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Book Review/Prikaz knjige

Nobelove nagrade dodjeljuju se od 1901. godine od kamata glavnice, koju je s tom svrhom u obliku zaklade utemeljio izumitelj dinamita, švedski kemičar Alfred Nobel. Discipline za koje se dodjeljuju su fizika, kemija, medicina i fiziologija, književnost te mir, a počevši s kasnijim datumom ekonomija. Već prilikom prve dodjele navedene 1901. godine, Nobelovu nagradu za fiziku primio je njemački fizičar Wilhelm Conrad Roentgen za svoje otkriće X zraka 8. studenoga 1895. godine, što se smatra utemeljenjem suvremene medicinske discipline kliničke radiologije. Uslijedila su daljnja brojna otkrića, primjerice kompjutorizirane tomografije odnosno magnetske rezonancije, koja su značajno unaprijedila kliničku radiološku dijagnostiku. Na tome tragu bit će osvijetljeni i drugi dobitnici Nobelove nagrade za otkrića i izume vezane za specijalnost kliničke radiologije, bit će analizirana područja njihovih znanstvenih istraživanja iz kojih su i dobili navedene nagrade (fizika, kemija, medicina i fiziologija) te će biti evaluiran njihov utjecaj na razvoj kliničke radiologije.

Due to their small size, numerous cellular divisions of the still growing and developing tissues and organs, as well as a longer life expectancy, children are approximately three times more sensitive to the same doses of ionizing radiation than adults. This is especially the case with the computerized tomography (CT) examinations, which despite making only 17 % of the ionizing radiological examinations, account for as much as 49 % of the total patient irradiation. Because of this, the Image Gently campaign in the early 2010s was thinking about abandoning the CT examinations in pediatric radiology and replacing them with the ultrasound or magnetic resonance imaging as the methods of choice. The appearance of Flash CT technology, which simultaneously shortens the recording time and reduces radiation doses, has led to the abandonment of this way of thinking. This is also supported by the fact that, on the one hand, CT examinations are practically irreplaceable in the cases of trauma, while on the other hand, children, as well as members of all the other age groups, are constantly exposed to a smaller or larger amount of the environmental ionizing radiation (Earth, space, airplanes). In this sense, it is increasingly recommended to use the low dose CT (LDCT) techniques individually adapted to each patient, due to their small amount of ionizing radiation. On this track, we have tried to make a review of the latest findings on the mentioned problem based on the scientific papers published over the past three years (2016-2018). They show that the CT examinations are not only abandoned in the pediatric radiology, but that on the contrary, in the cases of numerous indications LDCT examinations make the gold standard., jeca su zbog svoje male veličine, brojnih staničnih dioba još uvijek rastućih i razvijajućih tkiva i organa, kao i dužeg očekivanog životnog vijeka, otprilike tri puta osjetljivija na iste doze ionizirajućeg zračenja od odraslih. To je posebno izraženo kod pregleda kompjutoriziranom tomografijom (engl. computerized tomography, CT) koji, iako čine samo 17 % ionizirajućih radioloških pregleda, sudjeluju s čak 49 % u ukupnom ozračivanju pacijenata. Zbog toga se pod utjecajem kampanje Image Gently početkom 2010-ih godina razmišljalo o potpunom napuštanju CT pregleda u pedijatrijskoj radiologiji te njihovoj zamjeni ultrazvučnim odnosno pregledima učinjenim magnetskom rezonancijom kao metodama izbora. Pojava Flash CT tehnike koja istovremeno skraćuje vrijeme snimanja i smanjuje doze zračenja dovela je do odustajanja od toga. Tome u prilog išle su i činjenice da su s jedne strane CT pregledi praktički nezamjenjivi u slučajevima trauma, dok su s druge strane djeca, kao uostalom i pripadnici svih drugih dobnih skupina, neprestano izložena manjoj ili većoj količini pozadinskog ionizirajućeg zračenja (Zemlja, svemir, zrakoplovi). U tome smislu danas se sve više preporučuje uporaba low dose CT (LDCT) tehnika individualno prilagođenih svakom pacijentu zbog njihove manje količine ionizirajućeg zračenja. Na tome putu nastojali smo napraviti pregled najnovijih spoznaja o spomenutoj problematici na temelju znanstvenih radova objavljenih u protekle tri godine (2016. – 2018.). Oni pokazuju da CT pregledi ne samo da nisu napušteni u pedijatrijskoj radiologiji, već naprotiv, u slučajevima brojnih indikacija LDCT pregledi čine zlatni standard.

