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Inovacije : AI revolucija u onkologiji: Prof. Štagljar predstavio novu tehnologiju za otkrivanje lijekova
No full textSelf-assessment of orofacial health, oral hygiene habits and knowledge of oral health in athletes
No full textCilj: Cilj istraživanja bio je ispitati razinu znanja o orofacijalnom zdravlju, oralno-higijenske navike te prisutnost simptoma i čimbenika povezanih s disfunkcijom temporomandibularnog zgloba među sportašima različitih disciplina i razina uključenosti, uz procjenu učestalosti ozljeda maksilofacijalne regije tijekom sportskih aktivnosti. Materijali i metode: U presječno istraživanje uključeni su sportaši različitih razina uključenosti te sportski treneri s područja Republike Hrvatske, raspoređeni unutar različitih sportskih grana. Podaci su prikupljeni putem strukturiranog anketnog upitnika koji je obuhvatio tematske cjeline vezane uz demografske podatke, znanje o oralnom zdravlju, sportske navike i ozljede, simptome temporomandibularnih poremećaja, oralno-higijenske navike te dentalne tegobe. Podatci su analizirani deskriptivnim metodama te primjenom generaliziranog regresijskog modela, Hi-kvadrat testa i Fisherovog testa. Rezultati: Analiza rezultata pokazala je da ispitanici u prosjeku posjeduju umjerenu razinu znanja o oralnom zdravlju (11,3±4,4 bodova od mogućih 18). Najslabiji rezultat zabilježen je kod pitanja vezanih uz postupanje s avulziranim zubom – točan odgovor dalo je svega 24,8% ispitanika. S obzirom na oralno-higijenske navike, samo 20,7% ispitanika redovito koristi tekućine za ispiranje usne šupljine, dok 25,4% koristi zubni konac ili interdentalne četkice. Od prijavljenih dentalnih problema, najčešće su se javljali krvarenje zubnog mesa (42,7%) i prisutnost zubnog kamenca (37,9%). Što se tiče simptoma povezanih s temporomandibularnim zglobom, 18,2% ispitanika navelo je čujno ili osjetno škljocanje/krepitacije tijekom pokreta usta, dok je 19,9% prijavilo bol u uhu, zujanje ili osjećaj začepljenosti. Zaključak: Rezultati ukazuju na umjerenu, ali nedostatnu razinu znanja o oralnom zdravlju kod sportaša i trenera. Značajne su potrebe za edukacijom, osobito u području postupanja s dentalnim ozljedama i prevencije funkcionalnih poremećaja temporomandibularnog zgloba.Aim: The aim of this study was to assess the level of knowledge about orofacial health, oral hygiene habits, and the presence of symptoms and factors associated with temporomandibular joint (TMJ) dysfunction among athletes of various disciplines and levels of involvement, along with the prevalence of maxillofacial injuries during sports activities. Materials and Methods: This cross-sectional study included athletes of different levels of involvement, as well as sports coaches from across the Republic of Croatia, representing various sports disciplines. Data were collected using a structured questionnaire covering thematic sections related to demographic data, knowledge of oral health, sports habits and injuries, TMJ symptoms, oral hygiene habits, and dental problems. Data were analyzed using descriptive statistics, generalized regression models, the chi-square test, and Fisher’s exact test. Results: The analysis showed that participants had a moderate level of knowledge about oral health (11.3±4.4 out of a maximum of 18 points). The poorest result was recorded on the question regarding the management of an avulsed tooth, with only 24.8% of participants answering correctly. Regarding oral hygiene, only 20.7% reported regular use of mouthwash, and 25.4% used dental floss or interdental brushes. The most commonly reported dental issues were bleeding gums (42.7%) and dental calculus (37.9%). As for TMJ-related symptoms, 18.2% reported audible or perceptible joint clicking or crepitus during jaw movement, and 19.9% experienced ear pain, tinnitus, or a feeling of ear fullness. Conclusion: The findings indicate a moderate but insufficient level of oral health knowledge among athletes and coaches. There is a clear need for targeted education, particularly regarding the management of dental injuries and prevention of functional TMJ disorders
Proslava 28. obljetnice fakulteta : Ponos Dalmacije: Gotovo tri desetljeća samostalnosti i izvrsnosti
No full textCD56-positive NK cells and CD138-positive plasma cells in the basal decidua and histopathological characteristics of placentas after treatment of the endometriosis-related infertility
