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Excessive body weight and quality of life
No full textKada je riječ o dugoročnim zdravstvenim stanjima, pretilost se smatra kompliciranom i uobičajenom bolešću koja brzo utječe na ukupnu kvalitetu života značajno pridonoseći porastu stope morbiditeta i mortaliteta, kao i skraćenju očekivanog životnog vijeka. Pretilost nije samo estetski problem, već ozbiljno zdravstveno stanje koje ima snažan utjecaj na brojne aspekte života. Ovo kompleksno područje istraživanja zahtijeva sveobuhvatan pristup kako bi se identificirali najučinkovitiji načini prevencije, dijagnostike i terapije pretilosti koja već predstavlja globalni problem te uzimajući u obzir individualne karakteristike. Svrha ovog znanstvenog rada je poboljšanje razumijevanja kompleksne veze između tjelesne mase i doživljaja kvalitete života, dok se kao glavni cilj utvrđuje koliko i na koji način prekomjerna tjelesna težina utječe na funkcioniranje i kvalitetu života pretilih osoba. Metodologija istraživanja uključivala je kvalitativnu metodu intervjua. Pet osoba prekomjerne tjelesne mase, dobi od 53 do 75 godina je sudjelovalo u intervjuima. Kao značajna karakteristika, svi sudionici istraživanja suočavaju se s prekomjernom tjelesnom težinom, čime se stavlja poseban fokus na ovaj aspekt zdravlja u starijoj dobi. Temeljem provedenog istraživanja i dobivenih rezultata, zaključci koji proizlaze ukazuju da samopercepcija kvalitete života ne ovisi o dobi i spolu. Nadalje, prekomjerna tjelesna težina zaista predstavlja problem u obavalju kako svakodnevnih tako i društvenih aktivnosti. Zaključno, možemo reći da je stupanj samoprocjene kvalitete života zajedno s zadovoljstvom življenja ocjenjen kao vrlo nizak i ne ukazuje na razlike između spola niti dobi ispitivanih pretilih osoba.When it comes to long-term health conditions, obesity is considered a complex and common disease that rapidly affects overall quality of life, significantly contributing to increased morbidity and mortality rates, as well as shortening life expectancy. Obesity is not just an aesthetic issue but a serious health condition that has a profound impact on numerous aspects of life. This complex field of research requires a comprehensive approach to identify the most effective ways of preventing, diagnosing, and treating obesity, which already represents a global problem, while also taking individual characteristics into account. The purpose of this scientific paper is to improve the understanding of the complex relationship between body weight and the perception of quality of life, with the main goal being to determine how and to what extent excessive body weight affects the functioning and quality of life of obese individuals. The research methodology included a qualitative interview method. Five overweight individuals, aged 53 to 75 years, participated in the interviews. A significant characteristic of the study is that all participants are facing excessive body weight, placing a special focus on this aspect of health in older age. Based on the conducted research and obtained results, the conclusions indicate that self-perception of quality of life does not depend on age and gender. Furthermore, excessive body weight indeed presents a problem in performing both daily and social activities. In conclusion, we can say that the level of self-assessment of quality of life, along with life satisfaction, is rated as very low and does not indicate differences between the genders or ages of the examined obese individuals
Retrospective analysis of the time frame from patient admission in the Emergency Department to the percutaneous coronary intervention in patients with acute myocardial infarction from January 2012 to October 2023 at the Clinical Hospital Center Rijeka
