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Znanje i stavovi prema crijevnim stomama kod zdravstvenih radnika
No full textObjectives: The aim of this diploma thesis is to test the knowledge and attitudes about diverting intestinal stomas in healthcare workers, as well as to find the differences in knowledge and attitudes between nurses and physicians. Materials and Methods: A survey was conducted among 199 healthcare professionals (119 nurses, 80 physicians) at University Hospital of Split. A validated questionnaire assessed demographics (12 questions), knowledge (23 questions) and attitudes (20 Likert-scale items). Statistical analysis included chi-square test, Mann-Whitney U test, Kruskal-Wallis test. The Ethics Committee of the University Hospital of Split approved the research. Results: Nurses demonstrated significantly higher knowledge level (nurses score median of 17 vs physicians’ score median of 15 correct answers; p = 0.022) and more positive attitudes towards intestinal stomas than physicians. Both groups reported limited formal education on stoma care (41.71% of all respondents had no formal education in stoma care), though nurses showed greater interest in further training (87% of nurses vs 45% of physicians; p < 0.001). Attitudes reflected higher confidence among nurses in managing stoma care tasks. Conclusions: This study reveals differences between nurses and physicians in knowledge, experience, and attitudes toward intestinal stoma care. Nurses demonstrated higher competence and greater interest in further training, likely due to more clinical exposure and workshop participation. Both groups had inadequate formal education, highlighting a need for improved training. Experience in surgical or gastroenterology departments correlated with better knowledge, emphasizing the importance of hands-on learning. The study recommends structured, multidisciplinary education programs and inclusion of specialized roles like enterostomal therapists, to enhance the quality of stoma care.Ciljevi: Cilj ovog diplomskog rada je ispitati znanje i stavove o crijevnim stomama u zdravstvenih djelatnika, kao i pronaći razlike u znanju i stavovima između medicinskih sestara i liječnika. Materijali i metode: U Sveučilišnoj bolnici u Splitu provedeno je istraživanje među 199 zdravstvenih djelatnika (119 medicinskih sestara, 80 liječnika). Validiranim upitnikom procijenjeni su demografski podaci (12 pitanja), znanje (23 pitanja) i stavovi (20 stavki Likertove skale). Statistička analiza uključivala je hi-kvadrat test, Mann-Whitneyjev U test i Kruskal-Wallisov test. Etičko povjerenstvo Kliničkog bolničkog centra Split odobrio je istraživanje. Rezultati: Medicinske sestre pokazale su značajno višu razinu znanja ( skor medicinskih sestara medijan 17, u odnosu na liječnički skor medijan 15 točnih odgovora; p = 0,022) i pozitivnije stavove prema crijevnim stomama nego liječnici. Obje skupine izvijestile su o ograničenom formalnom obrazovanju o njezi stome (41,71% svih ispitanika nije imalo formalno obrazovanje o njezi stome), iako su medicinske sestre pokazale veći interes za daljnju edukaciju (87% medicinskih sestara u odnosu na 45% liječnika; p < 0.001). Stavovi su odražavali veće samopouzdanje među medicinskim sestrama u upravljanju zadacima njege stome. Zaključci: Ova studija otkriva razlike između medicinskih sestara i liječnika u znanju, iskustvu i stavovima prema njezi crijevnih stoma. Medicinske sestre pokazale su veću kompetentnost i veći interes za daljnju edukaciju, vjerojatno zbog veće kliničke izloženosti i sudjelovanja u radionicama. Obje skupine imale su neadekvatno formalno obrazovanje, što naglašava potrebu za poboljšanom obukom. Iskustvo na kirurškim ili gastroenterološkim odjelima koreliralo je s boljim znanjem, naglašavajući važnost praktičnog učenja. Studija preporučuje strukturirane, multidisciplinarne obrazovne programe i uključivanje specijaliziranih uloga poput enterostomalnih terapeuta kako bi se poboljšala kvaliteta njege stome
Dvogodišnje praćenje novorođenčadi s izuzetno niskom i niskom porođajnom težinom s naglaskom na sljepoću, gluhoću, kognitivna oštećenja i cerebralnu paralizu