No full textUvod: Endometrioza je kroničan, estrogen-ovisan poremećaj povezan s neplodnošću, ponajprije zbog štetnog učinka na ovarijsku rezervu i receptivnost endometrija. Slično ektopičnim endometriotičnim lezijama, eutopični endometrij kod endometrioze pokazuje izmijenjene imunološke odgovore, uključujući poremećen broj prirodnoubilačkih stanica (NK) i plazma stanica. Postupci medicinski potpomognute oplodnje (MPO) predstavljaju mogućnost liječenja neplodnosti kod zahvaćenih žena, no dostupna literatura ukazuje na višu učestalost nepovoljnih perinatalnih ishoda u trudnoćama s endometriozom. Ipak, histopatološke značajke posteljice i imunološki odgovori u trudnoćama kod pacijentica s neplodnošću uzrokovanom endometriozom, a koji mogu pridonijeti tim ishodima, nisu dovoljno istraženi. Cilj: Cilj ove disertacije bio je istražiti histopatološke promjene posteljica, uz analizu ukupnog broja CD56-pozitivnih NK stanica i CD138-pozitivnih plazma stanica u uzorcima bazalne decidue (BD) jednoplodovih trudnoća nakon liječenja neplodnosti uzrokovane endometriozom. Sekundarni ishodi uključivali su učestalost perinatalnih komplikacija te povezanost faktora endometrioze s brojem imunoloških stanica decidue i histopatološkim karakteristikama posteljice. Materijali i metode: Ova disertacija objedinjuje rezultate dviju monocentričnih istraživanja slučaja i kontrola, koje su obuhvatile histopatološku analizu posteljica te imunohistokemijsku (IHC) analizu CD56 i CD138 biljega u BD uzorcima trudnoća nakon liječenja neplodnosti uzrokovane endometriozom, muškog faktora neplodnosti te fizioloških trudnoća. Minimalna potrebna izračunata veličina uzorka iznosila je 91 posteljicu. Lezije posteljice kategorizirane su prema Amsterdamskom konsenzusu o patologiji posteljica te su podijeljene u anatomske, upalne, lezije vilozne zrelosti i poremećaje vaskularne perfuzije. IHC analiza provedena je primjenom primarnih monoklonskih mišjih protutijela za CD56 i CD138, uz sekundarna protutijela prema standardiziranom protokolu. CD56 i CD138 pozitivne stanice prijavljene su kao ukupan broj stanica po 1 mm² BD uz pomoć mikroskopa Olympus BX46 i Olympus Image Analyzer sustava. Rezultati: U istraživanja je bilo uključeno 107 sudionica s terminskim posteljicama, raspoređenih u tri skupine: MPO Endometrioza (n=36), MPO muški čimbenik (n=31) i fiziološke trudnoće (n=40). Posteljice iz trudnoća s endometriozom pokazale su veću učestalost posteljičnih lezija u odnosu na kontrolne skupine, uključujući pojačano stvaranje sincicijalnih čvorova, skraćene pupkovine i višu učestalost poremećaja vaskularne malperfuzije (subkorijalno i perivilozno taloženje fibrina, interviloznu trombozu te fetalnu vaskularnu malperfuziju visokog stupnja). U prilagođenom regresijskom modelu čimbenik endometrioze bio je povezan s pojačanim stvaranjem sincicijalnih čvorova i hipertorzijom pupkovine. Trudnoće povezane s endometriozom imale su veću učestalost krvarenja u ranoj trudnoći i prijetećeg prijevremenog porođaja, kao i veću stopu carskih rezova te češću pojavu novorođenčadi s najnižom porođajnom masom. Uzorci BD posteljica iz trudnoća s endometriozom pokazali su najnižu medijalnu vrijednost CD56-pozitivnih NK stanica u usporedbi s kontrolnim skupinama, pri čemu je njihova smanjena prisutnost bila povezana s određenim posteljičnim lezijama (nezrelost resica, vilitis nepoznate etiologije niskog stupnja, intervilozna tromboza i pojačano perivilozno taloženje fibrina). S druge strane, nisu uočene značajne razlike u broju CD138-pozitivnih plazma stanica između ispitivanih skupina. Zaključak: Dobiveni rezultati upućuju na moguću izmijenjenu imunološku reakciju majke, temeljenu na sniženoj infiltraciji NK stanica, što može otežati pravilnu invaziju trofoblasta, remodeliranje spiralnih žila miometrija i razvoj posteljice, a čime je kompromitirana posteljična perfuzija koja pridonosi nepovoljnim perinatalnim ishodima u trudnoćama nakon liječenja neplodnosti uzrokovane endometriozom. S druge strane, adaptivna imunost, predstavljena infiltracijom plazma stanica, nije prikazana značajnom u patogenezi endometrioze. Uočeni poremećaji posteljične perfuzije naglašavaju potrebu za povećanim nadzorom funkcije posteljice u trudnoćama nakon MPO liječenja neplodnosti uzrokovane endometriozom. Buduća istraživanja trebala bi biti usmjerena na otkrivanje molekularnih mehanizama endometrioze na disfunkciju posteljice i razvoja perinatalnih komplikacija. Identifikacija potencijalnih biomarkera ili terapijskih intervencija usmjerenih na poremećaj imunološkog odgovora i vaskularno remodeliranje mogla bi poboljšati ishode trudnoća s endometriozom.Introduction: Endometriosis is a chronic, estrogen-dependent condition linked to infertility, primarily due to its detrimental effects on ovarian reserve and endometrial receptivity. Comparable to ectopic endometriotic lesions, the eutopic endometrium in endometriosis patients shows exhibits immune response irregularities, including alterations in