BADGES/PINS OF NURSING AND MIDWIFERY SCHOOLS IN SLOVENIA FROM 1925 UNTIL EARLY 1980s.

INTRODUCTION: Many nursing and midwifery schools in many countries around the world awarded or still award graduation badges or pins to their graduates. All graduates from different parts of the former Kingdom of Yugoslavia and later the Republic of Yugoslavia educated in Slovenian healthcare schools received badges from these schools. Some of the graduates later employed in medical institutions across former Yugoslavia wore these badges on their uniforms. The main purpose of this historical research was to establish which Slovenian health care schools awarded the graduation badges and what they looked like. It was also investigated why the badges ceased to be awarded and what motivated Angela Boskin Faculty of Health Care in Jesenice to reintroduce awarding the badges. METHODS: Due to a lack of written sources, we conducted 393 face to face and telephonic interviews with former badge recipients across Slovenia. Their existing badges were photographed. On the authors' initiative, a private collection of badges was started. RESULTS: It has been established that in the 20th century all Slovenian secondary health schools awarded badges. The Nursing College, Ljubljana also awarded graduation badges. Five different types of badges in many variants were issued. The first badges were awarded to graduates by Slovenian oldest Nursing School, Ljubljana in 1925. The badges ceased to be awarded in the late 1970s and the early 1980s. Some questions about probable reasons for cessation of awarding badges remain unanswered. Less than a fifth of interviewees kept their badges. Graduating nursing badges were reintroduced in Slovenia in 2017 with a new badge which is presented and depicted in this article. The motivation for the reintroduction of graduating badges is also investigated. DISCUSSION AND CONCLUSION: Unfortunately, many Slovenian nurses and midwives are not sufficiently aware of the meaning and importance of their badges. Although badges are important for professional image and identity of nurses, badges as a symbol of nursing have become almost completely forgotten. Graduation badges are miniature works of art and are proof of the existence and development of Slovenian healthcare schools. Nursing badges present a part of nursing history as well as being our cultural heritage. The badges deserve to be written and talked about and should be displayed in a planned future Slovenian Health Care Museum.

IVth scientific congress of Central society of balneologists of Austria in Opatija, 1904.

The authors were interested in the lectures' themes, organisation, the course, and the accompanied activities at the balneology congress in Opatija in 1904. The congress was organised by the principle of the health resort at the time Professor Dr Julius Glax, and consisted of two separate parts. The first part was held in Opatija from October 13 until 15, 1904. There were lectures, auto-papers, summaries, reports, discussions, and the afternoon expert trip to Crikvenica by boat. In Opatija the participants were shown the spa park, the rehabilitation paths for patients with heart difficulties, marine baths Angiolona and Slatina, the covered spa Erzherzog Ludwig Viktor Bad, and of the health institution Zander Institute. At the accompanying exhibition the Austrian and German companies represented their products, among them still recognised Bayer, C. Reichert in Karl Zeiß. Additionally, the owner of the Zanderinstitut in Opatija Dr Isor Stein presented his own therapeutic aid exerciteur there. The first part of the congress concluded on October 15, 1904 with the great banquet in the hotel Stephanie.The second part of the congress was held from October 16 until 20, 1904. The expert trip was organised to the Austrian Riviera on the Pannonia ship. The participants visited attractions and health institutions in Mali Losinj, Pula, Brijuni, Rovinj, Grado, Aquileia and Trieste, where they also had expert lectures. The closing ceremony of the second part of the congress was in Trieste, from where the participants returned to Vienna by the special train.

Hydrotherapeutic institutions in the Austro-Hungarian health resort Abbazia / Opatija owned by the South Railways Company.

