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Sekundarno omatanje i izlazak beta-herpesvirusa iz stanice: plan upravljanja istraživačkim podacima
No full textDigital technology and artificial intelligence for improving congenital heart disease care: alea iacta est
No full textReal-Time PCR Method as Diagnostic Tool for Detection of Periodontal Pathogens in Patients with Periodontitis
No full textThe most common type of periodontal disease is chronic periodontitis, an inflammatory condition caused by pathogenic bacteria in subgingival plaque. The aim of our study was the development of a real-time PCR test as a diagnostic tool for the detection and differentiation of five periodontopathogenic bacteria, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, and Treponema denticola, in patients with periodontitis. We compared the results of our in-house method with the micro-IDent® semiquantitative commercially available test based on the PCR hybridization method. DNA was isolated from subgingival plaque samples taken from 50 patients and then analyzed by both methods. Comparing the results of the two methods, they show a specificity of 100% for all bacteria. The sensitivity for A. actinomycetemcomitans was 97.5%, for P. gingivalis 96.88%, and for P. intermedia 95.24%. The sensitivity for Tannerella forsythia and T. denticola was 100%. The Spearman correlation factor of two different measurements was 0.976 for A. actinomycetemcomitans, 0.967 for P. gingivalis, 0.949 for P. intermedia, 0.966 for Tannerella forsythia, and 0.917 for T. denticola. In conclusion, the in-house real-time PCR method developed in our laboratory can provide information about relative amount of five bacterial species present in subgingival plaque in patients with periodontitis. It is likely that such a test could be used in dental diagnostics in assessing the efficacy of any treatment to reduce the bacterial burden
SURGICAL TECHNIQUES FOR BREAST RECONSTRUCTION AFTER CANCER REMOVAL
No full textBreast reconstruction after mastectomy is a significant aspect of reconstructive surgery, which has developed rapidly in recent decades. The goal goes beyond mere aesthetics, significantly improving the patient's quality of life. Initially, breast cancer therapy was based on demolitive techniques that altered the morphology and physiology of the anterior thoracic wall and axillary region. However, current techniques aim to minimize defacement while considering the patient's desire for good aesthetic outcomes. Breast surgery must be highly personalized, considering the stage of the neoplasia, the patient's preferences, and the oncological principles. The surgeon can choose from various techniques to achieve the best aesthetic and psychological outcomes for the patient. Breast cancer is considered a chronic disease, and reconstruction can be allowed during remission periods, even in cases of systematic diffusion. Various techniques can be used, including those that use existing tissues with simple volume integration, reconstruction through flaps and cutaneous-subcutaneous tissues, and the usage of distant flaps involving myocutaneous tissues. The choice of technique depends on the local situation left by the mastectomy, not the type of mastectomy performed. The agreement between the patient, the oncologic surgeon, and the plastic surgeon is crucial for successful breast reconstruction. The patient should be informed about what can and cannot be achieved with current techniques. Many women will settle for partial results, while others will never be fully satisfied.Breast reconstruction after mastectomy is a significant aspect of reconstructive surgery, which has developed rapidly in recent decades. The goal goes beyond mere aesthetics, significantly improving the patient's quality of life. Initially, breast cancer therapy was based on demolitive techniques that altered the morphology and physiology of the anterior thoracic wall and axillary region. However, current techniques aim to minimize defacement while considering the patient's desire for good aesthetic outcomes. Breast surgery must be highly personalized, considering the stage of the neoplasia, the patient's preferences, and the oncological principles. The surgeon can choose from various techniques to achieve the best aesthetic and psychological outcomes for the patient. Breast cancer is considered a chronic disease, and reconstruction can be allowed during remission periods, even in cases of systematic diffusion. Various techniques can be used, including those that use existing tissues with simple volume integration, reconstruction through flaps and cutaneous-subcutaneous tissues, and the usage of distant flaps involving myocutaneous tissues. The choice of technique depends on the local situation left by the mastectomy, not the type of mastectomy performed. The agreement between the patient, the oncologic surgeon, and the plastic surgeon is crucial for successful breast reconstruction. The patient should be informed about what can and cannot be achieved with current techniques. Many women will settle for partial results, while others will never be fully satisfied
The Crucial Triad: Endothelial Glycocalyx, Oxidative Stress, and Inflammation in Cardiac Surgery—Exploring the Molecular Connections