Objective: Providing suggestions for the evaluation of the sagittal spine curvatures in the supine patients because the sagittal spine curvatures are usually analyzed only in the erect patients.Methods:196 patients had their sagittal spine curva-tures analyzed in a retrospective study on both the standard X rays done in the erect position and on the native MR scans done in the supine position during the six months period, between the 1st January and the 30th June 2019, on the So-matom Avanto, Erlangen 1, 5 T machine at the Department of Radiology of the Clinical Hospital Center Rijeka. Harrison’s posterior tangential method was used for the evaluation of the sagittal spine curvatures due to its lesser standard mis-take and a greater measurement precision than the Cobb’s method.Results:In the cervical spines there were no significant changes in the patients with hyperlodoses and kyphoses, lesser changes were seen in the patients with hypolordoses and applanations, while the greatest changes were in the patients with normolordoses. The smallest changes overall were observed in the thoracic spines. Regarding the lum-bar spines there were again no significant changes in the patients with hyperlordoses and kyphoses, lesser changes were seen in the patients with hypolordoses and applana-tions, while the greatest changes were observed in the pa-tients with normolordoses.Conclusion:In the supine patients the sagittal spine cu-rvatures could with a certainty be assessed in the cases of thoracic spines and lumbar normolordoses as well as in the cervical and lumbar hyperlordoses and pathological kyphoses.

Epidemije kuge su u kolektivnoj svijesti do današnjih dana ostale zapamćene kao najsmrtonosnije. Zbog toga ne iznenađuje što tijekom povijesti odgovori na njih nisu bili samo medicinske već i religijske prirode. Isti se u ovoj studiji nastoje iščitati kroz kultove svetaca zaštitinika protiv epidemija kuge koji su se razvili u dva hrvatska grada komparabilne veličine, Rijeci i Osijeku, no dijametralno suprotnih zemljopisnih položaja te u skladu s time i prilično različitih povijesnih razvoja. S jedne strane, nastojat će se prikazati što iscrpniji pregled razvoja kultova različitih svetaca prisutnih u navedenim gradovima. S druge strane, na temelju prikaza istih u sakralnim baštinama tih gradova nastojat će se rasvijetliti širi kontekst vremena i prostora u kojima su se oni razvijali. Pri tome će osobita pozornost biti posvećena njihovim medicinskim konotacijama.

Ovaj prikaz posvećen je spomenu na petstotu obljetnicu smrti Leonarda da Vincija (Vinci kraj Firence, Italija, 15. travnja 1452. – Cloux Castle, Francuska, 2. svibnja 1519.), najvećega umjetnika renesanse i jednog od najvećih umjetnika uopće. Iz njegove neprocjenjive umjetničke i znanstvene baštine za ovu je prigodu izabran tek malen dio posvećen istraživanju prirode. U tome, po mnogima najznačajnije, mjesto zauzimaju anatomski crteži kao trajno svjedočanstvo njegova zanimanja za anatomiju i medicinu općenito. O toj je temi tijekom proteklih petsto godina puno toga izrečeno i napisano. Tragom brojnih bibliografskih izvora, ovdje je, uz nekoliko kratkih reminescencija, odabrano nekoliko najdojmljivijih crteža koji, svaki za sebe, najbolje svjedoče o genijalnom umu velikoga Leonarda, s pravom nazvanoga uomo universale., This editorial is dedicated to a commemoration of the 500th anniversary of the death of Leonardo da Vinci (Vinci near Florence, April 15, 1452 - Cloux Castle, France, May 2, 1519) - the greatest Renaissance artist and one of the greatest artists in general. From his invaluable artistic and scientific heritage, only a small part dedicated to the exploration of the Nature was selected for this occasion. In this part, according to many, the most significant place is dedicated to his anatomical drawings as a lasting testament to his interest in anatomy and medicine in general. Much has been said and written about this topic over the past 500 years. While searching through numerous bibliographic sources, several of the most impressive drawings have been selected for this occasion, with a few short reminiscences, which bear the most impressive testimony to the brilliant mind of the great Leonardo, rightfully called uomo universale.

American specialist of children’s surgery, John G Raffensperger, has recently published his newest book entitled A Surgeon’s Lessons: Learned and Lost (1). It presents the author’s autobiography from his graduate medical studies until his retirement, spanning more than 50 years. It is an easy and interesting read of 213 pages that is at the same time full of useful facts and life advice.

Although stethoscope was invented by French physician René-Théophile-Hyacinthe Laennec (1781-1826) in 1816, its wider clinical application started only after the publication of his book entitled De l’Auscultation Médiate ou Traité, du Diagnostic des Maladies des Poumons et du Coeur in 1819. Its invention coincided with the development of the ‘hospital medicine’ in the post-revolutionary Paris during the first quarter of the 19th century. It has enabled then contemporary physicians to explain the correlation between the patient symptoms and the clinical findings and thus has helped the shift from the humoral pathology towards the solitary pathology.

