Veterinary medicine - Repository of PHD, master's thesis
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Kompleksni um javnog zdravstva : kognitivni narativi u praksi javnog zdravstva
No full textU javnozdravstvenim istraživanjima dominira empirijski kvantitativni pristup.
Kognitivni narativ je akademski zanemaren. Međutim, kognitivni narativ ima
neke specifične prednosti u javnozdravstvenim istraživanjima, posebice u
populacijskim javnozdravstvenim intervencijama:
Prvo, kognitivni narativ omogućuje profesionalni razvoj javnozdravstvenog
istraživača u teoriji i praksi javnog zdravstva. Kognitivni narativ pruža
jedinstveni specifični uvid u javnozdravstvenu problematiku koji motivira
uključivanje istraživača u transformativno učenje i djelovanje u rješavanju
javnozdravstvenih problema.
Drugo, kognitivni narativ omogućuje propitivanje socijalno-kognitivnih potencijala istraživača, što može poboljšati njegovu sposobnost razumijevanja
kompleksnosti javnozdravstvenih problema.
Treće, kognitivni narativ omogućuje istraživaču da prijeđe različite kulturne,
teorijske i disciplinarne barijere.
Cilj ovih tekstova su teorijska i praktična javnozdravstvena promišljanja,
posebice u javnozdravstvenim populacijskim intervencijama.
Autori daju svoje proživljene spoznaje o različitim javnozdravstvenim
fenomenima.
Neke defi nicije ostavili smo na engleskom jeziku. To je učinjeno radi lakšeg
razumijevanja različitih pojmova. Naime mi još nemamo dogovorenu
terminologiju pojmova koje koristimo u javno zdravstvenim istraživanjima i
akcijama
Histološki, klinički, laboratorijski i genski prediktori ishoda bolesnika s Henoch-Schönleinovom purpurom i nefritisom - plan upravljanja istraživačkim podacima
No full textAssociation of anti-diabetic drugs and COVID-19 outcomes in patients with diabetes mellitus type 2 and cardiomyopathy
No full textThere is a scarcity of information on the population with diabetes mellitus type 2 and cardiomyopathy (PDMC) in COVID-19, especially on the association between anti-diabetic medications and COVID-19 outcomes. Study is designed as a retrospective cohort analysis covering 2020 and 2021. Data from National Diabetes Registry (CroDiab) were linked to hospital data, primary healthcare data, the SARS-CoV-2 vaccination database, and the SARS-CoV-2 test results database. Study outcomes were cumulative incidence of SARS-CoV-2 positivity, COVID-19 hospitalizations, and COVID-19 deaths. For outcome predictors, logistic regression models were developed. Of 231 796 patients with diabetes mellitus type 2 in the database, 14 485 patients had cardiomyopathy. The two2-year cumulative incidence of all three studies' COVID-19 outcomes was higher in PDMC than in the general diabetes population (positivity 15.3% vs. 14.6%, p = 0.01; hospitalization 7.8% vs. 4.4%, p
Šećerna bolest pridružena cističnoj fibrozi
No full textBackground: Cystic fibrosis (CF) is autosomal recessive genetic disorder caused by mutations in the CFTR gene. It leads to multisystem complications such as persistent pulmonary infections, pancreatic insufficiency with diabetes, and liver damage, significantly decreasing the quality of life and contributing to morbidity and mortality. This study aims to investigate the prevalence and age of diagnosis of cystic fibrosis-related diabetes (CFRD) in Croatia and explore the connection between the age of CFRD diagnosis, insulin therapy, and body mass index (BMI).
Participants and Methods: This retrospective study analyzes the medical data of 123 patients diagnosed with CF and followed at the Croatian Referral Centre of the Ministry of Health for cystic fibrosis. Data were retrieved from the hospital information system. Among the 123 patients, 17 (6 males, 11 females) were identified with CFRD. The median age was 23 years (range 13-38, SD
6,91), and the median BMI was 22.73 (range 13.55-29.59 SD 3,61) kg/m².
