Epidemiology of Osteoporosis

U većini zemalja u svijetu, pa tako i u Hrvatskoj ne postoji jedinstveni sustav registriranja oboljelih od osteoporoze, kao ni osoba s osteoporotskim prijelomima. Podatci iz epidemioloških istraživanja pokazuju da je učestalost osteoporoze veća u azijskim zemljama u odnosu na europsko i sjevernoameričko stanovništvo bijele rase, u kojih prevalencija iznosi 10 % do 15 %. U Hrvatskoj je učestalost slična onoj u drugim europskim zemljama, dok je incidencija osteoporotskih prijeloma nešto veća od europskog prosjeka. Također je broj prijavljenih slučajeva osteoporoze i osteomalacije od primarne zdravstvene zaštite zadnjih 10 godina u stalnom porastu i u 2004. godini je iznosio 0,70 % u odnosu na ukupan broj prijavljenih bolesti. Najvažniji rizični čimbenici bolesti su dob, naslijeđe, životne navike, postojanje kroničnih bolesti i hormonskih poremećaja te individualna fizikalna obilježja kosti. Kao u većine kroničnih bolesti, mjerama prevencije može se pravodobno spriječiti nastanak bolesti i njezinih komplikacija.In many countries, including Croatia, there is no disease registry for osteoporosis and osteoporotic fractures. Epidemiological data show that the prevalence of osteoporosis is much higher in Asian people than in white European or North American populations, where the prevalence ranges between 10 % and 15 %. Epidemiological characteristics of osteoporosis in Croatia are similar to other European countries, though the incidence of osteoporotic fractures is somewhat higher. According to the annual report of registered diseases, the number of patients with osteoporosis and osteoporotic fractures increased during the last 10 years. In 2004, 0.70 % of all registered diseases in Croatia referred to osteoporosis and osteomalacia. The most important risk factors for osteoporosis are age, heredity, lifestyle, chronic diseases, hormonal abnormalities and physical characteristics of bone. Like in other chronic diseases, prevention measures are most important for disease control

Utjecaj nasljeđa i okoliša na vršnu koštanu gustoću: pregled istraživanja u Hrvatskoj

One of the main determinants of who will develop osteoporosis is the amount of bone accumulated at peak bone density. There is poor agreement, however, on when peak bone density occurs. Ethnic differences were observed in age at peak bone density and their correlates. Since the diagnosis of osteoporosis and osteopaenia is based on the comparison between patients’ bone mineral density (BMD) and optimal peak bone density in healthy young people (T-score), it is of great importance that each country should provide its own reference peak bone density data. This review article presents our published results on peak bone density in Croatia and compares them with findings in other populations. Our research included 18 to 25-year-old students from Zagreb University and their parents. The results showed that peak bone mass in young Croatian women was achieved before the age of twenty, but BMD continued to increase after the mid-twenties in the long-bone cortical skeleton. BMD was comparable to the values reported by the National Health and Nutrition Examination Survey (NHANES) and other studies that included the same age groups, except for the cortical part of the radius, where it was signifi cantly lower. Men achieved peak bone density in the spine later than women, which cannot be explained by different diet or physical activity. As expected, heredity was more important for peak bone density than the environmental factors known to be important for bone health. However, the infl uence of heredity was not as strong as observed in most other populations. It was also weaker in the cortical than in the trabecular parts of the skeleton. Future research should include young adolescent population to defi ne the exact age of achieving peak bone density in different skeletal sites.Vršna koštana gustoća je jedna od najvažnijih pretpostavki za nastanak osteoporoze. Poznati su rizični faktori za vršnu koštanu gustoću, ali vrijeme njezinog postizanja nije u potpunosti defi nirano. S obzirom na to da se dijagnoza osteoporoze i osteopenije temelji na usporedbi mineralne gustoće kosti (BMD) pojedinca s prosječnom vršnom koštanom gustoćom u mladoj, odrasloj populaciji (T vrijednost), vrlo je značajno da svaka zemlja utvrdi vrijednosti vršne koštane gustoće za svoju populaciju. U ovom smo radu prikazali naša istraživanja i objavljene rezultate o vršnoj koštanoj gustoći u hrvatskoj populaciji i usporedili rezultate s drugim istraživanjima u svijetu. Naše je istraživanje obuhvatilo studentsku populaciju u dobi od 18 do 25 godina i njihove roditelje. Rezultati su pokazali da se u našoj populaciji vršna koštana gustoća postiže prije 20. godine na trabekularnoj kosti, a na kortikalnom dijelu skeleta nakon 25. godine života. Vrijednosti vršne koštane gustoće u našoj populaciji slične su onima iz studije National Health and Nutrition Examination Survey (NHANES), kao i iz ostalih studija koje su obuhvatile istu dobnu skupinu, osim na kortikalnom dijelu skeleta, gdje su u našoj populaciji nađene značajno niže vrijednosti. Kasnije postizanje vršne koštane gustoće u muškaraca nego u žena bilo je najizraženije na kralježnici, što se nije moglo objasniti različitim prehrambenim navikama i razinom tjelesne aktivnosti među spolovima. Nasljeđe je imalo veći utjecaj na koštanu gustoću od okolišnih faktora, ali taj utjecaj nije bio toliko značajan kao u većini drugih istraživanja. Utjecaj nasljeđa na vršnu koštanu gustoću bio je manji na kortikalnom nego na trabekularnom dijelu skeleta. Bilo bi važno proširiti istraživanje na mladu adolescentnu populaciju i tako točnije defi nirati vrijeme postizanja vršne koštane gustoće na pojedinim dijelovima skeleta

