HEALTH CARE IN SLAVONIAN PROVINCE DURING THE 19th CENTURY / Zdravstvena skrb u slavonskom Provincijalu tijekom 19. stoljeca

Due to its proximity to the Ottoman Empire, Slavonia was constantly exposed to the threat of invasion by numerous infectious and non-infectious diseases. An additional aggravating circumstance was the poor living and hygienic conditions in Slavonia, poverty, droughts, and floods. After the withdrawal of the Ottomans at the end of the 17th century, medical care was provided only by a few barbers and 'ranarniks' (i.e., feldshers) who remained in the Slavonian province. Due to the poor medical care, in 1770, the Empress and Queen Maria Theresa issued the General Health Law, which applied to the entire Habsburg Monarchy, including Slavonia. Among other things, it provided for the introduction of formal training for health personnel, ultimately leading to a better quality medical workforce. At the same time, charlatans were increasingly prohibited from working. The shortage of trained physicians, dentists, midwives, pharmacists, and veterinarians was addressed through various measures to promote their education and training. After obtaining their diplomas, these professionals were employed in hospitals, old people's homes, nursing homes, homes for people with disabilities, and other healthcare institutions where the inhabitants of the Slavonian province received medical care.

Does the Location of Fat Accumulation Affect the Degree of Aortic and Renal Arterial Calcification?

The vascular risk associated with obesity is particularly associated with visceral adiposity, but recent studies suggest that ectopic fat might contribute to the increased risk of atherosclerotic cardiovascular disease. Our study aimed to explore the connection between arterial calcification of the aorta and renal arteries with visceral and ectopic fat deposits, including liver, pancreatic, and renal sinus fat. Retrospective analysis of thoracoabdominal multi-slice computed tomography (MSCT) scans of 302 patients included measurements of calcification volumes of thoracic and abdominal aorta, and of both renal arteries. On the same scans, the visceral fat volume, liver-to-spleen ratio, pancreatic-to-spleen ratio, and both renal sinus fat areas were retrieved. Logistic regression showed the left kidney sinus fat area to be the most strongly associated with calcifications in the aorta and both renal arteries (coef. from 0.578 to 0.913, p < 0.05). The visceral fat positively predicted aortic calcification (coef. = 0.462, p = 0.008), and on the contrary, the pancreatic fat accumulation even showed protective effects on thoracic and abdominal aorta calcification (coef. = -0.611 and -0.761, p < 0.001, respectively). The results suggest that ectopic fat locations differently impact the calcification of arteries, which should be further explored.

Visceral and Ectopic Abdominal Fat Effect on the Calcification of the Abdominal Aorta and Its Branches-An MSCT Study.

Visceral and ectopic fat accumulation might have an impact on the atherosclerotic calcification of abdominal arteries. The pattern of calcification of the abdominal aorta and its branches is not fully investigated. We retrospectively analyzed the abdominopelvic MSCT images and calculated calcification volumes of the abdominal aorta, celiac trunk, superior and inferior mesenteric arteries, and both common and external iliac arteries. On the same MSCT scans, a visceral fat volume and ectopic fat deposits (liver-to-spleen ratio (L/S) and pancreas-to-spleen (P/S) ratio) were also measured. The results showed that calcifications of the abdominal aorta and its branches were associated with visceral fat volume, less strongly associated with L/S, and not associated with the P/S ratio. The abdominal aorta, the common iliac and external iliac arteries were more calcified arteries compared to the celiac trunk and superior and mesenterial arteries. In conclusion, visceral fat has a stronger effect on abdominopelvic arteries' calcification than ectopic fat. Visceral aortic branches are generally less calcified than iliac arteries.