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Background: Crohn's disease and ulcerative colitis are autoimmune idiopathic diseases whose incidence is constantly increasing, consequently representing a significant health problem of a developed Western society. They are characterized by chronic inflammation of the gastrointestinal wall and the high occurrence of relapse. Drug groups used in the treatment of IBDs are aminosalicylates, immunomodulators, corticosteroids and biological agents. Beside the basic pathology, patients with IBDs often have comorbidities and anemia is the most significant one. There are several etiology patterns to anemia of chronic disease – infections, autoimmune diseases, tumors, etc. Different disorders occur, in iron metabolism, erythropoiesis or shortening the life span of erythrocytes. The most common is mild anemia with concentration of hemoglobin between 70 and 110 g/L, MCV and MCHC are within physiological limits or mildly decreased. Aim: The aim of this study was to determine the correlation between hemoglobin concentration and duration of disease. Methods: The research was based on medical documentation of patients affected by inflammatory bowel diseases, treated at the Department of gastroenterology and hepatology, at Clinical Hospital Osijek. In total, 86 patients were involved, of which 44 of them were diagnosed with ulcerative colitis and 42 with Crohn's disease. Results: Anemia was found in anamnesis of 63 (72%) patients with inflammatory bowel disease. In this researched group of patients hemoglobin values were observed and was found that the values were below the reference. Hemoglobin values ranged from 49 to 155 g/L, with a median (interquartile range) of 119 g/L (109, 5 to 132 g/L). No statistically significant correlation was found between hemoglobin values and duration of disease in patients with IBDs at the time of research (ρ = 0, 052, P = 0, 635). Conclusion: Anemia is present in most patients with inflammatory bowel diseases. The average hemoglobin concentration does not depend on the duration of the inflammatory bowel diseases.

BACKGROUND: Crohn’s disease(CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBD), whose incidence is constantly increasing. The diseases are unpredictable and cyclical, because of that they have impact on the ability of patients to remain employed, and on their education. Our aim was to determine the relationship between education, employment, and marriage status with incidence and prevalence of inflammatory bowel disease. Results in this study are part of results of the doctoral dissertation by M. Žulj, MATERIALS AND METHODS: This study is based on medical documentation of patients affected by IBD treated in hospitals in area of Osijek-Baranja Country in period of 2000-2014. This research is part of the large project mentored by prof.dr.sc. A. Včev named "Povezanost polimorfizama jednog nukleotida u NOD 2 i MDR 1 genima s nastankom upalnih bolesti crijeva”. RESULTS: Patiens with elementary school education have a greater incidence to have UC, while patients with with higher education are more likely to have CD (χ2 test, P = 0, 02), also CD is significantly higher with employees (Fisher’s exact test, P = 0, 01), compared to retires or unemployed who have more UC. The prevalence of the UC is higher in patients with elementary school education, while in patients with higher education is much common CD (χ2 test, P < 0, 001). Speaking of employment, prevalence of CD is higher with employees (Fisher’s exact test, P < 0, 001), compared to retires or unemployed where is it more common UC. According to marital status 762 (66, 4%) of the respondents were married. CONCLUSION: It seems that risk factors in the observed group are higher education and being employed for the CD, while the risk factors for the UC are completed elementary school and being unemployed and retired.

The increasing incidence of the last decades of Crohn's disease and ulcerative colitis in the world has sparked a different way of thinking about their cause and susceptibility.Laboratory data confirm that the disease is a result of a disturbed immune response in a genetic subject, and the first identified gene responsible for the development of Crohn's disease is NOD2/CARD15.The aim of this study was to put Crohn's disease and ulcerative colitis in relation to the occurrence of relapse, duration of remission, number of hospitalizations and number of surgical procedures.This research is part of the large project mentored by prof.dr.sc. A. Včev named "Prevalence of NOD2 and MDR1 polymorphisms among patients with inflammatory bowel disease in KBC Osijek and OB Našice in the period 2000-2014", which seeks out more attention to molecular biology in the medical compatibility model and genetics in their role as a modifier of clinical diseases.The results obtained through research within the project used in this publication are the results of the doctoral dissertation of the chief investigator M. Žulj, MD. MATERIALS AND METHODS: The research was based on medical documentation and conducting a survey of patients affected by inflammatory bowel disease, treated at the Department of gastroenerology at Clinical hospital Osijek and County hospital Našice. In total, 81 patients were involved, of which 52 of them were diagnosed with ulcerative colitis and 29 with Crohn's disease. RESULTS: Relapse occurred in 60 patients, alike in Crohn's disease and ulcerative colitis. Operative procedure was performed in 20 (24.7%) patients, significantly more frequent in Crohn's disease (Fisher's exact test, P

