26 research outputs found
Could Tranexamic Acid Bias the Optimal Ratio of Fresh Frozen Plasma to Red Blood Cells During Massive Transfusion?—Reply
No full textGoat on the Istrian Coat of Arms Towards the Knowledge of the Historical Background of the Coat of Arms and the Istrian Goat-Breeding
No full textU članku se analiziraju podaci o istarskom grbu, kako iz heraldičke literature, tako i iz ostalih raznorodnih izvora. Uglavnom se radi o oskudnim i današnjem čitatelju teško razumljivim prilozima, već i stoga što su bili namijenjeni ciljanoj, upućenoj publici. Posebnu poteškoću predstavljaju tekstovi, a takvih je većina, u kojima izneseni podaci o grbu nisu uopće ili nisu izravno dokumentirani. Stoga se, npr., pretpostavka o vremenu njegova nastanka, a podaci potvrđuju da ga je prvotno koristila Mletačka Republika, temelji na prikazu ovog grba s jedne strane na mletačkim, a s druge na zemljopisnim kartama ostalih europskih kartografa. Iznesena je i pretpostavka o tome kada ga je preuzela Austrija.
Članak također razmatra popularno tumačenje, koje su sugerirali i neki autori, a neki ga smatraju tako očitim da mu argumentacija nije ni potrebna. Naime, da je ova domaća životinja imala iznimno važnu ulogu u istarskoj povijesti (kulturi, umjetnosti, religiji i gospodarstvu), što je dovelo do toga da postane obilježjem u grbu.Since 1990, Republic of Croatia has a new coat of arms. What is actually new is only its composition, while its constituent parts are historical Croatian coats of arms, including the Istrian one. Little is known about Istrian coat of arms, but a vague belief that it is an old feature of Istria is prevalent.
This paper presents contributions on the coat of arms that the author has found so far, mostly descriptions of simple figures and tinctures. Discovered examples of the coat of arms show various deviations in detail of its execution. A change of a simple figure in l915 has also been documented, and from that point on, it was no longer a she-goat but a he-goat.
The origin of this coat of arms is still an open issue, as well as the exact date of its origin and related details. The author explained her assumption that it didn't exist prior to the 17th century.
She was also interested whether the assumption that the goat was on the coat of arms because it was especially important for the existence of people in the past, and that it therefore left trace in religious life, language, monuments and various visual arts, could be proved. These traces probably wouldn't exist if the goats weren't so numerous. The data we presently have at our disposal affirm explicit importance and numerousness of goats in the history of Istria. They particularly left trace in the culture of Ćići (Istro-Romanians), specifically in their speech concerning the names of certain cattle-raising buildings.
Croatian ethnologist A. Stojanović, who recognised the existence of particular goat-breeding layer in the Adriatic and parts of Mediterranean in regards to cattle raising in general, defined one technical detail as a criterion for belonging to that particular layer. Namely, the fact that sheep are not milked, but that goats are milked instead, as is the case on the island of Mljet, but that was not confirmed in Istria, and there was no confirmation that goat milk had been considerably represented in nourishment which is a regular feature of the goat-breeding layer in question.
The author however feels that the role of the goat in the Istrian economy and tradition didn't necessarily have to be so strong in order for it to become a trademark in the coat of arms. So far none of the official documents that would prove that choice are known.
Data found have shown that this coat of arms had been officially used for Istria since the second part of the 17th century merely as a figure in primary Venetian and later Austrian official documents. The confirmation of using the coat of arms in the field work dates back only to the early 20th century.
