Search

The notion of complex influence of atmospheric conditions on modem human population, especially the relationship between weather, climate and human healths, has actuated the World Meteorological Organisation to commemorate the coming into force, on March 23, 1950, of the Convention of WMO and this year to celebrate this day by focusing on theme of current interest--"Weather, climate and health". In the light of this, the authors of this paper reveal the results of recent studies dealing with influence of sudden and short-term changes in weather and climate on human health, and future expected climate changes due to "greenhouse" effect, increase in global temperature and tropospheric ozone depletion, as well. Special attention is given to climate shifts due to ENSO (El Niño/Southern Oscillation) phenomenon because of its great impact on human society and epidemics of certain infectious diseases. The results of biometeorological studies dealing with complex influence of daily weather changes on incidence of certain diseases in Croatia have also been presented. In addition, the authors have stated their own view and opinion in regard to future biometeorlogical studies in Croatia in order to achieve better understanding of influence of climate and weather changes on human health, and help prevention of mortality and morbidity related to chronic noninfectious diseases.

Histopathologic and clinical data strongly suggest a causal relation between Helicobacter pylori infection and gastritis, peptic ulcer disease, or both. However, little has been written about the potential association between H. pylori infection and Brunner's gland adenoma. Therefore, we carried out a prospective study to determine the presence of H. pylori infection among patients with Brunner's gland adenoma. From November 1996 till October 1999, 19100 patients who had undergone upper gastrointestinal endoscopy at two clinical centers in Zagreb, Croatia, were candidates for participation in the study. Brunner's gland adenoma was diagnosed on the basis of histologic samples taken from the polyp (four patients) or after the entire polyp was made available upon endoscopic removal (three patients). When all endoscopic examinations had been performed, biopsy samples were taken from the antrum and body of the stomach, so that gastritis could be classified and H. pylori determined by histology. Biopsy samples were also taken from the duodenal bulb to verify duodenitis. Two other samples were taken from the antrum for rapid urease test. The patients were considered positive for H. pylori when both histology and rapid urease test were positive. Brunner's gland adenoma was diagnosed in seven patients (five women and two men; median age, 49 yrs). Five (71%) patients with diagnosed Brunner's gland adenoma had concurrent H. pylori infection. Duodenitis associated with gastric metaplasia was observed in six patients. Complete eradication of H. pylori was achieved in only two patients. Symptoms disappeared or markedly diminished in all patients with significant improvement during therapy or immediately upon endoscopic removal of the polyp. Although limited by a very small number of patients, our results suggest that concurrent H. pylori infection is very common in patients with Brunner's gland adenoma. However, the role of H. pylori infection in the pathogenesis and development of Brunner's gland hyperplasia remains unclear.

Spigelian hernia is a very rare anterior abdominal wall hernia with uncharacteristic symptoms and challenging diagnosis. The case of a 76-year-old male patient with colicky pain and vomiting lasting for 24 hours before admission to the hospital is presented. Physical examination of the patient revealed abdominal tenderness and a round-shaped tumefaction of 3 cm in size, located in the left lower abdominal quadrant. X-ray examination of the abdomen, obtained in left lateral position of the patient, showed small bowel ileus with distended jejunal loops. The abdominal ultrasound examination, followed by duplex ultrasonography, revealed a spigelian hernia with ischemic changes of strangulated bowel segment indicating incarceration of the herniated jejunal loop. Preoperative findings were confirmed by intraoperative diagnosis of spigelian hernia and incarcerated jejunal loop with ischemic changes and deserosation, followed by resection of the bowel segment involved and plastic surgical reconstruction of anterior abdominal wall. This case report highlights the role of duplex ultrasonography in the evaluation of circulatory status of potentially incarcerated bowel segment within hernial sac.

The aim of the study was to investigate the serum selenium concentration in patients with liver cirrhosis and hepatocellular carcinoma. A total of 59 patients, 49 with liver cirrhosis and 10 with liver cirrhosis and coexistent hepatocellular carcinoma, as well as 202 healthy volunteers entered the study. In the patients with liver cirrhosis and in those with liver cirrhosis and coexistent hepatocellular carcinoma, serum selenium concentrations were significantly lower (39.28 +/- 13.99 and 42.00 +/- 10.59 g/L, respectively), when compared to the group of healthy volunteers (66. 79 +/- 9.13 g/L) (p0.001). There was no significant difference in serum selenium concentrations between the two patient groups. In the group of patients with liver cirrhosis positive correlation was found between serum selenium and albumin concentrations, and negative correlation between serum selenium and bilirubin (p0.05 and p0.01, respectively). There was no correlation of serum selenium concentration with fibrinogen and prothrombin time. Results of the study suggested the possible important nutritive and protective role of selenium in the patients with liver cirrhosis and coexistent hepatocellular carcinoma, as well as the potential need of selenium supplementation in these patients.

