Comorbidity of posttraumatic stress disorder and alcohol dependence in displaced persons.
(25/692)
AIM: To investigate in displaced persons a) the prevalence rate of current posttraumatic stress disorder (PTSD) and alcohol dependence; b) the relationship of alcohol dependence and current PTSD; and c) trauma exposure in relation to alcohol dependence comorbid to PTSD. METHODS: A group of displaced persons (157 men and 211 women) was interviewed using structured clinical interview based on DSM-III-R criteria for diagnosing PTSD and alcohol dependence, Watson's PTSD Questionnaire, and CAGE Questionnaire. RESULTS: Men showed higher prevalence rate of a current PTSD (50.3% of men vs. 36.5% of women, p=0.011), alcohol dependence (60.5% of men vs. 8.1% of women, p<0. 001), and alcohol dependence comorbid with PTSD (69.6% of men vs. 11. 7% of women, p<0.001). The rate of alcohol dependence increased in relation to current PTSD in men but not in women. Comorbidity of alcohol dependence and PTSD in women was influenced by alcohol-related problems before the war, whereas in men it was not influenced by any of the pre-war variables. The highest number of traumas was experienced by the displaced persons with a current PTSD only, followed by those with PTSD and alcohol dependence. The lowest number of war traumas was experienced by displaced persons with alcohol dependence, but without current PTSD. CONCLUSION: War traumas may have a role in the development of alcohol dependence in displaced men with current PTSD. The number of war traumas had a strong effect on the development of PTSD. Sex is a relevant factor in studying comorbidity of current PTSD and alcohol dependence. (+info)
Psychotic symptoms and comorbid psychiatric disorders in Croatian combat-related posttraumatic stress disorder patients.
(26/692)
AIM: To investigate the prevalence rate of post-traumatic stress disorder (PTSD) comorbid psychiatric disorders and to explore psychotic symptoms in patients with combat-related current PTSD. METHOD: The sample included Croatian war veterans (N=41) who were hospitalized at the University Department of Psychiatry of the Vrapee Psychiatric Hospital during the 1995-1996 period and fulfilled the DSM-IV criteria for the current and chronic PTSD. The Schedule for Affective Disorder and Schizophrenia (SADS-L) was applied for the assessment of current and lifetime psychiatric disorders. Only three subjects had a prewar Axis I psychiatric disorder. One third of the patients met the criteria for personality disorder. RESULTS: After severe combat trauma, the majority of PTSD patients (33/41) had at least one comorbid psychiatric diagnosis on Axis I. In those with personality disorders the most frequent was alcohol dependence, whereas in those without personality disorders it was major depressive disorder. Psychotic symptoms occurred in 8 out of 41 PTSD patients. None of them had a primary psychotic disorder or a personality disorder. In all the patients, psychotic symptoms were different from flashbacks. They were symbolically related to the trauma and resistant to antipsychotic treatment. Psychotic symptoms were associated with depression in 5 out of 8 patients with psychotic symptoms. CONCLUSION: Severe and prolonged combat trauma may be followed by the co-occurrence of PTSD and psychotic symptoms, forming the atypical clinical picture of PTSD. (+info)
Influence of 1991-1995 war on breast-feeding in Croatia: questionnaire study.
(27/692)
AIM: To investigate the influence of 1991-1995 war on the prevalence, duration, and practice of breast-feeding Croatian children up to 5 years of age. METHOD: In 1996, interviews were conducted in households with children up to 2 years of age (757 children) and 2-5 years of age (1,180 children). Data for war-free areas, war-affected areas, and areas liberated after several years of occupation were analyzed separately. RESULTS: In 1996, 94.6% of mothers started breast-feeding, which lasted for an average of 3.4+/-2.9 months. The proportion of mothers who started breast-feeding did not vary with respect to either war-related or geographic areas of the country. Breast-feeding was significantly longer in war-free than in war-affected areas (3.7+/-3.1 vs. 2.7+/-2.1 months, respectively; p=0.015). The duration of breast-feeding in Croatia's geographic regions, Istria, Hrvatsko Primorje, and Gorski Kotar, was significantly longer than in Slavonia (3.9+/-3.4 vs. 3.4+/-3.0, respectively; p=0.037). On the country level, 49.4% of babies were fed on demand and 43.3% according to a daily schedule. The percent of children who were not breast-fed was significantly higher (p=0. 002) in the older age group (2-5 years of age, 9.3%) than in the younger age group (up to 2 years of age, 5.4%). CONCLUSIONS: The war decreased the prevalence and duration of breast-feeding, which might be related to regular humanitarian donations of infant food and mother's milk substitutes, especially in the war-affected areas. UNICEF breast-feeding campaign, which started in 1993, appeared to be effective. (+info)
Decreasing risk of viral transfusion-transmitted diseases in Croatia.
