Multiple Sclerosis and Cancers in Croatia – A Possible Protective Role of the »Mediterranean Diet«

Multiple sclerosis (MS) is an autoimmune disease triggered by a combination of genetic and environmental risk factors which are however individually insufficient to provoke the disease. Previous investigations studied the coexistence of cancer in MS patients, and only a few relations between the geographic distribution of MS and that of cancer. The aim of this research was to find an environmental link between the aetiology of MS and cancers in Croatia. Incidence and prevalence of MS in Croatia were compared with the incidence of the most frequent cancer sites: stomach cancer, cancer of the colon and the rectum, pancreatic cancer, lung cancer, cancer of the kidneys and brain cancer. Data for MS were collected from seven population-based epidemiologic studies which used Poser’ s diagnostic criteria and reported the number of cases and the magnitude of the studied population. Data for cancers were drawn from the Croatian National Cancer Registry. The analysis was done for single municipalities, grouped in their belonging regions or counties, and separately for the continental and the coastal area. For each rate a 95% confidence interval was calculated. The differences between rates were tested with the chi-square test as well. In addition, MS incidence or prevalence were correlated with the corresponding cancer incidence data. Pearson’s correlation coefficients were used to measure the correlation between both diseases. Calculations were done with the statistical package Statistica V 7.1. and the Smith’s Statistical Package freeware In the continental area of Croatia the mean annual incidence (per 100,000 inhabitants) of MS was nearly two folds higher than in the coastal area: 2.1 vs. 1.3 (p=0.0029). The difference was lower when expressed by prevalence: 46.5 vs. 36.7 (p=0.0601). Among the malignant neoplasms, in the continental area significantly higher incidence rates were found for stomach (32.9 vs. 20.8; p=3.14E-14) and lung cancer (55.8 vs. 46.4; p=1.21E-05), whilst colon cancer alone (20.4 vs. 15.7; p=9.44E-05) or colorectal cancer (38.3 vs. 31.6; p=8.18E-05) had a significantly higher incidence in the coastal area. The geographic distribution of MS expressed by incidence was significantly correlated with pancreatic (r=0,62024, df=23, p=0.00094) and lung cancer (r=0,46380, df=23, p=0.01953). This research adds further malignant neoplasms, possibly exposure-related, to the list of diseases with geographic distribution like MS. The similarity of MS distribution with the named malignancies is unlikely to be incidental. MS in Gorski Kotar and Slavonia seems to be associated with a diet rich in meat and fat. A diet rich in fat and meat and poor in vegetables is a risk factor for stomach, colorectum, pancreatic as well as lung cancers. Some authors have documented a possible protective role of the »Mediterranean diet« for the named cancers. Olive oil is the main source of fat in the »Mediterranean diet«. Oleocanthal, a phenolic compound of the extra-virgin olive oil was found to inhibit the cyclooxigenase enzymes which are involved in demyelination and tumorigenesis. We hypothesize that the »Mediterranean diet«, olive oil and particularly oleocanthal, to have a protective role in MS too

Effects of elevated total chlesterol on the common carotid artery wall in women

Cilj: S obzirom na poznate učinke kolesterola na zid arterije, cilj prikazanog istraživanja bio je, koristeći ultrazvučnu tehniku, odrediti odnos razine totalnog kolesterola (TK) i triju važnih strukturalno-funkcionalnih pokazatelja stanja zida zajedničke karotidne arterije (ZKA): širine intima-medija kompleksa (ZKA-IMŠ), širine unutarnjeg promjera (ZKA-UP) i brojčane vrijednosti kvocijenta relacije ZKA-IMŠ/ZKA-UP. Ispitanici i metode: Ispitivanjem je obuhvaćen uzorak od 97 uvjetno zdravih žena, dobnog raspona od 17 do 92 godine, prosječne starosti 53 ± 17 godina. Kriteriji uključenja u uzorak postavljeni su arbitrarno, a isključene su sve žene s većim vrijednostima specifičnih obilježja od dogovorenih. Kriteriji su postavljeni na osnovi analiza podataka iz niza sličnih studija. Tijekom istraživanja korišten je UZ kolor dopler dupleks uređaj SA 6000C (KRETZTECHNIK A. G.) s linearnom sondom od 7,5 MHz. Rezultati: Za analizu rezultata korištena je univariatna linearna regresijska analiza. Rezultati linearne regresijske analize ukazuju kod svih odnosa na blago pozitivnu statistički neznačajnu korelaciju (P > 0,05). Rasprava i zaključak: Rezultati regresijske analize ukazuju na to da između razine TK i tri analizirana parametra postoji slaba pozitivna, statistički neznačajna veza. Dobiveni rezultati, adekvatno primijenjeni, mogu poslužiti kao markeri, odnosno prediktori lokalne i opće ateroskleroze. Povećane vrijednosti totalnog kolesterola imaju nesumnjivo destruktivan učinak na zid arterije, pogotovo u slučaju dugoročne ekspozicije.Aim: The aim of the presented investigation was to determine ultrasonographically the relationship between total cholesterol level and three important structural/functional common carotid artery (CCA) wall state markers (intima-media thickness (IMT), internal diameter width (ID), and IMT / ID ratio) with the ultrasonic technique. This investigation was carried out with reference to the effects of the total cholesterol on the arterial wall. Subjects and methods: 97 healthy women aged 17-92 (average age 53 ± 17 years) were included in the investigation. The criteria for inclusion in the sample were determined randomly, and all women with higher specific characteristic values were eliminated. Criteria were determined according to the analysis of data from a number of similar studies. During the investigation the ultrasound color Doppler duplex device SA 6000C (KRETZTECHNIK A. G.) with a 7,5 MHz linear transducer was used. Results: The univariate linear regression analysis of the obtained results indicates a slightly positive statistically nonsignificant correlation in all three cases (P > 0.05). Discussion and conclusion: The results of linear regresson analysis indicate that between the three analysed parameters and total cholesterol level there is a slight positive statistically nonsignificant relation. Obtained results, adequately applied, can serve as markers, ie. predictors of local or generalized atherosclerosis. The elevated total cholesterol levels have a certain destructive effect on the arterial wall, especially in the case of long-term exposition

