[From the history of the Split hot springs]. / Iz proslosti Splitskih toplica.

The sulphurous waters of Split have been in traditional medicinal use for a full 17 centuries, ever since the construction of the Palace of the Roman Emperor Diocletian. The "Sulphur Baths" of Split (Croatia) reached their greatest recognition and popularity at the beginning of the 20th century, when the sulphurous spring was declared to be the source of some of the highest quality medicinal mineral water in Europe. However, interest in balneology and climatotherapy, hitherto so popular in the area, subsequently declined. The "Sulphur Baths" gradually lost their importance and medical use of the sulphurous water gave way to modern forms of physical therapy. The beginning of the 1990s marked the end of commercial and every other use of the mineral water in Split.

[Effect of rheumatoid arthritis on physical performance of patients]. / Utjecaj reumatoidnog artritisa na radnu sposobnost bolesnika.

To determine the changes occurRing in physical performance of patients with RA, 188 patients have been observed over a ten-year period. The observation included two groups: the test group comprising 93 patients with RA who have never been treated by any disease-modifying antirheumatic drugs (DMARDs) and the control group comprising 95 patients with RA who have regularly taken DMARDs under the rheumatologist's supervision. The average age of the test group was considerably higher, there were more retired persons with a prolonged course of illness, their physical performance being more intensely affected than that of the control group. Further analysis during the observation period showed significant decrease of physical performance in both groups regardless of their being treated or not by the DMARDs which, in our opinion, only modify the illness. To conclude, irrespective of the application of the DMARDs, RA is undoubtedly an illness with considerable socio-economic significance since it leads to great physical disability (invalidity) of all RA patients.

[Comparative study of the force of flexors and extensors of the cervical spine in patients with vertebral syndrome of the cervical spine and in healthy persons]. / Komparativno istrazivanje snage fleksora i ekstenzora vratne kraljeznice u bolesnika s vertebralnim sindromom vratne kraljeznice i zdravih osoba.

This paper deals with the muscle force of the cervical spine in patients with cervical syndrome compared to the muscle activity in non-patients. It has thus been observed that both the flexors' and the extensors' force of the cervical spine is much greater in non-patients (the flexors' P < 0.01 and the extensors' P < 0.01). The precise measurements having been carried out by a dynamometer. The groups being tested comprised 50 persons each, 25 men and 25 women. The average age of the patients group was 43.1 years, namely between 21 and 57 years, while that of the non-patients group was 42.3 years, between 24 and 56 years. As regards the professional engagement of both groups and, accordingly, the strain on the cervical spine and the corresponding musculature, they were approximately the same.

[Low back pain]. / Bolna kriza.

Many people suffer from low back pain in the course of their life, of whom not all seek health care. In the majority of patients who seek care and refrain from work, the problem of pain resolves within a few weeks. It is reason that chronic pain syndromes such as chronic back pain are responsible for enormous costs for health care and society. Also, many diagnostics procedures and durability of rehabilitation makes low back pain as a very expensive disease. All of that are good reasons to make algorithm for diagnostic and treatment of low back pain in Croatian Society for Rheumatology.

[Comparative study of the efficacy of ultrasound and sonophoresis in the treatment of painful shouder syndrome]. / Usporedno istrazivanje ucinkovitosti ultrazvuka i sonoforeze u lijecenju sindroma bolnog ramena.

This research tries to determine the difference between two forms of physical therapy, as regards their efficiency, in treating painful shoulder syndrome. They are ultrasound and sonophoresis. The research comprised 64 patients, divided in two groups. One group was treated by 10 ultrasound procedures (16 women and 17 men, average age 49.3 years), the other by 10 sonophoresis (14 women and 17 men, average age 45.1 years), both having in addition individual physical training (corrective medical exercises) for each patient. The difference in efficiency regarding both procedures were observed on the basis of objective measurable parameters (abduction, anteflexion, retroflexion, outer and inner rotation, the distance between vertebrae prominens and styloid radius) as well as in view of anamnestic terms (pain both at rest and in motion) recorded before the treatment started and after the application of 10 therapeutic procedures. The statistics results of data processing showed significant difference in efficiency, regarding the objective parameters--sonophoresis is more efficient (retroflexion--p < 0.05). Nevertheless, sonophoresis (diclofenac gel) proved much more efficient in reducing pain at rest (p < 0.01) and in motion (p < 0.05).

