Glycan clock of ageing-analytical precision and time-dependent inter- and i-individual variability.

Ageing is a complex biological process with variations among individuals, leading to the development of ageing clocks to estimate biological age. Glycans, particularly in immunoglobulin G (IgG), have emerged as potential biomarkers of ageing, with changes in glycosylation patterns correlating with chronological age.For precision analysis, three different plasma pools were analysed over 26 days in tetraplicates, 312 samples in total. In short-term variability analysis, two cohorts were analysed: AstraZeneca MFO cohort of 26 healthy individuals (median age 20) and a cohort of 70 premenopausal Chinese women (median age 22.5) cohort monitored over 3 months. Long-term variability analysis involved two adult men aged 47 and 57, monitored for 5 and 10 years, respectively. Samples were collected every 3 months and 3 weeks, respectively. IgG N-glycan analysis followed a standardized approach by isolating IgG, its subsequent denaturation and deglycosylation followed by glycan cleanup and labelling. Capillary gel electrophoresis with laser-induced fluorescence (CGE-LIF) and ultra-performance liquid chromatography analyses were employed for glycan profiling. Statistical analysis involved normalization, batch correction, and linear mixed models to assess time effects on derived glycan traits.The intermediate precision results consistently exhibited very low coefficient of variation values across all three test samples. This consistent pattern underscores the high level of precision inherent in the CGE method for analysing the glycan clock of ageing. The AstraZeneca MFO cohort did not show any statistically significant trends, whereas the menstrual cycle cohort exhibited statistically significant trends in digalactosylated (G2), agalactosylated (G0) and fucosylation (F). These trends were attributed to the effects of the menstrual cycle. Long-term stability analysis identified enduring age-related trends in both subjects, showing a positive time effect in G0 and bisected N-acetylglucosamine, as well as a negative time effect in G2 and sialylation, aligning with earlier findings. Time effects measured for monogalactosylation, and F remained substantially lower than ones observed for other traits.The study found that IgG N-glycome analysis using CGE-LIF exhibited remarkably high intermediate precision. Moreover, the study highlights the short- and long-term stability of IgG glycome composition, coupled with a notable capacity to adapt and respond to physiological changes and environmental influences such as hormonal changes, disease, and interventions. The discoveries from this study propel personalized medicine forward by deepening our understanding of how IgG glycome relates to age-related health concerns. This study underscores the reliability of glycans as a biomarker for tracking age-related changes and individual health paths.

Association between child/adolescent overweight/obesity and conduct disorder: A systematic review and meta-analysis.

BACKGROUND: Research findings of the association and its pattern between obesity and psychiatric/psychological comorbidities are not consistent across the types of comorbidities or the study subgroups. OBJECTIVES: We aimed to perform meta-analysis of cross-sectional studies and longitudinal studies analysing obesity as a risk factor for conduct disorder in order to assess the association between child/adolescent overweight/obesity and conduct disorder. METHODS: Systematic literature search, study selection and data extraction were performed independently by the two authors. Data were analysed by Comprehensive Meta-analysis software. RESULTS: Analysis of 13 high-quality cross-sectional studies including 79 027 children and adolescents indicated a significant association between overweight/obesity and conduct disorder among children and adolescents (OR 1.32 [95% CI, 1.18-1.49], I2 = 86.68), with no publication bias. Subgroup analyses yielded a significant difference (P < .01) between boys and girls. Analysis of four low- to moderate-quality longitudinal studies (OR 1.11 [95% CI, 0.89-1.38], I2 = 57.69) showed no prospective association between overweight/obesity and conduct disorder. Subgroup analysis according to gender revealed a significant positive association for boys and negative association for girls. CONCLUSIONS: Based on the high-quality cross-sectional data, overweight and obesity are associated with conduct disorder among children and adolescents, affecting boys more frequently than girls. Results of the longitudinal analysis indicated possible association in boys, while girls seem to be protected from conduct disorder. However, these results are very unreliable, indicating the need of well-designed longitudinal studies to elucidate the pattern of association between these disorders.

The EVOTION Decision Support System: Utilizing It for Public Health Policy-Making in Hearing Loss.

As Decision Support Systems start to play a significant role in decision making, especially in the field of public-health policy making, we present an initial attempt to formulate such a system in the concept of public health policy making for hearing loss related problems. Justification for the system's conceptual architecture and its key functionalities are presented. The introduction of the EVOTION DSS sets a key innovation and a basis for paradigm shift in policymaking, by incorporating relevant models, big data analytics and generic demographic data. Expected outcomes for this joint effort are discussed from a public-health point of view.