So far the least known aspect of this emblem, i. e. the goat as a simple figure, have been its national implications. Namely, in Stemmatographia by Vitezović from the early 18th century this Istrian coat of arms is represented among the Illyrian, therefore, according to Vitezović, Croatian coats of arms. In addition, it is left for the future to cast the light on the part of the history of this emblem, in which the goat became Italian-irredentist-fascist symbol late in the 19th and in the early 20th century
Pneumothoraces on Computed Tomography Scan: Observation using the 35 Millimeter Rule is Safe
No full textABSTRACT Introduction The management of a pneumothorax (PTX) either by observation or with a tube thoracostomy (TT) has long been dictated by practitioner discretion rather than objective criteria. Many physicians elect to routinely place a TT for traumatic PTX, particularly when patients undergo positive pressure ventilation (PPV). Placement of unnecessary TT exposes patients to avoidable morbidity and may prolong hospitalization. Based on prior work establishing a cutoff, we hypothesized that all PTXs ≤35 mm in patients who have no physiologic derangement may be safely observed without TT regardless of the need for PPV. Materials and methods Retrospective review of all patients diagnosed with a PTX between 1/2009 and 2/2013. All PTXs visible on chest computed tomography (CT) were identified. Any patient with an associated significant hemothorax or those patients who were moribund were excluded. All PTXs were measured by measuring the perpendicular distance of the largest air pocket between the chest wall and the mediastinal or pulmonary structure. Management of the PTX was categorized as observation or TT. Observed PTXs were labeled as success or failure with failure defined as enlargement of the PTX or physiologic deterioration, requiring a TT. Results Out of 165 PTXs, 17 (10.3%) measured >35 mm, whereas 148 (89.7%) measured ≤35 mm. Of the 17 > 35 mm, 15 (88.2%) received immediate TT. Of the two PTXs >35 mm which were observed, one received a delayed TT for a pleural effusion (6 days after PTX diagnosis) and one (5.9 %) was safely observed. Of the 148 PTXs which measured ≤35 mm, 10 (6.8%) received immediate TT. Of the 138 remaining PTXs, 129 (93.5%) were safely managed without TT. Six (4.3%) of the PTXs initially observed eventually required TT placement for enlargement of the PTX. Only one of those six had manifested ongoing desaturations prior to TT. The remaining three cases received TT for reasons unrelated to the PTX. Of the 27 PPV cases in the ≤35 mm cohort, none contributed to the six failures. A cutoff measurement of 35 mm demonstrated a negative predictive value (NPV) of 95.7% in its ability to predict successful observation of the PTX with an area under the receiver operating characteristic (ROC) curve of 0.90. Conclusion All PTXs measuring ≤35 mm perpendicular to the chest wall without physiologic derangement may be safely observed independent of the need for mechanical ventilation. How to cite this article Cropano C, Mesar T, Turay D, King D, Yeh D, Fagenholz P, Velmahos G, de Moya MA. Pneumothoraces on Computed Tomography Scan: Observation using the 35 Millimeter Rule is Safe. Panam J Trauma Crit Care Emerg Surg 2015;4(2):48-53
The Impact of the Organized Coach Tours on the Pollution in the Republic of Croatia
No full textTema diplomskog rada je „Utjecaj organiziranog autobusnog prijevoza na onečišćenje okoliša na području Republike Hrvatske“. Rad je temeljen na analizi sekundarnih podataka i izvora i na podacima prikupljenim primarnim istraživanjem. Onečišćenje okoliša definira se kao promjena stanja okoliša zbog nedopuštene emisije štetnih plinova ili zbog nekog drugog djelovanja koje bi moglo promijeniti kvalitetu okoliša.
U tekstu se upućuje na probleme onečišćenja okoliša koji nastaje emisijama štetnih plinova iz motora autobusa. Također, upućuje se i na potrebu istraživanja u koje bi se mogli uključiti svi sudionici lokalne zajednice i turisti. Prvo je istraživanje provedeno 2002., u kojem je zaključeno da autobusi u turizmu ne zadovoljavaju ekološke standarde i da u razdobljima povećane potražnje autobusi ne zadovoljavaju turističke potrebe.
Rezultati rada pokazuju da u Hrvatskoj prevladava još uvijek velik broj autobusa koji imaju zastarjelu tehnologiju. Također, dokumenti koje donosi zakonodavac sadržavaju implementaciju novih tehnologija i razvoja turizma prema načelima održivog razvoja. Zakonodavac regulira negativne efekte onečišćenja propisanom posebnom naknadom za onečišćenje i subvencijom za kupovinu novih vozila s čistom tehnologijom. U Hrvatskoj postoje preduvjeti za razvoj održivog turizma koji uključuje i novi trend koji se afirmira u Europskoj uniji a to je razvoj autobusnog turizma kao i uvođenje ekoloških zona u turističke destinacije. I na području Hrvatske bilježi se porast broja kružnih putovanja u organizaciji domaćih ili stranih turističkih agencija i organizatora putovanja. Međutim, unatoč brojnim zakonima, uredbama i strategijama o održivom turizmu, prometu ili razvoju društva u cjelini isti se ne provode u dovoljnoj mjeri u praksi. Ključni je problem još uvijek nedovoljno razvijena ideja i svijest o potrebi zaštite okoliša kao i nedovoljni izvori financiranja autobusnih prijevoznika za modernizaciju voznog parka.The subject of the thesis in this paper is "The Impact of the Organized Coach Tours on the Pollution in the Republic of Croatia." The pollution is defined as a change in the environment caused by the gas emissions from mobile sources into the environment or by some other impacts that are causing the changes of the environment.
