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2.
Acta Clin Croat ; 61(Suppl 2): 109-114, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36824634

RESUMO

In 10% to 30% cancer-pain cases standard analgesic therapy fails to provide effective pain relief. Interventional techniques, such as peripheral nerve blocks, neuraxial analgesia along with neurolytic blocks may be used for such refractory pain. Peripheral nerve blocks can be used when pain occurs in the territory of one or more peripheral nerves, but rarely as main therapy. Neuraxial analgesia is a valid option for progressive cancer pain, and healthcare possibilities and costs call into question the utility of intrathecal infusion pumps. Neurolysis is the targeted destruction of a nerve or nerve plexus, using chemicals, radiofrequency ablation (RFA), cryoablation, and neurosurgical procedures; however, it rarely completely eliminates pain because patients frequently experience coexisting somatic and neuropathic pain as well. Complex conditions of palliative patients along with limited high-quality randomized controlled trials limit the use of interventional procedures. Even so, some cancer patients benefit from interventional procedures to achieve pain alleviation and consequently improve quality of life.


Assuntos
Dor do Câncer , Dor Intratável , Cuidados Paliativos , Humanos , Dor do Câncer/complicações , Dor do Câncer/terapia , Neoplasias , Dor Intratável/complicações , Dor Intratável/terapia , Cuidados Paliativos/métodos , Qualidade de Vida
3.
Acta Clin Croat ; 56(3): 505-511, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29479917

RESUMO

Syphilis is a sexually transmitted, systemic disease caused by the spirochete bacterium Treponema pallidum. The most common mechanism of transmission is sexual intercourse. Although there are several hypotheses, the exact origin of the disease remains unknown. Newly published evidence suggests that the hypothesis supporting the theory of the American origin of the disease is the valid one. Among 1500 analyzed pathographies of composers and musicians, data on ten Anglo-American composers and jazz musicians having suffered from neurosyphilis (tertiary stage of the disease) were extracted for this report. In this group of Anglo-American composers and musicians, most of them died from progressive paralysis while still in the creative phase of life. Additionally, diagnoses of eleven other famous neurosyphilitic composers, as well as basic biographic data on ten less known composers that died from neurosyphilis-progressive paralysis are also briefly mentioned. In conclusion, neurosyphilis can cause serious neurological damage, as well as permanent disability or death, preventing further work and skill improvement.


Assuntos
Neurossífilis , Humanos , Música , Neurossífilis/diagnóstico , Neurossífilis/epidemiologia , Infecções Sexualmente Transmissíveis/epidemiologia , Estados Unidos/epidemiologia
4.
Lijec Vjesn ; 138(7-8): 179-88, 2016.
Artigo em Servo-Croata (Latino) | MEDLINE | ID: mdl-30091884

RESUMO

Introduction: The satisfaction of junior medical doctors is primarily associated with the training they receive during the residency period and working conditions. Given a considerable brain-drain of medical doctors from the Republic of Croatia, the present research focused on the evaluation of the satisfaction of junior medical doctors. Methodology: The Junior Doctors Committee of the Croatian Medical Chamber prepared a questionnaire on the satisfaction of junior doctors. The relevant questionnaire was available for filling in online in the period from February 1 to March 20, 2016. Results: The questionnaire was completed by 1,531 persons aged between 29 and 35 (mean age 32) of which 67% were females. A 58% of respondents would leave the Republic of Croatia if offered an opportunity. The main reasons for leaving the country include better working conditions (74%), well-regulated healthcare system (64%) and higher wages (64%). In case of staying in the country, their future professional status and development would remain unaltered (44%). Conclusion: The questionnaire results show a high level of dissatisfaction with the healthcare system, some segments of the specialist training and the mentor role. The analysis of factors affecting the satisfaction of junior doctors will facilitate the preparation and adoption of measures aiming to mitigate the above-mentioned trend.


Assuntos
Emigração e Imigração , Satisfação no Emprego , Corpo Clínico Hospitalar/psicologia , Adulto , Croácia , Meio Ambiente , Feminino , Humanos , Masculino , Salários e Benefícios , Inquéritos e Questionários
5.
Acta Clin Croat ; 55(4): 560-564, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-29117475

RESUMO

D-blade is a relatively new device in the field of videolaryngoscopy, designed for airway management by enabling indirectoscopic glottic view. In our study, we investigated efficiency of D-blade in comparison with direct Macintosh laryngoscope (gold standard). Fifty-two adult patients with normal airway scheduled for elective surgery in general anesthesia were randomly assigned in D-blade video or direct Macintosh group. In the first video group, patients were laryngo-scoped and intubated by D-blade, and in the second group laryngoscopy and intubation were performed by Macintosh laryngoscope. Glottic view was evaluated according to Cormack Lehane grading system (C-L), while duration of intubation and easiness of intubation were evaluated according to the intubation difficulty score (IDS). Additionally, hemodynamic parameters were recorded before and after induction. There were no statistically significant between-group differences in time to intubation, easiness of endotracheal tube insertion, C-L, and IDS. In comparison with direct Macintosh laryngoscope, D-blade showed similar but still favorable characteristics. In our opinion, D-blade is a useful device in airway management and should be used in daily anesthesiologist work.


Assuntos
Competência Clínica , Intubação Intratraqueal/instrumentação , Laringoscópios , Laringoscopia/instrumentação , Adulto , Croácia , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Laringoscopia/métodos , Masculino , Pessoa de Meia-Idade , Cirurgia Vídeoassistida
6.
PLoS One ; 8(9): e74042, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24066093

RESUMO

BACKGROUND: Twenty common genetic variants have been associated with risk of developing colorectal cancer (CRC) in genome wide association studies to date. Since large differences between populations exist, generalisability of findings to any specific population needs to be confirmed. AIM: The aim of this study was to perform an association study between risk variants: rs10795668, rs16892766, rs3802842 and rs4939827 and CRC risk in Croatian population. METHODS: An association study was performed on 320 colorectal cancer cases and 594 controls recruited in Croatia. We genotyped four variants previously associated with CRC: rs10795668, rs16892766, rs3802842 and rs4939827. RESULTS: SMAD7 variant rs4939827 (18q21.1) was significantly associated with CRC risk in Croatian population. C allele was associated with a decreased risk, odds ratio (OR): 0.70 (95% CI: 0.57-0.85, P=3.5E-04). Compared to TT homozygotes, risk was reduced by 34% in heterozygotes (OR=0.66, 95% CI: 0.47-0.92) and by 52% in CC homozygotes (OR=0.48, 95% CI: 0.33-0.72). CONCLUSION: Our results show association of rs4939827 with colorectal cancer risk in Croatian population. The higher strength of the association in comparison to other studies suggests population-specific environmental or genetic factors may be modifying the association. More studies are needed to further describe role of rs4939827 in CRC. Likely reason for failure of replication for other 3 loci is inadequate study power.


Assuntos
Neoplasias Colorretais/genética , Proteína Smad7/genética , Idoso , Croácia , Feminino , Predisposição Genética para Doença/genética , Variação Genética , Genótipo , Heterozigoto , Humanos , Masculino , Pessoa de Meia-Idade
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