Veterinary medicine - Repository of PHD, master's thesis
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Candidacy for cochlear implantation
No full textKohlearna implantacija predstavlja suvremenu metodu rehabilitacije sluha koja osobama s teškim do vrlo teškim zamjedbenim oštećenjem sluha omogućuje povratak slušne funkcije. Od njezinih začetaka i prvih implantacija 1980-ih godina, kriteriji za odabir kandidata značajno su se proširili zahvaljujući napretku tehnologije, poboljšanim kirurškim tehnikama i dobrim kliničkim ishodima, te danas nadilaze početne stroge indikacije. Uspjeh kohlearne implantacije uvelike ovisi o pažljivom i individualiziranom pristupu odabiru kandidata koji uzima u obzir ne samo audiometrijske pragove, već i etiologiju oštećenja, anatomske osobitosti, psihosocijalne faktore te realna očekivanja pacijenata. Sveobuhvatna evaluacija kandidata podrazumijeva audiološku obradu tonskom i govornom audiometrijom, primjenu objektivnih elektrofizioloških metoda te procjenu učinkovitosti slušnih pomagala. Dok audiološki kriteriji postavljaju temelje za indikaciju, radiološka obrada pomoću HRCT-a i MR-a neizostavna je za procjenu prohodnosti pužnice, isključivanje apsolutnih kontraindikacija poput aplazije pužnice ili slušnog živca, te planiranje kirurškog zahvata. Etiologija oštećenja sluha, bilo da je kongenitalna ili stečena, nije samo ključan prognostički čimbenik, već određuje i mogućnost implantacije, optimalno vrijeme intervencije i odabir kirurškog pristupa. Paradigma kohlearne implantacije evoluirala je od strogo unilateralnog pristupa kod bilateralne vrlo teške gluhoće prema uključivanju osoba s jednostranom gluhoćom (SSD), razvoju hibridnih električno-akustičnih sustava (EAS) za kandidate s ostatnim niskofrekventnim sluhom i prihvaćanju bilateralne implantacije kao opcije rehabilitacije. Nadalje, u literaturi se sve više ističe važnost rane implantacije u djece, čime se omogućuje iskorištavanje kritičnog razdoblja neuroplastičnosti, a postoje i dokazi da djeca koja su implantirana vrlo rano mogu postići govorne vještine usporedive s vršnjacima normalnog sluha. Stoga su pravodobno prepoznavanje dobrih kandidata, rana intervencija i timski pristup presudni za optimalan ishod i bolju kvalitetu života osoba s teškim oštećenjem sluha.Cochlear implantation represents a modern method of hearing rehabilitation that enables individuals with severe-to-profound sensorineural hearing loss to regain auditory function. Since its inception and first implants in the 1980s, candidate selection criteria have significantly expanded due to technological advancements, improved surgical techniques, and favorable clinical outcomes, now extending beyond the initial strict indications. The success of cochlear implantation largely depends on careful and individualized candidate selection, which considers not only audiometric tresholds but also the etiology of hearing loss, anatomical features, psychosocial factors, and patients’ realistic expectations. Comprehensive candidate evaluation includes audiological assessment with pure-tone and speech audiometry, use of objective electrophysiological methods, and an evaluation of hearing aid effectiveness. While audiological criteria establish the foundation for indication, radiological imaging using HRCT and MRI is essential for assessing cochlear patency, ruling out absolute contraindications such as cochlear or auditory nerve aplasia, and surgical planning. The etiology of hearing loss, whether congenital or acquired, is not only a key prognostic factor but also determines implantation feasibility, optimal timing of intervention, and surgical approach selection. The paradigm of cochlear implantation has evolved from a strictly unilateral approach for bilateral profound deafness to the inclusion of individuals with single-sided deafness (SSD), development of hybrid electric-acoustic stimulation (EAS) for candidates with residual low-frequency