Farmaceutski značaj procesa stereoizomerizacije Lucija Hok; Davor Šakić; Valerije Vrček ...
Kemija u industriji; časopis kemičara i tehnologa Jugoslavije,
01/2023, Volume:
72, Issue:
1-2
Journal Article
Peer reviewed
Open access
Proučavanje procesa stereoizomerizacije od iznimne je važnosti u farmaceutskoj kemiji i biomedicini. Različiti izomeri mogu pokazivati značajne razlike u interakciji s biološkim makromolekulama, što ...može dovesti do razlika i u njihovim farmakokinetičkim i farmakodinamičkim svojstvima te, u konačnici, u terapijskim i neželjenim učincima. Iako postoji velik broj primjera koji svjedoče o važnosti stereokemije, u ovome radu dan je pregled nekoliko najznačajnijih i najreprezentativnijih slučajeva u farmaciji.
Ramenski sklep je zaradi svoje zgradbe najbolj gibljivi sklep v človeškem telesu, hkrati pa tudi najbolj nestabilen. Ob popolnih ali nepopolnih izpahih rame pride do poškodbe stabilizatorjev sklepa. ...To pomeni, da je sklep še dodatno nestabilen, kar vodi v začarani krog. Nestabilnost ramenskega sklepa je pogosto tudi problem mladih, predvsem športnikov, zato je pred zdravljenjem nestabilnosti rame izjemno pomembno natančno diagnosticirati poškodbe drobnih struktur v sklepu. Standardno uveljavljena diagnostična metoda pri nestabilnosti rame je magnetnoresonančna artrografija (MR-artrografija) pod nadzorom fluoroskopije. V zadnjih letih je ob hitrem razvoju ultrazvočne tehnologije prišlo do velikega napredka v kakovosti visokofrekvenčnih linearnih sond, ki nam omogočajo natančen prikaz drobnih mehkotkivnih struktur. Slednje je, zlasti na področju mišično-skeletnega organskega sistema, omogočilo razvoj minimalno invazivnih posegov, pri katerih je natančnost in preglednost še posebno potrebna, mednje pa sodijo tudi artrografije.
Tumorji hrbtenice so primarni in sekundarni. Hrbtenica je najpogostejše mesto, kjer odkrijemo kostne metastaze. Do kar 70 % bolnikov z neoplazmo razvije metastazo v hrbtenici. Do 10 % bolnikov z ...neoplazmo utrpi metastatsko kompresijo hrbtenjače. Metastaze so kar 20-krat pogostejša neoplazma hrbtenice kot primarna neoplazma. Zelo pogosto je metastaza v hrbtenici prvi znak bolezni. Klinična slika je pestra in obstajajo različni pristopi k zdravljenju, ki so se precej spremenili v zadnjih letih. Revolucionarni uspeh je zdravljenje z uporabo stereotaktične radioterapije. Zdravljenje metastaz v hrbtenici je zelo pomembno in kompleksno področje, v katerem se prekriva veliko medicinskih strok in zahteva široko znanje in hitro ukrepanje. Pravilno diagnosticiranje in zdravljenje je ključnega pomena za bolnikovo kakovost življenja. Če se ne ta bolezen ne prepozna in se nepravilno ali nepravočasno ukrepa, pa so posledice grozljive.
Izolirana rekonstrukcija prednjeg križnog ligamenta (ACL) predstavlja zlatni standard u kirurškom liječenju rupture prednjeg križnog ligamenta. No, neuspjeh cijeljenja presatka i ostatna rotacijska ...nestabilnost koljena i dalje su česte postoperativne komplikacije. Anterolateralni ligament (ALL) i njegova uloga u kontroli rotacijske stabilnosti dobila je značajan interes 2013. nakon objave njegova „ponovnog otkrića”. Ta ligamentarna struktura, opisana još davne 1879., potječe od proksimalnog i stražnjeg dijela lateralnog epikondila bedrene kosti i hvata se na goljeničnoj kosti, na sredini između Gerdyjeva tuberkla i glavice fibule. Biomehanička ispitivanja pokazala su da anterolateralni ligament djeluje kao pasivni stabilizator koljena tijekom unutarnje rotacije koljena, i kod rupture ACL-a i lateralnih struktura koljena odgovoran je za nastanak pivot-shift fenomena. Pokazalo se da izolirana rekonstrukcija ACL-a u pacijenata s ozljedom ACL-a i ALL-a ne može vratiti normalnu kinematiku koljena, za razliku od njihove kombinirane rekonstrukcije. Uz to, dosadašnja literatura nudi brojne dokaze u smislu poboljšanja stabilnosti koljena nakon kombiniranog postupka rekonstrukcije ACL-a i ALL-a. Štoviše, nedavne kliničke studije pokazale su da ALL ima zaštitni učinak na očuvanje presatka ACL-a, kao i na brži ponovni povratak u sport i opće zadovoljstvo pacijenata s operativnim zahvatom. Ovaj pregledni rad ima za cilj dati pregled dosadašnjeg znanja anatomije, funkcije i učinka rekonstrukcije ACL-a i ALL-a u pacijenata s puknućem ACL-a.