Malignant neoplasms of male genital organs (C60-C63) in the Osijek-Baranja County, Croatia.

Cancers of male genital organs (C60-C63) and in particular, prostate cancer, represent one of the most frequent cancer groups among males in economically developed countries and growing cancer group in developing countries. The Institute of Public Health of the Osijek-Baranja County in collaborate with different county institutes provide updated information on the cancer occurrence and trends in the Osijek-Baranja County (OBC). The aim of this article is to provide information on the tendencies relating to this cancer group in the OBC during the period from 2001 to 2009, which will be the first report on these cancer sites on a county level in Croatia. This article processes data on cancer incidence and mortality, appertaining age distribution, median age at diagnosis and at death, cancer survival and length of stay in hospital in the OBC. From 2001 to 2009, a total of 891 males were diagnosed with cancers of male genital organs and treated in either of the two OBC hospitals. These cancers accounted for 6.2% of all registered cancers and for 12.5% of all registered cancers among males. Overall age-standardized incidence rate was 60.9/100,000 and it growing strongly during the nine-year period. Although the mortality rate increased too (overall rate was 30.5/100,000), the increase was not as huge as the one in the rate of incidence. Overall median ages at diagnosis and at death were 67.1 years and 74.6 years, respectively. The 5-year relative survival rate was estimated to be 53.4%. This report reveals weak reduction in the average length of stay in hospital per patient in the 9-years period (from 11.8 to 11.3 days) and at the same time, the number of admissions almost tripled (from 84 to 221), which is a consequence of the same rise in the number of newly registered cases. During the course of the illness, an average patient was hospitalized 1.6 times and the average length of hospital care was 11.0 days. All the indicators of the quality of the health care provided to C60-C63 cancer patients in the OBC suggest that further advancement in raising the level of diagnostics and treatment should and can be expected in order to reach the corresponding EU standards. An increased incidence and mortality rate from C60-C63 cancers leads to the conclusion that great efforts should be invested into raising the awareness of the male population over 45 years of age on the recognition of the first symptoms of this cancer group and on early preventive examination as to decrease the mortality rate and increase the survival rate and the quality of life of patients suffering from this cancer group.

Prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus strains isolated in a multicenter study of nursing home residents in Croatia.

BACKGROUND: Residents of nursing homes (NHs) are often hospitalized and could present a potential reservoir for methicillin-resistant Staphylococcus aureus (MRSA). The aim of the study was to determine the prevalence for MRSA carriage in residents and staff in Croatian NHs and to characterize MRSA strains using genotyping techniques. METHODS: A cross-sectional study was performed among 877 residents and staff of 7 NHs representing 3 major Croatian regions. Nasal swabs from residents and staff and other samples from residents with invasive devices were obtained. Identified isolates were submitted to susceptibility testing and genotyping with SCCmec typing, S aureus protein A (spa) locus typing, and pulsed-field gel electrophoresis (PFGE). RESULTS: The overall prevalence of MRSA colonization was 7.1% (95 confidence interval, 5.4%-8.8%), ranging from 0% to 28.8%. Four MRSA isolates were found in NH staff. All MRSA isolates were negative for Panton-Valentine leukocidin-encoding genes. SCCmec type II was found in 32 MRSA strains; SCCmec IV, in 27 strains; SCCmec I, in 3 strains. The predominant spa type was t008, found in 49 strains; PFGE analysis revealed 2 major clonal groups. CONCLUSIONS: MRSA strains were found to be colonizing residents and staff of 7 NHs in Croatia. Our study demonstrates the spread of 2 clones within and among Croatian NHs. The data presented here provide an important baseline for future surveillance of MRSA in NH.

Mosquito survey during West Nile virus outbreak 2012 in northeast Croatia.

During the August and September 2012, seven human cases of the West Nile neuro-invasive disease were reported in Croatia. Medical entomology research on a potential vectors during the outbreak was supported by the Ministry of Health. A mosquito survey has been done in 64 sites in three eastern Croatian counties (Osijek-Baranja County, Vukovar-Srijem county and in Brod-Posavina county). Dry ice baited CDC traps were used for mosquito sampling in a period from the 10th to 25th September 2012. A total of 1785 mosquitoes were collected and 5 species were determined. The most numerous species were Aedes vexans with 1634 specimens, a Culex pipiens c., the potential vector of WNV, was present with 6.39%, in 114 specimens. That species was present in 43 out of 64 investigated sites. Vector control included both the control of mosquito larvae and the adults. Treatments have been done on 184 small breeding sites and on 2900 ha of an urban area.

