•Proper assessment of the soil structure of arable soils requires a combination of various methods.•Results of evaporation and leaching experiments were fitted using a single-porosity flow ...model.•Data collected during flow experiments did not provide evidence of non-equilibrium flow.•Additional dye-staining and X-ray imaging revealed a complex biopore network.•The bi-modal flow behavior was revealed using the dual-permeability modeling of dye transport.
The appearance and distribution of soil pores have a significant influence on water flow and solute transport in the soil vadose zone. The pore system is highly variable in arable soils where crop rotation, tillage, trafficking, soil amendments, and various management practices are commonly implemented. The aim of this study was to assess the porous system and preferential flow pathways in a vineyard soil using undisturbed soil columns, and by combining laboratory and numerical methods with dye staining and X-ray imaging. It was hypothesized that the integration of various methods could reveal more information about soil structure, and flow and transport behavior of structured arable soil. Soil water retention and hydraulic conductivity curves were obtained using the evaporation method, while water flow was assessed using intermittent leaching experiments. Water flow and the transport of Brilliant Blue were simulated using HYDRUS-1D. A single-porosity model of soil hydraulic properties provided a good description of data collected during the evaporation experiments. Data collected during leaching experiments did not provide enough experimental evidence for the occurrence of nonequilibrium flow patterns and the differentiation between the single- and dual-permeability models of soil hydraulic properties. However, dye staining and X-ray imaging revealed a complex pore-architecture network with large vertical and horizontal biopores. The staining patterns (Brilliant Blue FCF) within the vertical column sections documented the extent of preferential flow. The study showed that the bi-modal character of pore structure could often be hidden when a limited number or non-adequate methods are applied for its quantification from water flow behavior. The impact of preferential pathways on dye transport can be investigated with observations and simulations. A combination of various methods enabled us to adequately assess vineyard soil structure and fine-tune the description and extent of preferential water flow.
Ischemic heart disease (IHD) morbidity and mortality indices, along with medical intervention rates, were analyzed among Mediterranean countries, Croatia, Slovenia, Spain, Italy, and France, in the ...pre-COVID period. Standardized IHD incidence and prevalence rates from 1990 and mortality rates from 1985 were obtained from the Global Burden of Disease Study 2017 and Health for All databases. Coronary artery bypass graft (CABG) and transluminal coronary angioplasty (TCA) rates in the 2011–2019 period were obtained from Eurostat. Trends were estimated with Joinpoint regression analysis. IHD mortality rates range from 13.6 to 74.3 for females and from 37.8 to 126.03 for males. IHD mortality rates in Croatia were 5.6-fold higher among females and 3.3-fold higher among males compared to France. All countries decreased standardized IHD prevalence and incidence rates, although the magnitude varied. The high-to-low ratio, Croatia vs. Spain, was 3.5-fold for CABG and 3.2-fold for TCA. Slovenia, as opposed to Croatia, reduced the gap for all medical indicators except for relatively high prevalence rates. Despite a significant rise in medical interventions in Croatia, ineffective clinical and public health initiatives have led to only modest declines in IHD mortality rates over the past decade.
The aim of the study was to analyse the temporal and geographic distribution of radiologists, computed tomography and magnetic resonance scanners in Croatia. In this observational study we estimated ...radiologists’ number per 100,000 population for 1997, 2006, and 2017 and compared private and public CT and MR scanners between 2011 and 2018. We analyzed the availability of radiologists and scanners, and the relationship between the radiological workforce and economic strength among counties. The workforce increased significantly from 1997 to 2017 and was associated with economic strength categories in 2017. In 2018, there were more CT scanners in the public sector, while MR scanners were distributed evenly. In 2011, there was similar distribution of CT and MR between sectors, while in 2018 there were significantly more public CT scanners. Counties with a medical school had significantly more radiologists and MR scanners. The high-to-low ratios per CT and MR were 11 and 8.2, suggesting inequality of health care. Croatia significantly increased its radiological workforce; however, cross-county inequality remained. Counties with higher economic strength and medical schools have better availability of radiologists and equipment. To ensure the sustainable activity of the health care system, a precise estimate of supply and demand of radiology services is needed.
To assess the variation in the waiting time for diagnostic imaging (DI) services among Croatian public hospitals and the utilization of computed tomography (CT) and magnetic resonance imaging (MRI) ...scanners.
We analyzed aggregated data from public hospitals. Counties were classified according to economic strength, and utilization was expressed as the average number of exams per machine. We compared the waiting times for 2018 and utilization for 2015 according to hospital category (high and low level) and economic strength by county.
The waiting time was longer for MRI compared with CT, 268 vs 77.61 days. Overall CT waiting time was in the unfavorable European Health Consumer Index category. High-level hospitals had longer waiting time for MRI and CT. The waiting time positively correlated with economic strength for MRI (P=0.019), but not for CT. In low-level hospitals, MRI utilization ranged from 104 to 6032, whereas CT utilization ranged from 48 to 17852. In high-level hospitals, MRI utilization ranged from 3846 to 11 026, while CT utilization ranged from 503 to 17 234. CT (P=0.041) and MRI (P=0.031) utilization in high-level hospitals was significantly higher than in low-level hospitals.
