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The use of the comet assay in large biomonitoring studies may present logistical and technical challenges because of the processing of numerous samples. Proper sample preservation becomes imperative to prevent spurious DNA breakage. Previous research has shown the feasibility of conducting the comet assay on frozen blood samples, highlighting the potential of freezing at - 80 °C in preserving DNA integrity. Nonetheless, this approach presents challenges, including potential DNA damage during freezing and thawing, variability in processing, and the need for standardized protocols. Our objective was to evaluate whether there are comparable results in DNA migration assessed by the comet assay between fresh and frozen blood samples on a larger scale (N = 373). In our findings, elevated DNA migration was evident in frozen samples relative to fresh ones. Additionally, smoking, alcohol consumption, and season were linked to increased DNA damage levels in whole blood cells. Based on our results and available literature, conducting the comet assay on frozen blood samples emerges as a practical and efficient approach for biomonitoring and epidemiological research. This method enables the assessment of DNA damage in large populations over time, with samples, if properly cryopreserved, that may be used for years, possibly even decades. These observations hold significant implications for large-scale human biomonitoring and long-term epidemiological studies, particularly when samples are collected during fieldwork or obtained from biobanks. Continued method optimization and validation efforts are essential to enhance the utility of this approach in environmental and occupational health studies, emphasizing caution when comparing data obtained between fresh and frozen blood samples.
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More than eight million premature deaths annually can be attributed to air pollution, with 99% of the world's population residing in areas below recommended air quality standards. Hence, the present study aimed to examine the association between primary DNA damage and air pollution data among 123 participants enrolled between 2011 and 2015 in Zagreb, Croatia. While most measured air pollutants adhered to regulatory limits, benzo[a]pyrene concentrations bound to PM10 exceeded them. Factorial analysis narrowed down air pollution data to four exposure factors (particulate matter, two metal factors, and other pollutants). Despite the absence of significant positive associations between modeled air pollution exposure factors and comet assay descriptors (tail length, tail intensity, tail moment, and highly damaged nuclei), the critical health implications of air pollution warrant further investigations, particularly with biomarkers of exposure and different biomarkers of effect in populations facing air pollution exposure.
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Air pollution is recognized as one of the most serious public health issues worldwide and was declared to be a leading environmental cause of cancer deaths. At the same time, the cytokinesis-block micronucleus (CBMN) assay serves as a cancer predictive method that is extensively used in human biomonitoring for populations exposed to environmental contamination. The objective of this cross-sectional study is two-fold: to evaluate genomic instability in a sample (N = 130) of healthy, general population residents from Zagreb (Croatia), chronically exposed to different levels of air pollution, and to relate them to air pollution levels in the period from 2011 to 2015. Measured frequencies of CBMN assay parameters were in agreement with the baseline data for the general population of Croatia. Air pollution exposure was based on four factors obtained from a factor analysis of all exposure data obtained for the examined period. Based on the statistical results, we did not observe a significant positive association between any of the CBMN assay parameters tested and measured air pollution parameters for designated time windows, except for benzo(a)pyrene (B[a]P) that showed significant negative association. Our results show that measured air pollution parameters are largely below the regulatory limits, except for B[a]P, and as such, they do not affect CBMN assay parameters' frequency. Nevertheless, as air pollution is identified as a major health threat, it is necessary to conduct prospective studies investigating the effect of air pollution on genome integrity and human health.
