The aim of this study was to estimate the frequency of fungal colonization of the stomach of patients suffering from gastric ulcer (GU) and chronic gastritis (CG) and the influence of fungal colonization of the stomach on the process of ulcer healing. We investigated 293 patients aged 20-80 years. Before and after 4 weeks of sucralfate treatment they underwent endoscopy of the stomach, histological examination of biopsies taken from the ulcer margin or inflamed gastric mucosa and mycological examinations of the gastric juice, surface brushing and biopsies. The studies revealed a high concentration of fungi in 54.2% patients with GU and 10.3% with CG. Candida albicans was the most frequently isolated organism. Fungal colonization of the stomach impairs the process of gastric ulcer healing. Control examination after 4 weeks of sucralfate therapy showed the ratio of GU healing in 62% of patients with a high concentration of fungi in comparison with 78% of patients not colonized with fungi (P < 0.05). A significantly longer duration of ulcer symptoms in the group of patients with a high concentration of fungi in the stomach was also observed. There was no correlation between the level of fungal antibodies, of Candida antigen in the serum and the concentration of fungi in the stomach.

Adult↗

PubMedDate not supplied

Effect of fungal colonization of gastric mucosa on the course of gastric ulcers healing.

BACKGROUND: The aim of the study was to evaluate the effect of fungal colonization on the course of gastric ulcer disease with particular regard to regression of clinical symptoms and reduction in ulcer niche size. MATERIAL AND METHODS: The study was performed on the group of 293 patients, aged 20-80, with clinical symptoms of peptic ulcer disease, who attended Gastroenterology Outpatient Department of Collegium Medicum of Kraków Jagiellonian University. Endoscopy of the upper gastrointestinal tract was performed before and following a-4-week period of a standard anti-ulcerous treatment. During the examination aspirate of the stomach contents and surface brushing were collected. Moreover, biopsy specimens from the bottom of the ulcer or inflamed gastric mucosa were taken for mycological and histopathological examinations. According to contemporary recommendations eradication treatment of Helicobacter pylori was introduced in urease-positive patients with endoscopy-proved gastric ulcer. RESULTS AND CONCLUSIONS: The results of our research showed that fungal colonization of gastric ulcers impairs the course of ulcer healing. Moreover, it results in clinical symptoms maintenance as compared with ulcers with non-significant fungal cells count.

Adult↗

PubMedDate not supplied

[Use of international databases for improvement of comprehensive care of patients with head and neck cancer].

The aim of this paper was to examine the usefulness of CancerNet in the improvement of knowledge of general practitioners on specific types of cancer and the procedures for patient management, thus indirectly producing an impact on quality improvement in comprehensive health care of patients with the head and neck cancer. Data on 58 patients with the head and neck cancer were collected from medical records in 28 general practices of the "Novi Zagreb" Health Center and from GPs' information. The GPs' knowledge on cancer of the larynx and hypopharynx was examined before and after they had studied the information provided by CancerNet. The mechanism of transferring information from the clinical and public health levels towards GPs was examined on GPs having in their care patients with the head and neck cancer. The following methodological characteristics were determined to have had an impact on patient care: within the structure of health care, a possible contribution of this procedure was identified in completing patient medical documentation as well as GPs' specific knowledge; within the health care process, a possible impact of this procedure on the quality of monitoring of a population health status, on more regular referrals to specialist consultations, as well as on pain and anxiety management, and a higher quality education on elimination of risk factors in patients' lifestyles. In average, the usefulness was scored by GPs with 4.0 for improving the communication with patients, and with 4.3 for expanding the GPs' knowledge. Three fifths of GPs involved in the study considered the contact range provided by CancerNet sufficient. All GPs assessed such information as useful for GPs in Croatia.

Databases as Topic↗

PubMedDate not supplied

Fungal colonization of gastric mucosa and its clinical relevance.

BACKGROUND: The aim of our study was to evaluate the incidence of fungi in the stomach in patients with gastric ulcer and chronic gastritis in comparison to healthy humans, and to identify the fungus species isolated from these patients and their susceptibility to antifungal agents. We also assessed the coincidence of the presence of antifungal antibodies and fungal mannan antigen in serum with the concentration of fungi in the stomach. MATERIAL AND METHODS: We investigated 293 patients, aged 20-80, who visited the Gastroenterology Outpatient Clinic at the Jagellonian University's Collegium Medicum in Cracow, complaining of dyspeptic symptoms or clinical manifestations of ulcer disease. The examinations included endoscopy of the upper part of the alimentary tract with sampling of gastric contents, as well as surface brushing and biopsy from the bottom of the ulceration for mycological analysis. Also, biopsy specimens from the margin of the ulceration or inflammatory mucosa were collected for histological examination and urease testing. RESULTS: Gastric mucosa and stomach contents are often an area of fungal colonization, which was detected in 54.2% of the gastric ulcer cases and 10.3% of the chronic gastritis cases. The most frequently isolated fungus species was Candida albicans, although other fungi, previously considered rare or uncommon, were also found. A difference in growth in vitro between the C. albicans, C. tropicalis and C. lusitaniae strains was discovered: C. albicans and C. tropicalis grew from pH 2.0, while C. lusitaniae grew from pH 3.0. This finding suggests differentiation in the properties of these fungi. CONCLUSIONS: The lack of correlation between the concentration of fungi, the titre of antifungal antibodies and the presence of fungal antigen in serum suggests that fungal colonization is secondary in nature.