Ovaj prikaz posvećen je spomenu na petstotu obljetnicu smrti Leonarda da Vincija (Vinci kraj Firence, Italija, 15. travnja 1452. – Cloux Castle, Francuska, 2. svibnja 1519.), najvećega umjetnika renesanse i jednog od najvećih umjetnika uopće. Iz njegove neprocjenjive umjetničke i znanstvene baštine za ovu je prigodu izabran tek malen dio posvećen istraživanju prirode. U tome, po mnogima najznačajnije, mjesto zauzimaju anatomski crteži kao trajno svjedočanstvo njegova zanimanja za anatomiju i medicinu općenito. O toj je temi tijekom proteklih petsto godina puno toga izrečeno i napisano. Tragom brojnih bibliografskih izvora, ovdje je, uz nekoliko kratkih reminescencija, odabrano nekoliko najdojmljivijih crteža koji, svaki za sebe, najbolje svjedoče o genijalnom umu velikoga Leonarda, s pravom nazvanoga uomo universale.

U radu autor sažeto prikazuje život i djelovanje liječnika Luje pl. Thallera, koji je više od 30 godina radio u bolnici Milosrdnih sestara u Zagrebu, i to prvo kao pomoćni liječnik, zatim primarni liječnik plućnoga odjela od 1919. do 1922. te konačno kao šef interne klinike od 1927. do 1941. godine. Kao dugogodišnji honorarni nastavnik predavao je povijest medicine na zagrebačkome Medicinskome fakultetu, a od 1943. do 1945. kao redoviti profesor povijesti medicine. Osobito je izučavao antičku i srednjovjekovnu medicinu te narodnu medicinu u Hrvatskoj. Autor navodi da je 1938. godine organizirao međunarodni kongres iz povijesti medicine u Zagrebu, Beogradu, Sarajevu i Dubrovniku te ga se zbog toga kao i zbog drugih doprinosa smatra utemeljiteljem hrvatske povijesti medicine.

Ignaz Phillip Semmelweis značajan je za povijest medicine zbog svojeg otkrića uzroka puerperalne sepse, do kojega je došao tijekom rada na Prvoj porodničkoj klinici bečke Allgemeines Krankenhaus. Budući da je ta klinika, koju su vodili liječnici, imala puno veću smrtnost rodilja od Druge porodničke klinike, koju su vodile babice, želio je utvrditi uzroke takva stanja. Došao je do zaključka da puerperalnu sepsu prenose sami liječnici i studenti medicine budući da su nakon obavljanja anatomskih sekcija odlazili izvoditi porođaje, pri čemu su ruke najčešće prali samo sapunom. Semmelweis je umjesto toga predložio obvezatno pranje ruku u otopini kalij-hipoklorita, čime je smrtnost na Prvoj izjednačio sa smrtnošću na Drugoj porodničkoj klinici. Unatoč tome, njegovo je otkriće naišlo na odbacivanje etabliranih medicinskih krugova., Ignaz Phillip Semmelweis’s significance for the history of medicine lies in his discovery of the cause of puerperal fever. He discovered it during his work at the First Obstetrics Clinic of the Vienna’s Allgemeines Krankenhaus. Since the mentioned Clinic, led by the doctors, had much higher mortality rates of the child-bearing women than the Second Obstetrics Clinic, led by the midwives, he wanted to determine the causes of such a state. He came to the conclusion that puerperal sepsis was transmitted by the doctors and medical students, who after performing the anatomical sections started to perform the births with their hands beforehand washed only with soap. Semmelweis instead proposed a mandatory hand washing in a potassium-hypochlorite solution thus making the mortality at the First equivalent to the mortality at the Second Obstetrics Clinic. Despite this, his discovery was rejected by the established medical circuits.

Aim: to give new evidences for proving of the importance of the contrast media application in the brain examination performed by the computerized tomography. Case Presentation: during a routine native examination of brain preformed with the computerized tomography of a patient suffering from the chronic headache and negating the experience of the previous trauma, the extensive edema of the brain tissue in the left frontal part of his brain with the contralateral displacement of the medio- sagittal structures was described, which according to its characteristics corresponded to a brain tumor and in the accordance with the established practice the intravenous contrast media application was performed. Subsequently there was no opacification of the mass, which would be typical for a tumor, while at the same time the extra axial formation which was previously isodense with the surrounding brain tissue was visualized, which suggested a diagnosis of the sub-acute subdural hematoma of an no traumatic cause. This was further confirmed after the neurosurgical operation during which craniotomy was performed in order to evacuate the mentioned hematoma. Conclusion: the above presented case report shows that the native brain examination performed by the computerized tomography is not enough for providing a final diagnosis, but could even point the radiologist in the wrong direction, which is why the contrast media application should be implemented in all unclear cases despite its potentially advers effects such as allergic reactions.