[Tramadol (Tramal) in the treatment of rheumatic diseases-- comparative study]. / Mjesto tramadola ("Tramal") u terapiji reumatskih bolesti--komparativno istrazivanje.

In order to evaluate the efficacy of centrally acting analgesics. In treating rheumatic diseases, tramadol hydrochloride (Tramal Grunental) has been administered to a group of 68 patients (36 women and 32 men), who received 100 mg twice a day during a 10-day treatment. The testing comprised 14 female patients with rheumatoid arthritis, 20 patients (7 women and 13 men) with degenerative (OA) hip and knee diseases and 34 patients (15 women and 19 men) affected by the vertebrogen painful syndrome of lumbar spine. The control group comprised 12 patients (9 women and 3 men) with rheumatoid arthritis using non-steroidal antiinflammatory drugs only, 22 patients (12 women and 10 men) with the OA of the hip and knee, using paracetamol only, and 30 patients (15 women and 15 men) affected by the vertebrogen painful syndrome of lumbar spine, also using paracetamol only. The visual analogue scale has been used in following the pain relief assessments during the therapy. It has thus been observed that the intensity of pain has not been significantly relieved with the acute rheumatic diseases (p > 0.05) in the control group either; that the significant pain relief has occurred with the degenerative (OA) rheumatic diseases (p < 0.05) but not in the control group; while the best analgetic effect of tramadol has been proved on the patients affected by the vertebrogen painful syndrome of lumbar spine (p < 0.01) but was not significant in the control group. During the therapeutic treatment 13 patients (19%), mostly the elderly, experienced side effects, manifested as nausea and the dry mouth.

[The effect of gold salts on rheumatoid factor dynamics in patients with rheumatoid arthritis]. / Utjecaj soli zlata na dinamiku reumatoidnog faktora u bolesnika s reumatoidnim artritisom.

The aim of research was to establish effect of gold-salts (under protected name "Tauredon" Byk Gulden) on the dynamics of rheumatoid factor, decreed with Waaler-Rose test, at patients with rheumatoid arthritis. Following the dynamics of rheumatoid factors was performed during 6 months continued application of "Tauredon" on a group of patients with certain diagnosis of rheumatoid arthritis. The group consisted of 8 men and 35 women, with age profile of 50 years. With continuous observation of patients and their laboratory findings (Waaler-Rose test) in regular time intervals it was found out that "Tauredon" has significant influence on oscillation of rheumatoid factor, decreed by the method of hemaglutination of sheep erythrocytes.

[The effect of Tauredon on the development of non-specific indicators of inflammatory activity in patients with rheumatoid arthritis]. / Djelovanje Tauredona na kretanje nespecificnih pokazateja upalne aktivnosti u bolesnika s reumatoidnim artritisom.

The objective of this research has been to determine the effects of the gold salts Tauredon Byk Gulden on the development of non-specific parameters with regard to the inflammatory processes in patients with rheumatoid arthritis. The group being tested comprised 8 men and 35 women with a positive diagnosis of rheumatoid arthritis, their average age being 50, the average disease course 9.5 years. During a six-month continuous application of Tauredon, the following parameters were observed in regular intervals: the erythrocyte sedimentation rate, the haemoglobin level in the serum and the C-reactive protein. The statistical processing of data indicated that Tauredon significantly reduces the erythrocyte sedimentation, considerably increases the haemoglobin level in the serum and significantly decreases the C-reactive protein value.

[The effect of 6 months of treatment with Tauredon on clinical indicators in rheumatoid arthritis]. / Ucinak Tauredona na neke klinicke pokazatelje reumatoidnog artritisa tijekom sestomjesecne primjene.

The objective of this research has been to evaluate the efficacy of Tauredon (the aqueous solution of Na-thiomalate) on the development of some clinical parameters in patients with rheumatoid arthritis. The group being tested comprised 8 men and 35 women, their average age being 50, the average duration of their illness being 9.5 years. As regards the anatomic development stage of illness, the majority of patients belonged to stage 2 (62.8%), with no patients belonging to stage 4. During the continuous six-month application of Tauredon, the following parameters have been observed: the Ritchie index, the PIP extent of the fist joints and the morning stiffness span of the small fist joints. The evaluation of the six-month treatment with Tauredon has proved its positive effect on all clinical parameters, shown in the lower value of the Ritchie index, the lower PIP extent of the fist joints as well as the shorter morning stiffness span. Further, the Tauredon effect has been seen in suppressing the inflammatory activities and in restituting the joint functions in patients with rheumatoid arthritis.

