Repository of the University of Rijeka, Faculty of Medicine
Not a member yet
7184 research outputs found
Sort by
High-Power Ultrasound and High-Voltage Electrical Discharge-Assisted Extractions of Bioactive Compounds from Sugar Beet (Beta vulgaris L.) Waste: Electron Spin Resonance and Optical Emission Spectroscopy Analysis
No full textTo achieve sustainable extractions, this study examines the impact of different extraction methods to utilize waste from the sugar industry. In addition to conventional thermal extraction, the impact of high-power ultrasound (US) and high-voltage electrical discharge (HVED)-assisted extractions on the yield of bioactive compounds and the antioxidant capacity (AC) value of sugar beet leaf extracts was determined. US extraction proved to be an excellent method for extracting bioactive compounds, while HVED extraction proved to be an excellent method for extracting Vitexin. AC was measured both spectrophotometrically (DPPH and FRAP) and spectroscopically via electron spin resonance (ESR). The AC results correlate with each other, and the highest AC values were found in the US-treated samples with 25% ethanol solution as the extraction solvent. Characterization of the plasma via optical emission spectroscopy (OES) showed that neither the solvent nor the sample influenced the plasma spectra, only the gas used (nitrogen/argon). All of the obtained results provide an excellent basis for future research into the utilization of food waste and by-products
A systematic review of economic evaluations of orphan medicines for the management of spinal muscular atrophy
No full textSpinal muscular atrophy (SMA) is a rare inherited autosomal recessive progressive disease of a varying phenotype, with varying clinical symptoms, and as a result the patients suffering from it require multiple types of care. It was deemed useful to conduct a systematic literature review on the pharmacoeconomic evaluations of all currently registered disease‐modifying therapies in order to inform policy and highlight research gaps. Pharmacoeconomic analyses written in English and published after 2016 were considered for inclusion. PubMed/Medline, Global Health and Embase were systematically and separately searched between 16 October and 23 October 2023. Hand‐searching was also conducted on PubMed based on reference lists of published literature. After the exclusion criteria were applied, 14 studies were included. BMJ checklist was used for quality assessment and the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to assess the quality of reporting of all included studies. Data extraction was performed manually. Regarding evidence synthesis, data were heterogeneous and are thus presented based on comparison. This study confirms the need for pharmacoeconomic analyses (cost‐effectiveness or cost‐utility) also in cases when the cost of treatment is very high and the incremental cost‐effectiveness ratio values exceed the usual, acceptable values for standard therapy. Specific willingness to pay thresholds for orphan medicines are of the utmost importance, to allow patients with SMA to have access to safe and effective treatments. With such economic evaluations, it is possible to compare the value of medications with the same indication, but it should be emphasized that in the interpretation of data and in making decisions about the use of medicines, the impact of new knowledge should be considered
The Influence of Standard and Freeze-Dried Tofu on the Phenols and Quality of Virgin Olive Oil Used as an Immersion Medium
No full textVarious protein-rich foods are traditionally immersed in virgin olive oil (VOO), a medium rich in phenols, which are health-promoting and sensorially important compounds. Immersing tofu in VOO may modify the sensory properties and nutritional value of both due to the oil’s hydrophilic phenol interactions with proteins and water. In this study, cubes of fresh tofu (T) (70% water) and freeze-dried tofu (FD-T) (5% water) were immersed in VOO for 7 days of cold storage. The changes in the phenolic compound content and standard quality parameters of the oil were noted after 1, 3, 5, and 7 days of contact with the tofu. The total phenols in the oil were determined using the Fast Blue BB assay, while single phenols were analyzed by HPLC-UV/VIS. During the 7 days, the total phenols in the oil decreased by up to 56% and 26% under the influence of fresh and freeze-dried tofu, respectively, including a significant decrease in hydroxytyrosol, oleacein, tyrosol, and oleocanthal. The water content and its release from fresh tofu significantly contributed to this decline. The degradation of the quality of the oil in contact with the fresh tofu was observed only in its sensory properties, with a marked reduction in the intensity of its fruitiness, bitterness and pungency
EFFICIENCY OF SELECTED PHYSIOTHERAPY TREATMENTS IN PATIENTS WITH LOW BACK PAIN
No full textCilj istraživanja: Glavni cilj je ispitati koji konzervativni postupak fizikalne terapije daje
najbolje rezultate u smanjenju boli kod pacijenata s lumbalnim bolnim sindromom.
