Veterinary medicine - Repository of PHD, master's thesis
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Association of BRAF V600E Mutant Allele Proportion with the Dissemination Stage of Papillary Thyroid Cancer
No full textThe early identification of aggressive forms of cancer is of high importance in treating papillary thyroid cancer (PTC). Disease dissemination is a major factor influencing patient survival. Mutation status of BRAF oncogene, BRAF V600E, is proposed to be an indicator of disease recurrence; however, its influence on PTC dissemination has not been deciphered. This study aimed to explore the association of the frequency of BRAF V600E alleles in PTC with disease dissemination. In this study, 173 PTC samples were analyzed, measuring the proportion of BRAF V600E alleles by qPCR, which was then normalized against the proportion of tumor cells. Semiquantitative analysis of BRAF V600E mutant protein was performed by immunohistochemistry. The BRAF V600E mutation was present in 60% of samples, while the normalized frequency of mutated BRAF alleles ranged from 1.55% to 92.06%. There was no significant association between the presence and/or proportion of the BRAF V600E mutation with the degree of PTC dissemination. However, the presence of the BRAF mutation was significantly linked with angioinvasion. This study’s results suggest that there is a heterogeneous distribution of the BRAF mutation and the presence of oligoclonal forms of PTC. It is likely that the BRAF mutation alone does not significantly contribute to PTC aggressiveness
Usporedba hemodijafiltracije i hemodijalize u pacijenata s terminalnom bubrežnom bolesti
No full textThe most common and widely used form of dialysis is hemodialysis. Throughout time new forms of dialysis and combinations out of existing methods were invented. The problem is where do the newer methods like hemodiafiltration fit in and which niche could they conquer. This study is a single center, case control study in a group of 68 patients with end stage renal disease (45 patients on hemodialysis, 25 patients on hemodiafiltration). We present structured analysis of in total 47 parameters, of which 43 were deemed essential for dialysis control and 4 counted as addition for an overview of inflammatory and cardiovascular biomarkers. The results indicate that hemodialysis and hemodiafiltration performed in our Department are equal methods regarding removal of uremic toxins, showing no significant differences in clearance ratios. Major differences were observed in N-Terminal pro Brain-type Natriuretic Peptide, which showed an increased net filtration in the patients treated with hemodiafiltration compared to hemodialysis (p.adj = 0.00073). Out of 68 patients, 53 of them had relevant comorbidities (68.8% in hemodialysis group and 92.0% in hemodiafiltration group), with no statistically significant difference between the groups. Hemodiafiltration provides an alternative to hemodialysis regarding the removal of uremic toxins with similar clinical efficacy. There are potential benefits of performing hemodiafiltration in patients with end stage renal disease and comorbidities affecting the cardiovascular system compared to patients receiving hemodialysis. The outcome shown by NT-proBNP levels may lead to the suggestion that hemodiafiltration should be preferred in patients with active cardiovascular disease.Najčešće korišteni oblik dijalize je hemodijaliza. Tijekom vremena razvijali su se novi oblici dijalize te kombinirale već postojeće metode. Postavlja se pitanje gdje smjestiti novije metode kao što je hemodijafiltracija te koji postojeći oblik dijalize bi one mogle zamijeniti. U ovom radu opisana je slučaj-kontrola studija u koju je uključeno 68 bolesnika s terminalnom bubrežnom bolesti liječenih dijalizom u KB Dubrava (45 bolesnika hemodijalizom, 25 bolesnika hemodijafiltracijom). Prikazani su podaci o ukupno 47 promatranih parametara od kojih se njih 43 smatra ključnim za kontrolu dijalize, a ostalih 4 pripada skupini inflamatornih i kardiovaskularnih biomarkera. Nakon analize dobijenih rezultata može se zaključiti kako su hemodijaliza i hemodijafiltracija u našoj ustanovi jednako uspješne metode za odstranjivanje uremijskih toksina (nije nađena statistički značajna razlika među klirensima). Najznačajnije razlike uočene su u koncentraciji NT-proBNP-a gdje se vidi veća neto filtracija kod bolesnika koji su liječeni hemodijafiltracijom u usporedbi s hemodijalizom (p.adj = 0.00073). Od ukupno
68 bolesnika njih 53 je imalo značajne komorbiditete (69.8% u skupini hemodijalize te 92.0% u skupini hemodijafiltracije), bez statistički značajne razlike između skupina. Hemodijafiltracija se pokazala kao alternativa hemodijalize s obzirom na uklanjanje uremijskih toksina s gotovo jednakim kliničkim ishodima. Postoje određene prednosti korištenja hemodijafiltracije kod bolesnika s terminalnom bubrežnom bolesti i komorbiditetima koji zahvaćaju srce i krvožilni sustav u usporedbi s hemodijalizom. Iz usporedbe razina NTproBNP- a može se zaključiti kako bi metoda izbora kod tih bolesnika možda trebala biti hemodijafiltracija
MEDBUSTER: Kreme, injekcije i suplementi kolagena - jesu li učinkoviti ili ne
No full textSTUDMEF-ov novi projekt MEDBUSTER: Stručno mišljenje vs zablude i mitovi o zdravlju!