[Complement (C3 and C4) in patients with rheumatoid arthritis during 6 months of treatment with gold salts]. / Komplement (C3 i C4) u bolesnika s reumatoidnim artritisom tijekom sestomjesecnog lijecenja solima zlata.

The aim of research was to establish effect of gold-salts under protected name "Tauredon" Byk Gulden, on the dynamics of fraction of complements C3 and C4 at patients with rheumatoid arthritis. Following the dynamics of both parameters, was performed during 6 months continued application of "Tauredon", on 8 men and 35 women with certain diagnosis. Profile of the age of patients was 50 years old. With continuous observation of patients and their laboratory findings, in regular time intervals, we found out that "Tauredon" has significant influence on increase of level of C3 in serum of patients (P = 0.006) but not in increase of fraction of complement C4 (P = 0.117).

[The effect of Na-aurothiomalate on circulating immune complex dynamics in patients with rheumatoid arthritis]. / Djelovanje Na-aurotiomalata na dinamiku cirkulirajucih imunih kompleska u bolesnika s reumatoidnim artritisom.

The objective of this research has been to determine the efficacy of Na-aurothiomalate, under the trade name Tauredon, on the development of circulating immune complexes (CIC) in patients with rheumatoid arthritis. During a continuous six month administering of Tauredon to a group of patients with the diagnosis of rheumatoid arthritis various parameters have been observed. The group comprised 43 patients, 8 men and 35 women, their average age being 50. By continuous observations of both the patients and their laboratory reports in regular intervals during six-month administering of Tauredon, a positive effect of Tauredon on the development of the CIC IgM values (P = 0.006) has been proved, i.e. reducing their level in the patients' serum. Owing to great individual differences in the decrease of the CIC IgG values, it has been difficult to prove the consequences of this fall (P = 0.086). The impossibility of testing the significant decrease of the CIC IgA values is due to a small number of patients with the positive CIC IgA values.

[Side effects of gold salt therapy in patients with rheumatoid arthritis]. / Nepozeljni ucinci lijecenja solima zlata u bolesnika s reumatoidnim artritisom.

Observing the efficacy of the gold sodium thiomalate (under the trade name of Tauredon Byk Gulden) during the treatment of 43 patients with rheumatoid arthritis, a certain number of side effects have been noted and registered. The group being tested comprised 43 patients, 8 men and 35 women, average age being 50. The side effects were observed in 14 patients (32.5%), namely in one man and 13 woman, the most frequent being thrombocytopenia (20.8%), serious exacerbation of the disease (16.6%), thrombocytosis and dermatitis (12.5%). The recurrence rate of the side effects during the treatment with the gold sodium thiomalate was greater during the first (14%) and the second month (11.8%) than during the third (4.6%) and the fourth month (2.5%).

[Comparative study of the effects of auranofin and aurothiomalate on laboratory and clinical indicators in patients with rheumatoid arthritis]. / Komparativno istrazivanje ucinka auranofina i aurotiomalata na pojedine laboratorijske i klinicke pokazatelje u bolesnika s reumatoidnim artritisom.

Is there any significant difference in the effect and tolerance of the gold salts applied peroral and intramuscular in patients with rheumatoid arthritis (RA)? 97 patients with RA have been included in the research. Group used auranofin perorally comprised 30 patients with RA, 25 women and 5 men. Their average age was 53.4 years, the average disease course was 9.06 years. Group used aurothiomalate parenterally comprised 30 patients with RA, 23 women and 7 men. Their average age was 52.5 years, the average duration of their illness being 10.87 years. Control group comprised 37 patients with RA, 27 women and 10 men. Their average age was 58.2 years, the average disease course was 8.3 years. They did not use any "second line drug" or corticosteroids. During a six-month (26 week) continuous application of the gold salts (perorally and parenterally) the following parameters were observed in regular intervals: the erythrocyte sedimentation rate, the hemoglobin level in the serum, the C-reactive protein. Ritchie index, the PIP extent of the fist joints and the morning stiffness span of the small fist joints. The tolerance of the gold salts has also been controlled. The results have shown that there is no any significant difference between two forms of the gold salts in patients with RA. The statistical processing of data indicated that auranofin and aurothiomalate have significant effect on all controlled parameters. As regard of the side effects, patients accepted aurothiomalate better than auranofin.

