Poboljšanje krvnog tlaka, cirkadijalnog ritma i proteinurije u bolesnika s kroničnom bubrežnom bolešću nakon postupka denervacije bubrežnih arterija

Renal sympathetic denervation (RSD) could be an effective antihypertensive treatment of resistant hypertension that triggers additional positive effects on glucose metabolism and insulin sensitivity in type 2 diabetes mellitus. We report the effects of RSD in a patient with chronic kidney disease, type 2 diabetes mellitus and resistant hypertension, manifesting as blood pressure reduction with dipping pattern restoration, followed by nephrotic proteinuria alleviation. The non-dipping blood pressure pattern and proteinuria increase the risk of cardiovascular complications and accelerate kidney disease progression. Thus, further research documenting the frequency and investigating the mechanisms of these effects reported after RSD in chronic kidney disease patients with type 2 diabetes mellitus and resistant hypertension is necessary for the benefit of this high-risk patient population.Denervacija bubrežnih arterija (DBA) je jedna od obećavajućih novih metoda liječenja rezistentne hipertenzije refraktorne na optimalno liječenje kombiniranom antihipertenzivnom terapijom koja uključuje 3 i više lijekova iz različitih antihipertenzivnih skupina, od kojih jedan mora biti diuretik. Uz učinak na sniženje tlaka, radiofrekventnom ablacijom periarterijskih simpatičkih niti denervacijom uočeni su dodatni pleotropni pozitivni učinci poput regulacije glikemije i inzulinske rezistencije u osoba sa šećernom bolešću tipa 2. U radu je prikazan učinak DBA u bolesnika s kroničnom bubrežnom bolešću (KBB), šećernom bolešću tipa 2 i refraktornom hipertenzijom: djelomično sniženje krvnog tlaka polučilo je dodatni učinak na snižavanje krvnog tlaka tijekom noći uz smanjenje nefrotičke proteinurije, bez pogoršanja KBB. Izostanak očekivanog sniženja krvnog tlaka tijekom noći i nefrotska proteinurija povećavaju kardiovaskularni rizik bolesnika i progresiju KBB. Daljnja prospektivna istraživanja mehanizama nastanka povoljnih učinaka DBA u bolesnika sa šećernom bolešću tipa 2, KBB i rezistentnom hipertenzijom su neophodna kako bi se dokazali dodatni učinci blokade simpatičkog sustava DBA u ove visoko rizične populacije

Zajednica veslonožaca od Arktika do Antarktike: upotreba „citizen science“ u poznavanju globalne raspodjele brojnosti nauplija i postnauplija u epipelagijskom sloju

