Repository of the University of Rijeka, Faculty of Medicine
Not a member yet
7184 research outputs found
Sort by
Constructed wetlands for wastewater treatment in Primorsko-Goranska County
No full textPročišćavanje otpadnih voda je proces smanjenja onečišćenja do onih koncentracija s kojima pročišćene otpadne vode ispuštene u prijemnike postaju neopasne za život i ljudsko zdravlje te ne uzrokuju neželjene promjene u okolišu. Jedan od alternativnih načina pročišćavanja otpadnih voda je korištenje biljnih uređaja. Cilj istraživanja završnog rada je usporedba efikasnosti dvaju različitih biljnih uređaja za pročišćavanje otpadnih voda na području Primorsko-goranske županije. Analizirani parametri na ulazu i izlazu uređaja bili su suspendirana tvar, kemijska potrošnja kisika, biokemijska potrošnja kisika, nitrati, nitriti, kjedahl dušik, ukupni dušik i ukupni fosfor. Analiza obuhvaća varijacije zabilježenih vrijednosti tijekom pet godina, u razdoblju od 2019. do 2023. godine.
Vrijednosti ulaznih koncentracija za uređaj A i B u razdoblju od 2019. do 2023. godine za sve ispitivane parametre prelazile su pripadajuće MDK vrijednosti. Na izlazu uređaja A proces obrade bio je učinkovit za parametre suspendirana tvar i KPK izuzev kolovoza 2022. godine kada su vrijednosti prelazile MDK. Za parametar BPK5 kod uređaja A vrijednosti nisu bile unutar granica MDK tijekom lipnja 2019. i 2020. godine dok za ostala razdoblja jesu. Na izlazu uređaja B proces obrade bio je u potpunosti učinkovit za parametre suspendirana tvar, KPK i BPK5 čije vrijednosti nisu prelazile MDK. Vrijednosti ukupnog dušika i fosfora na izlazu uređaja A i B nisu se nalazile unutar MDK kod svih provedenih mjerenja. Učinkovitost uređaja A bila je u prosjeku iznad 80 % za parametre suspendirana tvar, KPK i BPK5, a učinkovitost uređaja B bila je u prosjeku iznad 90 % dok za obradu ukupnog dušika i fosfora niti jedan od ispitanih uređaja nije bio učinkovit pošto su izlazne vrijednosti pojedinih mjerenja bila veće od ulaznih vrijednosti.
Primjenom stečenih iskustva i znanja, korištenje biljnih uređaja za obradu različitih otpadnih voda može biti temelj budućeg upravljanja otpadnim vodama u Republici Hrvatskoj. Provedena istraživanja otvaraju put mogućim adaptacijama i poboljšanju postojećih biljnih pročišćivača i same tehnike ovakve vrste pročišćavanja.Wastewater treatment is the process of reducing pollution to those concentrations with which purified wastewater discharged into receivers becomes harmless to life and human health and does not cause unwanted changes in the environment. One of the alternative methods of wastewater treatment is the use of constructed wetland. The aim of the research of this final paper is to compare the efficiency of two different plant devices for wastewater treatment in the area of Primorje-Gorski Kotar County. The parameters analyzed at the inlet and outlet of the device were suspended matter, COD, BOD5, nitrates, nitrites, kjedahl nitrogen, total nitrogen and total phosphorus. The analysis includes variations in recorded values over five years, in the period from 2019 to 2023.
The values of the input concentrations for device A and B in the period from 2019 to 2023 for all tested parameters exceeded the corresponding MDK values. At the outlet of device A, the treatment process was efficient for the suspended matter and COD parameters, except for August 2022, when the values exceeded the MDK. For the BOD5 parameter at device A, the values were not within the MDK limits during June 2019 and 2020, while they were for the other periods. At the outlet of device B, the treatment process was fully effective for the parameters suspended matter, COD and BOD5, whose values did not exceed the MDK. The values of total nitrogen and phosphorus at the output of devices A and B were not within the MDK for all measurements performed. The efficiency of device A was on average above 80% for the parameters suspended matter, COD and BOD5, the efficiency of device B was on average above 90%, while for the treatment of total nitrogen and phosphorus, none of the tested devices was efficient since the output values of individual measurements were higher than the input values.
