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.

Preschool teachers' knowledge and attitudes about dental trauma in Rijeka, Croatia: a cross-sectional study / Conocimientos y actitudes de los profesores de nivel preescolar sobre el trauma dental en Rijeka, Croacia: un estudio transversal

Introduction: Traumatic tooth injuries often occur in childhood. They are not life-threatening, but they can cause a number of complications that can affect the quality of life. Proper first aid can significantly facilitate further dental treatment. The aim of this research was to evaluate preschool teachers' knowledge and attitudes about dental trauma and their motivation for further education. Material and Methods: This cross-sectional study included 54 preschool teachers. It was carried out in the form of a questionnaire consisting of 23 questions regarding traumatic tooth injuries, experiences and knowledge and teachers' interest in additional education.Results: Most of the preschool teachers, 68.51%, did not witness any dental traumas during their work experience. From the teachers who witnessed dental trauma, only 11.76% gave first aid and none of them called the dentist and followed their instructions. In case of dental avulsion 72.22% would keep the avulsed tooth in a dry gauze or tissue. Even though 81.49% consider themselves uninformed about dental, all of them are interested in additional education. Conclusion: Despite the insufficient knowledge about dental trauma, its management, and first aid it is encouraging that all of the preschool teachers included in this research are motivated to educate themselves more on this subject.

Introducción: Las lesiones dentales traumáticas ocurren a menudo en la niñez. No ponen en peligro la vida, pero pueden causar una serie de complicaciones que pueden afectar la calidad de vida. Los primeros auxilios adecuados pueden facilitar significativamente el tratamiento dental posterior. El objetivo de esta investigación fue evaluar el conocimiento y las actitudes de los profesores de preescolar sobre el trauma dental y su motivación para la educación superior. Material y Métodos: Este estudio transversal incluyó a 54 maestros de preescolar. Se llevó a cabo en forma de un cuestionario que constaba de 23 preguntas sobre lesiones dentales traumáticas, experiencias y conocimientos y el interés de los profesores en la educación adicional. Resultados: La mayoría de los maestros de preescolar (68,51%) no presenció ningún traumatismo dental durante su experiencia laboral. De los profesores que presenciaron traumatismos dentales, solo el 11,76% dio primeros auxilios y ninguno llamó al dentista y siguió sus instrucciones. En caso de avulsión dental, el 72,22% mantendría el diente avulsionado en una gasa o tejido seco. A pesar de que el 81,49% se considera desinformado sobre odontología, todos están interesados en educación adicional. Conclusion: A pesar del conocimiento insuficiente sobre el trauma dental, su manejo y primeros auxilios, es alentador que todos los maestros de preescolar incluidos en esta investigación estén motivados para educarse más en este tema

Elite Croatian junior taekwondo competitors: morphological characteristics and body composition reference values / Competidores croatas de taekwondo junior de élite: características morfológicas y valores de referencia de composición corporal

SUMMARY: The main purpose of this study was to determine the body composition and anthropometric reference values of male and female junior Croatian taekwondo competitors according to official weight category. Additional aim of the study was to identify possible differences in variables between the weight categories. The sample comprised 247 junior participants of the national taekwondo championships divided into male (N=121) and female (N=126). The variable sample was defined by a set of 8 measurements: Body height (cm), Body mass (kg), Body mass index, Body fat (%), Body fat (kg), Muscle mass (kg), Lean body mass (kg) and Total body water (%). Results confirm previous studies proving that younger taekwondo practitioners have higher levels of body fat than their more experienced peers (seniors). Significant differences were only found between lean and heavy categories. Male junior taekwondo athletes show total body water percentages from 57.4 to 74.8 %, with significantly lower percentages in higher weight categories, while female athletes in heigher categories demonstrate a worrying level of hydration status, therefore endangering their performance and overall health. As the first paper that investigates the reference values of junior taekwondo athletes but based on official weight categories it is especially important as each weight category warrant different body composition requirements, as seen from significant differences across different variables. Future studies should include motor abilities inspection throughout the weight categories and possible use of calculation of metabolic age.