The most relevant clinical presentations of duodenal ulcer disease are pain and acute bleeding. The purpose of this study was to investigate the relevance of dyspepsia in patients with bleeding duodenal ulcer, and to compare the clinical and epidemiological characteristics of bleeding patients with and without dyspepsia. A total of 82 patients with isolated duodenal ulcer and bleeding were included in this study. There were 48 (58.5%) dyspeptic and 34 (41.5%) nondyspeptic patients. The patients with and without dyspepsia were almost identical with regard to their age (52.9 +/- 11.9 vs 53.4+/- 10.2 years, p0.05). In the dyspeptic group, significantly more patients had duodenitis and a deformed bulb (chi 2 = 4.05, p0.05 and chi 2 = 3.99, p0.05, respectively). Patients with bleeding duodenal ulcers and dyspepsia were more likely to have taken non-steroidal anti-inflammatory drugs (45.8 vs 8.8%; chi 2 = 11.18, p0.001), whereas significantly more patients in the nondyspeptic group have taken histamine H2 antagonists (85.3 vs 8.3%; chi 2 = 45.87, p0.01). No significant difference was found between the dyspeptic and nondyspeptic groups with regard to the previous diagnosis of peptic ulcer bleeding, the presence of environmental stress, gastritis, and alcohol or tobacco consumption. Furthermore, there was no significant difference in regard to the rebleeding, the need for urgent operation or hospital stay. The results of this study support the evidence that in patients with bleeding duodenal ulcers the dyspeptic symptoms were more often associated with objective signs of duodenal pathology, and the use of non-steroidal anti-inflammatory drugs and maintenance treatment with histamine H2 antagonists was associated with silent duodenal ulcer bleeding.

The aim of the study was to assess the diagnostic value of transrectal ultrasonography (TRUS) in detecting the depth of tumor infiltration as well as the involvement of lymph nodes in patients with rectal carcinoma diagnosed after rectoscopy and proven by examination of the biopsy specimen. TRUS was performed on thirty-three patients with rectal carcinoma prior to surgery, the first assessment of tumor growth, and extension by pathological examination of the operative specimen. TRUS correctly assessed perirectal growth in 18 out of 22 cases proven by pathology (two understaged, accuracy 86 percent), while in 12 cases with no perirectal growth proven by pathology this method was correct in 9 cases (three overstaged, accuracy 75 percent). The results of this study indicate that TRUS, combined with endoscopy and biopsy, is a useful procedure in the preoperative staging of malignant rectal lesions and provides valuable data for the therapeutic planning of patients with rectal carcinoma.

Laterality means functional dominance of one in the pair of organs. It represents the external manifestation of integrative activity of cerebral cortex meaning the domination of functionally dominant hand; the usability lateralization depends on the domination of cerebral hemisphere of gestural lateralization and the domination of cerebral hemisphere or gestural lateralization and the influence of the environment. On the basis of laterality population is divided into right-handed and left-handed with a very stressed degree of lateralization and those undecided with a minimal previal of handidness of one hand. In most people the domination of cerebral hemisphere is average or weak and that's the reason why the influence of the environment is of importance when forming the dominant hand. In the clinical practice the hand laterality is used as an index for the type and degree of cerebral hemisphere domination, for condition of gestural laterality with the usability of the dominant hand and form the differentiation of the dominant hand in the case of minimal difference in handidness.

Spontaneous bacterial peritonitis is one of the most common complications of ascitic fluid in patients with liver cirrhosis. The aim of this study was to investigate the role of total protein, albumin, globulin and complement ascitic fluid concentrations in development of spontaneous bacterial peritonitis in patients with liver cirrhosis. In patients with liver cirrhosis and spontaneous bacterial peritonitis (n = 8) the ascitic fluid total protein, albumin and globulin concentrations were significantly lower than in patients with sterile ascites (n = 11) (p0.01). The ascitic fluid complement C3 and C4 concentrations were significantly lower in patients with spontaneous bacterial peritonitis than in patients with sterile ascites (9.1 +/- 3.1 mg/dL to 22.9 +/- 17.4 mg/dL, p0.01; 3.8 +/- 5.9 mg/dL to 8.2 +/- 5.9 mg/dL, p0.01, respectively). The ascites total protein, albumin, globulin and complement concentrations in cirrhotic patients with spontaneous bacterial peritonitis were significantly lower than in patients with sterile ascites demonstrating the importance of those factors in ascitic fluid defense against secondary bacterial infection.

In the neurological examination of the child, there is a growing significance of subclinical semiotics and graphomotor expression. These discrete neurological signs give information about the maturity of complex motor organization and enable the following of cortical structure organization. Subclinical neurological semiotics in the form of muscular hypotonia, synkinesis and disturbed reciprocal coordination of movements at a certain age, present a physiological, developmental appearance, while at a later age they are a sign of immaturity, or of an organic neurological structure damage.

The purpose of this paper was to indicate the link between psychomotor organization and the success of studying. The examined 223 children of the age of 8-12, were divided into three groups. As indicators of psychomotor maturity the following were used: visual motor capabilities--Bender's Visual Motor Gestalt test and complex motor organization--Lury's trial. The paper proves that psychomotor maturity is an important factor in the success of studying in the early school age, and later on other factors from the multi-factorial etiology of unsuccessful studying have an even greater emphasis.

An insufficiently elucidated clinical picture of paroxysmal alternating torticollis in the developing age is considered in this paper. This phenomenon is characterized by inclination of the head temporary on one side and the other, it is of various duration, with pauses and without any disturbances and symptoms. This appearance is observed in children aged 1-5. The authors assume that this rare state is a sequel of asymmetric maturation of the axial tonus. In that case, this torticollis is only the most striking phenomenon in the whole clinical picture of one-sided predomination of the axial tonus in its maturation.