The South Railways Company built two hydrotherapeutic institutions Warm baths (Warmbade-Pavillion) and Hydrotherapeutic Institution (Hydropatische Anstalt) in the Angiolina Park in Opatija in 1884. The both institutions were in operation till 1904. Due to the deterioration of the both hydrotherapeutic institutions and increasing number of guests (in 1899 - 4009 guests, in 1902 - 19.001 guests) the South Railways Company built in 1902-1904 new modern hydrotherapeutic treatment institution the Covered Bath of the Archduke Ludwig Viktor (Erherzog Ludwig Viktor Bad). The leading physician (dirigierender Arzt) of these institutions was Professor Dr. Julius Glax, who added the thalassotherapy to the balneology. In 1907 the post of the leading physician of the Covered Bath of the Archduke Ludvig Victor (Erherzog Ludwig Viktor Bad) took over Dr. Albert Nussbaum. The Covered Bath of the Archduke Ludvig Victor institution was operating till 1919, when it was transformed into a hotel.

Dr Franz Tripold (1865-1956), one of the most important pioneer physicians in Opatija/Abbazia.

Dr Tripold was one of the first Austrian physicians to practice in Opatija. He graduated from Karl-Franzens University in Graz in 1889 and moved to Opatija in 1891. Along with his medical practice, Tripold was the head physician of the volunteer Fire Brigade and Rescue Society of Opatija and meteorological observer. In 1906, he published a climatological study entitled das Klima von Abbazia (The Climate of Opatija), which was based on his own 8-year observations of the weather conditions and the 12-year observations done by his predecessor, E. Krainz. In 1908, he was appointed Imperial Counsellor by the Austrian emperor. For his medical practice in Opatija, Dr Tripold received several foreign awards, and the Viennese Volunteer Rescue Society appointed him its honorary member. The Tripolds moved to Turin in 1947. He was buried there at Cimitero monumentale. Opatija, Town-Museum of Central Europe, a project designed to identify and reunite old friends, has honoured the memory of Dr Tripold by including him in a poster of the ten most famous citizens of Opatija, and the fire station in Opatija placed a plaque on the wall in his honour.

Beginning of biometeorology in Abbazia/Opatija.

In addition to health facilities and many other organizations, there was also a functioning weather station in the health and seaside resort of Abbazia/Opatija, known as the Nice of the Austrian riviera. Formal observation of weather in Abbazia/Opatija began in 1886 with the setting up of the weather station in Angiolina Park. During the period 1898-1915, the warden of this station and data collector was the local doctor, dr Franz Tripold. On the basis of the collected data, he wrote the first study of Abbazia/Opatija's climate and its effects on people. The study das Klima in Abbazia was published in 1906 in Abbazia als Kurort on the 60th birthday of Professor Julius Glax, head of the health resort in Abbazia/Opatija. The study highlighted the physiological effects of the maritime climate on people and examined the beneficial effects of the local climate on patients. The weather station in Opatija is still operating in Angiolina Park. Weather parameters to be gathered were determined by the First international Meteorological Congress in Vienna in 1873 and are still valid. The parameter of human well being÷bio meteorological prognosis has been added. Today, the collected data are sent to the National Meteorological and Hydrological service in Zagreb, from where they are returned to Opatija to be displayed on a screen in the town centre to help people to plan their daily activities and take appropriate measures to protect their health, which is especially important for patients.

Health Resort Opatija Volunteer Fire Brigade and Rescue Society.

