1,721,021 research outputs found
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
EPIDEMIOLOGICAL AND CLINICAL FEATURES OF SYPHILIS PATIENTS IN THE CLINICAL HOSPITAL CENTER RIJEKA FROM 2009 TO 2018
Full text linkSifilis je spolno prenosiva bolest (SPB) uzrokovana spirohetom Treponema pallidum karakterizirana dugim kliničkim tijekom u kojem se kroz period od deset i više godina izmjenjuje nekoliko stadija: primarni, sekundarni, rani i kasni latentni te tercijarni sifilis. Svrha ovog rada je ispitati pojavnost te klinička obilježja ove SPB u bolesnika dijagnosticiranih pri Kliničkom bolničkom centru Rijeka tijekom posljednjeg desetljeća kako bi se dobile informacije o regionalnim epidemiološkim i kliničkim obilježjima ove bolesti. U periodu od 2009. do 2018. godine, bolest je dijagnosticirana u 74 osobe i to većinom muškaraca (n=58, 78%). Prosječna dob bolesnika bila je 38.23 godine s medijanom 34 godine. Za usporedbu su analizirani i bolesnici dijagnosticirani u periodu od 1989. do 2008. godine, njih 304, od čega 186 muškaraca (61%) i 118 žena (39%). Uvidom u epidemiološke anamneze dostupne za 32 bolesnika, 7 bolesnika (22%) je navelo da su prije pojave simptoma imali rizični, nezaštićeni spolni odnos, a 8 (25%) se izjasnilo kao muškarci koji imaju spolne odnose sa muškarcima (MSM). U primarnom stadiju otkriveno je 7 (11%) bolesnika, 24 (39%) u sekundarnom, 22 u latentnom (35%) i niti jedan u tercijarnom stadiju. Svi bolesnici koji su bili dostupni za praćenje, njih 34 (64%), pokazali su zadovoljavajući pad serološkog titra na kontroli za 3 mjeseca od liječenja i njihova se bolest smatra izliječenom. Zaključci ovog rada su da incidencija sifilisa stagnira, ali se smanjila u odnosu na prošlih 30 godina. Najčešća pojavnost je među rizičnim skupinama, posebice MSM.Syphilis is a sexually transmitted disease (STD) caused by spirochete bacterium Treponema pallidum characterized by a long clinical course in which, over a period of more than ten years, alternate several stages: primary, secondary, early and late latent and tertiary syphilis. The purpose of this paper is to examine the incidence and clinical features of syphilis in patients diagnosed at the Clinical Hospital Center of Rijeka over the last decade with the aim of providing information on the current regional epidemiologic and clinical features of this STD. In the period from 2009 to 2018, 74 subjects were diagnosed with syphilis, out of which 58 males (78%) and 16 females (22%) with an average age of 38.23 years and median 34 years. For comparison, in the period from 1989 to 2008, there were 304 new cases of syphilis, out of which 186 men (61%) and 118 women (39%). Based on the epidemiological data available for 32 patients, 7 (22%) indicated a prior unprotected sexual intercourse, and 8 (25%) declared themselves as men who have sex with men (MSM). Clinically, 7 (11%) patients were detected in the primary stage, 24 (39%) in the secondary, 22 in latent (35%), and none in the tertiary stage. All patients who were available for follow-up, 34 (64%) of them, showed a satisfactory drop in control serological titers 3 months after treatment and their disease is considered cured. Conclusions are that the incidence of syphilis stagnates but has decreased compared to the previous 30 years. The most common occurrence is among the higher risk groups, especially the MSM
Cutaneous manifestations of polycystic ovary syndrome and their management : graduation thesis
No full textPolycystic ovarian syndrome is a complicated and prevalent metabolic condition affecting
women of childbearing years. The pathophysiology is not fully understood. The thesis focuses
on the complex relationship between PCOS and dermatological conditions. The emphasis is
on understanding how PCOS affects the state of the skin, resulting in acne, hirsutism, and
baldness. The fundamental hormonal disturbances and inflammation mechanisms that cause
those cutaneous conditions in PCOS individuals are reviewed. Furthermore, numerous therapy
approaches, spanning from hormone medications to lifestyle changes, are being evaluated for
their effectiveness in treating PCOS-related skin issues. The emphasis is on encouraging
interaction among dermatologists and endocrinologists in order to customize therapies and
