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New Cardiovascular Biomarkers in Hospitalized Heart Failure Patients
No full textZatajivanje srca je povezano je s velikim financijskim opterećenjem za zdravstveni sustav. Predlaže se uključivanje novijih biljega uz kliničku procjenu za dijagnozu i prognozu akutnog ZS kako bi se smanjile stope hospitalizacije i u konačnici smanjio morbiditet i mortalitet. Interes za uporabu biljega u ZS raste velikom brzinom. Natriuretski peptidi su i dalje primarni biljezi koji pomažu u dijagnozi akutnog dekompenziranog ZS uz srčani troponin. Također, sST2 i Gal-3 su ušli u smjernice ACC/AHA. Istovremeno GDF 15 pokazuje ohrabrujuće rezultate u prognozi bolesnika sa ZS. Navedenim biljezima često nedostaje specifičnosti, primjerice kod multisistemskih poremećaja kao što su akutno oštećenje bubrega i nekontrolirana hipertenzija. Rezultati vrijednosti biljega mogu biti „pogrešni“, ipak u odgovarajućem kliničkom kontekstu njihova primjena se i dalje može razmotriti. Područje biljega u ZS je vrlo dinamično sa velikim brojem istraživanja novih biljega. Potrebne su nove randomizirane kliničke studije za potvrdu upotrebe novih biljega u širokoj lepezi raznih kliničkih slika sindroma ZS.Heart failure is associated with a significant financial burden on the healthcare system. It is proposed to include newer biomarkers along with clinical assessment for the diagnosis and prognosis of acute heart failure (HF) to reduce hospitalization rates and ultimately decrease morbidity and mortality. Interest in the use of biomarkers in HF is rapidly growing. Natriuretic peptides remain the primary biomarkers aiding in the diagnosis of acute decompensated HF alongside cardiac troponin. Additionally, sST2 and Gal-3 have been incorporated into the ACC/AHA guidelines. Concurrently, GDF-15 shows promising results in the prognosis of HF patients. These biomarkers often lack specificity, for instance, in multisystem disorders such as acute kidney injury and uncontrolled hypertension. The biomarker values may be "misleading," but their application can still be considered in the appropriate clinical context. The field of biomarkers in HF is very dynamic, with numerous studies on new biomarkers. New randomized clinical trials are needed to confirm the use of new biomarkers across a wide range of clinical presentations of the HF syndrome
Fentanyl and Sudden Death—A Postmortem Perspective for Diagnosing and Predicting Risk
No full textSudden, unexpected deaths are extremely difficult for families, especially when the victim is a child. Most sudden deaths occur due to cardiovascular issues, and a smaller number (approximately one-quarter) are attributed to other causes, such as epilepsy. The medicinal and non-medicinal use of the synthetic opioid fentanyl, which can cause breathing problems, is frequently involved in these deaths. It is also being found more often in autopsies of sudden death cases, and the number of overdose deaths from illicit drugs containing fentanyl is increasing. There are cases in which it is mixed with other drugs. A gene known as the KCNH2 gene or human ether-a-go-go-related gene (hERG), involved in the heart’s electrical activity, can be related to abnormal heart rhythms. This gene, along with others, may play a role in sudden deaths related to fentanyl use. In response, we have examined the scientific literature on genetic variations in the KCNH2 gene that can cause sudden death, the impact of fentanyl on this process, and the potential benefits of genetic testing for the victims to offer genetic counseling for their family members
Spectrophotometric methods of analysis of environmental samples
No full textSpektrofotometrija, grana spektroskopije, bavi se mjerenjem optičkih svojstava tvari kao funkcije valne duljine i proučavanjem interakcije tvari s elektromagnetskim zračenjem. Različite vrste spektrofotometrije uključuju UV–VIS, IR, fluorescencijsku te atomsku apsorpcijsku i atomsku emisijsku spektrofotometriju, a svaka je vrsta prikladna za specifične primjene. Zbog svoje sposobnosti za preciznu identifikaciju i kvantificiranje spojeva, spektrofotometri se naširoko koriste u okolišnim analizama te u brojnim područjima znanosti i ljudskog djelovanja. Uz pregled spektrofotometrijskih načela i metoda, istraživanje je usmjereno na dva eksperimentalna cilja: procjenu mikrobiološke razgradnje azo bojila Ponceau S te procjenu kakvoće i autentičnosti maslinovog ulja. Za analizu dekolorizacije Ponceau S uzorci su pripremljeni u tri različita medija sa suspenzijom P. aeruginosa i otopinom boje koncentracije 100 mg/L te je u različitim vremenima pomoću VIS spektrofotometra izmjerena apsorbancija u uzorcima. Došlo je do mikrobiološke razgradnje azo boje, a spektrofotometrijska mjerenja utvrdila su stupanj obezbojenja. Za analizu maslinovog ulja, koristeći se propisanom metodom i UV–VIS spektrofotometrom mjerena je apsorbancija šest homogeniziranih uzoraka maslinovog ulja u izooktanu pri određenim valnim duljinama kako bi se otkrili oksidacijski produkti koji ukazuju na kakvoću ulja. Rezultati isključuju vjerojatnost patvorenja ulja te ukazuju na neodgovarajuće uvjete skladištenja. Opisane metode i rezultati dobiveni ovim istraživanjem pokazuju učinkovitost i svestranost spektrofotometrije u analizi složenih uzoraka.Spectrophotometry, a branch of spectroscopy, focuses on measuring optical properties of matter as a function of wavelength and on the interaction of matter with electromagnetic