natural killer (NK) and plasma cell activity. Assisted reproductive technology (ART) offers a viable fertility treatment for these patients, yet literature show endometriosis pregnancies are associated with a heightened risk of adverse perinatal outcomes. Despite this, here remains a data scarcity on the histopathologic characteristics of placenta and immunological responses in term pregnancies of patients with endometriosis-related infertility, which could contribute to these adverse outcomes. Aim: This dissertation aimed to explore histopathologic alterations of term placentas, and to investigate total counts of CD56-positive NK cells and CD138-positive plasma cells in the basal decidua (BD) samples in singleton pregnancies after ART treatment of endometriosisrelated infertility. Secondary outcomes encompassed the incidence of perinatal complications and examining the potential relationship of endometriosis factor on the decidual immune cell counts and placental pathology. Materials and methods: This dissertation integrates data from two case-control studies which provided placental histopathologic examination alongside immunohistochemical (IHC) analysis of CD56 and CD138 immune cell markers in term BD samples from pregnancies after ART treatment of endometriosis-related infertility, male factor infertility and physiological pregnancies. The minimum required samples size was calculated to be 91 placentas. Placental lesions were reported according to the Amsterdam Placental Workshop Group Consensus as anatomic, inflammatory, villous maturation and vascular malperfusion disorders. IHC study was conducted using primary monoclonal mouse antibodies for CD56 and CD138, followed by secondary antibody application under a standardized protocol, while CD56 and CD138 positive cells were quantified as the total cell count for each studied antibody per 1 mm² of BD (Olympus BX46 and Olympus Image Analyzer). Results: Studies examined term placentas with BD of 107 participants, according to ART Endometriosis (n=36), ART Male factor (n=31) and Physiological (n=40) pregnancies’ group. Endometriosis placentas yielded higher incidence of placental lesions compared to control groups including increased syncytial knot formation, shortened placental cords, and a higher frequency of vascular malperfusion disorders (subchorionic and perivillous fibrin deposition, intervillous thrombosis, and high-grade fetal vascular malperfusion). Endometriosis factor was associated with increased syncytial knots’ formation and placental cord hypercoiling in adjusted regression model. Endometriosis pregnancies experienced higher number of early pregnancy bleeding and imminent preterm labor events, as well as higher cesarean delivery with newborns frequently presenting with lowest birthweight. The BD from endometriosis placentas exhibited the lowest median CD56-positive NK cells’ count compared to control groups, associated with odds for several placental lesions (immature villous ramification, low grade villitis of unknown etiology, intervillous thrombosis and increased perivillous fibrin). Conversely, no significant differences were observed in CD138-positive plasma cell counts across the study groups. Conclusions: These findings could suggest potential impaired maternal immune response based on altered NK cell infiltration, which may hinder proper trophoblast invasion, vascular remodeling and placental development, with compromised placental perfusion contributing to adverse perinatal outcomes in pregnancies after ART treatment of endometriosis-related infertility. However, adaptive immunity with plasma cell infiltration did not show potential influence associated with endometriosis pathogenesis. The observed placental malperfusion lesions highlight the need for increased surveillance of placental function in pregnancies complicated by endometriosis, even in cases conceived through ART. Future research should aim to elucidate the molecular pathways linking endometriosis to placental dysfunction and perinatal complications. Identifying potential biomarkers or therapeutic interventions targeting immune dysregulation and vascular remodeling in endometriosis-related pregnancies may improve maternal and fetal outcomes
The role of mast cells in bladder cancer development in a murine model