The thesis is written on the basis and analysis of the secondary research in which the papers and documents are included. Also, the second part of the thesis is the primary research conducted by the author. The first research in this field was carried out in 2002. The aim of the thesis is to analyse the problems of the air pollution caused by the gas emissions from the coaches and buses. Additionally, this paper is inspecting the possible solutions that could be conducted by government or individuals in the tourism and transport sector. The organized coach tours are the most growing trend in tourism industry which is based on the use of the ecologically equipped vehicles that are the dominant factor regarding the coach tours. This trend is developing in Croatia as well.
The results of the research conducted in the thesis show the number of coaches that do not fulfill the technical and environmental requirements. The reasons are diverse and are co-related with the financial resources of the bus operators and the decreasing level of the environmental awareness. Despite the implementation of programs related to the sustainable development such as the subvention for buying new green vehicles there are problems that occur in communication between the policy and consumers. These problems are related to the information access and to the inefficency of the processing of legislative norms proscribed by government or NGO's. In conclusion, it is required to increase the environmental awarness by different campaigns in the tourism and the transport sector as well
Association Between Ratio of Fresh Frozen Plasma to Red Blood Cells During Massive Transfusion and Survival Among Patients Without Traumatic Injury
No full textHemostatic resuscitation has been shown to be beneficial for patients with trauma, but there is little evidence that it is equally beneficial for bleeding patients without trauma. The practice of a high transfusion ratio of fresh frozen plasma (FFP) to red blood cells (RBCs) has spread to other surgical and medical fields.
To identify whether ratio-based resuscitation in patients without trauma is associated with improved survival.
This study is a retrospective review of all massive transfusions provided in an urban academic hospital from January 1, 2009, through December 31, 2012. Massive transfusion was defined as the transfusion of at least 10 U of RBCs in the first 24 hours after a patient's admission to the operating room, emergency department, or intensive care unit. All patients who received massive transfusions within the study period and survived more than 30 minutes after hospital arrival were counted (n=865). Patients were grouped into those with trauma and those without trauma. Sources of data included the Research Patient Data Registry, patients' medical records, and blood bank records. All data collection occurred between April 26, 2013, and April 26, 2015. Data analysis took place from April 27, 2015, and June 22, 2016.
Examination of FFP:RBC transfusion ratios for patients without trauma.
There were 865 massive transfusion events that occurred within 4 years, transfusing 16 569 U of RBCs, 13 933 U of FFP, 5228 U of cryoprecipitate, and 22 635 U of platelets. Most of these transfusions were received by patients without trauma (767 [88.7%]), by men (582 [67.3%]), and for intraoperative bleeding (544 [62.9%]). The FFP:RBC ratios of survivors and nonsurvivors were nearly identical: the ratio for survivors was 1:1.5 (interquartile range [IQR], 1:1.1-1:2.2) and for nonsurvivors was 1:1.4 (IQR, 1:1.1-1:1.9; P = .43). Among the 767 patients without trauma, there was no difference in the adjusted odds ratio (aOR) for 30-day mortality when comparing the high FFP:RBC ratio vs the low FFP:RBC ratio subgroups (aOR, 1.10; 95% CI, 0.72-1.70; P = .65). In vascular surgery, the aOR for death favored the high FFP:RBC ratio subgroup (aOR, 0.16; 95% CI, 0.03-0.79; P = .02). However, in general surgery and medicine, the aOR for death favored the low FFP:RBC ratio subgroup; general surgery: aOR, 4.27 (95% CI, 1.28-14.22; P = .02); medicine: aOR, 8.48 (95% CI, 1.50-47.75; P = .02).
High FFP:RBC transfusion ratios are applied mostly to patients without trauma, who account for nearly 90% of all massive transfusion events. Thirty-day survival was not significantly different in patients who received a high FFP:RBC ratio compared with those who received a low ratio
Percutaneous Ventricular Assist Device and Extracorporeal Membrane Oxygenation Support in a Patient with Postinfarction Ventricular Septal Defect and Free Wall Rupture
No full textDesign and Making of a Hand-Held Spillage-Free Specimen Retrieval Robot for Laparoscopic Surgery
No full textChemInform Abstract: Design, Synthesis and Bioactivity Evaluation of Tribactam β Lactamase Inhibitors (VIII).
No full textUse of a Totally Artificial Heart for a Complex Postinfarction Ventricular Septal Defect
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