Public health problems in the medieval statutes of Croatian Adriatic coastal towns: from public morality to public health.

The article seeks out the regulations about public health in the oldest medieval statutes of fourteen cities of the eastern Croatian Adriatic coast, between the thirteenth and sixteenth century. The research revealed numerous examples of direct or indirect ways of protecting public health. Through the analyzed documents, a noteworthy relationship between public morality and public health can be noted. The described rules are important as a reflection of awareness about public health as a condition of survival and progress in the past. They witness a progressive transition from an original common law into a written law as well as the impact that religion had in influencing people's general opinion and lifestyle in light of public health problems.

The effects of long-term experimental diabetes mellitus type I on skeletal muscle regeneration capacity.

Muscle fibers are dynamic structures capable of altering their phenotype under various pathological conditions. The aim of the present study was to investigate the influence of long-lasting diabetes mellitus on the process of muscle regeneration in the skeletal muscle. Wistar rats were made diabetic by a single intraperitoneal injection of streptozotocin (STZ). The regeneration process in the skeletal muscle was induced in slow (m. soleus, SOL) and fast (m. extensor digitorum longus, EDL) muscles by injection of local anesthetic (bupivacaine). Skeletal muscles were analyzed 10 days, 4 and 8 weeks after bupivacaine treatment. Diabetes mellitus has changed morphological properties of both slow and fast skeletal muscles during the process of regeneration. These changes are evident in redistribution of muscle fibers and significant level of atrophy. All fiber types of diabetic fast muscles showed stronger atrophy than muscle fibers in slow muscles which have more oxidative metabolism. The changes of redistribution of muscle fibers depend on duration of diabetes and affect all types of muscle fibers.

Reg IV protein is expressed in normal rat tissue.

The Reg IV gene has been documented in the colon, small intestine, stomach and pancreas of the human. Expression of the Reg IV in different cell types has been associated with regeneration, cell growth and cell survival, cell adhesion and resistance to apoptosis. It is unknown whether the Reg IV protein is present in the normal rat tissue. The aim of this study was to reveal the expression of the Reg IV protein in the rat spleen and colon. Western blot analysis using antibody specific for Reg IV protein were performed on rat spleen and colon extracts. Low level of Reg IV expression was found in all examined colon samples. The expression of Reg IV protein in spleen tissue was significantly higher than in the colon. Reg IV protein was immunohistochemically stained in a few epithelial cells in the basal portion of colon crypts and in a large spleen cells which were scattered in the red pulp. Our results demonstrate for the first time the presence of the Reg IV protein expression in the healthy spleen and colon tissue of the rat. Other members of the Reg family, Reg I and Reg III proteins have been shown to act as a growth factors in gastrointestinal tract, but without further experiments we can only assume the potential role of the Reg IV protein in spleen and colon cell growth.

Kinematic measurement of the lumbar spine and pelvis in the normal population.

Spinal and pelvis motion has been studied by a variety of different methods, the majority of which have a number of limitations. The present study investigated motion characteristics of the lumbar spine and pelvis using a three-dimensional optoelectronic system. The aim of our study was to determine kinematic parameters of spine and pelvis during trunk flexion, extension and lateral bending in normal, healthy subjects. Kinematic motion analysis was performed on 63 asymptomatic volunteers for four different trunk motions. This study has shown that the pelvis range of motion is affected by the gender Contribution of pelvic movement to trunk flexion was 50%, while pelvic angle was significantly higher in women. During lateral bending female subjects had statistically significant higher values of vertebral arc with respect to male subjects. During extension the contribution of pelvic movement was 45%. There was no significant difference found in total angle, pelvic angle and vertebral arc.

Ultrasound-Guided Glossopharyngeal Nerve Block: A Cadaver and a Volunteer Sonoanatomy Study.

