Detecting the occurrence of indigenous and non-indigenous megafauna through fishermen knowledge: A complementary tool to coastal and port surveys.

Marine bioinvasions and other rapid biodiversity changes require today integrating existing monitoring tools with other complementary detection strategies to provide a more efficient management. Here we explored the efficacy of fishermen observations and traditional port surveys to effectively track the occurrence of both indigenous and non-indigenous megafauna in the Adriatic Sea. This consisted mainly of mobile taxa such as fishes, crustaceans and molluscs. Port surveys using traps and nets within 10 major Adriatic harbours, were compared with the information obtained from 153 interviews with local fishermen. Information gathered by traps and nets varied significantly and generally resulted of limited efficacy in exotic species detection. Interviews allowed tracking the occurrence of new species through time and space, providing complementary knowledge at the low cost. This combined approach improves our capability of being informed on the arrival of species of different origin, providing a more rational, improved basis for environmental management and decision making.

Sharing of prescription analgesics amongst patients in family practice: Frequency and associated factors.

OBJECTIVE: To analyse the frequency of nonrecreational prescription analgesic sharing, associated factors and differences between lenders and borrowers. METHODS: A cross-sectional study was conducted in 10 outpatient family medicine practices in Croatia amongst 1000 patients to whom their physicians have prescribed analgesics at least once in their lives. A questionnaire was used to collect data about patients' pain intensity, prescription analgesic sharing habits, factors associated with this behaviour, perception of risks associated with the conduct and demographic data. Logistic regression was conducted to analyse independent factors associated with lending and borrowing prescription analgesics. RESULTS: We found that 61% of patients in family medicine practices engage in sharing prescription analgesics, whether it was lending (42%) and/or borrowing (54%). Independent predictors of lending prescription analgesics were as follows: history of sharing prescription medication other than analgesics, providing information regarding the medication alongside the prescription medication itself, not reading package insert that accompanies medication, subjective perception of personal health and decreased awareness of personal harm associated with prescription analgesic sharing. Independent predictors of prescription analgesic borrowing were as follows: younger age, communicating details regarding the medication that was given, scanning of package insert accompanying the medication, biased subjective perception of personal health and perceiving alternative medicine as a safer option over conventional medicine. CONCLUSIONS: Sharing prescription analgesics is highly prevalent amongst patients in family medicine. Healthcare providers should remain alert by routinely questioning patients regarding such behaviours. Preventive interventions should be conceived and established. SIGNIFICANCE: Sharing of prescription analgesics is a highly prevalent behaviour amongst pain patients, and there exist independent factors associated with such conduct. This information can be useful in the design of interventions aimed at mitigating analgesic sharing behaviour in the future.

[COCHRANE SYSTEMATIC REVIEWS ON PROSTATE CANCER].

Prostate cancer is a common malignant tumor of the elderly, which accounts for a significant proportion of total morbidity but very low of mortality. In Croatia, it is the second most common cancer in men. Currently, there are many doubts concerning screening, early detection and treatment of prostate cancer. Therefore, this article brings results of Cochrane systematic reviews (SRs) on the topic of prostate cancer published in the last eight years. In June 2016, Cochrane database of systematic reviews was searched using the following keywords: Systematic Reviews, and Prostate Cancer (Malignancy, Neoplasm). Inclusion criterion was publication date of the Cochrane SR or its update in the last eight years. The abstracts were initially screened and those that matched the topic were included in further analysis. Then full texts of all SRs involved were obtained. SRs were classified into four topics: prevention, screening, treatment and psychosocial aspects. Our search retrieved a total of 19 Cochrane SRs on the topic of prostate cancer. Excluded were four articles that did not match the specific topic, and the remaining 15 full texts were obtained. One of these was on screening, two on prevention, the majority, i.e. eleven were on treatment, and one on the psychosocial aspects related to prostate cancer. Based on the results of the Cochrane SRs on prostate cancer, instead of mass/population screening, the individualized/opportunistic screening approach should be applied in men aged 55-69, always providing full information to the patient and taking into account the potential benefits and harms of this procedure.

When elders choose: Which factors could influence the decision-making among elderly in the selection of health tourism services?

BACKGROUND: Elderly beneficiaries (age 65+) exhibit specific characteristics that influence the distribution of health tourism market. High incidence of multiple morbidities and functional disability are hallmarks in this age group. For these reasons, elderly population requires different elements and diverse spectrum of services within health tourism, in comparison to younger beneficiaries. Thus, differences would occur within heterogeneous elderly population itself. A preliminary study that we conducted showed that the level of functional independence was one of the significant factors that guided decision-making among elderly beneficiaries when it came to their health tourism-related choices. Results suggested that beneficiaries recognized and appreciated the effect of the natural remedies and attractions available at the given destination. HYPOTHESIS: Maritime and continental health tourism are two different entities commonly selected by elderly beneficiaries for therapeutic purposes. We propose that the climate conditions, geographical location and availability of regional natural remedies are the key factors to why different services were elected by different groups of elderly. The model of Croatia, an established country in the field of health tourism was utilized for this purpose. Differences in the diagnostic categories of beneficiaries are expected due to effects of marine (sea, Mediterranean climate) and continental (thermal water, healing mud) health tourism. In addition, multitudes of mutually intertwined factors affect decision-making process among elderly regarding their health tourism choices. Such factors include the scale of preferences (with special emphasis on well-being and health), leisure opportunities, marketing influences, cost (price) and the availability/diversity of health tourism services within the particular region. Moreover, individual psychosocial and physical characteristics, disabilities and other debilitating conditions, examined in our preliminary study, significantly contributed to the decision-making scheme. We shouldn't disregard sociodemographic and cultural preferences among elderly as potential factors. CONCLUSIONS: Confirmation of our hypothesis could change the usual approach towards the group of elderly beneficiaries (65+) in the health tourism domain. This approach is often largely based on chronological age criteria exclusively. The contents of this manuscript could serve as a blueprint for the development of comprehensive and sustainable health tourism strategies worldwide.

