Stres na radnom mjestu kod zdravstevnih djelatnika verificiran je kao čimbenik koji ima negativan utjecaj na učinkovitost u izvršavanju svakodnevnih radnih zadataka, motivciju, te zdravstveno stanje ...djelatnika. Stresorom se procjenjuje svaki događaj koji osoba doživljava kao ugrožavajući ili opasni čimbenik, te koji mobilizira tijelo na reakciju, a u direktnoj je svezi s promjenama fizioloških, misaonih i emocionalnih reakcija. U svrhu istraživanja utjecaja stresora i percepciju istih kod zdravstvenih djelatnika, provedeno je istraživanje među medicinskim sestrama i tehničarima Klinike za onkologiju u Kliničkom bolničkom centru Zagreb. Cilj je provedenog istraživanja istražiti povezanost procjene izloženosti u izvršavanju svakodnevnih radnih zadataka, anksioznosti i depresivnosti, pojavnosti sindroma izgaranja na poslu sa zdravstvenim tegobama i stupnjem kvalitete života, te istražiti vjerovanja o štetnosti simptoma stresa kod medicinskih sestara i tehničara Klinike za onkologiju u Kliničkom bolničkom centru Zagreb. Rezultati su prikupljeni uporabom anketnog upitnika, koji je kreiran u svrhu procjene stupnja doživljenog stupnja stresa na radnom mjestu pri izvršavanju svakodnevnih radnih aktivnosti te procjenama utjecaja doživljenog stresa na kvalitetu zdravlja. Prikupljeni su kvalitativni podaci o stresorima na radnom mjestu i svakodnevnom životu te metodama relaksacije. Nadalje, prikupljeni su podaci o simptomima anksioznosti (GAD-7) i depresivnosti (PHQ-9), uporabljen je upitnik SF-36 (engl. Short-form Health Survey) za procjenu zdravstvene kvalitete života i upitnik procjene sindroma izgaranja na poslu -Christine Maslach MBI. Rezultati ukazuju na značajnu povezanost procjene doživljenog stupnja stresa pri izvršavanju svakodnevnih radnih zadataka sa stupnjem zdravstvenih tegoba, kao i značajan utjecaja stresa na opće stanje zdravlje. Istaknutima su se pokazala vjerovanja o stresu i štetnosti doživljenog stupnja stresa na opći stupanj zdravlja. Dobiveni rezultati ukazuju na važnost prepoznavanja stresora u radnom okruženju medicinskih sestara i tehničara Klinike za onkologiju u Kliničkom bolničkom centru Zagreb, te potreba prepoznavanja istih, uporabu metoda prevencije i intervencije radi poboljšanja stupnja zdravlja i stupnja kvalitete života zdravstvenih djelatnika.
Infective third-stage larvae (L3) of nematode Anisakis spp. have been recognized as one of the major food-borne threats in lightly processed fish products in Europe, particularly in the Mediterranean ...region. Therefore, the effect of different storage temperatures of fish on larval post-mortem migration from visceral cavity into fillets is an important parameter to take into account when evaluating the risk for consumer safety. The European anchovy (Engraulis encrasicolus) were caught during fishing season, a subsample of fillets was checked for the presence of Anisakis larvae at capture (mean abundance=0.07), and the rest was stored at four different temperatures (−18, 0, 4 and 22°C) in order to count migrating larvae and measure the production of biogenic amines over a period of time. Larvae were identified by morphological features and molecular tools. Post-mortem migration was observed in fillets stored at 0 and 4°C after three and five days, respectively, but not at 22 and −18°C. In case of storage at 22°C for two days, at the onset of putrefaction of the visceral organs, larvae migrated out of the visceral cavity towards the fish surface. Measured pH and biogenic amine profile during storage indicated that certain biochemical conditions trigger larval migration into fillets. Likewise, migration was observed at pH ~6.4 when sensory degradation of the fish was markedly visible. Although larval migration was delayed for approximately four days at a temperature of <4°C the correlation between pH and abundance of A. pegreffii larvae in the fillet was high and statistically significant at both 0 (r=0.998, p<0.01) and 4°C (r=0.946, p<0.05). Out of eight biogenic amines measured, cadaverine and putrescine levels correlated the most with the post-mortem migration at 4°C, while tyramine levels were significant at both temperatures.