Malignant Skin Melanoma in Croatia

Global heating and increased solar ultraviolet irradiance have caused an increase in number of many diseases, particularly skin malignant diseases. Aim of this study was to investigate the influence of climate changes on the health of the population of the Primorsko-goranska and Istria Counties. We gathered and analyzed data about the frequency of skin malignant melanoma in the period of eight years (1998–2005). The data were collected from the Croatian cancer registry. The incidence of malignant skin cancer was estimated overall, by age group and gender. We found that the incidence of the skin melanoma was approximately the same in both counties during the period 1998–2005. However, significant increase has been noted when compared to the situation in the period 1977–1996 (p=4.95 E–13) The incidence of malignant skin melanoma has risen during the last ten years. It is differently distributed between gender and age groups in Primorsko-goranska and Istria County. It can be related to climate changes, but also to different ways way of life between these two counties

Ultrasonographic analysis of the influence of aging process on the width of the common carotid artery lumen in women from our population

Cilj: Na krvožilnom sustavu tijekom starenja, uz brojne druge promjene, dolazi i do širenja lumena zajedničke karotidne arterije. Cilj ovog ispitivanja bio je odrediti vrijednosti odnosa između širine unutrašnjeg promjera zajedničke karotide (ZKA-UP) i životne dobi ispitanika. Ubrzana stopa uvećanja te vrijednosti ukazuje na određene promjene i može poslužiti kao smjernica za pojačanu ateroprotekciju. Ispitanici i metode: U istraživanje je uključeno 97 uvjetno zdravih osoba ženskog spola, raspona dobi između 17 i 92 godine. Za ispitivanje je korišten “color dupleks doppler” uređaj SA 6000C (KRETZTECHNIK A.G.) s linearnom sondom od 7,5MHz. Za mjerenje i analizu internog promjera ZKA korišten je uzdužni B-prikaz arterijalnog lumena. Mjerenje je obavljeno između odgovarajućih suprotnih točaka zidova udaljenih oko 1,0-1,5 cm od proksimalnog kraja bulbusa. Rezultati: Univariatnom linearnom regresijskom analizom dobivenih podataka dobivena je korelacija između širine UP-a i životne dobi. Statistički potvrđena značajnost tog odnosa određena je koeficijentom korelacije r (ZKA desna: r=0,26275; ZKA lijeva: r=0,27167) i vrijednošću p (ZKA desna: p=0,00963<0,01; ZKA lijeva: p=0,00997<0,01). Srednja vrijednost UP-a desno je 6,074 ± 0,608mm, a lijevo 6,041 ± 0,609mm. Rasprava i zaključak: Rezultati ukazuju kako je, s obzirom na dob, očit rast vrijednosti širine lumena arterije u skupini uvjetno zdravih žena. Dobivene vrijednosti odnosa UP/dob daju za svakodnevnu praksu dragocjen pokazatelj, odnosno prediktor budućeg tijeka starenja zida zajedničke karotide. Odstupanje od prikazanih linija regresije, što nalazimo kod karotidne i opće ateroskleroze, može biti znak za oprez i pojačanu ateroprotekciju.Aim: During aging, along with other changes in the vascular system, the width of the arterial lumen of the common carotid artery enlarges. The aim of this study was to determine the relation between the common carotid artery internal diameter (CCA-ID) and age in conditionally healthy women. The possibly accelerated rate of this value increase indicates particular alterations and can serve as a valuable guideline for stronger atheroprotection. Subjects and methods: 97 conditionally healthy female ages 17-92 were included in the study. The investigation was performed by the ultrasound color duplex Doppler device SA 6000C (KRETZTECHNIK A.G.), with the 7,5 MHz linear transducer. The longitudinal B-mode image of the arterial lumen was used for the measurement and analysis of the CCA-ID. The measurement was performed between appropriate opposite wall points ,1.0-1,5 cm proximal to the bulb start point. Results: The correlation between the ID width and age was obtained by the univariate linear regression analysis of the results (CCA-ID right=0,00963*age + 5,5597; CCA-ID left=0,00998*age + 5,5083; results are present in mm). The statistically confirmed significance of this relation was determined by the correlation coefficient r (CCA right: r = 0,26275; CCA left: r = 0,27167) and p value (CCA right: p = 0,00963, <0,01; CCA left: p = 0,00997, <0,01). Right ID mean value is 6,074 ± 0,608 mm, and left 6,041 ± 0,609 mm. Discussion and conclusion: The results of this study indicate that the width of the arterial lumen of the common carotid artery increases with age in the group of conditionally healthy women. The values of CCA-ID/age are a valuable predictor of the process of aging of the common carotid artery

