Epidemiologija problema mentalnog zdravlja u mladih s područja Osijeka, korištenjem upitnika snaga i teškoća (SDQ)

Introduction: Mental disorders begin at an early age. Screening is the first step in early intervention for the mental health problems of children and adolescents. The aim of this study was to analyse the prevalence of mental health problems among adolescents from Osijek, to early detect the risks of possible mental disorders, and to analyse gender differences. Materials and methods: The main screening instrument was The Strengths and Difficulties Questionnaire (SDQ), which assesses the emotional and behavioural difficulties of children and adolescents, as well as the prosocial skills. Over 5 school years (2012/13-2016/17), a total of 5787 students were examined. 5514 (95.3%) first-year students from 16 high schools and 273 (4.7%) seventh-grade students from 10 elementary schools were examined in the City of Osijek. Results: 10.4% of students had the borderline or abnormal score on the Total difficulties score. Girls had higher scores on the Total difficulties score (p<0.01), Emotional symptoms subscale (p<0.01), Prosocial behaviour subscale (p<0.01), and on the Hyperactivity/inattention subscale (p<0.01). On the Conduct problems subscale and the Peer relationships problem subscale, boys scored significantly higher than the girls (p<0.01). Conclusion: In the Osijek area, girls are more affected by mental problems than boys, scoring higher on the total scale, as well as on the emotional and hyperactivity scale. Whereas boys scored higher on the conduct and peer relationship scales. The data obtained through this screening allows for further planning of public health measures, preventive activities, treatment, and mental health promotion.Uvod: Mentalni poremećaji započinju u ranoj dobi. Probir je prvi korak u ranoj intervenciji mentalnih poremećaja djece i adolescenata. Ciljevi ove studije su bili istražiti prevalencije mentalnih poteškoća adolescenata s područja grada Osijeka, pravovremeno uočiti rizike mogućih mentalnih poremećaja te istražiti razlike među spolovima. Materijal i metode: Glavni instrument probira je bio Upitnik snaga i poteškoća namijenjen procjeni emocionalnih i poteškoća u ponašanju djece i adolescenata kao i procjeni prosocijalnih vještina. Tokom pet školskih godina (2012/13 - 2016/17), ispitano je ukupno 5787 učenika, od toga 5514 (95.3%)učenika prvih razreda 16 srednjih škola te 273 (4.7%) učenika sedmih razreda osnovnih škola grada Osijeka. Rezultati: 10.4% učenika je imalo graničan ili povišen rezultat na ljestvici ukupnih poteškoća. Djevojčice su imale viši rezultat na ljestvici ukupnih poteškoća (p<0.01), na ljestvicama emocionalnih poteškoća, prosocijalnog ponašanja i hiperaktivnosti (p<0.01). Na ljestvicama problema u ponašanju i problema s vršnjacima su dječaci imali viši rezultat (p<0.01). Zaključak: Na području grada Osijeka, djevojčice su češće pogođene mentalnim poteškoćama, emocionalnim poteškoćama i hiperaktivnošću. Dječaci su češće pogođeni problemima u ponašanju i problemima u odnosu s vršnjacima. Podaci dobiveni ovim probirom služe u planiranju javnozdravstvenih mjera, preventivnih aktivnosti, liječenja i promocije mentalnog zdravlja

Primarni serozni papilarni adenokarcinom jajovoda

Fallopian tube cancer is least common of all gynecologic tumors, with the mean age at onset between 54 and 63 years. This case report presents a 67-year-old female, gravida 1, para 1, with primary adenocarcinoma of the fallopian tube, detected and diagnosed preoperatively in clinical stage III c. The patient was asymptomatic, with only mild vaginal discharge of amber color and normal measured value of CA 125. The diagnosis was based on routine clinical and ultrasound examination, followed by surgery, surgical-pathological staging of the disease, and finally paclitaxel and platinum based chemotherapy. The patient has been in remission for nine years now.Rak jajovoda je najrjeđi među svim ginekološkim tumorima s najvećom incidencijom u dobnoj skupini od 54 do 63 godine. Rad prikazuje primarni adenokarcinom jajovoda kod 67-godišnje bolesnice, gravida 1, para 1, otkriven i prijeoperacijski dijagnosticiran u kliničkom stadiju III c. Bolesnica je bila asimptomatska, a jedini simptom je bio blagi vaginalni iscjedak jantarne boje, uz uredne izmjerene vrijednosti CA 125. Dijagnoza se temeljila na kliničkom pregledu i ultrazvučnoj dijagnostici, nakon čega je potvrđena perioperacijski, kroz kirurško-patološko određivanje stupnja proširenosti. Nakon operacijskog zahvata bolesnica je podvrgnuta kemoterapiji zasnovanoj na paklitakselu i platini. Bolesnica se devet godina nalazi u remisiji