U svijetu prepunom informacija i dezinformacija, teško je razlučiti činjenice od zabluda i mitova, posebno kada se radi o zdravlju i medicini. Upravo zato uredništvo STUDMEF-a s Medicinskog fakulteta Sveučilišta u Zagrebu pokreće novi projekt pod nazivom Studmefov MEDBUSTER. Projekt ima za cilj ponuditi javnosti stručna i na dokazima utemeljena objašnjenja najkontroverznijih zdravstvenih tema koje su često predmet rasprava i pogrešnih interpretacija.
Što je MEDBUSTER?
MEDBUSTER je projekt kroz koji će vrhunski stručnjaci iz područja medicine i javnog zdravstva analizirati i objašnjavati teme koje se u javnom prostoru često pogrešno tumače ili su obavijene mitovima. To su teme koje izazivaju interes javnosti i zbog kojih nastaju zablude koje nerijetko ugrožavaju zdravlje ljudi. MEDBUSTER će nastojati razjasniti činjenice koje stoje iza tih tema, pri čemu će se oslanjati isključivo na znanstvene dokaze.
Zašto je MEDBUSTER potreban?
Danas se sve više ljudi okreće "narodnim lijekovima" i nekonvencionalnim oblicima liječenja, koji često nisu znanstveno dokazani. Razne tvrdnje, od liječenja ozbiljnih bolesti prirodnim pripravcima, preko navodnih „čudotvornih“ dijeta, do razumijevanja pandemijskih mjera, stvaraju zbrku i ponekad potiču opasne zdravstvene prakse. Kroz MEDBUSTER, stručnjaci će nastojati iznijeti jasna i stručna mišljenja na ove teme, bez namjere za polemiziranjem, već isključivo kako bi informirali javnost.
Stručnjaci na čelu borbe protiv dezinformacija
Uredništvo STUDMEF-a planira pozivati stručnjake koji će u okviru projekta iznositi svoja mišljenja i stavove o aktualnim medicinskim pitanjima. Od vodećih liječnika specijalista, znanstvenika iz područja bazične i kliničke medicine, nutricionista, do stručnjaka za mentalno zdravlje i javno zdravstvo – MEDBUSTER će pokrivati širok spektar tema. Oni će putem jednostavnih i javnosti razumljivih predavanja, intervjua i prezentacija objasniti složene procese i razbiti zablude koje mogu ugroziti zdravlje.
Ne polemika, već stručna mišljenja
MEDBUSTER se neće baviti polemikama. Cilj je ponuditi argumente i činjenice, ostavljajući svakome na volju da odluči želi li prihvatiti ono što stručnjaci predlažu. Projekt se ne bavi uvjeravanjem, već služi kao edukativni izvor kojem se može pristupiti kako bi se čuli stavovi stručnjaka. Riječ je o doprinosu javnom zdravlju, kroz koji će MEDBUSTER, bez pritiska i nametanja mišljenja, pružiti korisne informacije temeljene na medicinskim istraživanjima i znanstvenim činjenicama.
Uloga javnosti
Javnost se također poziva na interakciju s MEDBUSTER-om. Pitanja koja izazivaju najviše interesa a uredništvo ih smatra relevantnim bit će proslijeđena stručnjacima, koji će kroz projekt nuditi odgovore i rasvjetljavati medicinske teme o kojima postoji široko rasprostranjena, ali često pogrešna percepcija
Methodological Pitfalls of Investigating Lipid Rafts in the Brain: What Are We Still Missing?
No full textThe purpose of this review is to succinctly examine the methodologies used in lipid raft research in the brain and to highlight the drawbacks of some investigative approaches. Lipid rafts are biochemically and biophysically different from the bulk membrane. A specific lipid environment within membrane domains provides a harbor for distinct raftophilic proteins, all of which in concert create a specialized platform orchestrating various cellular processes. Studying lipid rafts has proved to be arduous due to their elusive nature, mobility, and constant dynamic reorganization to meet the cellular needs. Studying neuronal lipid rafts is particularly cumbersome due to the immensely complex regional molecular architecture of the central nervous system. Biochemical fractionation, performed with or without detergents, is still the most widely used method to isolate lipid rafts. However, the differences in solubilization when various detergents are used has exposed a dire need to find more reliable methods to study particular rafts. Biochemical methods need to be complemented with other approaches such as live-cell microscopy, imaging mass spectrometry, and the development of specific non-invasive fluorescent probes to obtain a more complete image of raft dynamics and to study the spatio-temporal expression of rafts in live cells
Respiracijska membrana i difuzija plinova
No full textPredavanje na temu respiracijske membrane i difuzije plinov
Possible marfanoid habitus of Cesare Alessandro Scaglia di Verrua evidenced in portraits of Sir Anthony van Dyck?