•We confirmed post-mortal migration of anisakid larvae into the muscle of European anchovy.•Molecular identification confirmed Anisakis pegreffii.•The role of biogenic amines and pH in post-mortem migration was confirmed.•Storage at a temperature of <4°C delays larval migration for 3–5days.
The main objective of the study was to determine the degree of sensitization to Anisakis spp. antigens in healthy coastal population of Dalmatia given the high thermally unprocessed fish intake rate ...present in this area, suggested as a significant risk factor for anisakiasis. We performed a monocenter, cross-sectional pilot study stratified by geographic area of residence, conducted at the County secondary healthcare provider Medicine-biochemical Laboratory in Split (Croatia), from November 2010 till December 2011, on 500 unpaid volunteer subjects undergoing routine blood analysis and belonging to the south coast of the Adriatic Sea.
We studied the IgE seroprevalence to Anisakis spp. Ani s l and Ani s 7 allergens by indirect ELISA in healthy subjects, which were selected at random in the region of Dalmatia (Southern Croatia), among islands, coastal urban and inland rural populations. In order to detect possible cross-reactivity to other human helminthes, serum samples were tested also for the presence of IgG antibodies to Ascaris lumbricoides and Toxocara canis. The overall and coastal Anisakis seroprevalences for the sampled population were 2% and 2.5%, respectively. The logistic univariate regression analysis confirmed that regarding anti-Anisakis IgE seroprevalence, raw fish intake, daily fish intake, homemade origin of fish dish and occupational contact (professional, artisanal or hobby contact with fishery or fish industry) were risk factors associated to Anisakis spp. sensitization, but neither of the variables was exclusive for a particular seropositive population. Also, a significant difference was observed between seropositive and seronegative subjects that had stated allergy or symptoms associated with allergy (atopic dermatitis, asthma or rhinitis) in their previous history.
Being the first in Croatia, our study underlines the necessity of incorporating Anisakis spp. allergens in routine hypersensitivity testing of coastal population.
Anchovy Engraulis encrasicolus (L.) is a coastal pelagic and euryhaline species that represents the only European species of the family Engraulidae, with a widespread distribution. In Croatia, it is ...marketed fresh, frozen, salted or marinated and mainly exported to Italy and Spain, however Anisakis sp. larval infection is frequently the reason for border rejection. Since it is known that the prevalence and intensity of Anisakis infection varies with fish species, fishing area and season, the aim of our study was to identify Anisakis sp. parasitizing European anchovy and infer its population dynamic through a 2.5-year period. Larvae were found coiled and encysted on the external wall of intestine (94%) and reproductive organs (6%), rarely in fillets. Prevalence was 76.1% (95% confidence limits 74.51–77.56%), mean abundance 6.59 (bootstrap 95% confidence limits 5.81–7.26) and mean intensity 8.67 (bootstrap 95% confidence limits 7.82–9.35). The partial CO2 mitochondrial DNA sequence of the isolated anisakids confirmed clustering of the anchovy parasite within A. pegreffii sister group. Parasite population structure showed plasticity inferred by fishing ground, sampling year and fish gender and size. Compared to anisakid prevalence/abundance in other fish, the European anchovy in the Adriatic Sea represents a moderately high-infected paratenic host, although in the Mediterranean and Atlantic waters, anchovies have shown strikingly lesser values of prevalence. Since this host represents one of the most attractive Mediterranean fisheries products traditionally consumed without thermal preparation that in any case would not disrupt larval antigenicity and prevent human allergies, and given the high prevalence of the anisakid within the host, it is necessary to include anchovy into more firm risk assessment frames in order to develop measures that will support the safe alimentary production and consumption of seafood.
► 76.1% of anchovies were infected with Anisakis larvae. ► Mean abundance was 6.59. ► Larvae were identified as A. pegreffii. ► Larvae had plasticity in respect to season, fishing ground, host size and gender.
This is the first report of anisakiasis in a Croatian patient, evidenced from an archival paraffin-embedded and hematoxylin-eosin stained tissue section. Anisakiasis has been only suspected in the ...country based on previously detected anti-Anisakis IgE seroprevalence in the healthy coastal population, as well as an acute case where pathohistological and serological findings suggested the diseases, but the migrating larva has not been retrieved.