No full textObjectives: The aim of this retrospective observational study was to measure the incidence of severe neurodevelopmental impairments – including blindness, deafness, cognitive impairment, and cerebral palsy - in ELBW and LBW infants born in the REGIOMED hospital Coburg between 2013 and 2021. Materials and methods: This study enrolled 187 patients born from January 2013 till December 2021, with loosing 111 of them due to dropout by not attending the 2-year follow-up. Data were collected from the follow-up records at SPZ Coburg and the pediatric ward in the REGIOMED/SANA hospital Coburg. Chi-squared and Cramer´s V test was applied to assess associations between variables. Results: Among the 73 infants who completed the 2year follow-up, the overall incidence of blindness and deafness was each 1.37%, and cerebral palsy was diagnosed with an incidence of 5.4%. Cognitive impairment was noted with an overall incidence of 8.22%. A significant association was observed between gestational age and the occurrence of blindness, deafness, or having any impairments -not taking into consideration if an infant had more than one simultaneously. There was no statistically significant association shown between birthweight and any of the diagnosis. Conclusion: Most preterm infants in this cohort demonstrated positive outcomes at two years. The findings underline the need for comprehensive follow-up care.Ciljevi: Cilj ove studije bio je izmjeriti učestalost teških neuroloških razvojnih oštećenja – uključujući sljepoću, gluhoću, kognitivna oštećenja i cerebralnu paralizu – kod novorođenčadi s izuzetno niskom (ELBW) i niskom porođajnom težinom (LBW) rođene u bolnici REGIOMED Coburg između 2013. i 2021. godine. Materijali i methode: U ovu studiju uključeno je 187 pacijenata rođenih između siječnja 2013. i prosinca 2021. godine, pri čemu je 111 pacijenata izgubljeno zbog nedolaska na dvogodišnje praćenje. Podaci su prikupljeni iz evidencija praćenja u SPZ Coburg i pedijatrijskog odjela bolnice REGIOMED/SANA Coburg. Za procjenu povezanosti među varijablama primijenjeni su hi-kvadrat test i Cramerov V test. Rezultati: Među 73 novorođenčadi koja su dovršila dvogodišnje praćenje, ukupna učestalost sljepoće i gluhoće iznosila je po 1,37%, dok je cerebralna paraliza dijagnosticirana s učestalošću od 5,4%. Kognitivno oštećenje zabilježeno je s ukupnom učestalošću od 8,22%. Utvrđena je značajna povezanost između gestacijske dobi i pojave sljepoće, gluhoće ili bilo kojeg oštećenja – ne uzimajući u obzir je li dijete imalo više od jednog oštećenja istovremeno. Nije utvrđena statistički značajna povezanost između porođajne težine i bilo koje od dijagnoza. Zakljucci: Većina prijevremeno rođene novorođenčadi u ovoj kohorti pokazala je pozitivne ishode u dobi od dvije godine. Nalazi naglašavaju potrebu za sveobuhvatnom skrbi i praćenjem
Outcomes of surgical treatment of non-small cell lung cancer at the University Hospital of Split in 2024
No full textCilj istraživanja: Cilj ovog istraživanja je analizirati ishode kirurškog liječenja bolesnika s dijagnozom nemikrocelularnog karcinoma pluća (NSCLC) u Kliničkom bolničkom centru (KBC) Split u 2024. godini. Istraživanje se fokusira na ključne parametre uspješnosti kirurškog liječenja. Ispituju se poslijeoperacijski ishodi, uključujući stope komplikacija, trajanje hospitalizacije, drenaže prsnog koša te čimbenici koji utječu na ishode, uključujući stadij bolesti, trajanje prijeoperacijske obrade, vrsta kirurškog zahvata i iskustvo operatera. Ispitanici i metode: Ispitanici su svi bolesnici koji su bili podvrgnuti kirurškom zahvatu i u kojih je patohistološkom analizom potvrđena dijagnoza NSCLC-a, u razdoblju od 1. siječnja 2024. do 31. prosinca 2024. godine u Klinici za kirurgiju KBC-a Split. Izvor podataka jest arhiva elektronskih podataka iz Informacijskog Bolničkog Sustava i pisani protokol operacijskih zahvata. Svakom ispitaniku analizirani su sljedeći parametri: dob, spol, proteklo vrijeme od postavljanja sumnje na kompjuteriziranoj tomografiji do prikaza na multidisciplinarnom timu, proteklo vrijeme od prikaza na multidisciplinarnom timu do operacije, patohistološki podtip, stadij bolesti, vrsta zahvata, operater, trajanje zahvata, konverzije u otvoreni kirurški pristup, duljina trajanja drenaže, komplikacije, reoperacije i duljina hospitalizacije. Rezultati: Tijekom 2024. godine u KBC-u Split operirano je 98 bolesnika zbog NSCLC-a, pri čemu je spolna raspodjela bila gotovo jednaka, s blagom dominacijom muškaraca. Većina bolesnika operirana je u ranom stadiju bolesti (stadij IA), a adenokarcinom je bio najčešći histološki podtip. Videoasistirana torakoskopska sublobarna resekcija trajala je kraće od ostalih zahvata i bila je povezana s kraćim vremenom drenaže i hospitalizacije. Stopa konverzije iz minimalno invazivnih pristupa u otvoreni kirurški