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Biomedical subjects

J Kern

Publications and source records attributed to J Kern.

139 records · Page 8Linked to original sources
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[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↗
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[An expert system for differentiation of viral meningitis].

The LOSTI system for viral meningitis differentiation, by using promptly accessible attributes, has been described. It is based on attribute values (averages and percentages). Logical principles on similarities and diversities are used. The system is dynamic for its ability to make itself permanently adjusted by using new cases and their attribute values. Through the possibility of prompt data processing according to a certain methodology, the system is able to take part in medical decision making. Its intention is not to make any definite decisions, just to "substitute" aetiologic diagnostics of viral meningitis in case it has not been successful or has not been done. It can also be used in epidemiological and statistical studies so long as the fact still stands that over half of the cases of serous meningitis remain aetiologically undiagnosed.

Diagnosis, Differential↗
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[Computer-assisted teaching in medical education--development of methods and supplemental materials].

A review of the elementary types of materials for the computer assisted learning (CAI--Computer Assisted Instruction) is given in this paper. It shows our initial experiences in creating the computer educational materials of the patient management simulation type, destinated for the primary care physicians. A computer simulation program "First Aid in Traffic Accident" is described as an example. A typical structure of these materials is shown. The materials had been developed using the own authoring system, a computer program which enables the teachers and other experts to create the computer educational materials independently, with the minimal help of the professional computer experts.

Accidents, Traffic↗
PubMedDate not supplied

[Follow-up study of changes in respiratory function in the same workers after an additional 6 years of exposure to pollutants in the rubber industry].

Follow-up study of respiratory function was carried out in a group of 311 male workers employed in one rubber industry. The prevalence of respiratory symptoms and ventilatory capacity were recorded over te period of six years. Lung function was measured by recording maximum expiratory flow-volume (MEFV) curves on which forced vital capacity (FVC), one-second forced expiratory volume (FEVI) and flow rates at 50% and the last 25% of the vital capacity (FEF50, FEF25) were read. The prevalence of all chronic respiratory symptoms was higher during the follow-up study although not statistically significant (p > 0.05). During both studies smokers had significantly higher prevalence of chronic cough, chronic phlegm and chronic bronchitis than nonsmokers (p < 0.05 or < 0.025). Measured values of ventilatory capacity were significantly lower than predicted normal values during both studies (p < 0.01). Percentage of predicted values were lower during the follow-up study in comparison to that during the initial study. The mean lowest percentages were obtained for FEF25 (initial study: 77.4%; follow-up study: 70.5%). Smokers had larger mean annual decrease of FVC: 0.073 L; FEVI: 0.063 L; FEF50: 0.100 L/s; FEF25: 0.085 L/s than nonsmokers (FVC: 0.063 L; FEVI: 0.058 L; FEF50: 0.083 L/s; FEF25: 0.058 L/s). Workers exposed for more than 10 years had larger mean annual decrease of ventilatory capacity tests than hose with shorter exposure. Our data indicate that exposure to noxious agents in rubber industry may be responsible for the development of chronic respiratory symptoms and chronic lung function changes.

Adult↗
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↗
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[Respiratory symptoms and pulmonary ventilatory function in greenhouse workers].

Respiratory symptoms and ventilatory capacity were studied in a group of 135 women employed in greenhouses. In addition, a control group of 51 unexposed women were studied. Greenhouse workers had significantly higher prevalence of chronic cough, dyspnea, chest tightness and rhinitis (p < 0.01) than the controls. Smokers had significantly higher prevalence of chronic cough (p < 0.01) and rhinitis (p < 0.05) than nonsmokers. There was a high prevalence of acute symptoms during work shift. In greenhouse workers there was a statistically significant decrease of measured ventilatory capacity tests (except FVC) as compared to the predicted normal values, especially for FEF25. Smokers and nonsmokers had similar changes of ventilatory capacity as percentage of the predicted normals. Greenhouse workers exposed for more than 10 years had considerably lower FEF50 and FEF25 as percentage of the predicted values than those exposed for less than 10 years. Our data indicate that longer exposure in greenhouses may be associated with the development of acute and chronic respiratory impairment.

Adult↗
PubMedDate not supplied

[The inductive approach in the routine laboratory diagnosis of thyroid dysfunction].

The method for defining strategy for thyroid function laboratory testing is presented in this study. In order to accomplish this task an available software, ASSISTANT Professional, was used. The strategy is generated by induction from routine data, using the method of minimizing entropy. Each of 1002 patients was described by 15 attributes and thyroid function status (euthyreosis, hyperthyreosis, hypothyreosis). Seventy per cent of the patients were chosen at random for generating and 30% for testing the strategy. The result is the decision tree or a set of decision rules. Absolute prognostic accuracy is estimated to 96% and relative to 90.16%.