Not only the health service but also several other humanitarian institutions and societies were active in Abbazia÷Opatija, the most important town on the once Austrian Riviera, the town that was also known as the Austrian Nice. The most important of the societies was The Health Resort Opatija Volunteer Fire Brigade and Rescue Society. The authors of this article have been particularly interested in the society's founding and its activity until it moved into the new building at 6, St. Florjan's Street in 1910. The fast urbanisation and the development of the industry raised the need of the well organised activity of putting out fires. The German gymnastics societies were the first to include the education and the skills development of the volunteer firemen into their programmes. The first volunteer fire brigades appeared in Austria after 1863. The huge fire that broke out in Vienna in 1881 showed that the fast and efficient rescuing demanded a well prepared organization of a team of rescuers. Based on the initiative of the chimney sweep Franz Drescher and The South Railway Company, the volunteer fire brigade was founded in Opatija already in 1886. The founding of the volunteer rescue society was based on the idea given by dr. Jaromir Mundy, the permanent guest in Opatija and a friend of prof. dr. Theodor Billroth, in 1894. The intertwining activity of the both societies resulted in their formal joining. The head physician became dr. Franz Tripold, the chief commander was Franz Doberlet junior. For his special merits, the general assembly of the Health Resort Opatija Volunteer Fire Brigade and Rescue Society appointed him the honourable commander of the society in 1903 and he received a special photo album with the photos of the volunteer firemen and the rescuers' practice. The Emperor Franz Joseph I Jubilee Fire Station, the Rescue Station And the Sanatorium (Kaiser Franz Joseph I Jubiläums - Feuerwehrrüstungshaus, Rettungsstation und Erholungsheim) was given to the use on 1st October 1910. Since then, the two societies worked at this same location. The Volunteer Fire Brigade Opatija has been located in this building ever since.

Doctor Zander's Medico-Mechanical Institute in Opatija.

At the beginning of the 20th century, there were different kinds of medical institutions in the health and seaside spa resort Abbazia (nowadays Opatija). The Opatija Guidebooks (1904-1914) praised the three sanatoriums and Zander's Medico-Mechanical Institute, which was owned by Dr. Isor Stein. Dr. Zander, who is not well-known today, has been the main topic of the authors' research. The authors have found out that Dr. Gustav Zander (1835-1920) worked as a teacher of gymnastics, a physician, and a university lecturer about the remedial gymnastics at the University of Stockholm. He constructed several devices which enabled constant and regular movement of individual parts of the human body, as well as certain devices that replaced the manual massage. Zander started his first institute in Stockholm in 1865. People could do exercise using his apparatus. He gained international fame by exhibiting his devices at the International Exhibitions in Brussels and Philadelphia in 1876 and in Paris in 1878. Several Zander's medico-mechanical institutes were established around the world and they were all named after him. There were two hundred and two Zander's Institutes in 1911 when his success and fame reached its peak. Zander's Institute in Opatija was constructed already in 1904 and it was located on the ground floor of Stein's mansion, known as Vila Stein, nowadays Vila Dora. The First World War changed the fundamental role of Zander's Institutes and the Great Depression in 1929 destroyed them. It seems the Institute in Opatija closed down at that time too, even thought we have not found out the precise date. The modern fitness studios started to emerge in Europe in the 1950s, a few decades after Zander's medico-mechanical institutes ceased to exist. Many modern professional fitness devices are basically derived from the apparatus that was recommended, constructed and launched into the society already by Dr. Gustav Zander. The authors of this article presume that it was Dr. Zander who already used the methods of physiotherapy and fitness that are generally used today.

Current review on squamous intraepithelial lesions of the larynx.

Squamous intraepithelial lesions (SILs) of the larynx, clinically usually defined as leukoplakia and chronic laryngitis, have remained the main controversial topic in laryngeal pathology for decades as regards classification, histological diagnosis and treatment. SILs are caused by smoking and alcohol abuse. There is also mounting evidence that gastroesophageal reflux is a potential aetiological factor. Human papillomavirus infection seems to play little if any role in laryngeal carcinogenesis. Histological classification of SILs is the central disputed aspect of these lesions. There are as yet no generally accepted criteria for histological grading of laryngeal SILs. Three currently used classifications of SILs are reviewed here: the dysplasia system, the Ljubljana classification and the binary system of squamous intraepithelial neoplasia. One of the most important issues of SILs is the risk of malignant transformation. Data in the literature are controversial because of inconsistent use of morphological criteria in different classifications. It is often difficult for clinicians to agree on the most appropriate therapeutic option for a particular grade of SIL that has been diagnosed. Transition from normal epithelium to SILs and squamous cell carcinoma is related to progressive accumulation of genetic changes leading to a clonal population of transformed epithelial cells. Despite extensive research into these genetic changes in laryngeal carcinogenesis, reliable genetic markers with diagnostic and prognostic value are still lacking.