Malignant neoplasms of respiratory and intrathoracic organs (C30-C39) in the Osijek-Baranja County, Croatia.

The Institute of Public Health of the Osijek-Baranja County in collaborate with different county institutes provide updated information on the cancer occurrence and trends in the Osijek-Baranja County (OBC). The cancers were defined according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), codes of malignant neoplasms of respiratory and intrathoracic organs (C30-C39). The aim of this article was to show the size of cancer problem with the C30-C39 cancer group in the Osijek-Baranja County (OBC). This article processes data on cancer incidence and mortality, appertaining age distribution, median age, cancer survival and length of stay in hospital collected in period 2001-2009. Out of all patients diagnosed with C30-C39 cancers, there were 18.2% of females and 81.8% of males. The total incidence rate in males (119.5/100,000) decreases while the total mortality rate (110.9/100,000) does not change in 9-year period. In the same period, the total mortality rate in females (15.7/100,000) increase moderately. The age-standardized incidence rate was six times higher in males than in females. The overall median age at diagnosis of C30-C39 cancers of both genders was 64.5 years, which exceeds the average age at diagnosis of cancer in general in the OBC by 4.8 years. Five-year relative survival rate was 14.8%, 19.7% for females and 13.7% for males. Male lung and bronchus cancer patients (C34) were 1 year younger at diagnosis of cancer than the respective female patients. An average C30-C39 cancer patient was hospitalized 2.0 times during the course of their illness while the median length of stay in hospital amounted to 16.1 days. The number of hospital admissions in both genders decreased over the 2001-2009 period. In both genders, the total length of stay in hospitals was slightly reduced. Females spent 0.4 days more in hospital than males. The overall incidence and mortality rate in the OBC were among the highest in Europe. However, these rates in females reached neither the Croatian nor the EU average. Other data are similar to those in Europe.

The burden of hospitalised carcinoma patients in Osijek-Baranja County, Croatia, 1998-2010.

The purpose of this paper was to determine the number and trend of hospitalisations caused by carcinoma in the Osijek-Baranja County, to to determine the proportion of these hospitalizations compared to all other hospitalization, as well as to determine the burden put on the hospitals by external patients (those not residing in the Osijek-Baranja County area). There has been an average of 10.1% of hospitalisations caused by carcinoma in the Osijek-Baranja County from 1998 to 2010. In the aforementioned period there have been an average 15.9% days of hospitalisation caused by carcinoma. Patients hospitalised due to carcinoma stay in hospital 5.3 days longer than other patients. The number of hospitalisations as a whole, as well as those due to carcinoma, is rising, while the number of days of hospitalisation per patient is decreasing. The number of hospitalisations which refer to men is slightly higher than for women (51.2%:48.8%). Almost one third of patients hospitalised are not residents of the Osijek-Baranja County due to a gravitational hospitalisation instance. Residents of northern Bosnia and Herzegovina are the most common patients being treated in our county. This burden has to be taken in to account when planning our health care due to the geographically, economically and politically specific situation of Osijek-Baranya County. This data has to be taken in to account when further planning our health care, as to relieve the acute medical situation hospitals of some of their burden, as well as to provide adequate care to patients suffering chronically from carcinoma. It is especially important to stress out that our county does not have a palliative care facility, nor a hospice for the terminally ill.

Malignant neoplasms of digestive organs (C15-C26) in the Osijek-Baranja County, Croatia.