RESUMEN: El objetivo principal de este estudio fue determinar la composición corporal y los valores de referencia antropométricos de los competidores croatas masculinos y femeninos de taekwondo junior según la categoría oficial de peso. Además, se analizó identificar las posibles diferencias en las variables entre las categorías de peso. La muestra estuvo compuesta por 247 participantes junior de los campeonatos nacionales de taekwondo divididos en hombres (N = 121) y mujeres (N = 126). La muestra variable se definió mediante un conjunto de 8 medidas: altura corporal (cm), masa corporal (kg), índice de masa corporal, grasa corporal (%), grasa corporal (kg), masa muscular (kg), masa corporal magra (kg) y agua corporal total (%). Los resultados confirmaron estudios previos que demuestran que los practicantes de taekwondo más jóvenes tienen niveles más altos de grasa corporal que sus pares más experimentados (personas mayores). Solo se encontraron diferencias significativas entre las categorías magra y pesada. Los atletas masculinos de taekwondo junior muestran porcentajes de agua corporal total del 57,4 al 74,8 %, con porcentajes significativamente más bajos en las categorías de peso más alto, mientras que las atletas femeninas en las categorías más altas, demuestran un nivel preocupante de estado de hidratación, poniendo en peligro su rendimiento y salud en general. Como el primer artículo que investiga los valores de referencia de los atletas de taekwondo junior, pero basado en categorías de peso oficiales, es especialmente importante ya que cada categoría de peso garantiza diferentes requisitos de composición corporal, como se puede observar en las diferencias significativas entre las diversas variables. Los estudios futuros deberían incluir un análisis de las habilidades motoras en todas las categorías de peso y el posible uso del cálculo de la edad metabólica.

Differences in body composition between water polo players of national teams of Montenegro and Croatia participating in the European U15 Championship 2019 / Diferencias en la composición corporal entre los jugadores de waterpolo de las selecciones nacionales de Montenegro y Croacia participantes en el campeonato europeo U15 2019

The aim of this research was to determine the differences between the cadets (U15) water polo players of national teams of Montenegro and Croatia in the body composition and anthropometric characteristics. A sample of 32 subjects was divided into two sub-samples. The first sub-sample of the subjects was consisted of 16 water polo players of Montenegro national team of the average age 14.69±.48, the vice champions on the European Championships in Burgas (Bulgaria) 2019, while the other sub-sample was consisted of 16 water polo players of national team of Croatia of the average age of 14.75±.45, who occupied the eighth position on the European Championships in Burgas (Bulgaria) 2019. Water polo players were tested at the final preparations just before the European championship. Body composition and anthropometric characteristics were evaluated by a battery of 11 variables: body height, body weight, triceps skinfold, biceps skinfold, skinfold of the back, abdominal skinfold, upper leg skinfold, lower leg skinfold, body mass index, fat percentage and muscle mass. The standard central and dispersion parameters of all variables were calculated. The significance of the differences between the water polo players of two national teams in the variables for assessing body composition and anthropometric characteristics was determined by a t-test for independent samples. It was found that there are statistically significant differences in five variables, in three variables at p<0.01 (body height, triceps skinfold and biceps skinfold), and in two variables at p<0.05 (upper leg skinfold and muscle mass). It can be stated that the water polo players of Montenegro have statistically significantly higher triceps skinfold, biceps skinfold and upper leg skinfold, and statistically significantly lower body height and muscle mass than the water polo players of Croatia.

El objetivo de esta investigación fue determinar las diferencias entre los jugadores cadetes de waterpolo (U15) de los equipos nacionales de Montenegro y Croacia en la composición corporal y las características antropométricas. Se dividió una muestra de 32 jugadeores en dos submuestras. La primera submuestra consistió en 16 jugadores de waterpolo del equipo nacional de Montenegro con una edad promedio de 14,69 ± 0,48, los vicecampeones del Campeonato de Europa en Burgas (Bulgaria) 2019, mientras que la otra submuestra estuvo compuesta de 16 jugadores de waterpolo del equipo nacional de Croacia con una edad promedio de 14,75 ± 0,45, que ocuparon la octava posición en el Campeonato de Europa en Burgas (Bulgaria) 2019. Los jugadores de waterpolo fueron probados en los preparativos finales justo antes del campeonato europeo. La composición corporal y las características antropométricas se evaluaron mediante una batería de 11 variables: altura corporal, peso corporal, pliegue cutáneo del tríceps, pliegue cutáneo del bíceps, pliegue cutáneo de la espalda, pliegue abdominal, pliegue superior de la pierna, pliegue inferior de la pierna, índice de masa corporal, porcentaje de grasa y músculo masa. Se calcularon los parámetros estándar centrales y de dispersión de todas las variables. La importancia de las diferencias entre los jugadores de waterpolo de dos equipos nacionales en las variables para evaluar la composición corporal y las características antropométricas se determinó mediante una prueba t para muestras independientes. Se observó que existen diferencias estadísticamente significativas en cinco variables, en tres variables con p <0,01 (altura corporal, pliegue de tríceps y pliegue de bíceps), y en dos variables con p <0,05 (pliegue superior de la pierna y masa muscular). Los jugadores de waterpolo de Montenegro tienen pliegues cutáneos de tríceps estadísticamente significativamente más altos, pliegues cutáneos de bíceps y pliegues superiores de las piernas, y una altura corporal y masa muscular estadísticamente significativamente menor que los jugadores de waterpolo de Croacia.