No full textSince its introduction, the number of heart surgeries has risen continuously. It is a high-risk procedure, usually involving cardiopulmonary bypass, which is associated with an inflammatory reaction that can lead to perioperative and postoperative organ dysfunction. The extent of complications following cardiac surgery has been the focus of interest for several years because of their impact on patient outcomes. Recently, numerous scientific efforts have been made to uncover the complex mechanisms of interaction between inflammation, oxidative stress, and endothelial dysfunction that occur after cardiac surgery. Numerous factors, such as surgical and anesthetic techniques, hypervolemia and hypovolemia, hypothermia, and various drugs used during cardiac surgery trigger the development of systemic inflammatory response and the release of oxidative species. They affect the endothelium, especially endothelial glycocalyx (EG), a thin surface endothelial layer responsible for vascular hemostasis, its permeability and the interaction between leukocytes and endothelium. This review highlights the current knowledge of the molecular mechanisms involved in endothelial dysfunction, particularly in the degradation of EG. In addition, the major inflammatory events and oxidative stress responses that occur in cardiac surgery, their interaction with EG, and the clinical implications of these events have been summarized and discussed in detail. A better understanding of the complex molecular mechanisms underlying cardiac surgery, leading to endothelial dysfunction, is needed to improve patient management during and after surgery and to develop effective strategies to prevent adverse outcomes that complicate recovery
External Ophtalmomyasis Caused by Oestrus Ovis Larvae: The First Case in the Primorje Goranska County, Croatia – a Case Report
No full textCilj: Cilj rada je prikazati prvi slučaj oftalmomijaze uzrokovane larvama Oestrus ovis u Primorsko-goranskoj županiji te osvijestiti zdravstvene djelatnike o infestaciji larvama kao mogućem uzročniku konjunktivitisa. Prikaz slučaja: U hitnu oftalmološku ambulantu upućena je pacijentica zbog osjećaja stranog tijela u oku. Oftalmološkim pregledom lijevo je utvrđena kemoza bulbarne spojnice uz prisutnost triju larvi. Nakon aplikacije lokalnog anestetika larve su uklonjene i poslane na mikrobiološku analizu. Mikroskopskim pregledom uočene su larve koje su prema morfologiji odgovarale larvama ovčjeg štrka stadija L1. Pacijentici su preporučene kortikosteroidne i antibiotske kapi i mast za oko te je na kontrolnom pregledu za tri dana došlo do potpune regresije simptoma. Zaključci: U Hrvatskoj su do sada u literaturi zabilježena samo dva slučaja humane estroze. Rana dijagnoza i liječenje važni su zbog sprječavanja mogućih komplikacija. Za ovo stanje ne postoji sistemska terapija, nego se provodi mehaničko odstranjivanje uzročnika uz lokalni antibiotik za sprječavanje bakterijske infekcije.Aim: The objective of this case report is to present the first case of ophthalmomyiasis caused by Oestrus ovis larvae in the Primorje Goranska County, Croatia, and to raise awareness of healthcare professionals about larval infestation as a possible cause of conjunctivitis. Case report: A female patient was examined at the emergency ophthalmology clinic because of a foreign body sensation in her eye. Ophthalmological examination revealed chemosis of the left bulbar junction with the presence of three larvae. After the application of a local anesthetic, the larvae were removed and sent for microbiological analysis. In light microscopy, the morphology corresponded to the L1 stage larvae of sheep botfly. Corticosteroid, antibiotic drops and eye ointment were recommended to the patient, and at the follow-up examination three days later there was a complete regression of the symptoms. Conclusions: So far, only two cases of ophthalmomyiasis from Croatia have been reported. Early diagnosis and treatment are important to prevent complications. There is no systemic therapy for this condition, but mechanical removal of the causative agent is carried out with a local antibiotic to prevent bacterial infection
Guidelines for treatment of benign diseases of anorectal region
No full textBenigne bolesti anorektalne regije, u koje ubrajamo analne apscese, analne fistule, analne fisure i hemoroidalnu bolest, česta su stanja koja susreću liječnici obiteljske medicine kao i bolnički specijalisti. Unatoč rasprostranjenosti patologije, još uvijek ne postoje jasne smjernice za adekvatno liječenje navedenih stanja, koje se još uvijek često svodi na preporuke koje nemaju uporište u medicini temeljenoj na dokazima. Zbog toga je ekspertna skupina, u kojoj su sudjelovali članovi Hrvatskog društva za digestivnu kirurgiju kojima je uže područje interesa koloproktologija, odlučili sastaviti ove smjernice s namjerom da se standardizira liječenje benignih bolesti anorektalne regije, kako na primarnoj tako i na tercijarnoj razini.Benign anorectal illnesses, of which anal abscesses, anal fistulae, anal fissures and hemoroidal disease are a part of, are common conditions frequently encountered by general medicine practitioners and hospital specialists alike. Despite the prevalence of the pathology, there are still no clear guidelines for the adequate treatment of the mentioned conditions, which is still often reduced to recommendations that have no basis in evidencebased medicine. For this reason, the expert group, which included members of the Croatian Society for Digestive Surgery, with coloproctology as their area of interest, decided to compile these guidelines with the intention of standardizing the treatment of benign diseases of the anorectal region, both at the primary and tertiary levels
DIET THERAPY FOR TYPE 2 DIABETES: THE ROLE OF SPECIFIC NUTRIENTS AND DIETARY PRINCIPLES
No full textDue to the increase of diabetic patients, especially type 2, we are now facing a global
pandemic. Diet control is the first line of treatment, and if planned well, can delay or alleviate
its complications, both micro- and macrovascular.
