Differences in eating and lifestyle habits between first- and sixth-year medical students from Zagreb.

Eating and lifestyle habits of first (n=169) and sixth (n=272) year students, aged 18 to 26 years, attending a Medical School in Zagreb, were compared related to the years of study. A self-administered questionnaire created for this study incorporated a food frequency questionnaire. Both year students reported similar number of meals per day, irregular consumption of meals, skipping breakfast, frequency of vegetables, fruits, cereals, sweets, milk and dairy products consumption, body mass index (BMI) calculated from self-reported weight and height and alcohol consumption. Significant differences between groups were observed in consuming supper (p = 0.001), being on diet (p = 0.032), intake of supplements (p = 0.041), meat (p < 0.001), dried meat (p = 0.027), coffee and tea consumption (p = 0.016), physical activity (p = 0.041; p = 0.016), and smoking (p = 0.029). This study showed non-healthy eating arid lifestyle behavior among Medical School students. We observed association between the year of study, and some of the eating habits and lifestyle factors.

Regional pattern of physical inactivity in Croatia.

The aim of this paper was to analyze the regional pattern of physical inactivity in Croatia based on the Croatian Adult Health Survey 2003 data. A total of 9,070 adult respondents were included in this study. In men, the highest prevalence of physical inactivity was recorded in the City of Zagreb (39.6%), and it was significantly higher than in Central (25.6%), Coastal (25.6%) and Mountainous region (14.1%). Mountainous region had significantly lower prevalence of physical inactivity compared to any other region, except the Central region. The highest prevalence of physical inactivity in women was also recorded in the City of Zagreb (43.6%), and it was also significantly higher than in all other regions. The lowest prevalence of physical inactivity was recorded in Eastern Region (24.7%). The highest levels of physical inactivity in both in both genders were recorded in urban regions, suggesting that intervention measures in terms of health promotion should be undertaken, with strong emphasis on the people living in urban settings.

Regional differences in dietary habits of adult Croatian population.

The aim of this study was to investigate the dietary habits of the adult Croatian population according to geographical regions and gender. Date was obtained from the Croatian Adult Health Survey questionnaire, carried out in six regions of Republic of Croatia (Eastern, Northern, Central, City of Zagreb, Mountainous and Coastal), with a total of 9,070 responses. Results have shown that the highest prevalence of unhealthy dietary habits was recorded in Eastern and Central regions, while Coastal region and city of Zagreb had significantly lower prevalence of unhealthy dietary habits (P < 0.05). Prevalence of unhealthy dietary habits was higher in men in all regions. Women had healthier dietary habits, what was strongly expressed in Coastal and Mountainous region. This study has shown that the unhealthy dietary habits were practiced by approximately one quarter of the adult population, regardless on the region in which they resided. Regional differences in dietary habits should be taken into account in any new public health studies and interventions.

Treatment of hypertension by general practitioners and antihypertensive drugs expenditure in an urban environment.

Aim of our study was to determine the treatment habits of hypertension by general practitioners (GPs) as well as the monthly costs of prescribed antihypertensive drugs and their share in the total prescription drug expenditure approved by the Croatian Institute for Health Insurance (CIHI), the compulsory health insurance system. The study was performed in six GPs offices in Zagreb, serving 8,866 patients, in December 2005. The monthly costs of antihypertensive drugs prescribed by the GPs was obtained by summarizing the prices of all antihypertensive drugs prescribed in one month and then comparing the sum with total monthly prescription drug expenditure approved by the CIHI. The type and dosage of prescribed antihypertensive drugs were also analyzed. Hypertension was diagnosed in 2,342 (26.4%) patients. The monthly costs of prescribed antihypertensive drugs accounted for 52.33% of the total amount approved for medications by the CIHI. 945 (40.0%) hypertensive patients were taking antihypertensive monotherapy. The most frequently prescribed drugs as monotherapy were ACE inhibitors (38.3%), calcium-channel blockers (26.7%), beta blockers (18.6%), and diuretics (10.3%). a antagonists (3.6%). Angiotensin receptor blockers (2.5%) were rarely prescribed. As combination therapy, ACE inhibitors and diuretics (30.4%) were most frequently used. More than 50% of the funds allocated to GPs for medications were spent for the treatment of only one disease. The most used antihypertensive drugs were ACE inhibitors.

Respiratory function in wind instrument players.

