Surgical treatment of toxic adenoma

In the period ranging from 1985. to 1994. a total number of 86 patients have been treated for toxic adenoma (TA). Hyperthyroidism was more often present in males (70.83% versus 51.61%) and in enlarged adenomas (more then 2 cm in diameter). Pathohistologic type of adenoma influenced degenerative changes. Three carcinoma have been observed, two papillary and one follicular. Surgical treatment is the method of choice. Complications are rare (3.49%) and mild.     

Overview of the surgical importance of variations in the hepatic artery

Hepatobiliary and gastric surgery greatly depend upon knowledge and recognition of origin, relations and course of the hepatic artery. This paper presents the main variants of the arterial vessels in the hepatoduodenal ligament, with a concise review on their clinical relevance. Special attention was drawn to the aberrant hepatic arteries, which are found in nearly half of the cases, and to the macro- and microvasculature of the common bile duct.     

Local interferon therapy for lip carcinoma

In a prospective non-randomized study 21 patients with lower lip squamous cell carcinoma were treated with human natural leukocyte interferon (HNLI). The response rate was measured by a size reduction of more than 25% and was 81%. A complete response rate was considered to be a cure according to histopathological and clinical findings and was 48%. The response rate of six lower lip squamous cell carcinoma cases treated with recombinant interferon alpha 2c was 67% and the complete response rate was 17%. Three patients with basal cell carcinoma of the upper lip were also treated with HNLI. All three patients were cured, as determined by histopathological and clinical findings. These findings indicate that interferon can be a useful alternative therapy for lip carcinoma either with or without surgery.     

Iodine prophylaxis and nuclear accidents

Due to high volatility and environmental mobility, radioactive isotopes of iodine pose a serious risk in the acute phases of a nuclear accident. The critical organ for iodine is the thyroid. A number of studies dealing with thyroid protection from exposure to radioiodine have shown that radioiodine uptake by the thyroid can be effectively blocked by administration of stable iodine, usually in the form of potassium iodide (KI) pills. However, unless perfectly timed, this protective action may be counterproductive. The International Atomic Energy Agency recommends potassium iodide prophylaxis in cases when an avertable thyroid dose by protective action exceeds 100 mGy. This paper reviews experiences and practices with potassium iodide in the thyroid protection. This kind of information should serve as the basis for discussion and decision making on KI prophylactic programmes in nuclear emergency situations in Croatia. If Croatia adopts such programme, it will still have to develop the most effective way of KI stockpiling and distribution or predistribution.     

Shiftwork and quality of life

The aim of this study was to compare the quality of life of shiftworkers and non-shiftworkers. Satisfaction with various aspects of life and the overall satisfaction were examined by means of the Quality of Life Scale. A total number of 107 chemical industry workers participated in the study, of whom 56 worked shifts and 51 worked regular hours. The results revealed that the average satisfaction with the present job and financial status was lower in shiftworkers than in the non-shiftworkers (P < 0.05). The differences in the two predictors of life quality did not affect the overall satisfaction with life in either group.     

Ochratoxin A in blood of healthy population in Zagreb

Healthy blood donors from the city of Zagreb were checked for the presence of a nephrotoxic mycotoxin ochratoxin A (OTA) in the plasma. Samples of blood were collected in June, September, and December 1997, and March 1998, totalling 200 or 50 in each round. The concentrations of OTA were measured using high pressure liquid chromatography (HPLC) method (detection limit 0.2 ng OTA/ml of plasma). The frequency of OTA-positive samples (> 0.2 ng/ml of plasma) showed significant seasonal variation (P < 0.001). The frequency of OTA-positive samples was the highest in March (65%) and it gradually decreased towards December (12%). The high frequency of positive samples coincided with seasons favouring growth of moulds and production of toxins. The daily intake of OTA by healthy persons in Zagreb was estimated from the mean concentration of OTA in samples collected during the whole year (0.19 ng OTA/ml plasma). The estimated daily intake was 0.26 ng/kg b.w., that is, substantially below the tolerable daily intake proposed by World Health Organization (16.0 ng/kg b.w.).     

Comparison of two methods using atomic absorption spectrometry for determination of selenium in food

This study describes and compares two methods of atomic absorption spectrometry (AAS) for the selenium (Se) analysis in food: electrothermal AAS (ET AAS) and hydride generation method of AAS (HG AAS). The accuracy of the two methods was established by analysing two biological reference materials: Wheat Flour 1567a and Bovine Liver 1577b from the National Institute of Standards and Technology, USA. Good agreement with certified values was obtained for both methods. The accuracy of ET AAS method is 109% and 103% for Wheat Flour and Bovine Liver, respectively. The respective accuracies for HG AAS method were 88% and 87%. The detection limit obtained for ET AAS was 1 microgram Se/L and for HG AAS 0.02 microgram Se/L. The repeatability of ET AAS method was 5-11% and that of HG AAS 14-17%. Both methods are similar in accuracy and repeatability, but hydride generation (HG AAS) is more sensitive than graphite furnace technique (ET AAS) for determination of selenium in food.     

Occupational physical demands and hip osteoarthritis

The authors investigated the influence of physical strain at work on radiological signs of hip osteoarthritis. The study included 295 men and 298 women aged over 45 from an urban area who were classified in four groups according to physical demands of their occupation. The evaluation included clinical and radiological signs of hip osteoarthritis. The association between hip osteoarthritis and occupation was analysed using logistic regression. Though not significantly, radiological signs of hip osteoarthritis were common in subjects who worked in a standing position (odds 1.45 for men, 1.50 for women). Clinical signs of osteoarthritis in women were significantly associated with performance in a standing position (odds 3.00), whereas in men the association was more significant for jobs with high physical strain (odds 2.19). There was a sustained trend toward an increase in health risk with years of work in all job categories. Occupation did not appear to influence the development of radiological hiposteoarthritis, but the authors did establish association between clinical signs of hip osteoarthritis and work.     

Financing of dental health care in the Federation of Bosnia and Herzegovina

Financing dental health care in the Federation of Bosnia and Herzegovina (FBH) over the last 10 years was analyzed with respect to time before the war, during the 1992-1995 war, and after the war. In the first period (until 1991) the system was centralized, well structured, financed through the communities of interest, and burdened with a lack of financial discipline and high inflation. By the end of 1991, all citizens in the territory of BH Federation had the right to dental health insurance and participated in the price of dental service with 10-50%. During the 1992-1995 war, insurance and financial institutions ceased their work until the establishment of civilian governing authorities. The system of dental services was legalized within the health system as its integral part, yet, because of insufficient financial support, the rights of the insured were not fulfilled. Following the Dayton Peace Agreement in 1995, two systems (Croat and Muslim) were in function in FBH, each based on different legal grounds, and dental care stagnated considerably. The 1997 FBH Law on Health Care and Health Insurance and the Law on the Privatization of companies introduced a unique health system, widening the sources of financing and categories of health insurance. The process of health care privatization has been legalized, but not yet implemented. Lack of definitions of ownership diminish foreign investments, and without foreign financial support the improvements will be slower than needs. The process of health care restructuring will thus directly depend on the solving the political crisis in the country.