Cervical Cancer in Osijek-Baranja County – Possibilities for Prevention

In Osijek-Baranja County, there was a rise in the number of non-invasive and fall of invasive cervical cancer in the period 2000–2008, but cervical cancer still represents an important public health problem in Osijek-Baranja County. Cervical cancer in 2008 was the ninth female cancer site and represents 3.5% of all malignant diseases in women. In the same year it was also at the ninth place of all cancer deaths in women with a share of 3.3%. The large number of women cervical cancer was detected at an advanced stage of the disease so that there is an pincrease in mortality from cervical cancer. Although the incidence of cervical cancer is lower in relation to Croatia and other countries in the region, the mortality rate is still higher than in the countries of Western Europe. In order to reduce the incidence and mortality of cervical cancer primary task of the public health system is the introduction of secondary prevention through properly organized screening program. The program should be tailored to the financial and human resources and local specificities, with the agreement on a strategy that will give the best results

Značenje koncentracije cinka u sjemenoj tekućini kod muškaraca s dijagnozom neplodnosti

The prevalence and importance of male infertility make it a serious worldwide medical and social problem. The aim of this study was to determine if there were any significant differences in zinc concentrations in seminal fluid in men diagnosed with infertility compared to control group, and if there were, to determine how it affected the number and percentage of sperm cells with normal motility and morphology. A case-control study was conducted in the Osijek-Baranja County from January 2014 to June of 2015. The study included 276 subjects referred to biochemistry laboratory of the Osijek University Hospital Centre, 100 (36.2%) of them with low sperm count confirmed by spermiogram after 3 months. Semen samples were processed according to the World Health Organization criteria, and zinc concentrations were determined using spectrophotometry and direct colorimetry without deproteinization on a chemistry analyzer (Olympus AU 680, Beckman Coulter, Tokyo, Japan). Study results showed the men with low sperm count to be significantly older (Mann Whitney U test: p=0.013) and to have lower zinc levels (χ2-test: p<0.001). Further analysis included 100 (36.2%) patients with low sperm count. In the group of infertile men, those with low sperm count had higher zinc levels compared to men with azoospermia (Mann Whitney U test: p=0.036), suggesting a connection between lower zinc level in seminal fluid and male fertility. Zinc as a biological marker and an antioxidant affects sperm count, motility and morphology. Zinc supplemental therapy could improve seminal parameters in patients diagnosed with low sperm count. Dietary habits of the subjects differ regionally, and future research could make a solid foundation for complementary approach to treatment of male infertility.Muška neplodnost s obzirom na njenu učestalost i važnost predstavlja ozbiljan globalni medicinski i socijalni problem. Cilj ovoga istraživanja bio je utvrditi postoje li značajne razlike koncentracije cinka u sjemenoj tekućini muškaraca s dijagnozom smanjene plodnosti u odnosu na kontrolnu skupinu te ako postoje, utvrditi kako razina cinka djeluje na broj, postotak pokretnih i broj morfološki normalnih spermija. Studija slučajeva i kontrola provedena je na području Osječko-baranjske županije u razdoblju od siječnja 2014. godine do lipnja 2015. godine. U studiju je bilo uključeno 276 ispitanika koji su bili upućeni u biokemijski laboratorij KBC-a Osijek, od kojih je kod 100 (36,2%) ispitanika potvrđena dijagnoza smanjene plodnosti ponovljenim spermogramom nakon 3 mjeseca. Uzorci sjemene tekućine obrađeni su u skladu s kriterijima Svjetske zdravstvene organizacije, a koncentracija cinka određena je spektrofotometrijskom, direktnom kolorimetrijskom metodom bez deproteinizacije na kemijskom analizatoru tipa Olympus AU 680 (Beckman Coulter, Tokyo, Japan). Istraživanje je pokazalo kako su muškarci s dijagnozom smanjene plodnosti značajno stariji (Mann Whitney U test: p=0,013) i imaju značajno niže vrijednosti cinka (χ2-test: p<0,001). Vrijednosti cinka bile su značajno više u skupini ispitanika s dijagnozom smanjene plodnosti kod kojih su nađeni spermiji u odnosu na ispitanike kojima je utvrđena azoospermija (Mann Whitneyev U test: p=0,036). Koncentracija cinka kao značajnog biološkog biljega i antioksidansa utječe na broj, pokretljivost i morfologiju spermija. Nadomjesna terapija cinkom mogla bi poboljšati sjemene parametre kod bolesnika s dijagnozom smanjene plodnosti. Prehrambene navike ispitanika regionalno se razlikuju, a buduća istraživanja mogla bi postaviti dobre temelje za komplementarno liječenje muške neplodnosti