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.

Neuroticism and pain catastrophizing aggravate response to pain in healthy adults: an experimental study

BACKGROUND: The aim of this study was to investigate the association between neuroticism, pain catastrophizing, and experimentally induced pain threshold and pain tolerance in a healthy adult sample from two regions of the country of Croatia: the island of Korcula and city of Split. METHODS: A total of 1,322 participants were enrolled from the Island of Korcula (n = 824) and the city of Split (n = 498). Participants completed a self-reported personality measure Eysenck Personality Questionnaire (EPQ) and pain catastrophizing questionnaire Pain Catastrophizing Scale (PCS), followed by a mechanical pain pressure threshold and tolerance test. We have explored the mediating role of catastrophizing in the relationship between neuroticism and pain intensity. RESULTS: The results showed that pain catastrophizing partially mediated the relationship between neuroticism and pain intensity, suggesting the importance of pain catastrophizing in increasing vulnerability to pain. The results also indicated gender-related differences, marked by the higher pain threshold and tolerance in men. CONCLUSIONS: This study adds to the understanding of the complex interplay between personality and pain, by providing a better understanding of such mechanisms in healthy adults.

Effect of menopause, anthropometry, nutrition and lifestyle on bone status of women in the northern mediterranean / Efecto de la menopausia, la antropometría, la nutrición y el estilo de vida sobre la condición ósea de las mujeres en el mediterráneo norte

OBJECTIVE: The purpose of this study was to explore the influence of age, menopause, anthropometry, nutrition and lifestyle on bone status of women of the Northern Mediterranean Region of Croatia, which is considered the Adriatic Coast of Southeast Europe. METHODS: Quantitative ultrasound measurement was performed on the women's right heel and the values of the primary parameters (the Broad Ultrasonic Attenuation and the Speed of Sound [BUA and SOS]) were obtained. Dietary data were assessed with specially designed semi-quantitative food frequency questionnaire. Multiple regression analysis was employed to examine the influence of age and anthropometry, as well as hormonal and nutritional factors on BUA and SOS. RESULTS: In all female subjects, both primary parameters were predicted by menopause. Among nutrition and lifestyle factors, carbohydrates were significant predictors for BUA (β= -0.151, p < 0.05), and smoking is significant predictor for SOS (β= -0.113, p < 0.05). In premenopausal women, BUA is significantly predicted by body height (β= 0.71, p < 0.05) and body mass index (β= 1.44, p < 0.05). In postmenopausal women, both primary parameters are strongly predicted by age and anthropometric parameters. Besides, SOS is significantly predicted by smoking (β= -0.18, p < 0.01) and alcohol (β= -0.13, p < 0.05). Besides, SOS is significantly predicted by smoking (β= -0.18, p < 0.01) and alcohol (β= -0.13, p < 0.05). CONCLUSION: Bone quality in women from the Croatian Mediterranean Region mostly depends on their hormonal status. When the effect of menopause is controlled, bone status becomes dependent on age and anthropometry.

OBJETIVO: El propósito de este estudio fue explorar la influencia de la edad, la menopausia, la antropometría, la nutrición y el estilo de vida en la condición ósea de las mujeres de la región mediterránea norteña de Croacia, que es considerada la Costa Adriática del Sudeste de Europa. MÉTODOS: Se realizó una medicación cuantitativa mediante ultrasonido en el talón derecho de las mujeres y se obtuvieron los valores de los parámetros primarios (la atenuación del ultrasonido de banda ancha y la velocidad del sonido [AUB y VDS]). Los datos dietéticos fueron evaluados mediante un cuestionario semi-cuantitativo de frecuencia de alimentos, especialmente diseñado. Se empleo el análisis de regresión múltiple para examinar la influencia de la edad y la antropometría, así como los factores hormonales y nutritivos sobre AUB y VDS. RESULTADOS: En todas las sujetos hembras, ambos parámetros primarios fueron predichos por la menopausia. Entre los factores nutrición y estilo de vida, los carbohidratos fueron predictores significativas de para AUB (β= -0.151, p < 0.05), y fumar es el predictor significativo para VDS (β= -0.113, p < 0.05). En las mujeres premenopáusicas, la AUB es predicha significativamente por la altura del cuerpo (β= 0.71, < 0.05) y el indice de masa corporal (β= 1.44, p < 0.05). En las mujeres postmenopáusicas, ambos parámetros primarios son fuertemente predichos por la edad y los parámetros antropométricos. Además, la VDS es predicha significativamente por el hábito de fumar (β= -0.18, p < 0.01) y el alcohol (β= -0.13, p < 0.05). CONCLUSIÓN: La calidad ósea de las mujeres de la región mediterránea croata depende principalmente de su estado hormonal. Cuando el efecto de la menopausia se controla, la condición ósea se hace dependiente de la edad y la antropometría.

