Pheochromocytoma is a rare cause of hypertension in pregnancy. Unrecognized, it carries a great risk for both mother and the foetus. The main reason for missing the diagnosis is the misconception ...that any hypertension occurring in pregnancy is gestational hypertension or pre (eclampsia). As many as 90% of patients report one or more pheochromocytoma-related symptoms antenatally, but the diagnosis is made in 75% of patients, meaning that 3 out of 10 patients are diagnosed after childbirth or post-mortem. The symptoms are similar to other more common causes of hypertension in pregnancy, which presents a major diagnostic challenge. The diagnosis is based on determination of metanephrines in plasma or 24-hour urine. Magnetic resonance imaging (MRI) and ultrasound (US) are used to localize the tumour. If the diagnosis is made before the 24th week of pregnancy, laparoscopic removal of the tumour in the second trimester is recommended. If diagnosed later, the tumour could be removed during or after delivery. Preoperative preparation with alpha blockers is required to stabilize blood pressure. The decision on the mode of delivery depends on several factors, so an experienced multidisciplinary team is needed to minimize maternal and foetal mortality.
Uvod: Anksiolitici su jedni od najčešće propisivanih lijekova te su veoma popularni zbog svoje široke terapijske
primjene. Cilj: Cilj je ispitati učestalost korištenja anksiolitika kod studenata ...medicine.
Metode: U istraživanju je sudjelovalo 222 studenata od 1. do 6. godine Studija medicine na Medicinskom fakultetu
Osijek rješavajući anonimni upitnik. Rezultati: Od 222 studenata 19,5 % koristilo je benzodiazepin. Djevojke ih koriste
značajno češće od muškaraca. Najčešće indikacije za korištenje su osjećaj tjeskobe i anksioznost. Najčešće korišten
benzodiazepin je alprazolam. Najviše ih koriste studenti 6. godine medicine, dok ih studenti 1. godine ne koriste.
Razlozi za korištenje razlikuju se prema godinama studiranja; glavni razlog korištenja na 3. godini je nadolazeći
ispit, dok su na 5. i 6. godini razlozi uzimanja benzodiazepina obiteljski i ljubavni problemi. Jednom u više mjeseci
benzodiazepine koristi 59,1 % studenata, dok ih 5 % koristi svaki dan, 20,9 % studenata koristi i smatra korisnima
biljne preparate za smirenje. Pomoć stručnjaka za svoje probleme potražilo je 32,6 % studenata koji su koristili
benzodiazepine, dok ih je 41,9 % o tome razmišljalo. Zaključci: Unatoč tome što su studenti medicine izloženi velikom
stresu te anksiolitike koriste češće nego opća populacija, njihova je uporaba racionalna i kontrolirana.
Cilj: Ciljevi istraživanja bili su utvrditi postoji li razlika u mjerenju intraokularnog tlaka (IOT) Goldmanovom aplanacijskom tonometrijom (GAT) i air-puff tonometrijom (APT) te usporediti osjećaj ...ugode prilikom mjerenja IOT-a objema metodama. Ispitanici i metode: Ovom presječnom studijom obuhvaćena su 133 ispitanika kojima je učinjen standardni oftalmološki pregled. Ispitanici su na pregled dolazili zbog korekcije refrakcijske greške od listopada 2017. do travnja 2018. godine na Polikliniku za oftalmologiju „Oculus“ u Osijeku. Isključni kriteriji bili su dob manja od 18 godina, liječenje od glaukoma, operativni zahvat na prednjem ili stražnjem segmentu oka, degenerativne promjene na prednjem segmentu oka ili teži poremećaj suznog filma. Svim ispitanicima izmjeren je IOT objema metodama, nakon čega su ispitanici dobrovoljno ispunili anketu u kojoj su se prikupljali sljedeći podatci: dob, spol, nošenje leća, broj pregleda mjerenja IOT-a te procjena ugodnosti pregleda GAT-om i APT-om. Rezultati: Presječna studija uključila je 133 pacijenta (83 žene, 50 muškaraca). Medijan dobi ispitanika bio je 51 godina. Utvrđena je statistički značajna razlika između izmjerenog IOT-a desnog i lijevog oka GAT-om i APT-om (t-test za zavisne uzorke, P < 0,001). Nije bilo statistički značajnih razlika u ocjeni ugode mjerenja IOT-a GAT-om i APT-om (Fisherov egzaktni test, P = 0,180). Zaključci: Iako APT ima određene prednosti u odnosu na GAT, GAT daje preciznije rezultate mjerenja IOT-a te se s razlogom danas smatra zlatnim standardom u mjerenju IOT-a.