100th anniversary of the Fourth International Congress of Thalassotherapy in Opatija.

The authors of the text have been particularly interested into the organization, the procedure,the accompanying activities as well as the themes covered at 4th International Congress of Thalassotherapy in Opatija in 1908. The Congress was organised by the then head of the thermal spa resort Professor Dr.Julius Glax. The official languages at the Congress were German, French, English, and also Italian and Croatian as the languages of the hosting country. Each lecturer had twenty minutes time to give a lecture or a co-lecture, ten minutes for papers and five for a follow-up discussion. The participants could make use of the information centre of the Congress, in the centre of Opatija, the whole day. Unofficially, the Congress started on 27th September 1908 with the introductory evening for all the participants in Adria Club. The Congress officially began on 28th September 1908 when all the participants gathered at the theatre hall of Hotel Stephanie. The lectures were presented in the morning. In the afternoon, the participants were taken to visit some exhibitions (e.g. the medical exhibition at Hotel Palace, the exhibition of the native Istrian-Dalmatian home crafts and antiquates and the painting exhibition at Vila Angiolina), a short sea voyage through the bay of Kvarner. On the last day of the Congress, the participants observed the sanitary conditions in Opatija (the water supply, the sewer system, litter incinerator, and quarantine for infectious illnesses), three sanatoriums, Zander's Institute, the rehabilitating-heart paths and the Archduke Ludwig-Viktor's indoor baths. The round-Opatija tour was followed by the concluding meeting and the conclusion of the Congress. The authors of this research have established that there are no important differences in the organization and realization of the congresses in the past and now.

[Health resorts in Styria, Charinthia and Istria once (1897) and today (2007).].

The aim of this study is to determine which health resorts existed in 1897 in Istria, Carinthia and Styria region, how many of them are still in use today and how the spas and their offer were represented in the past and how they are represented today. The study is based on the textbook Balneotherapie II (Bibliothek des Arztes 1900) by prof. dr. Julius Glax. The second source of our study is based on the currently available presentation of the health resorts from the internet. The textbook Balneotherapie was intended for the post graduate education of physicians and general practitioners, so they could advise the patient on further treatment in an appropriate health resort. In the chapter Balneographie the author represented 1200 health resorts all over the world. From the book we have chosen the following regions: Istria, Carinthia and Styria which used to be three parts of the Austro-Hungarian Empire. Today they are divided in to three neighboring states: Croatia (Istria), Slovenia (Istria, Carinthia, Styria) and Austria (Carinthia, Styria). Within these regions Glax presented 22 health resorts, 19 of them are still working today. Barbarabad/Barbara bath (Carinthia, Austria) does not exist either as a resort or as a city. Rimske toplice (Römerbad/Roman baths) and Rimski vrelec (Römerquelle/ Roman springs) in Styria region do not function as health resorts any more. Nowadays we make a difference between spa and health resorts. Spa resorts offer numerous forms of recreation for better well being. Health resorts offer health services, as well as neglected, but various forms of alternative treatments and recreation. Each spa and health resort is represented in brochures and on the World Wide Web individually. Tradition is usually not mentioned, it is neglected but the exception is Opatija (Abbazia) which past is usually presented in the brochures. The museum of medical tourism was opened in November 2007 in Opatija where you can admire the development of Opatija from a small village to a mundane health resort.

Telomerase catalytic subunit gene expression does not influence survival of patients with squamous cell carcinoma of the larynx and hypopharynx: a case-control study.

