Functional Ability of the Elderly in Institutional and Non-Institutional Care in Croatia

Gerontology-public health indicators of functional ability of the elderly in institutional and non-institutional health care in Croatia were determined by use of expert methodology developed at Department of Gerontology, Dr. Andrija [tampar Institute of Public Health in Zagreb, with the aim to upgrade the Program of Health Care Measures and Procedures in Health Care of the Elderly. Comparison of functional ability between the users of selected Old People’s Homes (institutional care; N=5030) and Gerontology Centers (non-institutional care; N=2112) yielded highest between-group difference in the proportion of »fully movable« and »fully independent« categories in favor of the latter, thus steering the program of health care for the elderly accordingly. In addition, study results showed greater difference in the proportion of categories describing mental status of institutional and non-institutional care users as compared with the categories describing their physical status, suggesting that mental status plays a more important role than physical status in the geriatric user’s stay in non-institutional care versus institutional care. This issue requires additional studies. The results obtained by this indicator analysis pointed to the preventive and geroprophylactic measures to ensure efficient health care for the elderly and to develop the program of mental health promotion and preservation. According to 2007 estimate, there were 759,318 (16.9%) persons aged ł65 in Croatia. Data collected at gerontology database kept at Department of Gerontology, Dr. Andrija [tampar Institute of Public Health (September 2008) showed 2% of the elderly (N=14807) to be accommodated at Old People’s Homes, which is below the European average of 4%

Prvi bolnički registar bolesnika s multiplom sklerozom u Hrvatskoj

Th e fi rst hospital-based registry of patients with multiple sclerosis (MS) was established at the University Department of Neurology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia, in 2014. Th e aim of the registry was to continuously provide data on the number of hospital-managed MS patients, patterns of disease progression, predictors of disability progression, changes in lifespan and long-term outcomes. Relevant medical data included age and gender of MS patients, family history of MS, data on previous immunization, disease course, Expanded Disability Status Scale (EDSS) score, cerebral magnetic resonance imaging (MRI) lesion load quantification, and cerebrospinal fl uid analysis. Lifestyle habits in MS patients including smoking and alcohol consumption were also analyzed. All data were obtained from primary medical records between January 1, 2014 and January 1, 2015, and entered into the database. Data were evaluated retrospectively according to age and gender diff erences. Results showed that the majority of patients enrolled in the registry had the remitting relapsing course of disease, with low EDSS score indicating no disability or minimal disability. Cerebrospinal fl uid analysis showed that oligoclonal bands were present in the majority of MS patients, with aff ected blood-brain-barrier permeability. According to the remitting relapsing course of the disease, cerebral MRI quantitative analysis demonstrated a signifi cant lesion load in the majority of patients. When stratifi ed by lifestyle habits, smokers and alcohol consumers were more prevalent among male patients. Our hospital-based registry might be considered as a prototype for the national MS registry and should be improved for reliable statistical analysis.Prvi bolnički registar bolesnika s multiplom sklerozom (MS) u Hrvatskoj uspostavljen je 2014. godine u Klinici za neurologiju, Klinički bolnički centar “Sestre milosrdnice”, Zagreb. Cilj registra je kontinuirano prikupljanje podataka o broju hospitalno obrađenih bolesnika s MS, oblicima bolesti, prediktorima napredovanja onesposobljenosti, životnim navikama i dugoročnim ishodima za bolesnike. Relevantni medicinski podaci u registru MS uključivali su procjenu dobi i spola bolesnika, obiteljsku anamnezu na MS, podatke o prethodnim imunizacijama, tijeku bolesti, procjenu funkcionalne onesposobljenosti, kvantitativni prikaz lezija mozga magnetskom rezonancijom (MRI) i analizu cerebrospinalnog likvora. Nadalje, analizirane su životne navike bolesnika uključujući pušenje i konzumaciju alkohola. Svi podaci iz bolničke medicinske dokumentacije koji su prikupljeni od 1. siječnja 2014. godine do 1. siječnja 2015. godine upisani su u bazu podataka. Retrospektivno smo analizirali podatke prema dobi i spolu. Relevantni rezultati su pokazali da većina registriranih bolesnika ima relapsno remitirajući oblik bolesti s niskim stupnjem funkcionalne onesposobljenosti. Analiza cerebrospinalnog likvora u većine bolesnika pokazala je pozitivne oligoklonske vrpce i poremećenu propusnost krvno-moždane barijere. Kvantitativna MRI analiza mozga pokazala je značajno opterećenje brojem cerebralnih lezija u većine bolesnika, što odgovara relapsno remitirajućem obliku bolesti. Podjela prema životnim navikama pokazala je da je bilo više pušača i konzumenata alkohola u skupini muških bolesnika. Naš bolnički registar može poslužiti kao prototip za uspostavljanje nacionalnog registra MS, ali ga treba pobolj šati kako bi se osigurali svi potrebni podaci za pouzdanu statističku analizu podataka

