Background and purpose: The aim of this study was to examine the influence of subminimal inhibitory concentrations (subMICs) of ceftazidime, ciprofloxacin and gentamicin on the adherence ability and ...morphology of wild-type Pseudomonas aeruginosa strains to the Buffalo green monkey kidney cell line, using indirect immunofluorescence staining.
Materials and methods: Bacterial adherence changes were tested before and after exposure to 1/2, 1/4, 1/8, 1/16 and 1/32 MIC of antibiotics.
Results: A statistical difference in the number of attached bacteria after exposure to all subMICs of ceftazidime and ciprofloxacin was observed (p<0.05), even after only 1/2 MIC of gentamicin.
Conclusion: The results of this study have shown that antibiotics in much lower concentrations than those necessary for inhibition of bacterial multiplications could damage the adherence of Pseudomonas aeruginosa to the epithelial cell line.
Geriatric syndromes represent new, comprehensive concepts, which can help identifying vulnerable elderly people with multimorbidity. There is also a problem in using the result in a general practice ...working environment. We suggest fast audit as a method for conducting research on a small scale. The aim of this study was to find out the specific characteristics that can be used for a fast recognition of elderly women who have sleep problems and are susceptible to falls. We conducted a survey on a sample of 105 elderly women (age range 60-80 years, average 68.7±5.1 SD), in a general practice setting, in the town of Osijek, eastern Croatia. The sleep disturbance was identified using the standard Pittsburgh Sleep Quality Index, while information on falls were taken from electronic health records (eHRs) and patient interviews. We used a multi-item questionnaire for socio-demographic characteristics and lifestyle habits. EHRs were used to diagnose problems associated with sleep disturbances and falls, as well as for the use of medication that affect mental functions. We found out that 74.2% of examined women had sleep problems, and 25.7% of them experienced falls in the past two years. Diagnoses that distinguished women with and those without sleep problems included dyspepsia and urinary tract infections (50% vs. 23.1%). Women with sleep problems, compared to those without them, more commonly used two or more medications, usually antidepressants, analgesics and anxiolytics. Lower back pain and osteoporosis were used as screening tools for women susceptible to falls, compared to women without reports of falling. (81.5% vs 61.5% and 22.2% vs. 5.1%). Women with falls had a higher degree of overlapping with sleep disorders (81.5%). Anxiolytics application could be a link between sleep disorders and falls (the overlapping ratio 68%).
Aim To determine the use of evidence-based medicine
(EBM) information and the level of awareness and knowledge
of EBM among patients in Croatia.
Methods A cross-sectional study was conducted among
...987 patients in 10 family medicine practices in Croatia. Patients
from both urban (n = 496) and rural (n = 482) areas
were surveyed. A 27-item questionnaire was used to collect
data about sources that patients searched for medical
information, patient awareness and use of Cochrane systematic
reviews and other EBM resources, and their demographic
characteristics.
Results Half of the patients searched for medical information
from sources other than physician. Internet was
the most common place they searched for information.
Very few patients indicated using EBM sources for medical
information; one fifth of patients heard of EBM and 4%
of the patients heard of the Cochrane Collaboration. Patients
considered physician’s opinion as the most reliable
source of medical information. A logistic regression model
showed that educational level and urban vs rural residence
were the predictors of awareness about EBM and systematic
reviews (P < 0.001 for both).
Conclusion Our finding that patients consider a physician’s
opinion to be the most reliable source of healthrelated
information could be used for promotion of highquality
health information among patients. More effort
should be devoted to the education of patients in rural areas
and those with less formal education. New avenues for
knowledge translation and dissemination of high-quality
health information among patients are necessary.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Bone tissue banks are necessary for collection, production, testing, packaging, storage and delivery of bone transplants. Bone tissue bank is a link between the donor and the recipient by which the ...donation becomes a medium of health improvement for both the donor and the recipient. At the Department of Orthopedics, Mostar University Clinical Hospital, about 200 total hip replacements are performed
per
year. Most patients undergoing total hip replacement surgery (90%) have been diagnosed with osteoarthritis, and they are suitable donors, having in mind their age and comorbidities. In the same Department, around 50 procedures that require bone transplants are performed
per
year. A team of highly competent surgeons are working on an intensive process of adaptation oriented to quality improvement and intensification of the activity, both with the goal of meeting the standards of excellence in orthopedic surgery. The presence of a bone tissue bank has a favorable impact on the quality of health care owing to bone transplant availability, as well as on the scientific role of a highly specialized institution that examines the properties of bone tissue.