BACKGROUND AND OBJECTIVES: Glossopharyngeal nerve (GPN) blocks are usually performed by topical, intraoral, or peristyloid approaches, which carry significant complication risks due to the proximity of important neurovascular structures. This study presents a proof of concept for a new ultrasound (US)-guided technique, which would block the GPN distally, in the parapharyngeal space, away from the immediate vicinity of high-risk collateral structures. METHODS: Five cadaver heads were dissected, and the location of the GPN was explored bilaterally. In 40 healthy volunteers (20 men and 20 women; median age, 35.5 years [range, 24-69 years]) parapharyngeal sonograms were obtained, saved, and analyzed. To assess the technical feasibility of a distal GPN block in the parapharyngeal space, unilateral US-guided dye injections were performed in 3 fresh cadavers, followed by dissections. RESULTS: The GPN was consistently identified between the stylopharyngeal and middle pharyngeal constrictor muscles in all cadaver specimens. The median distance between the GPN and the ipsilateral greater horn of the hyoid bone was 2.4 cm (range, 2.3-2.7 cm) on the right and 2.6 cm (range, 2.3-2.9 cm) on the left. The mean skin-to pharyngeal wall distances in the volunteers were 2.03 (SD, 0.41) cm on the right and 2.02 (SD, 0.45) cm on the left. The mean hyoid bone-to-pharyngeal wall distances were 2.04 (SD, 0.35) cm (right) and 2.07 (SD, 0.35) cm (left). The fresh cadaver dissections demonstrated dye deposition adjacent to the GPN in the parapharyngeal space in all specimens. CONCLUSIONS: Based on our anatomical results in cadavers and healthy volunteers, we submit that successful and safe blockade of the distal GPN at the pharyngeal wall level is technically feasible under US guidance.

"Marina-Trinkkur" and a few more modern-time hydrotherapeutic myths from the Kvarner region of NW Croatia.

PURPOSE: The present paper tries to address the rise and decay of the sea-water "cult" in regional health tourism in NW Croatia, concentrating upon and analysing more thoroughly the example of Marina, chemically processed sea water, an invention of Dr Géza Fodor, the Hungarian physician practicing in that part of Croatia. METHOD: The original documents and archived items related to the topic were examined. Furthermore, we investigated numerous communal bulletins and medical authorities' records of respective time. RESULTS: Our research showed that the sea-water baths, introduced thanks to the influence of balneologists (like J. Glax), and "drinking cures" (advocated by M.-J. Ortel, for instance) were surprisingly popular not only among tourists of the time, but also among the physicians that used them extensively for therapeutical purposes. These baths and "drinking cures" enriched and completed the medical offer of the resorts regardless of their sometimes dubious effectiveness. CONCLUSIONS: This simple distilled sea-water preparation, advertised as a real panacea, demonstrates a paradigm that elucidates the mentality of physicians, merchants, and patients/consumers of the time.

[Correlation and regression]. / Korelacija i regresija.

Correlation and regression are statistical methods that help us determine interactions of variables. Both are being used in statistical analysis of basic and clinical research. Correlation (r) is a measure of linear relationship between two numerical measurements made on the same set of subjects and it is represented by correlation coefficient. Values of correlation coefficient range between -1 and 1. Pearson's and Spearman's coefficients of correlation are the most often used correlation coefficients. Correlation can be linear and non-linear. We calculate the significance of correlation (P) in an effort to determine significance of correlation coefficient. Regression is a statistical method that allows us to predict values of one variable from another. The simplest regression is linear regression. The success of regression equation is valued by analysis of residuals. Multiple regression is used to predict one variable from several known variables.

The thyrohyoid membrane as a target for ultrasonography-guided block of the internal branch of the superior laryngeal nerve.

STUDY OBJECTIVE: The objective was to present a proof of concept for a simple and consistently successful ultrasonograpy (US)-guided technique to block the internal branch of the superior laryngeal nerve (iSLN). DESIGN: This was a volunteer and cadaver anatomy study. SETTING: The setting was an anesthesiology department and an anatomy laboratory at a medical school MEASUREMENTS: H13-6 MHz US scans were performed in 40 healthy volunteers positioned supine and with extended necks. The goals were to identify the thyrohyoid membrane, measure its depth (in centimeters) using the shortest vertical distance from the skin, and record the scanning time (in seconds) needed to obtain the optimal image. Anatomical dissection was performed with an operating microscope bilaterally on 5 adult cadaver heads, fixed in formalin, to expose the point of iSLN penetration through the thyrohyoid membrane. The distance between the greater horn of the hyoid bone and the nerve entry point into the thyrohyoid membrane was measured. Ultrasonography-guided in-plane injections were performed unilaterally with 22-gauge 50-mm nerve block needles in 3 fresh cadavers with 2-mL lidocaine/methylene blue mixture deposited under direct vision just superficial to the thyrohyoid membrane to evaluate technical feasibility and injectate spread. MAIN RESULTS: Anatomically, the iSLN was identified in all formalin-preserved cadavers, with hyoid bone greater horn to nerve-membrane interface distances measuring 1.0-2.4 cm (mean, 2.0 cm; SD, 0.5). Sonographically, the iSLN was not visualized, whereas the hyoid bone and the thyrohyoid membrane were visualized in all volunteers. The mean distance from skin to thyrohyoid membrane was 1.69 cm (SD, 0.38). The mean time needed to scan was 15 seconds (SD, 2.3). After US-guided injection, the dye deposition was observed around the iSLN in all cadaver specimens. CONCLUSIONS: A simpler and consistently reproducible US-guided iSLN block is feasible using the thyrohyoid membrane as target plane for local anesthetic injection. Clinical trials are needed to determine its effectiveness and safety, needle entry point, trajectory, and local anesthetic volume.

