Ischemic heart disease (IHD) morbidity and mortality indices, along with medical intervention rates, were analyzed among Mediterranean countries, Croatia, Slovenia, Spain, Italy, and France, in the ...pre-COVID period. Standardized IHD incidence and prevalence rates from 1990 and mortality rates from 1985 were obtained from the Global Burden of Disease Study 2017 and Health for All databases. Coronary artery bypass graft (CABG) and transluminal coronary angioplasty (TCA) rates in the 2011–2019 period were obtained from Eurostat. Trends were estimated with Joinpoint regression analysis. IHD mortality rates range from 13.6 to 74.3 for females and from 37.8 to 126.03 for males. IHD mortality rates in Croatia were 5.6-fold higher among females and 3.3-fold higher among males compared to France. All countries decreased standardized IHD prevalence and incidence rates, although the magnitude varied. The high-to-low ratio, Croatia vs. Spain, was 3.5-fold for CABG and 3.2-fold for TCA. Slovenia, as opposed to Croatia, reduced the gap for all medical indicators except for relatively high prevalence rates. Despite a significant rise in medical interventions in Croatia, ineffective clinical and public health initiatives have led to only modest declines in IHD mortality rates over the past decade.
To assess the variation in the waiting time for diagnostic imaging (DI) services among Croatian public hospitals and the utilization of computed tomography (CT) and magnetic resonance imaging (MRI) ...scanners.
We analyzed aggregated data from public hospitals. Counties were classified according to economic strength, and utilization was expressed as the average number of exams per machine. We compared the waiting times for 2018 and utilization for 2015 according to hospital category (high and low level) and economic strength by county.
The waiting time was longer for MRI compared with CT, 268 vs 77.61 days. Overall CT waiting time was in the unfavorable European Health Consumer Index category. High-level hospitals had longer waiting time for MRI and CT. The waiting time positively correlated with economic strength for MRI (P=0.019), but not for CT. In low-level hospitals, MRI utilization ranged from 104 to 6032, whereas CT utilization ranged from 48 to 17852. In high-level hospitals, MRI utilization ranged from 3846 to 11 026, while CT utilization ranged from 503 to 17 234. CT (P=0.041) and MRI (P=0.031) utilization in high-level hospitals was significantly higher than in low-level hospitals.
The waiting times for CT and MRI were exceptionally long regardless of the hospital category, with highly varying utilization. Croatia performed more exams per scanner compared with other EU countries, but not significantly so. High-level hospitals' utilization was significantly higher than that of low-level hospitals, and CT utilization was significantly higher than EU average, while the difference for MRI utilization was not significant.
The aim of the study was to analyse the temporal and geographic distribution of radiologists, computed tomography and magnetic resonance scanners in Croatia. In this observational study we estimated ...radiologists’ number per 100,000 population for 1997, 2006, and 2017 and compared private and public CT and MR scanners between 2011 and 2018. We analyzed the availability of radiologists and scanners, and the relationship between the radiological workforce and economic strength among counties. The workforce increased significantly from 1997 to 2017 and was associated with economic strength categories in 2017. In 2018, there were more CT scanners in the public sector, while MR scanners were distributed evenly. In 2011, there was similar distribution of CT and MR between sectors, while in 2018 there were significantly more public CT scanners. Counties with a medical school had significantly more radiologists and MR scanners. The high-to-low ratios per CT and MR were 11 and 8.2, suggesting inequality of health care. Croatia significantly increased its radiological workforce; however, cross-county inequality remained. Counties with higher economic strength and medical schools have better availability of radiologists and equipment. To ensure the sustainable activity of the health care system, a precise estimate of supply and demand of radiology services is needed.
AimThe aim of this study was to estimate the effects of a pulmonary rehabilitation programme (PR) on the functional capacity and respiratory muscle strength of patients with post-COVID ...syndrome.MethodsA cross-sectional study was conducted using hospital data on patients who participated in a pulmonary rehabilitation programme at the Clinic for Lung Diseases, University Hospital Centre Zagreb, Croatia, between January 2021 and December 2022. Data on the spirometry, respiratory muscle strength, and functional exercise capacity of patients were collected at baseline and three weeks after the start of rehabilitation. The study included 80 patients (43 females, 37 males) with a mean age of 51±10 years.ResultsA significant increase in respiratory muscle strength (P<0.001) was observed after pulmonary rehabilitation, with effect sizes ranging from small to large (Cohen's d from 0.39 to 1.07), whereas the effect for PImax expressed as a percentage was large (Cohen's d=0.99). In addition, the pulmonary rehabilitation programme significantly improved the parameters of the six-minute walk test in patients, and the parameters of lung function, FVC, FEV1, and DLCO also improved significantly after PR (P<0.05).ConclusionThe results showed that the pulmonary rehabilitation programme has clinically significant effects on functional capacity and respiratory muscle strength in patients with post-COVID syndrome.
Myocardial Bridging: A cause for concern? Boban, Marin; Kovač, Antun Zvonimir; Jukić, Mladen ...
Liječnički vjesnik,
4/2023, Letnik:
145, Številka:
Supp 2
Web Resource, Journal Article
Recenzirano
Odprti dostop
Myocardial bridging(MB) is a condition where a segment of a coronary artery, which normally runs on the surface of the heart muscle, instead dives
into the heart muscle and then re-emerges to ...continue its normal path. In MB, a segment of the coronary artery dives into the heart muscle during systole and re-emerges during diastole. This can lead to compression of the artery, reducing blood flow to the heart muscle during systole and causing symptoms such as chest pain or shortness of breath.