zahvat iznosila je 5,2%. Komplikacije su bile relativno rijetke, bez značajne razlike među kirurškim tehnikama, a najčešća je bila pneumonija (10,2%). Zaključci: Rezultati pokazuju da se kirurško liječenje NSCLC-a u KBC-u Split provodi učinkovito, s visokom razinom podudarnosti kliničke i patohistološke evaluacije te niskom stopom komplikacija i reoperacija. Minimalno invazivni pristupi, osobito videoasistirana torakoskopska sublobarna resekcija, povezani su s kraćim trajanjem zahvata, drenaže i hospitalizacije, što potvrđuje njihovu kliničku prednost u pažljivo odabranih bolesnika.Objectives: The aim of this study was to analyze the outcomes of surgical treatment in patients diagnosed with non-small cell lung cancer (NSCLC) at the University Hospital of Split in 2024. The research focused on key parameters of surgical treatment success, evaluating postoperative outcomes including complication rates, length of hospitalization, chest drainage duration, and factors influencing outcomes such as disease stage, preoperative work-up duration, type of surgical procedure, and surgeon experience. Patients and methods: The study included all patients who underwent surgery and had a histopathologically confirmed diagnosis of NSCLC between January 1 and December 31, 2024, at the Department of Surgery, University Hospital of Split. Data were obtained from Hospital Information System and written surgical protocols. For each patient, the following parameters were analyzed: age, sex, time from suspicion on CT to multidisciplinary team (MDT) presentation, time from MDT to surgery, histological subtype, disease stage, type of surgery, surgeon, surgery duration, conversion to open procedure, chest drainage duration, complications, reoperations, and length of hospitalization. Results: In 2024, a total of 98 patients with NSCLC underwent surgery at University Hospital of Split. The sex distribution was nearly equal, with a slight predominance of male patients. Most patients were operated on in the early stage of disease (stage IA), and adenocarcinoma was the most common histological subtype. Video-assisted thoracoscopic sublobar resection had a shorter operative time compared to other procedures and was associated with reduced chest drainage duration and shorter hospital stay. The conversion rate from minimally invasive techniques to open thoracotomy was 5.2%. Postoperative complications were relatively infrequent, with no significant differences between surgical approaches; the most common complication was pneumonia (10.2%). Conclusions: The results indicate that surgical treatment of NSCLC at University Hospital of Split is conducted effectively, with high concordance between clinical and histopathological assessment, and low rates of complications and reoperations. Minimally invasive techniques, especially video-assisted thoracoscopic sublobar resection, are associated with shorter operative time, drainage duration, and hospitalization, confirming their clinical advantage in carefully selected patients
Number of teeth, dietary habits and physical activity in individuals with first myocardial infarction: A pilot study
No full textCilj istraživanja: Glavni cilj ovog diplomskog rada bio je istražiti moguću povezanost broja zubi kao indikatora težine parodontitisa, prehrambenih navika i fizičke aktivnosti s dobivanjem infarkta miokarda kod ljudi s dijagnosticiranim parodontitisom. Ispitanici i postupci: U ovom pilot istraživanju sudjelovale su 84 osobe raspoređene u dvije skupine. Kontrolnu skupinu činila su 44 ispitanika bez IM-a, a testnu skupinu 40 ispitanika s IM-om. Svi ispitanici iz obje skupine imali su parodontitis. Tijekom bolničkog liječenja akutnog IM-a prikupljeni su opći i parodontološki anamnestički podatci koji su sadržavali i vrijednosti tlaka i broj zubi svakog ispitanika. Uz njih dobiveni su i podatci o prehrambenim navikama i fizičkoj aktivnosti primjenom validiranih upitnika (MDSS upitnik, MEDAS upitnik, GPAQ upitnik) za testnu skupinu. Kontrolna skupina formirana je tijekom parodontološkog liječenja na temelju probira prema dijagnozi parodontitisa te su uzeti isti podatci kao i u testnoj skupini. Rezultati: Kontrolna i testna skupina nisu se statistički značajno razlikovale po spolu, iako su u uzorku prevladavali muškarci (n=62/84). Testna skupina bila je starija u odnosu na kontrolnu skupinu (P=0,005). Sistolički krvni tlak bio je viši u skupini s IM-om nego u kontrolnoj skupini (P=0,022), dok razlika u dijastoličkom tlaku nije bila