hearing, and acceptance of bilateral implantation as a rehabilitation option. Furthermore, the literature increasingly emphasizes the importance of early implantation in children, thus enabling utilization of the critical period of neuroplasticity, with evidence that children implanted very early can achieve speech skills comparable to their normal-hearing peers. Therefore, timely identification of suitable candidates, early intervention, and a multidisciplinary team approach are crucial for achieving optimal outcomes and improved quality of life for individuals with severe hearing impairment
The effects of obesity treatment on female reproduction
No full textPretilost predstavlja jedan od vodećih javnozdravstvenih izazova suvremenog društva, a njezina prevalencija u žena reproduktivne dobi je u porastu. Liječenje pretilosti kod ovih žena ima ključnu ulogu u poboljšanju njihova reproduktivnog zdravlja i ukupne šanse za začeće. Adipozno tkivo, djelujući kao endokrini organ, aromatizira estrogene iz androgena, što dovodi do hiperestrogenizma i poremećaja osovine hipotalamus–hipofiza–jajnici (HPO). Dodatno povišene razine leptina i inzulinska rezistencija pridonose anovulaciji, a hiperinzulinemija potiče proizvodnju androgena, dodatno narušavajući folikulogenezu. Pretilost je povezana s lošijom kvalitetom oocita, smanjenom receptivnošću endometrija te povišenim rizikom za spontani pobačaj. Prvi korak u liječenju pretilosti predstavlja prilagodba životnih navika: prehrambene intervencije snižavaju tjelesnu masu i poboljšavaju ovulacijski potencijal, dok tjelesna aktivnost dodatno smanjuje visceralnu mast. Psihološka podrška doprinosi ustrajnosti u promjenama, smanjuje stres i poboljšava funkciju HPO osi. U farmakološkom liječenju, agonisti GLP-1 receptora učinkovito smanjuju tjelesnu masu, poboljšavaju osjetljivost na inzulin i pozitivno utječu na uspostavu ovulacijskih ciklusa, osobito u žena s abdominalnom pretilošću i sindromom policističnih jajnika (PCOS). Povezani su s većom stopom spontanih trudnoća kao i pozitivnih ishoda MPO postupaka. Kombinacija bupropiona i naltreksona pridonosi smanjenju emocionalnog prejedanja i tjelesne mase. Orlistat, kao periferni inhibitor lipaza, utječe na gubitak tjelesne mase i privatljiv je oblik farmakološke terapije u pretilih žena koje planiraju trudnoću. Metformin, osobito kod žena s inzulinskom rezistencijom, regulira menstrualni ciklus i smanjuje rizik od spontanih pobačaja. Novi dualni agonisti GLP-1 i GIP receptora povezani su sa značajnim gubitkom tjelesne mase i ostvaruju pozitivne učinke na reprodukciju kroz uspostavu ovulacijskih ciklusa te povećanje stope spontanih trudnoća kao i ishoda MPO postupaka. Kirurške intervencije, poput bariatrijske kirurgije, omogućuju značajan i trajan gubitak tjelesne mase, a kod mnogih žena dolazi do spontane uspostave ovulacije i trudnoće već unutar godine dana nakon operacije. U zaključku, liječenje pretilosti treba biti sastavni dio pristupa u skrbi za žene s pretilošću koje planiraju trudnoću. Individualizirani, multidisciplinarni pristup ključan je za postizanje optimalnih reproduktivnih ishoda.Obesity represents one of the leading public health challenges of modern society, and its prevalence among women of reproductive age is increasing. Treating obesity in these women plays a key role in improving their reproductive health and overall chances of conception. Adipose tissue, acting as an endocrine organ, aromatizes estrogens from androgens, leading to hyperestrogenism and dysfunction of the hypothalamic–pituitary–ovarian (HPO) axis. Additionally, elevated leptin levels and insulin resistance contribute to anovulation, while hyperinsulinemia stimulates androgen production, further impairing folliculogenesis. Obesity is also associated with poorer oocyte quality, reduced endometrial receptivity and increased risk of miscarriage. The first step in treating obesity is the adjustment of lifestyle habits: