Health-Related Quality of Life in Antiviral-Treated Chronic Hepatitis C Patients

Chronic hepatitis C has a profound negative impact on both physical and mental well-being, thus decreasing health-related quality of life (HRQL). The most common complaints include symptoms such as fatigue, depression, and neurocognitive deficits. The burden of chronic HCV infections is multiplied by emotional and psychological issues that affect patients’ functional health and work ability. Treatment of chronic HCV infection may at the beginning cause worse HRQL rates, as a result of common adverse effects like fatigue, muscle aches, and depression. However, the relationship between sustained virologic response (SVR) and improvement in HRQL is well known. Treatment-related adverse effects may discourage patients from starting therapy and reduce their adherence to treatment. Novel agents, with improved adverse effect profiles and SVR rates, allow more patients the opportunity to achieve improvements in HRQL during and after treatment

HCV and Work Ability Assessment

Modifications to work and work ability assessment are required to prevent occupational transmission of hepatitis C virus (HCV). This is usually required in the health care setting, where exposure-prone procedures (EPPs) should not be carried out by infectious carriers of HCV. The risk of an individual surgeon acquiring HCV has been estimated at 0.001–0.032% per annum. Even in an area with a high prevalence of HCV among its population, the risk of acquiring HCV through occupational exposure is low. Rates of viral clearance with treatment of acute HCV infection are considerably higher than treatment of chronic HCV infection. Consequently, it is imperative that health care workers follow universal precautions and promptly report all exposures to blood or body fluid exposures according to their local policy. Health care workers who embark on, or transfer to, a career that requires EPP (exposure-prone procedures and dialysis work) should be assessed to ensure that they are free from infection with HCV. If the HCV antibodies are positive, the health care worker should be tested for HCV RNA PCR. If the HCV RNA PCR is negative on two separate occasions, the health care worker may be permitted to perform EPPs. If the HCV RNA PCR is positive, the health care worker should not be allowed to perform EPPs. Health care workers who already perform EPPs and who believe they may have been exposed to HCV infection should be advised to seek advice from their occupational health department for confidential advice on whether they should be tested

Legislation on Dental P Practice in Croatia in the Second Half of the 19th Century

In the second half of the 19th century, Croatia experienced a radical change in the performance of dental practice and legislation that regulates such practice. From the old feudal system when dental practice was practised by barbers-surgeons and feldshers (Old Croatian language: vidari), it is transferred to a more modern system where dental practice becomes a part of medical sciences and its implementation requires adequate medical education. The most important factor that contributed to this was the adoption of new modern laws in 1874, and then in 1894, as well as accompanying regulations, which adequately regulated the matter of public health and dental practice

Hepatitis C Treatment: A Review and Update

Hepatitis C virus infection (HCV) infects approximately 185 million individuals worldwide. It is a leading cause of chronic liver disease and the primary reason for liver transplantation. The main aim of antiviral treatment is to achieve a sustained virologic response, which means eradication of the virus. The combination of pegylated-interferon and ribavirin was the standardof care for over a decade, despite the long treatment duration and severe adverse effects. The introduction of direct-acting antivirals with pan-genomic properties and excellent tolerance increased rates of SVR and shortened the duration of the therapy. Furthermore, it allowed clinicians to customize HCV therapy according to important clinical parameters such as HCV- genotype and liver fibrosis stage

ASSESSMENT OF QUALITY OF LIFE IN GLAUCOMA PATIENTS

Glaukom je kronična, inicijalno asimptomatska degenerativna bolest, koja zahvaća 2% populacije starije od 40 godina. Uzrokuje znatna oštećenja vida s posljedicama za svakodnevne aktivnosti oboljelih čime se narušava kvaliteta njihova života (QoL). Cilj je ovog rada dati pregled instrumenata koji se rabe u određivanju QoL-a glaukomskih pacijenata i metoda s pomoću kojih se utvrđuje mogućnost funkcioniranja pacijenata u svakodnevnom životu. Istražena je relevantna literatura na PubMedu. Istraženo je 13 QoL-upitnika upotrebljavanih u glaukomskih pacijenata, metoda procjene funkcije vida pacijenata oboljelih od glaukoma na temelju izvedbe određenih radnja i tri mjere korisnosti. Iako nema „idealnog” instrumenta za ispitivanje QoL-a glaukomskih pacijenata, ono mora biti sadržano u planu liječenja glaukomskog pacijenta zbog višestruke koristi u liječenju, edukaciji i zadovoljstvu pacijenata, a time i smanjenju fi nancijskog opterećenja zdravstvenog sustava. Upitnik The Glaucoma Quality of Life (GQL-15) prihvatljiv je u kliničkim uvjetima zbog kratkoće i lakoće ispunjavanja.Glaucoma is a chronic, asymptomatic disorder which affects 2% of the population over 40 years of age. Glaucoma causes a signifi cant vision impairment with the consequences on daily activities of patients which affect negatively their quality of life (QoL). The purpose of this paper is to give a review of instruments used in the QoL assessments of glaucoma patients and methods of performance based assessment of visual function in glaucoma in daily life. The PubMed was searched for the relevant literature. Thirteen quality of life scores used in glaucoma patients, method of performancebased assessments of the ability to carry out daily activities, and three utility measures were investigated. Despite the fact that there are no ideal instruments for the assessment of QoL of glaucoma patients, it should be incorporated in the plan of glaucoma patients treatment because of multiple benefi ts in optimizing the plan of treatment, education of the patients, the patients’ self satisfaction, and in the reduction of fi nancial burden of the health care system. The Glaucoma Quality of Life (GQL-15) score is acceptable in clinical practice due to its shortness and implementatio