Primarni serozni papilarni adenokarcinom jajovoda

Fallopian tube cancer is least common of all gynecologic tumors, with the mean age at onset between 54 and 63 years. This case report presents a 67-year-old female, gravida 1, para 1, with primary adenocarcinoma of the fallopian tube, detected and diagnosed preoperatively in clinical stage III c. The patient was asymptomatic, with only mild vaginal discharge of amber color and normal measured value of CA 125. The diagnosis was based on routine clinical and ultrasound examination, followed by surgery, surgical-pathological staging of the disease, and finally paclitaxel and platinum based chemotherapy. The patient has been in remission for nine years now.Rak jajovoda je najrjeđi među svim ginekološkim tumorima s najvećom incidencijom u dobnoj skupini od 54 do 63 godine. Rad prikazuje primarni adenokarcinom jajovoda kod 67-godišnje bolesnice, gravida 1, para 1, otkriven i prijeoperacijski dijagnosticiran u kliničkom stadiju III c. Bolesnica je bila asimptomatska, a jedini simptom je bio blagi vaginalni iscjedak jantarne boje, uz uredne izmjerene vrijednosti CA 125. Dijagnoza se temeljila na kliničkom pregledu i ultrazvučnoj dijagnostici, nakon čega je potvrđena perioperacijski, kroz kirurško-patološko određivanje stupnja proširenosti. Nakon operacijskog zahvata bolesnica je podvrgnuta kemoterapiji zasnovanoj na paklitakselu i platini. Bolesnica se devet godina nalazi u remisiji

The Relationship Between Appearance Satisfaction and Self-Esteem Among High School Students in Eastern Croatia

Due to the imposition of social media, a large number of adolescents face problems related to physical appearance and social contact. The research objectives were to examine the degree of satisfaction of high school students in Eastern Croatia, Vinkovci, regarding their physical appearance and self-esteem based on their gender, type of high school and the differences in socioeconomic status. The study was designed as a cross-sectional research and included 278 students from medical schools and high schools. Data was collected using a survey on the demographic and socio-economic status of participants. The Body Image Questionnaire was used in a modified and validated version in Croatia and contained fourteen questions to examine the level of satisfaction with the body image. Using Rosenberg’s ten-question test, the level of self-esteem was examined. The Median age of students was 18 years. The female students in high school were significantly more concerned about their physical appearance than the male students in the same school (χ² = 23.6, p < 0.001). The linear correlation between the degree of satisfaction regarding physical appearance and self-esteem confirmed the association between body image satisfaction and gender of students in medical schools (r = 0,157; p = 0,04) and students in high school (r = 0,371; p < 0,001). Adolescents in this region of Croatia are not overly concerned about their physical appearance despite relatively decreased self-esteem. Alcohol consumption has proven to be a big problem especially for high school students, which can be a result of stress due to maintaining excellent grades

Gastrointestinal stromal tumors in Osijek-Baranja County (Eastern Croatia): a population-based incidence study (2004.-2017.)

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. The epidemiology of these tumors in Osijek-Baranja County is not known. The aim of this study is to determine the incidence of gastrointestinal stromal tumors (GIST) and anatomic localizations in Osijek-Baranja County patients. In this study, we show the incidence of gastrointestinal stromal tumors (GISTs) in Osijek-Baranja County. We studied 65 cases of GIST diagnosed in Osijek-Baranja County in the period from January 1, 2004 to December 31, 2017. In this period, we registered 65 cases of GIST from which 29 females (44.6%) and 36 males (55.4%). The mean age at diagnosis was 66.9 years ranging from 37 to 86. Only 1.5% of tumors occurred before the age of 40 years. The crude incidence rate of GISTs was 1.47/100,000 (1.26/100,000 for females and 1.70/100,000 for males). The age-standardized incidence rate was 0.76/100,000 (0.60/100,000 for females and 0.98/100,000 for males). The annual European age-standardized incidence rate was 1.10/100,000 (0.86/100,000 for females and 1.44/100,000 for males). GISTs were mostly localized in the stomach (33 cases) and small intestine (20 cases), followed by peritoneum and omentum (8 cases), two in the pancreas, 1 in the rectum and 1 in other locations. Gastrointestinal stromal tumors are rare, but more common in the older population. The incidence rate was higher among men. These results will serve as reference for studying the patterns of descriptive epidemiology of GISTs in Osijek-Baranja County and the surrounding region