Adolescent↗
PubMedDate not supplied

[The effect of atmospheric conditions on the occurrence of peptic ulcer hemorrhage].

The influence of atmospheric factors on the frequency of bleeding from the peptic ulcer was studied within the period from April 1, 1984, to March 31, 1989, consequently through 1826 days. The average daily atmospheric pressure, the average daily temperature and the relative humidity have been examined. There were 1102 cases of bleeding peptic ulcer, 537 bleeding gastric ulcers and 565 bleeding duodenal ulcers. During the study period there were 454 days with bleeding form ventricular ulcer and 465 days with bleeding from duodenal ulcer. There was 793 days with bleeding form either lesion. The discriminatory analysis demonstrated that the atmospheric pressure is the variable that discriminates the days with bleeding and the days prior to bleeding from the days without bleeding. The relative humidity occurs as the relevant discriminatory variable in the days prior to bleeding for the duodenal ulcer group and for the entire group. The centroids of the discriminatory function demonstrate that the days with ulcer bleeding are characterized by the fall of atmospheric pressure. The factor analysis of meterological variables clearly shows the correlation of the atmospheric pressure and the bleeding regardless to the localisation of bleeding ulcer, where the greatest number of bleedings is correlated with lower atmospheric pressure. We conclude that the incidence of bleeding form the peptic ulcer of the stomach and duodenum correlates in great measure with low atmospheric pressure in the days prior to bleeding and in the days of bleeding, as well as with fall of atmospheric pressure in the days of bleeding with respect to previous day.(ABSTRACT TRUNCATED AT 250 WORDS)

Atmospheric Pressure↗
PubMedDate not supplied

[Respiratory function in poultry workers].

A group of 343 workers (252 male and 91 female) employed in poultry farms was studied for the prevalence of acute and chronic respiratory symptoms and lung function changes. There were significantly higher prevalences of most of the chronic respiratory symptoms in poultry workers than in controls (p < 0.01 or < 0.05). Poultry male smokers had significantly higher prevalences of chronic cough, chronic phlegm and chronic bronchitis than poultry male nonsmokers (p < 0.01). Poultry workers employed for more than 10 years had also significantly higher prevalences of these symptoms than those with shorter employment (except female smokers). There was also a high prevalence of acute symptoms in poultry workers which develop during work shift. The measured FVC, FEV1 and FEF25 in poultry workers were significantly lower than predicted normal values. Changes were particularly pronounced in workers employed for more than 10 years. We showed additionally that a water-soluble poultry extract causes a dose-related contraction of nonsensitized guinea pig tracheal smooth muscle when studied in vitro. Our data suggest that the work in poultry farms may in some workers cause the development of acute and chronic respiratory impairment.

Acute Disease↗
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[A model for monitoring drug prescribing in general practice].

When prescribing drugs, general practitioners at the same should satisfy the requirements of medical science and their vocation, being aware of their task of a rational disposal of the limited resources allocated for health care. The aim of the paper was to determine the characteristics of monitoring model for drug prescription in general practice, taking into consideration the characteristics of the population, morbidity, drugs and physicians. A prospective monitoring of prescribing drug during one month was carried out in six doctor's offices of general practice/family medicine at the Dugave-Travno Health Station of the Novi Zagreb Health Center. In processing data on patients, drugs and physicians the following were used: distribution description and analysis, pair's tests and General Factorial Anova. Out of 3397 patients who visited the above mentioned doctor's offices, 2320 (68.3%) patients were prescribed 4796 prescriptions--an average of 2.07 prescriptions per patient (from 2.00 to 2.42). The total cost of drug prescription was 360,117.33 kunas (from 43,632 to 77,910 kunas). The number of prescriptions and the cost of prescribed drugs increased significantly in terms of statistics with the age of patients (Spearman's correlation coefficient 0.2263; p < 0.001). By General Factorial Anova statistically significant difference was determined in the cost variable among the physicians with the impact of covariate age and number of prescriptions. Professionally, the most appropriate and most rational prescribing was observed among physicians who had the highest educational level and the longest experience in practice. In order to analyze and assess the appropriatness of drug prescription in general practice, the first essential step is to collect data on what is being prescribed, for whom it is being prescribed, and to enable access to data for physicians. This paper has indicated some of the characteristics of a monitoring model for drug prescription in general practice. Formulation and implementation of this model would considerably promote the professional appropriateness and rationality in drug prescription in general practice.

Adolescent↗