Impact of the earthquake during COVID-19 lockdown on fracture admission at a tertiary trauma centre in Croatia / 中华创伤杂志(英文版)

PURPOSE@#To determine the impact of an earthquake during COVID-19 lockdown on fracture admission at a tertiary trauma centre in Croatia.@*METHODS@#A case-control study was performed at the tertiary trauma centre registry. Two different periods were studied. The case group included a period during COVID-19 lockdown right after the earthquakes until the end of the confinement period in Croatia. And the control group corresponded to the equivalent period in 2019. We identified all consecutive patients who were admitted due to urgent care requirements for the musculoskeletal trauma. Patient's demographic data and admitting diagnoses were assessed. Data were analyzed by statistical procedures using the program MedCalc statistical software version 16.4.3.@*RESULTS@#We identified 178 emergency admissions due to musculoskeletal trauma. During the COVID-19 lockdown and post-earthquake period, there was a drastic reduction in total admissions (359 vs. 662; p < 0.0001) with an increased proportion of trauma admissions within the emergency admissions (34.9% vs. 26.5%; p = 0.02926, Z = -2.1825). Furthermore, in the case group there was a significant increase in hospital admissions due to ankle/foot trauma (11 vs. 2, p = 0.0126) and a trend towards a decrease in the admissions due to tibia fractures (5 vs. 12, p = 0.0896), however without statistical significance. Also, an increased proportion of women within the group of femoral fractures in both case group (81.6% vs. 52.6%, p = 0.00194, Z = 3.1033) and the control group (82.3% vs. 60.5%, p = 0.0232, Z = 2.2742) was observed. In both analyzed periods, the osteoporotic hip fracture was the most common independent admitting diagnosis.@*CONCLUSION@#It is crucial to understand how natural disasters like earthquakes influence the pattern of trauma admissions during a coexisting pandemic. Accordingly, healthcare systems have to be prepared for an increased influx of certain pathology, like foot and ankle trauma.

Hepatitis E seroprevalence and associated risk factors in Croatian liver transplant recipients

Abstract INTRODUCTION Solid-organ transplant recipients are at risk of hepatitis E virus (HEV) infection. We analyzed the seroprevalence/risk factors of HEV in Croatian liver transplant recipients. METHODS Two hundred forty-two serum samples were tested for HEV immunoglobuline IgG/IgM and HEV RNA. Sociodemographic data and risk factors were collected using a questionnaire. RESULTS HEV IgG seroprevalence rate was 24.4%. Positive/equivocal HEV IgM were found in two patients. HEV RNA was not detected. Logistic regression showed that older age, female gender, rural area/farm, water well, and septic tank were associated with HEV seropositivity. CONCLUSIONS This study revealed a high exposure rate to HEV in Croatian liver recipients.

Maternal and Neonatal Effects of Substance Abuse during Pregnancy: Our Ten-year Experience

PURPOSE: The aim of the study was to assess perinatal outcome of pregnancy burdened with maternal addiction in comparison with an unselected population from a European transition country. MATERIALS AND METHODS: Data on pregnancies complicated by illicit drug abuse (n = 85) managed during a 10-year period (1997-2007) at Split University Hospital were analyzed. Data on the type of drug, course of gestation and labor, and on perinatal outcome were considered. Data on all non-dependence pregnancies recorded during the study period were used as a control group. RESULTS: During the study period, there were 85 dependence-complicated pregnancies (0.2%). Use of heroin alone during pregnancy was recorded in 51 women (50%), methadone alone in 6 (7%), and a combination of heroin and methadone in 9 (11%). Premature delivery was significantly more common in the group of pregnant addicts (21% vs. 6%); 49% of pregnant addicts were carriers of hepatitis C virus (HCV) and 14% of hepatitis B virus (HBV). Neonatal abstinence syndrome developed in 61 infants (7%) born to addicted mothers. There were 4 cases (4.6%) of early neonatal death; 7 neonates had 5-minute Apgar score < or = 7 (8%); 29 neonates had low birth weight for age (33%); and 7 neonates had congenital anomalies (8%). The risk of various congenital anomalies was 3-fold in the group of children born to addicted mothers. CONCLUSION: Addiction pregnancies present a small but high-risk group according to perinatal outcome. Appropriate obstetric and neonatal care can reduce the rate of complications in these pregnancies and improve perinatal outcome.

Impact of coffee and other selected factors on general mortality and mortality due to cardiovascular disease in Croatia.

In Croatia, the mortality rate is higher than that in the countries of the European Union (EU), and consumption of coffee is moderate compared to the EU countries. The study examined the effects of coffee consumption on all-cause (general) mortality, mortality due to cardiovascular disease, and survival. Analyses were based on data obtained from an epidemiological longitudinal study started in 1969 with follow-ups in 1972, including 1,571 men and 1,793 women aged 35-59 years, and in 1982, including 1,093 men and 1,330 women. The sample was age- and gender-stratified and included urban and rural populations from three coastal and three continental regions of Croatia. During the observation period from spring 1972 to the end of 1999, 568 men and 382 women died. In total, 254 men and 181 women died due to cardiovascular disease. The sample was classified in 4 groups: non-drinkers, consumption of coffee sometimes, regularly 1-2 cup(s), and regularly more than 2 cups per day. Apart from coffee, the effects of diastolic blood pressure, smoking habit, well-being, stomach ulcer, and resident status were analyzed. Data on general mortality and mortality due to cardiovascular disease were also analyzed. The influence of region and the effects of diastolic pressure and smoking habit on general mortality and cardiovascular disease-associated mortality were confirmed in both the sexes. No significant effects of coffee consumption on general mortality and mortality due to cardiovascular disease were found among men. Positive effects of coffee on general mortality (p = 0.0089) but not on cardiovascular disease-associated mortality were observed among women. Women who regularly drank coffee 1-2 cup(s) per day had a significantly lower risk of all-cause death adjusted for age, region, smoking, diastolic blood pressure, feeling of well-being, and history of stomach ulcer (relative risk = 0.631; p = 0.0033; confidence interval: 0.464-0.857). The role of coffee consumption on mortality was less relevant than other variables. However, it cannot be completely neglected in women.