Emotional and physical abuse in family: survey among high school adolescents.

AIM: To determine the prevalence of different forms of child abuse among high school pupils in Slavonski Brod, Croatia. METHOD: The study included 2140 first and fourth-grade pupils aged between 14 and 18 years from all 10 high schools in Slavonski Brod and the area (4 grammar and 6 vocational schools). The pupils were asked to complete an anonymous structured questionnaire during a 45-minute class. The questionnaire, developed for the needs of this study, collected basic demographic data on family life and experience of emotional or physical abuse. RESULTS: First-grade pupils were more satisfied with their family life than fourth-grade pupils (96.9% vs 91.3%, P<0.001, chi(2) test). The feeling of being insufficiently loved or unloved was reported by 17.5% of the first-grade and 24.6% of the fourth-grade pupils and a greater percentage of pupils whose parents were divorced or who had a step-parent. Almost 80% of pupils had been verbally or nonverbally punished for disobedience. Emotional abuse was significantly associated with female sex (Nagelkerke R(2)=0.87, beta=0.474, P=0.028), younger age (beta=1.263, P<0.001), and alcoholism in the family (beta=2.037, P<0.001. Physical punishment for disobedience was reported significantly more often by first-grade than fourth-grade pupils (15.6% vs 12.9% P=0.021, chi(2) test). Physical abuse was significantly associated (Nagelkerke R2=0.69) with younger age (Beta=0.379, P<0.012), emotional abuse (Beta=0.665, P<0.002), alcoholism in the family (Beta=1.791, P<0.001) and the lack of parental love (Beta=-0.645, P<0.001). Possible sexual molestation was admitted by 6.0% boys and 3.3% girls. CONCLUSION: Most high school pupils in Slavonski Brod were satisfied with their life at home. Disobedience was usually punished verbally or by aggressive behavior of the parents. Physical punishment was less common and usually did not result in serious injuries.

Increasing rate of childhood tuberculosis in a region of east Croatia.

BACKGROUND: The incidence of childhood tuberculosis as well as the number of children being in contact with persons having tuberculosis has increased in the region of Slavonski Brod during the past decade (1993-2003). The region is located in east Croatia along the border with Bosnia and close to the besieged and destroyed town of Vukovar. The region was heavily involved in recent military activities and migrations in Croatia and Bosnia (1991-1995). Before the war, the population was reasonably well situated, educated and provided with health services. METHODS: Routine clinical and epidemiological methods for the diagnosis of tuberculosis were used. RESULTS: A total of 225 cases of tuberculosis were discovered among 271 suspected cases in a total number of 19 623 children below 18 years of age admitted during the last decade to the county hospital (1.38%). The number increased from three patients with tuberculosis in 1993 to 59 in 2003. Discharge diagnoses were: latent infection 40.1%, specific hilar lymphadenopathy 22.1%, primary lung tuberculosis 18.0%, postprimary tuberculosis 3.0%, and contact with infected person but otherwise normal findings 16.9%. The infection was usualy (53.1%) acquired within the family, more often so in younger patients. Bacteriological cultures were positive in 19 of 117 patients with tuberculosis (16.4%). Antituberculosis drug treatment was carried out to completion in all children. Resistance was not encountered. CONCLUSION: The authors attribute high incidence of childhood tuberculosis in the region of Slavonski Brod, the second highest incidence in Croatia, to the sequellae of migrations during military activities in Croatia and Bosnia (1991-1995) and to the post-war recession.

Sources of infection in childhood tuberculosis in a region of east Croatia.

Possible sources of tuberculosis (TBC) infection in children have been assessed in a retrospective epidemiological study covering a north-east region of Croatia in which the incidence of childhood tuberculosis has been increasing since the war in 1991-1995. During the past decade (1993-2003), 271 children up to 18 years of age have been referred for hospital care because of known contacts with tuberculosis (142 children, group A) or because of indicative clinical signs and symptoms (129 children, group B). Possible sources of infection were identified on the basis of medical documentation and field investigations. Frequencies of source identification for different age groups were compared. In group A, the exposure took place most often within the family (parents, grandparents, siblings, 129 of 142 children, 90.87%). Relatives, neighbors, friends and schoolmates accounted for 9.2%. In group B, possible sources of infection were identified for 44 of 129 children (34.1%) and were within the family for 16 of those 44 (36.4%). Evidenced contact with tuberculosis was more usual among younger children (0-9 years of age, 65.5%) in group A than among the older ones (10-18 years of age, 34.5%). In group B, contacts with tuberculosis were equally distributed (50.0%) among younger and older children. High proportion of unrecognized contacts in children having clinical signs and symptoms indicative of tuberculosis (group B, 85 of 129, 65.9%) opens the possibility that extra-familial exposure to tuberculosis occurs more often than expected regardless of the age of children.

[Leiomyosarcoma of the breast]. / Leiomiosarkom dojke.

A 62-year old patient was treated at our hospital for a palpable change in the upper part of the left breast. The clinical finding was preoperatively confirmed by radiologic, ultrasound and cytology studies, however, the potential biologic process (malignant/benign) was not thus verified. Considering undefined diagnostic nature of the process, biopsy, pathohistology and immunoanalysis were performed to indicate leiomyosarcoma mammae. The incision interspace at certain sites was less than two centimeters, indicating radical breast excision in toto (ablation with evacuation of the contents of the axilla). At the time of scheduled surgery, the patient sustained cardiologic discomfort, so tumorectomy was supplemented by locoregional radiotherapy. Leiomyosarcoma of the breast is a very rare primary malignant breast tumor, with only 14 cases reported in the literature. Considering the rare occurrence of leiomyosarcoma of the breast, in radical surgery we used attitudes like in other breast tumors and leiomyosarcoma of other localizations.