No full textEffects of Tai Chi exercise on pain, functional status, and quality of life in patients with osteoarthritis or inflammatory arthritis
No full textObjectives: This study aims to assess the impact of a Tai Chi exercise program (TCEP) on pain, spinal flexibility, muscle strength, stability and balance, functional status, and quality of life (QoL) among home-dwelling patients with osteoarthritis (OA) or inflammatory arthritis (iA).
Patients and methods: Between October 2018 and April 2019, a total of 28 participants (4 males, 24 females; median age: 62 years; range, 34 to 79 years) who completed the training program participating in at least 18 sessions were included. The TCEP consisted of 50 sessions for 60 min twice a week. The average attendance rate was high (78%, 39 sessions).
Results: Chest mobility (breathing index, p<0.001), sagittal mobility of cervical (p<0.001), thoracic (p=0.009), and lumbar spine (Schober's test, p<0.001) improved significantly in participants with OA and iA. The improvement in functional status was significant only in participants with OA (Lequesne index, p=0.014). Although the change in Lequesne index was statistically significant, the median value remained in the range of severe disability and the change did not reach the minimal clinically important difference. Although the trends were positive, the changes in pain (Visual Analog Scale pain, p=0.599), stability and balance (functional reach test, p=0.341), muscular strength (wall sit test, p=0.069), and health-related QoL (15D, p=0.065) were non-significant in participants with OA and iA.
Conclusion: Our study results suggest that a 25-week TCEP is safe and can improve chest and spinal mobility in home-dwelling individuals with OA or iA
Huppke-Brendel syndrome: Novel cases and a therapeutic trial with ketogenic diet and N-acetylcysteine
No full textHuppke-Brendel syndrome (HBS) is an autosomal recessive disorder caused by SLC33A1 mutations, a gene coding for the acetyl-CoA transporter-1 (AT-1). So far it has been described in nine pediatric and one adult patient. Therapeutic trials with copper histidinate failed to achieve any clinical improvement. Here, we describe the clinical characteristics of two novel patients, one of them diagnosed by gene analysis and his sib postmortally based on clinical characteristics. We demonstrate a therapeutic trial with acetylation therapy, consisting of N-acetylcysteine and ketogenic diet, in one of them. We provide biochemical data on N-acetylated amino acids in cerebrospinal fluid (CSF) and plasma before and after starting this treatment regimen. Our results indicate that ketogenic diet and N-acetylcysteine do not seem to normalize the concentrations of N-acetylated amino acids in CSF or plasma. The overall metabolic pattern shows a trend toward lowered levels of N-acetylated amino acids in CSF and to a lesser extent in plasma. Although there are some assumptions, the function of AT-1 is still not clear and further studies are needed to better understand mechanisms underlying this complex disorder
Stanford A aortic dissection 40 years after aortic valve replacement with a Starr–Edwards caged-ball prosthesis: a case report
No full textStanford A aortic dissection is one of the most devastating acute medical conditions due to its high morbidity and mortality. We describe a 77-year-old male patient with a medical history of surgical aortic valve replacement with a still functioning Starr-Edwards caged-ball valve 40 years prior. The patient was promptly diagnosed with an ascending aortic aneurysm and dissection, and an emergency Bentall procedure in deep hypothermic circulatory arrest was performed. This is, to the best of our knowledge, the first Stanford A dissection case described in the literature in a patient with Starr-Edwards valve, and the longest still functioning caged-ball valve to have been replaced with the Bentall procedure. We also discuss the caged-ball valve's unfavorable hemodynamics as a potential predisposing factor of the dissection, as well as the patient's supposed initial bicuspid aortic valve disease which could also predispose to aortic aneurysm formation and dissection
Wearing surgical face mask has no significant impact on auscultation assessment
No full textObjective: During the COVID-19 pandemic, universal mask-wearing became one of the main public health interventions. Because of this, most physical examinations, including lung auscultation, were done while patients were wearing surgical face masks. The aim of this study was to investigate whether mask wearing has an impact on pulmonologist assessment during auscultation of the lungs.
Methods: This was a repeated measures crossover design study. Three pulmonologists were instructed to auscultate patients with previously verified prolonged expiration, wheezing, or crackles while patients were wearing or not wearing masks (physician and patients were separated by an opaque barrier). As a measure of pulmonologists' agreement in the assessment of lung sounds, we used Fleiss kappa (K).
Results: There was no significant difference in agreement on physician assessment of lung sounds in all three categories (normal lung sound, duration of expiration, and adventitious lung sound) whether the patient was wearing a mask or not, but there were significant differences among pulmonologists when it came to agreement of lung sound assessment.
Conclusion: Clinicians and health professionals are safer from respiratory infections when they are wearing masks, and patients should be encouraged to wear masks because our research proved no significant difference in agreement on pulmonologists' assessment of auscultated lung sounds whether or not patients wore masks