Cilj: Analizirati demografska obilježja i distribuciju reumatologa u Hrvatskoj po vrstama specijalizacija i županijama te izračunati stopu na broj stanovnika na državnoj i županijskoj razini. ...Materijal i metode: Ovo presječno istraživanje temeljeno je na podatcima dobivenima od Hrvatskoga zavoda za javno zdravstvo o djelatnim reumatolozima zaključno do rujna 2022. godine. Analizirana je raspodjela reumatologa po dobi, spolu, vrsti specijalizacije, vrsti ustanove (akademska vs. neakademska) i lokaciji (županija). Stopa je izračunata na 100.000
stanovnika opće populacije. Rezultati: Od ukupno 77 reumatologa, 54% je fizijatara, 34% internista i 12% reumatologa s internističkim „deblom“. Žene čine 70% svih reumatologa. Prosječna dob je 50 godina, pri čemu je gotovo trećina (32,5%, N=25) starija od 55 godina. Gotovo dvije trećine (63,64%, N=49) radi u županijama s medicinskim fakultetima. Gotovo 90% internista i reumatologa radi u županijama s medicinskim fakultetima, a više od 50% u tercijarnim bolnicama. Reumatolozi rade u 15/21 županije (71%) i stopa na 100.000 stanovnika iznosi 1,99. Omjer najviše i najniže stope između županija iznosi 7 (Primorsko-goranska vs. Sisačko-moslavačka). Zaključci: Reumatologija je heterogena struka obilježena visokim udjelom žena i različitim profilima specijalističke izobrazbe. Stopa reumatologa na 100.000 stanovnika slična je europskom prosjeku, međutim razlike između pojedinih županija i regija jasno su izražene s tendencijom ka centralizaciji. Procjena dostupnosti reumatološke skrbi u hrvatskom zdravstvenom sustavu ograničena je zbog nedostatne informatizacije zdravstvenog sustava i
izostanka mogućnosti usporedbe određenih kvantitativnih pokazatelja zdravstvene skrbi.
Myocardial CT-perfusion In A Case Of Anomalous Rca Origin Jukic, Mladen; Pavic, Ladislav; Medakovic, Petar ...
Journal of cardiovascular computed tomography,
January-February 2020, 2020-01-00, Letnik:
14, Številka:
1
Journal Article
To evaluate how coronary computed tomography-angiography (CCTA) altered the management and treatment of patients with suspected coronary artery disease (CAD).
During 2009, we studied 792 consecutive ...patients with suspected CAD. CCTA was performed in all patients using a 64-slice dual-source CT scanner and standard scanning protocols.
After CCTA, obstructive CAD was excluded in 666 patients. During the 12-month clinical follow-up, 98.6% of these patients were free of major adverse cardiac events. Also, the indication for cardiac catheterization (CC) was revoked in 77.2% of patients. It was also revoked in all patients with low Morise pre-test risk, 80.7% with intermediate risk, and 72.6% with high risk. Medical therapy was changed in 54.7% of patients with confirmed CAD.
CCTA can reliably exclude significant CAD not only in patients with low and moderate risk, but also in those with high risk. It can also reliably replace CC in the majority of elective patients regardless of risk stratification. It can also be useful in risk reclassification and optimization of medical therapy in patients with CAD.
Cilj rada: Cilj istraživanja jest utvrditi opću i dobno-specifičnu stopu smrtnosti za akutni i ponavljajući infarkt miokarda (IM) po hrvatskim županijama za razdoblje od 2015. do 2019. godine, ...koristeći revidiranu europsku populaciju iz 2013. godine (RESP). Dodatni je cilj usporediti utvrđene stope s prosječnim stopama za Hrvatsku i EU, kao i istražiti povezanost između stopa i makroekonomskih pokazatelja. Materijal i metode: Izračunate su opće i dobno standardizirane stope mortaliteta za akutni i ponovljeni IM koristeći RESP kao i njegovu stariju verziju, europsku standardnu populaciju iz 1976. godine (ESP). Dobno standardizirane stope uspoređene su s prosječnom stopom u Hrvatskoj (2017. godine) i EU (2019. godine). Prosječna stopa smrtnosti u EU temeljena je na RESP-u i dobivena je iz baze Eurostat. Broj umrlih dobiven je od Hrvatskog zavoda za javno zdravstvo, a popis
stanovnika iz Državnog zavoda za statistiku. Analizirana je povezanost stopa mortaliteta i dvaju indikatora: bruto domaćeg proizvoda (BDP) i indeksa gospodarske snage Hrvatske gospodarske komore. Rezultati: Opće stope mortaliteta za akutni i ponovljeni IM iznosi od 72 do 91 (na 100.000 stanovnika), s velikim rasponom između županija od 35 do 120. Dobno standardizirane stope temeljene na RESP-u za većinu županija brojčano su više spram stopa temeljenih na ESP-u. U svim županijama dobno standardizirane stope nadilaze prosjek EU-a (do tri puta), a smrtnost u kontinentalnim županijama viša je od smrtnosti u obalnim županijama. Dok indeks HGK-a ne korelira značajno sa smrtnošću, BDP negativno korelira u muškaraca (r = -0.492, p = 0,023). Zaključci: Primjena RESP-a umjesto ESP-a preduvjet je za usporedbu dobno standardiziranih stopa smrtnosti s članicama EU-a. Usprkos međužupanijskim razlikama, stope smrtnosti u Hrvatskoj i dalje uvelike nadilaze prosjek EU-a.
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