Isolated anterior cruciate ligament (ACL) reconstruction is the gold standard in surgical treatment of anterior cruciate ligament rupture. However, graft failure rates and residual rotational instability of the knee are still common post-operative complications. The anterolateral ligament (ALL) and its role in controlling rotational stability gained considerable interest in 2013 following the announcement of its ‟rediscovery”. This ligamentous structure, described back in 1879, originates just proximal and posterior of the lateral epicondyle of the femur and it ends on the tibia, midway between Gerdy's tubercle and the head of the fibula. Biomechanical studies have shown that the anterolateral ligament acts as a passive knee stabilizer during internal knee rotation and in the rupture of the ACL and lateral knee structures is responsible for the presence of a pivot-shift knee phenomenon. It has been shown that isolated ACL reconstruction in patients with ACL and ALL injury cannot restore normal knee kinematics unlike their combined reconstruction. In addition, recent literature shows evidence in terms of improving knee stability after a combined ACL and ALL reconstruction procedure. Moreover, recent clinical studies have shown that ALL has a protective effect on the preservation of ACL graft as well as on the faster return to sport and overall patient satisfaction. This review aims to give an overview of our current knowledge of the anatomy, function, and effect of combined ACL and ALL reconstruction in patients with ACL rupture.
Cilj: Cilj rada jest prikazati rezultate anatomske stabilizacije kronično nestabilnog gležnja uz augumentaciju fibularnim periostealnim režnjem. Ispitanici i metode: Ukupno 7 muškaraca i 7 žena s ...kroničnom nestabilnošću gležnja, medijan životne dobi 37 godina (20 – 61 godinu), liječeno je operacijski transponiranim fibularnim periostealnim režnjem. Transponirani periostealni režanj fiksiran je sidrima ili transosealnim šavima za kost talusa i petne kosti, u rekonstrukciji prednjeg talofibularnog i kalkaneofibularnog ligamenta. Svi pacijenti analizirani su AOFAS i FADI biljezima prije operacije i najmanje godinu dana nakon zahvata. Rezultati: Prijeoperacijski AOFAS porastao je s medijana 47 (17 – 82) na medijan 95 (84 – 100) nakon stabilizacije periostealnim fibularnim režnjem (p < 0,05). Medijan preoperacijskog FADI-ja iznosio je 89,2 (13,8 – 95,2), a nakon operacije medijan FADI-ja iznosio je 95 (79,5 – 98,8) (p < 0,05). Četrnaest pacijenata vratilo se svojim redovitim životnim i sportskim aktivnostima. Anatomske metode stabilizacije gležnja daju bolje funkcijske rezultate u odnosu na neanatomske metode. Periostealno tkivo s fibule čvrsto je i odlično se remodelira, te nakon godinu dana u cijelosti formira originalni ligament. Većina istraživanja različitih oblika korištenja fibularnog periostealnog režnja u lateralnoj stabilizaciji gležnja, bez obzira na način i vrstu fiksacije, daje odlične funkcijske rezultate. Zaključak: Metoda lateralne stabilizacije gležnja periostealnim presatkom s fibule pouzdana je metoda liječenja kronične lateralne nestabilnosti gležnja.