No full textUvod: Ovaj diplomski rad analizira »door-to-balloon« (DTB) vrijeme u Kliničkom bolničkom centru Rijeka od siječnja 2012. do listopada 2023. godine, s naglaskom na utjecaj faktora na vrijeme od dolaska u Odjel za hitan bolnički prijem (OHBP) do hospitalizacije i kasnije zahvata perkutane koronarne intervencije (PCI) kod pacijenata s akutnim infarktom miokarda (AIM). Ciljevi rada i hipoteze: Cilj istraživanja je istražiti varijacije u DTB vremenu prema demografskim i vremenskim faktorima te identificirati organizacijske prepreke. Pretpostavljamo da će DTB vremena biti duža tijekom noći i vikenda, dok će bolja koordinacija i 24/7 dostupnost PCI tima rezultirati kraćim vremenima. Ispitanici i postupci: Analiza obuhvaća 3983 pacijenta s AIM-om, korištenjem statističkog softvera STATISTICA 14. Primijenjene su metode poput Spearmanovog koeficijenta korelacije i Mann-Whitney U testa za procjenu povezanosti između varijabli. Rezultati: Nakon provedenog ispitivanja nisu utvrđene varijacije u vremenu od upisanog vremena dolaska do pregleda među pacijentima u odnosu na dan u tjednu, vrijeme u danu, spol, dok nije utvrđena niti veza sa starosnom dobi pacijenata. Rasprava: Studija istražuje varijacije u DTB vremenima ovisno o dobi pacijenata i dobu dana kada se javlja infarkt miokarda. Raspravljamo o implikacijama nalaza za poboljšanje hitne medicinske skrbi i potrebu za prilagođenim protokolima prema demografskim i vremenskim faktorima. Zaključci: Prilagođavanje protokola hitne medicinske skrbi moglo bi značajno smanjiti DTB vremena i poboljšati ishode pacijenata s infarktom miokarda. Daljnja istraživanja trebaju istražiti kako optimizirati resurse i poboljšati pristup tim pacijentima u hitnim situacijama.Introduction: This thesis analyses the door-to-balloon (DTB) time at the Clinical Hospital Centre Rijeka from January 2012 to October 2023, focusing on factors influencing the time from arrival at the Emergency Department to hospitalization and subsequent percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Aims and hypotheses: The aim is to investigate variations in DTB time based on demographic and temporal factors and identify organizational barriers. We hypothesize that DTB times will be longer during nights and weekends, whereas better coordination and 24/7 availability of the PCI team will result in shorter times. Participants and methods: The analysis includes 3983 AMI patients using the statistical software STATISTICA 14. Methods such as Spearman's correlation coefficient and Mann-Whitney U test were applied to assess associations between variables. Results: The study found no variations in the time from recorded arrival to examination among patients concerning day of the week, time of day, or gender, nor was there a correlation with patients' age. Discussion: The study explores variations in DTB times depending on patients' age and time of day of myocardial infarction occurrence. We discuss the implications of findings for improving emergency medical care and the need for tailored protocols based on demographic and temporal factors. Conclusions: Adapting emergency medical care protocols could significantly reduce DTB times and improve outcomes for myocardial infarction patients. Further research should explore optimizing resources and enhancing access to these patients in emergencies
SNX27:Retromer:ESCPE-1-mediated early endosomal tubulation impacts cytomegalovirus replication
No full textIntroduction: Cytomegaloviruses (CMVs) extensively reorganize the membrane
system of the cell and establish a new structure as large as the cell nucleus called
the assembly compartment (AC). Our previous studies on murine CMV (MCMV)-
infected fibroblasts indicated that the inner part of the AC contains rearranged
early endosomes, recycling endosomes, endosomal recycling compartments
and trans-Golgi membrane structures that are extensively tubulated, including
the expansion and retention of tubular Rab10 elements. An essential process that
initiates Rab10-associated tubulation is cargo sorting and retrieval mediated by
SNX27, Retromer, and ESCPE-1 (endosomal SNX-BAR sorting complex for
promoting exit 1) complexes.
Objective: The aim of this study was to investigate the role of SNX27:Retromer:
ESCPE-1 complexes in the biogenesis of pre-AC in MCMV-infected cells and
subsequently their role in secondary envelopment and release of infectious virions.
Results: Here we show that SNX27:Retromer:ESCPE1-mediated tubulation is
essential for the establishment of a Rab10-decorated subset of membranes
within the pre-AC, a function that requires an intact F3 subdomain of the SNX27
FERM domain. Suppression of SNX27-mediated functions resulted in an almost
tenfold decrease in the release of infectious virions. However, these effects
cannot be directly linked to the contribution of SNX27:Retromer:ESCPE-1-
dependent tubulation to the secondary envelopment, as suppression of these
components, including the F3-FERM domain, led to a decrease in MCMV protein
expression and inhibited the progression of the replication cycle.