radiation. Different types of spectrophotometry include UV–VIS, IR, fluorescence, atomic absorption and atomic emission spectrophotometry, each suitable for specific applications. Because of their ability to precisely identify and quantify compounds, spectrophotometers are widely used in environmental analysis and in numerous fields of science and human activity. In addition to an overview of spectrophotometric principles and methods, this research focuses on two experimental goals: evaluation of microbiological degradation of azo dye Ponceau S and evaluation of quality and authenticity of olive oil. For the Ponceau S decolorization analysis, samples were prepared in three different media with Pseudomonas aeruginosa suspension and a 100 mg/L dye solution, and absorbance in samples was measured at different times using a VIS spectrophotometer. Microbiological degradation of azo dye occurred, and spectrophotometric measurements determined the degree of discoloration. For the analysis of olive oil, absorbance of six homogenized samples of olive oil in isooctane was measured at certain wavelengths using the prescribed method and a UV-VIS spectrophotometer, in order to detect oxidation products that indicate the quality of oil. Results exclude the possibility of adulteration of oil and indicate inadequate storage conditions. Methods described and results obtained from this research show the effectiveness and versatility of spectrophotometry in the analysis of complex samples
Slike i tablice koje pobliže objašnjavaju ketonska tijela u energetskom metabolizmu, staničnoj signalizaciji i terapijskoj primjeni
No full textBeyond Blood Sugar: Low Awareness of Kidney Disease among Type 2 Diabetes Mellitus Patients in Dalmatia—Insights from the First Open Public Call
No full textBackground and Objectives: Kidney disease (KD) is a common complication of diabetes mellitus (DM) associated with adverse outcomes of renal failure, cardiovascular disease, and mortality. The aim of this study was to determine the prevalence and awareness of the KD among the DM type 2 (T2DM) patients. Materials and Methods: This cross-sectional study was conducted at the University Hospital of Split between November and December of 2023 during an open call for DM patients. For each participant, blood and urine samples, along with relevant medical information, were collected, and adherence to the Mediterranean diet (MeDi) was assessed using the Mediterranean Diet Service Score (MDSS). Furthermore, blood pressure was measured, along with body composition and anthropometric parameters. Results: Of 252 T2DM patients with a median age of 67 years (IQR: 60–73), 130 (51.6%) were women. The median duration of T2DM was 10 years (IQR: 6–20). Despite the fact that 80.95% of total participants reported receiving dietary guidelines from any source, only 53.2% reported adhering to the suggested instructions, while according to the MDSS, only 7.2% adhered to the MeDi. The median body mass index was 27.6 kg/m2 (24.2–31), with 70.1% of participants overweight or obese. Only 6% of participants believed they had KD, but after blood and urine sample analysis, 31% were found to have KD. Conclusions: This study highlights a significant gap in awareness of KD, low adherence to MeDi, and a high prevalence of obesity among T2DM patients. Due to the increasing number of T2DM patients, it is crucial to improve healthy lifestyle education and make modifications within this group, as well as perform regular screening for KD and medical check-ups
The effect of natural antioxidants on long-term stability of sweet red pepper seed oil
No full textOils obtained from fruit and vegetable by-products represent a new category of niche oils. Cold-pressed oil from the seeds of sweet peppers of the Podravka and Slavonka varieties is a new, high-quality oil from the vegetable niche oil category, naturally rich in polyunsaturated linoleic fatty acid, γ-tocopherol, and sterols as antioxidants that exhibit positive effects on human health in preventing chronic non-communicable diseases. However, for a broader commercial reach of this oil, preserving its quality over a longer period is of utmost importance. Based on monitoring four parametres (peroxide value, free fatty acids, antioxidative power, and radical potential), pure pepper seed oil did not have adequate quality by the end of the period of 9 month stored at room temperature due to oxidative changes. The addition of natural antioxidants such as green tea extract (0.2%), especially rosemary extract (0.2%) and a blend of rosemary extract (0.2%), and citric acid (0.01%) extended the stability of pure pepper seed oil to a period of one year. Since oxidation affects the organoleptic quality and nutritional composition of the oil, these results are encouraging for niche oil producers, not only because of the expansion of this category of edible oils made from secondary source raw materials (by-products), but also because of the evidence that their special quality will not be compromised within the declared shelf life due to oxidative spoilage
Validation of Diagnostic Accuracy and Disease Severity Correlation of Chest Computed Tomography Severity Scores in Patients with COVID-19 Pneumonia