The use of citizen science and opportunity sampling during commercial or tourist voyages can provide valuable insights into the structuring of the marine plankton community in broad biogeographic areas. With the goal of studying the distribution and abundance of smaller zooplankton using citizen science approach, plankton samples were collected at 33 stations spanning from the Arctic to Antarctic during the cruise of the S/V “Croatian Tern” (1994-1997), using vertical tows with a 53µm mesh size Nansen net in the upper epipelagic layer. In this study, we summarize the observed distribution patterns of planktonic copepods by ontogenetic stages (nauplii, copepodites, adults) and by postnaupliar assemblages (calanoids, oithonids, oncaeids, harpacticoids, corycaeids), reporting also on the numerical ratio of nauplii to postnaupliar copepods, as an important indicator of the stability of copepod reproduction. The highest abundances of total copepods were found in the northeastern and southeastern Pacific, while the lowest values were found in the Mediterranean Sea and Southern Ocean. Overall, the copepod community was dominated by naupliar stages, while most postnaupliar assemblages (calanoids, oithonids, and oncaeids) were dominated by copepodites. Spatially, nauplii and postnaupliar oithonids showed similar latitudinal patterns, with both assemblages dominating in high latitudes of temperate zones on both sides of the equator, while contributions of calanoids, oncaeids, and corycaeids increased at lower latitudes. The ratio of nauplii to postnauplii varied from 1.1 to 6.4, and only at five stations was it slightly < 1. Latitudinally, the median values of this ratio varied from 1.1 in the marginal Arctic to 3.1 in the South Pacific, with no statistically significant differences among areas. The sudden change in nauplii/ postnauplii ratio could signal disturbances in the copepod community, provided that the average values are determined for all marine areas under different productivity conditions.Korištenje „citizen science“ prilikom sakupljanja uzoraka tijekom komercijalnih ili turističkih brodskih putovanja može pružiti vrijedan uvid u strukturu zajednica morskog planktona u širokim biogeografskim područjima. S ciljem proučavanja raspodjele i brojnosti manjeg zooplanktona korištenjem navedenog pristupa, uzorci planktona prikupljeni su u gornjem dijelu epipelagijskog sloja na 33 postaje od Arktika do Antarktike tijekom krstarenja jedrilice “Hrvatska čigra” (1994.-1997.). Uzorci su sakupljeni vertikalnim potezima Nansen planktonske mreže veličine okca od 53 mikrometra. U ovoj studiji saželi smo uočene obrasce raspodjele planktonskih račića veslonožaca po ontogenetskim stadijima (naupliusi, kopepoditi, adulti) i po postnauplijarnim skupinama (kalanoidi, oitonidi, onceidi, harpaktoidi, koriceidi). Izneseni su podaci o brojčanom odnosu naupliusa i postnauplijskih kopepoda , kao pokazatelju stabilnosti razmnožavanja kopepoda. Najveće abundancije ukupnih kopepoda utvrđene su u sjeveroistočnom i jugoistočnom Pacifiku, dok su najmanje vrijednosti utvrđene u Sredozemnom moru i Južnom oceanu. Sveukupno, zajednicom kopepoda prevladavali su nauplijski stadiji, dok su u većini postnauplijskih skupina (kalanoidi, oitonidi i onceide) dominirali kopepoditi. Brojnosti nauplija i postnaupliarni oitonidi pokazali su slične geografske obrasce, pri čemu su obje skupine dominirale na visokim geografskim širinama umjerenih zona s obje strane ekvatora, dok su se udjeli kalanoida, onceida i koriceida povećali na nižim geografskim širinama. Omjer nauplija i postnauplija kolebao je od 1,1 do 6,4, a samo na pet postaja bio je neznatno < 1. Latitudinalno, srednje vrijednosti ovog omjera varirale su od 1,1 u rubnom Arktiku do 3,1 u južnom Pacifiku, bez statistički značajnih razlika među područjima. Nagla promjena u omjeru brojnosti nauplija i postnauplijarnih stadija mogla bi signalizirati poremećaje u zajednici kopepoda, pod uvjetom da su prosječne vrijednosti određene za sva morska područja pod različitim uvjetima produktivnosti

Embolisation of Posttraumatic Superior Mesenteric Artery Pseudoaneurysm in a Patient with Short Bowel Syndrome Preceding Bowel Transplantation

Penetrating abdominal trauma often causes bowel injuries which may lead to “short bowel syndrome” which is a potential indication for bowel transplantation. Posttraumatic pseudoaneurysms of abdominal arteries are often a result of penetrating abdominal trauma. We report a successful embolisation of posttraumatic superior mesenteric artery (SMA) branch pseudoaneurysm using microcoil, in a patient with short bowel syndrome who was successfully transplanted three months after embolisation

Endovaskularno kreiranje dijalizne arteriovenske fistule

Surgical fistulas have been used to create dialysis access for over 50 years in chronic kidney disease patients. However, due to problems like slow maturation and a high risk of thrombosis or stenosis, results remain sub-optimal with high intervention and surgery rates to maintain patency. Endovascular methods for fistula creation were invented recently to resolve these issues, allowing haemodialysis patients to have an alternative non-surgical option, with two different devices currently available. Endovascular creation of A-V fistulas is involved with minimal vessel trauma, which could be the reason for encouraging initial results demonstrating high technical success rates, low intervention rates, and good patient satisfaction. This article describes the technical aspects of these procedures, patient selection as well as trial results, and the status of endovascular arteriovenous fistula creation.Kirurški napravljene fistule se koriste više od 50 godina za stvaranje pristupa za dijalizu kod pacijenata s kroničnim bubrežnim zatajenjem. Međutim, zbog problema kao što su dugotrajna maturacija te visok rizik tromboze ili stenose rezultati ostaju suboptimalni s učestalim reintervencijama i operacijama kako bi se održala prohodnost fistule. Kako bi se premostilo ove nedostatke od nedavno su stvorene endovaskularne metode za kreiranje fistula, što pacijentima na dijalizi daje dodatnu nekiruršku opciju, s dva različita trenutno dostupna sustava.Endovaskularno kreiranje A-V fistule je povezano s minimalnom traumom krvnih žila što može biti razlog za ohrabrujuće rane rezultate, koji pokazuju visoku stopu tehničke uspješnosti, nisku stopu reintervencija uz dobro prihvaćanje od strane pacijenata. U ovom radu opisujemo tehničke aspekte ovih zahvata, pravilan izbor pacijenata kao i rezultate istraživanja te trenutni status endovaskularnog zahvata stvaranja arteriovenske dijalizne fistule

