – onih kojima se prenosi verbalni sadržaj u izvornom zvukovnom kanalu i onih kojima se prenosi neverbalni sadržaj u izvornom zvukovnom kanalu. Prikazana je njihova zastupljenost, kao i primijenjeni prevodilački postupci i strategije. Cilj ovog rada je promicanje prilagodbe audivozualnog sadržaja osobama sa senzornim oštećenjima, kao i ukazivanje na potrebu za daljnjim istraživanjima na području unutarjezičnog audiovizualnog prevođenja, kojem pripada i inkluzivno podslovljavanje. Željelo se ukazati na važnost prilagodbe različitih kulturnih sadržaja osobama s invaliditetom općenito, kako bi se stvorilo inkluzivnije društvo u kojem sve osobe imaju pristup kulturi i umjetnosti.Audiovisual content in Croatia is often not adapted for individuals with sensory impairments, specifically blind and visually impaired individuals as well as deaf and hard-of-hearing individuals. Through the efforts of various associations and platforms at the national level, people with disabilities, including those with sensory impairments, have been increasingly integrated into the community in recent years, raising awareness about the obstacles they face daily, including the field of culture. To make audiovisual content accessible to everyone, audio description is created for blind and visually impaired individuals, while content is adapted for deaf and hard-of-hearing individuals using sign language interpreters and inclusive subtitles. This paper focuses on inclusive subtitles for hearing-impaired individuals in the children's film Vlak u snijegu (A Train in the Snow). An analysis of inclusive subtitles was conducted, examining those that convey verbal content from the original audio channel as well as those that convey non-verbal content from the original audio channel. Their prevalence, along with the translation methods and strategies employed, is presented. The aim of this paper is to promote the adaptation of audiovisual content for individuals with sensory impairments and to highlight the need for further research in the field of intralingual audiovisual translation, which includes inclusive subtitling. The goal is to emphasize the importance of adapting various cultural content for individuals with disabilities in general, and to foster a more inclusive society where everyone has access to culture and art
KNOWLEDGE OF STUDENTS ON CARE OF PATIENTS WITH LIMB AMPUTATION : FINAL THESIS
No full textOvo istraživanje imalo je za cilj ispitati razinu znanja studenata sestrinstva o zbrinjavanju pacijenata s amputacijom ekstremiteta te identificirati izvore iz kojih su studenti stjecali znanje. Rezultati pokazuju da studenti sestrinstva posjeduju relativno dobro znanje o ovoj temi, s prosjekom točnih odgovora od 76%, čime se potvrđuje da studenti točno odgovaraju na više od 60% pitanja. Pokazalo se da studenti treće godine imaju značajno veće znanje u usporedbi s prvom i drugom godinom, što naglašava važnost specijaliziranih kolegija u obrazovanju. Studenti su najviše znanja stekli kroz kolegije "Kirurgija, traumatologija i ortopedija" te "Zdravstvena njega odraslih II", koji su se pokazali ključnima za razvoj kompetencija. Većina ispitanika izrazila je potrebu za više kliničkih vježbi kao načina za unapređenje znanja i vještina. Ograničenja istraživanja uključuju korištenje prigodnog uzorka te prikupljanje podataka putem online anketa, što može utjecati na generalizaciju rezultata. Potrebna su dodatna istraživanja kako bi se osiguralo bolje razumijevanje praktičnih kompetencija studenata u kliničkom okruženju.The aim of this study was to examine the level of knowledge of nursing students regarding the care of patients with limb amputation and to identify the sources from which students acquired this knowledge. The results indicate that nursing students possess relatively good knowledge on this topic, with an average correct response rate of 76%, confirming that students correctly answer more than 60% of the questions. It was found that third-year students have significantly higher knowledge compared to first- and second-year students, highlighting the importance of specialized courses in education. Students acquired most of their knowledge through courses such as "Surgery, Traumatology, and Orthopedics" and "Adult Health Care II," which proved crucial for developing competencies. The majority of respondents expressed the need for more clinical exercises as a way to improve their knowledge and skills. Limitations of the study include the use of a convenience sample and data collection via online surveys, which may affect the generalizability of the results. Further research is needed to better understand students' practical competencies in a clinical environment
Karakterizacija prirođenog imunosnog odgovora na citomegalovirus u jajniku (CIRCO) : Plan upravljanja istraživačkim podacima
No full textBreaking the Cycle: Enhancing Cardiovascular Health in the Elderly Through Group Exercise