dietary interventions reduce body weight and improve ovulatory potential, while physical activity further lowers insulin resistance and visceral fat. Psychological support contributes to adherence, reduces stress, and improves HPO axis function. In pharmacological treatment, GLP-1 receptor agonists effectively reduce body weight, improve insulin sensitivity, and positively influence the establishment of ovulatory cycles, especially in women with abdominal obesity and polycystic ovary syndrome (PCOS). They are associated with higher rates of spontaneous pregnancies as well as improved outcomes of assisted reproductive procedures (ART). The combination of bupropion and naltrexone contributes to the reduction of emotional overeating and body weight. Orlistat, as a peripheral lipase inhibitor, promotes weight loss and is a suitable form of pharmacological therapy for obese women planning pregnancy. Metformin, particularly in women with insulin resistance, regulates the menstrual cycle and reduces the risk of miscarriage. New dual GLP-1 and GIP receptor agonists are associated with significant weight loss and produce positive effects on reproduction by restoring ovulatory cycles and increasing rates of spontaneous pregnancies and ART outcomes. Surgical interventions, such as bariatric surgery, enable significant and lasting weight loss, and many women spontaneously resume ovulation and achieve pregnancy within a year after the operation. In conclusion, the treatment of obesity should be an integral part of care for obese women planning pregnancy. An individualized, multidisciplinary approach is crucial for achieving optimal reproductive outcomes
Comparison of the Quality of Life of Patients with Type 1 Diabetes who Use Insulin Pens and Insulin Pumps
No full textŠećerna bolest tip 1 ili dijabetes melitus ovisan o inzulinu kronično je stanje u kojem imunološki sustav napada β-stanice Langerhansovih otočića gušterače koje proizvode inzulin. Inzulin je hormon koji pomaže glukozi da uđe u stanice, gdje se koristi za stvaranje energije. Manjak inzulina dovodi do povišene koncentracije glukoze u krvi (hiperglikemije). Neregulirana šećerna bolest može dovesti do brojnih komplikacija koje narušavaju kvalitetu života. Liječenje je usmjereno na kontrolu količine glukoze u krvi pomoću inzulina, prehrane i načina života kako bi se spriječile komplikacije te poboljšala kvaliteta života. Inzulin se može primjenjivati putem inzulinskih penova, inzulinske pumpe ili hibridnog sustava zatvorene petlje. Cilj ovog istraživanja bio je usporediti kvalitetu života bolesnika sa šećernom bolešću tip 1 koji koriste različite oblike inzulinske terapije: inzulinske penove, inzulinske pumpe i hibridne sustave zatvorene petlje (HCL). U istraživanju je sudjelovalo 164 ispitanika (110 žena i 54 muškarca) koji su ispunili prijavljene upitnike: ADDQOL (kvaliteta života), DTSQ (zadovoljstvo terapijom) i PAID (emocionalno opterećenje). Prikupljeni su i podaci o dobi, trajanju bolesti, vrijednosti HbA1c te sociodemografskim obilježjima. Korisnici HCL sustava bili su statistički značajno stariji (p=0,011), s duljim trajanjem bolesti (p<0,001), te su imali viši obrazovni i radni status u usporedbi s korisnicima inzulinskih penova i pumpi. Nisu utvrđene značajne razlike u vrijednostima HbA1c između skupina (p=0,898). Također nije bilo razlika u ukupnoj kvaliteti života (ADDQOL) niti u emocionalnom stresu (PAID). Zadovoljstvo terapijom (DTSQ) bilo je nešto više u HCL skupini (p=0,030), ali nije ostalo značajno nakon korekcije. Percepcija učestalosti hiperglikemije bila je značajno niža među korisnicima HCL sustava u usporedbi s korisnicima inzulinskih penova (p=0,022).Type 1 diabetes mellitus, or insulin-dependent diabetes mellitus, is a chronic condition in which the immune system attacks the β-cells of the pancreatic islets of Langerhans that produce insulin. Insulin is a hormone that helps glucose enter the cells, where it is