Results: The prevalence of CFRD was 4.49% in the pediatric CF population and 38.24% in the adult CF population. The median age of CFRD diagnosis was 13 years (range 9-24, SD 4.43), with the majority diagnosed between 10 and 15 years (p=0.021; p<0.05). An earlier age of CFRD diagnosis (9-13 years) was associated with higher insulin doses required for therapy, peaking at
age 10 with an average of 1.32 IU/kg. Additionally, those diagnosed at a younger age (4-15 years) had a notably lower mean BMI.
Conclusion: This first study investigating CFRD in Croatia establishes that the median age of diagnosis is predominantly between 10 and 15 years. The prevalence of CFRD aligns with findings from other research. An earlier age of CFRD diagnosis is associated with higher insulin doses required for therapy and a lower BMI, highlighting the importance of early detection and
management of the disease to improve the health outcomes of CF patients.Uvod: Cistična fibroza (CF) je autosomno recesivna genetska bolest uzrokovana mutacijom CFTR gena. CF dovodi do multisistemskih komplikacija kao što su učestale plućne infekcije, insuficijencija rada gušterače s dijabetesom te oštećenje jetre. CF značajno smanjuje kvalitetu života te pridonoseći morbiditetu i mortalitetu. Cilj ove studije je istražiti prevalenciju i dob dijagnoze dijabetesa povezanog s cističnom fibrozom (CFRD) u Hrvatskoj te istražiti povezanost između dobi dijagnoze CFRD-a, terapije inzulinom i indeksa tjelesne mase (BMI).
Ispitanici i metode: Radilo se o retrospektivnoj studiji u kojoj su analizirani medicinski podatci 123 bolesnika s dijagnozom CF-a koji su praćeni u Referalnom centru Ministarstva zdravstva Republike Hrvatske za cističnu fibrozu. Podaci su prikupljeni iz bolničkog informacijskog sustava. Identificirano je ukupno 17 bolesnika (6 muškaraca, 11 žena) s CFRD-om. Medijan dobi bio je 23 godine (raspon 13-38, SD 6,91), a medijan BMI bio je 22,73 (raspon 13,55-29,59, SD 3,61) kg/m².
Rezultati: Prevalencija CFRD-a bila je 4,49% u pedijatrijskoj populaciji i 38,24% u odrasloj populaciji s CF-om. Medijan dobi dijagnoze CFRD-a bio je 13 godina (raspon 9-24, SD 4,43), s većinom dijagnosticiranih između 10 i 15 godina (p=0,021; p<0,05). Ranija dob dijagnoze CFRDa (9-13 godina) bila je povezana s većim dozama inzulina u liječenju CFRD-a, s vrhuncem u dobi od 10 godina s prosjekom od 1,32 IU/kg. Osim toga, oni dijagnosticirani u mlađoj dobi (4-15 godina) imali su značajno niži prosječni BMI.
Zaključak: U studiji u kojoj je po prvi puta evaluiran CFRD u Hrvatskoj ustanovljeno je da se dijagnoza postavlja najčešće u dobi između 10 i 15 godina. Prevalencija u hrvatskoj populaciji s CF-om slična je onima u drugima istraživanjima. Ranija dob dijagnoze CFRD-a povezana je s većim dozama inzulina i nižim BMI, što ukazuje na važnost ranog otkrivanja i liječenja bolesti kako bi se poboljšali zdravstveni ishodi pacijenata s CF-om
Pregled rezultata kliničkih studija temeljenih na transplantaciji matičnih stanica pacijentima oboljelima od bolesti živčanog sustava
No full textStem cell transplantation (SCT) is a promising strategy in developing new treatments for diseases like Parkinson’s, Alzheimer’s, multiple sclerosis (MS), stroke and amyotrophic lateral sclerosis (ALS). Stem cells are undifferentiated cells with potential to develop into any needed cell type. They have the ability to regenerate damaged nerve tissue or restore nerve cell functions. Following that, stem cell transplantation has been successfully applied in clinical trials for the treatment of neurological disorders, with varying degrees of progress and success. For example, mesenchymal stem cells have been shown to improve stroke outcomes by restoring blood flow, removing intracranial blood clots and reducing intracranial pressure. On the other hand, human neural stem cells can increase the degree of neuroregeneration, while autologous CD-34 positive hematopoietic stem cells can improve outcomes in patients with MS. Finally, neural stem cells (NSCs) can be used to treat MS by re-establishing functional interactions between neural and glial cells or by activating endogenous neural