improve the general health of those who suffer from PCOS-related skin symptoms
Dermatologic manifestations of inflammatory bowel disease
No full textU spektru upalnih bolesti crijeva razlikujemo ulcerozni kolitis, Crohnovu bolest te intermedijarni oblik bolesti. Radi se o idiopatskoj, upalnoj bolesti kroničnog tijeka koja zahvaća probavni sustav uz česte ekstraintestinalne manifestacije. Incidencija upalne bolesti crijeva u porastu je na globalnoj razini. Unatoč brojnim istraživanjima, etiopatogeneza još nije u potpunosti razjašnjena. Prema dosadašnjim saznanjima, kronična upalna bolest crijeva posljedica je interakcije između genetske predispozicije domaćina, crijevnog mikrobioma, okolišnih čimbenika te abnormalnog imunološkog odgovora. Ekstraintestinalne manifestacije IBD-a javljaju se u 25% do 40% oboljelih, a najčešće zahvaćaju muskuloskeletni sustav, kožu, hepatobilijarni trakt te oči. Dermatološke manifestacije IBD-a se na temelju patogeneze mogu podijeliti u 4 kategorije: 1) dermatološke manifestacije s istim histološkim značajkama kao i temeljna bolest crijeva, 2) reaktivne dermatološke manifestacije zbog aktivacije imunoloških mehanizama na iste antigene crijeva i kože, 3) mukokutane manifestacije povezane sa IBD-om, 4) kožne poremećaje ili dermatoze povezane s IBD-om. Najčešće dermatološke manifestacije vidljive u sklopu upalne bolesti crijeva su erythema nodosum, pyoderma gangrenosum te aftozni stomatitis. Rjeđe se javljaju Sweetov sindrom, sindrom dermatoze-artritisa povezan sa crijevima, metastatska Crohnova bolest te stečena bulozna epidermoliza. Neke kožne manifestacije izravno su povezane s aktivnošću osnovne bolesti te adekvatnim liječenjem upalne bolesti crijeva dolazi do regresije kožnih promjena. Kožne manifestacije koje nisu osu neovisne o aktivnosti IBD-a zahtijevaju multidisciplinarni tim te dodatnu terapiju.The spectrum of inflammatory bowel diseases includes ulcerative colitis, Crohn's disease and unclassified inflammatory bowel disease. It is an idiopathic, chronic inflammatory disease that affects the digestive system with frequent extraintestinal manifestations. The incidence of IBD is increasing globally. Despite numerous studies, the etiopathogenesis is still not fully understood. According to current knowledge, chronic intestinal inflammation is the result of the interaction between the genetic predisposition of the host, the intestinal microbiota, external environmental factors and an abnormal immune response. Extraintestinal manifestations of IBD occur in 25% to 40% of patients and most commonly affect the musculoskeletal system, skin, hepatobiliary tract and eyes. Based on the pathogenesis, the dermatological manifestations of IBD can be divided into 4 categories: 1) dermatological manifestations with the same histological features of underlying IBD, 2) reactive manifestations of IBD due to immunological response to common antigens shared by gut bacteria and skin, 3) mucocutaneus manifestations associated with IBD, 4) skin disorders or dermatoses associated with IBD. The most common dermatological manifestations of inflammatory bowel disease are erythema nodosum, pyoderma gangrenosum and aphthous stomatitis. Sweet's syndrome, bowel-associated dermatosis-arthritis syndrome, metastatic Crohn's disease and acquired epidermolysis bullosa occur less frequently. Some skin manifestations are directly related to the activity of the underlying disease and adequate treatment of IBD leads to regression of skin changes. Skin manifestations that are independent of IBD require multidisciplinary team and additional therapy
Oral Janus kinase inhibitors in the treatment of atopic dermatitis - experience from the Clinical hospital center Rijeka
No full textUvod: Atopijski dermatitis česta je kronično recidivirajuća upalna bolest kože čija je patogeneza
vrlo složena i uvjetovana brojnim faktorima. Klinička slika značajno varira, a dominantni je
simptom intenzivni svrbež koji ima značajan utjecaj na kvalitetu života bolesnika, ali i njihovih
članova obitelji. Zahvaljujući sve boljem razumijevanju patofiziologije, pojavljuju se nove,
sigurne i ciljane, terapijske mogućnosti, među kojima, prema dosadašnjim istraživanjima, oralni
JAK inhibitori obećavaju svojom učinkovitošću i dobrim sigurnosnim profilom.