Aim: The objectives of the study were to determine whether there is any difference in the measurement of intraocular pressure (IOP) by Goldmann applanation tonometry (GAT) and air-puff tonometry (APT) and to compare the feeling of comfort when measuring the IOP by both methods. Participants and methods: This cross-sectional study included 133 participants, who underwent standard ophthalmic examination. Participants were examined for correction of refractive error from October 2017 to April 2018 at the Ophthalmology polyclinic “Oculus”, Osijek. Exclusion criteria were age under 18 years, glaucoma treatment, operative surgery at the anterior or posterior eye segment, degenerative changes in the anterior eye segment, or tear film disorder. IOP was measured in all participants by both methods, after which participants voluntarily completed a questionnaire in which the following data were collected: age, gender, data on wearing lenses, number of IOP measures, and evaluation of the comfort level of GAT and APT. Results: This cross-sectional study included 133 patients (83 women, 50 men). The median of the participants’ age was 51. There was a statistically significant difference between the measured IOP of the right and left eye with the GAT and APT (t-test, P < 0.001). There was no significant difference in the comfort level of IOP measured with GAT and APT (Fisher’s exact test, P = 0.180). Conclusions: Although APT has some advantages over GAT, GAT provides more accurate results for IOP measurement and is therefore considered a gold standard for IOT measurement today.
The aim of this study was to examine which experiences related to war were considered to be the most difficult for adolescents and young adults living in areas not directly affected by conflicts. A ...total of 795 high school and college students of both sexes were asked to describe their worst war experience. The answers were classified into 27 content categories. Age and gender differences in specific categories of war experiences were not very pronounced, but significant differences were found in the number of reported experiences. Female subjects reported more war experiences than male, and college students reported more experiences than high school students. Subjects reported a great variety of war experiences, the most frequent being sympathizing with victims, financial hardship, death of close persons, their own emotional states, separation from friends, and answers such as "nothing or nothing compared to others." The results suggest that adolescents and young adults living in areas not directly affected by war experience chronic war stress. Identifying stressors and their reactions to them is the first step in trying to assist them.
Adolescents, Stressful events, War, Young adults.
Abstract Purpose This study aims to investigate the association of compliance amongst lens wearers and lens case contamination as assessed by the microbial profile of lens cases. Methods Fifty-two ...asymptomatic lens wearers filled out questionnaires seeking demographic data and several aspects of compliance to lens wear. Subsequently, contamination profiles of the inside bottom and rim of their lens cases was obtained for bacteria, fungi and Acanthamoeba. The association of the self-reported responses in the questionnaire with contamination profile of the lens case was then analyzed. Results Based on compliance criteria, 21% of the participants were described as fully compliant lens wearers. Contamination of lens case was prevalent in 42% of the cases. Frequent non-compliant behaviours reported by study participants included, showering and sleeping with contact lenses, and irregular lens case replacement. In comparison to soft contact lens wearers prevalence of non-compliance and contamination amongst rigid gas permeable (RGP) lens wearers was significantly greater. There was a statistically significant correlation between bacterial contamination and current case age. Conclusion These results suggest that majority of lens wearers do not fully comply with recommendations for lens wear and case care. Crucially, none of the fully compliant patients had contaminated lens cases. However it would appear that several non-compliant behaviours significantly increase the risks of case contamination. These results suggest that greater efforts should be invested with lens wearers to ensure enhanced compliance as this is likely to reduce the possibility of case contamination.