BACKGROUND: One of the significant health issues in modern era are ulcerative colitis (UC) and Crohn's disease (CD). Beneath clinical manifestation of those inflammatory bowel diseases (IBDs) lays chronic inflammation of gastrointestinal wall, mediated by the release of interleukins, cytokines and TNF. Drugs used in treatment are antibiotics, corticosteroids, immunomodulators and biological agents. Aim of this study was to compare usage of immunomodualting drugs vs. antibiotics and corticosteroids in treatment of IBDs during the time. Results in this study are part of results of the doctoral dissertation by M. Žulj, MD. MATERIAL AND METHODS:This study is based on medical documentation of IBD patients treated at KBC Osijek and OB Našice in the period of 2000-2014. In total of 78 patients, 51 was diagnosed with UC and 27 with CD. This study is a part of the university project "Povezanost polimorfizama jednog nukleotida u NOD 2 i MDR 1 genima s nastankom upalnih bolesti crijeva" VIF 2016-MEFOS 16 conducted at the University J.J.Strossmayer led by prof.dr.sc. A.Včev. RESULTS: At the beginning of treatment there was a statistical significant difference in usage of antibiotics between groups with UC and CD (32 UC, 10 CD, p=0, 03 χ2test), immunosupressants (11 UC, 15 CD, p=0, 001 χ2test) and biological agents (7 UC, 9 CD, p=0, 04 χ2test) while there was no statistical significant difference in usage of corticosteroids (36 UC, 21 CD, p=0, 59, χ2test). During this study drugs used in treatment of those patients were modified. Statistical significant differences were found in usage of biological agents (7 UC, 17 CD, p0, 99, χ2test), corticosteroids (13 UC, 3 CD, p=0, 13, χ2test) and immunosupressants (6 UC, 4 CD, p=0, 72, χ2test). CONCLUSION: Although drug groups used in treatment of UC and CD are similar, biological agents are mostly used in CD while corticosteroids are used in UC and CD equally, regardless of time of the treatment. Immunosupressants are mostly used in patients with CD while antibiotics in patients with UC at the beginning of treatment.

BACKGROUND: Inflammatory bowel diseases (IBDs), ulcerative colitis (UC) and Crohn's disease (CD), represent inflammation in the gastrointestinal (GI) tract and often are associated with other autoimmune diseases. Aim of this study was to investigate corelation between IBDs, autoimmune diseases and malignancy of GI tract in family anamnesis. Results in this study are part of the doctoral dissertation of M. Žulj, MD. MATERIAL AND METHODS: This study is based on prevalence of patients with IBDs treated in hospitals in area of Osijek-Baranja County in period of 2000- 2014. Results shown in this study are part of project "Povezanost polimorfizama jednog nukleotida u NOD 2 i MDR 1 genima s nastankom upalnih bolesti crijeva conductedby prof.dr.sc. A.Včev. RESULTS: In researched group of patients negative family anamnesis for IBDs were found in patients with UC (92, 6%) and CD (88, 3%) while positive was found in 9% of patients, notably more in patients with CD (P=0, 008, Fisher's exact test). Similar was found for malignancy of GI tract, negative in 92, 4% patients with UC and 88, 3% patients with CD while positive was found in 9, 1% patients (P=0, 01, Fisher's exact test). There was greater percent of psoriasis (26, 5%), systemic lupus erythematosus (SLE) (14, 3%), Bechterew's disease (15, 3%), rheumatoid arthritis (RA) (12, 2%) and asthma (13, 3%) in family anamnesis of patients with UC unlike patients with CD (0%). Diabetes mellitus (DM) type I was found in family anamnesis of 75% of patients with CD and lower percentage in group of patients with UC, 18, 4% (P