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Contaminación del Aire , Citocinesis , Contaminación del Aire/efectos adversos , Croacia , Estudios Transversales , Daño del ADN , Humanos , Linfocitos , Pruebas de Micronúcleos/métodos , Estudios ProspectivosRESUMEN
BACKGROUND: Strong associations exist between Balkan endemic nephropathy (BEN) and upper urothelial carcinomas (UUCs). However, the common etiology between the two remains unclear and there are no studies to date that visualize UUC risks in Croatia. In Croatia, 14 villages in the southwestern part of Brod-Posavina County are considered endemic for BEN. The aim of this ecological study is to map cancer risks and describe the case distribution of UUCs in Croatia at the county level during 2001-2011. METHODS: A total of 608 incident cases from the Croatian National Cancer Registry were identified. Indirect standardization was employed to compute standardized incidence ratios (SIRs). RESULTS: Counties with SIRs greater than 1 were concentrated around the agricultural region of Slavonia and the coastal region of Dalmatia. However, only Brod-Posavina County and Vukovar-Srijem County had a statistically significant risk of UUC development, where there were 390 and 210% more UUC cases observed than expected, respectively. Only unique to Brod-Posavina County, females were at higher risk (SIR 4.96; 95% CI 3.59-6.34) of developing UUCs than males (SIR 3.03; 95% CI 2.04-4.01) when compared to their Croatian counterparts. Although Brod-Posavina County only made up 3.7% of the total Croatian population (as of 2011), it had the highest frequency of incident UUC cases after the capital City of Zagreb. No elevated cancer risks were noted in the City of Zagreb, even after stratifying by sex. CONCLUSION: Our findings suggest that Brod-Posavina County had the highest cancer risk for UUCs, especially among females, when compared to Croatia as a whole during 2001-2011. Given that a majority of BEN patients develop associated UUCs, concurrent screening programs for UUCs and BEN should be considered not only in endemic areas of BEN but also the surrounding rural areas and amongst at-risk groups such as those undergoing hemodialysis, who frequently develop UUCs, to help clarify BEN-UUC associations by identifying common risk factors while standardizing disease estimates across endemic regions for BEN.
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Nefropatía de los Balcanes/epidemiología , Carcinoma de Células Renales/epidemiología , Neoplasias Renales/epidemiología , Sistema de Registros , Neoplasias Ureterales/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Croacia/epidemiología , Enfermedades Endémicas , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Tamizaje Masivo/métodos , Persona de Mediana Edad , Riesgo , Factores Sexuales , Urotelio , Adulto JovenRESUMEN
- Headaches are very common in school population. The aim of this study was to determine epidemiological data on headaches among Croatian schoolchildren and their connection to risk factors and other health complaints. In the study, we used the Croatian database of the international research entitled Health Behavior in School-aged Children for 2013/2014. It is a cross-sectional study conducted every four years in 44 countries among children aged 11-16. The students were interviewed using an anonymous standardized questionnaire. The Croatian sample consisted of 5741 students, of which 2857(49.8%) girls and 2884 (50.2%) boys. The response rate was 85.9%. Headaches were reported to be often (once a week to daily) by 23.5% of students and were more often in girls and in higher school grades. They were positively linked to cigarette smoking and health complaints such as back pain and stomachache, bad mood, nervousness, irritability, difficulties with sleeping and dizziness. Headaches are associated to many health problems and can cause difficulties in student functioning. This could be a serious problem. This study pointed to connection of headaches with cigarette smoking and importance to underpin the smoking prevention programs.
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Cefalea/epidemiología , Dolor Abdominal/epidemiología , Adolescente , Ansiedad/epidemiología , Dolor de Espalda/epidemiología , Niño , Croacia/epidemiología , Estudios Transversales , Mareo/epidemiología , Femenino , Humanos , Genio Irritable , Masculino , Prevalencia , Factores de Riesgo , Distribución por Sexo , Trastornos del Sueño-Vigilia/epidemiología , Fumar/efectos adversos , Fumar/epidemiologíaRESUMEN
INTRODUCTION: Chronic kidney disease (CKD) is a significant public health problem and it is not possible to precisely predict its progression to terminal renal failure. According to current guidelines, CKD stages are classified based on the estimated glomerular filtration rate (eGFR) and albuminuria. Aims of this study were to determine the reliability of predictive equation in estimation of CKD prevalence in Croatian areas with endemic nephropathy (EN), compare the results with non-endemic areas, and to determine if the prevalence of CKD stages 3-5 was increased in subjects with EN. MATERIALS AND METHODS: A total of 1573 inhabitants of the Croatian Posavina rural area from 6 endemic and 3 non-endemic villages were enrolled. Participants were classified according to the modified criteria of the World Health Organization for EN. Estimated GFR was calculated using Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). RESULTS: The results showed a very high CKD prevalence in the Croatian rural area (19%). CKD prevalence was significantly higher in EN then in non EN villages with the lowest eGFR value in diseased subgroup. CONCLUSIONS: eGFR correlated significantly with the diagnosis of EN. Kidney function assessment using CKD-EPI predictive equation proved to be a good marker in differentiating the study subgroups, remained as one of the diagnostic criteria for EN.