Seventy years-old female, operated in 1998 for pulmonary carcinoma, was admitted to the General hospital Šibenik, Croatia in 2003, because of gastric pain and nausea that lasted for couple of days. She was showing good general condition, full mobility and lucidity, subfebrile status. Abdominal palpation inferred acute pain in paraumbilical and ileocecal region. Exploratory right pararectal laparotomy revealed a hardened, 5 cm-long structure, located intraluminally in the sigmoid colon, not perforating colon serosa. The process has been dissected and sent for patohistological diagnosis. Results showed a 2 mm-long whitish nematode spiralised in muscular layer of colon mucosa surrounded by granulomatous inflammation.
After genomic DNA isolation of the nematode from the histological section, and amplification at the mitochondrial cytochrome oxidase 2 locus, etiological agent has been identified as Anisakis pegreffii. Used methodology suggests that screening of archival suspicious sections is feasible in order to study epidemiology of this zoonotic disease poorly recognised in Croatia.
Stability of a dental implant is very important when planning immediate loading and design of a final restoration. The aim of this study was to compare the primary and the secondary stability of ...dental implants inserted by three different surgical techniques: conventional (standard) technique using a sequence of drills for implant bed preparation, osteotome technique using tapered hand instruments for creating implant sites by condensing the bone and guided flapless implant surgery with surgical templates.
The study included 150 patients (80 males and 70 females), 46–71 years old, who required implant supported fixed partial dentures in the posterior maxilla of D3 or D4 bone density. Patients were randomly assigned into one of the three surgical insertion technique groups. All patients received tapered implants of the same manufacturer of the same length and two different widths (3.3 × 11.5 mm or 4.2 × 11.5 mm). Primary and secondary implant stability were measured by means of resonance frequency analysis (RFA) at the time of implant placement and 5 months after surgery using the Ostell ISQ device (Osstell AB, Sampgatan, Goteborg, Sweden). Statistical analysis included one-sample Kolmogorov Smirnov test, descriptive statistics, multivariate analysis (Bonferoni post-hoc tests) and paired t-tests.
Patients in the osteotome group exhibited higher primary stability (P < 0.01) than in the conventional and surgically guided flapless groups. There were no significant differences in the secondary stability (p > 0.05). Wider implants presented higher ISQ values (P<0.01).
The osteotome technique led to the highest implant primary stability, therefore it can be recommended when immediate loading is planned or for one-piece implant insertion.
Background The main objective of the study was to determine the degree of sensitization to Anisakis spp. antigens in healthy coastal population of Dalmatia given the high thermally unprocessed fish ...intake rate present in this area, suggested as a significant risk factor for anisakiasis. We performed a monocenter, cross-sectional pilot study stratified by geographic area of residence, conducted at the County secondary healthcare provider Medicine-biochemical Laboratory in Split (Croatia), from November 2010 till December 2011, on 500 unpaid volunteer subjects undergoing routine blood analysis and belonging to the south coast of the Adriatic Sea. Methodology/Principal Findings We studied the IgE seroprevalence to Anisakis spp. Ani s l and Ani s 7 allergens by indirect ELISA in healthy subjects, which were selected at random in the region of Dalmatia (Southern Croatia), among islands, coastal urban and inland rural populations. In order to detect possible cross-reactivity to other human helminthes, serum samples were tested also for the presence of IgG antibodies to Ascaris lumbricoides and Toxocara canis. The overall and coastal Anisakis seroprevalences for the sampled population were 2% and 2.5%, respectively. The logistic univariate regression analysis confirmed that regarding anti-Anisakis IgE seroprevalence, raw fish intake, daily fish intake, homemade origin of fish dish and occupational contact (professional, artisanal or hobby contact with fishery or fish industry) were risk factors associated to Anisakis spp. sensitization, but neither of the variables was exclusive for a particular seropositive population. Also, a significant difference was observed between seropositive and seronegative subjects that had stated allergy or symptoms associated with allergy (atopic dermatitis, asthma or rhinitis) in their previous history. Conclusions/Significance Being the first in Croatia, our study underlines the necessity of incorporating Anisakis spp. allergens in routine hypersensitivity testing of coastal population.