značajna. Broj zubi bio je manji u testnoj skupini u usporedbi s kontrolnom skupinom (P=0,003). Obiteljska anamneza parodontitisa bila je prisutna kod 46 % ispitanika kontrolne skupine, a u testnoj skupini kod 15 % ispitanika (P=0,005). Također, redoviti odlasci parodontologu bili su značajno češći u kontrolnoj skupini (77 %) nego u testnoj skupini, gdje čak 90 % ispitanika ne posjećuje parodontologa (P < 0,001). Obje skupine redovito posjećuju izabranog stomatologa, a kontrolna skupina ipak češće odlazi na profesionalno uklanjanje tvrdih i mekih zubnih naslaga (P=0,001). U obje skupine prevladavali su pušači i bivši pušači, s nešto više ispitanika za testnu skupinu. Bivši pušači razlikovali su se po trajanju apstinencije – u testnoj skupini svi bivši pušači nisu pušili više od 5 godina (P=0,030). Većina iz obje skupine negirala je simptome parodontitisa (krvarenje, zadah, klimanje zubi). Svi ispitanici imali su nezadovoljavajuće prehrambene navike. Niti jedna od ispitanih varijabli u području prehrane i tjelesne aktivnosti nije bila statistički značajna među skupinama. Za unos voća, povrća i orašastih plodova nije postojala značajna razlika među skupinama kao ni za MDSS i MEDAS rezultate. Ovime je pokazano kako se obje skupine ne pridržavaju smjernica mediteranske prehrane. U slučaju fizičke aktivnosti, 57 % ispitanika u obje skupine klasificirano je kao fizički aktivno, a 43 % kao fizički neaktivno. Zaključak: Rezultati ovog pilot istraživanja ukazuju da bi teži oblici parodontitisa mogli predstavljati značajan čimbenik rizika za IM. Prehrambene navike kao i navike vezane za provođenje fizičke aktivnosti u obje skupine nisu bile zadovoljavajuće, što ukazuje da osobe koje razviju teže oblike parodontitisa povećavaju kumulativni rizik za dobivanje IM-a. Stoga bi bilo preporučljivo educirati i pravovremeno liječiti osobe s parodontitisom u svrhu očuvanja oralnog i sistemskog zdravlja.Objectives: The main objective of this thesis was to investigate the potential association between the number of teeth as an indicator of periodontitis severity, dietary habits and physical activity, with the occurrence of myocardial infarction in individuals diagnosed with periodontitis. Subjects and methods: This pilot study included 84 participants divided into two groups. The control group consisted of 44 individuals without myocardial infarction (MI), while the test group included 40 individuals with MI. All participants in both groups were diagnosed with periodontitis. During the hospital treatment of acute MI, general and periodontal medical history data were collected, including blood pressure measurements and the number of teeth for each participant. Additionally, dietary habits and physical activity data were obtained for the test group using validated questionnaires (MDSS, MEDAS, GPAQ). The control group was formed during periodontal treatment based on periodontitis diagnosis screening, and the same data were collected as in the test group. Results: There was no statistically significant difference between the control and test groups in terms of gender, although males predominated in the sample (n=62/84). The test group was older compared to the control group (P=0.005). Systolic blood pressure was higher in the MI group than in the control group (P=0.022), while the difference in diastolic blood pressure was not significant. The number of teeth was lower in the test group compared to the control group (P=0.003). A family history of periodontitis was present in 46% of the control group participants and 15% of the test group participants (P=0.005). Additionally, regular visits to a periodontist were significantly more frequent in the control group (77%) than in the test group, where as many as 90% of participants did not visit a periodontist (P < 0.001). Both groups regularly visited their general dentist, but the control group more often underwent professional removal of hard and soft dental deposits (P=0.001). Smokers and former smokers predominated in both groups, with slightly more participants in the test group. Former smokers differed in the duration of abstinence — in the test group, all former smokers had abstained from smoking for less than 5 years (P=0.030). The majority in both groups denied symptoms of periodontitis (bleeding, bad breath, tooth mobility). All participants had unsatisfactory dietary habits. None of the examined variables related to diet and physical activity showed statistically significant differences between the