PREGLED ŽENSKE SPOLNE FUNKCIJE S PRIKAZOM HRVATSKOG PRIJEVODA INDEKSA ŽENSKE SPOLNE FUNKCIJE

Introduction: The Female Sexual Function Index (FSFI) is a questionnaire used to assess female sexual function and diagnose sexual dysfunction (SD). Aim: to provide a Croatian translation of the FSFI. Methods: The translation procedure consisted of creating two independent forward translations, merging them into a single forward translation, creating a back translation, comparing the back translation with the original, and deciding on a fi nal translation. Results: no semantic differences were found when comparing the back translation with the original. Therefore, minimal changes were made to the earlier translation when the fi nal translation was created. Conclusions: The Croatian translation of the FSFI is now available for assessing the widespread problem of female SD in the Croatian-speaking population.Uvod: Indeks ženske seksualne funkcije (engl. Female Sexual Function Index, FSFI) je upitnik koji se rabi za procjenu ženske seksualne funkcije i dijagnosticiranje seksualne disfunkcije (SD). Cilj: prikazati prijevod upitnika FSFI na hrvatski jezik. Postupci: Postupak prevođenja sastojao se od stvaranja dvaju neovisnih prijevoda upitnika s engleskog na hrvatski jezik, njihovog spajanja u jedan prijevod, ponovnog prevođenja stvorene hrvatske inačice upitnika na engleski jezik te usporedbe konačne inačice prijevoda s originalnim upitnikom i konačnih prilagodba fi nalne verzije prijevoda. Rezultati: Nisu pronađene semantičke razlike pri usporedbi hrvatskog prijevoda s originalnom verzijom upitnika. Stoga su napravljene minimalne promjene u prvoj verziji prijevoda pri stvaranju konačnog prijevoda. Zaključak: Hrvatski prijevod upitnika FSFI je sada na raspolaganju za ispitivanje raširenog problema SD u ženskoj populaciji hrvatskog govornog područja

PREGLED ŽENSKE SPOLNE FUNKCIJE S PRIKAZOM HRVATSKOG PRIJEVODA INDEKSA ŽENSKE SPOLNE FUNKCIJE

Introduction: The Female Sexual Function Index (FSFI) is a questionnaire used to assess female sexual function and diagnose sexual dysfunction (SD). Aim: to provide a Croatian translation of the FSFI. Methods: The translation procedure consisted of creating two independent forward translations, merging them into a single forward translation, creating a back translation, comparing the back translation with the original, and deciding on a fi nal translation. Results: no semantic differences were found when comparing the back translation with the original. Therefore, minimal changes were made to the earlier translation when the fi nal translation was created. Conclusions: The Croatian translation of the FSFI is now available for assessing the widespread problem of female SD in the Croatian-speaking population.Uvod: Indeks ženske seksualne funkcije (engl. Female Sexual Function Index, FSFI) je upitnik koji se rabi za procjenu ženske seksualne funkcije i dijagnosticiranje seksualne disfunkcije (SD). Cilj: prikazati prijevod upitnika FSFI na hrvatski jezik. Postupci: Postupak prevođenja sastojao se od stvaranja dvaju neovisnih prijevoda upitnika s engleskog na hrvatski jezik, njihovog spajanja u jedan prijevod, ponovnog prevođenja stvorene hrvatske inačice upitnika na engleski jezik te usporedbe konačne inačice prijevoda s originalnim upitnikom i konačnih prilagodba fi nalne verzije prijevoda. Rezultati: Nisu pronađene semantičke razlike pri usporedbi hrvatskog prijevoda s originalnom verzijom upitnika. Stoga su napravljene minimalne promjene u prvoj verziji prijevoda pri stvaranju konačnog prijevoda. Zaključak: Hrvatski prijevod upitnika FSFI je sada na raspolaganju za ispitivanje raširenog problema SD u ženskoj populaciji hrvatskog govornog područja

