Gender differences in specific trends of COPD mortality in Croatia.

OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is one of the most common lower respiratory chronic diseases. The aim of this study was to analyze the COPD mortality trends in Croatia for the period 2010-2019 and to identify possible changes and differences by age group and gender. STUDY DESIGN AND METHODS: In data analysis were included COPD death cases for the period 2010-2019 defined as ICD-10 code J44.0 - J44.9. Mortality data were obtained from the Croatian Institute of Public Health based on death certificates. To model temporal changes in mortality rates joinpoint regression analysis was carried out. RESULTS: The number of COPD deaths increased in men from 878 in 2010 to 1083 in 2019 and in women from 520 in 2010 to 737 in 2019. Over the 10-year period, there was a stable age-standardized COPD mortality rate among men and statistically significant increasing age-standardized COPD mortality rate among women at the national level. CONCLUSIONS: The findings show a narrowing of the gender gap of COPD mortality. Observed higher COPD mortality rates with age in both men and women confirm previous data and imply that the number of COPD deaths will continue to increase in the future. The healthcare system should focus on the improvement of the quality of care and investment in health promotion and prevention programs aimed at reducing risk factors for COPD, especially tobacco smoking, as well as raising awareness and knowledge about COPD as a chronic disease.

Unusual way of loosened total hip arthroplasty treatment with an Austin Moore endoprosthesis.

A 65-year-old female patient with aseptic loosening of total cemented hip endoprosthesis and pathologic fracture of the femur at the level of the stem of endoprosthesis was presented. As no appropriate endoprosthesis was available due to the war in Croatia and war priority, the problem was managed by femur osteosynthesis and implantation of a partial Austin Moore hip endoprosthesis. The endoprosthesis is still functioning well (for 20 years).To the best of the author's knowledge, nobody has ever treated problem like this using this alternative, an unconventional method, with an Austin Moore endoprosthesis.

The incidence and seasonal variations of acute primary angle-closure glaucoma.

The incidence and seasonal variations of acute primary angle-closure glaucoma (APACG) was studied. It was based on a retrospective chart review of 121 hospital patients in Split, Croatia for the fifteen-year period from 1985 through 1999. The average incidence was 4.1 cases per 100,000 per year in the total population and 7.1 per 100,000 in those aged 30 years and older. APACG affects women almost twice more often than men. The incidence rate increased with age. No seasonal variations in the occurrence of APACG and no correlation with the mean duration of light exposure per season were found.

Increased incidence of colorectal cancer in the split-dalmatia county: epidemiological study.

AIM: To investigate the incidence of colorectal cancer in the Split-Dalmatia County in the 1981-1998 period, and compare it with the incidence in the Republic of Croatia. METHODS: The data were obtained using case records and registries of all hospitals and Public Health Institute in the County and the Croatian Cancer Registry. Age-standardized incidence per 100,000 was calculated from the number of patients with colorectal cancer and the number of inhabitants. RESULTS: There were 2,454 new cases of colorectal cancer (1,383 men and 1,071 women) in the Split-Dalmatia County in 1981-1998. Colon cancer was diagnosed in 55% of the cases. Age-standardized incidence rates for colorectal carcinoma per 100,000 population were 11.4 (men 14.8, women 9.0) in 1981, and 63.5 (men 93.1, women 42.5) in 1998. The total incidence increased from 16.1 (colon cancer 7.9, rectal cancer 8.2) in 1981-1985 period to 52.8 (colon cancer 30.5, rectal cancer 22.3) in 1994-1998 period, or approximately 3.3 times. The colorectal cancer incidence rate in the Split-Dalmatia County increased from 16.2 in 1985 to 46.4 in 1995, and in whole Croatia from 32.4 in 1985 to 37.8 in 1995. CONCLUSION: There was a great increase in the reported incidence of colorectal cancer in the Split-Dalmatia County in the 1981-1998 period. The relative increase of incidence in the colorectal cancer was much greater in the Split-Dalmatia County than in Croatia as a whole. These changes call for preventive and screening measures for colorectal carcinoma.

Recurrent posterior dislocation following primary posterior-stabilized total knee arthroplasty.