The Institute of Public Health for the Osjek-Baranja County (OBC) has processed the data on cancer patients that were collected from mandatory county hospitals data reports, county bureaus of statistics and the County Register of Deaths. The cancers were defined according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), codes of malignant neoplasms of digestive organs (C15-C26). The aim of this article is to show the size of the problem and the burden of the health care system caused by cancers of the digestive system (C15-C26) in the OBC in the period 2001-2006. This article deals with cancer incidence and mortality data, appertaining age distribution, cancer survival, median age at diagnosis and at death and length of stay in hospitals. The overall incidence and mortality rate from cancer group C15-C26 (101.1 and 80/100,000, respectively, EU standard population) declined in all age groups, comparing the data originating from the 2001-2003 period to the data referring to the 2004-2006 period. The median age at diagnosis of cancer was 67.8 years with a shift of 0.91 year up in second period (the median age in the first period was 67.3 years and in the second one 68.2 years). The median age at diagnosis of cancer in females was 69.7 years while in males was 66.3 years, which represents a difference of 2.9 years in favour of females. The overall relative survival rate of all ages was 23.6%. This figure was slightly bigger for females (24.3%) than for males (23.1%). Concerning all age groups, the number of hospital admissions of males increased during the observation period while the number of hospital admissions of women decreased at the same time. The average length of stay over the six years did not changed significantly. Group of cancer C15-C26 was the most common group of cancers regarding both genders. The five-year relative survival as one of the reliable benchmarks of the quality of the health care system needs to be raised to a great extent in order to come nearer to the EU average within a short period of time.

Malignant neoplasms of breast and female genital organs (C50, C51-C58) in the Osijek-Baranja County, Croatia.

Breast cancer (C50) and neoplasms of female genital organs (C51-C58) represent one of the most frequent cancer groups among females in economically developed countries. The Institute of Public Health of the Osijek-Baranja County in collaboration with different county institutes provide updated information on the cancer occurrence and trends in the Osijek-Baranja County (OBC). The aim of this article is to provide information on the tendencies relating to these cancer groups in the OBC during the period from 2001 to 2009, which will be the first report on these cancer sites on a county level in Croatia. This article processes data on cancer incidence and mortality, appertaining age distribution, median age, cancer survival and length of stay in the county hospitals collected in period 1996-2010. In the OBC, the overall incidence rates of breast, cervix uteri, corpus uteri and ovary cancer were, using the EU standard population, 82.9, 13.0, 19.0 and 14.5/100,000, respectively, and are all characterized by a declining tendency in the second period except breast can- cer. The overall breast incidence rate resembles the Croatian average and way exceeds the corresponding Central and Eastern Europe incidence rates, but is still bellow the Northern Europe ones. Also, the overall mortality rates of breast, cervix uteri, corpus uteri and ovary cancer were 29.6, 5.0, 8.1 and 9.6/100,000, respectively, and are all featured by a increasing tendency. The cancer 5-year relative survival rate from breast, cervix uteri, corpus uteri and ovary cancer in period 2001-2005 amounted to 64.2%, 66.1%, 57.4% and 43.0%, respectively. The overall median ages at diagnosis of breast, cervix uteri, corpus uteri and ovary cancer totalled 61.9, 56.4, 66.4 and 60.8 years, respectively, while the median ages at death from these cancers were 68.7, 65.7, 70.3 and 67.6 years, respectively. During the entire 9-year period, the average length of stay in hospital due to breast, cervix uteri, corpus uteri and ovary cancer were 12.1, 14.8, 18.5 and 11.3 days, respectively. The length of stay in hospital decreased for all but for ovary cancer. Implementation and consolidation of women's awareness of these cancers and relating early diagnostic activities within the OBC population seem to be the most effective ways to reduce the appertaining risks and thus to encourage changes in the lifestyle.

First six years of implementing colorectal cancer screening in the Osijek-Baranja County, Croatia--can we do better?

The primary goal of this paper is to evaluate the efficiency of the Colorectal Cancer Screening Program in the Osijek-Baranja County. The screening method for early detection of colorectal cancer was the guaiac Faecal Occult Blood Test (gFOBT) and colonoscopy for gFOBT positive finding. The target population were asymptomatic subjects at average risk, aged 50-74. The responding rate was 20.3% (14.9% of men and 19.3% of women). The percentage of gFOBT positive tests was 8.5% (11.2% of men and 6.6% of women). From the 1,657 individuals who were invited to further assessment (884 men and 773 women), 1,157 underwent a colonoscopy exam (649 men and 508 women). We can conclude that the response to FOBT in our county was extremely poor. 83 carcinomas were found, with almost double findings among men than among women. Our population has a significantly higher number of men with malignant and premalignant changes when compared with women. Considering the higher incidence among men, as well as an increase in incidence in the entire population, we have to take care that our public health programmes are being created with this taken into account, as to increase the response rate, especially among those with a higher risk of developing a disease.

West Nile virus outbreak in humans in Croatia, 2012.