No full textThe aim of our study was to establish and compare the diagnostic accuracy and clinical applicability of published chest CT severity scoring systems used for COVID-19 pneumonia assessment and to propose the most efficient CT scoring system with the highest diagnostic performance and the most accurate prediction of disease severity. This retrospective study included 218 patients with PCR-confirmed SARS-CoV-2 infection and chest CT. Two radiologists blindly evaluated CT scans and calculated nine different CT severity scores (CT SSs). The diagnostic validity of CT SSs was tested by ROC analysis. Interobserver agreement was excellent (intraclass correlation coefficient: 0.982–0.995). The predominance of either consolidations or a combination of consolidations and ground-glass opacities (GGOs) was a predictor of more severe disease (both p < 0.005), while GGO prevalence alone was not. Correlation between all CT SSs was high, ranging from 0.848 to 0.971. CT SS 30 had the highest diagnostic accuracy (AUC = 0.805) in discriminating mild from severe COVID-19 disease compared to all the other proposed scoring systems (AUC range 0.755–0.788). In conclusion, CT SS 30 achieved the highest diagnostic accuracy in predicting the severity of COVID-19 disease while maintaining simplicity, reproducibility, and applicability in complex clinical settings
The European Trauma Course: Transforming systems through training
No full textThe European Trauma Course (ETC) exemplifies an innovative approach to multispecialty trauma education. This initiative was started as a collaborative effort among the European Society for Emergency Medicine, the European Society for Trauma and Emergency Surgery, and the European Society of Anaesthesiology under the auspices of the European Resuscitation Council. With the robust support of these societies, the project has evolved into the independent European Trauma Course Organisation. Over the past 15 years, the ETC has transcended traditional training by integrating team dynamics and non-technical skills into a scenario-based simulation course, helping to shape trauma care practice and education. A distinctive feature of the ETC is its training of doctors and allied healthcare professionals, fostering a collaborative and holistic approach to trauma care. The ETC stands out for its unique team-teaching approach, which has gained widespread recognition as the standard for in-hospital trauma care training not only in Europe but also beyond. Since its inception ETC has expanded geographically from Finland to Sudan and from Brazil to the Emirates, training nearly 20,000 healthcare professionals and shaping trauma care practice and education across 25 countries. Experiencing exponential growth, the ETC continues to evolve, reflecting its unmet demand in trauma team education. This review examines the evolution of the ETC, its innovative team-teaching methodology, national implementation strategies, current status, and future challenges. It highlights its impact on trauma care, team training, and the effect on other life support courses in various countrie
The Effect of Low-Intensity Pulsed Ultrasound on Bone Regeneration and the Expression of Osterix and Cyclooxygenase-2 during Critical-Size Bone Defect Repair
No full textLow-intensity pulsed ultrasound (LIPUS) is a form of ultrasound that utilizes low-intensity pulsed waves. Its effect on bones that heal by intramembranous ossification has not been sufficiently investigated. In this study, we examined LIPUS and the autologous bone, to determine their effect on the healing of the critical-size bone defect (CSBD) of the rat calvaria. The bone samples underwent histological, histomorphometric and immunohistochemical analyses. Both LIPUS and autologous bone promoted osteogenesis, leading to almost complete closure of the bone defect. On day 30, the bone volume was the highest in the autologous bone group (20.35%), followed by the LIPUS group (19.12%), and the lowest value was in the control group (5.11%). The autologous bone group exhibited the highest intensities of COX-2 (167.7 ± 1.1) and Osx (177.1 ± 0.9) expression on day 30. In the LIPUS group, the highest intensity of COX-2 expression was found on day 7 (169.7 ±1.6) and day 15 (92.7 ± 2.2), while the highest Osx expression was on day 7 (131.9 ± 0.9). In conclusion, this study suggests that LIPUS could represent a viable alternative to autologous bone grafts in repairing bone defects that are ossified by intramembranous ossification
Science Sundays
No full textProjekt Science Sunday podrazumijeva izradu kratkih sažetaka zanimljivih znanstvenih članaka i projekata na zabavan način te njihovu objavu na profilima Studentske sekcije znanstveno-stručnog časopisa Medicina Fluminensis na društvenim mrežama. Autori ovog formata su studentski predstavnici sekcije, koji na ovaj način educiraju te potiču interes pratitelja o brojnim novostima iz različitih područja znanosti, približavajući na taj način visokospecifične informacije široj javnosti na jednostavan i pristupačan način, koje bi inače ostale “zatvorene” uskom krugu istraživača. Nadalje, osim promocije znanosti, ovim projektom studentski predstavnici naglašavaju i važnu ulogu koju studenti imaju kao medicinski edukatori, potičući osvještavanje odgovornosti poticanja zdravstvene i znanstvene pismenosti koju svaki zdravstveni djelatnik ima prema studentima, drugim zdravstvenim djelatnicima i široj javnosti. Također, inovativni koncept Science Sunday može poslužiti kao primjer drugim sekcijama koje žele promicati svoja područja u različitim ciljnim skupinama. U ovom popularno-znanstvenom izdanju objedinjeno je 55 Science Sunday-a, koji su objavljeni između 2021. i 2024. godine