Prostorne i vremenske promjene brojnosti i biomase oligotrihnih ciliata u Kaštelanskom zaljevu (srednji Jadran)

The nonloricate ciliate (NLC) community was investigated in Kaštela Bay from January 1998 until November 1999. Samples were collected at four sites characterized by different trophic states. Cell abundance, carbon content, and size categories of the oligotrich ciliates were investigated. NLC abundance was highest in spring with average values of 400-608 ind.l-1. Abundance during the second highest period, autumn-winter, was less pronounced. In the eutrophicated part of the bay, conditions were most favorable for NLC proliferation in summer, with the highest average density (1430±1348 ind.l-1) in August 1998. The size structure of the NLC populations changed with the trophic gradient. Organisms of <104 μm3 were useful in distinguishing trophic conditions in the marine ecosystem. Eutrophication favored growth of organisms of <104 μm3 while the succession of NLC categories changed without a clear seasonal pattern. Eutrophication also increased NLC biomass and affected seasonal fluctuations of biomass values. Average monthly biomass values ranged from 0.012±0.014 to 3.925±5.094 μgC l-1. The high abundance and biomass in Kaštela Bay suggest that NLC play a critical role in the secondary production of the area.Zajednica nelorikatnih ciliata (NLC) je istraživana u Kaštelanskom zaljevu od siječnja 1998. do studenog 1999. godine. Uzorci su sakupljeni na četiri postaje različitog trofičkog stanja. Istraživana je brojnost, sadržaj ugljika i veličinske kategorije oligotrihnih cilijata. Najviša je brojnost NLC zabilježena u proljeće s prosječnim vrijednostima od 400 do 608 jed.l-1, dok je drugi godišnji maksimum, u jesensko-zimskom razdoblju, slabijeg intenziteta. U eutrofiziranom su dijelu Kaštelanskog zaljeva povoljni uvjeti za razmnožavanje NLC zabilježeni u ljetnom razdoblju s najvišom prosječnom gustoćom od 1430±1348 jed.l-1 (kolovoz 1998.). Veličinska se struktura populacija ovih organizama mijenjala i duž trofičkog gradijenta. Organizmi biovolumena manjeg od 104 μm3 su korisni za razlikovanje trofičkih uvjeta u morskom ekosustavu. Eutrofikacija povoljno djeluje na zastupljenost ove veličinske kategorije organizama, a sezonska sukcesija veličinskih kategorija NLC postaje nepravilna. Osim toga eutrofikacija utječe i na povećanje biomase NLC, te na njene sezonske promjene. Pro-sječne su vrijednosti biomase na istraživanim postajama kolebale u granicama od 0.012±0.014 do 3.925±5.094 μgC l-1. Visoke vrijednosti brojnosti i biomase NLC u Kaštelanskom zaljevu ukazuju na iznimnu važnost ovih organizama u sekundarnoj proizvodnji ovog područja

Kompetitivne prednosti nacija: Porterov Dijamant za Hrvatsku

In my thesis I examined several aspects of Strategic Management with a focus on Porter's Diamond Framework. I explained main characteristics of Strategic Management, listed the important components of Management itself and finally focused on Porter's Framework. I especially focused on a model for Croatia which was a topic of my thesis. I mostly focused on a tourism aspect, but others as well and finally I gave a proposition for better achievement of national competitive advantage.U svom završnom radu analizirala sam nekoliko aspekata Strateškog Menadžmenta sa posebnim naglaskom na Porterov Model. Objasnila sam glavne karakteristike Strateškog Menadžmenta, navela glavne karakteristike samog Menadžmenta i na kraju se fokusirala na Porterov Dijamant. Posebno sam se fokusirala na primjenu Dijamanta za Hrvatsku obzirom da je to bila tema samog rada. Najviše sam pažnje pridala turističkoj grani obzirom da je ona jedna od većih aduta te na kraju iznjela mišljenje koje bi promjene mogle biti uvedene kako bi se postigla i veća kompetentnost na tržištu