The Radiomorphometric Indices of the Mandible as a Screening Method for Early Detection of Osteoporosis in Postmenopausal Women

The aim of the study was to compare radiomorphometric indices measured on panoramic radiographs: mandibular cortical width (MCW), panoramic mandibular index (PMI) and mandibular cortical index (MCI) with the densitometric values of skeletons in postmenopausal women, as well as and to determine the possibilities of their use in screening for early detection of osteoporosis in risky populations. Radiomorphometric indices were measured on panoramic radiographs of 146 postmenopausal patients, mean age 66.3 (±9.7) years, mean menopausal age 16.3 (±10.6) years. By dual energy X-ray absorptiometry (DXA) method were measured bone mineral density of the femur and the lumbar vertebrae (L1–L4). The Receiver Operating Characteristic (ROC) curve analysis was used to determine the changed densitometric finding, and to distinguish osteopenia and osteoporosis. The examinees with lower densitometric values had significantly lower MCW (3.60 mm) and PMI (0.36 mm) than those with regular densitometric values (p 1 (p<0.001). For early detection of osteopenia and osteoporosis in postmenopausal women in everyday clinical practice, panoramic radiograph as a screening method can be of help

Učinak dnevne tjelesne aktivnosti na aktivnost upalnih bolesti crijeva kod bolesnika koji ne uzimaju terapiju

It has been suggested that various environmental factors play a very important role in the etiology of inflammatory bowel diseases (IBDs) and that they have a significant effect on the course of these diseases. The aim of this study was to investigate the effect of daily physical activity on the activity of IBDs in therapy-free patients. This cross-sectional population based study was conducted in eastern Croatia from January to June 2016. e study included 312 patients, mean age 49.9±15.0 years, 53.2% of males and 46.8% of females; there were 63.4% of ulcerative colitis (UC) and 36.6% of Crohn’s disease (CD) patients. Sociodemographic characteristics of patients, data on their daily physical activity and type of therapy taken were collected through a specifically designed and validated questionnaire, while the activity of UC and CD was evaluated using the Mayo index and Harvey-Bradshaw index. The study showed that 24.0% of patients were not taking therapy. Daily physical activity was connected to IBD in study patients when taking both diseases collectively (Fisher exact test; p<0.001), as well as to the inactivity of CD (Fisher exact test; p=0.001) and UC (Fisher exact test; p=0.006), when observing each disease separately. Daily physical activity was connected to the inactivity of IBDs in patients not taking therapy. It is necessary to educate all IBD patients about the importance of physical activity in order to control their disease.Smatra se kako različiti okolišni čimbenici igraju vrlo važnu ulogu u etiologiji upalnih bolesti crijeva (UBC) te kako imaju značajan učinak na tijek ovih bolesti. Cilj ovog istraživanja bio je ispitati učinak dnevne tjelesne aktivnosti na aktivnost UBC kod bolesnika koji ne uzimaju terapiju. Ovo presječno populacijsko istraživanje provedeno je u istočnoj Hrvatskoj od siječnja do lipnja 2016. godine. Istraživanje je obuhvatilo 312 bolesnika srednje dobi 49,9±15,0 godina; 53,2% muškaraca i 46,8% žena; 63,4% oboljelih od ulcerativnog kolitisa (UC) i 36,6% oboljelih od Crohnove bolesti (CB). Sociodemografska obilježja bolesnika, podaci o njihovoj dnevnoj tjelesnoj aktivnosti i vrsti terapije koju uzimaju prikupljeni su pomoću posebno dizajniranog i validiranog upitnika, dok je aktivnost UC i CB ocijenjena primjenom indeksa Mayo i indeksa Harvey-Bradshaw. Istraživanje je pokazalo kako 24,0% bolesnika ne uzima terapiju. Dnevna tjelesna aktivnost bila je povezana s neaktivnom UBC kod bolesnika kada su zajednički promatrane obje bolesti (Fisherov egzaktni test; p<0,001) te je bila povezana s neaktivnošću CB (Fisherov egzaktni test; p=0,001) i UC (Fisherov egzaktni test, p=0,006) kad je svaka bolest promatrana zasebno. Dnevna tjelesna aktivnost povezana je s neaktivnošću UBC kod bolesnika koji ne uzimaju terapiju. Potrebno je sve bolesnike s UBC podučiti o važnosti tjelesne aktivnosti za kontrolu njihove bolesti