groups. There was no significant difference in fruit, vegetable, and nut intake between the groups, nor in the MDSS and MEDAS scores. This indicates that both groups do not adhere to the Mediterranean diet guidelines. Regarding physical activity, 57% of participants in both groups were classified as physically active, while 43% were physically inactive. Conclusion: The results of this pilot study suggest that severe forms of periodontitis may represent a significant risk factor for myocardial infarction. Dietary habits and physical levels were unsatisfactory in both groups, indicating that individuals who develop severe periodontitis increase their cumulative risk of experiencing a myocardial infarction. Therefore, it would be advisable to educate and provide timely treatment to individuals with periodontitis to preserve both oral and systemic health
Association between bronchial hyperreactivity and pulmonary function parameters, Th2 inflammation, and asthma control in children aged 7 to 18 years
No full textCilj istraživanja: Cilj istraživanja bio je ispitati povezanost bronhalne hiperreaktivnosti s parametrima plućne funkcije, markerima Th2 upale i stupnjem kontrole bolesti u djece s astmom u dobi od 7 do 18 godina. Materijali i metode: U istraživanje je uključeno 152 ispitanika u dobi od 7 do 18 godina koja su obrađena radi dijagnoze astme. U istraživanje su bili uključeni ispitanici kojima je učinjen bronhoprovokacijski test metakolinom te šira laboratorijska obrada unutar godinu dana od pretrage. Obrada je uključivala mjerenje broja eozinofila u krvnoj slici, ukupni i specifični IgE te eozinofilni kationski protein. Isključeni su ispitanici koji nisu imali kompletne kliničke podatke. Rezultati: U ovom istraživanju dokazana je značajna povezanost BHR s povišenim FeNO (p=0,036) i eozinofilijom (p=0,006) što upućuje na njegovu povezanost sa pokazateljima Th2- dominantne upale. Ispitanici s BHR bili su mlađi (p=0,001) i kraće liječeni (p=0,002) dok je značajnost za FEV1/FVC bila granična (p=0.053). BHR povezana s narušenom plućnom funkcijom – djeca s BHR imala su niži FEV1. Značajno je češće bronhalna hiperreaktivnost dokazana u ispitanika s nekontroliranom astmom (p=0,015), uz to zabilježena je statistički značajna razlika u kumulativnoj dozi metakolina koja je uzrokovala pad FEV1 za 20 % (43 mcg vs. 101 mcg, p=0,038). Djeca s kontroliranom astmom imala su značajno viši FEV1 (FEV1 (z)=0,024) u odnosu na djecu s nekontroliranom astmom (FEV1(z)= -,247), p=0,007). Značajna razlika dokazana je i za omjer FEV1/FVC između ispitanika s kontroliranom (FVC (z)= -1,294 ) i nekontroliranom astmom (FVC (z)= -0,553), p=0,002). Zaključci: Ovo istraživanje pokazalo je značajnu povezanost BHR s povišenim FeNO i eozinofilijom što upućuje na njegovu ulogu funkcionalnog pokazatelja Th2-dominantne upale. Nadalje, stupanj BHR korelirao je sa slabijom kontrolom bolesti – bolesnici s nekontroliranom astmom pokazivali su veću BHR izraženu nižim pragom za 20-postotno smanjenje FEV1 na metakolinskom testu. Daljnje su studije potrebne za dodatno istraživanje povezanosti BHR i parametara Th2 upale.Objectives: This study aimed to examine the association between bronchial hyperreactivity with lung function parameters, Th2 inflammation markers, and the degree of disease control in children with asthma aged 7 to 18 years. Materials and methods: The study included 152 children aged 7 to 18 years who underwent evaluation for asthma diagnosis. The study only included participants who underwent bronchial challenge testing and an extended laboratory workup within a year of the examination. The workup included measuring the number of eosinophils in the blood count, total and specific IgE and eosinophil cationic protein. Subjects who did not have complete clinical data were excluded. Results: This study demonstrated a significant association between BHR with elevated FeNO levels (p=0.036) as well as eosinophilia (p=0.006), indicating a link with markers of Th2- driven inflammation. Children with BHR were younger (p=0.001) and had a shorter duration of treatment (p=0.002), while the association with the FEV1/FVC ratio was borderline (p=0.053). BHR was associated with impaired lung function, as children with BHR exhibited lower FEV1 values. Bronchial hyperresponsiveness was significantly more prevalent in patients with uncontrolled asthma (p=0.015), and a statistically significant difference was observed in the cumulative dose of metacholine required to induce a 20 % decrease