Functional Ability of the Elderly in Institutional and Non-Institutional Care in Croatia

Gerontology-public health indicators of functional ability of the elderly in institutional and non-institutional health care in Croatia were determined by use of expert methodology developed at Department of Gerontology, Dr. Andrija [tampar Institute of Public Health in Zagreb, with the aim to upgrade the Program of Health Care Measures and Procedures in Health Care of the Elderly. Comparison of functional ability between the users of selected Old People’s Homes (institutional care; N=5030) and Gerontology Centers (non-institutional care; N=2112) yielded highest between-group difference in the proportion of »fully movable« and »fully independent« categories in favor of the latter, thus steering the program of health care for the elderly accordingly. In addition, study results showed greater difference in the proportion of categories describing mental status of institutional and non-institutional care users as compared with the categories describing their physical status, suggesting that mental status plays a more important role than physical status in the geriatric user’s stay in non-institutional care versus institutional care. This issue requires additional studies. The results obtained by this indicator analysis pointed to the preventive and geroprophylactic measures to ensure efficient health care for the elderly and to develop the program of mental health promotion and preservation. According to 2007 estimate, there were 759,318 (16.9%) persons aged ł65 in Croatia. Data collected at gerontology database kept at Department of Gerontology, Dr. Andrija [tampar Institute of Public Health (September 2008) showed 2% of the elderly (N=14807) to be accommodated at Old People’s Homes, which is below the European average of 4%