By applying the acquired experience and knowledge, the use of constructed wetland for the treatment of various wastewaters can be the basis of future wastewater management in the Republic of Croatia. The conducted research paves the way for possible adaptations and improvement of existing herbal purifiers and the very technique of this type of purification
Hypoplastic left heart syndrome (HLHS) becomes of age: Assessing the young adult with HLHS including the neoaorta/aortic arch
No full textHypoplastic left heart syndrome (HLHS) is one of the most complex congenital heart defects (CHD), characterized by a hypoplastic left ventricle (LV), dominant right ventricle (RV) and small left-sided heart structures. The introduction of the Norwood operation has significantly improved outcomes, with 5-year survival reported up to 65 %. Despite these advances, post-operative morbidity and mortality remain high, and the long-term complications in adult survivors represent a challenge. The number of HLHS patients with Fontan circulation is expected to double in the next 20 years, leading to a growing population requiring specialized care from adult congenital heart disease (ACHD) teams. This article reviews current management strategies for HLHS, outlines potential long-term complications, and highlights existing knowledge gaps. Specific considerations in this population include the assessment of the neo-aorta and aortic arch, and systemic RV dysfunction in the setting of a Fontan circulation. The proposed surveillance strategy emphasizes the need for vigilant monitoring and timely intervention to treat the complications unique to this population, ensuring better outcomes for HLHS patients reaching adulthood
The Microbial Diversity and Biofilm Characteristics of d-PTFE Membranes Used for Socket Preservation: A Randomized Controlled Clinical Trial
No full textBackground: Understanding microbial colonization on different membranes is critical for guided bone regeneration procedures such as socket preservation, as biofilm formation may affect healing and clinical outcomes. This randomized controlled clinical trial (RCT) investigates, for the first time, the microbiome of two different high-density polytetrafluoroethylene (d-PTFE) membranes that are used in socket preservation on a highly molecular level and in vivo. Methods: This RCT enrolled 39 participants, with a total of 48 extraction sites, requiring subsequent implant placement. Sites were assigned to two groups, each receiving socket grafting with a composite bone graft (50% autogenous bone, 50% bovine xenograft) and covered by either a permamem® (group P) or a Cytoplast™ (group C). The membranes were removed after four weeks and analyzed using scanning electron microscopy (SEM) for bacterial adherence, qPCR for bacterial species quantification, and next-generation sequencing (NGS) for microbial diversity and composition assessment. Results: The four-week healing period was uneventful in both groups. The SEM analysis revealed multispecies biofilms on both membranes, with membranes from group C showing a denser extracellular matrix compared with membranes from group P. The qPCR analysis indicated a higher overall bacterial load on group C membranes. The NGS demonstrated significantly higher alpha diversity on group C membranes, while beta diversity indicated comparable microbiota compositions between the groups. Conclusion: This study highlights the distinct microbial profiles of two d-PTFE membranes during the four-week socket preservation period. Therefore, the membrane type and design do, indeed, influence the biofilm composition and microbial diversity. These findings may have implications for healing outcomes and the risk of infection in the dental implant bed and should therefore be further explored
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
Mediterranean Diet and Metabolic Syndrome
No full textMetabolic syndrome (MetS) is a major health issue defined by central obesity and at least two more of the following factors: high triglycerides, low high-density lipoprotein (HDL) cholesterol, high blood pressure, and high fasting glucose. Managing MetS involves lifestyle changes, with the adherence to a Mediterranean diet (MeDi) playing a crucial role. MeDi, emphasizing the consumption of whole grains, fruits, vegetables, legumes, nuts, and olive oil, has been linked to a reduced risk of type 2 diabetes and improved glucoregulation. A randomized controlled trial showed that a low-carb MeDi resulted in a 30% lower relative risk of developing type 2 diabetes compared to a low-fat diet. Additionally, meta-analytic data highlighted a strong inverse