The importance of collaboration and interdisciplinary approaches to solving problems of urolithiasis: yesterday, today and tomorrow

Suradnja kemičara, liječnika i urologa s Instituta Ruđer Bošković Zagreb, Instituta za medicinska istraživanja i medicinu rada Zagreb te Kliničke bolnice Osijek (danas Kliničkoga bolničkoga centra Osijek) započela je prije više od tridesetak godina na projektima povezanim s nastankom urolitijaze. Sama istraživanja pridonijela su novim spoznajama o različitim faktorima važnim za nastajanje kamenaca, dijagnosticiranje i liječenje urolitijaze. Više radova objavljeno je u znanstveno-stručnom časopisu Medicinski vjesnik (1984. i 1985.) te u knjizi Urolitijaza (1989.). U radu V. Babić-Ivančić i sur., objavljenom u Medicinskom vjesniku 2004. godine, danje detaljan pregled bazičnih, primijenjenih i kliničkih istraživanja do 2004. godine na zajedničkim projektima financiranim iz Hrvatske (MZOŠ) i na međunarodnim projektima (EZ, USA, TEMPUS) provedenim u trima suradnim ustanovama čiji su rezultati objavljeni u znanstvenim časopisima i/ili prezentirani na znanstvenim skupovima u zemlji i inozemstvu. U ovome radu dat će se osvrt na rezultate istraživanja, te suradnju u vremenskom razdoblju od 2004. godine do danas (2010.). Iz ranijih istraživanja te istraživanja u zadnjih šest godina dat će se viđenje o istraživanjima te problematike u budućnosti.Collaboration between chemists, physicians and urologists from the Ruđer Bošković Institute, the Institute for Medical Research and the Occupational Health and Clinical Hospital Osijek, has started more than 30 years ago through the projects in the filed of urolithiasis. Those investigations have contributed to new understandings of risk factors for kidney stones formation and also for diagnostic and therapy of urolithiasis. Several articles have been published in the journal „Medicinski vjesnik (1984 and 1985) and in the book „Urolitijaza (1989.). The article published in 2004 (Babić-Ivančić V, et al; Medicinski vjesnik presented the review of basic and clinical investigations which results have been published in scientific journals or presented at the scientific conferences til 2004 and financed by the Croatian Ministry of Science, European Union, USA or TEMPUS. This article presents the results of investigations from 2004 until today and also gives a vision about future scope in this issue

Razlike u vršnoj koštanoj masi između studentica i studenata

As an important determinant of osteoporotic fracture risk, peak bone density tends to be higher in men than in women. The aim of this study was to see whether young men and women differed in the time and skeletal region of peak bone density. We also investigated the infl uence of diet and physical activity on bone mass. The study group included 51 male and 75 female students aged 19 to 25 years. Bone mineral density was measured for the spine, total femur, and the distal third of the radius using dual energy x-ray absorptiometry. Dietary data were obtained using a specially designed semiquantitative food frequency questionnaire. Bone mineral density (BMD; g cm-2) was higher in boys than in girls at all measured sites, while bone mineral apparent density (BMAD; g cm-3) was higher in girls. Age negatively correlated with bone mineral density in all measured sites except in the boys’ spine. Sodium, protein, and fi bres were nutrients that signifi cantly correlated with bone mineral density. The study suggests that boys achieve peak bone density later than girls, and that this delay is the most prominent in the spine. In our study group, this difference could not be explained by different nutrition or the level of physical activity.Vršna koštana masa važna je odrednica nastanka osteoporotskih prijeloma i poznato je da je veća u muškaraca nego u žena. Cilj istraživanja bio je analizirati razlike u postizanju vršne koštane mase na različitim regijama skeleta između mladih muškaraca i žena. Također je procijenjen utjecaj prehrane i tjelesne aktivnosti na mineralnu gustoću kostiju. Ispitanici su studenti u dobi od 19 do 25 godina, 51 muškog i 75 ženskog spola. Mineralna gustoća kostiju određena je metodom dvoenergetske apsorpciometrije X-zraka na kralježnici, ukupnom femuru i distalnoj trećini radijusa. Podaci o prehrani dobiveni su semikvantitativnim upitnikom o prehrani. Mineralna gustoća kostiju (BMD; g cm-2) bila je veća u studenata na svim mjerenim regijama, dok je procijenjena volumetrijska koštana gustoća (BMAD; g cm-3) bila veća u studentica. U studenata obaju spolova vrijednosti mineralne gustoće kostiju smanjuju se s porastom dobi, jedino se s dobi povećava mineralna gustoća kralježnice u muških studenata. Unos proteina, natrija i vlakana značajno je povezan s koštanom masom. Dobiveni rezultati upućuju na zaključak da muškarci kasnije postižu vršnu koštanu masu, što je najizraženije na kralježnici. U ispitivanoj grupi te se razlike ne mogu objasniti mogućim razlikama u prehrani i/ili tjelesnoj aktivnosti između muških i ženskih ispitanika