Conclusion: This study demonstrates a novel and important function of membrane
tubulation within the pre-AC associated with the control of viral protein expression
Enhanced Differentiation of Amiodarone-Induced Thyrotoxicosis Types Using Semi-Quantitative 99mTc-MIBI Uptake Analysis: A Pilot Study
No full textBACKGROUND Technetium (99mTc)-labelled Methoxy-2-Isobutylisonitrile (MIBI) is a diagnostic lipophilic cationic radiotracer used to evaluate the cardiac, breast, thyroid, and parathyroid pathology. This study aimed to evaluate the role of MIBI combined with Tc-99m pertechnetate thyroid scintigraphy, thyroid ultrasonography, and measurement of thyrotropin, thyroid hormones, and autoantibodies to subtype amiodarone-induced thyrotoxicosis (AIT) and the contribution of semi-quantitative analysis of MIBI uptake. MATERIAL AND METHODS This cross-sectional study included 36 patients with AIT who underwent thyrotropin, thyroid hormone, and autoantibody analysis using chemiluminescent method, ultrasonography, pertechnetate, and MIBI thyroid scintigraphy with semi-quantitative uptake, including calculation of the target-to-background ratio (TBR) with 2 different background regions. The MIBI washout rate (WR) was analyzed in all groups. Statistical analysis was performed using descriptive statistics, correlations, and the receiver operating characteristic curve - area under the curve (ROC-AUC). The results were compared with the control group. RESULTS Based on visual and semi-quantitative analyses, patients were successfully categorized into AIT groups (AIT-1, AIT-2 and AIT-3) but the latter method enabled better differentiation of MIBI uptake between all groups. Additionally, ROC-AUC analysis determined cutoff values which enabled discerning between AIT-1 and AIT-2 groups, and AIT-1 and AIT-3 groups. WR showed no significant difference between all AIT groups and controls (P>0.05). CONCLUSIONS Visual MIBI analysis enabled differentiation between AIT-1 and 2 groups, but the method was substantially improved with semi-quantitative analysis, especially in defining AIT-3 group. However, multicenter collaboration with larger studies is needed to standardize the method and obtain more accurate and consistent results
Examination of milk samples for the presence of mycotoxins
No full textMlijeko je ključan izvor životinjskih proteina i esencijalnih hranjivih tvari, posebice za djecu. Kontaminacija mlijeka mikotoksinima, toksinima koje proizvode plijesni, može značajno ugroziti njegovu kvalitetu i sigurnost. Mikotoksini, prisutni u hrani, određeni su rizik za ljude i životinje zbog mogućnosti uzrokovanja bolesti poput raka i imunosupresije. Aflatoksin uglavnom proizvode plijesni Aspergillus flavus i Aspergillus parasiticus. Hidroksilirani metaboliti aflatoksina B1 i B2, poznati kao M1 i M2, mogu se pronaći u mlijeku i mliječnim proizvodima stoke koja je konzumirala kontaminiranu hranu. Cilj ovog istraživanja je ispitati prisutnost aflatoksina M1 u uzorcima mlijeka koristeći test AflaSensor nova. Test omogućuje analizu bez složene pripreme uzorka i pruža rezultate u desetak minuta. Rezultati su pokazali da AflaSensor nova učinkovito identificira aflatoksin M1 u uzorcima mlijeka, što omogućuje pravovremeno djelovanje i očuvanje visoke kvalitete mliječnih proizvoda. Dobiveni rezultati pokazuju da ispitana komercijalno dostupna mlijeka te domaća sirova mlijeka sadrže prihvatljivu količinu aflatoksina M1 te su u skladu s propisima Europske unije. Samo jedan ispitani uzorak mlijeka nije prikladan konzumaciji dojenčadi obzirom na propisane dopuštene količine aflatoksina M1 u mlijeku za dojenčad. Ova metoda osigurava pravilan nadzor nad sirovim mlijekom, tijekom prerade te u konačnoj kontroli mliječnih proizvoda, čime se štiti zdravlje potrošača i održava sigurnost na tržištu.Milk is a key source of animal protein and essential nutrients, especially for children. Contamination of milk with mycotoxins, toxins produced by molds, can significantly threaten its quality and safety. Mycotoxins, present