Finger width as a measure of femoral block puncture site: an ultrasonographic anatomical-anthropometric study.

STUDY OBJECTIVE: Femoral nerve blockade is a regional anesthetic procedure that may be used in prehospital and emergency settings in cases of femoral trauma. Its speed and performance depend on how well the puncture site can be accurately located, something that usually is achieved via visible landmarks and/or by combining various universal preestablished measurements. Most of these methods have been derived from cadaver studies, which often suffer limitations in clinical settings. To facilitate a quick and easy determination of the puncture site, we here attempt to find an in vivo anthropometric measure that closely corresponds to the distance between the femoral artery and femoral nerve. DESIGN: This is a prospective observational study. PATIENTS: The study includes 67 patients presenting for elective surgery. MEASUREMENTS: The distance from the femoral nerve to the femoral artery, projected to the skin, was measured by a 13-MHz ultrasonographic linear probe. Anthropometric measurements of the width of the hand fingers were carried out at the distal interphalangeal joints. RESULTS: The distance from the femoral artery to the femoral nerve projected to the skin was found to closely correspond to the width of the fifth finger of the dominant hand measured at the distal interphalangeal joint. CONCLUSION: Because it relies on individual anthropometric information, this finding offers an individualized approach to determining the puncture site in a given patient. We believe that such an approach can improve and simplify femoral nerve blockade procedures in prehospital and emergency settings.

Dive-related fatalities among tourist and local divers in the northern Croatian littoral (1980-2010).

BACKGROUND: The aim of the study was to retrospectively analyze diving fatalities occurring in Primorje-Gorski Kotar County (northern Croatian littoral), Croatia between 1980 and 2010 in order to identify differences between fatally injured tourist and resident divers, as well as temporal changes in the frequency of diver deaths. METHODS: Medico-legal and police reports of 47 consecutive fatal diving cases were reviewed to determine the frequency of death among divers in relation to year and month of death, age, sex, nationality, organization of diving, diving type, and health condition. RESULTS: The majority of victims were foreign citizens (59.6%) most of whom fell victim to scuba diving (70.4%). It was found that 79% of resident divers succumbed during free-diving. The number of diving fatalities increased significantly in the last three decades, especially among free-divers. Of the victims, 93% were males, usually belonging to younger age groups with tourist divers being significantly older than local divers. And 31.9% of divers, mostly tourists, showed signs of acute, chronic, or congenital pathological conditions. CONCLUSION: Fatally injured foreign divers differ from resident diver fatalities in diving method and age. Tourists are the group most at risk while scuba diving according to the Croatian sample. Occupational scuba divers and free-divers are the group most at risk among resident divers. This study is an important tool in uncovering the most common victims of diving and the related risk factors. It also highlights the problems present in the legal and medical monitoring of recreational divers and discusses possible pre-event, event, and post-event preventive actions that could lead to reduced mortality rates in divers.

Reg IV protein and mRNA expression in different rat organs.