Ultrasound Measurement of the Volume of Musculus Quadriceps after Knee Joint Injury

The monitoring of the recovery of femoral muscles, after the knee-joint injury, is possible by the method of ultrasound measurement of the muscular volume. In a clearly defined longitudinal study, our object was to standardize the method of ultrasound measurement of muscular volume and to evaluate its adequacy in practical application in quadriceps muscle rehabilitation. The ultrasound measurements of m. rectus femoris and m. vastus intermedius were conducted in three intervals: in the first 24 hours after the injury; after 1 week, when immobilization was removed; and after 6 weeks, when rehabilitation was finished. The study comprised 30 patients with knee-joint injury, and 30 asymptomatic subjects, who formed the control group. The results showed significant decrease of muscular volume (mm3) after joint immobilization on injured leg and a significant increase of volume after rehabilitation. The same differences were observed on healthy legs, but without significance. Within the same intervals, there were no changes in the muscular mass in the control group. M. rectus femoris was completely recovered in greater number of patients (54.1%), comparing to m. vastus intermedius (25.4%). We conclude that the ultrasound is an appropriate method for monitoring the process of muscular atrophy during immobilization, as well as the course of muscular restitution during the physical therap

Ultrasound Measurement of the Volume of Musculus Quadriceps after Knee Joint Injury

The monitoring of the recovery of femoral muscles, after the knee-joint injury, is possible by the method of ultrasound measurement of the muscular volume. In a clearly defined longitudinal study, our object was to standardize the method of ultrasound measurement of muscular volume and to evaluate its adequacy in practical application in quadriceps muscle rehabilitation. The ultrasound measurements of m. rectus femoris and m. vastus intermedius were conducted in three intervals: in the first 24 hours after the injury; after 1 week, when immobilization was removed; and after 6 weeks, when rehabilitation was finished. The study comprised 30 patients with knee-joint injury, and 30 asymptomatic subjects, who formed the control group. The results showed significant decrease of muscular volume (mm3) after joint immobilization on injured leg and a significant increase of volume after rehabilitation. The same differences were observed on healthy legs, but without significance. Within the same intervals, there were no changes in the muscular mass in the control group. M. rectus femoris was completely recovered in greater number of patients (54.1%), comparing to m. vastus intermedius (25.4%). We conclude that the ultrasound is an appropriate method for monitoring the process of muscular atrophy during immobilization, as well as the course of muscular restitution during the physical therap

Wi-Fi i ljudsko zdravlje

An enormous increase in the application of wireless communication in recent decades has intensified research into consequent increase in human exposure to electromagnetic (EM) radiofrequency (RF) radiation fields and potential health effects, especially in school children and teenagers, and this paper gives a snap overview of current findings and recommendations of international expert bodies, with the emphasis on exposure from Wi-Fi technology indoor devices. Our analysis includes over 100 in vitro, animal, epidemiological, and exposure assessment studies (of which 37 in vivo and 30 covering Wi-Fi technologies). Only a small portion of published research papers refers to the “real” health impact of Wi-Fi technologies on children, because they are simply not available. Results from animal studies are rarely fully transferable to humans. As highly controlled laboratory exposure experiments do not reflect real physical interaction between RF radiation fields with biological tissue, dosimetry methods, protocols, and instrumentation need constant improvement. Several studies repeatedly confirmed thermal effect of RF field interaction with human tissue, but non-thermal effects remain dubious and unconfirmed.Značajan porast uporabe bežične RF komunikacije u posljednjim desetljećima te s tim povezane izloženosti ljudi umjetno stvorenom neionizirajućem zračenju (RF polja), koje prije nije postojalo na Zemlji, tema su velikog broja istraživanja mogućih utjecaja tih zračenja na okoliš i zdravlje ljudi, osobito djece i mladih, kako bi se utvrdile činjenice o međudjelovanju RF polja s genskim materijalom živih bića. U ovom radu dan je pregled aktualnih istraživanja i preporuka međunarodnih stručnih tijela. Poseban naglasak dan je na mogući utjecaj radiofrekvencijskoga zračenja na mlade odnosno na školsku djecu koja su mu tijekom školovanja svakodnevno dodatno izložena tijekom e-škole korištenjem najmodernijih Wi-Fi tehnologijskih rješenja za komunikaciju u obrazovanju