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Algoritmos , Insuficiencia Renal Crónica/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Creatinina/sangre , Croacia/epidemiología , Estudios Transversales , Femenino , Tasa de Filtración Glomerular , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
BACKGROUND AND OBJECTIVES: Improvements in agricultural practices in Croatia have reduced exposure to consumption of aristolochic acid-contaminated flour and development of endemic (Balkan) nephropathy. Therefore, it was hypothesized that Bosnian immigrants who settled in an endemic area in Croatia 15-30 years ago would be at lower risk of developing endemic nephropathy because of reduced exposure to aristolochic acid. To test this hypothesis, past and present exposure to aristolochic acid, proximal tubule damage as a hallmark of endemic nephropathy, and prevalence of CKD in Bosnian immigrants were analyzed. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this cross-sectional observational study from 2005 to 2010, 2161 farmers were divided into groups: indigenous inhabitants from endemic nephropathy and nonendemic nephropathy villages and Bosnian immigrants; α-1 microglobulin-to-creatinine ratio >31.5 mg/g and eGFR<60 ml/min per 1.73 m(2) were considered to be abnormal. RESULTS: CKD and proximal tubule damage prevalence was significantly lower in Bosnian immigrants than inhabitants of endemic nephropathy villages (6.9% versus 16.6%; P<0.001; 1.3% versus 7.3%; P=0.003, respectively); 20 years ago, Bosnian immigrants observed fewer Aristolochia clematitis in cultivated fields (41.9% versus 67.8%) and fewer seeds among wheat seeds (6.1% versus 35.6%) and ate more purchased than homemade bread compared with Croatian farmers from endemic nephropathy villages (38.5% versus 14.8%, P<0.001). Both Croatian farmers and Bosnian immigrants observe significantly fewer Aristolochia plants growing in their fields compared with 15-30 years ago. Prior aristolochic acid exposure was associated with proximal tubule damage (odds ratio, 1.64; 95% confidence interval, 1.04 to 2.58; P=0.02), whereas present exposure was not (odds ratio, 1.31; 95% confidence interval, 0.75 to 2.30; P=0.33). Furthermore, immigrant status was an independent negative predictor of proximal tubule damage (odds ratio, 0.40; 95% confidence interval, 0.19 to 0.86; P=0.02). CONCLUSIONS: Bosnian immigrants and autochthonous Croats residing in endemic areas are exposed significantly less to ingestion of aristolochic acid than in the past. The prevalence of endemic nephropathy and its associated urothelial cancers is predicted to decrease over time.
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Enfermedades de los Trabajadores Agrícolas/inducido químicamente , Agricultura , Ácidos Aristolóquicos/efectos adversos , Nefropatía de los Balcanes/inducido químicamente , Dieta/efectos adversos , Emigrantes e Inmigrantes , Contaminación de Alimentos , Túbulos Renales Proximales/efectos de los fármacos , Exposición Profesional/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades de los Trabajadores Agrícolas/diagnóstico , Enfermedades de los Trabajadores Agrícolas/etnología , Enfermedades de los Trabajadores Agrícolas/fisiopatología , Enfermedades de los Trabajadores Agrícolas/prevención & control , alfa-Globulinas/orina , Nefropatía de los Balcanes/diagnóstico , Nefropatía de los Balcanes/etnología , Nefropatía de los Balcanes/fisiopatología , Nefropatía de los Balcanes/prevención & control , Biomarcadores/sangre , Biomarcadores/orina , Bosnia y Herzegovina/etnología , Creatinina/sangre , Creatinina/orina , Croacia/epidemiología , Estudios Transversales , Femenino , Tasa de Filtración Glomerular/efectos de los fármacos , Humanos , Túbulos Renales Proximales/patología , Túbulos Renales Proximales/fisiopatología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Exposición Profesional/prevención & control , Oportunidad Relativa , Prevalencia , Características de la Residencia , Factores de Riesgo , Factores de Tiempo , Adulto JovenRESUMEN