Broadband Dielectric Spectroscopy with a Microwave Ablation Antenna

Microwave ablation is a technique used to treat tumorous tissue. Its clinical use has been greatly expanding in the last few years. Because the design of the ablation antenna and the success of the treatment greatly depend on the accurate knowledge of the dielectric properties of the tissue being treated, it is highly valuable to have a microwave ablation antenna that is also able to perform in-situ dielectric spectroscopy. In this work, an open-ended coaxial slot ablation antenna design operating at 5.8 GHz is adopted from previous work, and its sensing abilities and limitations are investigated in respect of the dimensions of the material under test. Numerical simulations were performed to investigate the functionality of the floating sleeve of the antenna and to find the optimal de-embedding model and calibration option for obtaining accurate dielectric properties of the area of interest. Results show that, as in the case of the open-ended coaxial probe, the accuracy of the measurement greatly depends on the likeness between the calibration standards' dielectric properties and the material under test. Finally, the results of this paper clarify to which extent the antenna can be used to measure dielectric properties and paves the way to future improvements and the introduction of this functionality into microwave thermal ablation treatments

Dissecting lesions of common carotid artery after carotid surgery: a case report

This case report represents rare complication of carotid surgery, iatrogenic dissection of the common carotid artery and its successful endovascular treatment. We herein report a case of 55 year-old female patient in whom carotid surgery was performed due to constant tinnitus caused by kinking of right internal carotid artery. On day 7th carotid control ultrasound was performed, according to hospital’s protocol. The carotid ultrasound showed dissecting lesion of right common carotid artery in a length of three centimeters that was confirmed with computed tomography angiography of neck vessels, and dual antithrombotic therapy was initiated. One month later percutaneous angioplasty was performed with stent implantation

Učinkovitost zaštite dojke omatanjem prsišta u slikovnoj dijagnostici abdomena kompjutoriziranom tomografijom

The dose absorbed by sensitive breast glandular tissue in abdominal computed tomography examinations, even when the breasts are outside the primary imaging beam, is still significant. Several studies have explored using breast shielding with a protective lead sheet or a bra. Since the source of radiation in computed tomography rotates by 360° around the patient, we made a custom-tailored shielding device that wraps around the entire thorax. The hypothesis is that such a custom-tailored breast shielding device provides significantly better dose reduction. Study participants were female patients with no anatomic anomalies. Entrance surface doses were measured using thermoluminescence dosimeters placed on the skin of the breast in the control group without shielding and on the surface and below the shielding device in the group with anterior shielding and the group with the new device. As expected, according to literature data, doses measured at breast level were above the threshold that epidemiological studies determine as an increased risk of breast cancer development although they were not in the primary imaging plane. Preliminary results of our study showed that average dose reduction was 42% with conventional anterior shielding and 57% with wrapped shielding compared to the doses measured with no shielding.Doza koju apsorbira osjetljivo žljezdano tkivo dojke prilikom pregleda abdomena kompjutoriziranom tomografijom značajna je čak i kad su dojke izvan primarnog polja snimanja. Brojne studije istraživale su primjenu olovne plahte ili „grudnjaka“ za zaštitu dojki. S obzirom na to da se izvor zračenja prilikom kompjutorizirane tomografije rotira 360° oko bolesnika izradili smo vlastitu zaštitnu pregaču koja se omata oko cijelog opsega prsišta. Naša hipoteza je da tako skrojena pregača pruža značajno bolju zaštitu. U istraživanje su bile uključene bolesnice bez anatomskih anomalija. Ulazne doze na površini kože mjerene su putem termoluminiscentnih dozimetara koji su postavljeni na kožu dojke u kontrolnoj skupini bez zaštite, na površinu i ispod površine pregače u skupini s prednjom zaštitom i u skupini s novom pregačom. Prema očekivanjima i u skladu s literaturnim podacima, izmjerene doze na razini dojke su bile iznad granice koju epidemiološke studije označuju kao povišeni rizik za razvoj karcinoma dojke, iako su bile izvan primarnog snopa snimanja. Preliminarni rezultati naše studije pokazuju prosječno smanjenje doze uz konvencionalnu prednju zaštitu za 42% te uz obuhvatnu novu pregaču za 57% u usporedbi s dozama izmjerenima bez zaštite