One of the main postulates in diabetes mellitus type 2 treatment is nutrition education,
glycaemic self-control and eventual adjustment of drug dosage. When making suggestions to
individuals about diet therapy it is very important to consider various individual, social and
economic characteristics.
There is no perfect diet for diabetics, or a dietary regime, which would properly
reflect a person’s individual needs, from clinical presentation to everyday life. There
is no perfect diet therapy suitable for every type 2 diabetic . However, the so-called
diabetic diet, avoiding the consumption of simple carbohydrates and refined starches, is
recommended to the majority of patients.
Therefore, anyone planning a diet for a type 2 diabetic should familiarize themselves with
the effects of macro- and/or micro-nutrients which have a clinical impact on type 2 diabetes.
Dietary therapy for patients with type 2 diabetes offers special dietary regimens such as
the Mediterranean diet, low-fat diet, vegetarian and vegan diets.
This review provides insights into particular nutrients and some dietary regiments,
including the Mediterranean diet, intermittent fasting and the Dietary Approach to Stop
Hypertension diet
Antigenic determinants driving serogroup-specific antibody response to Neisseria meningitidis C, W, and Y capsular polysaccharides: Insights for rational vaccine design
No full textMeningococcal glycoconjugate vaccines sourced from capsular polysaccharides (CPSs) of pathogenic Neisseria meningitidis strains are well-established measures to prevent meningococcal disease. However, the exact structural factors responsible for antibody recognition are not known. CPSs of Neisseria meningitidis serogroups Y and W differ by a single stereochemical center, yet they evoke specific immune responses. Herein, we developed specific monoclonal antibodies (mAbs) targeting serogroups C, Y, and W and evaluated their ability to kill bacteria. We then used these mAbs to dissect structural elements responsible for carbohydrate-protein interactions. First, Men oligosaccharides were screened against the mAbs using ELISA to select putative lengths representing the minimal antigenic determinant. Next, molecular interaction features between the mAbs and serogroup-specific sugar fragments were elucidated using STD-NMR. Moreover, X-ray diffraction data with the anti-MenW CPS mAb enabled the elucidation of the sugar-antibody binding mode. Our findings revealed common traits in the epitopes of all three sialylated serogroups. The minimal binding epitopes typically comprise five to six repeating units. Moreover, the O-acetylation of the neuraminic acid moieties was fundamental for mAb binding. These insights hold promise for the rational design of optimized meningococcal oligosaccharides, opening new avenues for novel production methods, including chemical or enzymatic approaches
COMPLICATION OF MONOCHORIONIC TWIN PREGNANCIES: TWIN-TWIN TRANSFUSION SYNDROME (TTTS)
No full textTTTS is a severe complication characterized by an imbalance in blood flow between the donor and recipient twins and it affects 10% to 15% of MC twin pregnancies. This imbalance arises due to the presence of abnormal vascular connections in the shared placenta, leading to one twin (donor) having insufficient blood and the other (recipient) receiving excess blood. Consequently, the donor twin often experiences oligohydramnios and growth restrictions, while the recipient twin suffers from polyhydramnios and potential cardiac pathologies.
The thesis explores the pathophysiology, diagnosis, and treatment of TTTS, highlighting the importance of early detection and intervention. The pathophysiology involves the presence of AV anastomoses, which are typically deep and unidirectional, creating a significant imbalance in blood flow between the twins. The presence of AA and VV anastomoses, which are more superficial and bidirectional, can mitigate this imbalance but are often scarce in TTTS cases.
Early diagnosis through detailed ultrasound monitoring is crucial. Key markers such as polyhydramnios and oligohydramnios, identified through staging systems like the Quintero classification and others, are vital for the early detection of TTTS. These systems guide the intervention process and improve treatment outcomes. The preferred treatment, fetoscopic laser photocoagulation (FLPC), aims to ablate the connecting vessels to balance the blood flow. While FLPC has significantly improved outcomes, it carries risks, including the potential for complications such as preterm birth, cardiac, renal, and neurological impairments, as well as missed anastomoses.
Despite advancements in diagnosis and treatment, TTTS remains a challenging condition. Ongoing research and refinement of management protocols are essential to improve long-term health outcomes for affected twins. This emphasizes the need for continuous advancements in therapeutic techniques and prenatal care strategies