This clinical report describes an emergency case of a 49-year-old man, ASA E III status, with clinical symptoms of acute abdomen and ileus, who was scheduled for urgent surgery. Predictors of ...difficult intubation (Mallampati test Class III, short thyro-mental (< 6 cm) and sterno-mental distance (<10 cm) with limited mouth opening (inter-incisor gap < 3 cm) were associated with significant comorbidity (rheumatoid arthritis, heart disease, obesity (body mass index 32.6 kg m-2), cervical spine mobility and generalized vascular disease). A specialist experienced in airway management decided on one attempt of Bonfils fiberoptic intubation as primary intervention and urgent tracheotomy, if needed, as secondary intervention. Immediately after assuming supine position on the operating table, the patient lost consciousness and cardiac arrest developed. Successful intubation with oxygenation was followed by cardiopulmonary resuscitation. Upon stabilization of the patient's vital functions, urgent surgery was performed. In the emergency case presented, we succeeded quickly to secure the airway with Bonfils fiberoptic intubation, which allowed for appropriate oxygenation and starting resuscitation. The high risk of the possible aspiration was avoided by timely provision of airway in the experienced anesthetist's hands.
New localities of three rare and floristically interesting NATURA 2000 species in the north-western Dinaric Mountains in Croatia are presented in this paper. Pulsatilla grandis Wender. was found on ...the mountains around Rijeka, above Vinodol valley (Croatian Littoral), and in the central part of Mt Velebit. Genista holopetala (Koch) Bald. was found on the mountains around Rijeka and above Vinodol valley (Croatian Littoral), while Cypripedium calceolus L. was noticed on the southern part of Mt Velebit. Information about new sites will be of great help in the future research that is essential for all three species to ensure protection and assist in setting up population monitoring. Additionaly, it was ascertained that afforestation of grassland habitats by natural forest vegetation represents the greatest threat to P. grandis and G. holopetala.
New localities of three subendemic species (Berberis croatica, Teucrium arduini and Micromeria croatica) have been found in the Dinaric Alps. Berberis croatica was found at ten new locations, nine of ...them in Croatia and one in Bosnia and Herzegovina. Teucrium arduini was found on Mt Učka, Mt Velebit, Mt Biokovo and Mt Sniježnica, at nine new locations while Micromeria croatica was found at four new locations, only on Mt Velebit.
Opisuje se hitan slučaj 49-godišnjeg bolesnika statusa ASA E III s jasnim kliničkim simptomima akutnog abdomena i ileusa, koji je bio predviđen za hitan kirurški zahvat. Uza začajan komorbiditet ...(reumatoidni artritis, bolesti srca, pretilost (indeks tjelesne mase 32.6 kg m-2), deformitet vratne kralježnice te generaliziranu aterosklerozu) kliničkim pregledom otkriveni su i prediktori teške intubacije (Mallampati test klasa III ., kratka tiro-mentalna (<6 cm) i sterno-mentalna udaljenost (<10 cm) s ograničenim otvaranjem usta (razmak između sjekutića <3 cm). Iskusni anesteziolog u zbrinjavanju dišnog puta primarno se odlučio za fiberoptičku intubaciju Bonfilsom, odnosno sekundarnu hitnu traheotomiju ako se intubacija Bonfilsom ne uspije učiniti iz prvoga pokušaja. Neposredno nakon premještaja bolesnika na operacijski stol te njegovog namještanja u leđni položaj bolesnik gubi svijest uz razvoj asistolije srca. Odmah je izvedena uspješna intubacija, omogućena oksigenacija bolesnika praćena kardiopulmonalnom reanimacijom. Nakon stabilizacije vitalnih funkcija bolesnika uspješno je dovršen i hitan kirurški zahvat. U prikazanom hitnom slučaju smo fiberoptičkom intubacijom uz Bonfils uspješno i brzo osigurali dišni put te time osigurali dostatnu oksigenaciju i brz početak reanimacije. U ovom slučaju je pravodobna intubacija u rukama iskusnog anesteziologa bila presudna za zaštitu dišnoga puta bolesnika od prijeteće aspiracije uz prisutan ileus.
U radu su navedeni novi, do sada neobjavljeni lokaliteti dviju endemičnih i floristički zanimljivih vrsta rasprostranjenih na području sjeverozapadnih Dinarida u Hrvatskoj. Obje vrste su u nas i ...zakonom strogo zaštićene. Jedna od njih je Kitaibelov pakujac (Aquilegia kitaibelii Schott) koji je kao rijetka, endemična vrsta uvrštena na popis NATURA 2000 vrsta. Nova nalazišta Kitaibelova pakujca zabilježena su na širem području planinske skupine planine Obruč te na srednjem i južnom Velebitu, dok su novi lokaliteti hrvatske gušarke (Cardaminopsis croatica (Schott, Nyman et Kotschy) Jáv.) utvrđeni na području srednjeg Velebita i na padinama brežuljaka regije Gacke. Obje vrste na većini novih nalazišta rastu u pukotinama stijena zajedno s drugim petrofilnim vrstama, a Kitaibelov pakujac zabilježili smo i na točilima. Za hrvatsku gušarku posebno su zanimljiva nalazišta u regiji Gackoj, gdje raste na termofilnim stijenama različitih ekspozicija, u okruženju mješavine termofilnih submediteranskih vrsta i nekih brdskih vrsta bukovo-jelovih šuma. Uz Premužićevu stazu na srednjem Velebitu C. croatica se također pojavljuje u termofilnim zajednicama šumskih stijena. Opaženo je i da, osim stijena, hrvatska gušarka nastanjuje i sekundarna, antropogena staništa, kao što su rubovi šumskih cesta, što ukazuje na ekološku plastičnost ove endemične vrste.