CONDUCT DISORDER AMONG THE OVERWEIGHT AND OBESE CHILDREN AND ADOLESCENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

2016. je godine procijenjeno kako je broj djece i adolescenata s prekomjernom tjelesnom masom (ptm) i debljinom (deb) u zadnjih 40 godina porastao čak 10 puta. Mladi koji pate od prekomjerne tjelesne mase i debljine češće obolijevaju od psihičkih poteškoća. Neke studije su pokazale povezanost između konduktivnog poremećaja i debljine, no druge studije ne pokazuju takav rezultat. Cilj je ovog sus-tavnog pregleda i meta-analize bio proučiti povezanost konduktivnog poremećaja s ptm i deb među djecom i adolescentima. Sustavno je pretraživanje literature provedeno 31. listopada 2019. u bazama: MEDLINE preko OVID-a, PsycINFO i PsycARTICLES preko EBSCOhost, SCOPUS i OpenGrey. Uključene su presječne i kohortne studije iz bilo koje države ukoliko sadrže podatak o omjeru šansi (OR) za konduktivni poremećaj među ptm i/ili deb djecom i/ili adolescentima, ili iz kojih se ti podaci mogu izračunati, studije u kojima su korišteni validirani psihijatrijski testovi te one u kojima ispitanici imaju trenutnu dijagnozu konduktivnog poremećaja. Kriteriji za isključenje su bili: studije provedene na kliničkim uzorcima ispitanika, ispitanicima starijim od 21 godinu te ispitanicima koji imaju morbidnu debljinu. Ekstrakciju podataka uključenih studija vršila su dva istraživača neovisno (DN i JM) prema unaprijed pripremljenom obrascu. Podaci su analizirani pomoću programa Comprehensive Meta-analysis. Statistička heterogenost među studijama je procijenjena pomoću I2 testa i Cochran Q statis-tičkog testa. Podaci su analizirani prema modelu slučajnih učinaka. Ukupno 10 studija je uključeno u meta-analizu, koje su sadržavale podatke o 73 903 ispitanika. Postoji statistički značajna povezanost između ptm i deb u djece i adolescenata i konduktivnog poremećaja (OR 1.34 [95% CI, 1.16- 1.54]). Meta-analitički rezultati pokazuju postojanje značajne varijacije u veličinama učinaka među studijama (Q=79.75; df=8; I2=89.97). Postoji značajna razlika u veličinama učinaka među djevojčicama u odnosu na dječake (Q=10.94; df=1; p<.01). Prekomjerna tjelesna masa i debljina su rizični čimbenici za kon-duktivni poremećaj među djecom i adolescentima, s tim da su dječaci češće pogođeni. Bilo bi korisno uvesti probir na konduktivni poremećaj u ovoj populaciji.In 2016 it is estimated that in just 40 years the number of school-age children and adolescents with obesity has risen more than 10-fold. Overweight (ow) and obese (ob) young individuals are more likely to experience psychiatric and psychological disorders. Some studies pointed out the association be-tween conduct disorder (CD) and obesity, but others did not. The aim of this systematic review and meta-analysis was to analyse the association between ow/ob and CD among the children and adoles-cents. A systematic literature research was conducted in MEDLINE via OVID, PsycINFO and PsycARTICLES via EBSCOhost, SCOPUS and OpenGrey on 31 October 2019. The inclusion criteria was cross-sectional or cohort studies from any country if they provided odds ratio for CD among ow/ob children and adolescents or from which they could be calculated, usage of validated psychiatric tools and the current CD diagnosis. The exclusion criteria was studies performed on the clinical sam-ples, participants older than 21 years or morbidly obese. Data extraction was performed by the two authors independently (DN and JM) according to predesigned data extraction form. Data were ana-lyzed using the program Comprehensive Meta-analysis. The amount of statistical heterogeneity among the studies was assessed by computing the I2 and Cochran’s Q-statistic. Data were analyzed using a random-effects model. A total of 10 studies were included in the meta-analysis comprising 73 903 of participants. There was a statistically significant relationship between childhood and adolescent ow/ob and CD (OR 1.34 [95% CI, 1.16- 1.54]). Meta-analytic results showed that there was a large degree of variance in the study effect sizes (Q=79.75; df=8; I2=89.97). There was a significant difference in ef-fect sizes between samples consisting entirely of boys or entirely of girls (Q=10.94; df=1; p<.01). Overweight and obesity are risk factors for conduct disorder among children and adolescents, boys are more often affected. This population should be screened for CD