The Adriatic Island Rab, situated in the northern part of the Croatian sea, is more strongly exposed to sunlight (especially from May to October) than the other parts of Croatia and most of the ...European countries. As consequences of higher solar radiation, significant percentage of Pseudoexfoliation of lens capsula occurs in 15% and fundus picture of AMD (Age-Related Macular Degeneration) in 18% of agriculturalists and fishermen (45-70 years old). We previously presented the first clinical study showing that in AMD the peripheral visual field is also damaged. In this clinical study we examined 68 children (8-15 years old), including following procedures: vision correction, slit lamp examination, visual field in technic of isopters and profile quantitative perimetry (meridian retinal thresholds examination) using Kowa automated perimeter. In 15% of examinees we found strictly foveal "degeneration", and changes of visual fields: higher meridian thresholds and typical changes with invagination of isopters. It is very interesting that these children with damaged visual field and fundus picture do not protect their eyes from the sunlight during summertime. We suggest the possibility of the influence of higher sun radiation as one of the risk factors in the earlier development of future AMD.
are Gram-negative bacteria that are ubiquitous in the natural environment. Contaminated water in man-made water systems is a potential source of transmission of legionnaires' disease. The aim of this ...study is to explore the prevalence of
in the drinking water distribution system (DWDS) of Primorje-Gorski Kotar (PGK) County, Croatia, for the period 2013-2019, coupled with the incidence of legionnaires' disease. A number of
positive samples (>100 CFU/L), serogroup distribution and the degree of contamination of specific facilities (health and aged care, tourism, and sports) were assessed. Based on the obtained results, the reasoning for the implementation of a mandatory
environmental surveillance program was assessed.
Sample testing for
was carried out according to the standard method for enumeration of this bacterium. A heterotrophic plate count (HPC) and
number were analysed along with the basic physicochemical indicators of drinking water quality. The research period was divided into two parts, namely, the 2013-2018 period (before implementation of the prevention program, after the outbreak of legionnaires' disease), and the year 2019 (proactive approach, no disease cases recorded).
During the 7-year observation period in PGK County, an increase in the number of samples tested for
was found. An increase in
-positive samples (particularly pronounced during the warmer part of the year) was recorded, along with a growing trend in the number of reported legionnaires' disease cases. In addition to hot water systems, the risk of
colonisation also applies to cold water systems. Health and aged care facilities appear to be at highest risk. In addition to the higher proportion of positive samples and a higher degree of microbiological load in these facilities, the highest proportion of
SGs 2-14 was identified. Due to the diagnostic limitations of the applied tests, the number of legionnaires' disease cases is underdiagnosed.
The introduction of a mandatory preventive approach to monitoring
in DWDS water samples, along with the definition of national criteria for the interpretation of the results will create the preconditions for diagnosis and adequate treatment of larger numbers of legionnaires' disease cases.
To investigate the differences in parental knowledge, attitudes, and practice about antibiotic use and resistance among the urban and rural populations in Croatia.
A cross-sectional study based on a ...structured questionnaire was distributed to 1,000 parents of children attending 11 elementary schools of Primorsko-Goranska County in 2017.
The overall response rate was 65.1% (651/1,000)-50.6% (253/500) in urban and 79.6% (398/500) in rural population. Urban parents had a higher overall knowledge about antibiotics (
< 0.001), while urban and rural parents held mostly similar knowledge and attitudes related to antibiotic use when split into individual statements (
> 0.05). Age, education, income, work, and family member working in a health-related field were significantly related with the overall knowledge about antibiotics. In the previous year, 28.2% of children and 28.9% of parents reported using an antibiotic. Croatian parents had a high level of trust in doctors' antibiotic-prescribing practices (96.3% reported trusting the doctors' decision not to prescribe antibiotics, 93.5% to prescribe antibiotics) and high awareness of antimicrobial resistance (94.8%). The public's misconception regarding the terms "bacteria" and "virus" was found in 15.5% of parents. The source of information about antimicrobial resistance was television (60.4%), internet (57.1%), newspapers (44.2%), and medical professionals (30.9%).
Although the knowledge about antibiotics was higher in urban parents, it was not reflected on the level of antibiotic consumption. There are indications that medical professionals should be more involved in communicating the problems of antibiotic use and resistance to patients.