Izbor staništa vjetruše Falco tinnunculus u Zagrebu

Common Kestrel Falco tinnunculus is a bird of prey that colonized European cities most successfully. It is a resident bird in Zagreb, nesting in the centre of the city. The main purpose of this study was to locate and analyse the positions of active nests of Common Kestrels during the breeding season of 2017 in Zagreb. “The Atlas of breeding birds of Zagreb” was used as the basis of knowledge about the distribution of Kestrels in Zagreb. After the field research, the characteristics of nesting sites were analysed; subsequently – by using GIS program – the distances between nesting sites and nearest urban green areas that are used for foraging were measured. This study gave insight into the habitat preferences for the nesting of Kestrels in Zagreb. It has been shown that the most suitable buildings for the nesting of Kestrels in Zagreb are residential buildings with an average height of 50.1 meters. Beside smaller urban green areas, large green areas outside the city centre were also of great importance, with the embankment of the Sava river proved to be the most significant one.Urbanizirana područja sve se više šire te uništavajući prirodna staništa utječu na smanjenje raznolikosti životinjskih vrsta, a u manjoj mjeri stvaraju i nova staništa za određene vrste. Povećanje urbanizacije obično dovodi do povećanja biomase ptica ali i do smanjenja raznolikosti vrsta. Za ptice grabljivice urbana staništa mogu biti od vrhunske kvalitete, jer su u takvim staništima grabljivice često zaštićene od progona te mogu imati i zadovoljavajuću opskrbu hranom što im omogućava nastanjivanje inače neprikladnih ili neproduktivnih mjesta za gniježđenje. Među europskim grabljivicama, vjetruša (Falco tinnunculus) najuspješnije zauzima urbana područja što pokazuje viša stopa razmnožavanja kod urbanih populacija u usporedbi sa populacijama poljoprivrednih zemljišta. Vjetruša je jedna od najčešćih malih grabljivica u Europi koja, u usporedbi sa ostalim vrstama grabljivica, najuspješnije zauzima urbana područja. Stanarica je u gradu Zagrebu, prisutna je u gradu kroz cijelu godinu, te se gnijezdi i u samom centru grada. Cilj ovoga rada bio je najprije locirati a zatim i analizirati položaj trenutno aktivnih gnijezda vjetruša na području grada Zagreba u sezoni gniježđenja 2017. godine. Kao osnova poznavanja rasprostranjenosti vjetruše u Zagrebu poslužio je Atlas ptica gnjezdarica grada Zagreba. Nakon provedenog terenskog istraživanja, analizirane su značajke gnjezdišta, te su pomoću GIS programa izračunate udaljenosti analiziranih gnijezda do najbližih gradskih zelenih površina koje vjetruše koriste za lov i prehranu. Ovo istraživanje dalo je uvid u izbor staništa za gniježđenje vjetruša u Zagrebu. Rezultati su pokazali da je vjetrušama od najveće važnosti pri odabiru staništa tip građevine na kojima se gnijezdi te udaljenosti gnijezda do zelenih površina unutar i izvan centra grada. Stambene zgrade pokazale su se kao najpogodniji tip građevina za gniježđenje vjetruša, a visine građevina u većini slučajeva iznose između 25 i 70 metara (prosječno 50,1± 26,1 metara) visine. Također je dokazano i to da vjetruše većinom biraju najviše dostupne građevine. Važnu ulogu pri odabiru staništa unutar centra grada predstavljaju manje zelene površine unutar kojih se nalazi većina analiziranih gnijezda, no od velike važnosti zbog mogućnosti lova predstavljaju i velike zelene površine udaljenije od samog centra grada

Socioekonomski utjecaj upotrebe duhana i iskustvo zubnog karijesa u različitih hrvatskih populacija muškaraca

The purpose was to evaluate dental caries experience in different male subpopulations of Croatian Army recruits and dental students, and subsequently, smoking habits related to the level of education and place of residence. Croatian army recruits (n=248; mean age 20.2) and male dental students (n=56; mean age 21.5) were evaluated according to DMFT and FST indices, divided according to age and place of residence, and interviewed about their dietary habits and smoking of tobacco. In the subpopulation of recruits, the median value of DMFT was 6 and of FST index 25. A statistically significant difference was recorded between DT and FST index (p<0.05) according to dietary role of carbohydrates reflected in caries development. The number of recruits with finished elementary school coming from a rural area who smoked (in total 57.66% of smokers) was significantly larger (p=0.0041). In dental students, the median value of DMFT was 5, with statistical significance in comparison with recruits (p=0.03). There was a difference in FST index (median 28) (p<0.0001). Students were mostly nonsmokers (71.43%) and had urban residence (p<0.0001). FST index was a more specific indicator in the socioeconomically heterogeneous sample of recruits (more subjects coming from rural areas and with a lower level of education) than in the sample of dental students (more subjects coming from urban areas).Svrha istraživanja je bila procijeniti iskustvo dentalnog karijesa u različitih populacija muškaraca: novaka Hrvatske vojske i studenata dentalne medicine, kao i naviku pušenja vezano za stupanj obrazovanja i prebivalište. Prema indeksima DMFT i FST evaluirani su novaci Hrvatske vojske (n=248, prosječne dobi 20,2 godina) i muški studenti dentalne medicine (n=56, prosječne dobi 21,5 godina) podijeljeni prema dobi i prebivalištu te intervjuirani vezano za njihove prehrambene navike i pušenje duhana. Medijan indeksa DMFT za novake bio je 6, a indeksa FST 25. Statistički značajna razlika zabilježena je između DT i FST indeksa (p<0,05) s obzirom na ulogu prehrane ugljikohidratima vezano za razvoj karijesa. Bilo je značajno više (p=0,0041) novaka koji puše te sa završenom osnovnom školom iz ruralnog područja (ukupno 57,66% pušača). Za studente dentalne medicine medijan indeksa DMFT je bio 5, sa statističkom značajnošću u usporedbi s novacima (p=0,03). Postojala je i razlika za indeks FST (medijan 28, p<0,0001). Studenti su većinom bili nepušači (71,43%) i imali su urbano prebivalište (p<0,0001). Indeks FST bio je specifičniji indikator za socio-ekonomski heterogeni uzorak novaka (više ih je bilo s ruralnim prebivalištem i nižim stupnjem obrazovanja) nego kod studenata dentalne medicine (više ih je bilo s urbanim prebivalištem)