To determine the use of evidence-based medicine (EBM) information and the level of awareness and knowledge of EBM among patients in Croatia.
A cross-sectional study was conducted among 987 patients ...in 10 family medicine practices in Croatia. Patients from both urban (n=496) and rural (n=482) areas were surveyed. A 27-item questionnaire was used to collect data about sources that patients searched for medical information, patient awareness and use of Cochrane systematic reviews and other EBM resources, and their demographic characteristics.
Half of the patients searched for medical information from sources other than physician. Internet was the most common place they searched for information. Very few patients indicated using EBM sources for medical information; one fifth of patients heard of EBM and 4% of the patients heard of the Cochrane Collaboration. Patients considered physician's opinion as the most reliable source of medical information. A logistic regression model showed that educational level and urban vs rural residence were the predictors of awareness about EBM and systematic reviews (P<0.001 for both).
Our finding that patients consider a physician's opinion to be the most reliable source of health-related information could be used for promotion of high-quality health information among patients. More effort should be devoted to the education of patients in rural areas and those with less formal education. New avenues for knowledge translation and dissemination of high-quality health information among patients are necessary.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In this article, we present a rare case of calcified deep vein thrombosis in a 42-year-old female patient with frequent relapses of pulmonary sarcoidosis since 1995, for which she was on maintenance ...therapy with corticosteroids and with consequential secondary diabetes. Recent femoral vein thrombosis was diagnosed with color Doppler in 2012. At the same time, calcified occlusive thrombus in vena cava inferior from the level of renal vein to the confluence of hepatic veins was diagnosed on abdominal multi-slice computed tomography (MSCT). Digital subtraction venography (DSV) revealed a well-developed collateral circulation through the paravertebral veins, azygos and hemiazygos vein. There were no risk factors for thrombosis other than sarcoidosis and diabetes. Deep vein thrombosis is rarely described with sarcoidosis, but according to literature reports, it usually appears as a recurrence and simultaneously at multiple locations. According to the current knowledge, we cannot say for sure whether it is a disease with an increased risk of deep vein thrombosis or there is a combination of multiple risk factors present simultaneously.
A 6-year-old boy was referred to a hematologist due to excessive mucocutaneous bleeding. Diagnostic assessment for von Willebrand disease (VWD) was indicated and included both coagulation and genetic ...testing. Laboratory testing revealed proportionally decreased von Willebrand factor (VWF) glycoprotein 1b-binding activity (23.6%) compared to VWF antigen (24.7%), similarly decreased VWF collagenbinding activity (24.2%), and normally distributed VWF multimers, with decreased intensity of all fractions. Diagnosis of type 1 VWD was established. Genetic analysis by means of next-generation sequencing (NGS) of VWF and coagulation factor VIII genes did not identify any causative mutations. Additionally, multiplex ligation-dependent probe amplification (MLPA) of VWF gene exons revealed a heterozygous deletion of exons 1 to 6, which is reported in type 1 VWD for the first time. Application of MLPA was crucial for revealing the genetic basis of type 1 VWD in this case, which would have remained undetected if only NGS was used. Keywords: von Willebrand disease, bleeding, von Willebrand factor, coagulation testing, next-generation sequencing, multiplex ligation-dependent probe amplification
Background and purpose: The aim of this study was to examine the influence of subminimal inhibitory concentrations (subMICs) of ceftazidime, ciprofloxacin and gentamicin on the adherence ability and ...morphology of wild-type Pseudomonas aeruginosa strains to the Buffalo green monkey kidney cell line, using indirect immunofluorescence staining.
Materials and methods: Bacterial adherence changes were tested before and after exposure to 1/2, 1/4, 1/8, 1/16 and 1/32 MIC of antibiotics.
Results: A statistical difference in the number of attached bacteria after exposure to all subMICs of ceftazidime and ciprofloxacin was observed (p<0.05), even after only 1/2 MIC of gentamicin.