Adult↗

PubMedDate not supplied

[Problems and recommendations for the care of refugees displaced by war in Croatia].

The present situation in Croatia and the principles of displaced person camp organization are described. Displaced person care has become the urgent problem imposed on the Croatian social service and health care system. The up to now work has revealed that their is a need for more precise categorization of displaced persons in order that a comprehensive registration system be developed. The number of registered displaced persons in Croatia up to 26 September 1991 is quoted. Based on problems noted in the organization of displaced person camps, elements of organization and known principles of health care system in Croatia, a new model of displaced person camp organization is proposed.

Humans↗

PubMedDate not supplied

[Attitude of nurses to aged persons].

Explore the source record for details and available documents.

Aged↗

PubMedDate not supplied

[Presence of lipophilic fungi of the genus Pityrosporum in patients with pityriasis versicolor and their pathogenicity in experimental animals].

Explore the source record for details and available documents.

Adult↗

PubMedDate not supplied

[Free choice of a physician in general medicine].

The purpose of this paper was to study the implementation of a free choice of a physician in general practice (GP) in 1992, as well as to study how it was influenced by the characteristics of GPs, population that made this choice, and health system. The study group of 71 GPs consisted of 37 (52.1%) specialists of general practice, 50 (70.4%) female GPs, 42 (59.2%) who worked in town and 52 (73.3%) who had their practices situated close to the place of residence of the majority of their patients. There were significant differences in the number (range, 450-5000 patients) and structure of patients on the lists of the studied GPs. The proportion of partial and whole families on the lists of the examined GPs was somewhat over 50%, and the same proportion of 50% had preschool children in care. No statistically significant differences were found in the size and structure of population on the lists between the studied GPs according to their age, sex or level of professional education. However, the site of outpatient clinic in a village and suburban area of a town or a town had a significant influence on the size and structure of the population in care of GPs. GPs who worked in the rural or outlying residential district of a town had a statistically significantly higher portion of families and preschool children on their lists than GPs who worked in towns. For the implementation of a free choice of a physician, it is mandatory to anticipate the period for adjustment and reconstruction of the primary health care (PHC) system.(ABSTRACT TRUNCATED AT 250 WORDS)

Croatia↗

PubMedDate not supplied

[Patterns of referring patients by general practitioners to specialist consultation--an international comparison].

The prospective study of referrals from 46 general practices in the Republic of Croatia to specialist consultation was carried out in the course of 1989 and 1990. A total of 39 specialists in GP, 3 trainees and 4 general practitioners were involved. Each GP marked period required for referral of 30 patients. The data collected included 1375 referrals and 22740 examined patients. The results from our study were compared with the analogous data collected in other 14 countries within the European Study of Referrals from Primary Care. In European countries the observed range of referral rates was almost fourfold (81.7 in Norway, 26.0 in France). The referral rate for the Republic of Croatia is 60.7 ranking Croatia fourth in the European comparison. The re-referral make 55.3% of all referrals in Croatia thus ranking Croatia first in the European comparison. Croatian GPs consult the following specialists (in order of importance): ophthalmologist (11.9%), surgeon (10.8%), internist (7.8%), otolaryngologist (7.6%), cardiologist (6.7%) and orthopedist (6.0%). A considerable variability of individual referral rates was noticed in the studied group of Croatian GPs (from 23.4 to 461.5). The value of determination coefficient R2 = 0.3233 was obtained using the classical multiple linear regression based on the system of predictors, which included 12 referral characteristics. This explained 32% of referral variability of the studied group. The ratio of routine referred patients (having the largest ratio of re-referrals), and the median age of referred patients had the most significant contribution to the coefficient of determination.(ABSTRACT TRUNCATED AT 250 WORDS)

Croatia↗

PubMedDate not supplied

[Are there too many doctors in Croatia?].

Estimates of the needs for education of physicians in Croatia must be based on analysis of population health condition and age structure, on the country's economic capacities on which the employment of those specialists depends, and on estimates of realistic educational capacities of the Croatian medical schools. Basic analysis of mentioned parameters indicates that in the upcoming decade there are no possibilities of more extensive employment. Thus, it is obvious that it is necessary to educate only a certain number of physicians: those which will serve as replacement for the deceased, retired or physicians leaving for other positions. To keep in mind--presently the unemployed physicians constitute a number which usually satisfies two-year needs for new employment. Thus it is recommended that the number of enrolled medical students in Croatia be reduced to around 400 students yearly. Together with a proper selection of candidates at admission, these would guarantee that about 320 students would be graduating eventually. This number does not include students from abroad, yet their number is almost inconsiderable according to the past few years and their studies are financed from separate funds. Medical studies should not be financed according to the number of enrolled students, because it stimulates larger enrollment, but according to the actual cost of the educational programme. Financing the programme, and not the number of students, would improve its quality and stimulate a larger number of highly skilled and competent students. Medical studies are expensive not only because of the length of the programme (6 years) but also because of the nature of these studies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

[The smoking habit in schoolchildren].