No full textCILJEVI ISTRAŽIVANJA: Ovo istraživanje se bavilo ulogom jedne vrste imunoloških stanica, mastocita, u razvoju tumora mokraćnog mjehura. Cilj je bio bolje razumjeti kako mastociti utječu na rast tumora, te može li se blokiranjem njihove aktivnosti lijekom kromolinom utjecati na tijek bolesti. MATERIJALI I METODE: Istraživanje je provedeno na miševima uz korištenje dva različita tumorska model. U prvom modelu, miševima je dana kemikalija BBN koja s vremenom uzrokuje razvoj tumora mokraćnog mjehura. Pred kraj eksperimenta je započet tretman kromolinom kako bi se spriječila aktivacija mastocita. U drugom modelu, miševima su ispod kože ubrizgane tumorske stanice koje su s vremenom formirale tumor. U tim su eksperimentima provedena dva protokola terapije kromolinom. Terapijski protokol, u kojem je kromolin davan svakodnevno nakon što se tumor razvio, te protokol kontinuiranog tretmana, koji je započet dan prije injiciranja tumorskih stanica i provodio se do kraja eksperimenta. Kako bi se dodatno provjerilo kako mastociti utječu na razvoj tumora, oba tumorska modela su ponovljena i na miševima koji nemaju mastocite. REZULTATI: Terapijski protokol primjene kromolina (nakon pojave tumora) je rezultirao smanjenom veličinom tumora, jačom aktivacijom imunološkog odgovora i smanjenim stvaranjem novih krvnih žila za opskrbu tumora kisikom i hranjivim tvarima. S druge strane, kontinuirani protokol primjene kromolina je doveo do lošijih ishoda, odnosno većih tumora, slabijeg imunološkog odgovora i smanjenog odumiranja tumorskih stanica. Miševi bez mastocita su razvili veće tumore u potkožnim tumorskim eksperimentima, dok su u BBN eksperimentima imali nešto više invazivnih tumora. ZAKLJUČCI: Ovo istraživanje je pokazalo da mastociti imaju zaštitnu ulogu u ranoj fazi raka mokraćnog mjehura. Međutim, tijekom napredovanja bolesti mijenjaju svoje djelovanje i počinju poticati napredak tumora. Pokazano je da primjena lijeka kromolina može biti korisna ako se koristi u pravo vrijeme, no kontinuirana uporaba može imati negativne učinke.OBJECTIVES: The primary aim of this study was to explore the role of mast cells in the development and progression of bladder cancer, as well as the effects of their pharmacological inhibition using cromolyn. Particular emphasis was placed on understanding the mechanisms through which mast cells, and their inhibition, shape the tumor microenvironment. The study aimed to investigate how these factors influence gene expression, with a focus on genes involved in immune cell recruitment and activation, as well as regulation of cell death pathways. MATERIALS AND METHODS: This research utilized a murine model of bladder cancer induced by the chemical carcinogen BBN. In this model, C57BL/6J mice received intraperitoneal injections of cromolyn at a dose of 50 mg / kg every 48 hours during the final four weeks of the experiment. In addition, the study employed a subcutaneous tumor model using murine MB49 bladder cancer cells, which were injected subcutaneously into the same mouse strain. Two treatment protocols were applied in this model. In the first, therapeutic protocol, cromolyn treatment began after tumors had formed and continued daily (50 mg / kg, intraperitoneally) until the end of the experiment to evaluate its effect on tumor progression. In the second protocol, designed to mimic a scenario in which individuals are already undergoing cromolyn therapy at the time of tumor initiation, cromolyn was administered one day before MB49 cell inoculation and continued daily at the same dosage throughout the experiment. To further investigate the role of mast cells, both experimental models were also conducted using genetically mast cell-deficient mouse strains: Cpa3Cre/+ and KitW-sh/W-sh. RESULTS: In the BBN-induced model, therapeutic administration of cromolyn showed a trend toward reduced tumor mass and an improved phenotype. A similar beneficial effect was observed in the subcutaneous tumor model, where cromolyn treatment partially reduced tumor burden. Cromolyn therapy led to decreased expression of genes associated with angiogenesis and increased expression of genes involved in the activation of cytotoxic T cells and NK cells. Conversely, continuous cromolyn administration resulted in lower expression of genes essential for immune cell recruitment and activation, as well as for apoptotic and necroptotic pathways ultimately leading to a significantly increased tumor burden. Additionally, mice lacking mast cells (Cpa3Cre/+ and KitW-sh/W-sh) developed larger tumors in the subcutaneous model and showed a trend toward worse outcomes in the BBN model. CONCLUSIONS: Results of the study have shown that mast cells play a protective role in the early stages of bladder cancer but undergo phenotypic changes during tumor progression, shifting toward a protumorigenic function. Cromolyn, which primarily acts through mast cell inhibition, appears to improve the phenotype of established tumors. However, prolonged treatment was found to promote tumor progression in the mouse model
