"Inferiority complex" for a reason.
Explore the source record for details and available documents.
Acetates↗
Biomedical subjects
Davor Plavec
Publications and source records attributed to Davor Plavec.
Secular birth weight changes in liveborn infants before, during, and after 1991-1995 homeland war in Croatia.
AIM: To assess secular trends in birth weights of liveborn infants in Croatia from 1983 to 2003. METHODS: Of a total of 959,591 liveborn infants in the study period, 384,367 were born in the prewar (1983-1989), 226,226 during the war (1991-1995), and 348 998 in the postwar (1996-2003) period. The birth weight of liveborn infants was assessed by 500 g weight groups on the basis of data provided by the Croatian National Institute of Public Health. RESULTS: The gradual and significant increase in the share of infants with birth weight > or =3500 g (<0.001) was paralleled by a reduction in the share of infants with birth weights 2500-3449 g (P<0.001) and <2500 g (P<0.05) in the study period. There was a positive trend in the proportion of 4000-4499 g, > or =4500 g (P<0.001 for both), and 500-999 g (P=0.002) birth weight groups and negative trend in 1000-1499 g, 2500-2999 g, and 3000-3499 g weight groups (P<0.001 for all). During the war period, the proportion of liveborn infants in the 2500-3499 g weight group decreased in comparison with prewar proportion; this trend continued in the postwar period (P<0.001 for both). In the war period, the proportion of liveborn infants with birth weights of 2000-2499 g was significantly larger (P<0.001) and that of > or =4500 g significantly smaller in comparison with the prewar and postwar proportions (P<0.001 for both). CONCLUSION: Positive secular changes in infant birth weights observed in the prewar and postwar period contrasted negative changes during the war period in Croatia. This finding may suggest the association between war suffering and stress and changes in birth weights of newborns.
Birth Weight↗
[The importance of exhaled breath condensate analysis in diagnosing a lung disease].
Exhaled breath condensate (EBC) contains aerosolised airway lining fluid and volatile compounds that provide non-invasive insight in biochemical and inflammatory activities in the lung. The interest in EBC has grown rapidly since this easily sampled fluid showed measurable properties that clearly indicate a disease. EBC assays provide evidence of redox deviation, acid-base status, and of the degree and type of inflammation in acute and chronic asthma, chronic obstructive pulmonary disease, cystic fibrosis, adult respiratory distress syndrome, and other lung diseases. Because of uncertain and variable degrees of dilution, EBC does not provide precise assessment of individual solute concentrations within native airway lining fluid. However, it can provide information when concentrations differ substantially between health and disease. Because, EBC assays are approachable and easy to perform, they will become integral components of future clinical studies, and after standardisation is accomplished, they might be used to diagnose and monitor therapy in clinical practice.
Breath Tests↗
Effect of educational programs on asthma control and quality of life in adult asthma patients.
This study investigated the effectiveness of different educational programs in obtaining better asthma control and asthma-related quality of life (QoL). In 60 adult patients with moderate persistent asthma we tested the benefit of individual verbal instructions (IVI), written information ("asthma booklet", B), and integrated asthma classes ("asthma school", AS). At the enrollment and at the end of the study, all participants completed the questionnaires regarding their asthma-related knowledge (ArK) and QoL. During the 12-week period all patients recorded their asthma symptoms, morning and evening peek expiratory flow rates (PEFR), and the use of rescue medication. AS and IVI groups showed a significantly greater improvement in QoL than the B group. AS group obtained the highest ArK but no difference in the level of improvement among the groups has been documented. The improved average asthma symptom score and decreased utilization of the rescue medication were documented in all groups without significant differences among them. We also found significant improvements in both morning and evening PEFR in IVI group as well as in the morning PEFR in AS group. We conclude that among tested educational interventions the AS caused the best improvement in QoL while IVI produced the best overall response in both parameters of the asthma control and QoL.
Adult↗
[ARIA--one airway, one disease: what links our research to the concept?].
ARIA (Allergic Rhinitis and its Impact on Asthma) is a public health initiative of the World Health Organization (WHO) based on the "one airway, one disease" concept. The trigger for the initiative was a growing evidence (from epidemiology, anatomy, pathophysiology, clinical diagnostics, therapy) of a pandemic increase in the prevalence of allergic disorders of the respiratory tract (allergic rhinitis and asthma), of the deficiency of primary and secondary preventive measures, and of incomplete therapeutic control over these conditions using current management strategies. Evidence gathered so far suggest a strong link between allergic rhinitis and asthma (anatomical and histological features, aetiology, similar pathophysiological mechanisms, related therapeutic results). Therefore, ARIA as a public health initiative aims at uniting the management of these, till now separated disorders. This review discusses the evidence on which the "one airway, one disease" concept and ARIA are based, including a contribution made by scientists from the Institute of Medical Research and Occupational Health, Zagreb, Croatia.