Results of the National Program of Breast Cancer Early Detection in Brod-Posavina County during the 2006-2012 period are presented. Response rate in two National Program cycles, cancers detected according to factors such as first and last menstruation, age at cancer detection, deliveries and mammography findings according to the Breast Imaging Reporting and Data System (BI-RADS) before diagnosis verification were analyzed. Data were obtained from the software connecting Public Health Institutes via Ministry of Health server and questionnaires filled out by the women presenting for screening and processed by the method of descriptive statistics. Mammography findings were classified according to the BI-RADS classification. In two National Program cycles during the 2006-2012 period, women aged 50-69 were called for mammography screening. In the first cycle, the response rate in Brod-Posavina County was 53.2%, with 71 cancers detected at a mean age of 61.3 years. In the second cycle, the response rate was 57.0%, with 44 cancers detected at a mean age of 62.5 years. In the first and second cycles, there were 21.1% and 14.3% of mammography findings requiring additional work-up (BI-RADS 0), respectively. Particular risk factors such as early menarche, late menopause, parity, positive family history and presence of benign breast lesions were not demonstrated in women with verified cancer. There was no increase in the incidence of breast cancer per 100,000 inhabitants in the Brod-Posavina County following implementation of the National Program. In conclusion, efforts should be focused on increasing public health awareness, ensuring appropriate professional staff engaged in screening, and improving medical care in order to reduce the time elapsed from establishing suspicion to confirming the diagnosis of breast cancer.
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Neoplasias de la Mama/diagnóstico , Detección Precoz del Cáncer , Anciano , Croacia , Femenino , Humanos , Mamografía , Persona de Mediana Edad , Programas Nacionales de SaludRESUMEN
Endemic nephropathy is a chronic tubulointerstitial disease characterized by early damage to the proximal tubule, with low-molecular weight proteinuria being an important hallmark and possible tool for early diagnosis. The aim of this retrospective cohort study was to assess the risk of developing endemic nephropathy in subjects with proteinuria from the endemic region in Croatia. The cohort study included subjects with proteinuria determined by the sulfosalicylic acid method (after 1988 with strip method), involved in the field survey conducted in the Croatian endemic village of Kaniza in 1975 and followed up until 1997. Subjects with endemic nephropathy established at the first visit and patients that failed to present for follow up visits after 1975. were excluded. In the field survey group that consisted of 624 subjects (286 male and 338 female), proteinuria was established in 157 subjects. Upon the application of exclusion and inclusion criteria, the study cohort included 111 of 157 subjects. The mean follow up was 7.26 years (95% confidence interval 4.06-10.46 years). During the follow up period, 19 (17%) subjects with initial proteinuria developed endemic nephropathy. The incidence density of endemic nephropathy among subjects with proteinuria was 1.3 per 100 persons/year. Estimated risk was 0.0137 (confidence interval 0.0087-0.0214) per year of exposure. The presence of proteinuria determined by the sulfosalicylic acid or test strip in subjects from the endemic village indicated that endemic nephropathy would develop in 1.3 of 100 subjects with proteinuria per year.
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Nefropatía de los Balcanes/epidemiología , Proteinuria/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Croacia/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Adulto JovenAsunto(s)
Nefropatía de los Balcanes/epidemiología , Plantas Medicinales/efectos adversos , Té/efectos adversos , Adulto , Anciano , Ácidos Aristolóquicos/efectos adversos , Nefropatía de los Balcanes/inducido químicamente , Bosnia y Herzegovina/epidemiología , Exposición a Riesgos Ambientales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Características de la Residencia , Factores de Riesgo , Serbia/epidemiologíaRESUMEN
Currently used diagnostic criteria in different endemic (Balkan) nephropathy (EN) centers involve different combinations of parameters, various cut-off values and many of them are not in agreement with proposed international guidelines. Leaders of EN centers began to address these problems at scientific meetings, and this paper is the outgrowth of those discussions. The main aim is to provide recommendations for clinical work on current knowledge and expertise. This document is developed for use by general physicians, nephrologists, urologist, public health experts and epidemiologist, and it is hoped that it will be adopted by responsible institutions in countries harboring EN. National medical providers should cover costs of screening and diagnostic procedures and treatment of EN patients with or without upper urothelial cancers.