AIMS: to determine correlations between relative quantities of telomerase catalytic subunit m-ribonucleic acid (hTERT mRNA) and conventional clinicopathological parameters (such as site, size and grade of tumour, the presence of regional lymph node metastases, and, in particular, survival) in patients with laryngeal and hypopharyngeal squamous cell carcinomas (SCCs). MATERIAL AND METHODS: The relative quantity of hTERT mRNA was analysed by a commercially available LightCycler Telo TAGGG hTERT Quantification Kit in 56 cases of SCC (40 laryngeal and 16 hypopharyngeal). The association with cancer-specific survival was evaluated by univariate and multivariate analysis. RESULTS: Location of the tumour in the hypopharynx was the only significant negative predictive factor for survival, as determined by univariate analysis (p = 0.028). Although a tendency towards a better overall survival was observed for female patients younger than 50 years, for lower tumour grades and sizes, and for the absence of regional lymph node metastases, the prognostic significance of these factors could not be confirmed. No differences existed in hTERT mRNA expression between laryngeal and hypopharyngeal SCCs. Furthermore, no correlation was found between the relative quantities of hTERT mRNA and the tumour size, regional lymph node metastases or survival of patients with laryngeal or hypopharyngeal SCCs. CONCLUSIONS: The results of the present study suggest that genetic abnormalities other than telomerase reactivation are responsible for progression of laryngeal and hypopharyngeal SCCs.

Repair of anterior floor of mouth defects by a central or paramedian island tongue flap.

One method for restoring the anterior floor of mouth defects resulting from T(1) and especially T(2) cancer excision involves the creation of a myomucosal island flap from the dorsal median portion of the tongue and transferring it as a transit flap to the floor of the mouth. We are not the first to advocate this method. In this paper we present a previously unreported, slightly modified technique utilizing this tongue flap. The modification consists of a 90 degrees twisting of the flap to achieve a more appropriate adaptation to the defect. In the case of spreading carcinoma from the floor of the mouth to the central portion of the tongue, a similar paramedian one-sided tongue flap was created instead of a central island tongue flap. Our present experience consists of a small series of 12 patients. The procedures were successful in all patients. No remarkable disturbances of speech or deglutition were observed in any of the patients. There were two complications: one haematoma and one partial necrosis of the tip of the tongue. In our opinion, the reconstruction of the anterior floor of mouth defects using a central island tongue flap has not gained the popularity it deserves.

Proliferation of myofibroblasts in the stroma of epithelial hyperplastic lesions and squamous carcinoma of the larynx.

OBJECTIVES: The immunohistochemical phenotype, distribution and significance of proliferation of myofibroblasts in laryngeal epithelial hyperplastic lesions (EHL) and squamous carcinoma (SC) were analyzed. METHODS: Samples of 42 resected larynxes and 40 laryngeal biopsies of EHL and SC were included. Immunohistochemistry was performed using antibodies against vimentin, alpha-smooth muscle actin (SMA), desmin and leukocyte common antigen. RESULTS: Myofibroblasts were vimentin- and SMA-positive, and were found exclusively in SC, indicating that invasion beyond the basement membrane is necessary to evoke a myofibroblastic stromal reaction. We observed two patterns of stromal reaction in SC: one was characterized by a marked proliferation of myofibroblasts and desmoplasia, with scarce lymphocytic infiltration; this pattern tended to be associated with well- or moderately differentiated SC. The other was characterized by few myofibroblasts, weak desmoplasia, and dense lymphocytic infiltration; the latter pattern tended to be associated with moderately or poorly differentiated SC. The degree of myofibroblast proliferation was inversely related to the density of lymphocytic infiltration. Antibodies against SMA also stained stromal blood vessels, demonstrating a gradual increase of vessel density as the grade of EHL increased. CONCLUSIONS: Immunohistochemical analysis of myofibroblasts provides useful information on the phenotypic characteristics of the stroma in laryngeal EHL and SC, and can serve as an additional marker of invasion.