in food, are a certain risk for humans and animals due to the possibility of causing diseases such as cancer and immunosuppression. Aflatoxin is mainly produced by the molds Aspergillus flavus and Aspergillus parasiticus. Hydroxylated metabolites of aflatoxin B1 and B2, known as M1 and M2, can be found in milk and milk products from livestock that have consumed contaminated feed. The aim of this research is to examine the presence of aflatoxin M1 in milk samples using the AflaSensor nova test. The test enables analysis without complex sample preparation and provides results in ten minutes. The results showed that AflaSensor nova effectively identifies aflatoxin M1 in milk samples, which enables timely action and preservation of high quality dairy products. The obtained results show that the tested commercially available milk and domestic raw milk contain an acceptable amount of aflatoxin M1 and are in accordance with the regulations of the European Union. Only one tested sample of milk is not suitable for consumption by infants considering the prescribed permitted amounts of aflatoxin M1 in milk for infants. This method ensures proper supervision of raw milk, during processing and in the final control of dairy products, which protects the health of consumers and maintains safety on the market
Microbiological analysis of different types of honeydew honey
No full textZdravstvena ispravnost hrane jedna je od osnovnih pretpostavki ljudskog zdravlja.
U ovom radu ispitana mikroorganizama u nekoliko različitih uzoraka meda od medljike. Ovaj
med poznat i kao šumski med, specifična je vrsta meda koja se ističe svojim složenim
kemijskim sastavom i brojnim zdravstvenim koristima, što ga čini predmetom interesa kao u
terapiji (metoda liječenja i prevencije bolesti korištenjem pčelinjih proizvoda), tako i u
suvremenim istraživanjima na područjima medicine. Med od medljike je prirodni proizvod koji
pčele stvaraju procesom prikupljanja biljnih sokova iz dubljih slojeva vegetacije, a zatim ga obrađuju
unutar košnice. Ovaj složeni proces uključuje enzimske reakcije i dehidraciju, što rezultira stvaranje
visoko nutritivnog i aromatičnog proizvoda koji se koristi u prehrani i tradicionalnoj medicini. S
obzirom da je med u konstantnom doticaju s ljudskom populacijom i lako može prenijeti
određene vrste mikroorganizama, ali može biti i izvor određenih bolesti.
Cilj rada je istražiti mikrobiološku kvalitetu različitih vrsta meda meduna te
utvrditi kontaminaciju različitim mikroorganizmima. Kod svih uzoraka je dokazana prisutnost
aerobnih mezofilnih bakterija. Prisutnost kvasaca i plijesni je utvrđena kod 60% uzoraka
meda. Daljnjom identifikacijom uzoraka meda utvrđeno je nekoliko različitih rodova
mikroorganizama : Bacillus, Staphlylococcus, Enterobacter, Lactobacillus, Pseudomonas.
Također, neki od identificiranih mikroorganizama ukazuju na nepravilno provođenje
pčelarske prakse i pokazuju kako je potrebno sustavno provoditi mikrobiološku analizu meda
kao proizvoda.The healthiness of food is one of the basic assumptions of human health. In this
work, microorganisms were examined in several different samples of honey from honeydew.
This honey, also known as forest honey, is a specific type of honey that stands out for its
complex chemical composition and numerous health benefits, which makes it an object of
interest both in therapy (methods of treatment and prevention of diseases using bee products)
and in modern research in the fields of medicine. . Honey from honeydew is a natural product
that bees create by the process of collecting plant juices from the deeper layers of vegetation,
and then process it inside the hive. This complex process involves enzymatic reactions and
dehydration, resulting in the creation of a highly nutritious and aromatic product used in
nutrition and traditional medicine. Given that honey is in constant contact with the human
population and can easily transmit certain types of microorganisms, it can also be the source
of certain diseases.