(28/692)
AIM: To assess the risk of viral transfusion-transmitted infections in Croatia. METHODS: The following parameters were analyzed: frequency of blood donations repeatedly reactive for HBsAg and anti-HCV (1993-1999); blood donations confirmed positive for HBsAg and anti-HCV (1997-1999), anti-HIV1/2, and syphilis reactivity (1993-1999); number of registered patients with hepatitis B and C; transfusion-associated hepatitis B and hepatitis C; and frequency of HBV, HCV and HIV markers in patients with congenital bleeding disorders (1993-1998). RESULTS: The frequency of repeatedly reactive HBsAg and anti HCV markers and confirmed positive HBsAg, anti-HCV, and syphilis markers in donors blood decreased during the study, whereas the frequency of anti-HIV1/2 positivity did not change. The frequency of confirmed positive donors in 1999 was 0.068% for HBsAg, 0.035% for anti HCV, 0.002% for anti HIV1/2, and 0.0056% for syphilis. The number of patients with hepatitis B, hepatitis C, and transfusion-associated hepatitis B and C steadily decreased during the 1993-1998 period. The number of transfusion-associated hepatitis patients leveled off in 1997. From the beginning of the follow-up of AIDS patients in 1987, only 7 (2%) of hemophiliacs have been HIV-infected, all before 1990 and due to non-inactivated coagulation factor concentrates. There were no cases of transfusion-associated HIV2 infection in patients with congenital bleeding disorders or transfusion-associated HIV1 infection through transfusion of labile blood components. CONCLUSION: The safety of transfusion therapy in Croatia has improved, and the present risks of viral transfusion transmitted diseases are very low. (+info)
Substance abuse in the Republic of Croatia and National Program for Drug Control.
(29/692)
AIM: To establish the proportions of drug abuse problem in Croatia, with special reference to illicit drugs abuse, in order to assess the quality of implementation of National Program for Drug Control on the basis of relevant indicators. METHODS: Collection and review of data on the extent of particular drug abuse among adolescents (aged 13-19), epidemiological data on treated drug addicts, and the data from the police and justice. RESULTS: Drug abuse epidemic in Croatia started with the beginning of the war in 1991. Tobacco smoking and alcohol consumption among adolescents have also become more frequent. In the last 10 years, the number of illicit drug addicts increased from 1.0 per thousand population in 1991 to 2.7 in 1999. The extent of drug use varies within the country. The situation is most serious in the coastal area. Data for 1999 indicate a possible cessation of the epidemic spread, but on the high level of incidence (around 1,500 new drug addicts per year, with 85% of heroin addicts). CONCLUSION: Although a lot was done due to the initiative of the experts in the Government Commission for Suppression of Drug Abuse and the Government Center for Prevention and Outpatient Treatment of Addiction, many measures on the National Program agenda were not carried out due to the insufficient political support and scarcity of mobilized resources. Since the illicit drug abuse is the most serious problem among the adolescents today, it must be set high on the list of national priorities. (+info)
Distribution of alleles at DQCAR microsatellite locus in the Croatian population.