The waiting times for CT and MRI were exceptionally long regardless of the hospital category, with highly varying utilization. Croatia performed more exams per scanner compared with other EU countries, but not significantly so. High-level hospitals' utilization was significantly higher than that of low-level hospitals, and CT utilization was significantly higher than EU average, while the difference for MRI utilization was not significant.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
U Kliničkoj bolnici Dubrava u Zagrebu prvi je put u Hrvatskoj ugrađen novi sustav za krvožilni pristup kod bolesnika koji se liječi kroničnom hemodijalizom. Radi se o kombinaciji centralnoga venskog ...katetera i grafta engleskog naziva Hemodialysis Reliable Outflow (HeRO) device, skraćenog naziva HeRO-graft. Glavna je indikacija za primjenu ovoga krvožilnog pristupa okluzija ili značajna stenoza centralnih vena. Iz literature se doznaje da ovaj krvožilni pristup ima značajne prednosti u odnosu na tunelirani centralni venski kateter koji bi trebao biti zadnja opcija kod bolesnika koji zahtijevaju trajno nadomještanje izgubljene bubrežne funkcije. Za razliku od tuneliranih
katetera ovaj je sustav u potpunosti smješten potkožno, što ga čini otpornijim na infekcije. Do sada su u Kliničkoj bolnici Dubrava ugrađena dva HeRO-grafta za hemodijalizu i prema prvim iskustvima potrebna je detaljna obrada kandidata za ovu proceduru. Potrebno je dobro poznavati indikacije i kontraindikacije te je nužna suradnja više timova: nefrološkog, anesteziološkog, radiološkog i kirurškog. Osobito je potrebno obratiti pažnju na stanje arterijske cirkulacije okrajine koja se koristi za ovaj krvožilni pristup kako bi se izbjegle moguće ishemijske komplikacije. Kod obaju naših bolesnika postupak ugradnje protekao je uredno te smo započeli s korištenjem HeRO-grafta za potrebe hemodijalize.
The purpose of the study was to evaluate and compare opacification of the renal collecting system and ureters detected by computed tomographic urography (CTU) performed 20 min and 1 h after the ...ingestion of 1,000 ml of water. CTU was performed on 89 patients (55 men, 34 women; age 28–77 years) and 168 collecting systems and ureters were evaluated. A 16-detector-row scanner (Sensation 16, Siemens) was used; a two-phase protocol with a split bolus of contrast agent (total 120 ml) was applied. A combined nephrographic-excretory phase was obtained 100 s after the second injection. Three-dimensional reconstructions of the excretory phase were created and used to evaluate the degree of opacification of the collecting system and ureters. In 44 patients, water was administered 20 min before examination, and in 45 patients, 1 h before examination. CTU performed 1 h after water ingestion demonstrated complete opacification of calices in 87.5%, of renal pelvis in 97.5%, of upper ureter in 91.8% and of lower ureter in 87.5% of patients. CTU performed 20 min after water ingestion demonstrated complete opacification of calices in 79.5%, of renal pelvis in 85%, of upper ureter in 62.5% and of lower ureter in 54.5% of patients. Complete opacification of the proximal and distal ureter in the group with a 1-h delay was statistically higher (
P
< 0.01). CTU performed on the distended bladder, 1 h after the oral ingestion of water, enables excellent opacification of collecting system, including distal ureters.
A female patient with giant cell vasculitis of the abdominal aorta and its branches and strongly suspected of having extrapulmonary tuberculosis is presented. The diagnoses were based on the clinical ...picture, laboratory findings, and magnetic resonance imaging (MRI) findings. MRI is highly useful in cases where echosonography and/or vascular biopsy for histopathological analyses are not possible. A combination of giant cell vasculitis and extrapulmonary tuberculosis is extremely rare, and therefore, choosing the right treatment presents a considerable challenge. MRI performed after 6-month antituberculous therapy and 1-year glucocorticoid plus methotrexate therapy showed normal wall of the aorta and its branches, which was consistent with clinical and laboratory remission. Patients with large vessel vasculitis require regular follow-up by MRI.
Some 25 years ago endoscopic ultrasound (EUS) was introduced in clinical practice for better visualization of pancreas. At the time of introduction EUS was superior to other methods in detection of ...pancreatic masses allowing tissue diagnosis by later introduced EUS-guided fine needle aspiration (FNA). During the time EUS was improved, electronic probes replaced mechanical probes adding ability of color Doppler, power Doppler, contrast enhanced endosonography as well as EUS elastography analysis. Meanwhile, CT technology has also experienced significant improvements raising the question whether EUS has lost ground in diagnostics of solid pancreatic masses. The aim of this review was to discuss the current evidence of clinical impact of EUS and EUS-FNA in evaluation of solid pancreatic masses with special emphasis on differentiation between benign and malignant pancreatic lesions. According to the literature, the detection of small pancreatic tumors, preoperative localization of pancreatic endocrine tumors and tissue sampling by fine-needle aspiration of pancreatic masses in cases with therapeutic consequences are considered firm indications for EUS. Cytological tissue analysis remains undisputed in differentiation benign from malignant lesions, but the question when FNA is needed is discussed. Color Doppler, power Doppler, contrast enhanced endosonography and especially elastography are also discussed as tools that are bringing additional information in evaluation of pancreatic masses, however insufficient for definitive judgment of the lesion's nature. Pancreatic cancer staging as indication for EUS is discussed controversially, inconsistent results and conflicting evidence in literature making adequate conclusion impossible. However, this indicates that at least the role of EUS is no longer undisputed in this matter. Resuming the role of EUS we can state that despite some controversies EUS is very valuable method in evaluation of solid pancreatic masses and with EUS guided FNA is nowadays by far the best method for obtaining tissue diagnosis.
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