Kuga je bila jedna od najsmrtonosnijih epidemijskih bolesti XVIII. stoljeća. Odgovori na nju nisu bili samo medicinski već i religijski. Dobar je primjer toga spomenik Presvetoga Trojstva u gradu Osijeku što ga je u baroknome stilu između 1729. i 1730. dala podići udovica generala Maksimilijana Petraša koji je preminuo tijekom epidemije kuge 1728. Njegova se izgradnja može protumačiti kao izraz katoličke obnove pa se u tome smislu spomenik može percipirati kao simbol uspješnog uvođenja habsburških rekatolizacijskih vjerskih mjera u Osijek i Slavoniju nakon njihova oslobođenja od Osmanlija, ali i i kao kontinuitet teurgičkoga razumijevanja medicine i kao znak neuspješnog uvođenja habsburških prosvijećenih zdravstvenih mjera. Pregledom arhivske građe i analizom samoga spomenika, rad nastoji razjasniti spomenute suprotnosti., Plague was one of the most deadly epidemic diseases of the Baroque period. Responses to it were not only medical, but religious as well. A good example of the latter is the Most Holy Trinity monument in the city of Osijek, which was in the 18th century the biggest town of the Kingdom of Slavonia and today is the regional centre in the Republic of Croatia. The monument was erected between 1729 and 1730 on the main square of the Osijek military fortress Tvrđa by the widow of the General Maksimilijan Petraš who died during the 1728 plague epidemic. Inscription on it implores the mercy of God as a protection against plague. Its foundation could be also interpreted as a part of the Catholic Revival, which was implemented by the Habsburgs in Osijek and Slavonia after their liberation from the Ottomans. But although, on the one hand, it could be interpreted as a symbol of the successful implementation of the Habsburg unifying religious policies due to its strong resemblance with the similar columns throughout the Habsburg Monarchy, on the other hand, it represented a continuation of the theurgic understanding of medicine, which could be interpreted as the failure of the Habsburg enlightened medical policies. Thus the archival documents from the Osijek State Archive together with the Osijek plague column itself were analysed with the aim of explaining the above mentioned ambiguities.

Lujo Thaller je rođen u Osijeku 1891. godine u obitelji dr. Emanuela Huga pl. Thallera (1852. – 1921.), koji je od starijeg brata Vatroslava naslijedio zaslužno ugarsko plemstvo i Adilije rođene Amruš (1853. – 1923.), inače sestre zagrebačkoga gradonačelnika dr. Milana Amruša. Otac mu je po zanimanju bio pravnik, a radio je kao sudbeni auskultator u Požegi, Donjem Miholjcu i Našicama i naposlijetku sudbeni vijećnik u Osijeku te je bio vijećnik kraljevskog banskog stola i kraljevski septimver u Zagrebu. Obitelj Thaller je podrijetlom bila iz Tirola, a njezin rodonačelnik Paul Joseph Thaller je doselio u Požegu 1766. godine, gdje je radio kao kemičar i ljekarnik te je bio utemeljitelj pošte. Lujin je stariji brat Milan Thaller također bio liječnik te je radio kao šef poliklinike i profesor higijene te predsjednik Crvenog križa u Požegi. Lujo je završio osnovnu školu i prvi razred gimnazije u Osijeku te gornjogradsku klasičnu gimnaziju u Zagrebu. Potom je pohađao studij medicine u Pragu od 1909. godine i Beču do 13. rujna 1914. godine kada je diplomirao s pohvalama zbog čega je od cara i kralja Franje Josipa dobio prsten za uspjeh. 1916. godine u Zagrebu je upisao IV. i V. semestar mudroslovlja te je 31. srpnja 1917. godine postao doktor filozofije iz prirodoslovnih znanosti. Iste godine se učlanio u Zbor liječnika Hrvatske. Preko trideset godina je radio u bolnici Milosrdnih sestara u Zagrebu, prvo kao pomoćni liječnik, zatim kao primarni liječnik te konačno kao šef interne klinike od 1927. do 1938. godine. Usporedno je godinama kao honorarni nastavnik predavao povijest medicine na zagrebačkom medicinskom fakultetu da bi od 1943. do 1945. godine bio redoviti profesor povijesti medicine. Osobito je izučavao antičku i srednjovjekovnu medicinu te medicinski folklor u Hrvatskoj na temelju čega je 1928. godine izdao knjigu pod naslovom Povijest medicine u Hrvatskoj i Slavoniji od godine 1770. do 1850. Sudjelovao je na međunarodnim kongresima povijesti medicine u Bukureštu 1932. godine i Madridu 1935. godine po uzoru na koje je organizirao je međunarodni kongres iz povijesti medicine u Zagrebu, Beogradu, Sarajevu i Dubrovniku 1938. godine. Tom prigodom je iste godine izdao prvi udžbenik iz povijesti medicine na hrvatskom jeziku pod naslovom Od vrača i čarobnjaka do modernog liječnika. Zbog svega navedenoga s pravom se smatra utemeljiteljem hrvatske povijesti medicine. Bio je u braku s Martom Vrbanić (1891. – 1975.), kćerkom sveučilišnog profesora šumarstva iz Fužina, s kojom je imao troje djece: Martu te Luju i Tatjanu također liječnike. Preminuo je u Zagrebu sa svega 58 godina 23. rujna 1949. godine te je sahranjen na Mirogoju. 1999. godine postavljena je spomen ploča na njegovu domu u Prolazu Đure Deželića broj 32 u Zagrebu.

