The aim of our study was to examine the scabies incidence in the Croatian population and to analyse potential related factors.
This mixed ecological study is based on a retrospective medical record ...review. National data from communicable disease reports was sourced and analysed for an 11-year period (2007-2017), with more focus on the period 2014-2017. Descriptive statistics were used to calculate trends. Differences between the groups were studied using Chi-square test and Kendall's tau (τ) correlation coefficient. Levels of significance were set at p<0.05 or p<0.01.
From 2007 to 2017, scabies infestation in Croatia increased by 6-fold, particularly affecting children and young adults (19 years or younger). In the period 2014-2017, border counties which are part of migration flows were the counties with the highest average scabies incidences. A linear trend of increase in the number of tourists, immigrants and scabies infestations was noted on the national level for the analysed period, although a significant association was not observed. Regarding outbreaks of scabies within institutions, more than 80% of outbreaks occurred in institutions for adults. In the capital, Zagreb, the crude incidence rate increased 3-fold between 2014 and 2017.
The increased incidence of scabies, large disparities between counties, and prolonged outbreaks within families due to under-recognition and misdiagnoses points to a need for increased awareness among health practitioners. To the best of our knowledge, this is the first recent epidemiologic analysis on this topic, not only in Croatia but within the wider geographic region as well.
Particulate matter (PM) is a major component of urban air pollution and has a significant effect on human health. Natural PM sources are volcanic eruptions, dust storms, forest and grassland fires, ...living vegetation and sea spray. Traffic, domestic heating, power plants and various industrial processes generate significant amounts of anthropogenic PM. PM consists of a complex mixture of solid and liquid particles of organic and inorganic substances suspended in the air. The chemical composition of particles is very complex and depends on emission sources, meteorological conditions and their aerodynamic diameter. Several epidemiological studies have demonstrated that exposure to PM of varying size fractions is associated with an increased risk of respiratory and cardiovascular diseases. Adverse health effects have been documented from studies of both acute and chronic exposure. The most severe effects in terms of overall health burden include a significant reduction in life expectancy by a several months for the average population, which is linked to long-term exposure to moderate concentrations of PM. Nevertheless, numerous deaths and serious cardiovascular and respiratory problems have also been attributed to short-term exposure to peak levels of PM. Although many studies attribute greater toxicity to smaller size fractions, which are able to penetrate deeper into the lung, the molecular mechanisms and the size fractions of the PM that are responsible for the observed diseases are not completely understood.
Prašni delci so eden najpogostejših onesnaževal zraka in imajo velik vpliv na zdravje ljudi. Kemijska sestava prašnih delcev je zelo zapletena in je odvisna od vira emisij, meteoroloških okoliščin in od aerodinamskega premera delcev. Naravni izvori prašnih delcev so vulkanski izbruhi, puščavski pesek, naravni požari in morska sol. Promet, domača kurišča, termoelektrarne in industrijski obrati pa so glavni vir antropogenih prašnih delcev. Prašni delci so sestavljeni iz zapletene mešanice trdnih in tekočih delcev, sestavljenih iz organskih in anorganskih snovi. Številne epidemiološke študije so pokazale, da je izpostavljenost prašnim delcem različnih velikosti povezana s povečanim tveganjem za razvoj dihalnih in srčno-žilnih obolenj. Škodljiv učinek na zdravje je bil ugotovljen na osnovi raziskav, ki so proučevale akutno, in na osnovi raziskav, ki so proučevale kronično izpostavljenost prašnim delcem. Najbolj škodljiv učinek prašnih delcev je skrajšanje življenjske dobe povprečne populacije za nekaj mesecev, kar je povezano z dolgoročno izpostavljenostjo prašnim delcem zmernih koncentracij. Kljub temu pa so vzroki za številne smrti in resne dihalne ter srčno-žilne bolezni povezane s kratkoročno izpostavljenostjo visokim koncentracijam prašnih delcev. Številne raziskave pripisujejo večje negativne učinke na zdravje ljudi manjšim prašnim delcem, ker lahko globlje prodrejo v pljuča. Kljub številnim raziskavam še ni popolnoma pojasnjeno, kateri prašni delci so ključni za povzročene neželene učinke in prek katerih molekularnih mehanizmov sprožajo neželene učinke.
Migraine is associated with significant morbidity and a significantly negative impact on the quality of life. A better understanding of the economic impact of migraine is becoming increasingly ...important. This paper aims to shed light on absenteeism and presenteeism costs of migraine in Slovenia.
We use the administrative national-level database on sick leave due to migraine for 2016. The absenteeism cost estimate is based on the number of patients with migraine on physician-determined sick leave and average daily labour costs. We calculate productivity costs from a social perspective regardless of who incurs them. Data from the national registry on sick leave are coupled with data from a web-based self-reported survey to also include the cost of presenteeism. MIDAS and WPAI presenteeism items were used and several different scenarios were designed to assess presenteeism costs.
We estimated annual absenteeism costs per absentee due to migraine at the amount of EUR 531 in 2016 using the NIPH's administrative data on sick leave. Annual absenteeism costs per absentee due to migraine based on self-reported data amounted to EUR 626. The estimated annual presenteeism costs per patient range from EUR 344 - 900.
Estimating the economic burden of a disease is becoming increasingly important. This paper is an insight into the absenteeism and presenteeism costs of migraine in Slovenia.
