THE EFFECT OF DAILY PHYSICAL ACTIVITY ON THE ACTIVITY OF INFLAMMATORY BOWEL DISEASES IN THERAPY-FREE PATIENTS.

It has been suggested that various environmental factors play a very important role in the etiology of inflammatory bowel diseases (IBDs) and that they have a significant effect on the course of these diseases. The aim of this study was to investigate the effect of daily physical activity on the activity of IBDs in therapy-free patients. This cross-sectional population based study was conducted in eastern Croatia from January to June 2016. The study included 312 patients, mean age 49.9±15.0 years, 53.2% of males and 46.8% of females; there were 63.4% of ulcerative colitis (UC) and 36.6% of Crohn's disease (CD) patients. Sociodemographic characteristics of patients, data on their daily physical activity and type of therapy taken were collected through a specifically designed and validated questionnaire, while the activity of UC and CD was evaluated using the Mayo index and Harvey-Bradshaw index. The study showed that 24.0% of patients were not taking therapy. Daily physical activity was connected to IBD in study patients when taking both diseases collectively (Fisher exact test; p<0.001), as well as to the inactivity of CD (Fisher exact test; p=0.001) and UC (Fisher exact test; p=0.006), when observing each disease separately. Daily physical activity was connected to the inactivity of IBDs in patients not taking therapy. It is necessary to educate all IBD patients about the importance of physical activity in order to control their disease.

Transcranial Cerebral Oxymetric Monitoring Reduces Brain Hypoxia in Obese and Elderly Patients Undergoing General Anesthesia for Laparoscopic Cholecystectomy.

The aims of this prospective, observational study were to evaluate the changes of the regional cerebral saturation (rSO2) measured by near-infrared spectroscopy during elective laparoscopic cholecystectomy under total intravenous anesthesia and the association between patient's characteristics and critical decline of rSO2. Hemodynamics, rSO2, and oxygen saturation were recorded in different time points: before the anesthesia (Tbas), 2 minutes after the induction (supine position) (Tind), 2 minutes after CO2 insufflation (supine) (TCO2), 10 minutes after CO2 insufflation (reverse Trendelenburg) (TrevT), and 2 minutes after deflation (supine) (Tpost). Average age was 53±13 (range: 22 to 79 y). In 12 of a total of 62 patients (19.4%) the rSO2 decreased >20% (20.5% to 28.4%) in TCO2 or TrevT times. Significantly higher decrease of the rSO2 was found in patients older than 65 years and those with body mass index >30 kg/m (P<0.05). Noninvasive monitoring of cerebral oxygenation could be an important part of perioperative care in obese and older patients.

Sevoflurane preserves regional cerebral oxygen saturation better than propofol: Randomized controlled trial.

STUDY OBJECTIVE: To investigate possible effects of volatile induction and maintenance anesthesia with sevoflurane (VIMA) and total intravenous anesthesia with propofol (TIVA) on regional cerebral oxygen saturation (rcSo2) during laparoscopic cholecystectomy. DESIGN: Randomized, prospective and single-blinded study. SETTING: Academic hospital. PATIENTS: ASA physical status of I and II surgical patients, scheduled for elective laparoscopic cholecystectomy from March 2013 to October 2014. MEASUREMENTS: Changes of regional cerebral oxygen saturation were measured by near-infrared spectroscopy on the left and right sides of forehead at different time points: before anesthesia induction (Tbas), immediately after induction (Tind), after applaying a pneumoperitoneum (TCo2), 10 minutes after positioning the patient into reverse Trendelenburg's position (TrtCo2), immediately after desufflation of gas (Tpost) and 30 (Trec30) and 60 (Trec60) minutes after emergence from anesthesia. MAIN RESULTS: Study population included 124 patients, 62 in each group. There was no significant difference between these groups according to demographic characteristics, surgery and anesthesia times as well as in the basal rcSo2 values. Statistically higher rSco2 values were noted in the VIMA group when compared to the TIVA group in all time points Tind, TCo2, TrtCo2, Tpost, Trec30 and Trec60 and incidence of critical rcSo2 decreases was statistically lower in VIMA group (P<.05). There were no serious perioperative complications. CONCLUSIONS: VIMA technique provides significantly (4%-11%) higher rcSO2 values during general anesthesia for laparoscopic cholecystectomy, when compared with TIVA and also provides significantly less number of critical rcSO2 decreases.

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.

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.

Effects of magnesium, chromium, iron and zinc from food supplements on selected aquatic organisms.

The aim of this study was to determine the effect of uncontrolled environmental disposal of food supplements containing magnesium (Mg), chromium (Cr), iron (Fe) and zinc (Zn) on selected aquatic organisms including freshwater algae Scenedesmus subspicatus and Raphidocelis subcapitata, water flea Daphnia magna and duckweed Lemna minor. Thirty different food supplements containing Mg, Cr, Fe and Zn were analyzed. Results were expressed as effective concentration 50 (EC50), i.e. growth inhibiting Mg, Cr, Fe and Zn (mg/L) concentration immobilizing 50% of treated organisms. Particular metal EC50 differed significantly (p < 0.001) among study organisms, as follows (in ascending order): Scenedesmus subspicatus EC50 Fe (median 46.9 mg/L) < Zn (59.8 mg/L) < Mg (73.0 mg/L) < Cr (88.1 mg/L) (KW-H(3;120) = 36.856; p < 0.001); Raphidocelis subcapitata EC50 Fe (median 44.9 mg/L) < Zn (52.6 mg/L) < Mg (62.2 mg/L) < Cr (76.8 mg/L) (KW-H(3;120) = 44.0936; p < 0.001); Daphnia magna EC50 Zn (median 59.4 mg/L) < Cr (79.2 mg/L) < Fe (80.8 mg/L) Mg (82.0 mg/L) (KW-H(3;120) = 39.2637; p < 0.001); and Lemna minor EC50 Zn (median 131.0 mg/L) < Fe (186.8 mg/L) < Mg (192.5 mg/L) < Cr (240.4 mg/L) (KW-H(3;120) = 58.6567; p < 0.001). Uncontrolled environmental disposal of food supplements containing Mg, Cr, Fe and Zn exerts adverse effects on aquatic organisms. Therefore, legal provisions should regulate both the utilization and disposal of food supplements into the environment.

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.