U radu su navedeni novi, do sada neobjavljeni lokaliteti triju rijetkih i floristički zanimljivih NATURA 2000 vrsta na području sjeverozapadnih Dinarida u Hrvatskoj. Novi lokaliteti vrste Pulsatilla ...grandis Wender. zabilježeni su na planinama u zaleđu grada Rijeke, iznad Vinodola te na području srednjeg Velebita. Genista holopetala (Koch) Bald. pronađena je na novim lokalitetima na planinama u zaleđu Rijeke i iznad Vinodola, dok su novi mikrolokaliteti vrste Cypripedium calceolus zabilježeni na području južnog Velebita. Podaci o novim lokalitetima predstavljaju značajan doprinos budućim istraživanjima ovih triju vrsta koja su neophodna za njihovu adekvatnu zaštitu i moguću uspostavu monitoringa nad njihovim prirodnim populacijama. Također, utvrđeno je da zaraštanje prirodnih travnjačkih staništa drvećem i grmljem trenutno predstavlja najveću opasnost za populacije vrsta P. grandis i G. holopetala.
More than 6,000 km2 of the central and southern areas of the Republic of Croatia were liberated by the Storm campaign, August 4 to 7, 1995. On August 8, 1995, the Ministry of Health sent expert teams ...to the newly liberated areas, to ensure the basic conditions for the displaced persons to return and live there. To describe the public health measures taken we used the examples of Lika-Senj County (3,746 km2 and 71,215 population). By October 1, 1995, 50 bodies, killed in action, had been detected, pathologically and forensically examined, and then buried. Two hundred thirty-three mostly elderly and sick persons were admitted to the reception center in Gospić; 93 of them returned to their homes, 133 were accommodated with their relatives and friends, and 7 were referred for treatment (4 of them died). Two hundred ten cattle carcasses were buried using adequate sanitation measures, whereas 5,575 sheep, 3,138 head of horned cattle, 298 head of hoofed animals, and 300 head of other cattle were caught alive. The procedures of disinfection, disinfestation, and deodorization were performed in 720 apartments, 2 hotels, 3 schools, 1 kindergarten, 1 health care unit, 1 sports hall, and 5 shops. The main water pump was cleared of mines and partially repaired, whereas some 20 water supply facilities were placed under surveillance. Three food depots were found and properly treated. The entire territory was closely observed for possible occurrence of infectious disease.
Obesity is on the rise worldwide, and consequently, obesity-related non-communicable diseases are as well. Nutritional overload induces metabolic adaptations in an attempt to restore the disturbed ...balance, and the byproducts of the mechanisms at hand include an increased generation of reactive species. Obesity-related oxidative stress causes damage to vulnerable systems and ultimately contributes to neoplastic transformation. Dysfunctional obese adipose tissue releases cytokines and induces changes in the cell microenvironment, promoting cell survival and progression of the transformed cancer cells. Other than the increased risk of cancer development, obese cancer patients experience higher mortality rates and reduced therapy efficiency as well. The fact that obesity is considered the second leading preventable cause of cancer prioritizes the research on the mechanisms connecting obesity to cancerogenesis and finding the solutions to break the link. Oxidative stress is integral at different stages of cancer development and advancement in obese patients. Hypocaloric, balanced nutrition, and structured physical activity are some tools for relieving this burden. However, the sensitivity of simultaneously treating cancer and obesity poses a challenge. Further research on the obesity-cancer liaison would offer new perspectives on prevention programs and treatment development.
Purpose
Polycystic ovary syndrome (PCOS) is a complex reproductive disorder often associated with obesity, insulin resistance, and dyslipidemia. Hormonal changes in PCOS may also include altered ...glucocorticoid signaling. Our aim was to examine whether alterations in hepatic glucocorticoid signaling are associated with disturbances of glucose and lipid metabolism in animal model of PCOS.
Methods
Female rats, 3 weeks old, were subcutaneously implanted with 5α-dihydrotestosterone (DHT) or placebo pellets for 90 days to induce PCOS. Expression of 11β-hydroxysteroid dehydrogenase 1 (11βHSD1) and A-ring reductases (5α and 5β), as well as intracellular distribution of glucocorticoid receptor (GR) and expression of its regulated genes were examined in the liver. Proteins of hepatic lipid and carbohydrate metabolism and markers of inflammation were also assessed.
Results
DHT treatment induced increase in body and liver mass, as well as in triglycerides and free fatty acids levels in plasma. Elevation of 11βHSD1 and reduction of 5α-reductase expression was observed together with increased hepatic corticosterone concentration and nuclear GR activation. Induced expression of Krüppel-like factor 15 and decreased expression of genes for proinflammatory cytokines and de novo lipogenesis (DNL) were detected in the liver of DHT-treated rats, while DNL regulators and proinflammatory markers were not changed. However, increased mRNA levels of stearoyl-CoA desaturase and apolipoprotein B were observed in DHT animals.
Conclusions
DHT treatment stimulated hepatic glucocorticoid prereceptor metabolism through increased corticosterone availability which is associated with enhanced GR activation. This does not affect gluconeogenesis and DNL, but could be linked to stimulated triglyceride synthesis and hypertriglyceridemia.
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