relationship between adherence to the MeDi and the incidence of diabetes. Furthermore, the MeDi’s anti-inflammatory properties help manage obesity-related low-grade chronic inflammation, crucial for weight management and the improvement of quality of life. The improvement of lipid profiles, reductions in low-density lipoprotein and total cholesterol, and an increase in HDL cholesterol were also found to be linked to MeDi adherence. However, despite its benefits, adherence to the MeDi varies widely, often being low to moderate in many Mediterranean populations. Improving adherence through physician advice and patient education is crucial for maximizing the MeDi’s potential to prevent and manage diabetes and diabetes-related complications
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
Students’ attitudes toward euthanasia and abortion: a cross-cultural study in three Mediterranean countries
No full textIntroduction: Abortion and euthanasia are still one of the greatest bioethical challenges. Previous studies have shown that there are differences in attitudes towards these issues depending on socio-demographic characteristics and socio-cultural environment (country of residence). As part of the scientific research project EuroBioMed, we compared the attitudes of students from three Mediterranean countries towards abortion and euthanasia and examined them from the perspective of Mediterranean bioethics. Methods: A pen-to-paper survey was conducted on a convenient sample of students (N = 1097) from five universities and four fields of study (Medicine, Law, Theology and Philosophy) in Croatia, Greece and Italy to investigate their attitudes towards abortion and euthanasia. Three hypotheses were tested using t-test and ANOVA for differences in attitudes according to country, field of study, year of study, gender, religiosity, political orientation, financial status, and size of place of residence. Results: While attitudes towards abortion were not statistically significantly different between students from different countries, the analysis showed that students from Italy had more liberal attitudes towards euthanasia. Theology students had more conservative attitudes towards both abortion and euthanasia, while there were no differences between the other groups. Women, final year students, non-religious and politically left-oriented students had more liberal attitudes. Conclusion: The results provided an insight into students’ attitudes towards abortion and euthanasia. Knowledge of the attitudes of these future experts can be valuable for the discussion of these issues. These results also provided a basis for a better understanding of the construct of Mediterranean bioethic
Navigating challenges and opportunities in orphan medicines: A spotlight commentary on rare diseases
No full textChallenges and variability in breast cancer screening: diagnostic work-up and strategies for standardization across Europe
No full textGlial Cells in Spinal Muscular Atrophy: Speculations on Non-Cell-Autonomous Mechanisms and Therapeutic Implications
No full textSpinal muscular atrophy (SMA) is a neuromuscular disorder caused by homozygous deletions or mutations in the SMN1 gene, leading to progressive motor neuron degeneration. While SMA has been classically viewed as a motor neuron-autonomous disease, increasing evidence indicates a significant role of glial cells—astrocytes, microglia, oligodendrocytes, and Schwann cells—in the disease pathophysiology. Astrocytic dysfunction contributes to motor neuron vulnerability through impaired calcium homeostasis, disrupted synaptic integrity, and neurotrophic factor deficits. Microglia, through reactive gliosis and complement-mediated synaptic stripping, exacerbate neurodegeneration and neuroinflammation. Oligodendrocytes exhibit impaired differentiation and metabolic support, while Schwann cells display abnormalities in myelination, extracellular matrix composition, and neuromuscular junction maintenance, further compromising motor function. Dysregulation of pathways such as NF-κB, Notch, and JAK/STAT, alongside the upregulation of complement proteins and microRNAs, reinforces the non-cell-autonomous nature of SMA. Despite the advances in SMN-restorative therapies, they do not fully mitigate glial dysfunction. Targeting glial pathology, including modulation of reactive astrogliosis, microglial polarization, and myelination deficits, represents a critical avenue for therapeutic intervention. This review comprehensively examines the multifaceted roles of glial cells in SMA and highlights emerging glia-targeted strategies to enhance treatment efficacy and improve patient outcomes