Conclusion: The results of this study have shown that antibiotics in much lower concentrations than those necessary for inhibition of bacterial multiplications could damage the adherence of Pseudomonas aeruginosa to the epithelial cell line.
The aim of this study was: 1. to evaluate treatment results of combined therapy (surgery, postoperative craniospinal radiotherapy with or without chemotherapy) and 2. to assess factors affecting ...prognosis (extend of tumor removal, involvement of the brain stem, extent of disease, postoperative meningitis, shunt placement, age, sex and time interval from surgery to start of postoperative radiotherapy).
During the period 1986-1996, 78 patients with medulloblastoma, aged 1-22 years (median 8.6 years), were treated with combined modality therapy and 72 of them were evaluable for the study endpoints. Entry criteria were histologically proven diagnosis, age under 22 years, and no history of previous malignant disease. The main characteristics of the group are shown in Table 1. Twenty-nine patients (37.2%) have total, 8 (10.3%) near total and 41 (52.5%) partial removal. Seventy-two of 78 patients were treated with curative intent and received postoperative craniospinal irradiation. Radiotherapy started 13-285 days after surgery (median 36 days). Only 13 patients started radiotherapy after 60 days following surgery. Adjuvant chemotherapy was applied in 63 (80.7%) patients. The majority of them (46; 73%) received chemotherapy with CCNU and Vincristine. The survival rates were calculated with the Kaplan-Meier method and the differences in survival were analyzed using the Wilcoxon test and log-rank test.
The follow-up period ranged from 1-12 years (median 3 years). Five-year overall survival (OS) was 51% and disease-free survival (DFS) 47% (Graph 1). During follow-up 32 relapses occurred. Patients having no brain stem infiltration had significantly better survival (p = 0.0023) (Graph 2). Patients with positive myelographic findings had significantly poorer survival compared to dose with negative myelographic findings (p = 0.0116). Significantly poorer survival was found in patients with meningitis developing in the postoperative period, with no patient living longer than two years (p = 0.0134) (Graph 3). By analysis of OS and DFS in relation to presence of the malignant cells in liquor, statistically significant difference, i.e. positive CSF cytology was not obtained, which was of statistical importance for survival (p = 0.8207). Neither shunt placement nor shunt type showed any impact on survival (p = 0.5307 and 0.7119, respectively). Children younger than three years had significantly poorer survival compared to those older than 16 years (p = 0.0473). Although there was a better survival rate in females than in males this was not statistically significant (p = 0.2386). The analysis results of treatment showed that significantly better survival occurred in patients in whom total or subtotal tumor removal was possible (p = 0.0022) (Graph 4). Patients who started radiotherapy within two months after surgery have better survival, but again this was not statistically significant, probably due to the small number of patients receiving delayed radiotherapy (p = 0.2231) (Graph 5).
Based on this factors standard and high risk group could be defined. Combined chemotherapy should to be investigated particularly for high risk subgroup. Future research should be done to define new therapeutic modalities (gene therapy, compounds active in tumor antiangiogenesis etc).
Banke koštanog tkiva su odgovorne za skupljanje, proizvodnju, ispitivanje, pakiranje, skladištenje i isporuku koštanih transplantata. Banka koštanog tkiva premosnica je od donora k primatelju ...prilikom koje se donacija pretače u sredstvo za poboljšanje zdravstvenog stanja kako primatelja tako i davatelja. Na Klinici za ortopediju Sveučilišne kliničke bolnice Mostar na godinu se ugradi oko 200 totalnih proteza kuka. Većini bolesnika kojima se ugrađuje totalna proteza kuka (90%) identificirana je dijagnoza osteoartritisa te su pogodni davatelji, s tim da se u obzir uzimaju komorbiditeti i životna dob. Na godinu se na Klinici izvodi oko 50 različitih operacija za koje trebaju koštani presatci. Tim visoko kompetentnih kirurga bavi se intenzivnim procesom adaptacije koji je orijentiran poboljšanju kvalitete i jačanju aktivnosti s ciljem zadovoljenja standarda izvrsnosti u ortopedskoj kirurgiji. Prisutnost ovakve koštane banke učinkovito utječe na kvalitetu skrbi kako zbog brže dostupnosti implantata tako i zbog znanstvene uloge visoko specificirane ustanove koja bazično istražuje svojstva koštanog tkiva.
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