In our series of 136 patients with primary total knee arthroplasty using posterior-stabilized prosthesis, a female patient with Parkinson disease developed posterior dislocation of the knee 9 months after surgery. Eventually, the dislocation became recurrent, occurring several times a day. The patient made the reposition always by herself. Two months after the first dislocation, we performed the revision of the polyethylene tibial insert and found wearing of the tibial insert's cam as an hitherto unreported cause of the mechanical instability of the total knee prosthesis.

Electrochemical study of cefetamet-Na and its polarographic determination.

Polarographic behavior of cephalosporin cefetamet-Na (Cef-Na) in aqueous solutions of pH ranging from 1.7 to 12.5 was investigated by applying direct current (dc) polarography, differential pulse polarography (dpp), alternating current (ac) polarography, cyclic voltammetry and electrolysis at constant potential. The characteristics of the corresponding electrode reaction are presented and discussed. The electrode reaction was found to be affected by strong adsorption, strongly and slightly pronounced in acidic and alkaline media, respectively. The methoxyimino group electroreduction was carried out and the mechanistic scheme was suggested. In addition, a sensitive dpp method was proposed for analytical determination of a very low concentrations of Cef-Na.

[Results of treatment of hip joint prosthesis-related infections]. / Nasi rezultati lijecenja inficiranih endoproteza kuka.

The article present results of the operative treatment of deep infections in the hip joint prostheses. Ninetieth patients treated from 1980 through 1998 were analysed. Gram-positive organisms were found in 65% of the cases and gram-negative in 35%. Staphylococcus aureus were isolated in 50% of the cases. The two-stage reimplantation procedure is performed in four patients. Excellent results were reported in three patients, and poor results in one patient. The Girdlestone pseudarthrosis as a definitive procedure is performed in fifteen patients. Good results were reported in two patients, fair results in twelve, and poor results in one patient. The mean shortening of the limb was 4.5 cm. The infection were controlled in 93% of the cases. Better functional results are obtained by the two-stage reimplantation than the Girdlestone pseudarthrosis, though is an acceptable method of controlling infection.

[The treatment of Dupuytren's contracture by partial fasciectomy]. / Lijecenje Dupuytrenove kontrakture djelomicnom fascijektomijom.

The authors present their own experience in the treatment of Dupuytren's disease. From 1977 until 1991, 102 patients were treated with partial palmar and digital fasciectomy. Postoperative complications occurred in 16 (15.68%) cases: infection in 1 (0.98%), skin necrosis also in 1 (0.98%), hematoma in 6 (5.88%) and postoperative stiffness of the hand in 8 (7.84%). Excellent postoperative results were reported in 61 patients (59.8%), good results in 37 (36.3%) and poor results in 4 (3.9%). Twenty-three patients were followed-up. There were 9 recurrences (39.1%) and 11 extensions of the pathologic process (47.8%). In summary, we feel Dupuytren's contracture can be controlled and the patient's hand function can be improved by partial fasciectomy.

Polarographic investigation of beta 2-microglobulin and ferritin thermal denaturation.

A temperature dependence of the corresponding signals, obtained by differential pulse (d.p.) and alternating current (a.c.) polarography, from a buffered aqueous solution of ferritin and beta 2-microglobulin is used for the characterization of a protein thermal denaturation process. The method is based on the significant differences in the interaction of folded and unfolded protein forms with a dropping mercury electrode due to a different accessibility, for the redox process, of protein electroactive groups. From the analysis of the resulting current, or capacitance, signals in function of temperature the thermal transition reversibility of different protein forms in the solution, protein melting points, and the apparent activation energies of the corresponding processes were determined.

[Treatment of femoral neck fractures with bipolar hemiarthroplasty]. / Lijecenje prijeloma vrata femura bipolarnom hemiartroplastikom.

The aim of the study was determine the effectiveness of treatment with bipolar prosthesis in elderly patients with the femoral neck fractures. Patients admitted from 1980 through 1994 were analysed. Over this period, a total of 152 hip joint bipolar prostheses were implanted. Postoperative complications occurred in 9.2% of cases (luxations of endoprostheses 2.63%, loosening of the femoral component 1.31%, infections 2.63%, intrahospital mortality 1.31%, fractures of the endoprosthetic stem 0.65% and fracture of the polyethylene cup 0.65%). Ten (6.5%) hips required revision surgery. Twenty eight patients were followed-up. Excellent results were reported in twenty-three patients (82.1%), good results in four (14.3%), and fair results in one patient (3.6%). There were no poor results. In summary, we feel that bipolar hemiarthroplasty is the method of choice in elderly patients with femoral neck fractures.