[Comparative study of the effectiveness of lasers and cryotherapy in the treatment of painful shoulder syndrome]. / Komparativno istrazivanje ucinkovitosti lasera i krioterapije u lijecenju sindroma bolnog ramena.

This research tries to determine the difference between two forms of physical therapy, as regards their efficiency, in treating the painful shoulder syndrome. They are: laser treatment, representing modern technology, and cryotherapy, an old and traditional form of treatment. The research comprised 60 patients, divided in two groups of 30 patients each. One group was treated by the cryotherapy procedures, the other by ten laser treatments, both having in addition individual therapeutic exercise for each patient. The difference in efficiency regarding both procedures were observed on the basis of objective measurable parameters (abduction, anteflexion, retroflexion, external and internal rotation, the distance vertebrae prominens and styloid radius) as well as in view of anamnestic terms (pain both at rest and in motion) recorded before the treatment started and after the application of ten therapeutic procedures. The statistic results of data processing showed no significant difference in efficiency, regarding the objective parametres, between the two procedures treating painful shoulder syndrome. Nevertheless, laser treatment proved more efficient in reducing pain. In assessing the efficiency of both treatments there is a slight discrepancy as to the outcome between patients and the researcher: the patients found the laser treatment more efficient than cryotherapy, while the researcher's evaluation was equal both procedures.

[Comparative study of the occurrence of gastrointestinal side-effects of tenoxicam and other nonsteroidal antirheumatic agents in patients with rheumatoid arthritis]. / Komparativno istrazivanje ucestalosti gastrointestinalnih nuspojava tenoksikama i ostalih nesteroidnih antireumatika u bolesnika s reumatoidnim artritisom.

This research tries to determine the difference between granular tenoxicam (Tilcotil Roche) and other non-steroidal antiinflammatory drugs administered to patients with rheumatoid arthritis. The research comprised 143 patients with rheumatoid arthritis divided in two groups (71 + 72). As regards patients with rheumatoid arthritis, granular tenoxicam of a twenty-miligram dose daily showed both a good clinical effectiveness and a good bearing in long-term medicine taking, rarely causing gastrointestinal side effects, compared to other nonsteroidal antiinflammatory drugs in peroral taking.

[Occurrence of subcutaneous rheumatoid nodules in patients with rheumatoid arthritis in Croatia]. / Ucestalost pojave potkoznih reumatoidnih cvorica u bolesnika s reumatoidnim artritisom u Hrvatskoj.

The subcutaneous rheumatoid nodules (RN) have been recognized by the American Rheumatism Association, both in 1958 and in 1987, as one of the diagnostic criteria (ARA criteria) among other rheumatoid arthritis (RA) symptoms. The aim of this research has been both to provide the incidence of occurrence of RN in patients with RA in Croatia and to determine its significance in making the RA diagnose. The test group comprised 233 patients (182 women and 51 men) with RA, their average age being 48.3 years in the range of 18 to 77. Both the anamnesis and the clinical examination have determined the occurrence of RN in 54 (23.2%) of 233 patients. The range of occurrences was more evident in men (31.4%) than in women (20.8%), though this difference was statistically irrelevant. The most common localization of benign rheumatoid nodules was the exterior side of elbow and PIP hand joints. The obtained results prove that the incidence of RN in our tested patients with RA can be compared with those of the earlier researches done in Croatia (18.1% Jajic, Vlak; 20-25% Jajic), as well as with those obtained in the western European countries (20% Doherty, George; 25% Ziff; 20-25% Miehle; 21% Wolf et al.).

[The mode of onset of rheumatoid arthritis and seasonal variations]. / Nacin pocetka reumatoidnog artritisa i sezonske varijacije.

The aim of the study was to establish age and sex distribution, seasonal variations, and mode, of onset in a sample of patients with rheumatoid arthritis. One hundred eighty nine patients (146 women and 43 men), whose age ranged from 18 to 77 yrs. (mean age 49.1, SD 12.93) were included in the survey. In majority of patients the disease started between 31-50 years, whereas in the age group from 21-30 it occurred more frequent in women, and in the age group from 51-60 in men. The onset of rheumatoid arthritis was in almost equal proportions acute or insidious, regardless sex. No difference was found concerning onset of the disease and seasonal variations. However there was a statistically significant correlation between mode of the onset and seasonal variations (P < 0.05). Rheumatoid arthritis started abruptly more often in springtime, and more insidiously in autumn, whereas in summer and winter there was an equal number of patients with acute or insidious onset of the disease.