Kuga je bila jedna od najsmrtonosnijih epidemijskih bolesti 18. stoljeća. Odgovori na nju nisu bili samo medicinski, već i religijski. Dobar primjer spomenutoga je spomenik Presvetoga Trojstva u gradu Osijeku, koji je u baroknome stilu između 1729. i 1730. godine dala podići udovica generala Maksimilijana Petraša, a koji je preminuo tijekom epidemije kuge 1728. godine. S jedne strane, njegova izgradnja može se protumačiti kao izraz Katoličke Obnove, pa se u tome smislu spomenik može percipirati kao simbol uspješnoga uvođenja habsburških rekatolizacijskih vjerskih mjera u Osijek i Slavoniju nakon njihovoga oslobođenja od Osmanlija. Međutim, s druge strane, isto se može percipirati kao kontinuitet teurgičkoga razumijevanja medicine, pa se na tome putu može protumačiti kao znak neuspješnoga uvođenja habsburških prosvijećenih zdravstvenih mjera. U tome kotekstu, pregledom arhivske građe i analizom samoga spomenika, rad nastoji razjasniti spomenute suprotnosti.

S obzirom na to da je razvojni poremećaj kuka najčešća prirođena deformacija lokomotornog sustava, cilj rada je bio utvrditi incidenciju i prevalenciju različitih stupnjeva prirođenog iščašenja kukova prema Grafu u novorođenčadi tijekom desetogodišnjeg razdoblja od 2004. do 2013. godine. Svoj novorođenoj djeci tijekom desetogodišnjeg razdoblja od 2004. do 2013. godine obavljen je neselektivni ultrazvučni neonatalni skrining razvojnog poremećaja kuka metodom prema Grafu, pri čemu su I.A i I.B stupnjevi smatrani zdravima, II.A+ stupanj graničnim nalazom, kod kojega je za četiri do šest tjedana obavljena kontrola ultrazvukom, dok su uopćeni II.A i viši, III. i IV. stupanj smatrani patološkim nalazom te su upućeni specijalistu ortopedije na daljnju obradu. Istraživanjem tijekom desetogodišnjeg razdoblja ukupno je obuhvaćeno 3874 kukova u 1937-ero novorođenčadi čiji su modificirani stupnjevi zrelosti kukova prema Grafu bili: I.A kod 1265 kukova, I.B kod 1532, II.A+ kod 828, uopćeni II.A- i viši kod 173, III. kod 66 te IV. kod 10 kukova. Istraživanje je potvrdilo opravdanost provođenja neselektivnog ultrazvučnog neonatalnog skrininga metodom prema Grafu radi utvrđivanja stupnjeva zrelosti kukova, jer je kod djece s prirođenim iščašenjima kukova uopćenog II.A i višeg, III. i IV. stupnja održanim nakon redovite kontrole provedena ortopedska korekcija te je tako na vrijeme spriječena njihova progresija.

Emanuel Edward Klein (1844 - 1925) was a British microbiologist of Croatian origin. He was born in Osijek in what is currently the Republic of Croatia and which was then part of the Habsburg Monarchy, he completed his medical studies in Vienna in 1869, and went on to spend his entire career in London. Although trained as an anatomist, embryologist and histologist, his main area of research was microbiology. Due to the fact that back then it was a new and fast developing discipline, he was able to pursue his interests in many directions and make significant discoveries, such as the identification of the ‘Bacillus enteritidis sporogenes’ as a cause of summer hospital diarrhoeas. Although the overwhelming majority of his researches dealt with bacteria which attacked humans, in 1892 he published a book entitled The Etiology and Pathology of Grouse Disease, Fowl Enteritis, and Some Other Diseases Affecting Birds, which revealed the results of his experiments on the bacteria which affected birds. In the context of the general development of the microbiology, this paper tries to give an objective evaluation of this until now widely neglected book.

Prije pet godina smo u “Liječničkim novinama” pisali o muzeju povijesti medicine u Parizu, a sada se javljamo nakon posjete drugom i drukčijem muzeju. To je Međunarodni muzej Crvenoga križa i Crvenoga polumjeseca (Musée international de la Croix-Rouge et du Croissant-Rouge) koji se nalazi u Genevi, samo nekoliko minuta od palače Svjetske zdravstvene organizacije. Već na samom ulazu u muzej nas medicinare obuzme ushit jer postoji muzej posvećen spašavanju života, mjesto gdje su dokumentirane brojne tragedije 20. stoljeća i gdje se podsjeća na ljude koji su pridonijeli da rane nakon tih strašnih događaja brže zacijele.