The effectiveness of acupuncture versus clonazepam in patients with burning mouth syndrome.

OBJECTIVE: Burning mouth syndrome (BMS) is a chronic oral condition, characterised by burning symptoms, which mainly affects perimenopausal and postmenopausal women. Neuropathy might be the underlying cause of the condition. There are still insufficient data regarding successful therapy. The aim of this study was to compare the effectiveness of acupuncture and clonazepam. METHODS: Forty-two patients with BMS (38 women, 4 men) aged 66.7±12.0 years were randomly divided into two groups. Acupuncture was performed on 20 participants over 4 weeks, 3 times per week, on points ST8, GB2, TE21, SI19, SI18 and LI4 bilaterally as well as GV20 in the midline, each session lasting half an hour. Twenty-two patients took clonazepam once a day (0.5 mg in the morning) for 2 weeks and, after 2 weeks, two tablets (0.5 mg in the morning and in the evening) were taken for the next 2 weeks. Prior to and 1 month after either therapy, participants completed questionnaires: visual analogue scale, Beck Depression Inventory, Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale, 36-item Short Form Health Survey (SF-36) and Montreal Cognitive Assessment (MoCA). RESULTS: There were significant improvements in the scores of all outcome measures after treatment with both acupuncture and clonazepam, except for MoCA. There were no significant differences between the two therapeutic regimens regarding the scores of the performed tests. CONCLUSIONS: Acupuncture and clonazepam are similarly effective for patients with BMS.

[MALNUTRITION SCREENING TOOLS FOR ELDERLY IN GENERAL PRACTICE].

Malnutrition of elderly is an unrecognized condition, which can be effectively treated. It is associated with increased morbidity, hospitalizations, lower quality of life, increased mortality and significant costs. Body mass index (BMI) is not a sufficient measure of nutritional status of the elderly as it does not take into account changes in body structure and composition caused by aging. Various validated screening tools are recommended to use in elderly. General practitioner (GP) provides health care for all the elderly living in the community and therefore has an ideal opportunity to screen them for malnutrition. The objective of the article is to show malnutrition screening tools for elderly, with an emphasis on those with sufficient sensitivity and specificity, applicable in family medicine. We searched databases Medline, Library of Congress and the Web of Science using selected keywords. The search was limited to articles published in the last 20 years, with no language restrictions. We found 37 articles: in initial screening we excluded 20 and 17 articles remained. After retrieving all 17 full texts, one more was excluded so that the final number of analyzed articles was 16. Among reviewed studies, following malnutrition screening tools were used for elderly: Geriatric Nutritional Risk Index (GNRI), Malnutrition Screening Tool (MST), Mini Nutritional Assessment-Short Form (MNA-SF), Nutritional Risk Screening 2002 (NRS 2002), Malnutrition Universal Screening Tool (MUST), Short Nutritional Assessment Questionnaire 65+ (SNAQ(65+)) and Australian Nutrition Screening Initiative (ANSI). The most frequently used tool (in nine articles) was MNA-SF, for its convenience, simplicity, sufficient sensitivity and specificity. Screening for malnutrition is the first step in nutritional care for the elderly. For the purpose of screening, GP has many tools available and should choose a simple one with sufficient sensitivity and specificity and easy to incorporate in the course of consultation with an elderly patient. It seems that such a tool for GP is MNA-SF.

Evaluation of DNA damage in vivo induced by combined application of cisplatin and sevoflurane.

BACKGROUND AND OBJECTIVE: The influence of the combined application of cisplatin and sevoflurane on a variety of cell types of healthy mice or mice bearing Ehrlich ascites tumour has been investigated in an in vivo study. METHODS: The alkaline comet assay method was carried out on peripheral blood leucocytes, brain, liver, kidney and tumour cells of healthy mice or mice bearing Ehrlich ascites tumour. Groups of mice were treated intraperitoneally with cisplatin, exposed to sevoflurane or by combined treatment of sevoflurane after treatment with cisplatin for 3 consecutive days. RESULTS: The in vivo exposure to sevoflurane induced genotoxicity to all assayed cells. A strong synergistic genotoxic effect to peripheral blood leucocytes, liver and kidney cells was found in mice receiving both cisplatin and sevoflurane. In contrast, a decrease of the comet tail lengths of brain cells in the combined treatments was found as compared to cisplatin alone in both healthy (P < 0.001) and Ehrlich ascites tumour-bearing mice (P < 0.05), respectively. In addition, Ehrlich ascites tumour cells of mice treated with combined treatments showed a decrease in tail lengths (P < 0.001). These findings indicate an antagonistic effect of combined treatments. CONCLUSION: Treatment of mice with cisplatin and sevoflurane induced genotoxic effect in peripheral blood leucocytes, liver, kidney, brain and Ehrlich ascites tumour cells; synergistic effect of combined treatments was expressed in all cells but brain and Ehrlich ascites tumour cells.