Quality of Life of HIV-Infected Persons in Croatia

The aim of this study was to examine health-related quality of life among Croatian HIV infected individuals, and to assess the impact of socio-demographic and disease-related variables on health-related quality of life. This was a crosssectional study of 111 HIV-infected adults who received care at the University Hospital for Infectious Diseases in Zagreb, Croatia. The World Health Organization Quality of Life Questionnaire for HIV brief version (WHOQOL-HIV BREF) was used to assess each patient’s quality of life. Ratings of quality of life differed across age, marital status, level of education, health status and »currently ill« status. Subjects who perceived themselves as not ill and their health status as better reported better quality of life for all quality of life domains (p<0.01). Subjects who were in relationships gave higher ratings for the social relationships domain (p<0.01). Subjects with higher level of education gave significantly higher ratings within the independence (p<0.05) and environment (p<0.01) domains. Younger subjects perceived their psychological state as better (p<0.05). The findings demonstrate a moderate degree of overall quality of life (X=112.2; SD= 18.92) with main concerns related to social relationships. These results highlight the need for better access to psychosocial support and medical and legal services for people living with HIV/AIDS in Croatia

Izvedivost multimodalne intervencije za prestanak pušenja tijekom hospitalizacije sa šetomjesečnim praćenjem nakon otpusta: pilot istraživanje

The main aim of this pilot project was to introduce multimodal smoking cessation intervention in the hospital setting and to analyze users’ satisfaction and efficacy of the intervention within six months post-discharge. Multimodal intervention for smoking cessation was used and it consisted of the “5 A’s” model (Ask, Advice, Assess, Assist, Arrange) for behavior change, printed self-help materials for smoking cessation, and telephone counseling (one, three and six months after discharge from the hospital). The main outcome of the study was smoking status at six months. A total of 103 participants were included in this pilot project. At six-month follow-up, 49% of participants self-reported continuous non-smoking. Among the remaining participants, 20 reported smoking reduction, 19 were still smoking, and 16 participants were unable to make contact with. In the logistic regression, among all analyzed variables, only two of them were positively associated with smoking cessation after six months: participants’ response that they would like to quit smoking within the next six months (B=4.688; p=0.018) and answering that they did not smoke when they were ill and bed-ridden due to illness (B=3.253; p=0.020). Satisfaction with the intervention was very high; 70% of participants rated the intervention as ‘excellent’. Therefore, multimodal smoking cessation intervention can be successfully introduced at hospital setting yielding high smoking abstinence rates at six months post-discharge and high level of user satisfaction. Healthcare workers who work in hospitals should be educated so they can provide such intervention on a regular basis.Glavni cilj ovoga probnog projekta bio je provesti multimodalnu intervenciju za prestanak pušenja kod hospitaliziranih bolesnika i analizirati učinkovitost intervencije šest mjeseci nakon otpusta iz bolnice, kao i zadovoljstvo korisnika intervencijom. Primijenjena je multimodalna intervencija za prestanak pušenja koja se sastojala od pristupa „5 P“ (Pitati, Poticati, Procijeniti, Pomoći i Pratiti) za promjenu ponašanja, tiskanih materijala za samopomoć kod prestanka pušenja i telefonskog savjetovanja (nakon jednog mjeseca, tri mjeseca i šest mjeseci od otpusta iz bolnice). Glavni ishod studije bio je pušački status nakon šest mjeseci. Uključeno je ukupno 103 sudionika. Nakon šest mjeseci praćenja 49% sudionika izjavilo je da su prestali pušiti. Među preostalim sudionicima 20 ih je smanjilo broj popušenih cigareta na dan, 19 ih je i dalje pušilo, a sa 16 sudionika se nije moglo stupiti u kontakt. U logističkoj regresiji su od svih analiziranih varijabla samo dvije bile pozitivno povezane s prestankom pušenja nakon šest mjeseci: odgovor sudionika da bi htjeli prestati pušiti u sljedećih šest mjeseci (B=4,688; p=0,018) i odgovor da ne puše kad su bolesni u toj mjeri da moraju ležati u krevetu (B=3,253; p=0,020). Zadovoljstvo intervencijom bilo je vrlo visoko; 70% sudionika ocijenilo je intervenciju kao “izvrsnu”. Stoga se multimodalna intervencija za prestanak pušenja može uspješno uvesti u bolničkim uvjetima, omogućuje visoku stopu apstinencije od pušenja šest mjeseci nakon otpusta i veliko zadovoljstvo korisnika. Zdravstveno osoblje koje radi u bolnicama trebalo bi se obrazovati kako bi mogli redovito pružati takvu intervenciju

Urine-based testing for Chlamydia trachomatis among young adults in a population-based survey in Croatia: Feasibility and prevalence