Materijal i metode: U istraživanju je sudjelovalo 210 ispitanika koji su bili raspoređeni u
sedam skupina, 6 eksperimentalnih i jedna kontrolna skupina. Kontrolnu skupinu činili su
pacijenti koji su dolazili u ordinaciju fizikalne medicine i rehabilitacije zbog drugih dijagnoza
te ne obuhvaćaju problematiku lumbalnog bolnog sindroma. Svaki je pacijent prošao kroz 10
terapijskih ciklusa tijekom 10 dana. Prosječna dob ispitanika iznosi 50,11 godina (s = 12,9
godina). Od 210 ispitanika bilo je 128 žena (61 %) i 82 muškarca (39 %). Na početku
istraživanja pacijenti su ispunili oba upitnika Roland-Morris Disability Questionnare i
Oswestry Low Back Pain Disability Questionnare, dok se na kraju istraživanja ispunjavao
Roland-Morris Disability Questionnare.
Rezultati: Nakon provedene terapije u svim skupinama došlo je do značajnog poboljšanja kod
svih tretiranih pacijenata. U svim skupina postoji statistički značajna razlika p < 0,05 i p <<
0,001 kod post hoc Scheffeova testa za ukupni Roland-Morrisov upitnik. Rezultati istraživanja
pokazuju da je kombinirana terapija najučinkovitija kod ispitanika s lumbalnim bolnim
sindromom. Naime, između ispitanika skupine 3 (elektroanalgezija) i skupine 4
(magnetoterapija) nema statistički značajne razlike p = 0,987. Također kod ispitanika koji su
koristili pojedinačnu terapiju lasera i ultrazvuka nema statistički značajne razlike p = 0,999.
Testovi kojima smo mjerili opseg pokreta lumbalne kralježnice, indeks sagitalne gibljivosti,
Lasegueov test i Thomayerova mjera, pokazuju poboljšanja kod svih skupina.
Zaključak: Nakon provedenog istraživanja svi sudionici studije imaju veći stupanj
osposobljenosti. Najbolja metoda fizikalne terapije pokazala se u skupini 6, koja obuhvaća
kombinaciju svih fizioterapijskih procedura s kineziterapijom lumbosakralne kralježnice.Objectives: The main goal is to examine which conservative physical therapy procedure gives
the best results in reducing pain in patients with low back pain.
Material and Methods: In the research 210 respondents participated were divided into seven
groups, 6 experimental and one control group. The control group includes patients who come
to the physical medicine and rehabilitation office due with other diagnoses and do not include
the issue of low back pain. Each patient goes through 10 therapeutic cycles over 10 days. The
average age of the respondents is 50.11 years (s = 12.9 years). Out of 210 subjects, 128 were
women (61 %) and 82 (39 %) were men. At the beginning of the study, patients completed both
the Roland-Morris Disability Questionnaire and the Oswestry Low Back Pain Disability
Questionnaire, while at the end of the study, the Roland-Morris Disability Questionnaire was
completed.
Results: After the therapy in all groups, there was a significant improvement in all treated
patients. In all groups there is a statistically significant difference of 0.05 and p << 0.001 in the
post-hoc Scheffe test for the total Roland-Morris questionnaire. Research results show that
combined therapy is the most effective in subjects with lumbar pain syndrome. Namely, there
is no statistically significant difference between the subjects of group 3 (electroanalgesia) and
group 4 (magnetotherapy) p = 0.987. There is also no statistically significant difference in
subjects who used individual laser and ultrasound therapy p = 0.999. The tests we used to
measure the range of motion of the lumbar spine, the index of sagittal mobility, the Lasegue
test and the Thomayer measure show improvements in all groups.