Association of TNF promoter polymorphisms with type 1 diabetes in the South Croatian population

Type 1 diabetes mellitus (TIDM) is an autoimmune disease characterized by the destruction of pancreatic p cells. Tumor necrosis factor (TNF) is a pleotropic cytokine with potent immunomodulatory and inflammatory activity. Association studies of TNF polymorphisms and type 1 diabetes (TIDM) frequently demonstrated TNF involvement with TIDM. Although TNF may play an important role in the pathogenesis of TIDM, the genetic association of TNF región with the disease has not been conclusive because of the strong linkage disequilibrium with HLA genes. In this study, we examined two TNF promoter variants (rs 1800629 at position -308, and rs361525 at position -238) for TIDM association in 233 patients and 144 controls from the population of South Croatia. A higher frequency of TNF -308 A alíele and also, a more frequent specific -308A -238G haplotype in TIDM patients were observed with a limited significance. However, we did not find strong evidence of association of TNF promoter polymorphisms with TIDM. In order to elucidate the trae contribution of TNF to TIDM susceptibility in our population, more comprehensive studies with HLA adjustment in a larger sample are required.

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.

Tattoo and Personality Traits in Croatian Veterans

To examine whether tattooed patients, treated for posttraumatic stress disorder (PTSD) caused by war at the Ward for Psycho-trauma of the Clinical Hospital Osijek, differ from non-tattooed patients by certain personality traits. The study was conducted on one hundred Croatian veterans who were divided into two groups with respect to the presence/ absence of tattoo. To assess the symptoms of PTSD, the Clinical Administered PTSD Scale (CAPS-2) was used for all subjects. To assess personality traits the following psychology tests were applied: Purdue non-verbal IQ test, Minnesota Multiphasic Personality Inventory (MMPI-1), and Eysenck's Personality Questionnaire (EPQ/A and EPQ/IVE). With respect to the examined pre-traumatic variables and PTSD symptoms, the two groups manifested no differences. The non-tattooed group achieved higher scores on the IQ test (IQ=100) than the tattooed group (IQ=95). EPQ test showed results either above or below the norms on all scales that were applied. The tattooed group demonstrated significantly higher levels of impulsiveness, adventurism, empathy and neuroticism than the non-tattooed one (p < 0.05). In the group of 100 Croatian veterans treated for PTSD, 33 had tattoos and 67 did not. The results indicated more impulsiveness, adventurism / risk behavior, empathy and neuroticism in the tattooed group than in the non-tattooed group, while there was no significant difference in the intensity of the PTSD symptoms.

Serum Lipid Concentrations in Croatian Veterans with Post-traumatic Stress Disorder, Post-traumatic Stress Disorder Comorbid with Major Depressive Disorder, or Major Depressive Disorder

The aim of this study was to assess eventual differences in serum cholesterol, low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDLC), triglycerides, LDL-C/HDL-C ratio between veterans with combat-related posttraumatic stress disorder (PTSD) only or comorbid with major depressive disorder (MDD), veterans with combat experiences with MDD, and healthy control group. PTSD and/ or MDD were diagnose according to structured clinical interview based on DSM-IV criteria. Additional criteria to diagnose PTSD were Clinician Administered PTSD Scale (CAPS), and to diagnose MDD Montgomery-Asberg Depression Rating Scale (MADRAS). Serum lipid concentrations were determined by using the enzyme-assay method. Veterans with combat-related PTSD as well as veterans with combat-related PTSD comorbid with MDD showed significantly higher concentrations of cholesterol (F=9.858, p<0.01), triglycerides (F=10.112, p<0.01), LDL-C (F=11.145, p<0.01), and LDL-C/HDL-C ratio (F=8.346, p<0.01) vs. veterans with MDD or healthy control group. Contrary healthy control group and veterans with MDD showed significantly higher concentrations of HDL-C (F=8.421, p<0.01), vs. veterans with PTSD or PTSD comorbid with MDD. In conclusion, there are no differences in serum lipid concentrations between veterans with combat-related PTSD and PTSD comorbid with MDD, but they have higher lipid concentrations than veterans with MDD or healthy control subjects.

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.