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Nefropatía de los Balcanes , Consenso , Manejo de la Enfermedad , Tamizaje Masivo/métodos , Nefropatía de los Balcanes/clasificación , Nefropatía de los Balcanes/diagnóstico , Nefropatía de los Balcanes/terapia , HumanosRESUMEN
Between September 6 and 21, 2012, seven human cases of West Nile virus (WNV) neuroinvasive infection were laboratory confirmed in Croatia. The median patient age was 62 years (range 48-77). Five patients presented with meningoencephalitis and two patients with meningoencephalitis followed by acute flaccid paralysis. Four of them had an underlying disease (hypertension). Using enzyme-linked immunosorbent assay (ELISA), WNV-specific immunoglobulin M (IgM) and IgG antibodies of low avidity were detected in six patients, whereas one showed only IgM antibodies. All samples were confirmed using plaque-reduction neutralization and microneutralization tests. Five patients recovered fully. Before human cases were reported, acute asymptomatic WNV infection was demonstrated by detection of IgM antibodies in sentinel horses. Moreover, an increased WNV IgG seropositivity in horses was detected in counties where human cases occurred. Adulticidal and larvicidal treatments were administered immediately in the respective places of residence. The end of the warm season contributed to the fact that there were no new cases of WNV disease recorded.
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Anticuerpos Antivirales/sangre , Brotes de Enfermedades , Meningoencefalitis/complicaciones , Parálisis/complicaciones , Fiebre del Nilo Occidental/epidemiología , Virus del Nilo Occidental/inmunología , Anciano , Animales , Croacia/epidemiología , Femenino , Enfermedades de los Caballos/epidemiología , Enfermedades de los Caballos/virología , Caballos , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Pruebas de Neutralización , Estaciones del Año , Fiebre del Nilo Occidental/complicaciones , Fiebre del Nilo Occidental/virología , Virus del Nilo Occidental/genética , Virus del Nilo Occidental/aislamiento & purificaciónRESUMEN
BACKGROUND/AIMS: Endemic nephropathy (EN) is a chronic tubulointerstitial disease. Strong association between EN and urothelial carcinoma was noted as early as 40-50 ago. The aim of the study was to determine and compare specific mortality and morbidity of renal pelvis and ureter (upper urothelium) carcinoma (UUC) among Croatia as a whole, Brod-Posavina County, and Croatian endemic area. METHODS: Data on UUC mortality and morbidity were analyzed. Indirect standardization was employed on data comparison by calculating standardized mortality ratio and morbidity ratio. RESULTS: Our study results showed the specific mortality rate in the endemic area to be 26.3-fold and 7.3-fold the rate recorded in Croatia and Brod-Posavina County, respectively. The mean standardized mortality ratio obtained by indirect standardization yielded an 8-fold and 32-fold risk of death from UUC in the endemic area vs. Brod-Posavina County and Croatia as a whole, respectively. These data revealed the specific morbidity in the Croatian endemic area and Brod-Posavina County to be 13.95-fold and 3.78-fold the morbidity recorded at the national level, respectively. The standardized morbidity ratio also showed the risk of developing UUC in the Croatian endemic area to be 3.75-fold the risk in Brod-Posavina County and 16.4-fold the risk in Croatia. CONCLUSIONS: These results showed that specific mortality and morbidity as well as standardized morbidity ratio and standardized mortality ratio were higher in Croatian endemic area than in Brod-Posavina County and Croatia.
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Enfermedades Endémicas/estadística & datos numéricos , Neoplasias Renales/mortalidad , Neoplasias Uretrales/mortalidad , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Comorbilidad , Croacia/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Medición de Riesgo , Distribución por Sexo , Análisis de SupervivenciaRESUMEN
Colorectal carcinoma (CRC) is a major public health problem as the third leading malignant tumor in men and fourth in women in Croatia. Prognosis and treatment greatly depend on tumor stage at the time of detection. Therefore, the National Program of Colorectal Carcinoma Early Detection has been performed since 2007. The aim is to present the response rate, colonoscopy findings and number of newly detected CRC cases in Brod-Posavina County. During five years of the National Program performance, 28 CRC cases were detected in Brod-Posavina County, with the 3.3% rate of carcinoma detection. The majority of CRC cases were found in the 50-64 age group. The response rate in the County was low (20.4%), corresponding to the national rate but far from the recommended one. Such a result could be attributed to the low level of awareness in the population at large, complex testing technique for general population, fear from disease detection and from colonoscopy as a diagnostic procedure. Note should be made of the underestimated role of family physicians; their involvement in the National Program should certainly result in better response rate in our County as well as at the national level.