Cilj: Sveobuhvatna procjena ishoda primjene oralnih JAK inhibitora kod pacijenata s AD-om
liječenih u KBC-u Rijeka do svibnja 2023.godine.
Ispitanici i metode: Retrospektivno su analizirani klinički i laboratorijski parametri bolesnika s
AD-om liječenih baricitinibom ili upadacitinibom u razdoblju od odobrenja do svibnja 2023.
godine u KBC-u Rijeka. Težina bolesti, kao i terapijski učinak procijenjeni su pomoću
SCORAD/EASI i DLQI indeksa.
Rezultati: U ispitivanom je razdoblju 10 pacijenata primjenjivalo baricitinib. Srednji SCORAD
rezultat na početku bio je 62,2. U 8 tjedana 9 od 10 pacijenata je postiglo smanjenje od barem 50%
(ili više) SCORAD vrijednosti, kod jednog pacijenta nije zabilježen željeni terapijski odgovor
(smanjenje SCORAD indeksa od barem 50%) posljedično neredovitom uzimanju lijekova, ali je
značajno poboljšanje nastupilo nakon dodatna 4 tjedna. U dvoje pacijenata primijećen je rani
gubitak učinkovitosti terapije, radi čega su prebačeni na terapiju upadacitinibom. Kod preostalih
bolesnika, bolest je kod njih 5 zahvaljujući terapiji održana pod kontrolom, uz samo povremene
blage recidive koji su se povukli nakon primjene topikalne terapije emolijensima ili lokalnim
kortikosteroidima srednje jakosti. Kod jednog pacijenta došlo je do klinički značajnog pogoršanja,
radi kojeg je hospitaliziran, nakon 16 mjeseci, ali je brzo po primjeni lokalnih kortikosteroida uz
nastavak sustavne terapije došlo do poboljšanja. Kod jednog je pacijenta nakon 9 mjeseci došlo do
značajnog porasta DLQI vrijednosti, zbog čega je prebačen na upadacitinib. Nekoliko pacijenata
razvilo je blaže nuspojave koje nisu zahtijevale prekid terapije: jedan je imao asimptomatsku
mikrohematuriju, drugi je imao blage akne, a 2 pacijenta prijavila su dispeptičke simptome. Jedan
pacijent prezentirao se s povišenim brojem trombocita, a 6 pacijenata imalo je asimptomatsko
povećanje razine kreatin kinaze. Pet bolesnika imalo je povišenje kolesterola, a jedan prolazno
povećanje triglicerida.
Šest pacijenata je u ispitivanom razdoblju primjenjivalo upadacitinib u minimalnom razdoblju od
12 tjedana. Kod svih 6 je došlo do najmanje 50% poboljšanja SCORAD vrijednosti unutar 8
tjedana od početka primjene lijeka. Kod jedne je pacijentice nakon 12 tjedana zabilježeno značajno
pogoršanje, radi čega je terapija prekinuta. Među preostalim pacijentima, kod dvije je osobe
postignuta potpuna kontrola bolesti (SCORAD=0, DLQI=0), a kod tri je postignuto i održano
značajno poboljšanje. Kod dva pacijenta došlo je do pogoršanja akni, a blagu je neutropeniju
razvilo također dvoje pacijenata.
Zaključak: Obzirom da je u većine naših pacijenata po primjeni terapije brzo postignuto i
dugotrajno održano kliničko poboljšanje, uz odsustvo značajnih nuspojava, do sada prikupljena
iskustva u KBC-u Rijeka podupiru daljnju uporabu JAK inhibitora kao vrlo učinkovitih i sigurnih
terapijskih opcija za bolesnike oboljele od teškog AD-a.Introduction: Atopic dermatitis is a common, chronically recurrent inflammatory skin disease
characterized by a heterogenous clinical presentation and complex pathogenesis. Itch is the
hallmark symptom of the disease and it has a huge impact on the quality of life of the patients, as
well as their families. Thanks to a better understanding of pathophysiology, safe and targeted
treatment options are emerging and for now, JAK inhibitors hold great promise due to their
efficacy and safety profile.