Aim: The aim of this article is to evaluate the method of anatomical stabilization of a chronically unstable ankle with augmentation with a fibular periosteal graft. Patients and Methods: A total of 7 men and 7 women with chronic ankle instability, with an median age of 37 years (20-61 years), were treated by surgically transposed fibular periosteal graft. The transposed periosteal flap is fixed by anchors or transoseal sutures on the talus and calcaneus, in reconstruction of the anterior talofibular and calcaneofibular ligaments. All patients were analyzed with AOFAS and FADI scores before surgery and at least one year after surgery. Results: Preoperative AOFAS increased from median 47 (17-82) to median 95 (84-100) after stabilization with periosteal fibular lobe (p <0.05). The median preoperative FADI was 89.2 (13.8-95.2), and after surgery, the median FADI was 95 (79.5-98.8) (p <0.05). Fourteen patients returned to their regular life and sports activities. Anatomical ankle stabilization methods give better functional results than non-anatomical methods. The periosteal tissue from the fibula is firm and remodels perfectly, forming a whole ligament after a year. Most studies of different techniques of using fibular periosteal graft, in lateral ankle stabilisation regardless of the type of fixation, give excellent functional results. Conclusion: The lateral ankle stabilization method with periosteal fibular graft is a reliable method of treating chronic lateral ankle instability.
To provide physicians and patients with the tools needed to evaluate patients' problems and health-related quality of life by cross-culturally adapting and validating the Chronic Otitis Media ...Questionnaire 12 (COMQ-12), the Dizziness Handicap Inventory (DHI), the Neuropsychological Vertigo Inventory (NVI) and the Tinnitus Handicap Inventory (THI).
COMQ-12, DHI, NVI and THI were translated into the Slovenian language and completed by patients treated at our department for chronic otitis media, vertigo or tinnitus. The control group for each questionnaire consisted of healthy volunteers. Internal consistency, test-retest reliability, discriminant validity, diagnostic accuracy and cut-off value were determined for each questionnaire.
Test-retest reliability was excellent for DHI (ICC A=0.946) and NVI (p=0.315, ICC A=0.975), good to excellent for COMQ-12 (p=0.680, ICC A=0.858) and satisfactory for THI (p=0.120). Discriminant validity was confirmed for each questionnaire (p>0.05) using the Mann-Whitney U test (COMQ-12, DHI, THI) or the Welch t-test (NVI). COMQ-12 had acceptable (α=0.796) and DHI (α=0.910), NVI (α=0.950) and THI (α=0.924) perfect internal consistency. COMQ-12 and DHI had excellent, NVI acceptable and THI perfect diagnostic accuracy (AUC=0.987, AUC=0.999, AUC=0.781 and AUC=1.000 respectively). Cut-off values determined by Youden's index were 7, 7, 9 and 56 for COMQ-12, THI, DHI and NVI, respectively.
Slovenian COMQ-12, DHI, NVI and THI are a valid and accurate tool for the diagnosis and measurement of health-related quality of life in patients with chronic otitis media, vertigo and tinnitus. They could aid general practitioners, occupational health specialists, neurologists and otorhinolaryngologists.
Namjera ove studije je pojasniti posljedice Sokratove filozofije za razumijevanje odnosa između filozofije i politike, njihove međusobne tenzije i Sokrata kao neprijatelja naroda. Autor istražuje ...tenziju između filozofije i javnoga života usporedbom dva suprotstavljena filozofska projekta – one Sokrata i Platona – pojašnjavajući različite metode i smjerove koje slijede u svojem shvaćanju filozofije i politike. Autorova je tvrdnja da je Sokratova filozofija antipolitička i subverzivna, beskorisna za javni život, te vodi političkoj nestabilnosti i, kako Platon otkriva u svojim dijalozima, tragično osuđena na propast u susretu s političkom moći. S druge strane, Platonov politički projekt, uz sve njegove kontradikcije, neuspjehe i preokrete, predstavlja radikalni zaokret od Sokratove filozofije. Radi se o projektu osnivanja grada na novim političkim temeljima, pokušavajući učiniti filozofiju političkom, a grad siguran za filozofiju stalnom potragom za modus vivendijem između filozofije i politike.