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Neoplasias Colorrectales/diagnóstico , Tamizaje Masivo/organización & administración , Programas Nacionales de Salud/organización & administración , Anciano , Neoplasias Colorrectales/epidemiología , Croacia/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Hypertension is not considered to be a characteristic of endemic nephropathy (EN). Recent observations suggested that it might be more prevalent than it was reported before. AIM: The aim of our study was to analyze prevalence, treatment and control of hypertension in a Croatian endemic area. METHODS: In the present cross-sectional study, 1,602 farmers were enrolled, 1,246 from EN and 356 from control villages. Epidemiological and medical histories were taken and clinical and laboratory examinations performed for kidney function. Blood pressure was measured following the ESH/ESC guidelines. RESULTS: The prevalence of hypertension in EN villages was higher than in control (50.8 vs. 46.5%, p = 0.005). There was no difference in overall treatment, control of all and treated hypertensives between the villages. In all villages, women were treated more than men (EN 41.6 vs. 28.4%, p < 0.001; control 46.4 vs. 27.3%, p < 0.001), but better control of treated was achieved in men (EN 24.7 vs. 17.4%, p = 0.002; control 29.6 vs. 15.5%, p = 0.002). Women had lower income and level of education than men (p < 0.01). CONCLUSION: Hypertension is highly prevalent in endemic villages. In all villages, men had better blood pressure control despite being treated less. This finding could be explained by poorer education and income in women.
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Enfermedades Endémicas/prevención & control , Hipertensión/epidemiología , Hipertensión/terapia , Enfermedades Renales/epidemiología , Enfermedades Renales/terapia , Adulto , Anciano , Croacia/epidemiología , Estudios Transversales , Femenino , Humanos , Hipertensión/diagnóstico , Enfermedades Renales/diagnóstico , Masculino , Persona de Mediana Edad , Prevalencia , Resultado del TratamientoRESUMEN
Hay fever or pollinosis is the allergic reaction of the human body to allergic pollen grains and is a seasonal phenomenon. Pollen concentrations depend on the climate, geographic features, and vegetation. Trees, grass, and weed pollinosis is frequent in Croatia, common ragweed (Ambrosia artemisifolia L.) pollinosis in particular. Continuous monitoring of pollen air concentrations can provide timely information to the general public and can help sensitised patients and their physicians to prevent or alleviate allergic reactions. This is the task of health ecology services such as our Public Health Institute of the Brod-Posavina County. This article reports pollen concentrations in Slavonski Brod measured in March 2008 to November 2008, March 2009 to October 2009, and April 2010 to October 2010 and discusses the increasing exposure to ragweed and ways to control it.
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Contaminantes Atmosféricos/análisis , Alérgenos/análisis , Polen , Croacia , Humanos , Estaciones del AñoRESUMEN
BACKGROUND/AIMS: An epidemiological survey of endemic nephropathy (EN) was performed in endemic Croatian areas and the current prevalence was compared to that reported for the same villages several decades ago. METHODS: A total of 2,487 adult farmers from 6 endemic villages and 3 non-endemic villages were enrolled. An extensive epidemiological questionnaire, clinical examination and laboratory analyses of blood and urine were performed. According to the modified WHO criteria, participants were classified into diseased, suspected of having EN, and those at risk of developing EN. RESULTS: The overall prevalence of EN in the Croatian areas was 1.0%, ranging between 0.3 and 2.3% in different villages. Those suspected of having EN amounted to 3.9%. In the endemic villages a decreasing trend in the prevalence of EN was observed comparable to the results obtained in previous surveys. It is interesting to note that no EN patients were recorded in the endemic village of Dubocac. CONCLUSION: The prevalence of EN in the endemic Croatian areas appears to be decreasing. For the first time, we failed to detect any EN patients in a village that was previously considered endemic, which might indicate that EN is diminishing.