Clinical otoneurological features and psychiatric comorbidities in patients with vestibular migraine
No full textUVOD: Vestibularna migrena (VM) najčešći je neurološki uzrok ponavljajućih vrtoglavica, pri čemu se dijagnoza temelji uglavnom na anamnezi zbog nedostatka specifičnih dijagnostičkih testova. Vestibularna migrena često je povezana sa psihijatrijskim komorbiditetima i smanjenom kvalitetom života. Cilj ovog istraživanja bio je sveobuhvatno ispitati bolesnike sa sigurnom VM-om (sVM) analizirajući kliničke otoneurološke značajke, vestibulo-okularne reflekse (VOR) i subjektivnu vizualnu vertikalu (SVV), uspoređujući rezultate između simptomatske i asimptomatske faze sVM-a te procjenjujući psihijatrijske komorbiditete i kvalitetu života. METODE: Istraživanje je provedeno u dvije kliničke vizite i obuhvatilo je 31 bolesnika sa sVM-om. Vestibularna funkcija procijenjena je s pomoću video Head Impulse Testa (vHIT) za evaluaciju VOR-a i testiranjem SVV-a za procjenu vertikalnosti. Dodatno, u drugom presječnom kliničkom istraživanju sudjelovalo je 104 ispitanika [19 bolesnika sa sVM-om, 22 bolesnika s migrenom bez vrtoglavice (MO) i 63 zdrava ispitanika (HC)] koji su ispunili upitnike Hospital Anxiety and Depression Scale (HADS), Dizziness Handicap Inventory (DHI) i Short Form - 36 (SF-36). REZULTATI: Analiza je pokazala značajno veća odstupanja SVV-a tijekom simptomatske faze u usporedbi s asimptomatskom fazom sVM-a (β = 0,678, p = 1,51 × 10-6). Nasuprot tome, vrijednosti VOR-a ostale su stabilne kroz obje faze sVM-a (p > 0,05). Simptomi povezani s migrenom, uključujući mučninu, fotofobiju i fonofobiju, bili su značajno češći tijekom simptomatske faze bolesti (p 0.05). Migraine-associated symptoms, including nausea, photophobia, and phonophobia, were significantly more frequent during the symptomatic phase (p < 0.001). According to the psychiatric clinical examination, 11 out of 19 (57.89%) dVM patients were diagnosed with anxiety. Furthermore, dVM patients exhibited significantly higher anxiety, depression, and dizziness scores in questionnaires compared to the MO and HC groups, indicating greater impairment. They also reported lower physical functioning in the SF-36 health survey, which was strongly correlated with dizziness symptoms. CONCLUSIONS: Patients with dVM exhibited phase-dependent alterations in spatial orientation and vestibular function, with increased SVV deviations during the symptomatic phase despite stable VOR. Psychiatric comorbidities such as anxiety and depression, along with reduced physical functioning, significantly affect the quality of life in dVM patients. These findings highlight the necessity for a multidisciplinary approach involving otolaryngologists, neurologists, and psychiatrists to ensure comprehensive health care and timely screening for psychiatric comorbidities in dVM patients, improving diagnostic accuracy and patient well-being
Behavior and attitudes of young women in treatment and prevention of urinary tract
No full textCilj istraživanja: Infekcije mokraćnog sustava spadaju među najučestalije infekcije. Do 14 puta su zastupljenije u žena poglavito mladih žena nego u muškaraca primarno zbog anatomski čimbenika (kratka mokraćna cijev, blizina anusa) a među ostalim čimbenicima koji doprinose pojačanoj prevalenciji IMS u mladih žena su seksualna aktivnost i uporaba higijenskih uložaka. Cilj ovog istraživanja bio je ispitati stavove i znanja studentica Sveučilišta u Splitu biomedicinskog i nebiomedicinskog usmjerenja o infekcijama mokraćnog sustava. Nadalje, ovim istraživanjem je ispitana i usklađenost registriranih pakiranja lijekova u Hrvatskoj s nacionalnim i međunarodnim smjernicama za njihovu primjenu. Ispitanici i postupci: Istraživanje stavova i znanja studentica biomedicinskog i nebiomedicinskog usmjerenja Sveučilišta u Splitu je ustrojeno kao presječno anketno istraživanje, a istraživanje podudarnosti registriranih antimikrobnih lijekova sa smjernicama za njihovu primjenu je pregledno. Anketno istraživanje je bilo anonimno, a sudjelovanje u istraživanju dragovoljno. Pakiranja lijekova registrirana u Hrvatskoj su uspoređena sa smjernicama Interdisciplinarne sekcija za kontrolu rezistencije na antibiotike (ISKRA) i smjernicama za urološke infekcije Europskog društva za urologiju (EUA). Rezultati: Ovo istraživanje obuhvatilo je ukupno 392 studentice upisane u akademsku godinu 2022./2023. na Sveučilištu u Splitu, od kojih je 243 (62,0%) s medijanom dobi od 22 godine (IQR 20,0–24,7 godina) pohađalo studij biomedicinskog usmjerenja, a 149 (38,0%) prosječne dobi od 24 godine (IQR 22,0–29,0 godina) pohađalo je studij nebiomedicinskog usmjerenja. Samo 22 (5,6%) žena smatralo je da ne mogu prepoznati UTI. Veći udio studenata biomedicine brisao se