During August and September 2012, seven cases of West Nile neuroinvasive disease were identified in three north-eastern counties of Croatia. Four cases were reported in Osijek-Baranja County, two in Brod-Posavina County and one in Vukovar-Srijem County. The median age of the patients was 62.7 years. All patients were hospitalized for 2-5 weeks. The patients from Slavonski Brod had more severe clinical presentation of disease with prolonged hospitalization. Medical entomological research was carried out in 64 localities, where 1785 mosquitoes were captured. Among the analyzed mosquitoes, 114 were determined to be Culex pipiens and subjected to molecular characterization for the presence of virus. No viral RNA was detected in mosquitoes. Subsequent public health measures taken include mosquito control in all settlements where disease was detected.

Polymorphisms of interleukin-23 receptor in patients with inflammatory bowel disease in a Croatian tertiary center.

The Interleukin-23 signalling pathway is important for the differentiation of TH17 lymphocytes and is involved in the pathogenesis of Inflammatory bowel disease. Polymorphisms in the IL-23 receptor gene were previously found to be associated with Inflammatory bowel disease in various populations. The aim of this study was to determine whether the specific rs11209026 and rs7530511 single-nucleotide polymorphisms in the Interleukin-23 receptor gene are associated with Crohn's disease and ulcerative colitis in a Croatian patient population. A total of 50 patients with Crohn's disease and 93 patients with ulcerative colitis, as well as 99 healthy control subjects were included in the study. The results determined a significantly higher occurrence of rs11209026 in control group compared to patients with inflammatory bowel disease, suggesting a protective effect of this polymorphism. The rs11209026 variant was strongly associated with Crohn's disease, but it was absent in ulcerative colitis. However, there was no significant association between the rs7530511 polymorphism with either ulcerative colitis or Crohn's disease. Associations presented in this study give potentially important insight into the roles of specific Interleukin-23 receptor polymorphisms in Crohn's disease pathogenesis in the Croatian population.

Neoplasms (C00-D48) in Osijek-Baranja County from 2001 to 2006, Croatia.

The Institute of Public Health of the Osijek-Baranja County has processed the data on cancer patients that were collected from mandatory county hospitals data reports, county bureaus of statistics and the County Register of Deaths. The cancers were defined according the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), codes of malignant neoplasms (C00-C97), in situ neoplasms (D00-D09) and neoplasms of uncertain or unknown behaviour (D37-D48). The aim of this article was to show the size of the cancer problem in Osijek-Baranja County (OBC) according to the all ICD-10 cancer groups. The cancer incidence and mortality estimated in period 2001-2006 were prepared for all cancers based on gender and for age groups 0-19, 20-44, 45-64, 65+ by the year of the first diagnosis of cancer. The median age at cancer diagnosis was 62.7 years, 61.2 years for females and 64.1 years for males. Applying the EU age-standardized rate, the average annual incidence and mortality rates in the OBC were 411.6/ 100,000 and 240.7/100,000, respectively. The incidence rates in both genders were highest for neoplasms of digestive organs (C15-C26), respiratory and intrathoracic organs (C30-C39) and for breast (C50) (101.1, 63.6 and 44.3/100,000, respectively). The first two groups of cancer in both genders were also the leading groups of cancer in males (141.6 and 124.9/100,000). The third position in males belonged to neoplasms of male's genital organs (C60-C63, 58/100,000). The leading group in females was C50 (79.3/100,000), followed by groups C15-C26 (73.2/100,000) and in situ neoplasms (D00-D09) (51.4/100,000). The course and shape of mortality rate in the whole corresponded to the incidence rate, but at the lower level. The only exception referred to group C15-C26 (56.8/100,000) as leading mortality cancer group in females. The overall 5-year relative survival was 40.1%. Considering females, this rate amounted to 48.8% while this figure was much lower in men--32.4%. In age group 65+, 52.6% of cancer patients developed a cancer and 65.4% of patients died at the same age. These basic parameters indicate that the OBC must put great efforts in creating a long-term strategy for cancer prevention and early diagnostics in order to prolong life and improve the quality of life of cancer patients and raise the proportion of 5-year survival.

Prevalence and risk factors for herpes simplex virus type 2 infections in East Croatia.