BACKGROUND: The playing of wind instruments has been associated with changes in respiratory function. STUDY OBJECTIVES: To investigate the effect of playing wind instruments on lung function and respiratory symptoms. METHODS: The present study included 99 wind instrument players and a group of 41 string instrument players as a control from 3 major orchestras in Zagreb, Croatia. Data on chronic respiratory symptoms were recorded in all studied subjects. Lung function was measured in wind instrument players by recording maximum expiratory flow-volume curves. RESULTS: Wind instrument players demonstrated significantly higher prevalences of sinusitis, nasal catarrh and hoarseness compared to control musicians. One wind instrument player developed asthma associated with his work. Odds ratios for wind instrument players were significant for chronic cough, chronic phlegm and chronic bronchitis by smoking habit (p<0.05 or p<0.01) but not for length of employment. Ventilatory capacity data indicate that wind instrument players had significantly greater FEV1 (smokers and nonsmokers) as well as FEF50 (nonsmokers) (p<0.05) compared to predicted values. Regression analysis of pulmonary function tests in wind instrument players demonstrate a significant link between FEV1 and FEF50 and length of employment. Those wind instrument players with longer employment had the greatest increases in lung function. CONCLUSIONS: Our data suggest that musicians playing wind instruments may be susceptible to chronic upper airway symptoms. Interestingly wind instrument playing may be associated with higher than expected lung function parameters.

Indoor carbon dioxide concentrations in Croatian elementary school classrooms during the heating season.

Aware that exposure to stuffy indoor air with high levels of carbon dioxide (CO2) is associated with higher absenteeism and reduced academic performance in school pupils, the World Health Organization (WHO) Regional Office for Europe initiated indoor air quality surveys in schools, including CO2 monitoring, to assess ventilation and exposure to stuffy air. Here we report the findings of the first such survey in Croatia. It was conducted in 60 classrooms of 20 urban and rural elementary schools throughout the country during the heating season. Measurements of CO2 levels showed that all 60 classrooms exceeded the international guidelines of 1938 mg/m3. Mean CO2 concentrations ranged from 2771 to 7763 mg/m3. The highest concentration measured in urban schools was 7763 mg/m3 and in rural schools 4771 mg/m3. Average CO2 levels were higher in continental schools (3683 mg/m3) than the coastal ones (3134 mg/m3), but all demonstrate poor ventilation during the heating season all over Croatia.

Hazardous agents in anode manufacture.

The aim of this study was to assess to which extent the modernisation of an anode plant had reduced occupational chemical health hazards for jobs with the highest potential of exposure. Periodical measurements of dust and gases were performed at the same workplaces using the same methods, before and after modernisation. These measurements were compared with the recommended standards. Before modernisation the concentrations of total dust, carbon monoxide, carbon dioxide, sulphur dioxide, hydrogen fluoride, benzene, and phenol were above the recommended standards in 56.9 % (74/130) of the samples. After modernisation, only 12.3 % (21/171) of the samples were non-conforming. Before modernisation, workers were exposed to higher concentrations of all agents in all production sections. After modernisation, dust remained the primary pollutant in harmful concentrations in the anode baking furnace (GM=22.1 mg m-3) and in the anode rodding room (GM=22.1 mg m-3), hydrogen fluoride in the anode rodding room (GM=4.2 mg m-3), and sulphur dioxide in all production sections. As plant modernisation has not completely resolved the exposure issue, stringent compliance to safety rules and regular medical checkups are necessary.

Women in medicine through the ages.

BACKGROUND: Female practitioners of the medical arts have been active since the ancient world The role of women in science, and particularly in medicine, has changed significantly over time. METHODS: We provide a chronological review of the growing knowledge in medicine related to women's activities through the ages with particular attention to occupational medicine. Throughout history hazards have been shaped by the forces that shape work itself social evolution, shifting economic powers and demographic changes. RESULTS: Mythical Greece, Egypt and ancient Rome were the cradle of ancient medicine. In the past century, women were allowed to enter the medical profession with increasing acceptance. Some of the most important women in ancient and modern medicine are recalled, such as Mother Peseshet in ancient Egypt, Artemisia of Caria and Phanostrate and Philista in the Greek period, Hildegard of Bingen, Marie Marguerite Biheron in England, Elisabeth Blackwell, Emily Jennings, Maude E. Abbott and others. Women in occupational medicine are described separately, such as Alice Hamilton, Harriet L. Hardy, Molly Newhouse and Olga Macek. CONCLUSIONS: Certainly, the first few women who iluminated the way for the generations that followed them into medicine, the women who made outstanding contributions to medicine, and the women who are currently finding success in medicine deserve our respect and admiration.