No full textThe global increase in aging populations underscores the urgency of addressing cardio–kidney metabolic health indicators, particularly among sedentary elderly individuals. This study investigates the impact of an 8-month structured group exercise program on cardiovascular health indicators among 320 women aged 60 and older living independently in Rijeka. Participants engaged in biweekly sessions designed to improve mobility, balance, and strength. Key metrics, including blood pressure (BP), body mass index (BMI), waist-to-hip (WHR) and waist-to-height ratio (WHtR), and hand grip strength, were measured before and after the intervention. Results revealed significant reductions in systolic blood pressure (mean −3.4 mmHg) and pulse pressure among hypertensive participants, highlighting improved cardiovascular function. BP control significantly improved (7.2%), and 19% of untreated hypertensive subjects at the start become normotensive at the end of follow-up. Although BMI changes were minimal, WHtR improvements indicated reductions in central obesity and muscle fat redistribution. Hand grip strength increased significantly on both arms, correlating with physical capacity. The results underline the benefits of group training for improving health even in the elderly population through an organized exercise program. While these preliminary results demonstrate promising health improvements, further research with longer follow-up and inclusion of diverse participant groups is recommended to validate these outcomes and refine intervention strategies
Depression and Its Effect on Geriatric Rehabilitation Outcomes in Switzerland’s Aging Population
No full textAbstract: Background and Objectives: Depression is a common mental problem in the older
population and has a significant impact on recovery and general well-being. A comprehensive
understanding of the prevalence of depressive symptoms and their effects on
functional outcomes is essential for improving care strategies. The primary aim of this
study was to determine the prevalence of depressive symptoms in older patients undergoing
geriatric rehabilitation and to assess their specific impact on their functional abilities.
Materials and Methods: A retrospective study was conducted at the Lucerne Cantonal Hospital
inWolhusen, Switzerland, spanning from 2015 to 2020 and including 1159 individuals
aged 65 years and older. The presence of depressive symptoms was assessed using the
Geriatric Depression Scale (GDS) Short Form, while functional abilities were evaluated
using the Functional Independence Measure (FIM) and the Tinetti test. Data analysis was
performed using TIBCO Statistica 13.3, with statistical significance set at p < 0.05. Results:
Of the participants, 22.9% (N = 266) exhibited depressive symptoms, with no notable differences
between genders. Although all patients showed functional improvements, the
duration of rehabilitation was prolonged by two days (p = 0.012, d = 0.34) in those with
depressive symptoms. Alarmingly, 76% of participants were classified as at risk of falling
based on the Tinetti score. However, no significant correlation was found between the
GDS and Tinetti scores at admission (p = 0.835, r = 0.211) or discharge (p = 0.336, r = 0.184).
The results from the non-parametric Wilcoxon matched-pairs test provide compelling
evidence of significant changes in FIM scores when comparing admission scores to those
at discharge across all FIM categories. Conclusions: Depressive symptoms are particularly
common in geriatric rehabilitation patients, leading to prolonged recovery time and increased
healthcare costs. While depressive symptoms showed no correlation with mobility
impairments, improvements in functional status were directly associated with reduced GDS
scores. Considering mental health during admission and planning is critical in optimizing
rehabilitation outcomes
Development of the Crossmatch Test in Kidney Transplantation Up to the Virtual Level
No full textThe Human Leukocyte Antigen (HLA) system forms the central part of the immune system and is crucial in the recognition and elimination of “non-self” antigens. While this role of the HLA system is essential in the effective defense of the organism against pathogens, it is undesirable in organ and tissue transplantation because it enables the recognition of mismatched HLA molecules of the donor as being foreign and stimulates the graft rejection reaction. Organ transplantation involves the introduction of antigens that are more or less mismatched to the recipient; therefore, in order to achieve the best possible match in the HLA system between the recipient and the donor, a whole series of immunogenetic tests is performed, including crossmatching (XM). If performed before kidney transplantation, it represents the final in vitro test to rule out the presence of donor-specific antibodies, which may cause graft rejection and which may not have been detected by earlier serum screening. The beginning of XM was marked by the complement-dependent cytotoxicity (CDC) method developed by Terasaki and colleagues in 1964. Later, as a result of advances in technology and the need for methods that overcome the limitations of CDC, flow cytometry and Luminex XM assays were developed. The introduction of solid-phase technology brought a new dimension to the detection of low-level HLA antibodies and the determination of their specificities, which enabled the development and implementation of the virtual XM test (vXM). It is an in silico test that assesses the immunological match between the recipient and the organ donor based on the analysis of the specificity of the antibodies present in the recipient’s serum and the HLA typing of the organ donor. Each method has its own advantages and limitations, which are described below and need to be taken into account, considering their significant impact on clinical application in kidney transplantation