BACKGROUND: Inflammatory bowel diseases (IBDs), ulcerative colitis (UC) and Crohn's disease (CD), represent inflammation in the gastrointestinal (GI) tract and often are associated with other autoimmune diseases. Aim of this study was to investigate corelation between IBDs, autoimmune diseases and malignancy of GI tract in family anamnesis. Results in this study are part of the doctoral dissertation of M. Žulj, MD. MATERIAL AND METHODS: This study is based on prevalence of patients with IBDs treated in hospitals in area of Osijek-Baranja County in period of 2000- 2014. Results shown in this study are part of project "Povezanost polimorfizama jednog nukleotida u NOD 2 i MDR 1 genima s nastankom upalnih bolesti crijeva conductedby prof.dr.sc. A.Včev. RESULTS: In researched group of patients negative family anamnesis for IBDs were found in patients with UC (92, 6%) and CD (88, 3%) while positive was found in 9% of patients, notably more in patients with CD (P=0, 008, Fisher's exact test). Similar was found for malignancy of GI tract, negative in 92, 4% patients with UC and 88, 3% patients with CD while positive was found in 9, 1% patients (P=0, 01, Fisher's exact test). There was greater percent of psoriasis (26, 5%), systemic lupus erythematosus (SLE) (14, 3%), Bechterew's disease (15, 3%), rheumatoid arthritis (RA) (12, 2%) and asthma (13, 3%) in family anamnesis of patients with UC unlike patients with CD (0%). Diabetes mellitus (DM) type I was found in family anamnesis of 75% of patients with CD and lower percentage in group of patients with UC, 18, 4% (P

Introduction: Ulcerative colitis and Crohn’s disease are inflammatory bowel diseases with increased incidence over the years. Some of the affected patients undergo the surgical procedure due to disease. Anti-TNF agents have become part of standard treatment for patients with IBDs. Some of the studies show that 70% of patients affected with Crohn’s disease and 35% of patients with ulcerative colitis will need the surgical treatment, and many population-based studies show that anti-TNF agents may reduce the surgical rates. The aim of this study was to compare surgical rates of patients with and without anti-TNF agents treatment, duration of remission and frequency of disease relapses in those two types of therapy. Materials and methods: For this study, medical documentation of adult patients has been used. Those patients were treated at Clinical Hospital Osijek, at the Department of Gastroenterology and Hepatology from 2000. To 2014. They are all affected by ulcerative colitis or Crohn’s disease, some of them had to undergo surgical treatment during their disease. Results: The remission time was significantly shorter in patients who had no surgical operation in comparison with patients who had a surgical procedure along with receiving both conventional and biologic therapy (double-tailed independent T-test, p = 0.009). The duration of relapse was longer in patients who had surgical operation and received biologic and conventional therapy compared to patients who had only surgical and conventional therapy (double-tailed independent T-test, p=0.373) and those who didn’t have operation (double-tailed independent T-test, p=0.143). Patients who had operation and received both biologic and conventional therapy had second operation later than patients who only received conventional therapy (double-tailed independent T-test, p=0.311). Conclusion: Our study has demonstrated that patient who had received combined conventional and biologic therapy had better results compared to patients who had only conventional therapy. Those patients had fewer relapses which were shorter in duration, while the remission time was longer. Furthermore, the indication for the surgical procedure as final treatment option came noticeably later after the diagnose of inflammatory bowel disease.