used to produce energy. A lack of insulin leads to elevated blood glucose levels (hyperglycemia). Unregulated diabetes can result in numerous complications that impair quality of life. The treatment focuses on controlling blood glucose levels using insulin, diet, and lifestyle modifications to prevent complications and to improve quality of life. Insulin can be delivered via insulin pens, insulin pumps, or hybrid closed-loop (HCL) systems. The aim of this study was to compare the quality of life of patients with type 1 diabetes using different forms of insulin therapy: insulin pens, insulin pumps, and hybrid closed-loop (HCL) systems. The study included 164 participants (110 women and 54 men) who completed self-reported questionnaires: ADDQOL (quality of life), DTSQ (treatment satisfaction), and PAID (emotional burden). Data about age, duration of disease, HbA1c values, and sociodemographic characteristics was also collected. Users of the HCL system were significantly older (p=0.011), had a longer duration of disease (p<0.001), and had higher education and employment status compared to users of insulin pens and pumps. There were no significant differences in HbA1c values between the groups (p=0.898). Likewise, there were no differences in overall quality of life (ADDQOL) or emotional distress (PAID). Treatment satisfaction (DTSQ) was somewhat higher in the HCL group (p = 0.030), but this was not statistically significant after correction. Perceived frequency of hyperglycemia was significantly lower among users of the HCL system compared to users of insulin pens (p=0.022)
Dapagliflozin vs empagliflozin in patients with chronic heart failure: a registry analysis
No full textAim: To assess the relative efficacy of dapagliflozin and empagliflozin in routinely treated chronic heart failure (CHF) patients.
Methods: Data from a registry of prevalent and incident CHF patients were used to set up cohorts (new-user design) of patients started on dapagliflozin or empagliflozin in addition to other guideline-directed therapy. Cohorts were mutually balanced on a range of characteristics, and were assessed for the incidence of a composite of all-cause death/major adverse cardiac events (primary outcome) over the initial 6 months of treatment, and for New York Heart Association (NYHA) functional class at 6 months (secondary outcome). Frequentist and Bayes estimates were generated for the dapagliflozin vs empagliflozin comparison.
Results: In both prevalent (dapagliflozin n=393, empagliflozin n=328) and incident (dapagliflozin n=124, empagliflozin n=116) patients, those prescribed dapagliflozin had somewhat higher incidence of the primary outcome, but the confidence intervals were wide (RR=1.385, 95%CI 0.882-2.173 [prevalent], RR=2.192, 95%CI 0.765-6.282 [incident]), and were more likely to present with a worse NYHA class at 6 months (OR=1.552, 95%CI 1.142-2.108 [prevalent], OR=1.503, 95%CI 0.844-2.676 [incident]). In the pooled data, primary events (n=102) were more common in dapagliflozin-prescribed patients (frequentist estimate RR=1.519, 95%CI 1.239-1.861; Bayes RR=1.380, 95%CrI 0.981-1.944). Dapagliflozin-prescribed patients were also more likely to have a worse NYHA class at 6 months (OR=1.540, 95%CI 1.208-1.962; Bayes OR=1.425, 95%CrI 1.098-1.781).
Conclusion: CHF patients prescribed with dapagliflozin had poorer outcomes than their empagliflozin-prescribed peers over the initial 6 months of treatment. Data emphasize a need for a direct randomized comparison of the two treatments in this setting
The relation between intracranial and intraocular pressure in patients with acute increase of intracranial pressure
No full textUVOD: S obzirom na suprotstavljena mišljenja o povezanosti intrakranijskog tlaka (ICP) i intraokularnog tlaka (IOP), provedeno je istraživanje kako bi se pokušao razjasniti odnos između tlakova i utvrditi postoji li klinička uloga IOP-a u prepoznavanju akutnog povišenja ICP-a.