<p>Abstract</p> <p>Background</p> <p>We assessed the feasibility of collecting urine samples for testing on genital <it>Chlamydia trachomatis </it>infection in a population-based survey, and prevalence of this infection among young people aged 18-25 in Croatia. In Croatia, as in the other countries of Eastern Europe, there is a lack of data on prevalence of <it>C trachomatis </it>in the general population, including young adults.</p> <p>Methods</p> <p>We sampled participants using a nationally representative, multi-stage stratified probability sample of young men and women. Detection of <it>C trachomatis </it>DNA in urine samples was performed by using a real-time PCR assay COBAS^®TaqMan^®CT Test, v2.0.</p> <p>Results</p> <p>Overall, 1005 young adults participated in the behavioural part of the survey, and 27.9% men and 37.5% women who were sexually experienced agreed to provide urine samples for testing on <it>C trachomatis</it>. Using multivariate analysis, women were significantly more likely to provide urine samples than men (aOR = 1.53, 95% CI 1.14-2.06) as were those who reported no condom use at last intercourse (aOR = 1.95, 95% CI 1.44-2.62). Prevalence of <it>C trachomatis </it>infection among those who were sexually experienced was 7.3% in men and 5.3% in women.</p> <p>Conclusions</p> <p>Population-based surveys that use probabilistic sampling are a feasible way to obtain population estimates of <it>C trachomatis </it>prevalence among young adults in Croatia, but it is challenging to obtain an adequate response rate. The prevalence of <it>C trachomatis </it>among young adults in Croatia found in this study was higher than that found in other European countries with similar survey response rates.</p

Stres i suočavanje kod ovisnika o opijatima

Ovisnost je u našoj zemlji u zadnjih desetak godina poprimila zabrinjavajuće razmjere, broj ovisnika se iz godine u godinu povećava. Brojni su razlozi zašto osobe zlouporabljuju droge (psihološki, sociološki i biološki). Jedna od pretpostavki od koje smo i mi krenuli je da su ovisnici izloženi većem broju stresnih događaja tijekom svog života te da koriste neefikasne strategije suočavanja sa stresom što ih čini podložnima da počnu konzumirati droge i razviju ovisnost. Cilj našeg istraživanja bilo je provjeriti razlike ovisnika i neovisnika s obzirom na količinu i intenzitet stresnih događaja te s obzirom na načine suočavanja sa stresom. U istraživanju je sudjelovalo 47 ovisnika koji se nalaze pod ambulantnim psihoterapijskim tretmanom pri Klinici za psihijatriju, alkoholizam i druge ovisnosti Kliničke bolnice "Sestre milosrdnice- u Zagrebu i 47 neovisnika izjednačenih po dobi, spolu i obrazovanju. Dobiveni rezultati omogućuju zaključak da između ovisnika i neovisnika postoji značajna razlika s obzirom na broj stresnih događaja i s obzirom na strategije suočavanja koje koriste. Tako su ovisnici navodili da su izloženi većem broju stresnih događaja u toku života, događaje su doživljavali stresnije i čeće su koristili strategije izbjegavanja kao način suočavanja nego neovisnici. Pri navođenju rezultata posebna pozornost upućena je na činjenicu da je izloženost velikoj količini stresnih iskustvima kod ovisničke populacije dijelom rezultat i samog ovisničkog statusa, što nas ograničava u zaključivanju

Acute encephalopathy associated with Campylobacter jejuni enteritis

We present for the first time a case of acute encephalopathy in an adult patient induced by Campylobacter jejuni enteritis. Possible pathogenic mechanisms and importance of neuropsychological testing in the assessment of infection-related encephalopathy are discussed

Genome-wide Association Study of Anthropometric Traits in Korčula Island, Croatia

AIM: To identify genetic variants underlying six anthropometric traits: body height, body weight, body mass index, brachial circumference, waist circumference, and hip circumference, using a genome-wide association study. ----- METHODS: The study was carried out in the isolated population of the island of Korcula, Croatia, with 898 adult examinees who participated in the larger DNA-based genetic epidemiological study in 2007. Anthropometric measurements followed standard internationally accepted procedures. Examinees were genotyped using HumanHap 370CNV chip by Illumina, with a genome-wide scan containing 316730 single nucleotide polymorphisms (SNP). ----- RESULTS: A total of 11 SNPs were associated with the investigated traits at the level of P<10(-5), with one SNP (rs7792939 in gene zinc finger protein 498, ZNF498) associated with body weight, hip circumference, and brachial circumference (P=3.59-5.73 x 10(-6)), and another one (rs157350 in gene delta-sarcoglycan, SGCD) with both brachial and hip circumference (P=3.70-6.08 x 10(-6). Variants in CRIM1, a gene regulating delivery of bone morphogenetic proteins to the cell surface, and ITGA1, involved in the regulation of mesenchymal stem cell proliferation and cartilage production, were also associated with brachial circumference (P=7.82 and 9.68 x 10(-6), respectively) and represent interesting functional candidates. Other associations involved those between genes SEZ6L2 and MAX and waist circumference, XTP6 and brachial circumference, and AMPA1/GRIA1 and height. ----- CONCLUSION: Although the study was underpowered for the reported associations to reach formal threshold of genome-wide significance under the assumption of independent multiple testing, the consistency of association between the 2 variants and a set of anthropometric traits makes CRIM1 and ITGA1 highly interesting for further replication and functional follow-up. Increased linkage disequilibrium between the used markers in an isolated population makes the formal significance threshold overly stringent, and changed allele frequencies in isolate population may contribute to identifying variants that would not be easily identified in large outbred populations