sprijeda prema natrag, dok je značajno više studenata koji nisu biomedicinskog usmjerenja odabralo pamučno donje rublje i izbjegavalo dnevne higijenske uloške u usporedbi sa studentima biomedicine. Čak 215 (54,8%) žena izjavilo je da je koristilo pripravke od brusnice. Studenti biomedicine pokazali su veću svijest o mogućoj rezistenciji na ponovljeno liječenje (p = 0,002) i bolje poznavanje mogućih interakcija antibiotika (p < 0,001). Analizom usklađenosti pakiranja lijekova sa smjernicama za njihovu primjenu u slučaju ISKRA smjernica utvrđena usklađenost tek za jedan antibiotik prve linije i jedan alternativni, dok je kod EUA smjernica usklađen bio samo fosfomicin. Zaključci: Istraživanje je pokazalo da su studentice biomedicinskog usmjerenja imale bolja znanja o antimikrobnom liječenju IMS u odnosu na studentice nebiomedicinskog usmjerenja dok su studentice nebiomedicinskog usmjerenja češće su koristile neantibiotske pripravke poput brusnice, d manoze i probiotika. U slučaju ISKRA smjernica analizirajući njenu usklađenost sa pakiranjima lijekova ista je utvrđena samo za fosfomicin i koamoksiklav dok je u slučaju EUA smjernica usklađen bio samo fosfomicin.Title: Behavior and attitudes of young women in treatment and prevention of urinary tract infections Objectives: Urinary tract infections (UTIs) are among the most common infections. They are up to 14 times more common in women, especially young women, than in men primarily due to anatomical factors (short urethra, proximity to the anus), and among other factors that contribute to the increased prevalence of UTIs in young women are sexual activity and the use of sanitary pads. The aim of this research was to examine the attitudes and knowledge of biomedical and non-biomedical students at the University of Split about urinary tract infections. Furthermore, this research examined the compliance of registered pharmaceutical packaging in Croatia with national and international guidelines for their use. Subjects and Methods: The study of the attitudes and knowledge of biomedical and non-biomedical students at the University of Split was structured as a cross-sectional survey, and the study of the compliance of registered antimicrobial drugs with the guidelines for their use is transparent. The survey was anonymous, and participation in the research was voluntary. The packages of medicines registered in Croatia were compared with the guidelines of the Interdisciplinary Section for the Control of Antibiotic Resistance (ISKRA) and the guidelines for urological infections of the European Association of Urology (EUA). Results: This research included a total of 392 female students enrolled in the academic year 2022/2023. at the University of Split, of which 243 (62.0%) with a median age of 22 years (IQR 20.0–24.7 years) attended biomedical studies, and 149 (38.0%) with an average age of 24 years (IQR 22.0–29.0 years) attended a non-biomedical course. Only 22 (5.6%) women felt that they could not recognize a UTI. A greater proportion of biomedical students wiped from front to back, while significantly more non-biomedical students chose cotton underwear and avoided daily sanitary napkins compared to biomedical students. As many as 215 (54.8%) women stated that they used cranberry preparations. Biomedical students showed greater awareness of possible resistance to repeated treatment (p = 0.002) and better knowledge of possible antibiotic interactions (p < 0.001). An analysis of the compliance of the drug packaging with the guidelines for their use in the case of the ISKRA guidelines found accordance only for one first-line antibiotic and one alternative, while only fosfomycin was in accordance with the EUA guidelines Conclusions: The research showed that female biomedical students had better knowledge about the antimicrobial treatment of IMS compared to non-biomedical students, while non- biomedical students more often used non-antibiotic preparations such as cranberry, d mannose and probiotics. In the case of the ISKRA guidelines, analyzing its accordance with drug packaging, the same was determined only for fosfomycin and coamoxiclav, while in the case of the EUA guidelines, only fosfomycin was compliant
Transparency of clinical trials of targeted therapeutics for endocrine and metabolic disorders in registries and corresponding publications