Esophagocutaneous fistulas are a failure of the NO-system, due to NO-synthase blockage by the NOS-blocker L-NAME consequently counteracted by l-arginine and gastric pentadecapeptide BPC 157 ...(l-arginine <BPC 157), precipitating a therapeutic benefit. Previously, there was an established BPC 157—NO-system interaction. BPC 157 GEPPPGKPADDAGLV, MW 1419 (LD1 not achieved), is a safe and stable anti-ulcer peptide, successful in inflammatory bowel disease trials, counteracting esophagitis, sphincter failure, gastrointestinal and skin ulcers, gastrocutaneous or colocutaneous fistulas. We treated rats with established cervical esophagocutaneous fistulas throughout four days (both open skin and esophageal defects, with significant leakage) with BPC 157 (parenterally and perorally) and L-NAME (blocking NO genesis) and l-arginine (NO-substrate) alone or in combination. RT-PCR investigated eNOS, iNOS, COX-2 mRNA levels in the fistulas. We evidenced a closely inter-related process of unhealed skin, esophageal defects, unhealed fistulas (up regulated eNOS, iNOS and COX2 mRNA levels), usually lethal, particularly NO-system related and therapy dependent. Generally, the course of fistula healing was accelerated either to a greater extent (with BPC 157 (in particular, less eNOS gene expression) completely counteracting L-NAME effects, in L-NAME+BPC 157 and L-NAME+l-arginine+BPC 157 groups), or to a lesser extent (with l-arginine). Conversely, the process was aggravated, rapidly and prominently (with L-NAME). In particular, BPC 157 was effective either given per-orally/intraperitoneally, in μg- and ng-regimens. Shortly, defects started to heal, with less fistula leakage and no mortality at day 4. Failure of pyloric and lower esophageal sphincter pressure was restored, with practically no esophagitis.
Introduction
Insulin glargine 300 U/mL (Gla-300) is a novel glargine formulation which shows slower and more prolonged absorption following subcutaneous administration in comparison to insulin ...glargine 100 U/mL. In this prospective, observational, single-arm, multicenter, real-world study conducted in Serbia, we evaluated the effectiveness and safety of Gla-300 in patients with type 2 diabetes mellitus (T2DM) previously inadequately controlled with different basal or premix insulin therapy regimes.
Methods
A total of 350 patients with T2DM were enrolled by 27 physicians, from date of the first patient in (12 December 2017) to the date of last patient completed/last patient out (30 October 2018), from both medical centers and general hospitals. Patients’ observation and data collection were performed at visit 1 (V1), i.e., the inclusion visit (3–6 months after Gla-300 introduction), including collection of retrospective data from the patients’ medical charts at the time of Gla-300 introduction, and at visit 2 (V2) (3–6 months after V1). The primary objective was to assess the change in glycated hemoglobin (HbA1c) level from day of the Gla-300 initiation to the end of the observational period, while the secondary objectives included other effectiveness, as well as safety and other clinically relevant data.
Results
The mean age of the 350 patients was 63.4 ± 8.4 years and 56.3% were female. The mean duration of diabetes was 13.4 ± 7.4 years, while the mean duration of insulin therapy prior to Gla-300 initiation was 5.3 ± 3.9 years. There was a significant reduction in HbA1c level at each visit compared to the previous visit (8.63 ± 1.52% at baseline prior to Gla-300 initiation, 7.87 ± 1.13% at V1, 7.45 ± 1.05% at V2;
p
< 0.01 vs. previous visit) accompanied by significant reduction of all hypoglycemic events (
p
< 0.01).
Conclusion
Initiation of Gla-300 therapy significantly improved glycemic control and reduced the risk of hypoglycemia in patients with T2DM inadequately controlled with different basal or premix insulin therapy regimes.
Funding
Sanofi Serbia.
The results of a 5-year monitoring study of air pollution in the city of Split area are presented and evaluated statistically with descriptive and multivariable analysis. Heavy metals Cd, Pb, Tl, ...cation Ca super(2+) and anions SO super(2) sub(4) super(-) and Cl super(-) were measured in the total deposited matter (TDM) for the period of 2003. - 2007. Basic statistical analysis of the measured values was calculated for each parameter. Statistical analyses show the highest average value for Pb, Cd, Tl of 74.80; 1.90 and 1.80 mu g m super(-2) day super(-1) in the industrial zone, respectively, while the values of Ca super(2+), SO super(2) sub(4) super(-) and Cl super(-) were 37.90; 14.50 and 24.00 mg m super(-2) day super(-1). The analysis shows correlations between individual variables, which are explained by the position and the significance of each location. The locations in which industry and traffic are significant factors show a strong correlation between Pb and Cd concentrations, while at tourist locations and those along the coast there is strong correlation between SO super(2) sub(4) super(-) and Cl super(-). Furthermore, principal component analysis (PCA) shows that two major components describe about 70% of the data variance at almost all locations. For all locations factor analysis for individual variables was done and groups, corresponding to the position and significance of the location were obtained. The results of PCA analysis will be used as driving parameters for air modeling with the aim of simulating its behavior, which can result in reliable forecasts. Obtained forecast can be used for operational air quality management in tourist region of Croatia.
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