Goal: We aimed to assess the overall outcomes with the use of these drugs in AD patients treated
at the Clinical Hospital Center Rijeka (CHCR) until May 2023.
Materials and methods: We retrospectively reviewed clinical and laboratory parameters of patients
with AD treated with baricitinib or upadacitinib in the period from approvals until May 2023 at
the CHCR. Disease severity and therapeutic response were assessed by the SCORAD/ EASI and
DLQI index.
Results: In the examined period, 10 patients were prescribed baricitinib. Mean SCORAD score at
baseline was 62.2. At 8 weeks 9 out of 10 patients achieved a reduction of at least 50% (or better)
in SCORAD; one patient that did not achieve it reported irregular usage of medication, but
achieved it after additional 4 weeks of treatment. Two patients experienced early loss of efficacy
at 12 weeks and were therefore switched to upadacitinib. Five of the remaining 8 patients, have
sustained disease control, with only occasional mild recurrences that resolved upon treatment with
emollients or mid-potency topical corticosteroids, while one patient experienced late loss of
efficacy (increase in DLQI) after 9 months and was also switched to upadacitinib. One patient was
hospitalized after 16 months due to clinically significant exacerbation, but symptoms resolved
upon the admission of TCS and with continuation of systemic treatment with baricitinib.
Several patients developed mild side effects which did not require discontinuation of therapy: one
had asymptomatic microhematuria, another one had mild acne and 2 patients reported dyspeptic
symptoms. One patient presented with an elevation in platelet count, and 6 patients had
asymptomatic increases of creatine kinase levels. Five patients had an increase in cholesterol and
one patient had transient increase in triglycerides.
Six patients were prescribed upadacitinib and have been using it for at least 12 weeks. All of them
experienced at least 50% improvement in SCORAD within the first 8 weeks. One patient,
previously treated with baricitinib, experienced early loss of efficacy which is why she
discontinued treatment. From the 5 remaining patients, 3 of them achieved and maintained
significant improvement and 2 of them achieved complete disease control (SCORAD=0,
DLQI=0). Two of the patients experienced worsening of acne, and 2 patients had mild neutropenia.
Conclusion: Based on the rapid and maintained clinical improvement observed in the majority of
our patients and the lack of significant side effects, the experience gathered so far supports further
use of JAK inhibitors as highly efficient and well-tolerated therapeutic options for patients with
severe AD
Teški oblici medikamentoznih egzantema
No full textTeški oblici medikamentoznih egzantema su rijetke, nepredvidive, vjerojatno imunološkim mehanizmima posredovane reakcije na lijekove, praćene značajnim morbiditetom i mortalitetom, a obično zahtijevaju hospitalno liječenje. Potrebno ih je na vrijeme prepoznati i odmah prekinuti primjenu uzročnog lijeka, uz provedbu odgovarajuće potporne i eventualno sistemske imunomodulacijske terapije. Stevens-Johnsonov sindrom i toksična epidermalna nekroliza su teške bulozne reakcije koje se međusobno razlikuju po stupnju zahvaćenosti kože, a karakterizirane su značajnim gubitkom epidermisa, uz mogućnost zahvaćanja sluznica kao i sistemskim simptomima. Mortalitet je visok, a preživjeli često imaju posljedice koje bitno narušavaju kvalitetu života. AGEP je febrilna erupcija karakterizirana brojnim malim pustulama na edematozno-eritematoznoj podlozi. Osip se spontano povlači unutar 1-2 tjedna, obično uz superficijalnu deskvamaciju. Prognoza bolesti je povoljna, bez daljnjih posljedica. DRESS karakterizira dugi period latencije nakon čega slijedi čitav niz srednje teških do teških kliničkih manifestacija uključujući vrućicu, osip, limfadenopatiju, oštećenje jetre, bubrega te potencijalno i drugih unutarnjih organa. Ishod bolesti varira od potpunog oporavka do trajnih sistemskih posljedica, a najčešći uzrok smrti je hepatitis. Ostali teški medikamentozni egzantemi uključuju generaliziranu fiksnu erupciju izazvanu lijekovima, antikoagulansima induciranu nekrozu koţe, lijekovima induciranu eritrodermiju i anafilaksiju.Severe cutaneous adverse drug reactions are rare, non-predictable, probably of immunological mechanism drug induced reactions, associated to a significant morbidity and mortality and usually