METODE I ISPITANICI: Istraživanje je dizajnirano kao prospektivna studija u trajanju od 2018. do 2023. godine. Ispitanici su odrasli pacijenti s akutnim povišenjem ICP-a kojima je bilo indicirano kontinuirano mjerenje ICP-a metodom ventrikularne vanjske drenaže likvora. Inicijalno mjerenje IOP-a kod ispitanika bilo je pri prvom nalazu povišenog ICP-a. Sljedeća mjerenja su obavljana dva puta dnevno tijekom iduća tri dana, simultano, u točno definiranom položaju tijela.
REZULTATI: Analizom dobivenih vrijednosti intrakranijskog i intraokularnog tlaka kod pacijenata s akutnim povišenjem ICP-a u ovom istraživanju nije nađena povezanost između IOP-a i ICP-a koristeći Spearmanov koeficijent korelacije ni u početnoj točki mjerenja (rs = 0,00, p > 0,05) kao ni u mjerenjima tijekom iduća tri dana (rs = 0,01, p > 0,05; rs = -0,08, p > 0,05; rs = 0,08, p > 0,05; rs = 0,23, p > 0,05; rs = -0,01, p > 0,05; rs = 0,12, p > 0,05).
ZAKLJUČAK: Ovo istraživanje pokazalo je da mjerenje IOP-a nema prognostičku vrijednost u ranom prepoznavanju akutnog povišenja ICP-a, kao ni u svrhu monitoringa. Razvoj funkcionalnih slikovnih dijagnostičkih metoda, bolje razumijevanje anatomskih odnosa u orbitalnom prostoru vidnog živca, kao i potencijalne neuralne sprege mogle bi dovesti do potpunijeg razumijevanja ovog međuodnosa.INTRODUCTION: Due to conflicting opinions in the literature regarding the relationship between intracranial pressure (ICP) and intraocular pressure (IOP), the aim was to clarify the interrelationship between the pressures in the settings of acute ICP elevation.
METHODS: The research was a prospective study lasting from 2018 to 2023. The subjects were adult patients with acute ICP elevation who needed continuous ICP monitoring using the external ventricular drainage. The initial measurement of IOP was obtained at the first finding of elevated ICP. The following measurements were performed twice a day for the next three days, simultaneously, in a precisely defined position of the body.
RESULTS: Analyzing the values of intracranial and intraocular pressure in patients with an acute increase in ICP, no correlation between IOP and ICP has been found using Spearman correlation coefficient, neither at the starting point of measurement nor in subsequent measurements (rs = 0,00, p > 0,05; rs = 0,01, p > 0,05; rs = -0,08, p > 0,05; rs = 0,08, p > 0,05; rs = 0,23, p > 0,05; rs = -0,01, p > 0,05; rs = 0,12, p > 0,05, respectively).