Perception of Stress, Depression, Hypertension and Myocardial Infarction as Predictors of Adherence to Hypertension Drug Treatment

This survey was performed to determine the relationship between the adherence to hypertension drug treatment and the perception of stress, depression, hypertension, and myocardial infarction. 300 patients with uncomplicated hypertension from Rijeka, Croatia, were included (131 women, 169 men, mean age 53.5 years). Adherence to hypertension drug treatment as criterion, and the perception of stress, depression hypertension and myocardial infarction as prediclors were determined by self-assessment. Collected data were analysed using factor analysis, regression analysis, Kolmogorov- Smirnov test, χ2-test and t-test. The statistical signifi cance was set at a probability rate of less than 5% (p<0.05). 45.09% of women (p=0.479), and 64.08% of men (p=0.032) were motivated to take antihypertensives. 55.79% of women (p=0.382) and 64.78% of men (p=0.028) had suffi cient knowledge about drug treatment of hypertension. The positive predictors of motivation for taking antihypertensives were physiological disturbances and perceived potency of hypertension and the negative were perceived helplessness in stress control and negative thoughts and emotions. The positive predictors of knowledge about taking antihypertensives were perceived helplessness in stress control, perceived potency of hypertension and myocardial infarction and the negative predictors were perceived self-effi cacy in stress control, physiological disturbances and evaluation of hypertension. Both the motivation as well as the knowledge about taking antihypertensives should be improved, especially in women. The perception of stress, depression, hypertension and myocardial infarction can be used to predict adherence to hypertension drug treatment

Perception of Arterial Hypertension and Myocardial Infarction in hypertensive and Normotensive Men and Women

The research aims were to test perception of arterial hypertension and myocardial infarction in hypertensive and normotensive men and women as well as to test perception of arterial hypertension and myocardial infarction as predictors of blood pressure control in hypertensives. In the research 470 subjects of 4 general practices from Rijeka, Croatia participated, hypertensive group from the list of hypertensive patients without cardiovasular complications and other major chronic conditions, normotensive group from the list of patients without chronic conditions. Each group had 235 subjects, 128 men and 107 women. Perception of hypertension and myocardial infarction was measured as the result on semantic differential questionnaire. Factor analysis extracted evaluation, potency and activity factor. Blood pressure control was interpreteted on the five degrees scale. Statistical significance was defined under 5% (p<0.05). Hypertensive subjects perceived hypertension as less negative and more active, while myocardial infarction was percieved as more potent term than by normotensives. Women perceived myocardial infarction as less negative, and less potent term than men. Both groups perceived myocardial infarction as more negative, potent and active term than hypertension. Normotensive women evaluated hypertension as more negative, and percieved myocardial infarction as less potent than other subjects. Well-controlled hypertension was correlated with a lower potency of hypertension and lower activity of myocardial infarction. Both conditions are perceived as more »male« diseases. As perception of hypertnsion and myocardial infarction is correlated with blood pressure regulation in hypertensives, and hypertension is major risk factor for myocardial infarction, family doctors should put additional effort in changing perception of cardiovascular diseases in their patients, especially in women

Work conditions as risk factors for varicose veins of the lower extremities in certain professions of the working population of Rijeka.

This research aims to establish the effect of working conditions on the appearance of varicose veins. The epidemiological study was carried out on 1,324 examinees, 530 males and 794 females, employed in 5 highly represented groups of professional activities in Rijeka (catering, trade, light industry, heavy industry and finances). The data were collected by survey and clinical examination. Varicose veins were more prevalent in the trade than in the office workers (odds ratio (OR) = 2.08; 95% confidence interval (CI) = 1.31-3.31), and more prevalent in catering industries than in the office workers (OR = 1.56; 95% CI = 1.001-2.43). chi 2-testing suggested that standing in the workplace (OR = 1.35; 95% CI = 0.95-1.92), weight handling while working (OR = 1.29; 95% CI = 1.01-1.64) and working indoors (OR = 1.61; 95% CI = 1.02-2.53) were risk factors for varicose veins. By multiple logistic regression, the following risk factors were isolated in the total population: female sex (OR = 1.92; 95% CI = 1.37-2.67), workplace (OR = 0.89; 95% CI = 0.78-0.99), age (OR = 1.05; 95% CI = 1.03-1.07), body mass index (OR = 1.04; 95% CI = 1.01-1.07) and family history of the disease (OR = 1.99; 95% CI = 1.55-2.57).</p