Conclusion: After the research, all study participants have a higher level of training. The best
method of physical therapy was shown in group 6, which includes a combination of all
physiotherapy procedures with kinesitherapy of the lumbosacral spine
Transcatheter Cardiac Procedures in Children in Clinical Hospital Centre Rijeka: Retrospective Study
No full textCilj: Kateterizacije srca postale su standard u dijagnostici i liječenju djece s prirođenom srčanom greškom i adekvatno zamjenjuju operativne zahvate na otvorenom srcu. Cilj ovog rada je analizirati kateterizacije srca učinjene u pedijatrijskoj populaciji u Kliničkom bolničkom centru Rijeka. Ispitanici i metode: Ova retrospektivna studija obuhvatila je svu djecu od 0 do 18 godina, koja su zbog bilo kojeg razloga imala indikaciju za kateterizaciju srca u periodu od
1. siječnja 2016. do 31. prosinca 2021. Podatci su dobiveni iz informatičkog bolničkog sustava (IBIS) i povijesti bolesti ispitanika. Analizirani su spol i dob ispitanika, broj i vrsta kateterizacije, vrste intervencija te komplikacije nakon zahvata. Rezultati: U promatranom šestogodišnjem periodu učinjene su 183 kateterizacije srca kod 175-ero djece – 78 (42,6 %) je bilo dijagnostičkih, a 105 (57,4 %) intervencijskih. Od ukupnog broja kateterizacija 78 (43 %) ih je učinjeno kod djevojčica. U dobnoj skupini djece mlađe od 10 godina učinjeno je 108 kateterizacija (59 %), od toga najviše u dojenčadi (N = 25 ili 13,7 %). Transkatetersko zatvaranje defekta atrijskog septuma bio je najčešći intervencijski zahvat (N = 85, 47,2 %). Komplikacije su bile rijetke (N = 10, 5,5 %), a smrtnih slučajeva nije bilo. Zaključak: Zadnjih godina smanjuje se broj dijagnostičkih kateterizacija s istovremenim povećavanjem broja intervencijskih. Kateterizacije srca u djece u Kliničkom bolničkom centru Rijeka zahvati su s izrazito malim postotkom komplikacija i rezultatima koji se podudaraju s onima iz drugih europskih centara.Aim: Cardiac catheterizations have become the standard in the diagnosis and treatment of children with congenital heart defects and are adequately replacing open heart surgery. This paper aims to analyse cardiac catheterizations performed in the paediatric population at the Rijeka Clinical Hospital Centre. Subjects and methods: This retrospective study included all children aged 0-18 years, who for any reason had an indication for cardiac catheterization in the period from January 1, 2016 to December 31, 2021. The data were obtained from the hospital information system (IBIS) and the subjects’ medical history. The gender and age of the subjects, number and type of catheterization, types of interventions and complications per procedure were analysed. Results: In the last six years, 183 cardiac catheterizations were performed in 175 children; 78 (42.6%) were diagnostic, and 105 (57.4%) were interventional. Of the total catheterizations, 78 (43%) were performed on girls. In the age group of children younger than 10 years, 108 catheterizations (59%) were performed, of which the majority were in infants (N=25 or 13.7%). The most common intervention was transcatheter closure of the atrial septal defect (N=85, 47.2%). Complications were rare (N=10, 5.5%), with no deaths. Conclusion: In recent years, the number of diagnostic catheterizations has decreased while the number of interventional catheterizations has increased simultaneously. Cardiac catheterizations in children at Clinical Hospital Centre Rijeka are procedures with an extremely low percentage of complications and results that match those of other European centres
The Hidden Legacy of Dimethoate: Clay Binding Effects on Decreasing Long-Term Retention and Reducing Environmental Stability in Croatian Soils