cells. In addition to positive effects observed in clinical trials, this thesis also reviews possible drawbacks and points towards elements which need to be improved before such protocols become routine part of therapeutic procedures.Transplantacija matičnih stanica (SCT) je obećavajuća strategija u razvoju novih terapija za bolesti kao što su Parkinsonova bolest, Alzheimerova bolest, multipla skleroza (MS), moždani udar i amiotrofična lateralna skleroza (ALS). Matične stanice su nediferencirane stanice s potencijalom koji im omogućuje razviti se u bilo koju potrebnu vrstu stanica, a imaju sposobnost obnove oštećenog živčanog tkiva koju prati i obnova funkcije živčanih stanica. Transplantacija matičnih stanica uspješno je primijenjena u kliničkim ispitivanjima za liječenje neuroloških poremećaja, s različitim stupnjevima napretka i uspjeha. Na primjer, pokazalo se da mezenhimalne matične stanice poboljšavaju ishode moždanog udara obnavljanjem protoka krvi, uklanjanjem intrakranijalnih krvnih ugrušaka i smanjenjem intrakranijskog tlaka. S druge strane, ljudske živčane matične stanice mogu povećati stupanj obnove tkiva, dok autologne CD-34 pozitivne hematopoetske matične stanice mogu poboljšati ishode kod bolesnika s MS-om. Konačno, živčane matične stanice (NSC) mogu se koristiti za liječenje MS ponovnim uspostavljanjem funkcionalnih interakcija između neurona i glijalnih stanica ili aktiviranjem endogenih stanica. Osim pozitivnih učinaka uočenih u kliničkim ispitivanjima, ovaj rad razmatra i moguće nedostatke te ukazuje na elemente koje je potrebno poboljšati prije nego što takvi protokoli postanu rutinski dio terapijskih postupaka
Clinician treatment choices for post-traumatic stress disorder: ambassadors survey of psychiatrists in 39 European countries
No full textBackground: Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians' treatment choices for post-traumatic stress disorder (PTSD).
Methods: The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148).
Results: About 82% woulduse antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct "profiles" of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines.
Conclusions: Clinicians' decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines
The Value of Local Therapies in Advanced Adrenocortical Carcinoma
No full textInternational guidelines recommend local therapies (LTs) such as local thermal ablation (LTA; radiofrequency, microwave, cryoablation), transarterial (chemo)embolisation (TA(C)E), and transarterial radioembolisation (TARE) as therapeutic options for advanced adrenocortical carcinoma (ACC). However, the evidence for these recommendations is scarce. We retrospectively analysed patients receiving LTs for advanced ACC. Time to progression of the treated lesion (tTTP) was the primary endpoint. The secondary endpoints were best objective response, overall progression-free survival, overall survival, adverse events, and the establishment of predictive factors by multivariate Cox analyses. A total of 132 tumoural lesions in 66 patients were treated with LTA (n = 84), TA(C)E (n = 40), and TARE (n = 8). Complete response was achieved in 27 lesions (20.5%; all of them achieved by LTA), partial response in 27 (20.5%), and stable disease in 38 (28.8%). For the LTA group, the median tTTP was not reached, whereas it was reached 8.3 months after TA(C)E and 8.2 months after TARE (p 47 months. Fewer than four prior therapies and mitotane plasma levels of >14 mg/L positively influenced the tTTP. In summary, this is one of the largest studies on LTs in advanced ACC, and it demonstrates a very high local disease control rate. Thus, it clearly supports the guideline recommendations for LTs in these patients
Validation and application of caged Z-DEVD-aminoluciferin bioluminescence for assessment of apoptosis of wild type and TLR2-deficient mice after ischemic stroke