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Nefropatía de los Balcanes/etnología , Enfermedades Endémicas , Encuestas Epidemiológicas/tendencias , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Nefropatía de los Balcanes/diagnóstico , Croacia/etnología , Enfermedades Endémicas/prevención & control , Femenino , Predicción , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
On 21 September 2008, heavy oil penetrated the drinking water supply in Slavonski Brod, Croatia. The accident was caused by the damage of heat exchange units in hot water supply. The system was polluted until the beginning of November, when the pipeline was treated with BIS O 2700 detergent and rinsed with water. Meanwhile, water samples were taken for chemical analysis using spectrometric and titrimetric methods and for microbiological analysis using membrane filtration and total plate count. Mineral oils were determined with infrared spectroscopy. Of the 192 samples taken for mineral oil analysis, 55 were above the maximally allowed concentration (MAC). Five samples were taken for polycyclic aromatic hydrocarbon (PAH), benzene, toluene, ethylbenzene, and xylene analysis (BTEX), but none was above MAC. Epidemiologists conducted a survey about health symptoms among the residents affected by the accident. Thirty-six complained of symptoms such as diarrhoea, stomach cramps, vomiting, rash, eye burning, chills, and gastric disorders.This is the first reported case of drinking water pollution with mineral oil in Slavonski Brod and the accident has raised a number of issues, starting from poor water supply maintenance to glitches in the management of emergencies such as this.
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Accidentes de Trabajo , Aceite Mineral , Contaminación del Agua , Abastecimiento de Agua , Croacia , Humanos , Aceite Mineral/análisis , Espectrofotometría Infrarroja , Contaminación del Agua/análisisRESUMEN
BACKGROUND: Tubular proteinuria and enzymuria are hallmarks of endemic nephropathy (EN). The role of I/D angiotensin convertase (ACE) gene polymorphism has not yet been elucidated in this peculiar chronic tubulointerstitial nephritis, and our aim was to investigate the role of this polymorphism in EN focusing on the urinary N-acetyl-ß-D-glucosaminidase (NAG) excretion, a biomarker of proximal tubular damage. METHODS: ACE genotype and allele frequencies were determined in 229 farmers (147 women and 82 men) from an endemic Croatian village. The farmers were stratified according to the WHO criteria into the following subgroups: those 'at risk' for EN (n = 37), 'suspected of having EN' (n = 57), and 'others' (n = 135). RESULTS: There were 74 (32.3%) subjects homozygous for the D allele, 99 (43.2%) heterozygous (ID genotype) and 56 (24.4%) homozygous for the I allele. No differences in allele frequency were found between the established WHO subgroups (p > 0.05). In the whole group, DD subjects had significantly higher values of diastolic blood pressure (p = 0.003) and urinary NAG than subjects with ID and II genotype (5.5 ± 1.2 vs. 4.0 ± 3.0 vs. 3.8 ± 4.2, respectively; p = 0.023). The highest values of serum creatinine (p = 0.02), proteinuria (p = 0.03) and urinary NAG (6.0 ± 3.7 vs. 3.7 ± 2.1 vs. 3.0 ± 1.6, respectively; p = 0.008) were observed in those suspected of having EN group with the DD genotype. CONCLUSION: ACE gene polymorphism is not a risk factor for EN. However, it might influence the clinical course of EN, and increased excretion of NAG might be a prognostic marker of this chronic tubulointerstitial nephritis.
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Acetilglucosaminidasa/orina , Nefropatía de los Balcanes/genética , Peptidil-Dipeptidasa A/genética , Polimorfismo Genético , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Alelos , Nefropatía de los Balcanes/enzimología , Presión Sanguínea , Creatinina/sangre , Croacia , Femenino , Frecuencia de los Genes , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Proteinuria , Adulto JovenRESUMEN
We are reporting on a household outbreak of measles, in which cases of simultaneous measles and chickenpox infection occured in children of a family who resided in Italy during the incubation period (June 2011). In three children, fever and generalized confluent macular rash were the dominant symptoms. Serology testing revealed simultaneous measles and chickenpox infection in four children.