[Health care professionals--attitudes towards their own health]. / Zdravstveni radnici--odnos prema vlastitom zdravlju.

AIM: The aim of the study was to investigate differences in health behavior and life habits between physicians and medical nurses as related to their own health. EXAMINEES AND METHODS: Study subjects were health professionals from various parts of Croatia attending a scientific meeting, who filled out a special questionnaire (36 males and 178 females). They were divided into two groups according to education and work performed: physicians (n = 125) and medical nurses (n = 89). The questionnaire designed for the study, How medical workers keep their health, was used to estimate the factors influencing their health. The study was performed during 2005. RESULTS: The results showed that, regardless of education or work, our health professionals did not have healthy life habits. Both physicians and nurses were equally obese (p = 0.423) and physically inactive (p = 0.403). There was a significant difference between these two groups in smoking habits (p = 0.008), occasional alcohol consumption, regularity of breakfast intake (p = 0.019), and number of daily meals (p = 0.047). The following was done for the control of risk factors: laboratory tests of cholesterol and glucose, measurement of blood pressure, dental examination (p = 0.404), prostate examination (p = 0.406), breast self examinations (p = 0.810), mammography (p = 0.289), and Pap test (p = 0.683). None of these factors showed significant between group differences. There was a statistically higher number (64.9%; p < 0.001) of physicians without family physicians than among medical nurses (8.1%). CONCLUSION: Medical nurses consulted their family physicians more frequently than doctors, but most physicians were inclined to self treatment. A great proportion of nurses were smokers, whereas many physicians reported alcohol consumption. Physicians used sedatives more than nurses, and their physical activity was better. Nurses had more frequent control laboratory tests of cholesterol and glucose, and measurements of blood pressure. They were also better in the number of daily meals. A vast majority of patients cite their physicians as their primary source of information regarding healthy lifestyle decisions. These findings suggest strategies to improve the physicians' health behavior.

[Metabolic syndrome in family medicine]. / Metabolicki sindrom u obiteljskoj medicini.

AIM: To investigate the possibilities of diagnosing metabolic syndrome (MS) based on the data collected from patient records at the level of family health care, and to assess possible sex differences in MS prevalence as well as differences between individuals with and without MS. SUBJECTS AND METHODS: Data on age, sex, body mass index (BMI), systolic and diastolic blood pressure, and laboratory findings (blood sugar, triglycerides, total cholesterol and HDL cholesterol) were collected during a one-year period (June 2004 - June 2005) from standardized existing records of all patients covered by three general practitioners in Zagreb. MS was defined according to WHO criteria. Statistical analysis was performed with chi2-test for qualitative and t-test for quantitative variables. RESULTS: The data recorded showed that general practitioners either did not practice some activities or did not take notes of what they did. The overall incidence of MS was 6.64% (6.01% in men and 6.78% in women). Men and women with MS showed statistically significant differences in BMI (p=0.033) and age (p<0.001). Men with MS showed a statistically significant increase in fasting glucose (p<0.001), triglycerides (p=0.005), systolic blood pressure (p<0.001), diastolic blood pressure (p=0.0020), and lower HDL cholesterol (p=0.021). MS men were older than men without MS (p<0.001). Women with MS had a statistically significantly higher level of fasting glucose (p<0.001), triglycerides (p<0.001), BMI (p=0.035), systolic blood pressure (p<0.001), and diastolic blood pressure (p<0.001), and lower HDL cholesterol (p<0.001) than women without MS. MS women were by 18.6 years older (p<0.001). CONCLUSION: The data recorded by general practitioners in medical documentation are sufficient for MS diagnosis. However, the low prevalence of MS shows inadequate awareness of the role of MS in cardiovascular disease.

[Human lifespan: to live and outlive 100 years?]. / Ljudski vijek: dozivjeti i nadzivjeti 100 godina?

Aged population dominates in developed countries. Centenarians are a select group, and only one in 7,000 to 10,000 reach that age. Factors of longevity are numerous and include genetic predisposition (a locus on chromosome 4), environment, healthy lifestyle (hypocaloric diet, regular physical and mental exercise), accessible health services, and efficient health protection at old age. Centenarians are well adapted to the new life and compensate for the loss of functions with age. The limits of human life are extended, so that nowadays the oldest person has reached the age of 128. Some geographic areas are characterised by higher numbers of centenarians. This article mentions a few individuals who outlived 100 years in the world, Croatia, and neighbouring countries. Although some argue that the limits of human life cannot be extended over the age of 120 years, for now we cannot predict the actual limits of human life.