Bušenje kroz šejlove upotrebom isplake na bazi vode podložno je znatnoj vremenski ovisnoj nestabilnosti kanala bušotine. Operatorske kompanije u fazi projektiranja bušaćih radova za problematična ...područja provode studije optimalizacije svojstava isplake kako bi definirale prikladan tip i gustoću te vrste soli i pripadajuće koncentracije soli za različite vrste šejlova. Analizom podataka prikupljenih tijekom izrade okolnih bušotina u polju o prodorima filtrata isplake u stijene pribušotinske zone te podataka o mehanizmu kemijskoga potencijala procjenjuje se njihov utjecaj na vremenski ovisnu nestabilnost kanala bušotine. Glavni je cilj ovoga rada prikaz i osvrt na analizu vremenski ovisne mehaničke nestabilnosti kanala bušotine i poteškoća tijekom izrade kanala bušotine kroz šejlove različitoga mineralnog sastava, koji su pokrovne stijene plinsko-kondenzatnoga ležišta polja D u Perzijskome zaljevu. Istaknuta je važnost rezultata istraživanja optimalizacije isplake za bušenje i prikazana su primijenjena rješenja prevladavanja problema nestabilnosti kanala bušotine u šejlovima. Kao doprinos određivanju optimalne gustoće isplake za bušenje predstavljen je koncept efektivnoga naprezanja te mehanizam vremenski ovisnoga sustava narušavanja stabilnosti kanala bušotine. Prikazani model proračuna gustoće isplake uzima u obzir odnos pornoga tlaka i efektivnoga tangencijalnog naprezanja u pribušotinskoj zoni i utemeljen je na mjerenim podatcima bušotine A, plinsko-kondenzatnoga polja D u Perzijskome zaljevu.
The main objective of the research presented in this paper was to determine whether or not there are significant differences in marital quality and stability among women in various stages of ...marriage, and to determine the structure of these differences, if they exist. We have also examined the differences in the characteristics of marriage between the wives in the first stage of marriage, i.e. the marriage period without children, and the wives in the next stage, after the childbirth. Those differences were analyzed separately because numerous studies from other countries suggest that the transition to parenthood changes marital relationships and makes them more difficult. The studies also suggest that the motherhood affects a wife’s life much more to than fatherhood affects the life of the man. The sample included 1580 wives of different socioeconomic status, 19 to 64 years old, living in formal or informal marriage. The quality of the marital relationship was measured by a Dyadic Adjustment Scale – DAS (Spanier, 1989), and marital stability was assessed through the indicators of the potential for the divorce (Booth, Johnson, & Edwards, 1983). Discriminant function analysis of the different periods of marriage, found only one statistically significant discriminant function (Rc = 0.26, p = 0.00), which was interpreted as “High attractiveness of the marriage along with reduced barriers to leaving the relationship.” The results are suggesting a downward tendency of the marital quality and marital satisfaction followed by the decrease in the divorce potential across the stages of marriage. In other words, there is a continual tendency of decreases in marital quality and satisfaction, and the increase of the marital stability over the different developmental stages of marriage. The greatest differences on isolated dicriminant function are between wives from the first and last of the examined stages of marriage, i.e. marriages in which the children are not yet born and marriages with late adolescent children that are ready to leave their parents. Second discriminant function analysis showed significant discriminative dimension (Rc = 0.25, p = 0.00), primarily determined by the potential for divorce, and marital satisfaction. Based on the results of this study, we may conclude that the transition to parenthood significantly strengthens marriage, and that the perception of marital quality and satisfaction steadily declines from the beginning to the end of marriage continuum. It is important to emphasize that, despite the existence of statistically significant inter-group differences, there is a large individual variation among wives within the same marital stage, and therefore it is not possible to make a reliable prediction of perceptions of the quality and stability of marital relations based solely on the stage of the marriage.
The aim of this two-wave study was to examine the mediating
role of adolescent appraisals of family security in the relation
between family instability and adolescent self-esteem in a sample
of 377 ...adolescents and their mothers. Mothers' reports of family
instability at Time 1 were significantly and positively associated
with adolescent appraisals of family insecurity at Time 1 and
Time 2. Adolescent self-esteem at Time 2 was significantly and
negatively related to family instability at T1 and family insecurity
at Time 1 and Time 2. Findings from structural equation models
supported the hypothesis that family instability undermines adolescents' self-esteem one year later by directly threatening adolescents' appraisals of family as a safe and secure system. The results indicated that adolescent appraisals fully mediated the
relation between family instability and adolescent self-esteem.
The implications of the findings for adolescent development in a
secure and stable family environment are discussed and suggestions
for further process-oriented research on the relation between
family instability and adolescent development are stated.
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