No full textUVOD: Ciljana terapija napravila je revoluciju u liječenju brojnih indikacija u različitim medicinskim područjima, uključujući endokrine i metaboličke poremećaje. Kako se tržište ciljane terapije nastavlja širiti, transparentno izvještavanje o kliničkim ispitivanjima koja koriste ovu vrstu terapije postaje ključno za osiguravanje pouzdanosti podataka, pravilnu procjenu omjera rizika i koristi te donošenje informiranih kliničkih odluka. CILJ ISTRAŽIVANJA: Procijeniti potpunost registracije i dosljednost izvještavanja u registrima kliničkih ispitivanja i odgovarajućim znanstvenim člancima za klinička ispitivanja koja koriste ciljanu terapiju za liječenje endokrinih i metaboličkih poremećaja. MATERIJALI I METODE: U rujnu 2022. godine pretraženi su registri kliničkih ispitivanja kako bi se identificirala završena intervencijska ispitivanja ciljane terapije za liječenje endokrinih i metaboličkih poremećaja. Primijenjeni su obavezni registracijski podaci iz minimalnog skupa podataka Svjetske zdravstvene organizacije za procjenu cjelovitosti registracije kliničkih ispitivanja te podaci o štetnim događajima u registrima kliničkih ispitivanja te je potom ispitana potpunost i usklađenost tih informacija s podacima objavljenima u odgovarajućim znanstvenim člancima. REZULTATI: Nepotpunost u obaveznim registracijskim podacima utvrđena je u 67% kliničkih ispitivanja pri njihovu inicijalnom unosu u registre, u 13% pri konačnom ažuriranju registracije te u 77% odgovarajućih znanstvenih članaka. Podaci o ozbiljnim štetnim događajima navedeni su u 86% odgovarajućih znanstvenih članaka, dok su podaci o ostalim štetnim događajima prisutni u 91% članaka. Sva klinička ispitivanja imala su promjene u obaveznim registracijskim podacima između inicijalnog unosa i konačnog ažuriranja registracije, dok je 98% ispitivanja pokazalo je promjene od inicijalnog unosa u registre do objave u odgovarajućim znanstvenim člancima. Neslaganja u broju ozbiljnih štetnih događaja između registra i odgovarajućih znanstvenih članaka zabilježena su u 38% kliničkih ispitivanja, dok su za ostale štetne događaje takve razlike primijećene u 86% ispitivanja. ZAKLJUČAK: Unatoč postojećim regulatornim zahtjevima za pravovremenom i potpunom registracijom kliničkih ispitivanja te transparentnim izvještavanjem o rezultatima i štetnim događajima u odgovarajućim znanstvenim člancima, razina potpunosti i dosljednosti izvještavanja za klinička ispitivanja koja koriste ciljanu terapiju za liječenje endokrinih i metaboličkih poremećaja ostaje nezadovoljavajuća. Ova otkrića dovode u pitanje cjelovitost i vjerodostojnost kliničkih ispitivanja provedenih u ovim granama medicine.INTRODUCTION: Targeted therapy has revolutionized the treatment of numerous indications across various medical fields, including endocrine and metabolic disorders. As its market continues to expand, transparent reporting of clinical trials employing this type of therapy is crucial to ensure data reliability, adequately assess the risk-benefit ratio, and facilitate informed clinical decisions. AIM OF THE STUDY: To assess the completeness of registration and the consistency of reporting registries and corresponding publications for clinical trials of targeted therapy for endocrine and metabolic disorders. MATERIALS AND METHODS: In September 2022, clinical trial registries were searched to identify completed interventional trials of targeted therapy for the treatment of endocrine and metabolic disorders. Mandatory registration data items from the World Health Organization's minimal dataset were applied was extracted to assess the completeness of clinical trial registration along with adverse event data. The completeness and consistency of this information were then compared to data published in the corresponding publications. RESULTS: Incomplete mandatory registration data items were found in 67% clinical trials at their initial registry entry, in 13% at the final registration update, and in 77% corresponding publications. Data on serious adverse events were reported in 86% of the corresponding publications, while data on other adverse events were present in 91% of them. All clinical trials exhibited changes in the mandatory registration data items between the initial registration entry and the final registration update, and 98% of the trials showed changes between the initial registry entry to corresponding publications. Discrepancies in the number of serious adverse events between the registry and the corresponding publications were observed in 38% of clinical trials, whereas differences for other adverse events were noted in 86% them. CONCLUSION: Despite existing regulatory requirements for the timely and complete registration of clinical trials and transparent reporting of results and adverse events in corresponding scientific publications, the level of completeness and consistency of reporting for clinical trials of targeted therapy for endocrine and metabolic disorders remains unsatisfactory. These findings call into question the integrity and credibility of clinical trials conducted in these medical fields