(30/692)
AIM: To investigate the polymorphism of DQCAR alleles and their association with HLA-DRB1, -DQA1, -DQB1 haplotypic associations in the Croatian population. METHODS: Blood samples were collected from 135 healthy unrelated donors from Zagreb area previously typed for HLA class II alleles (DRB1, DQA1, DQB1). The DQCAR samples were run on a standard denaturing sequencing gel in a DNA sequencer and the sequences were analyzed and compared. RESULTS: Among 10 different DQCAR alleles found in the population of Croatia, the most frequent were DQCAR 103 bp (41.5%), 121 bp (13.7%), 111 bp (11.9%), and 99 bp (10.7%). DQCAR alleles 101 bp, 115 bp, 123 bp, and 125 bp were not observed. Comparison of DQCAR allele frequencies between Croatians and other populations did not reveal any significant difference. The study proved a little diversity in DQ1 haplotypic associations. Among 141 examined DQ1 associations, 120 were DQCAR 103 bp, whereas the remaining 21 were DQCAR 107 bp. The DRB1*07 haplotypic association showed the highest diversity of DQCAR alleles (111 bp, 113 bp, 117 bp, 119 bp, and 121 bp). Three unusual haplotypic combinations were found: HLA-DRB1*0401, -DQA1*0301, -DQB1*0302, -DQCAR119bp; HLA-DRB1*0408, -DQA1*0301, -DQB1*0304, -DQCAR117bp; and HLA-DRB1*0701, -DQA1*0201, -DQB1*02, -DQCAR 105bp. CONCLUSION: Specific DQCAR alleles observed in association with common Caucasoid haplotypes are also found in the Croatian population, but in new and unusual associations. These associations have not been reported in other populations, which suggests that they might be a characteristic of Croatians. (+info)
Neurophysiology and molecular genetics of Charcot-Marie-Tooth type 1 neuropathy in Croatian children: follow-up study.
(31/692)
AIM: Longitudinal assessment of clinical and neurophysiological abnormalities in childhood and adolescence and incidence analysis of tandem Charcot-Marie-Tooth disease type 1A gene duplication in Croatian children with Charcot-Marie-Tooth type 1 neuropathy. METHODS: Eight Croatian children with Charcot-Marie-Tooth type 1 neuropathy, aged 4-19 years, were studied clinically, neurophysiologically, and neuropathologically during 1-11 years of follow-up. All children were examined at least once, and in 4 children the measurements were repeated. Molecular genetic analysis was performed in all patients and their family members in order to determine the presence of the Charcot-Marie-Tooth disease type 1A duplication on chromosome 17p11.2-p12, using restriction fragment length polymorphic and short tandem repeat markers. RESULTS: Clubfoot was the most frequently observed clinical feature in children under 10 years of age, whereas muscle hypotrophy, scoliosis, and contractures developed in the second decade of life. All patients showed decreased motor nerve conduction velocity (7-30 m/s) and prolonged distal motor latencies on the first and follow-up examinations. Compound muscle action potential amplitude reduction (0.1-1.25 mV) was recorded in the first and second decade of life. In 6 out of 8 children, molecular genetic studies demonstrated the presence of the 1.5 megabase tandem Charcot-Marie-Tooth disease type 1A duplication in 17p11.2-p12, mostly of paternal origin. CONCLUSION: Pronounced neurographic abnormalities and mild clinical features characterize Charcot-Marie-Tooth type 1 neuropathy in the first decade. There were no significant differences in neurographic abnormalities in the first or second decade of life between Croatian children with and without Charcot-Marie-Tooth type 1A duplication. (+info)
Liver angiosarcoma and hemangiopericytoma after occupational exposure to vinyl chloride monomer.
(32/692)
Various malignant tumors of the liver, especially liver angiosarcoma, have been described after occupational exposure to vinyl chloride monomer. We present the case records and pathologic findings of two plastic industry workers who had been exposed to high concentrations of vinyl chloride. These workers developed hepatic neoplasms, angiosarcoma, or hemangiopericytoma. We discuss the histogenesis of these tumors; the common vascular origin and the mutual transformation of these two tumors suggest that the hemangiopericytoma may also have developed during occupational exposure to high concentrations of vinyl chloride monomer. (+info)