Svjetska zdravstvena organizacija navodi utapanje kao treći vodeći uzrok nenamjernih ozljeda u svijetu, a prema podatcima Hrvatskoga zavoda za javno zdravstvo, utapanje je četvrti uzrok smrtnosti ...nakon padova, prometnih nesreća i otrovanja. U Hrvatskoj oko stotinu ljudi godišnje umre od posljedica utapanja. Mala djeca i muške odrasle osobe pod najvećim su rizikom. Obrazovanje studenata osnovna je misija Fakulteta za odgojne i obrazovne znanosti, a edukacija građana ključna je sastavnica Hrvatskoga Crvenogakriža u strategiji sprječavanja utapanja. Kako se svatko može naći u situaciji postati slučajni spasilac, a osobito učitelji razredne nastave u svome radu s učenicima mlađe školske dobi, osmišljen je zajednički projekt Sigurnost na vodi koji se redovito provodi od 2011. godine. Projektom se podiže svijest javnosti o opasnostima i rizicima povezanim s vodom te kodovima sigurnosti na vodi, a što kao prevencija značajno doprinosi smanjenju broja nesretnih događanja na vodi i rizika od utapanja. U sklopu projekta provode se radionice za studente Učiteljskoga studija, a od 2018. godine i za studente Kineziologije. Cilj je provedenih radionica u okviru seminara Slučajni spasilac podučiti studente o postupcima prevencije nesreća na vodi, uočavanju opasnosti pri boravku uz vodu, općenitim postupcima i priručnim sredstvima spašavanja na vodi te postupcima prve pomoći. Od 2019. godine planiramo ovaj edukacijski projekt provoditi i sa studentima Ranoga i predškolskoga odgoja.
Abstract
Background
Methotrexate is widely used in inflammatory diseases during the patients’ reproductive years. The effect on male fertility and sperm DNA integrity is largely unknown. We evaluated ...sperm DNA integrity and basic semen parameters according to the World Health Organization (WHO) in male patients with inflammatory diseases treated with methotrexate.
Methods
Semen samples from 14 patients on low-dose maintenance methotrexate were compared with samples from 40 healthy volunteers. Further, 5 patients delivered samples on and off methotrexate therapy for paired comparison. Sperm DNA fragmentation index (DFI), concentration, motility, and morphology were evaluated. Blood sex hormones and methotrexate levels were measured in blood and semen.
Results
DNA fragmentation index in methotrexate-treated patients was comparable with that in healthy volunteers (DFI, 11.5 vs 15.0; P = .06), and DFI did not change significantly on and off methotrexate in the paired samples (DFI, 12.0 vs 14.0; P = 0.35). Sperm concentration, motility, and morphology did not differ between men treated with methotrexate and healthy volunteers. Sperm progressive motility increased off therapy compared with on therapy (65.0% vs 45.0%, P = .04), but all fluctuations in progressive motility were within the WHO reference interval. All methotrexate polyglutamates1-5 were detected in blood, but only methotrexate polyglutamate1 in semen. Serum testosterone was unaffected by methotrexate therapy.
Conclusions
Patients treated with low-dose methotrexate have a sperm quality comparable with that of healthy volunteers, and methotrexate treatment does not increase sperm DNA fragmentation. This study does not support cryopreservation of semen before treatment initiation nor a 3-month methotrexate-free interval prior to conception.