To determine epidemiological characteristics of thyroid carcinoma in Dalmatia, and to compare the incidence rate in Dalmatia with that in Croatia.
Retrospective epidemiological study.
Epidemiological ...indicators of thyroid carcinoma were compared between Dalmatia and Croatia as a whole, while some epidemiological indicators were compared with the characteristics of persons suffering from thyroid carcinoma in Croatia. The study included 651 persons suffering from and/or operated for thyroid carcinoma in Dalmatia between 1997 and 2006. Data were obtained from case histories, including the results of histopathologic analysis. The area of Dalmatia includes Zadar, Sibenik-Knin, Split-Dalmatia and Dubrovnik-Neretva counties (overall 861,060 inhabitants, surface 11,960 square kilometers).
The incidence of thyroid carcinoma in Dalmatia ranged from 5.2 (1997) to 10.2 per 100,000 inhabitants (2006). The mean age adjusted incidence rate of thyroid cancer in the last 10 years was 8.1 in Croatia and 9.32 per 100,000 inhabitants in Dalmatia. All incidence rates observed (Europe and world-age standardized rates, crude incidence, incidence based on research) showed a rising trend and were significantly higher in Dalmatia than in Croatia. According to sex structure, in both study areas thyroid cancer affected predominantly women, who had four times more chances of falling ill. In Dalmatia, in the overall sample, women accounted for 81.4% of all patients. In Dalmatia, papillary thyroid carcinoma was diagnosed in 80.0% of the overall sample. The median age of newly diagnosed thyroid cancer patients was 50 in Dalmatia. There was no statistically significant sex difference in the prevalence of histologic types of thyroid carcinoma in Dalmatia (P=0.318). In both sexes, papillary carcinoma was the most common type, followed by follicular, medullary and anaplastic thyroid carcinomas.
The incidence rate of thyroid cancer showed a rising trend and was significantly higher in Dalmatia than in Croatia. Epidemiological characteristics of thyroid gland carcinoma in Dalmatia were consistent with the reported characteristics of this carcinoma in iodine-sufficient areas: papillary carcinoma was prevalent and the papillary to follicular carcinoma ratio was 6.4:1.
Cilj istraživanja ove retrospektivne epidemiološke studije bio je utvrditi epidemiološke osobitosti karcinoma štitnjače u Dalmaciji i usporediti ih s epidemiološkim osobitostima karcinoma štitnjače u ...Hrvatskoj. Korišteni su podaci Hrvatskog registra za rak objavljeni u Hrvatskom zdravstveno-statističkom ljetopisu i godišnjim biltenima, te podaci o 651 bolesniku od raka štitnjače operiranom u bolnicama Dalmacije u razdoblju 1997.-2006. godina. Stope incidencije u Dalmaciji uspoređene su sa stopama u Hrvatskoj. Nađeno je da je prosječna, dobno standardizirana stopa incidencije karcinoma štitnjače posljednjih deset godina u cijeloj Hrvatskoj 8,1, a u Dalmaciji 9,32 na 100.000 stanovnika. Razlika je statistički značajna (p<0,05). Stope incidencije (dobno standardizirana na europsko i svjetsko stanovništvo, gruba, na temelju istraživanja) pokazuju trend porasta i značajno su više na području Dalmacije u odnosu na cijelu Hrvatsku. Spolna struktura oboljelih pokazuje da žene u odnosu na muškarce četiri puta češće obolijevaju. U Dalmaciji, u ukupnom uzorku, žene čine 81,4% oboljelih, a papilarni karcinom čini 80,03% oboljelih od karcinoma štitnjače. Medijan životne dobi novooboljelih na području Dalmacije je 50 godina. Zaključeno je da su stope incidencije karcinoma štitnjače značajno više u Dalmaciji u odnosu na Hrvatsku. Po navedenim karakteristikama Dalmacija se ne razlikuje od ostalih priobalnih ili otočnih područja svijeta s visokim stopama incidencije, a odnos papilarni: folikularni karcinom u istraživanom uzorku je 6,4:1.
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