Srednji vijek se uglavnom percipira kao razdoblje propadanja i stagnacije između vrhunaca antike i renesanse. Navedena mispercepcija se smatra osobito točnom u slučaju srednjovjekovne latinske znanosti, koja se pod okriljem Katoličke Crkve i na latinskome jeziku razvijala u srednjovjekovnoj Europi. S ciljem dokazivanja da je spomenuti zaključak prvenstveno posljedica pretjeranih pojednostavljivanja, a ne stvarnih činjenica, ovaj rad nastoji učiniti objektivnu evaluaciju srednjovjekovnih znanstvenih i medicinskih postignuća. Na tome tragu, izabrani primjeri srednjovjekovnih postignuća su analizirani s obzirom na opći kontekst njihovoga pojavljivanja i kroz prizmu oprečnih stavova različitih filozofa znanosti. U tome smislu, teorija znanstvenih revolucija američkoga filozofa znanosti, Thomasa Samuela Kuhna, je primijenjena na spomenute primjere.

Background. This cross-sectional study assessed the prevalence of the various blood safety sexual behavioural risks among the blood donors from East Croatia and the possibilities for the improvement of the present blood donor screening procedure. Materials and Methods. The study included 423 blood donors of both sexes who completed the specially designed anonymous questionnaire immediately after their blood donations. The questionnaire contained questions on their demographic data, their sexual preferences, and the possible sexual risk behaviour in the period before the blood donation. Results. The study revealed that the most common forms of sexual risk behaviour among Croatian blood donors had been irregular condom use during the sexual contacts with new partners (294/423 ; 69.5%) and five or more sexual partners during the lifetime (213/423 ; 50.4%). There were more male than female subjects with five or more sexual partners during the lifetime (p

This lecture tends to give an overview of the historical development of dermatovenerology. It starts with the empirical phase in the history of medicine, continues with the ancient civilisations, and brings writings of Hippocrates and Galen. It then describes various epidemics of the Middle Ages with the special highlight of the invention of quarantine in Dubrovnik in 1377. It describes syphilis and its various treatments. Through evaluation of the achievements of the First and Second Viennese School and its influence on the Croatian medicine, it finally concentrates on the development of dermatovenerology in Osijek. It describes the foundation of the Ward for Dermatovenerology at the Huttler-Kohloffer- Monsperger Trust Hospital, first as part of the Ward for Surgery since the foundation of the mentioned Hospital in 1874 and then as an independent ward since 1911. It explains the improvements in the treatments of dermatovenerological ailments and their reflection in the reduction of the number of beds reserved for dermatovenerological patients, which have more than halved after the introduction of the antibiotics. It evaluates the methods in the prevention of syphilis and other venereal diseases. Finally, it mentiones the achievements of the most prominent Osijek dermatovenerology specialists, starting with the Doctor Aleksandar Blašković as the founder of the Ward for Dermatovenerology, then continues with Doctor Marjan Maržik, Doctor Erich Ditz, Doctor Dinko Erman, and Primarius Nikola Mudrovčić, and ends with the pre- contemporary heads of the Ward for Dermatovenerology Primarius Marin Brničević, Primarius Mira Margold-Bubalović and Primarius Vladimira Barišić-Druško.

INTRODUCTION Antioxidant micronutrients are a heterogeneous group of different molecules (vitamins A, C and E, coenzyme Q, glucose, ubiquinon, bilirubine, urates, flavonoids, some amino-acids and certain peptides) which have in common a functional possibility for the binding of oxygen radicals. Previous studies have shown that the antioxidants through their binding with the oxidants could prevent cell deterioration and cancer development. This study evaluated the impact of vitamins A, C and E intake in the prevention of gastroesophageal reflux disease (GERD), Barrett's oesophagus (BE), and oesophageal adenocarcinoma (EADC). METHODOLOGY There were 180 subjects included in the study, 109 males and 71 females, which were divided in the four groups (70 patients with GERD, 20 patients with BE, 20 patients with EADC, and 70 healthy examinees composing a control group). Their antioxidant vitamins intake was investigated through the usage of the dietary questionnaires. Concentration of the mentioned antioxidant vitamins in serum was detected by HPLC method. RESULTS AND DISCUSSION The results showed that the healthy examinees had consumed the greater quantities of the vitamins A, C and E, through both the natural (fruits and vegetables) and the supplementary (industrial vitamin additives) way, than the patients with GERD, BE and EADC. This was reflected in the higher serum levels of the mentioned vitamins in the control group in the comparison with the other groups. The Fischer's exact test has showed that all the differences were statistically significant with p