Smoking habit was studied in 2776 school boys aged 9-16 years from Zagreb and surrounding area. In a total sample, 422 (15.2%) examinees were smokers. The most of the smokers smoke 1 to 5 cigarettes daily and the most frequent duration of smoking is 1 to 3 years (62.6%). Boys started smoking already at the preschool age. Most of them started smoking during the first four years of primary school (54.1%). Statistical analysis did not show association between intensity and duration of smoking. Smoking intensity increases significantly with age. Significantly larger frequency of cough was found in smokers compared to nonsmokers (p < 0.0001). However, there is no significant association between cough and duration and intensity of smoking. Significantly larger number of fathers and other members of the family who smoke was found for boys smokers than for boys nonsmokers (p < 0.0001). Intensity of smoking and age of starting smoking in school children were independent of smoking status of the family members.

Adolescent↗

PubMedDate not supplied

[Ventilatory function and immunologic reactions in female workers processing dried fruits and teas].

Ventilatory capacity and immunological reactions were studied in 54 female workers employed in processing dried fruits and teas, and in 40 control workers. There was higher prevalence of all chronic respiratory symptoms in the exposed compared to control workers, although the differences were statistically significant only for dyspnea and nasal catarrh (p < 0.01). The exposed workers with positive skin tests had significantly higher prevalence of dyspnea (p < 0.05) and nasal catarrh (p < 0.01) than those with negative skin tests. In exposed workers there were statistically significant acute reductions of ventilatory capacity tests during the shift, particularly in flow rates at 50% and the last 25% of vital capacity on maximum expiratory flow-volume (MEFV) curves (FEF50, FEF25). In comparison to predicted normal values, the mean FEF25 was significantly lower than normal (p < 0.01). Significantly larger number of exposed workers compared to controls reacted with positive skin tests to at least one of the occupational allergens (p < 0.01). However, only the prevalence of positive skin test to sage (60.0%) was significantly higher than in control workers (20.0%) (p < 0.01). Our data indicate that exposure to aerosols of dried fruits and teas may in some workers cause the development of respiratory symptoms and increased skin reactivity to work-related allergens, with an increase of immunoglobulin IgE.

Adult↗

PubMedDate not supplied

[Acute respiratory infection in general clinical practice].

Due to high frequency, certain risk of related complications, absenteeism, direct and indirect costs related to them, acute respiratory infections represent a significant health problem. The aim of the paper is to examine the frequency and characteristics of acute respiratory infections, as well as the characteristics of patients with these infections among the population in care of general practitioners/family physicians. In 11 teaching general practices in Zagreb, data were collected from medical records on patients and acute respiratory infections which the patients developed over the period from October 1, 1994 to September 30, 1995. For statistical data processing description, distribution analysis and chi-square test were used. Out of 17,888 patients in care of general practitioners involved in the study, acute respiratory infections were noticed in 4,114 (22.9%) patients ranging in age from newborn to 97 years out of which 1,473 (35.8%) were males and 2,641 (64.2%) were females. A total of 5,892 acute respiratory infections were observed, in average 1.43 infections per patient, for which the patients visited their general practitioners 11,610 times (1.97 visits per infection). Most of the patients 2,958 (71.9%) attended their general practitioners because of one acute respiratory infection. The initial diagnosis of acute upper respiratory tract infection was registered in 4,601 (78.1%) infections, and final diagnosis in 4,475 (75.9%) infections. The most frequent diagnoses included: pharyngitis and tonsillitis (including streptococcal pharyngitis and tonsillitis), nasopharyngitis, sinusitis and bronchitis. In 4,874 (82.7%) cases, general practitioners based their diagnosis on patient history and clinical examination. Antibiotics were prescribed in 3,892 (66.1%) cases. Out of 42 (1.2%) patients treated in hospital, seven patients were admitted for tuberculosis and two for bronchi cancer detected during the acute respiratory infection. Follow-up was reported in 3,644 (60.3%) cases, and sick leave in 1,236 (31%) cases. The results of this study have shown significantly higher frequency of acute respiratory infections in the morbidity in outpatient health care, and also that management of patients with these diseases is mainly the responsibility of general practitioners. In order to improve professional competence of general practitioner/family physician and quality of work in the management of patients with acute respiratory infections in general practice/family medicine, it is necessary to continuously improve the knowledge on all characteristics of the management of patient with these diseases in general practice, as well as to make a critical assessment of the existing practice.

Acute Disease↗