Abstract
Background
Antibiotic consumption in the paediatric population is one of the key drivers of the emergence and spread of antimicrobial resistance, which is a serious global threat to public ...health and clinical medicine. The aims of this study were to investigate systemic antibiotic consumption in school children and to assess the associations among antibiotic consumption, carriage rate and resistance of respiratory pathogens residing in the upper respiratory tract mucosa.
Methods
In this prospective study, throat and nasopharyngeal swabs from 450 school children, 6–15 years of age (225 healthy children and 225 patients who were ambulatory treated for upper respiratory tract infection), were processed in 2014 in Rijeka, Croatia, and clinical data were obtained via a questionnaire.
Results
In total, 17% of the children had consumed an antibiotic in the previous 6 months, including 7% of the healthy children and 27% of the acutely ill patients. The most commonly prescribed antibiotics were amoxicillin (26%), amoxicillin with clavulanic acid (26%) and macrolides (18%). Respiratory pathogens were more frequently isolated from children who had consumed an antibiotic in the previous 6 months odds ratio (OR) 3.67, P < 0.001. Antibiotic-resistant bacteria were also more frequent in children who had been exposed to antibiotics (OR 5.44, P < 0.001).
Conclusions
Penicillins are the most frequently used antibiotics among school children. The results of this study demonstrate that antibiotic consumption is linked with higher carriage rates and resistance rates of respiratory tract pathogens. Therefore, rational use of antibiotics could prevent the emergence and spread of resistant bacteria.
Objective. It has been suggested that the incidence of inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn's disease (CD), is higher in northern than in southern ...Europe. Recent epidemiological studies showed the loss of the previously described geographical north-south gradient. The aim of this study was to investigate the incidence of UC and CD in Primorsko-goranska County, Croatia. Material and methods. In the period 1 January 2000 to 31 December 2004 (5 years) all new patients diagnosed with IBD were prospectively identified according to a standard protocol for case ascertainment and definition. A total of 178 residents (81 F, 97 M) were newly diagnosed as having IBD during the study period. Of these, 70 had UC and 100 CD. Eight patients had indeterminate IBD. The data on patients were collected using a data form completed by gastroenterologists. Results. Annual age-standardized incidence rates were 4.3/105 (95% CI 2.6-6.0) for UC and 7.0/105 (95% CI 3.4-10.6) for CD. The highest incidence rate was observed in the age group 35-44 years for UC and the 25-34 years age group for CD. The incidence of IBD was higher in the urban than in the rural population, with the exception of on the islands. Conclusions. The incidence of IBD was higher than previously observed in Croatia. Our results suggest that CD incidence rates in the northern coastal part of Croatia are currently comparable with those reported in northern Europe.
The research aim was to investigate and establish the perception of health among population groups with different number of industrial polluters in their living environment. Namely, the Kostrena ...living area (3250 inhabitants) is situated near big industrial pollutant producers: INA oil refinery Urinj, thermo power plant Rijeka, shipyard "Viktor Lenac", while in Crikvenica living area such pollutant producers do not exist. In this research 146 subjects from Kostrena participated (74 men and 72 women with age average 40.8, SD 9.2 years), and 157 subjects from Crikvenica area (79 men and 78 women with age average 39.4, SD 10.1 years). The perception of health was measured by the means of SF-36 questionnaire variables. Lung function (FEV1, FVC, FEV25/75, PEF), cardiovascular function (systolic and diastolic arterial blood pressure, heart rate were also measured, including body proportion measures by the means of waste and hip circumference and silhouette test, in order to establish the eventual objective physical health parameter difference among examined population groups. Subjects from Kostrena perceived their general health, mental health, and vitality worse than subjects from Crikvenica. Group from Kostrena felt themself more limited in their roles due to emotional problems, perceiving more pain than group from Crikvenica. On the opposite site, social functioning of subjects from Kostrena was better in comparison to Crikvenica group. No signifficant differences between groups were found in physical functioning and in role limitation due to physical problems. In addition, there were no significant differences between groups in objective physical health parameters, such as pulmonary function, arterial blood pressure, pulse, and waist to hip ratio. Subjects using sensoric systems and the mental cognition about harmful environmental factors, perceive their health worse if there are present industrial resources in their environment, even when concentration of the pollutants are within legal ranges.