Introduction: High blood pressure is a major cause of cardiovascular disease, responsible for 62% of stroke and 49% of coronary heart disease. There is overwhelming evidence that dietary salt is the major cause of high blood pressure and that a reduction in salt intake lowers blood pressure, thereby, reducing blood pressure-related diseases. Despite that, the large proportion of population still does not take much care about their dietary salt intake. The aim of this study was to identify the amount of dietary salt intake among hypertensive and normo-tensive adult patients from Eastern Croatia, to determine is there difference in dietary salt intake between these two groups and to evaluate the prevalence of uncontrolled blood pressure among hypertensive patients and role of dietary salt intake in that sense. Materials and methods: During June 2010 all together 100 patients that had been cured for hypertension by their chosen family physician were asked to participate in this study on voluntary basis. Response rate was 89.0% (89/100). The main age of this group of patient was 57.5±10.6 (range 38 to 78) years. The control group of patients consist of 71 patients cured for some other reasons in the same family physician office. Response rate for controls was 71.0% (71/100), and their mean age was 53.4±9.4 (range 38 to 77) years. Each participant who agreed to participate in study on voluntary basis had been asked to fill out the specially designed questionnaire that contained questions on gender, age, work status, average monthly income of household, number of members of the household, place of residence, anamnestic data concerning the chronic illnesses and daily used medicines, monthly consumption of salt in household, daily consumption of bread, various bakery products and salty snacks in the household and practice to put extra amount of table salt in the meal before eating. The weight and height of each participant as well as blood pressure were measured. In the Institute of Public Health of Osijek-Baranja County the values of salt content in 23 breads and 42 bakery products from bakery shops in Osijek area were established. Besides that the value of salt content in 31 different salty snacks available in Croatian market was also established. The amount of salt consumed daily through the cooking, consumption of bread, bakery products and salty snacks as well as the overall daily salt consumption for each participant has been calculated. Results: Average daily dietary salt intake among hypertensive adult patients from Eastern Croatia was 8.8±3.4 (range 3.3 to 18.1) grams and among normo-tensive ones 10.2±4.5 (range 4.0 to 24.7) grams. Among hypertensive patients there were 44.9% (40/89) of them with well controlled blood pressure and 55.1% (49/89) of them with uncontrolled blood pressure. The average daily salt intake among hypertensive patients with well controlled blood pressure was 8.3±3.3 (range 3.3 to 16.5) grams and among hypertensive patients with uncontrolled blood pressure was 9.1±3.5 (range 4.1 to 18.1) grams. Discussion and conclusion: The study revealed that average daily salt intake among hypertensive and normo-tensive adult patients from Eastern Croatia is much higher then maximum recommended intake of 6 grams of salt daily. In the milieu of increasing cardiovascular disease worldwide, particularly in low- and middle-income countries, salt reduction is one of the most cost-effective strategies to combat the epidemic of high blood pressure, associated cardiovascular disease and to improve population health in general.

Emanuel Edward Klein (Osijek, 1844 - Hove, 1925) was British microbiologist of Croatian origin. He completed his medical studies in Vienna in 1869. In 1869 he was sent to England to determine terms for the translation of Samuel Stricker's manual Handbuch von den Geweben des Menchen und der Tiere. During his visit he made a good impression on John Burdon Sanderson and John Simon, which was the main reason why he was invited to London in 1871 to conduct investigations under their guidance. In 1873 Klein began his collaboration with the Saint Bartholomew's Hospital, where he was appointed as a Joint Professor of General Anatomy and Physiology. His researches were in the fields of anatomy, histology, pathology, embriology, physiology, and especially microbiology. He did a great deal to its development in Britain. He has written about 260 scientific papers on a broad range of different topics, Despite all the aforementioned facts, his work was never properly studied, and he is almost unknown outside academic circules. For that reason, attitudes towards him still range between the extremes of calling him the father of British microbiology on one side, and attributing him as a dilligent and industrious plodder on the other. In this paper we will try to prove the first attitude. We will put his researches in a general context. Finally we will highlight his original achievements in the isolation of new microbes.