CONCLUSION: This study showed that IOP measurement has no prognostic value in the early recognition of acute ICP elevation, nor for monitoring purposes. The development of imaging and functional methods, a better understanding of the anatomical relationships in the orbital space of the optic nerve, as well as potential neural connections will lead to a better understanding of this interrelationship
Interakcije između autonomnog i imunološkog sustava u multiploj sklerozi – AUTIM-MS: plan upravljanja istraživačkim podacima
No full textPlan upravljanja istraživačkim podacim
Influence of Toll-like receptor 2 deficiency on neuroplastin and ATPases expression in mouse brain
No full textDosadašnja istraživanja pokazala su da receptor sličan Toll-u 2 (TLR2) u mozgu sisavaca sudjeluje u neuroinflamaciji dok tijekom razvoja utječe na proliferacijski i diferencijacijski status progenitorskih stanica. Cilj ovog rada je bio utvrditi utjecaj nedostatka TLR2 na izražaj proteina uključenih u sinaptičku plastičnost (neuroplastin) i membranski prijenos iona (ATPaze tipa P) u mišjem mozgu. Provedena je analiza sinaptičkog proteoma, genske i proteinske ekspresije navedenih proteina, njihovog tkivnog i membranskog smještaja, utvrđen je gangliozidom i određena katalitička aktivnost ATPaza u uzorcima moždane kore, hipokampusa i malog mozga mišjeg modela s nedostatkom TLR2 u usporedbi s kontrolnim tkivom. Rezultati su pokazali da je nedostatak TLR2 u mišjem mozgu povezan s: a) značajnim promjenama sinaptičkog proteoma, posebice zastupljenosti proteina nužnih za regulaciju aksonskih projekcija i mijelinizacije, glutamatergičke transmisije i energetskog metabolizma; b) manjim izražajem neuroplastina u hipokampusu i malom mozgu što vjerojatno ukazuje na smanjenje broja sinapsi, dok utvrđena količina ATPaza tipa P upućuje na manji broj sinapsi hipokampusa i povećani broj astrocita u malom mozgu; c) većim izražajem i katalitičkom aktivnošću membranske kalcijeve ATPaze u hipokampusu, što govori u prilog poremećenog transporta kalcijevih iona; d) većim udjelom jednostavnog gangliozida GD3 u hipokampusu te većim udjelom složenih gangliozida GT1b i GQ1b u malom mozgu, što može odražavati promjenu membranske homeostaze i poremećene specifične membranske procese poput proliferacije i ionskog transporta. Zaključno, u ovom radu je dokazano da nedostatak TLR2 u mišjem mozgu utječe na izražaj i funkciju membranskih sustava neophodnih za sinaptičku plastičnost i ionski transport, što predstavlja temelj za daljnje istraživanje novih uloga TLR2 u moždanom tkivu sisavaca.Previous studies have shown that roles of Toll-like receptor 2 (TLR2) in mammalian brain encompass its involvement in neuroinflammation and neurodevelopmental processes such as proliferation and differentiation of neuronal progenitor cells. The aim of this study was to determine whether lack of TLR2 influences on the expression of proteins which participate in synaptic plasticity (neuroplastin) and membrane ion transport (P-type ATPases) in mouse brain. The variations of the synaptic proteome, gene and protein expression of neuroplastin and P-type ATPases as well as their tissue and membrane localization, ATPases catalytic activity, and gangliosidome were analyzed in the tissue samples of cortex, hippocampus, and cerebellum derived from mouse model lacking TLR2 in comparison to control tissue. Results demonstrate that the lack of TLR2 is associated with: a) adjustments in the synaptic proteome related markedly to protein systems involved in regulation of axon projections and myelinization, glutamatergic transmission, and energy metabolism; b) lower expression of neuroplastin in the hippocampus and cerebellum indicating potential loss of synapses, while detected variable content of P-type ATPases may suggest reduced number of synapses in the hippocampus and increased number of astrocytes in the cerebellum; c) higher expression and increased catalytic activity of plasma membrane calcium ATPase in hippocampus arguing for deranged calcium transport; d) increased ratio of simple ganglioside specie GD3 in the hippocampus and complex gangliosides GT1b and GQ1b in the cerebellum which may reflect alteration of membrane homeostasis and specific membrane functions such as proliferation and ion transport. In conclusion, presented findings reveal that the lack of TLR2 in mouse brain effects on the expression and function of membrane systems essential for synaptic plasticity and ion transport, opening new avenues for investigation of yet undescribed roles of TLR2 in the mammalian brain
