Acta medica Croatica : c̆asopis Hravatske akademije medicinskih znanosti
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The aim is to give a review of the anesthesiological approach to neuroradiological endovascular treatment of intracranial aneurysm in Croatia since 2004, when the first procedure was done. It took place at University Department of Radiology, Zagreb University Hospital Center. The optimal conduct of anesthesia in the neuroradiology suite requires careful planning of each individual procedure. ⋯ It is essential to keep up-to-date in the knowledge of neuroanesthesia, neuropathology and interventional neuroradiology. In spite of the relatively non-invasive nature of the procedures, serious, even fatal complications may occur. Therefore, the role of anesthesiologist and his/her cooperation with neuroradiologist is crucial for successful results.
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Multicenter Study
[Coronary heart disease risk factors in Croatia and worldwide: results of the Interheart study].
In the past 30 years, an increased cardiovascular disease (CVD) mortality has been observed in both industrialized and transition countries. The latter countries, such as Croatia, are considered to be in the third stage of epidemiological transition, defined as having 35%-65% of total as CVD mortality, predominantly ischemic heart disease and cerebrovascular disease. The CVD epidemic in transition countries is due to increasing rates of hypertension, obesity, smoking and sedentary lifestyle. Among CVD diagnoses, the most important is coronary heart disease (CHD), which varies in incidence among different ethnic groups and countries. Worldwide, it is estimated that nine potentially modifiable risk factors contribute to more than 90% of myocardial infarctions. Approximately 80%-90% of patients with symptomatic CHD and more than 95% of patients who died from CHD had at least one of the four traditional risk factors (smoking, hypertension, hyperlipidemia, and diabetes). ⋯ The most important AMI risk factor in south Croatia is current smoking, followed by diabetes, abnormal ApoB/ApoA-1 ratio, abdominal obesity, and hypertension. A protective risk factor is alcohol consumption, while physical activity and fruit and vegetable consumption are less important. These results are similar to the global INTERHEART data showing that most of AMI risk could be predicted with nine simple, measurable risk factors worldwide. Protective measures for CHD, including increased daily consumption of fruits and vegetables, moderate physical activity and particularly smoking cessation should be implemented worldwide. In specific regions such as south Croatia, moderate alcohol consumption (mostly red wine) may be included among protective measures due to sociologic and cultural reasons.
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This prospective study assessed the efficacy of the predicting power for mortality of two different prehospital scoring systems in trauma with ISS > 14. We present an improved Mainz Emergency Evaluation Scoring system (MEES) in combination with capnometry (MEESc). MEESc is a new scoring system. ⋯ There were significant differences between MEES and MEESc. MEESc improved the results of MEES in predicting trauma outcome with ISS > 14. The prehospital use of the improved MEESc system could be an efficient communication protocol between the prehospital and hospital settings.
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Depression is an important public health problem today. In the primary care setting, a high percentage of patients with depression present exclusively with physical symptoms; depression can often go undiagnosed in these patients. Another challenge for primary care doctors is the treatment of patients with depression and somatic comorbidity. When faced with demands to treat multiple chronic diseases, physicians may give depression less priority. The consequences of exposure to war stress on mental health have been constantly explored. Posttraumatic stress disorder and depression have been identified as the most common psychopathological consequences of exposure to war stressors. The 1991-1995 war in Croatia left deep psychosocial scars and affected self-perceived health, physical ability and mental health of the entire Croatian population stricken by war. Otocac is one of the areas that were more severely affected by war. ⋯ The results of our study indicated a high prevalence of depression in the group of general practice patients in Otocac, Croatia, ten years after the war in Croatia. Severe and moderate depressive episodes predominated, without sex difference in the frequency of depressive symptoms. Long-term psychological consequences of exposure to war stress as well as other characteristics of the post-war period in the area affected by war may in part explain these findings.
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Childhood morbidity has changed. Western children more often present with skin problems than with respiratory problems. A significant percentage of the workload of a general practitioner is dermatologic. ⋯ Intervention activities done by planning a strategy for frequent attenders with skin diseases require additional knowledge, attitudes and skills for a new approach to patients in daily work of primary health care physicians.