Disertacija proučava važnost eksperimentalizma Emanuela Edwarda Kleina za razvoj temeljnih medicinskih znanosti, institucionalizaciju laboratorija, te širenje eksperimentalizma u medicinskoj znanosti. Kleinov eksperimentalizam je stavljen u kontekst njegovoga podrijetla, obrazovanja i karijere, te je razjašnjen njegov utjecaj na razvoj temeljnih medicinskih znanosti. Analizirani su rezultati njegovih istraživanja u području anatomije, embriologije, eksperimentalne fiziologije, histologije, te mikrobiologije. Kleinov eksperimentalizam je sustavno istražen, te je pregledno ocjenjen s obzirom na opći kontekst razvoja eksperimentalne medicine krajem 19. i početkom 20. stoljeća, pri čemu je analiziran utjecaj, koji su na njegovo formiranje izvršili pozitivizam, naturalizam i evolucionizam. Izvorni znanstveni doprinos samoga doktorata je sustavni prikaz cjelokupnoga eksperimentalnoga rada Emanuela Edwarda Kleina s obzirom na konceptualni kontekst tadašnjega razvoja medicine s jedne strane, te s obzirom na suvremene spoznaje u medicinskoj znanosti s druge strane. Materijal disertacije je arhivska građa, koja obuhvaća originalne dokumente o Kleinovome životu, knjižnična građa, koja obuhvaća primarnu i sekundarnu literaturu o Kleinovoj karijeri, te Kleinovi objavljeni radovi. U radu su korištene opisne, komparativne i analitičke metode rada u svrhu raščlambe i interpretacije primarnih i sekundarnih izvora, te dostupne literature. Konačno je napravljena evaluacija doprinosa eksperimentalnih istraživanja Emanuela Edwarda Kleina razvoju suvremene medicine.

Aim The aim of this abstract is to evaluate the importance of comparative anatomy in the development of modern anatomy during late 19th and early 20th centuries, as observed in the work of Emanuel Edward Klein (Osijek, 1844 - Hove, 1925). His anatomical researches in the fields of general, comparative and pathological anatomy were coducted between 1868 and 1880, and were based on dead body section, laboratory animal vivisection and their combination, which has resulted in the eleven studies. Despite this, his work was never properly studied. Methods Our investigation is based on the work in archives (State Archive Osijek ; Archive of Saint Bartholomew's Hospital), and libraries (Oxford Bodleian Library ; Cambridge University Library), precisely on collection of primary sources and their analysis in broader context of secondary sources. Results Klein's researches dealt with esophagus muscles, oral muscles, corneal nerves, peripheral nerves endings and distribution, Auerbach's plexus, Jacobson's organ, lymphatic system, and serosal membranes. They could be divided into the Viennese period prior to 1871, and the London period after it. His researches were conducted on toads, frogs, rats, cats, dogs, rabbits, and guineapigs. His most important discovery was the descripton of musculus rectus labii proprius, which is still named after him. His most inluental book was The Anatomy of the Lymphatic System, which was the first book on the mentioned topic. Conclusion Comparative anatomy as a new scientific discipline, developed together with experimental physiology, played a crucial role in the Klein's work and enabled him to make his significant discoveries.

Hrvatski znanstvenik Emanuel Edward Klein, anatom, embriolog, fiziolog, histolog i mikrobiolog, rođen je u Osijeku, medicinu je završio u Beču, a svoju profesionalnu karijeru ostvario je u Londonu. Njegov život i karijera do sada nisu sustavno istraženi, što je autora ponukalo da se njima posveti u svome doktoratu. U ćlanku su predstavljena Kleinova najvažnija medicinska djela.

After the Christian liberation from Turks in 1687 health service in Osijek was in very poor state. Franciscans were taking care of pharmacy stores and healing was mostly in hands of surgeons or lay people. The only hospital in town was military hospital which was used exclusively for soldiers. Due to the fact that Slavonia was the border region epidemics were very often. The most dreadful among them was the great epidemic of plague devastating this region in the period from 1736 to 1741. It killed almost one third of Osijek residents. Consequently the network of quarantine lazarettos and stationeries were opened in and around Osijek in due time. In this paper we examine the role of plague in the 18th century as well as its consequences regarding development of the public health care system in Osijek. We argue that epidemic of plague which appeared in Osijek in 1736 was among the principal influential factors in improving public health services in Osijek. This was evident in advancing public services, increasing number and structure of medical practitioners, as well as in intensifying awareness for the establishment of the civil hospital suitable to serve its purpose during the subsequent decades.

U radu smo prikazali pojavnost i ulogu medicinskih praktičara, osobito kirurga- ranarnika i brijača-Badera u Osijeku u razdoblju od kršćanskoga oslobođenja 1687. do proglašavanja “ Regulationen für Baderen” 1746. godine. Na temelju arhivskih izvora i građe prikazali smo njihov identitet, porijeklo, broj i status, te ukazali na određena odstupanja u njihovoj nadležnosti u odnosu na druge gradove Habsburške Monarhije. Prisutnost i široki raspon poslova, koje su ranarnici ovdje obnašali mogu se objasniti geostrateškim položajem Osijeka kao vojne utvrde u blizini granice s Osmanskim Carstvom i snažnim vojnim utjecajem na njegov razvoj, te odsutnošću školovanih liječnika. Podatci prikazani u ovom radu ukazuju na same početke djelovanja medicinskih praktičara u Osijeku i važni su za razumijevanje razvoja organizacije zdravstva na ovom području.