Health-related quality of life (HRQoL) is measuring a patient's experience of his health status and represents an outcome of medical interventions. Existing data proves that a healthy lifestyle is ...positively associated with HRQoL in all age groups. Patients with a high risk for cardiovascular disease typically led an unhealthy lifestyle combined with risk diseases. We aimed to analyse these characteristics and their reflection in HRQoL.
A cross-sectional study in 36 family practices, stratified by location and size. Each practice invited 30 high-risk patients from the register. Data were obtained from medical records and patient questionnaire. The EQ-5D questionnaire and the VAS scale were used for measuring the patient's HRQoL as an independent variable.
871 patients (80.6% response rate) were included in the analysis. 60.0% had 3-4 uncontrolled risk factors for CVD. The average VAS scale was 63.2 (SD 19.4). The correlation of EQ-5D was found in the number of visits in the practice (r=-0.31, p<0.001), the socioeconomic status (r=-0.25, p=0.001), age (r=-0.27, p=0.001) and healthy diet (r=0.20, p=0.006). In a multivariate model, only physical activity among lifestyle characteristics was an independent predictor of HRQoL (p=0.001, t=3.3), along with the frequency of visits (p<0.001, t=-5.3) and age (p=0.025, t=-2.2).
This study has been performed on a specific group of patients, not being "really sick", but having less optimal lifestyle in many cases. Encouragement to improve or keep healthy lifestyle, especially physical activity, is important, not only to lower the risk for CVD, but also to improve HRQoL.
V članku se osredotočamo na izkušnjo doživljanja kronične bolezni in soočanja z njo. Zanimalo nas je, kako se oblikujejo bolnikove strategije soočanja z boleznijo in od katerih dejavnikov je ...odvisen stil prilagajanja bolezni. Opiramo se na rezultate kvantitativne in kvalitativne raziskave bolnikov s kronično revmatično boleznijo. Rezultati raziskave kaežjo, da obstajata različni skupini bolnikov, ki se razlikujeta po stopnji udeležbe v socialnem svetu, po načinu reševanja težav in po prilagoditvi življenjskega stila na bolezen. Naklo- njenost družbenega okolja in empatičen odnos z bližnjimi bistveno pripomorejo k uspešni prilagoditvi bolnika na bolezen.
Health-related absenteeism impacts individuals, companies, and society. Its consequences are reflected in the cost of benefits, substitutes, and reduced productivity. Research shows that ...musculoskeletal disorders (MSDs) are the most common work-related health problem reported by hospital staff. This study determines the groups at the Ljubljana University Medical Centre that are most susceptible to MSDs, especially low back pain.
Using data from the Health Data Centre of the Slovenian National Public Health Institute and the medical centre, this cross-sectional study analysed absenteeism among medical centre employees. The correlation between MSD / low-back pain risk factors and incidence was determined using logistic regression. An odds ratio was calculated to determine the probability of MSDs, most especially low back pain via sex, age, occupation, and education.
Sick leave at the medical centre is higher than 5%, exceeding the Slovenian healthcare sector average. MSDs, as the main reason for absence, is significantly more frequent in women, non-medical staff, and employees with a maximum secondary school education. Among the MSDs, low back pain predominates as a reason for absence and is most frequent among nurses, midwives, and employees of 20 to 44.9 years old.
This study offers insight into the health status of medical centre employees. The high percentage of sick leave is mainly due to musculoskeletal disorders, including low back pain. This is an important basis for further monitoring and analysis of sick leave indicators and for planning systematic and continuous workplace health-promoting measures to manage ergonomic risk factors and reduce health-related absenteeism.
Overdiagnosis is the diagnosis of deviations, abnormalities, risk factors, and pathologies that in themselves would never cause symptoms (this applies only to risk factors and pathology), would never ...lead to morbidity, and would never be the cause of death. Therefore, treating an overdiagnosed condition (deviation, abnormality, risk factor, pathology) cannot, by definition, improve the patient’s prognosis, and can therefore only be harmful.
Overdiagnosis is an extremely harmful and big problem all over the world, and the problem is increasing. This is especially the case in high-income countries, where more sensitive tests, more testing, more screening and earlier diagnosis is in focus, and more of the same will be implemented in the future. Moreover, disease definitions have been and are still being widened, plus thresholds for treating, e.g. risk factors, have been and are still being lowered. Finally, disease mongering is growing, because it is cheaper and faster to invent new “diseases” than new pharmaceutical drugs.
From the definition of overdiagnosis it can be reasoned that a patient who has been correctly diagnosed and a person who has been overdiagnosed can have the same kind of pathologies. Therefore, at the level of the individual person or patient it can never be verified whether he or she has in fact been correctly diagnosed or overdiagnosed. Therefore, the complexity, dilemmas and pitfalls in understanding what overdiagnosis really is so succinctly captured by this quote from the Danish philosopher S⊘ren Kirkegaard (1813-55): ‘Life can only be understood backwards; but it must be lived forwards’.
Uvod. V Sloveniji ima zdravnik družinske medicine pomembno vlogo pri izvajanju preventive. Delež cepljenih proti gripi je v Sloveniji nizek. Razlogi za to niso povsem jasni. Preučevali smo mnenje ...bolnikov glede cepljenja proti gripi pri njihovem družinskem zdravniku ter njihova stališča in prepričanja o gripi in cepljenju. Cilj naloge je bil odkriti dejavnike, ki vplivajo na odločitev o cepljenju v ambulanti družinske medicine.
PDF