Association between dietary patterns and plasma thyroid hormone concentrations
No full textCilj istraživanja: Cilj ovog istraživanja bio je ispitati povezanost konzumacije određenih skupina namirnica s koncentracijama hormona štitnjače u plazmi zdravih odraslih ispitanika. Ispitanici i metode: U ovu presječnu studiju uključeno je 2657 zdravih ispitanika s otoka Korčule. Podaci o prehrambenim navikama ispitanika prikupljeni su putem standardiziranog upitnika o učestalosti konzumacije hrane (engl. Food Frequency Questionnaire, FFQ). Za redukciju dimenzionalnosti prehrambenih varijabli primijenjena je analiza glavnih komponenti (engl. Principal Component Analysis, PCA). Prikladnost podataka za faktorsku analizu procijenjena je pomoću Bartlettova testa sferičnosti (χ²) te Kaiser-Meyer-Olkinova (KMO) indeksa. Povezanost između prehrambenih obrazaca dobivenih metodom PCA i koncentracije TSH i fT4 u plazmi ispitana je primjenom linearne regresijske analize, pri čemu su P-vrijednosti manje od 0,05 smatrane statistički značajnima. Rezultati: Linearna regresijska analiza pokazala je pozitivnu povezanost učestale konzumacije punomasnog sira, svježeg sira i kiselog vrhnja s koncentracijom TSH (β = 0,072, SE = 0,008, P = 0,055). Učestala konzumacija voćnih sokova, Cedevite i bezalkoholnih pića (β = -0,108, SE = 0,008, P = 0,006), divljači i puretine (β = -0,092, SE = 0,008, P = 0,014) te sušenog voća (β = -0,091, SE = 0,008, P = 0,015) je negativno povezana s koncentracijom TSH. Linearna regresijska analiza pokazala je da su učestala konzumacija bijelog kruha i smanjeni unos kruha od cjelovitog zrna, pozitivno povezane s koncentracijom fT4 (β = 0,071, SE = 0,060, P = 0,052), dok je učestala konzumacija biljnog ulja negativno povezana s koncentracijom fT4 (β = -0,086, SE = 0,059, P = 0,018). Žene su pokazale značajno više koncentracije TSH u odnosu na muškarce, dok razlike u koncentraciji fT4 između spolova nisu bile značajne. Zaključak: Prehrana bogata punomasnim mliječnim proizvodima povezana je s višim koncentracijama TSH, dok je prehrana bogata šećernim napitcima, divljači, puretinom i sušenim voćem povezana s nižim koncentracijama TSH. Prehrana koja uključuje učestalu konzumaciju bijelog kruha i smanjenu konzumaciju kruha od cjelovitog zrna, pozitivno je povezana s koncentracijom fT4, a prehrana bogata biljnim uljem povezana je s nižom koncentracijom fT4.Aim of the study: To investigate the association between the consumption of specific food groups and plasma concentrations of thyroid hormones (TSH and fT4) in healthy individuals. Participants and Methods: This cross-sectional study included 2,657 healthy participants from the island of Korčula. Dietary habits were assessed using a standardized Food Frequency Questionnaire (FFQ). To reduce the dimensionality of dietary variables, Principal Component Analysis (PCA) was applied. The suitability of the data for factor analysis was evaluated using Bartlett’s test of sphericity (χ²) and the Kaiser-Meyer-Olkin (KMO) index. The associations between dietary patterns derived from PCA and plasma concentrations of TSH and fT4 were examined using linear regression analysis, with p-values less than 0.05 considered statistically significant. Results: Linear regression analysis showed a positive association between frequent consumption of full-fat cheese, fresh cheese, and sour cream and plasma TSH concentrations (β = 0.072, SE = 0.008, P =0.055). Frequent consumption of fruit juices, Cedevita, and soft drinks was negatively associated with TSH concentrations (β = -0.108, SE = 0.008, P = 0.006). A similar negative association was observed with the frequent consumption of venison and turkey (β = -0.092, SE = 0.008, P = 0.014), as well as dried fruit (β = -0.091, SE = 0.008, P = 0.015). A dietary pattern characterized by frequent consumption of white bread and rare consumption of whole grain bread was positively associated with fT4 concentrations (β = 0.071, SE = 0.060, P = 0.052). Frequent consumption of vegetable oil was negatively associated with fT4 (β = -0.086, SE = 0.059, P = 0.018). Women had significantly higher TSH concentrations than men, while no significant sex differences were observed in fT4 concentrations. Conclusion: A diet rich in full-fat dairy products (full-fat cheese, fresh cheese, and sour cream) was associated with higher TSH concentrations. In contrast, diets high in sugary beverages, venison, turkey and dried fruit were associated with lower TSH concentrations. A diet characterized by frequent consumption of white bread was associated with higher fT4 concentrations, whereas higher intake of vegetable oil was associated with lower fT4 concentrations