AGREGACIJA TROMBOCITA U ZAVRŠNOM STADIJU ZATAJIVANJA BUBREGA – RAZLIKE IZMEĐU BOLESNIKA KOJI SU LIJEČENI HEMODIJALIZOM I PERITONEJSKOM DIJALIZOM

End-stage renal disease patients (ESRD) suffer from procoagulant abnormalities that lead to excessive cardiovascular events, as well as from platelet dysfunction manifesting as an increased risk of bleeding. The exact pathogenesis of complex hemostatic disorders in ESRD patients is not completely understood. The aim of our study was to investigate the possible different effects of hemodialysis (HD) and peritoneal dialysis (PD) on platelet function in patients with ESRD by using the platelet function analyzer (PFA-100) which in vitro simulates the process of aggregation and platelet activation. Tests were performed with collagen/epinephrine (COL/EPI) and collagen/adenosine-5-diphosphate (COL/ADP) cartridges. The study included 44 patients with ESRD undergoing regular HD (n=32) or PD (n=12). Although there were no significant differences in COL/EPI and COL/ADP tests, it is indicative that more than 50% of HD patients had COL/EPI test values above the upper limit. These findings correlated with a higher chance for bleeding in HD group.Additionally, patients in HD group were significantly older and had significantly lower platelet count compared to PD patients.Završni stadij kronične bubrežne bolesti obilježen je različitim prokoagulantnim odstupanjima koja dovode do razvoja tromboembolijskih komplikacija uz istodobno poremećenu funkciju trombocita s posljedičnim porastom rizika za nastanak krvarenja. Točna etiologija složenih hemostatskih poremećaja u završnom stadiju kronične bubrežne bolesti nije u potpunosti razjašnjena. Cilj ovoga istraživanja bio je usporediti učinak hemodijalize i peritonejske dijalize na funkciju tromobocita kod bolesnika u završnom stadiju kronične bubrežne bolesti primjenom analizatora funkcije trombocita (PFA-100) koji in vitro stimulira proces aktivacije i agregacije trombocita. Ispitivanje je provedeno na 2 testa (COL/EPI i COL/ADP) koji mjere vrijeme potrebno cirkulirajućoj krvi da okludira membranu obloženu kolagenom i adrenalinom (COL/EPI) odnosno kolagenom i ADP-om (COL/ADP). U istraživanje su bili uključeni bolesnici na hemodijalizi (n=32) odnosno peritonejskoj dijalizi (n=12). Premda nije zabilježena statistički značajna razlika između testova COL/EPI i COL/ADP, indikativno je da su u više od 50% ispitanika na hemodijalizi vrijednosti testa COL/EPI bile iznad gornje granice referentnog intervala. Ovi rezultati mogu se povezati s većom mogućnosti krvarenja u bolesnika na hemodijalizi. Uz to, bolesnici na hemodijalizi bili su značajno stariji te su imali statistički značajno niži broj trombocita u odnosu na ispitanike na peritonejskoj dijalizi