Kronične nezarazne bolesti kod hrvatskih branitelja u odnosu na opću populaciju: 25 godina nakon rata

Many published reports have documented an increased prevalence of chronic medical conditions among veterans, but there were only a few studies that compared these increases with the general population. The aim of this study was to determine differences in chronic medical conditions between Croatian war veterans and the general population. This study included two groups of subjects, i.e. 1453 participants who are Croatian war veterans and 1429 participants from the general population. Medical history, physical examination, laboratory tests and specific diagnostic procedures were taken during systematic physical examination in both groups. The prevalence of hypertension, diabetes, hyperlipidemia, hypothyroidism and hyperthyroidism, chronic obstructive pulmonary disease, coronary heart disease, malignancy, psychiatric diseases, cholelithiasis, nephrolithiasis, smoking and alcohol consumption was analyzed. Croatian war veterans were found to be more likely to develop hypertension than individuals in the general population (29.5% vs. 24.3%), as well as diabetes (7.3% vs. 3.8%), hyperlipidemia (56.4% vs. 27.3%), hyperthyroidism (3.1% vs. 0.8%), coronary heart disease (4.3% vs. 1 %), malignancy (4.1% vs. 2.2%), psychiatric diseases (15.4% vs. 1.1%), and alcohol consumption (53% vs. 29%). Significant difference was found in favor of the general population for hypothyroidism (14.3% vs. 8%). There were no differences in the prevalence of chronic obstructive pulmonary disease, cholelithiasis, nephrolithiasis, and smoking. Our findings confirmed the hypothesis of a higher prevalence of cardiovascular diseases, malignancy and psychiatric diseases among Croatian war veterans and emphasized the need of better control of their medical conditions.Povećana učestalost kroničnih bolesti među veteranima dokumentirana je kroz brojna istraživanja, no samo ih je nekoliko studija uspoređivalo s općom populacijom. Cilj ovog istraživanja bio je utvrditi razlike u pojavnosti kroničnih bolesti između hrvatskih branitelja i opće populacije. Ovo istraživanje obuhvatilo je dvije skupine ispitanika, 1453 hrvatskih branitelja i 1429 sudionika iz opće populacije. Anamneza, fizikalni pregled, laboratorijske pretrage i specifični dijagnostički postupci provedeni su tijekom sistematskog fizikalnog pregleda u obje skupine. Analizirana je učestalost hipertenzije, šećerne bolesti, hiperlipidemije, hipotireoze i hipertireoze, kronične opstruktivne plućne bolesti, koronarne bolesti, malignih bolesti, psihijatrijskih bolesti, kolelitijaze, nefrolitijaze, pušenja i konzumacije alkohola. Utvrđeno je da hrvatski branitelji imaju veću vjerojatnost za razvoj hipertenzije (29,5% prema 24,3%), dijabetesa (17,3% prema 3,8%), hiperlipidemije (56,4% prema 27,3%), hipertireoze (3,1% prema 0,8%), koronarne bolesti srca (4,3% naspram 1%), zloćudne bolesti (4,1% naspram 2,2%), psihijatrijske bolesti (15,4% naspram 1,1%) i češću konzumaciju alkohola (53% naspram 29%) nego pojedinci u općoj populaciji. Uočena je značajna razlika u korist opće populacije za hipotireozu (14,3% naspram 8%). Nije bilo razlika u učestalosti kronične opstruktivne plućne bolesti, kolelitijaze, nefrolitijaze i pušenja. Naši nalazi potvrdili su hipotezu o višoj učestalosti kardiovaskularnih bolesti, malignih i psihijatrijskih bolesti među hrvatskim braniteljima te naglasili potrebu bolje kontrole njihovog zdravstvenog stanja

Approaches and Considerations for the Successful Treatment of HCV Infection

The complexity of the hepatitis C virus (HCV) infection is reflected in its therapy, and great efforts are needed from the patient and the physician to be successful in eliminating the infection. How HCV will progress depends a lot on patient characteristics and social factors, in addition to the timing of initiation, duration, and final results of the therapy. The first treatment approved for patients with chronic hepatitis C was interferon (IFN) which had a sustained viral response (SVR) rate in 20%. Due to side effects, the adherence to this treatment was limited and required a patient-tailored approach with various medical disciplines working together and intervening at the right time to minimize potential obstacles. The introduction of direct-acting antivirals (DAAs) has contributed to the advancement of HCV treatment. However, a major obstacle to wide use of DAAs is their high price which has largely limited access to treatment. Guidelines and recommendations on treatment of hepatitis C have been developed to assist physicians and other health care providers to determine priority. Despite that, the arrival of new oral therapies has been met with enthusiasm as shorter, simpler, safer treatment allows for the possibility of delivering antiviral therapy on a large scale