No full textUnderstanding the dynamics of sorption and desorption is essential for assessing the persistence and mobility of pesticides. These processes continue to influence ecological outcomes even after pesticide use has ended, as demonstrated by our study on dimethoate behavior in distinct soil samples from Croatia, including coastal, lowland, and mountainous regions. This study focuses on the sorption/desorption behavior of dimethoate in soil, explores the relationship between its molecular structure and the properties of soil organic and inorganic matter, and evaluates the mechanisms of the sorption/desorption process. The behavior of dimethoate was analyzed using a batch method, and the results were modeled using nonlinear equilibrium models: Freundlich, Langmuir, and Temkin models. Soils with a higher organic matter content, especially total organic carbon (TOC), showed a better sorption capacity compared to soils with a lower TOC. This is probably due to the less flexible structures in the glassy phase, which, unlike the rubbery phase in high TOC soils, do not allow dynamic and flexible binding of dimethoate within the organic matter. The differences between the H/C and O/C ratios indicate that in high TOC soils, flexible aliphatic compounds, typical of a rubbery phase, retain dimethoate more effectively, whereas a higher content of oxygen-containing functional groups in low TOC soils provides strong association. The lettered soils showed stronger retention of dimethoate through interactions with clay minerals and metal cations such as Mg2+, suggesting that clay plays a significantly more important role in enhancing dimethoate sorption than organic matter. These results highlight the importance of organic matter, clay, and metal ions in the retention of dimethoate in soil, indicating the need for remediation methods for those pesticides that, although banned, have had a long history of use
Guidelines for ketogenic dietary treatment in infants and children with refractory epilepsy
No full textTerapijska primjena ketogene dijete postala je moćnim terapijskim pristupom u liječenju tvrdokornih epilepsija, osobito u dojenčadi i djece. Povezivanje praksi utemeljenih na dokazima i kliničke stručnosti dovelo je do razvoja internacionalnih sveobuhvatnih smjernica s ciljem standardizacije primjene i optimizacije učinkovitosti ketogene dijete na temelju kojih su pripremljene nacionalne smjernice. Ove smjernice pružaju strukturirani protokol za zdravstvene djelatnike koji primjenjuju ketogene dijete u svojoj kliničkoj praksi. Pored toga, naglašavaju važnost individualiziranih planova liječenja, pažljive procjene oboljelih i stalnog praćenja kako bi se osigurala sigurnost i učinkovitost. Središnji aspekt istaknut u ovim smjernicama jest temeljita procjena prikladnosti terapijske primjene ketogene dijete za oboljelog, uzimajući u obzir čimbenike poput dobi, epileptičkog sindroma, učestalosti napadaja, komorbiditeta i osobne preferencije oboljelog/obitelji. Uvođenje i održavanje primjene ketogene dijete zahtijeva blisku suradnju multidisciplinarnog tima, uključujući neuropedijatre, nutricioniste, roditelje/ skrbnike i druge zdravstvene djelatnike kako bi se lakše upravljalo mogućim izazovima i optimizirali ishodi dijetoterapije. Ključne komponente smjernica obuhvaćaju protokole za preevaluaciju, uvođenje i praćenje. Fokus je na postizanju i održavanju odgovarajuće nutritivne ketoze uz osiguravanje adekvatnosti prehrane i umanjivanje nuspojava. Redovito praćenje biokemijskih parametara, parametara rasta i kontrole epileptičkih napadaja imperativ je za podešavanje ketogene dijete i učinkovito ublažavanje mogućih neželjenih pojava. Nadalje, smjernice zagovaraju kontinuirano obrazovanje i podršku oboljelima i roditeljima/skrbnicima kako bi se poboljšalo pridržavanje dijetoterapije i promicao dugoročni uspjeh. Ove smjernice služe kao važan izvor za zdravstvene djelatnike, nudeći preporuke utemeljene na dokazima i praktične uvide za upravljanje izazovima terapijske primjene ketegene dijete, u konačnici nastojeći poboljšati njen učinak i kvalitetu života oboljelih od tvrdokornih epilepsija.The use of ketogenic dietary therapy has become a potent therapeutic approach for managing drugresistant epilepsy, particularly in infants and children. The binding of evidence-based practices and clinical expertise has culminated in the development of international comprehensive guidelines, aiming to standardize the implementation and optimize the efficacy of ketogenic dietary treatment, based on which the national guidelines were created. These guidelines provide a structured protocol for healthcare professionals involved in the administration of ketogenic dietary treatment. In addition, they emphasize the importance of individualized treatment plans, careful patient assessment, and ongoing monitoring to ensure safety and efficacy. Central aspect highlighted in these guidelines is the thorough evaluation of patient eligibility, considering factors such as age, epilepsy syndrome, seizure frequency, comorbidities, and patient/family preferences. The initiation and maintenance