Epidemiological and Clinical Characteristics of Adult RSV Infections: A Retrospective Analysis at University Hospital Center Zagreb (2022–2024)
No full textRespiratory syncytial virus (RSV) is a significant cause of respiratory infections in adults, particularly among older adults and individuals with chronic diseases. While traditionally linked to pediatric populations, RSV’s impact on adults, especially the elderly, is increasingly recognized but remains understudied in many regions. This retrospective study, conducted at the University Hospital Center Zagreb from October 2022 to April 2024, is the first to analyze RSV-positive adults in Croatia. Using RT-PCR testing, we evaluated clinical and epidemiological characteristics in both hospitalized and outpatient populations, focusing on those aged > 65 years. Among 2631 tested individuals, the RSV prevalence was 5.25%, with older adults experiencing the most severe outcomes, including pneumonia, COPD exacerbation, and intensive care admissions. Seasonal analysis confirmed a winter peak in RSV cases, while chronic conditions such as cardiovascular and respiratory diseases were strongly associated with higher complication rates. These findings demonstrate that older adults with comorbidities bear the greatest burden of RSV infection, highlighting the need for the early identification of high-risk patients. By providing detailed insights into RSV-related outcomes in this population, this study supports the development of targeted prevention and management strategies to reduce the burden of RSV in vulnerable groups
Analysis of patient's depth of field after Presbyopia correcting intraocular lenses implantation
No full textProspektivna, randomizirana studija, provedena je na 198 očiju pacijenata podijeljenih u četiri skupine ugrađenih leća (AT LISA tri 839MP IOL, Tecnis 1-piece Low Add ZKB00 IOL, Tecnis Symfony ZXR00 IOL te Tecnis Synergy ZFR00 IOL) nakon operacije katarakte ili refrakcijske izmjene leće (RLE). Dubinska oštrina vida (DOV) predstavlja dioptrijski raspon jasnog vida pri defokusiranju slike. Ispitivan je subjektivnom metodom mjerenja. Rezultati su pokazali da pacijenti u skupini Tecnis Synergy ZFR00 IOL imaju statistički značajno veći DOV od ostalih skupina. Nadalje, preoperativni i postoperativni parametri veličine zjenice, dubine prednje očne sobice (ACD), zakrivljenosti rožnice (K) i aberacije višeg reda (HOA) nisu korelirali s DOV-om ni kod jedne skupine leća. Na osnovu tih rezultata možemo zaključiti da su izmjerene razlike u DOV-u između leća rezultat isključivo dizajna leća te da se predikcijski empirijski model na temelju tih parametara ne može učiniti. Postojala je pozitivna korelacija s DOV-om nekorigirane vidne oštrine na srednju udaljenost (UIVA) kod Tecnis Symfony ZXR00 leća te nekorigirane vidne oštrine na blizinu (UNVA) i daljinu (UDVA) kod Tecnis 1-piece Low Add ZKB00 leća. Za Synergy IOL i AT LISA tri IOL skupine nije potvrđena ispitivana korelacija. U usporedbi vidnih oštrina među lećama Tecnis Synergy ZFR00 i AT LISA tri 839MP pokazale su se superiornim za vid na blizinu dok je Tecnis 1-piece Low Add ZKB0, bifokalna leća bila inferiorna u odnosu na druge leće u intermedijarnoj udaljenosti. Dobiveni rezultati potvrđuju da su optički dizajni leće dominantni prediktori optičke izvedbe i utjecaja na postoperativni DOV te ih kirurg mora dobro poznavati da bi odabir leće uskladio sa životnim aktivnostima pacijenta i dobio optimalan rezultat.A prospective, randomized study was conducted on 198 eyes of patients, who were divided into four groups based on implanted lenses: AT LISA tri, Tecnis Low Add bifocal, Tecnis Symfony, and Tecnis Synergy. Depth of field (DOF) was assessed through subjective measurement methods. Results revealed a statistically significant higher DOF in the Tecnis Synergy IOL group. Preoperative and postoperative parameters such as pupil size, anterior chamber depth (ACD), keratometry (K), and higher-order aberrations (HOA) did not correlate with DOF in any lens group. These findings suggest that the differences in DOF between lenses are solely attributed to lens design, rendering a predictive empirical model based on these parameters unattainable. Symfony lenses exhibited a positive correlation with DOF for uncorrected distance visual acuity, while Tecnis Low Add lenses showed such a correlation for uncorrected near and distance visual acuity. Synergy IOL and AT LISA lenses did not confirm the investigated correlation. In comparing optimal visual acuity among lenses, Synergy and AT LISA emerged as superior for near vision, while Low Add lenses were least effective in intermediate distance.