Introduction: Postgraduate Doctoral Study of Biomedicine and Health is the highest level of education at the Faculty of Medicine Osijek. It is constantly evaluated in order to maintain suitable standards for an educational institution. The aim of this study was to assess students' satisfaction with current PhD program at the Faculty of Medicine Osijek. Matherials and methods: 60 PhD students enrolled at the program have filled an anonymous questionnaire covering several aspects of the PhD program, including prevalence of different fields of biomedicine in the curricula, quality of teaching, opportunities for advanced language course, teachers’ commitment to PhD courses and overall quality of communication between students and Faculty. They were asked to rank their satisfaction with the quality of different domains of the program with grades from 1 (insufficient) to 5 (excellent). Results: Most of the students completely (36.7%) or partially disagreed (61.7 %) that all field of biomedicine are equally represented at MEFOS PhD program. Two- thirds of students agreed partially or completely that quality of teaching at MEFOS PhD program is satisfactory. Significantly more clinician scientist agreed that advanced language courses during PhD program are important for personal development of researches, comparing to teacher or research scientist (Fischer’s Exact Test, p=0.04). Another claim that clinician scientist agreed with significantly more is that guest professors can increase the quality of a PhD program (Fischer’s Exact Test, p=0.013). Clinician scientist were also significantly more satisfied with the quality of personal communication between PhD students and Faculty (Fischer’s Exact Test, p=0.001). We have found some significant differences between male and female PhD students – male students attended formal lectures and practices less regularly than female (Fischer’s Exact Test, p=0.011), and they were more satisfied with the teachers’ dedication to MEFOS PhD program than female students (Fischer’s Exact Test, p=0, 01). Conclusion: Results of our study suggest that there is a need for introducing new courses from all fields of biomedicine. Inviting guest professors and introduction of advanced language courses would further increase the quality of the programme.

Background: Ulcerative colitis and Crohn’s disease are idiopathic autoimmune diseases whose incidence is constantly increasing, consequently representing a significant health problem of a developed Western society. They are characterized by chronic inflammation of the gastrointestinal wall and the high occurrence of relapse. Drug groups used in the treatment of inflammatory bowel disease are aminosalicylates, corticosteroids, immunomodulators and biological agents. By developing new drugs, therapeutic approach has changed from the simpler “step up” to the “topdown” approach, where more complex and more effective drugs are applied from the start. The basic goal of the treatment is to develop a deep remission and its longer duration, along with the smaller number of relapses. The aim of this study was to determine frequency of disease relapses in various types of the therapy. Materials and Methods: The research was based on medical documentation of patients affected by inflammatory bowel disease, treated at the Department of Gastroenterology and Hepatology, at Clinical Hospital Osijek. In total, 79 patients were involved, of which 40 of them were diagnosed with ulcerative colitis and 39 with Crohn’s disease. Results: Patients with Crohn’s disease achieved the longest remission, up to 2450 days, when receiving biological therapy. Much shorter remission is seen in patients taking aminosalicylates. However, there was no significant difference in remission duration between different treatment strategies (Mann-Whitney U test, P = 0, 2836). For patients with ulcerative colitis, the best results, with the remission up to 2500 days, gave the combination of aminosalicylates and immunosuppressives. Still, there was no significant difference in remission duration between different treatment strategies (Mann- Whitney U test, P = P = 0, 4762). Conclusion: Almost all patients in this study started treatment with a »step-up« approach, and only at later stages of the disease were treated with biological therapy. Because of the reason mentioned above, there was no statistically significant difference between the »step up« and »top down« therapeutic approaches, and further assessment of these investigated groups is required.

Questions: There is a paucity of data on the effect of high salt diet on cerebral vessels dilation mechanisms in response to various stimuli in humans. Present study aimed to evaluate the effect of HS diet on middle cerebral artery (MCA) reactivity to breath holding test (BHT) in healthy human. Methods: Healthy women (N=6) and men (N=5) age 20±1 were included in the study. 3x measurements were performed: 1) before any diet intervention, 2) after 1 week of low salt (LS) diet (< 2, 3g kitchen salt/day) and 3) after 2 week of HS diet (>11, 2 g kitchen salt/day). Transcranial doppler signal (TCD) of the MCA in response to BHT (in duration of 30 seconds) was recorded. Blood pressure was recorded simultaneously by Finopres. Results: Diastolic cerebral blood flow (dCBF) and velocity time integral (VTI) were significantly reduced after HS diet compared to the first measurement. R-R interval, heart rate, systolic cerebral blood flow, cerebral perfusion pressure, cerebral vasomotor reactivity and cerebral pulsatility index did not show statistically significant difference. HS diet did not significantly affect any of arterial blood pressure values. Increased 24h-urinary Na+ excretion after HS diet confirmed that subjects conformed to diet. Conclusions: One week of HS diet can impair the cerebrovascular reactivity in human, even without affecting blood pressure values. Support: University of Osijek research grant, INGI- 2015-16

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