of ketogenic dietary treatment require close collaboration among multidisciplinary team, including child neurologists, dietitians, parents/caregivers, and other healthcare professionals to navigate potential challenges and optimize outcomes of ketogenic dietary treatment. Key components of the guidelines encompass protocols for preevaluation, initiation, and monitoring. The focus is on achieving and maintaining appropriate ketosis while ensuring nutritional adequacy and minimizing adverse effects. Regular monitoring of biochemical parameters, growth parameters, and seizure control is imperative for fine-tuning the ketogenic diet and mitigating adverse events effectively. Furthermore, the guidelines advocate for continuous education and support for patients and caregivers to enhance adherence and promote long-term success. In essence, these guidelines serve as an important resource for healthcare professionals, offering evidence-based recommendations and practical insights for managing the challenges of ketogenic dietary therapy, ultimately striving to optimize outcomes and improve the quality of life for individuals with drug-resistant epilepsy
The diagnostic yield of non-invasive testing features in cardiac amyloidosis
No full textBackground: Cardiac amyloidosis (CA) is a progressive disease in which amyloid fibrils infiltrate the heart muscle. This study aimed to identify features from cardiac biomarkers, electrocardiography (ECG), and echocardiography that may distinguish between transthyretin amyloidosis (ATTR) scintigraphy-positive and negative patients. Material and methods: Seventy-eight consecutive patients, median age 69 years (range 34–81), with suspected CA, negative serum free light chains, and negative serum and urine protein electrophoresis with immunofixation, referred to cardiac scintigraphy between 2021 and 2024, were retrospectively enrolled. Cardiac uptake was assessed by Perugini grades. Troponin T, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and various ECG and echocardiographic features were compared between ATTR scintigraphy-positive and negative participants using the t-test, Mann–Whitney U-test, and χ2-test as appropriate. Multivariable stepwise logistic regression created the prediction model for ATTR-positive scintigraphy. The significance level was 0.05. Results: Scintigraphy was ATTR-positive in 24 participants (30.77%). The variables significantly connected with ATTR-positive testing were atrial fibrillation (p = 0.010), first- or second-degree atrioventricular block (p = 0.041), left ventricle (LV) end-diastolic dimension (p = 0.018), LV global longitudinal strain (GLS) (p = 0.040), a restrictive transmitral inflow pattern (p = 0.025), LV posterior wall thickness (p < 0.001), interventricular septum (IVS) thickness (p < 0.001), QRS voltages (p < 0.001), the pseudo-infarct pattern (p < 0.001), and relative apical sparing of the GLS ratio (p < 0.001). The latter four were incorporated into the prediction model for ATTR-positive scintigraphy. Conclusions: ECG and echocardiography remain the essential diagnostic procedures that raise the suspicion of CA and trigger further diagnostics. Low QRS voltages, the pseudo-infarct pattern, IVS thickness, and relative apical sparing of the GLS ratio are sensitive predictors of ATTR-positive scintigraphy findings
Women as Forensic Patients – Comparison of Patients with Schizophrenia and Related Disorders and Those with Other Mental Disorders
No full textŽene su mnogo rjeđe forenzički pacijenti u odnosu na muškarce. Najčešće su hospitalizirane pod dijagnozom
iz spektra psihotičnih poremećaja. Ipak, istraživanja pokazuju kako se forenzičke pacijentice mogu podijeliti u
određene podskupine s različitim karakteristikama, ovisno o dijagnozi. Stoga je glavni cilj ovoga rada bio prikazati
razlike između podskupina forenzičkih pacijentica. Uzorak se sastojao od 31 pacijentice Zavoda za forenzičku
psihijatriju “Dr. Vlado Jukić”. Pacijentice su na Zavodu bile hospitalizirane u razdoblju od 2009. do 2023. godine.