The present study investigates the response of three hepatic biomarkers in adult sea bass (
Dicentrarchus labrax
, Linnaeus 1758) caged at a wastewater outlet of an oil refinery with fish caged at a ...pristine site used as controls. The biomarkers that were investigated were the hepatosomatic index (HSI), 7-ethoxyresorufin-
O
-deethylase (EROD) activity and glutathione-
S
-transferase (GST) activity. In addition, we have measured the levels of polycyclic aromatic hydrocarbons (PAHs) and selected heavy metals (lead, cadmium, mercury, copper and zinc) in sediment samples at the polluted site. Although the polluted site had high environmental levels of PAHs and heavy metals, there was no difference in hepatic EROD activity and HSI between fish caged at the polluted site and controls. On the other hand, GST activity was significantly lower in fish caged at the polluted site compared to controls. Our results point out that the studied biomarkers have limited use in environmental risk assessment studies, at least when caged adult sea bass is used as the sentinel species and complex toxicant mixtures are involved.
The use of
in vitro biotests in combination with chemical determination of priority pollutants is considered a promising approach in environmental risk assessment. The main goal of this study was to ...evaluate the relationship between the CYP1A induction potential and the concentration of priority pollutants (PAHs, PCBs and heavy metals) in contaminated marine sediments. Six sediment samples characterized by different types of pollution were collected from the Bay of Kvarner, Croatia. CYP1A induction potency was determined
in vitro by the measurement of ethoxyresorufin-
O-deethylase (EROD) activity in PLHC-1 fish hepatoma cells. The results were compared to the potency of the model CYP1A inducer 2,3,7,8-tetrachlorodibenzo-
p-dioxin (TCDD) and expressed in 2,3,7,8-TCDD equivalents. All of the tested sediment samples were able to induce CYP1A activity in a dose-dependent manner. On a general scale, there was a good correlation between CYP1A induction and the concentration of priority pollutants in the tested samples. However, some samples, which had relatively low levels of priority pollutants, exhibited a strong CYP1A induction response. Therefore, apart from the confirmed usability and sensitivity of the EROD determination in the PLHC-1 cells as a suitable
in vitro model in ecotoxicology, the results of this study indicate that the list of priority pollutants usually determined in the attempt to evaluate the risk of adverse effects to marine wildlife should be reconsidered.
Abstract In an attempt to assess the intensity of environmental pollution in industrial zones of Kvarnerian Bay in Northern Adriatic Sea and the reactivity of Mytilus galloprovincialis to these ...changes, in this study we estimated the concentration of heavy metals at four locations in both sea-sediment and in the mussels. Further we tried to correlate these changes with seasonal variations in environmental temperature, pH and salinity, as well as with the expression of metallothioneins (MTs) and heat shock proteins (HSPs) in the digestive tract of the mussels. Sampling in vivo was performed monthly, during the year 2008, while under the laboratory conditions the reactivity of acclimated mussels were tested to increasing concentrations of CdCl2 and to thermal stress. The data have shown that the induction of MTs and HSP isoforms of the 70-kDa size class were highly affected by model agents treatment including contamination of sea-sediment by Pb, Hg and Cd, implying that these stress proteins might be power biomarkers of marine pollution.
The connection between socio-economic status and health is documented, yet not fully understood. The goal of this research was to analyze the relationship between socio-economic status, lifestyle and ...health status, availability of health-care, social capital, and satisfaction with life.
Subjects were 1117 women aged 25-65 years divided in two groups. Group 1 consisted of women who receive public assistance (N1=591), while Group 2 consisted of women who do not (N2=526). The sample was stratified by random choice into multiple stages based on six regions of Croatia, residential area size, and the age of respondents. Visiting nurses surveyed the deprived population, while in Group 2 self-interviewing was conducted. A questionnaire entitled "Inequalities in health" was used. The respondents participated in this research voluntarily and anonymously.
Socially deprived women consume spirits and wine more often (p<0.001). There is no difference between groups regarding tobacco consummation. Working women perform significantly less strenuous physical tasks (p<0.001). Deprived women are significantly less engaged in physical activities (p<0.001). Health conditions in deprived women more commonly limit their physical activity (p<0.001). There is a significant difference in utilization of health-care among groups (p<0.001). Younger women who are married, with a higher number of household members, a larger income, and with higher education are generally more satisfied with life (p<0.001). Although deprived women are significantly less satisfied with their lives, feel less free, are less physically active, and less likely to consume spirits or beer, they are significantly happier than working women (p<0.001).
Personal health status and lifestyle, access to health-care services, and life satisfaction have a high importance as predictors and protective factors of mental health in women - recipients of state-provided financial welfare.
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