These results demonstrate that optical lens designs predict optical performance and impact postoperative DOF. Surgeons must understand these designs thus achieving optimal results
Assessment of microRNAs expression in maternal and neonatal pairs in association with cigarette smoke exposure
No full textUvod: Mehanizam štetnog djelovanja pušenja uključuje promjene miRNA koje reguliraju gensku ekspresiju. Cilj istraživanja bio je ispitati povezanost ekspresije odabranih miRNA, koncentracije toksičnih i esencijalnih metala te biokemijskih parametara u ovisnosti o pušenju majke u svim uzorcima fetoplacentalne jedinice.
Materijali i metode: Presječno retrospektivno istraživanje uključivalo je 72 para majka-novorođenče (35 pušačica i 37 nepušačica) regrutirana tijekom 2018. i 2019. godine. Ekspresije ciljnih miRNA (miR1537, miR190B, miR16-1, miR21 i miR146A) određene su RT-PCR-om. Koncentracije esencijalnih (Fe, Cu i Zn) i toksičnih metala (Cd i Pb) izmjerene su ICP-MS-om. Biokemijski parametri (glukoza, urati, trigliceridi, ukupni kolesterol, LDL-C i HDL-C) analizirani su na biokemijskom analizatoru enzimatskim metodama, a CRP metodom imunoturbidimetrije. Programski paket Statistica korišten je za statističku obradu podataka (P<0,050).
Rezultati: Pušačice vs. nepušačice imaju višu ekspresiju miRNA16-1 u majčinoj plazmi i miRNA146A u plazmi pupkovine, a nižu ekspresiju miRNA21 u posteljici te niže koncentracije Fe u serumu i urata u plazmi. Koncentracije Cd u pušačica povećane su u svim ispitivanim uzorcima fetoplacentalne jedinice, dok su koncentracije Pb povećane samo u majčinoj krv i posteljici.
Zaključak: Istraživanje je pokazalo da toksične tvari kojima smo izloženi pušenjem mogu imati utjecaja na molekularne regulacijske mehanizme i time utjecati na zdravlje majke i djeteta.Introduction: The smokings' harmful effects mechanism involves miRNA changes which regulate gene expression. The study aims to investigate impact of maternal smoking on candidate miRNAs expression, essential and toxice metal levels, and biochemical parameters in feto-placental unit.
Materials and methods: Cross-sectional retrospective study included 72 mother-newborn pairs (35 smokers and 37 non-smokers) recruited during 2018/2019. Candidate miRNAs (miR1537, miR190B, miR16-1, miR21, and miR146A) were determined by RT-PCR. Essential (Fe, Cu, and Zn) and toxic metals (Cd and Pb) were measured by ICP-MS. Biochemical parameters (glucose, urates, triglycerides, total cholesterol, LDL-C and HDL-C) were analyzed by biochemical analyzer using enzymatic methods, and CRP by immunoturbidimetry. Statistical analysis was done by Statistica software (P<0.050).
Results: Smokers vs. non-smokers have higher expression of miR-16-1 in maternal and miR-146A in cord plasma, and lower expression of miR-21 in placenta, as well as lower concentration of serum Fe and plasma urate. Cd concentrations in smokers were higher in all compartments of feto-placental unit, while Pb concentrations were higher only in maternal blood and placenta.
Conclusion: Research showed that toxic substances to which we are exposed through smoking can have an impact on molecular regulatory mechanisms and thus affect health of the mother and child