The aim of the work is to investigate the microbiological quality of different types
of meduna honey and to determine the contamination by aerobik mesophilic bacteria. The
presence of some type of microorganism was proven in all samples. The presence of yeast and
mold was determined in 60% of the honey samples. Further identification of honey samples
revealed several different genera of microorganisms: Bacillus, Staphlylococcus, Enterobacter,
Lactobacillus, Pseudomonas. Also, some of the identified microorganisms indicate improper
implementation of beekeeping practices and show that it is necessary to systematically carry
out microbiological analysis of media as a product
Treatment-Related Risk Factors for Adverse Outcomes of COVID-19 in Patients Treated for Lymphoid Malignancies in the Pre-Omicron Era—A Study of KroHem, the Croatian Group for Hematologic Diseases
No full textPatients with lymphoid malignancies are at increased risk of death or prolonged infection due to COVID-19. Data on the influence of different antineoplastic treatment modalities on outcomes are conflicting. Anti-CD20 monoclonal antibodies increase the risk of prolonged infection. It is unclear whether this risk is affected by the choice of the antibody (rituximab vs. obinutuzumab). To elucidate the role of antineoplastic therapy on COVID-19 outcomes, KroHem collected data on patients with lymphoid malignancies diagnosed with COVID-19 between October 2020 and April 2021. A total of 314 patients were identified, 75 untreated, 61 off treatment and 178 on treatment. The mortality rate in untreated and off-treatment patients was 15% and 16%; 9% and 10% had prolonged infection. In the on-treatment group, 3% were still prolonged positive at time of data collection, 62% recovered and 35% died; 42% had prolonged infection. Disease type, use of anti-CD20 monoclonal antibodies, prior autologous stem-cell transplantation (ASCT) and line of treatment did not significantly affect mortality. Mortality was higher in older patients (p = 0.0078) and those treated with purine analogues (p = 0.012). Prolonged COVID-19 was significantly more frequent in patients treated with anti-CD20 monoclonal antibodies (p = 0.012), especially obinutuzumab, and purine analogues (p = 0.012). Age, prior ASCT and treatment line did not significantly affect risk of prolonged infection. These data suggest that increased age and use of purine analogues are main risk factors for increased mortality of COVID-19 in patients with lymphoid malignancies. Obinutuzumab further increases the risk of prolonged disease, but not of death, in comparison to rituximab. Epidemiological considerations should be taken into account when choosing the appropriate antineoplastic therapy for patients with lymphoid malignancies
Effectiveness of Oral versus Injectable Semaglutide in Adults with Type 2 Diabetes: Results from a Retrospective Observational Study in Croatia
No full textBackground: The number of people with type 2 diabetes is increasing daily, and therefore, effective therapy is needed to successfully regulate glycemia and reduce the risk of associated complications. Recently, an oral formulation of the glucagon-like peptide-1 receptor agonist (GLP-1 RA) semaglutide has become available. Therefore, the aim of our study was to compare the effectiveness of the new oral formulation and the existing injectable formulation of semaglutide in terms of glycemic and body weight control in a real-world setting. Patients and methods: This was a single-center retrospective observational study conducted at the Rijeka Clinical Hospital Centre. A total of 106 patients with inadequately controlled type 2 diabetes (HbA1c ≥ 7%) on different oral or basal insulin supported oral therapy were enrolled in the study, and data from electronic medical records were retrospectively collected and analyzed from May 2021 to November 2022. All subjects were GLP-1 RA-naive and consequently prescribed 0.5 or 1.0 mg of once weekly injectable semaglutide (IS) or 7 mg or 14 mg of once daily oral semaglutide (OS) for at least 6 months. Glycated hemoglobin (HbA1c), body weight, and body mass index (BMI) were assessed prior to semaglutide administration and after a 6-month follow-up period. The primary endpoint was the change from baseline in HbA1c, and secondary endpoints were the change in body weight and the proportion of participants with a reduction in body weight of ≥5% and ≥10%, respectively, 6 months after the initiation of semaglutide treatment. Results: At the 6-month follow-up, no significant difference was observed between the two formulations in terms of HbA1c reduction (IS −1.1% vs. OS −1.4%, p = 0.126) and weight loss (IS −6.50 kg vs. OS −5.90 kg, p = 0.714). Exactly the same proportion of participants in both groups achieved a weight loss of ≥5% (56.7%, n = 30). A weight loss ≥ 10% was observed in 20.7% (n = 11) of participants administered IS and 15.1% (n = 8) of participants administered OS, respectively (p = 0.454). Conclusion: In a real-world setting, oral semaglutide as an add-on therapy to ongoing antihyperglycemic treatment in patients with inadequately controlled type 2 diabetes who had not previously received GLP-1 RA demonstrated a similar effectiveness as injectable semaglutide in terms of glycemic control and weight loss after 6 months of treatment
The Approach to the Psoriasis Treatment - Part Two: Phototherapy and Photochemotherapy
No full textPsorijaza je kronična, upalna, imunosno posredovana bolest kože i drugih organskih sustava, koja zahvaća 2-3 % cjelokupne svjetske populacije i predstavlja značajan javnozdravstveni problem. Poželjno je da suvremena terapija psorijaze ima dugoročnu učinkovitost i dobar sigurnosni profil, a danas obuhvaća upotrebu lokalne i sustavne terapije, kao i fototerapije i fotokemoterapije. Fototerapija se provodi izlaganjem sunčevoj svjetlosti te ultraljubičastom A i B zračenju, dok konvencionalna fotokemoterapija podrazumijeva zajedničku upotrebu ultraljubičastog zračenja i fotosenzibilizirajućeg lijeka. Oba su se oblika terapije pokazala iznimno učinkovitima, posebice pri njihovoj kombiniranoj primjeni s određenim lokalnim ili sustavnim lijekovima. U današnje vrijeme je, također, sve više zastupljen holistički pristup liječenju psorijaze poput balneofototerapije, zahvaljujući kojoj su brojne zemlje postale poznata odredišta lječilišnog turizma.Psoriasis is a chronic, inflammatory, immune-mediated disease of the skin and other organ systems, which affects 2-3 % of the entire world population and represents a significant public health problem. It is desirable that modern psoriasis therapy has long-term efficacy and a good safety profile, and today includes the use of local and systemic therapy, as well as phototherapy and photochemotherapy. Phototherapy is carried out by exposure to sunlight and ultraviolet A and B radiation, while conventional photochemotherapy involves using of ultraviolet radiation and a photosensitizing drug. Both forms of therapy have proven to be highly effective, especially when combined with certain local or systemic medications. Nowadays, a holistic approach to treating psoriasis, such as balneophototherapy, is also increasingly common, thanks to which numerous countries have become well-known health resort destinations
Evaluation of Absolute Neutrophil, Lymphocyte and Platelet Count and Their Ratios as Predictors of Thrombotic Risk in Patients with Prefibrotic and Overt Myelofibrosis
No full textAim: To investigate the prognostic contribution of absolute neutrophil (ANC), lymphocyte (ALC), platelet count and their ratios, neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR), to thrombotic risk in patients with prefibrotic and overt fibrotic myelofibrosis (MF). Methods: We retrospectively analyzed a cohort of 256 patients with prefibrotic (85 patients) and overt fibrotic MF (171 patients) treated in six Croatian hematological centers. Results: Prefibrotic compared to overt fibrotic MF patients presented with significantly higher ALC, platelet count and PLR, and experienced longer time to thrombosis (TTT). Among prefibrotic patients, ANC > 8.33 × 109/L (HR 13.08, p = 0.036), ALC > 2.58 × 109/L (HR 20.63, p = 0.049) and platelet count > 752 × 109/L (HR 10.5, p = 0.043) remained independently associated with shorter TTT. Among overt fibrotic patients, ANC > 8.8 × 109/L (HR 4.49, p = 0.004), ALC ≤ 1.43 × 109/L (HR 4.15, p = 0.003), platelet count ≤ 385 × 109/L (HR 4.68, p = 0.004) and chronic kidney disease (HR 9.07, p < 0.001) remained independently associated with shorter TTT. Conclusions: Prognostic properties of ANC, ALC and platelet count are mutually independent and exceed those of NLR and PLR regarding thrombotic risk stratification. ALC and platelet count associate in opposite directions with thrombotic risk in prefibrotic and overt fibrotic MF patients