in FEV1 (43 mcg vs. 101 mcg, p=0.038). Children with controlled asthma had significantly higher FEV1 values (FEV1(z)=0.024) compared to those with uncontrolled asthma (FEV1(z) = -0.247, p=0.007). A significant difference in the FEV1/FVC ratio was also observed between the two groups with the values of FVC(z)=-1.294 in the controlled asthma group vs. -0.553, p=0.002 in the uncontrolled group. Conclusions: This study demonstrated a significant between BHR and elevated markers of TH2 inflammation (FeNO and eosinophilia), which suggests, which points to its role as a functional indicator of Th2-dominant inflammation. Furthermore, the degree of BHR correlated with poorer disease control – children with uncontrolled asthma showed more pronounced BHR as expressed by a lower threshold for a 20 % decrease in FEV1 on the methacholine challenge test. Further studies are needed to investigate the association between BHR and parameters of Th2 inflammation
Electroneurographic characteristics of median nerve after carpal tunnel syndrome surgery
No full textCiljevi: Cilj ovog istraživanja bio je procijeniti učinkovitost kirurškog liječenja sindroma karpalnog tunela analizom elektrofizioloških promjena prije i nakon operacije. Glavni fokus bio je na promjenama u parametrima elektroneurografije (ENG) medijanog živca, s ciljem objektivizacije terapijskog učinka. Materijali i metode: Retrospektivna studija provedena je u Klinici za neurologiju MEFST-a i KBC-a Split. U istraživanje je uključeno 41 pacijent koji su tijekom razdoblja od travnja do srpnja 2023. godine podvrgnuti EMNG testiranju prije i poslije operacije karpalnog tunela. Analizirani su podaci o brzini provođenja, latenciji i amplitudi motornih i senzornih vlakana medijanog živca. Statistička analiza uključivala je D’Agostino-Pearsonov test, upareni t-test i Wilcoxonov test. Rezultati: Zabilježeno je statistički značajno poboljšanje u gotovo svim parametrima nakon operacije. Brzina senzornih vlakana povećana je s prosječnih 23,53 ± 18,92 m/s na 38,41 ± 14,39 m/s (P<0,001), brzina motornih vlakana s 50,38 ± 14,20 m/s na 55,33 ± 5,80 m/s (P=0,035), a latencija motornih vlakana smanjena je s 5,83 ± 1,52 ms na 4,33 ± 0,71 ms (P<0,001). Također je zabilježeno povećanje amplitude motornih vlakana na razini zapešća (5,82 ± 4,05 mV na 7,47 ± 3,00 mV, P=0,003). Nije zabilježena značajna promjena amplituda na razini lakta (5,64 ± 3,76 mV vs. 5,76 ± 2,66 mV, P=0,801). Zaključci: Dobiveni rezultati pokazuju da kirurška dekompresija karpalnog tunela dovodi do značajnog elektrofiziološkog poboljšanja u funkciji medijanog živca. Operacijsko liječenje može se smatrati učinkovitom terapijskom metodom za pacijente s umjerenim i teškim oblicima sindroma karpalnog tunela.Objectives: The aim of this study was to evaluate the effectiveness of surgical treatment of carpal tunnel syndrome by analyzing electrophysiological changes before and after surgery. The focus was on assessing changes in electroneurography (ENG) parameters of the median nerve to objectively evaluate therapeutic outcomes. Materials and methods: This retrospective study was conducted at the Department of Neurology, KBC Split. A total of 41 patients who underwent ENG testing before and after carpal tunnel release surgery between April and July 2023 were included. Parameters such as conduction velocity of sensor and motor nerve fibers, latency, and amplitude of motor fibers of the median nerve were analyzed. Statistical analysis included the D’Agostino-Pearson test, paired t-test, and Wilcoxon test. Results: A statistically significant improvement was observed in nearly all parameters after surgery. Sensory conduction velocity increased from a mean of 23.53 ± 18.92 m/s to 38.41 ± 14.39 m/s (P<0,001), motor conduction velocity from 50.38 ± 14.20 m/s to 55.33 ± 5.80 m/s (P=0.035), and motor latency decreased from 5.83 ± 1.52 ms to 4.33 ± 0.71 ms (P<0.001). Additionally, a significant increase in motor amplitude at the wrist level was recorded (5.82 ± 4.05 mV to 7.47 ± 3.00 mV, P=0.003). No significant change was observed in amplitudes measured at the elbow (5.64 ± 3.76 mV vs. 5.76 ± 2.66 mV, P=0.801). Conclusions: The results confirm that surgical decompression of the carpal tunnel leads to significant electrophysiological improvement in median nerve function. Surgical treatment is therefore an effective therapeutic option for patients with moderate to severe carpal tunnel syndrome
Anatomski jezični kutak : Što su kucavice, a što vlasastice i krvice?