Congenital elevation of the scapula (Sprengel's deformity).

A case of Sprengel's deformity (congenital elevation of the scapula) in a 4-year-old boy, with a major cosmetic defect and compromised shoulder function, especially on abduction, is presented. The boy was operated on by Green's technique, with excellent cosmetic and functional result. Although Woorward's operative technique has generally been preferred in the treatment for Sprengel's deformity, the result obtained showed Green's procedure to be a satisfactory choice in this patient.

[Results of surgical treatment of congenital muscle torticollis]. / Nasi rezultati kirurskog lijecenja prirodenog misicnog tortikolisa.

The article present results of the operative treatment of congenital muscular torticollis at the Department of Orthopaedics, Clinical Hospital Split from 1950 to 1995. 197 patients were operated and in 1995 50 patients responded for the follow-up. Our results confirm that the best results are obtained by open distal tenotomy of the sternocleidomastoid muscle after the first year of life. Children older than six years need bipolar tenotomy, and the results are poorer than in those operated in the first six years of life.

Primary wound closure in war amputations of the limbs.

We have reviewed 75 amputees, 58 in the lower limb and 18 in the upper. Closed amputation was performed in 69 patients (92%) and an open procedure in six (8%). Wound infection occurred in six (8%) and one patient died from thromboembolism. Wound healing was normal in the remainder. The results of closed amputation in war conditions are very good, if performed within 6 hours of injury.

War injuries to the extremities.

AIM: The authors present their own experience in the treatment of war injuries to the extremities during the war in Croatia and in Bosnia and Herzegovina. METHOD: From November 1991 until April 1994, 186 patients with war injuries to the extremities were treated. Treatment began with first aid offered at the battlefield, followed by transport of patients to war hospitals, and transfer of the most severe cases to the rear hospital (Split University Hospital). RESULTS: Isolated injuries to the extremities were present in 155 patients (83%), 38% of them with injuries to soft tissues of the extremities and 62% with both soft-tissue injuries and bone fractures. Associated minor injuries to the other parts of the body were present in 31 patients (17%). Amputation of the extremity was performed on 22.5% of the patients. All fractures were treated by external fixation, whereas soft-tissue lesions were managed by debridement and excision of the damaged tissue, with compulsory antibiotic and antitetanic therapy. The rates of mortality and infection were 0.5 and 6.4%, respectively. CONCLUSION: Our experience emphasizes the importance of field hospitals in timely and adequate treatment of war wounds to the extremities. Treatment of the wound by a trained professional within 2 hours after wounding saved many lives and extremities. The patients were only rarely referred to the rear hospital.

Spectrophotometric and polarographic investigation of the Ofloxacin-Cu(II) complexes.

By means of spectrophotometric methods it was found that ofloxacin reacts with copper(II) ions to form complexes with molar ratios of ofloxacin: Cu(II) of 1:1 at pH 4.00, 2:1 at pH 7.02 and 3:1 at pH 8.30. The stability constants of the complexes were determined. The formation of ofloxacin:Cu(II) 1:1 and 3:1 complexes was confirmed by a polarographic method and the corresponding overall stability constant was evaluated.

Determination of very-long-chain fatty acids in plasma by a simplified gas chromatographic-mass spectrometric procedure.

The concentration of very-long-chain fatty acids (VLCFA) (straight chain, more than 22 carbon atoms) in plasma or in cultured fibroblasts is one of the most important diagnostic criteria for the diagnosis of the peroxisomal disorders. A sensitive method for VLCFA assay in plasma, using small sample volume and a simplified procedure, is described. After adequate extraction and derivatization, methyl esters of VLCFA are separated, identificated and quantified by gas chromatography-mass spectrometry (GC-MS). The method is sensitive, reproducible, accurate and relatively simple. GC-MS equipment used for routine organic acid analysis can be used.