The Reg IV gene has been documented in the human colon, small intestine, stomach and pancreas. Expression of the Reg IV in different cell types has been associated with regeneration, cell growth and cell survival, cell adhesion and resistance to apoptosis. Since the distribution of the Reg IV protein in normal rat tissues is unknown, the aim of this study was to reveal the expression of the Reg IV protein in structurally and functionally different rat organs. The expression of Reg IV gene was analyzed by Western blot and reverse transcription-polymerase chain reaction. Immunohistochemistry was used to localize Reg IV protein. Reg IV protein was expressed in pancreas, stomach, small intestine, colon, brain, spleen, kidney and urinary bladder in two-month-old male Wistar rats. In addition, the expression of Reg IV mRNA by reverse transcription-polymerase chain reaction was confirmed. Our study provides detailed information about the expression and localization of Reg IV protein in different rat organs. These findings provide an evidence of Reg IV expression in different rat organs, which may help elucidate a potential role in growth and proliferation of different cells like other members of the Reg family genes which act as growth factors in the different organs.

Is there an effective approach to deterring students from plagiarizing?

The purpose of this study was to evaluate the effectiveness of plagiarism detection software and penalty for plagiarizing in detecting and deterring plagiarism among medical students. The study was a continuation of previously published research in which second-year medical students from 2001/2002 and 2002/2003 school years were required to write an essay based on one of the four scientific articles offered by the instructor. Students from 2004/2005 (N = 92) included in present study were given the same task. Topics of two of the four articles were considered less complex, and two were more complex. One less and one more complex articles were available only as hardcopies, whereas the other two were available in electronic format. The students from 2001/2002 (N = 111) were only told to write an original essay, whereas the students from 2002/2003 (N = 87) were additionally warned against plagiarism, explained what plagiarism was, and how to avoid it. The students from 2004/2005 were warned that their essays would be examined by plagiarism detection software and that those who had plagiarized would be penalized. Students from 2004/2005 plagiarized significantly less of their essays than students from the previous two groups (2% vs. 17% vs. 21%, respectively, P < 0.001). Over time, students more frequently choose articles with more complex subjects (P < 0.001) and articles in electronic format (P < 0.001) as a source for their essays, but it did not influence the rate of plagiarism. Use of plagiarism detection software in evaluation of essays and consequent penalties had effectively deterred students from plagiarizing.

Public health problems in the medieval statutes of Vinodol, Vrbnik and Senj (West Croatia).

BACKGROUND: The ancient Croatian statutes were written in the thirteenth and fourteenth centuries. The aim of this study was to seek out regulations concerning public health in the oldest medieval statutes of the towns on the northern Adriatic coast (W Croatia). METHODS: All translated text editions of the statutes of the three towns were examined. The statutes were written in the thirteenth and fourteenth centuries. RESULTS: The research of the materials revealed the examples of direct and indirect ways of protecting public health. Regulations on keeping towns clean and the rules for dealing with animal products were found. Additionally, witches and fortunetellers were found to be treated as a negative force and defined as the embodiment of evil: they were thus considered to be heavily connected to illness and misfortune. CONCLUSION: The aforementioned rules are not only important from the historical point of view, but also as a reflection of people's awareness of public health as a condition of survival and the progress of the community as a whole. Furthermore, since those statutes were created from people's customs that were to eventually become a law, they show substantial progress in medical history for that particular part of Croatia.

Prevalence of plagiarism among medical students.

AIM: To determine the prevalence of plagiarism among medical students in writing essays. METHODS: During two academic years, 198 second year medical students attending Medical Informatics course wrote an essay on one of four offered articles. Two of the source articles were available in an electronic form and two in printed form. Two (one electronic and one paper article) were considered less complex and the other two more complex. The essays were examined using plagiarism detection software "WCopyfind," which counted the number of matching phrases with six or more words. Plagiarism rate, expressed as the percentage of the plagiarized text, was calculated as a ratio of the absolute number of matching words and the total number of words in the essay. RESULTS: Only 17 (9%) of students did not plagiarize at all and 68 (34%) plagiarized less than 10% of the text. The average plagiarism rate (% of plagiarized text) was 19% (5-95% percentile=0-88). Students who were strictly warned not to plagiarize had a higher total word count in their essays than students who were not warned (P=0.002) but there was no difference between them in the rate of plagiarism. Students with higher grades in Medical Informatics exam plagiarized less than those with lower grades (P=0.015). Gender, subject source, and complexity had no influence on the plagiarism rate. CONCLUSIONS: Plagiarism in writing essays is common among medical students. An explicit warning is not enough to deter students from plagiarism. Detection software can be used to trace and evaluate the rate of plagiarism in written student assays.