The aim of the study was to establish the seroprevalence of herpes simplex virus type 2 (HSV-2) among sexually active adults from East Croatia and to evaluate its correlates with demographic and behavioural risk factors. This cross-sectional study was conducted from the 1st June until the 30th September 2005 at the Department of Transfusion Medicine, Osijek University Hospital Center. The study included 423 blood donors composed of 366 (86.5%) men and 57 (13.5%) women. Demographic data and data on the risky sexual behaviour during the lifetime were collected with usage of an anonymous questionnaire consisting of 15 questions. Western blot testing revealed that 3.3% (14/423) subjects were positive for the presence of IgG antibodies to herpes simplex virus 2, i.e. 10 (2.7%) men and 4 (7.0%) women. A higher HSV-2 seroprevalence was associated with female sex, older age, marital status (with single subjects been under the greater risk), irregular condom use on sexual intercourses with new partners and with higher number (five or more) of sexual partners during lifetime. Among determined risk factors in the study population, only the connection between the HSV-2 positivity and the older age was statistically significant. The study has showed that the demographic rather than the behavioural risk factors are associated with higher prevalence of HSV-2 antibodies in the observed population.

Cross-sectional biomonitoring of metals in adult populations in post-war eastern Croatia: differences between areas of moderate and heavy combat.

AIM: To determine differences in metal and metalloid exposure between residents of areas in eastern Croatia exposed to heavy fighting during the war in Croatia and residents of areas exposed to moderate fighting. METHODS: Concentrations of aluminum (Al), arsenic (As), barium (Ba), cadmium (Cd), chromium (Cr), copper (Cu), iron (Fe), nickel (Ni), lead (Pb), uranium (U), vanadium (V), and zinc (Zn), reported to be associated with military operations, were determined in hair, serum, and urine samples using inductively-coupled plasma mass spectroscopy. A total of 127 and 46 participants from areas of heavy and moderate fighting, respectively, were included. RESULTS: Compared with participants from areas exposed to moderate fighting, participants from areas exposed to heavy fighting had significantly higher serum concentrations of Al (87.61 vs 42.75 µg/L, P=0.007), As (5.05 ∓ 1.79 vs 4.16 ∓ 1.55 µg/L, P=0.003), Ba (7.12 vs 6.01 µg/L, P=0.044), and V (17.98 vs 16.84 µg/L, P=0.008); significantly higher urine concentrations of As (43.90 vs 11.51 µg/L, P<0.001) and Cd (0.67 vs 0.50 µg/L, P=0.031); and significantly higher hair concentrations of Al (12.61 vs 7.33 µg/L, P<0.001), As (0.32 vs 0.05 µg/L, P<0.001), Cd (0.03 vs 0.02 µg/L, P=0.002), Fe (22.58 vs 12.68 µg/L, P=0.001), Pb (1.04 vs 0.69 µg/L, P=0.006), and V (0.07 vs 0.03 µg/L, P<0.001). CONCLUSION: Differences between populations from eastern Croatian areas exposed to heavy and populations exposed to moderate fighting point to the need for extensive monitoring of metal and metalloid exposure, emphasizing the role of biomonitoring through ecologic and preventive activities.

Prevalence and risk factors of alcohol abuse among university students from eastern Croatia: questionnaire study.

The aim of the study was to examine the prevalence of alcohol abuse among university students in Osijek, Croatia and its possible interconnections with gender, year of study, repetition of year of study, faculty subject area, sources of financing and type of residence during study. A validated questionnaire was self-administered to cross-faculty representative student sample of "J. J. Strossmayer" University of Osiek in June 2006. General demographic data, as well as data on academic features and student socio-economical status were obtained. The Alcohol Use Disorders Identification Test (AUDIT) was used for assessing the extent of alcohol consumption, with cut off value of 8 indicating possible alcohol problems. The majority of study participants 90.9% (755/831) had tried alcohol at least once in their life. Among this group, 43.8% (331/755) had an AUDIT total score of 8 or more: 69.2% (229/331) were males and 30.8% (102/331) were females. Among the study participants who screened positive, 70.4% (233/331) responded positively to simple advice focused on the reduction of hazardous drinking (AUDIT 8-15), 14.5% (48/331) needed brief counseling and continued monitoring (AUDIT 16-19), and 15.1% (50/331) clearly warranted further diagnostic evaluation for alcohol dependence (AUDIT 20 and above). Significantly different statistical data was found within the following factors: gender, repetition of year of study, faculty subject area and type of residence (chi2 = 76.232, p = 0.0000; Fisher exact test = 31.828, p = 0.0000; chi2 = 11.667, p = 0.0086 and chi2 = 6.639, p = 0.0362 respectively). Alcohol consumption resulting in risk behaviors is common among university students from eastern Croatia. These findings emphasize the need for comprehensive and effective preventative strategies directed towards student population.