No full textProgrammed cell death or apoptosis is a critically important mechanism of tissue remodeling and regulates conditions such as cancer, neurodegeneration or stroke. The aim of this research article was to assess the caged Z-DEVD-aminoluciferin substrate for in vivo monitoring of apoptosis after ischemic stroke in TLR2-deficient mice and their TLR2-expressing counterparts. Postischemic inflammation is a significant contributor to ischemic injury development and apoptosis, and it is modified by the TLR2 receptor. Caged Z-DEVD-aminoluciferin is made available for bioluminescence enzymatic reaction by cleavage with activated caspase-3, and therefore it is assumed to be capable of reporting and measuring apoptosis. Apoptosis was investigated for 28 days after stroke in mice which ubiquitously expressed the firefly luciferase transgene. Middle cerebral artery occlusion was performed to achieve ischemic injury, which was followed with magnetic resonance imaging. The scope of apoptosis was determined by bioluminescence with caged Z-DEVD-aminoluciferin, immunofluorescence with activated caspase-3, flow cytometry with annexin-V and TUNEL assay. The linearity of Z-DEVD-aminoluciferin substrate dose effect was shown in the murine brain. Z-DEVD-aminoluciferin was validated as a good tool for monitoring apoptosis following adequate adjustment. By utilizing bioluminescence of Z-DEVD-aminoluciferin after ischemic stroke it was shown that TLR2-deficient mice had lower post-stroke apoptosis than TLR2-expressing wild type mice. In conclusion, Z-DEVD-aminoluciferin could be a valuable tool for apoptosis measurement in living mice
Inteligentne ideje iz Hrvatske: 20. rođendan ORPHEUS-a, organizacije za usklađivanje i poboljšanje doktorskih studija
No full textSram i namjerni pobačaj
No full textThis research endeavors to provide a thorough examination of the often underestimated but profoundly influential role of shame in the process of abortion decision-making. Despite its prevalence and the frequency of abortion procedures, conversations surrounding this topic remain clouded by stigma and societal taboos, which can significantly impact individuals' experiences and mental well-being. Through a meticulous analysis of existing literature and empirical data, this study aims to bridge the existing gap in understanding regarding abortion, elucidating the factors that influence individuals' decisions and the intricate emotional landscapes they navigate. Central to our investigation is the recognition of shame as a critical element in shaping attitudes towards abortion, both on individual and societal levels. By illuminating the complexities of this phenomenon we advocate for the importance of destigmatization efforts, the provision of comprehensive mental health support, and the cultivation of supportive environments that foster open and empathetic dialogue about abortion. Ultimately, our research underscores the imperative of prioritizing the voices and experiences of those directly affected, with the aim of fostering a more compassionate and inclusive society where individuals can make informed reproductive choices free from the burden of shame and judgment.Ovo istraživanje nastoji pružiti temeljitu analizu često podcijenjene, ali iznimno utjecajne uloge srama u procesu donošenja odluka o pobačaju. Unatoč njegovoj učestalosti i čestim postupcima pobačaja, razgovori o ovoj temi ostaju zasjenjeni stigmom i društvenim tabuima, što može značajno utjecati na iskustva pojedinaca i njihovo mentalno blagostanje. Kroz temeljitu analizu postojeće literature i empirijskih podataka, ovaj rad ima za cilj premostiti postojeću prazninu u razumijevanju pobačaja, razjašnjavajući složene čimbenike koji utječu na odluke pojedinaca i kompleksne emocije kroz koje prolaze. Središnji dio našeg istraživanja je prepoznavanje srama kao ključnog elementa u oblikovanju stavova prema pobačaju, kako na individualnoj tako i na društvenoj razini. Osvjetljivanjem složenosti ovog fenomena zagovaramo važnost destigmatizacije, te pružanje sveobuhvatne podrške mentalnom zdravlju i razvijanje okruženja koje potiče otvoren i empatičn dijalog o pobačaju. U konačnici, naše istraživanje ističe nužnost iznošenja stavova i iskustava onih koji su izravno pogođeni, s ciljem poticanja suosjećajnijeg i inkluzivnijeg društva u kojem pojedinci mogu donositi odluke o svom reproduktivnom zdravlju, bez tereta srama i osude