No full textI ovaj je put anatomski jezični kutak nadahnut Schwarzovom „Opisnom anatomijom čovječjega tiela“ iz 1873. godine i to Knjigom IV, koja sadrži detaljan Opis žilja. Pogađate, radi se o prikazu krvožilnog sustava
Protective effect of pentadecapeptide BPC 157 on organ damage in abdominal compartment syndrome in a rat model
No full textNedavna istraživanja ukazuju da stabilni želučani pentadekapeptid BPC 157 djeluje protektivno na oštećenja tkiva i organa kod okluzivnih sindroma velikih krvnih žila – bilo da se radi o perifernoj ili centralnoj okluziji na način da aktivira kolateralnu cirkulaciju. U ovom istraživanju po prvi smo puta u svijetu ispitivali utjecaj stabilnog želučanog pentadekapeptida BPC 157 na oštećenje organa u abdominalnom kompartment sindromu na animalnom modelu. Inducirali smo abdominalni komapartment sindrom u štakora koji predstavlja model polikompartment multiokluzivnog sindroma. Istraživali smo oštećenje organa i protektivno djelovanje BPC 157 na modelu ishemije i modelu reperfuzije. Intraabdominalni tlak, kojim je induciran abdominalni kompartment sindrom, i vrijeme trajanja ishemije je za štakore koji su bili anestezirani tiopentalom iznosio je 25 mm Hg (60 min), 30 mm Hg (30 min), 40 mm Hg (30 min) i 50 mm Hg (15 min) te kod štakora koji su bili anestezirani sa esketaminom (25 mm Hg tijekom 120 min). Kod modela reperfuzije prije dekompresije (kalvariektomija, laparotomija) štakori su imali dugotrajnu tešku intraabdominalnu hipertenziju, stupanj III (25 mm Hg/60 min) i stupanj IV (30 mm Hg/30 min; 40 mm Hg/30 min) te tešku okluziju / sindrom sličan okluziji odnosno ishemiju. Daljnje pogoršanje oštećenja organa uzrokovano je reperfuzijom od 60 minuta ili 30 minuta nakon dekompresije. Ozbiljno vaskularno i multiorgansko zatajenje (lezije mozga, srca, jetre, bubrega i probavnog sustava), raširena tromboza (periferno i centralno), teške aritmije, intrakranijalna (gornji sagitalni sinus) hipertenzija, portalna i kavalna hipertenzija te aortalna hipotenzija su se javile umodelu ishemije, a dodatno su se pogoršale u modelu reperfuzije. Štakori s intraabdominalnom hipertenzijom u modelu ishemije (stupanj III, stupanj IV) primili su BPC 157 (10 μg ili 10 ng/kg sc) ili fiziološku otopinu (5 ml) nakon 10 minuta. Kod modela reperfuzije, terapija BPC 157 (10 μg/kg, 10 ng/kg sc) primijenjena je u reperfuzijskim vremenima od 3 minute po dekompresiji i induciranju reperfuzije. Primjena BPC 157 oporavila je venu azygos putem spasonosnog kolateralnog puta gornje i donje šuplje vene. Dodatno, smanjena je intrakranijska (gornji sagitalni sinus), portalna i kavalna hipertenzija te aortalna hipotenzija, kao i izrazita kongestija želuca i velike hemoragijske lezije, oticanje mozga, venska i arterijska tromboza, kongestija donje šuplje vene i gornje mezenterične vene te kolabirana vena azygos; stoga je inače neuspjeli kolateralni put potpuno oporavljen kod primjene BPC 157. Ozbiljni EKG poremećaji (tj. teška bradikardija i ST-elevacija do asistolije) također su bili poništeni. Mikroskopski, transmuralna hiperemija gastrointestinalnog trakta, redukcija resica crijevne sluznice, redukcija kripte s fokalnom denudacijom površinskog epitela i dilatacija debelog crijeva bili su inhibirani. U jetri je BPC 157 smanjio kongestiju i ozbiljno povećanje sinusoida. U plućima je primijećena normalna prezentacija, bez žarišnog zadebljanja alveolarne membrane i bez plućne kongestije ili edema, a izostalo je ozbiljno intraalveolarno krvarenje. Spriječena je teška srčana kongestija, subendokardijalni infarkt, bubrežno krvarenje, edem mozga, krvarenje i neuralna oštećenja. Terapija s BPC 157 u reperfuziji eliminirala je / smanjila je vensku hipertenziju (intrakranijalnu (gornji sagitalni sinus), portalnu i kavalnu) i aortnu hipotenziju i spriječila povećanje lezije organa i vrijednosti malondialdehida (krv ˃ srce, pluća, jetra, bubrezi ˃ mozak, gastrointestinalni trakt). Brzo je došlo do vaskularnog oporavka (tj. začepljene donja šuplja vena i gornja mezenterična vena preokrenute su u normalnu prezentaciju krvnih žila, kolabirana vena azigos preokrenuta je u potpuno funkcionalno stanje, šant donje šuplje vene vene–gornje šuplje vene je oporavljen i vraćena je izravna isporuka krvi). Terapija s BPC 157 gotovo je poništila trombozu i krvarenje (tj. intracerebralno krvarenje) kao dokaz suzbijanja općeg zastoja i okolnosti Virchow trijade i reorganiziranog krvotoka. Poboljšanjem funkcije venskog sustava s BPC 157 preokrenuli smo lanac štetnih događaja u ishemiji i reperfuziji. Terapija s BPC 157 i protektivni učinak na organe mogao bi biti prenesen na pacijente, poništavajući lezije uzrokovane povišenim intraabdominalnim tlakom, potičući tako potpuni oporavak oštećenih organa. U konačnici, terapijska primjena