Podijelili smo ih u dvije podskupine: podskupina pacijentica s dijagnozom shizofrenije ili srodnim poremećajem te
podskupina pacijentica kojima su dijagnosticirani drugi psihički poremećaji. Pojedine karakteristike dviju podskupina
uspoređivale su se pomoću hi-kvadrat-testa i t-testa. Istraživanje je pokazalo kako se navedene dvije podskupine
pacijentica razlikuju. Prva glavna razlika je u razini postignutog obrazovanja. Pacijentice bez dijagnoze shizofrenije
ili srodnog poremećaja bile su slabije obrazovane. Druga razlika je u većoj prisutnosti komorbiditeta u pacijentica
bez dijagnoze shizofrenije ili srodnog poremećaja. Ove razlike treba uzeti u obzir za unaprjeđenje ishoda liječenja
kao i u svrhu prevencije pogoršanja bolesti, a posljedično i prevencije počinjenja samog djela.Women are much less likely to be forensic patients than men. They are most commonly hospitalized for a diagnosis within
the psychotic disorder spectrum. However, studies show that female forensic patients can be divided into specific subgroups
with different characteristics, depending on their diagnoses. The main aim of this study was, therefore, to reveal the differences
between the subgroups of female forensic patients. Our sample consisted of 31 female forensic inpatients of the Department
of Forensic Psychiatry “Dr. Vlado Jukić”, who were hospitalized in the period from 2009 to 2023. We divided them into two
subgroups: a subgroup of patients diagnosed with schizophrenia or related disorders, and a subgroup of patients diagnosed
with other mental disorders. The individual characteristics of the two subgroups were compared using a chi-square test and
a t-test. The study showed that differences exist between these two subgroups of patients. The first main difference is in the
level of education. Patients who were not diagnosed with schizophrenia or related disorder were less educated. The other
difference involved a more frequent occurrence of comorbidity in the patients who were not diagnosed with schizophrenia
or related disorder. These differences should be taken into account in order to achieve the best possible treatment outcome
and also to prevent the aggravation of the illness, consequently preventing the commission of the offence itself
Periarthritis Humeroscapularis – A Rare Radiological Case Report
No full textCilj: U ovome radu prikazujemo vrlo rijedak rendgenski i ultrazvučni nalaz u akutnoj egzacerbaciji periartritisa ramena. Prikaz slučaja: Temeljna lezija lokalizirana je tipično u tetivi m. supraspinatusa i inflamiranoj subakromijalnoj burzi u kojoj je radiološki dokazan izljev bogat otopljenim kalcijevim solima (engl. milk of calcium). Ovakav se rendgenski i ultrazvučni nalaz u kliničkom radu, a tako i u literaturi, rijetko zabilježi jer je vezan za tranzitornu, mehaničku fazu u evoluciji periartritisa tijekom koje solidni periartikularni vapneni depoziti prelaze u tekuću suspenziju. Zaključak: Radiološka dijagnostika, u prvom redu rendgenski i ultrazvučni pregled optimalne su metode za dijagnostiku, diferencijaciju i praćenje periartritisa.Aim: This paper presents a very rare X-ray and ultrasound finding in acute exacerbation of shoulder periarthritis. Case Report: The underlying lesion is typically localized in the tendon of the supraspinatus muscle and the inflamed subacromial bursa with calcium rich effusion – milk of calcium. Such X-ray and ultrasound findings are rarely recorded in clinical practice and in the literature, as they are associated with the transient, mechanical phase in the evolution of periarthritis during which solid periarticular calcium deposits transitions into a liquid phase. Conclusion: Radiological diagnostics, primarily X-ray and ultrasound examinations, are optimal methods for diagnosing, differentiating, and clinical monitoring of the shoulder periarthritis