Suchergebnisse

Hamstring sindrom mišića stražnje kože natkoljenice obično nastaje u trkača na kratke staze, skakača u vis i rvača. Od SO vojnika Hrvatske vojske koji su liječeni u Poliklinici za reumatske bolesti, fizikalne medicine i rehabilitacije u Zagrebu koji su imali simptomatologiju bolova u kralježnici, odabrali smo lO vojnika s simptomima različitim od klasične lumbois hijalgije, uzrokovane neobičnim uzrocima. Cilj rada bio je utvrditi točnu dijagnozu u slučajevima netipične lumbois hijalgije. Metode rada su bile: detaljna anarnne1.a ozljede tj. simptomi, funkcionalni testovi za lumbosakralnu kralježnicu i kineziološki testovi 1.a sindrome prenaprezanja. Anamnestič ki su podaci pokazali siijedeće: 6 od lO vojnika su ozlijeđeni na bojištu (dvojica prilikom preskakanja rovova a četvorica prilikom iskakanja iz vojnog transportera) a 4 su se ozljedila prilikom terenske obuke Qedan prilikom skakanja u vis, dvojica prilikom skoka u dalj, a jedan prilikom trčanja). Na početku liječenja oba Wellov i Wallaeov test bili su pozitivni u lO bolesnika, a "test otirača" je bio pozitivan u 8 bolesnika. Na kraju liječenja u 80% slučajeva testovi su bili negativni a u 20% djelomično pozitivni. Zaključujemo da u slučajevima atipične lurnhoishijalgije uzrokovane ozljedama pozornost se valja obratiti na druge entitete kao što je hamstring sindrom. Navedenu dijagnozu potvrdili smo uporabom odmdenih kinezioloških testova, vježbama istezanja kao i testovima jačanja hamstring mišića . ; The llamstings Syndrome (a syndrome of overstanding the muscles on the back side of the thigh) usually appears in sprinters, high jumpers and hurdlers. Out of fifty Croatian soldiers, treated in the Polyclinic Institution for l{heumalic Diseases, Physical Medicine ami Rehabilitation in Zagreb who showed the sympornatology of the spi ne pain syndrome, we selected ten soldiers who showed syrnpt.oms diffe rent from classic lurnboishialgia caused by extraordinary exertion. Our objective was lo set the exact diagnosis in cases of atypicallumboishialgia. The methods were: a detailed anam11esis of the injury i.e. the symptoms, functional tests of the lumbosacral spi ne and kinesiologicaltests for the overstraining syndrome. The anamnestic examination showed the following facts: six out of ten soldiers were i nj ured on the baulefied (two while leaping over trenches and fo ur while jumping out of a military transporter), and four were i nj ured on the driling-grounds one of them was inj ured while high-j umping, two while long jumping, and one while running. At the beginning of the treatment, both the Well test and the Wallace test were positive in ten subjects, and the "doormat test" was positive in eight subjects. Upon the end of the treatment in 80 o/o of the cases tests were negative, and in 20% only partially positive. We can conclude that in cases of aty pical lumboishialgia caused by injuries we should pay attention to the other entities as well, such as the l lamstrings Syndrome. The above diagnosis was confinned by the use of <:ertain kinesiological tests, stretehing exercises as well as the exercises for s trengthening the hamstrings muscles.

Vitamin D može smanjiti rizik od virusnih infekcija respiratornog trakta te smanjiti težinu i dužinu trajanja bolesti. Sama činjenica da stanice respiratornog epitela, monociti/makrofazi, dendritične stanice, T i B limfociti posjeduju receptore za vitamin D i da mogu autonomno aktivirati vitamin D koji onda djeluje autokrino i parakrino, ukazuje na značajan imunomodulatorni učinak vitamina D u urođenome i stečenome imunom odgovoru. Mehanizmi obrane od respiratornih virusa, uključujući i virus SARS-CoV-2, a koji su pod utjecajem aktivnog oblika vitamina D uključuju: indukciju stvaranja katelicidina antivirusnog proteina respiratornog epitela koji može smanjiti opterećenje virusom, poticanje urođenog imunog odgovora na virusnu infekciju, čuvanje integriteta respiratornog epitela kroz učvršćivanje uskih spojeva između stanica te kroz smanjenje prekomjernog stvaranja proupalnih citokina i pojačanje stvaranja protuupalnih citokina omogućavajući uravnotežen imuni odgovor na infekciju, time smanjujući nepotrebno oštećenje tkiva i takozvanu citokinsku oluju i posljedičnu akutnu ozljedu pluća koja u najtežim slučajevima bolesti COVID-19 rezultira respiratornim distres sindrom. Nadoknada vitamina D je jednostavna, sigurna i jeftina te bi trebala biti neizostavni dio javnozdravstvene politike sprječavanja zaraznih bolesti uključujući i COVID-19, posebice stoga što su za vrijeme pandemije ljudi dodatno izloženi nedostatku vitamina D jer su prisiljeni boraviti u zatvorenom prostoru, čime je onemogućen glavni put sinteze vitamina D u koži djelovanjem UV zraka. Za vrijeme pandemije virusom SARS-CoV-2 racionalno je nadoknadu provesti višim dozama, do 10 000 IJ dnevno, kako bi se u kratkom vremenu postigle koncentracije u krvi potrebne za nekalcemijske učinke vitamina D. ; Vitamin D may reduce the risk of respiratory tract viral infection, and the severity and duration of the disease as well. Respiratory epithelial cells, monocytes/macrophages, dendritic cells, T and B lymphocytes express vitamin D receptors, and can autonomously activate vitamin D. This points to a significant immunomodulatory effect of vitamin D in the innate and acquired immune response to viral infection. Defense mechanisms against respiratory viruses, including SARS-CoV-2, that are under the influence of the active form of vitamin D are: enhanced production of cathelicidin - an antiviral protein of the respiratory epithelium, induction of innate immune response to viral infection, preservation of the integrity of the respiratory epithelium, suppression of pro-inflammatory cytokine production and enhancement of anti-inflammatory cytokine production. The immunomodulatory effect of vitamin D supports a balanced immune response to viral infection and may reduce the risk of a cytokine storm and consequent acute lung injury, which in the most severe cases of COVID-19 disease results in respiratory distress syndrome. Vitamin D supplementation is simple, safe and inexpensive and should be an indispensable part of public health policy to reduce the risk of infectious diseases, including COVID-19. During a pandemic, the risk of vitamin D deficiency is increased because people are forced to stay indoors, thus disabling the main route of vitamin D synthesis in the skin under the effects of ultraviolet light. During the SARS-CoV-2 pandemic, Vitamin D supplementation should be prescribed with higher doses, up to 10,000 IU per day, to more rapidly achieve blood concentrations required for non-calcemic effects of vitamin D.