leading to hospitalization. Early recognition and withdrawal of the causative drug is mandatory, while providing adequate supportive therapy with systemic immunomodulatory treatments if necessary. Stevens-Johnson syndrome and toxic epidermal necrolysis are severe bullous reactions that differ from each other in the level of skin detachment and are characterized by a great loss of epidermis, mucous membrane involvement and systemic symptoms. Mortality rate is high and surviving patients often suffer from sequelae that impair seriously their quality of life. AGEP is a febrile eruption characterized by numerous small pustules that arise on a widespread edematous erythema. They resolve spontaneously within 1-2 weeks, typically followed by a superficial desquamation. Prognosis is good, usually without any consequences. DRESS is characterized by a prolonged latency period, followed by a variety of clinical manifestations including fever, rash, lymphadenopathy, liver and kidney damage as also other visceral organs involvement. Outcome of the disease varies from the complete recovery to permanent systemic complications. Hepatitis is the most common cause of death. Other severe cutaneous adverse drug reactions include generalized fixed drug eruption, anticoagulant-induced skin necrosis, anaphylaxis and drug-induced erythroderma
MELANOCYTIC NEVI
No full textMelanocitni nevusi (madeži) su dobroćudne pigmentirane promjene koje najčešće predstavljaju samo estetsko obilježje, za razliku od malignog melanoma koji je potencijalno smrtonosan. Zbog moguće maligne alteracije, kao i zbog ponekad teškog razlikovanja dobroćudnog nevusa od zloćudnog melanoma, melanocitni nevusi predstavljaju jedno od najvažnijih područja dermatologije odnosno dermatološke onkologije. Postoji više podjela melanocitnih nevusa, a ona osnovna je na prirođene i stečene. Histološki se, temeljem distribucije melanocitnih nakupina u koži, nevusi dijele na junkcijske, složene i dermalne. Prema morfološkim obilježjima vidljivim dermatoskopom, nevusi mogu biti retikularni, globularni, zvjezdasti, bestrukturni (plavi), nevusi uvjetovani lokalizacijom, nevusi posebnih karakteristika i drugih podtipova. Često je prisutno preklapanje karakteristika između različitih skupina nevusa, prvenstveno zbog njihovog mijenjanja tijekom života, pa je jasne granice ponekad teško definirati. Nevusi su pod utjecajem okolišnih (ultraljubičaste zrake), hormonskih i genetskih čimbenika. Neki od njih podliježu promjenama, stoga ih je potrebno redovito pratiti, osobito jer se, prema podatcima različitih istraživanja, nešto više od 25% melanoma razvija iz melanocitnih nevusa. Poznavanje kliničkih i dermatoskopskih obilježja melanocitnih nevusa izuzetno je važno radi adekvatnog praćenja postojećih nevusa s ciljem što ranije dijagnostike melanoma.Melanocytic nevi are benign pigmented proliferations that most often represent only an aesthetic feature, as opposed to malignant melanoma that is potentially fatal. Because of the possibility of malignant transformation, and due to occasionally difficult differentiation between benign nevi and malignant melanoma, melanocytic nevi represent one of the most important areas of dermatology and dermatological oncology. There are several classification schemes of melanocytic nevi, but they can be basically divided into congenital and acquired. Histologically, based on the distribution of melanocytes within the skin layers, nevi are divided into junctional, compound and intradermal. In accordance with the morphological features visible with dermatoscope, nevi can be divided into reticular, globular, starburst, homogenous (blue) nevi, nevi of special sites, nevi with special characteristics, and other subtypes. There is often a certain amount of overlap between different groups of nevi, primarily due to the alterations occuring within melanocytic lesions in course of a lifetime, so that clear boundaries are oftentimes difficult to define. Nevi are influenced by the environmental (exposure to ultraviolet light), hormonal and genetic factors. Nevi need to be monitored regularly, especially since, according to various studies, slightly more than 25% of melanomas develop from melanocytic lesions. Knowledge of the clinical and dermatoscopic features of melanocytic nevi is extremely important for their adequate monitoring with the aim of early diagnosis of melanom
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