BPC 157 kod pacijenata s abdominalnim kompartment sindromom smanjila bi visoku stopu smrtnosti i potrebom za hitnom dekompresijskom laparotomijom.Recent research indicates that the stable gastric pentadecapeptide BPC 157 has a protective effect on tissue and organ damage in occlusive syndromes of large blood vessels, whether there is a case of peripheral or central occlusion, by activating collateral circulation. In this research, for the first time in the world, we examined the influence of stable gastric pentadecapeptide BPC 157 on organ damage in abdominal compartment syndrome in an animal model. We induced abdominal compartment syndrome in rats, which represents a model of polycompartment multiocclusive syndrome. We investigated organ damage and the protective effect of BPC 157 in ischemia and reperfusion models. The intra-abdominal pressure that induced abdominal compartment syndrome and the duration of ischemia for rats anesthetized with thiopental was 25 mm Hg (60 min), 30 mm Hg (30 min), 40 mm Hg (30 min), and 50 mm Hg (15 min). and in rats anesthetized with esketamine (25 mm Hg for 120 min). In the reperfusion model before decompression (calvariectomy, laparotomy), rats had long-term severe intra-abdominal hypertension, grade III (25 mm Hg/60 min) and grade IV (30 mm Hg/30 min; 40 mm Hg/30 min) and severe occlusion/like syndrome or ischemia. Further worsening of organ damage was caused by reperfusion for 60 minutes or 30 minutes after decompression. Severe vascular and multiorgan failure (lesions of the brain, heart, liver, kidneys, and digestive system), widespread thrombosis (peripheral and central), severe arrhythmias, intracranial (superior sagittal sinus) hypertension, portal and caval hypertension, and aortic hypotension occurred in the ischemia model and further worsened in the reperfusion model. Rats with intra-abdominal hypertension in the ischemia model (grade III, grade IV) received BPC 157 (10 μg or 10 ng/kg sc) or saline (5 ml) after 10 minutes. In the reperfusion model, BPC 157 therapy (10 μg/kg, 10 ng/kg sc) was administered at reperfusion times of 3 minutes after decompression and induction of reperfusion. Administration of BPC 157 recovered the azygos vein via the superior and inferior vena cava salvage collateral route. In addition, intracranial (upper sagittal sinus), portal and caval hypertension and aortic hypotension were reduced, as well as pronounced gastric congestion and large hemorrhagic lesions, brain swelling, venous and arterial thrombosis, congestion of the inferior vena cava and superior mesenteric veins and collapsed azygos vein; therefore, the otherwise failed collateral pathway was fully restored with BPC 157 administration. Severe ECG disturbances (ie, severe bradycardia and ST-elevation to asystole) were also reversed. Microscopically, transmural hyperemia of the gastrointestinal tract, villi reduction of the intestinal mucosa, crypt reduction with focal denudation of the surface epithelium, and colon dilatation were inhibited. In the liver, BPC 157 reduced congestion and severe sinusoidal enlargement. A normal presentation was observed in the lungs, without focal thickening of the alveolar membrane and without pulmonary congestion or edema, and severe intraalveolar hemorrhage was absent. Severe cardiac congestion, subendocardial infarction, renal hemorrhage, brain edema, hemorrhage, and neural damage were prevented. Therapy with BPC 157 in reperfusion eliminated/reduced venous hypertension (intracranial (upper sagittal sinus), portal and caval) and aortic hypotension and prevented an increase in organ lesions and malondialdehyde values (blood ˃ heart, lungs, liver, kidneys ˃ brain, gastrointestinal tract). Vascular recovery occurred rapidly (ie, the occluded inferior vena cava and superior mesenteric vein were reversed to a normal presentation of blood vessels, the collapsed azygos vein was reversed to a fully functional state, the inferior vena cava–superior vena cava shunt was repaired and returned direct delivery of blood). BPC 157 therapy almost reversed thrombosis and hemorrhage (ie, intracerebral hemorrhage) as evidenced by suppression of general stasis and circumstances of the Virchow triad and reorganized blood flow. By improving the function of the venous system with BPC 157, we reversed the chain of harmful events in ischemia and reperfusion. Therapy with BPC 157 and the protective effect on the organs could be transferred to the patients, reversing the lesions caused by increased intra-abdominal pressure and thus promoting the full recovery of the damaged organs. Ultimately, the therapeutic use of BPC 157 in patients with abdominal compartment syndrome would reduce the high mortality rate and the need for emergency decompressive laparotomy