Effect of aminglycoside administration on the occurrence and multiplication of resistant bacteria.

In the prospective study the susceptibility of 41 Escherichia coli strains and 55 Pseudomonas aeruginosa strains to gentamicin, netilmicin and amikacin was tested at a 2-year interval (period I April 1998 to March 1999, and period II April to July 2001). Genotyping was performed by pulsed-field gel electrophoresis, and a clone based on 80% or 90% similarity was determined for each of the study bacteria. In 24 (32.0%) clones, strains showed no variation over 2-year interval, supporting the hypothesis on a priori susceptible strains. Transformation from susceptibility in period I to resistance in period II was demonstrated in 5 (6.7%) clones, a pattern consistent with the concept of bacterial development of resistance under the influence of antibiotics. However, there were 10 (13.3%) clones whose strains exhibited an inverse pattern. Accordingly, two-way transformation of susceptibility took place during the study period. The utilization of the study aminoglycosides had no major impact on the variation of microbial susceptibility. Changes in microbial susceptibility were found to follow some regular patterns, which were not influenced by the study aminoglycosides. Two phenomena were observed: (i) there were stable clones that did not develop resistance in spite of selective antibiotic challenge; and (ii) changes of susceptibility in isolated bacteria from both inpatient and outpatient strains of the same clone were two-way and reversible.

The characteristics of sexual behavior and extent of condom usage among sexually active Croatians from Eastern Croatia.

OBJECTIVE: To determine the extent of condom usage as a method of protection from sexually transmitted infections (STIs) among sexually active individuals obliged to present for periodical health examination at the Institute of Public Health for the Osijek-Baranya County, in Osijek, eastern Croatia. MATERIAL AND METHODS: During February 2004, a cross-sectional questionnaire survey was conducted. The research tool was an unidentified 20-item questionnaire addressing the sexual behavior of study subjects and their partners and methods of protection from STIs. Descriptive statistics and χ(2) - test were used for data analysis. RESULTS: The response rate was 84.2% (278/330). A total of 278 subjects, 96 (34.5%) males and 182 (65.5%) females, 167 (60.1%) married and 111 (39.9%) single, mean age 31.3±8.4, age range 18-52 years were enrolled in the study. Study results revealed 22.3% (62/278) subjects to have had two or more sexual partners over the one-year period and the use of condom was reported by 40.3% (25/62) of those subjects. CONCLUSIONS: The obtained results point to the need for additional education on protection from sexually transmitted infections and on risky sexual behavior, with special reference to the role of condom usage in the prevention of these diseases and their detrimental effects on the reproductive health of sexually active individuals.

Demonstrating reduced environmental and genetic diversity in human isolates by analysis of blood lipid levels.

AIM: To test the hypothesis that phenotypic diversity in isolated human populations is decreased in comparison with general outbred population because of reduced genetic and environmental diversity. To demonstrate this in populations for which reduced genetic and environmental diversity had already been established, by studying the amount of variation in plasma lipid levels. METHODS: Fasting plasma lipid levels (cholesterol, triglycerides, low density lipoprotein [LDL], and high density lipoprotein [HDL]) were measured in randomly selected 300 inhabitants from 2 isolated human populations, the island of Rab and the neighboring islands of Vis and Lastovo, Croatia. The populations were chosen based on previous analyses of genetic diversity and lifestyle patterns, which were shown to be both less diverse and more uniform than the general Croatian population. We studied whether the 25'-75' and 5'-95' interpercentile ranges in observed values were consistently smaller in 2 samples of 300 examinees from isolated populations in comparison with nearly 6000 examinees from an earlier study who were demographically targeted to represent the larger Croatian population. RESULTS: General population had much wider range of observed values of triglycerides and HDL than both isolated populations. However, both isolated populations exhibited greater extent of variation in the levels of LDL, while the ranges of cholesterol values were similar. CONCLUSION: Although reduced genetic and environmental diversity in isolated human populations should necessarily reduce the variance in observed phenotypic values, it appears that specific population genetic processes in isolated populations could be acting to maintain the variation. Departure from the Hardy-Weinberg equilibrium due to consanguinity, sub-structuring and differentiation within the isolates, and increased rate of new mutations could theoretically explain this paradox.