U radu se razmatraju ključna pitanja osposobljavanja radnika za siguran rad u operativnom šumarstvu kao temeljnom uvjetu kvalitete i ekonomičnosti rada u šumarskoj proizvodnji. U osvrtu na stanje osposobljavanja u razvijenim europskih zemljama navode se obveze poslodavaca vezano za odgovarajuće osposobljavanje rukovatelja strojeva, uređaja i alata pri izvođenju šumskih radova. Pritom se prikazuju pristupi i trendovi u osposobljavanju u posljednjem desetljeću te modeli i postignuti dosezi s posebnim naglaskom na do sada razvijene sustave certificiranja osposobljavanja u Europi i ključne elemente takvih sustava. Kao primjer uspješnih rješenja prikazuju se modeli osposobljavanja putem šumarskih trening centara, gdje se obukom stečena znanja i vještine potvrđuju obveznom provjerom i izdavanjem certifikata. Stanje stručnog osposobljavanja šumskih radnika u Hrvatskoj razmatra se u kontekstu moguće primjene pojedinih europskih sustava certificiranja šumskog rada u Hrvatskoj. S obzirom na potrebe, postojeće stanje osposobljavanja i profil ključnih aktera šumarskog sektora Hrvatske, kao najizglednijom za skoru primjenu u Hrvatskoj, ocjenjuje se provedba europskog standarda za rukovatelja motornom pilom. Zaključno se daje pregled zakonodavnih i organizacijskih zahtjeva za primjenu do sada razvijenih europskih modela u izgradnji sustava certifikacije osposobljavanja šumskih radnika u Hrvatskoj. ; The Introduction provides an overview of research findings related to danger and risk in the forestry profession toward other sectors through the standard indicators of safety at work on the example of the United States, Spain, Germany, Austria and other countries. On the other hand, training and periodical qualification verifying of the employee to work with the operating machinery and safe working practice are emphasized as an essential element in the process of improving the quality of work and safety in operational forestry. In addition, trends and changes in the education and training of human resources in forestry in general and the role of vocational training of forest workers in the prevention of injury and increase operational safety levels at work are cited.The subtitle material and method provides the most relevant sources that are used as the basis for drafting paper, such as, a document entitled »Professions and Training in Forestry – results of an inquiry in Europe and North America«, Eduforest International internet platform and internet platform of the European Forestry and Environmental Skills Council. Also, for the purpose of the paper forming the application of analysis and synthesis, comparison and compilation methods is explained.The third subtitle displays situation analysis of workers vocational training in forestry sector within which the Copenhagen Declaration is highlighted, which advocates strengthening and popularization of vocational education and training.Networks and programs in the field of forestry training within Europe are listed in the Table 1., and more detailed analysis of registered educational institutions in the Eduforest network basis and the results of the analysis are shown in Figure 1 and Figure 2. Heading 3.1 clarifies the role of vocational training of workers in forestry. In addition, a positive step of vocational training of workers in forestry at European level is highlighted through the establishment of the European Forestry and Environmental Skills Council whose mission is to simplify the mobility of workers in forestry and arboriculture within the EU through processes of accreditation and promotion of individual national qualifications between the partner countries at European level. Current condition on vocational training for chainsaw operator in the forestry of Croatia are explained in subtitle 3.2. Inconsistent and incomplete programs and training activities, a significant reduction, or the absence of practical training and the use of non-transparent criteria in the carried out training assessment are cited as the biggest problem. Subtitle 3.3 clarifies the role and contribution of the European Forestry and Environmental Skills Council in the training of workers. The subtitle lists the criteria for acquiring the status of a national center / agency prescribed by EFESC Handbook, and the list of national agencies accredited by the EFESC in Table 2. The logo of the European Forestry and Environmental Skills Council is presented in Figure 4. Implementation of the European Chainsaw Standard is explained in the text and four levels of European Chainsaw Standards are presented in Figure 6. Figure 7 displays German example of the European Chainsaw Standards implementation, and Table 3 shows the implementation of European Chainsaw Certificate within EFESC countries.The heading Discussion and Conclusion specify the limits of training and vocational training in the scope of forestry on the example of the dual education within the specialized institutions, namely, forestry training centers that provide comprehensive training in technical, safety and vocational aspect. In conclusion, in this paper the technical, organizational and legislative guidelines are listed for the potential implementation of the European model of certification of forest workers in the Croatian forestry with the aim of improving the current situation.