Asthma↗
Endotoxin measurement in house dust using the end-point Limulus amoebocyte lysate method.
Endotoxin is a lipopolysaccharide, a part of gram-negative bacteria cell membrane commonly present in general and many occupational environments. This paper describes sample preparation and endotoxin measurement in 16 samples of house dust from urban homes (Zagreb, Croatia) using end-point chromogenic Limulus amoebocyte lysate (LAL) bioassay. House dust was collected on cellulose filters by vacuuming bedroom and living room floors, and was kept frozen until assayed. Samples were extracted from filters with a 0.05% solution of Tween-20 in endotoxin-free water. Serial dilutions of samples were measured in duplicates. The linearity of the standard curve was satisfying (r=0.983), as well as the recovery (92 and 110%) and repeatability (coefficient of variation from 0 to 8.5%). The endotoxin levels found in the house dust samples ranged from 4.8 to 200 EU/mg, with the arithmetic mean of 49.5 EU/mg (standard error of the mean of 12.1 EU/mg), and were in the range of house dust endotoxin values obtained by other authors.
Air Pollution, Indoor↗
Exercise and allergic diseases.
The aim of this study was to compare exercise-induced bronchial reaction between healthy control subjects and subjects with allergic rhinitis (AR) and allergic asthma (AA). It included 16 controls, 16 subjects with AR and 19 subjects with AA. A skin prick test, pulmonary function test, histamine challenge test and exercise challenge test (ECT) were performed in all subjects. Bronchial reaction to exercise was expressed as the fall index FEV1 (%), AUC(0-30) (min x %), and fall index FEF(25-75) (%). After ECT, subjects with AA had a significantly greater bronchial reaction to exercise than subjects with AR and controls (respective fall index FEV1 8.4, 2.9, and 2.4%, P=0.0083; AUC(0-30) 127.7, 29.6, and 33.1 min x %, P=0.025; and fall index FEF(25-75) 14.6, 0.06, and 1.9%, P<0.001). No difference was found between subjects with AR and controls. In conclusion, ECT induced a significantly greater bronchial reaction in patients with AA and bronchial hyperreactivity to histamine than in patients with AR and bronchial normoreactivity to histamine and controls. This difference was not found between subjects with AR and controls.
Adolescent↗
Risk of acute bronchospasm and bronchial hyperreactivity from inhaled acid aerosol in healthy subjects: randomized, double-blind controlled trial.
AIM: To determine the risk of developing acute bronchial spasm and bronchial hyperreactivity in healthy subjects after inhaling hydrochloric acid aerosol of different pH, since various characteristics of inhaled aerosol, particularly its acidity, contribute to the reduction in lung function in patients with a pre-existing disease. METHODS: Randomized, double-blind, placebo-controlled trial included 79 healthy volunteers. After submitting a written consent, they were randomized in 4 groups with approximately equal number of participants. Each group was exposed to acid aerosol of different pH. The respiratory lung function expressed by forced expiratory volume (FEV1), forced expiratory flow at 50% (FEF50), 75% (FEF25), and between 25% and 75% of vital capacity (FEF25/75), and non-specific bronchial reactivity were measured after inhalation of hydrochloric acid aerosol of pH 7.0, pH 5.0, pH 3.0, and pH 2.0 and compared with baseline values. Twelve subjects, who reached the threshold doses in both bronchial challenges, were tested again after receiving a systemic beta-blockade with a single oral dose of propranolol. RESULTS: Significant bronchospasm developed after the inhalation of hydrochloric acid aerosol of pH 5.0, 3.0, and 2.0. After the inhalation of aerosols of pH 5.0 and pH 2.0, all parameters of respiratory lung function (FEV1, FEF50, FEF25, and FEF25/75) significantly decreased. After the inhalation of aerosol of pH 3.0, all parameters significantly decreased except for FEF25, which showed no significant difference (1.84+/-0.46 before vs 1.58+/-0.49 after inhalation; p=0.07). The inhalation of hydrochloric acid aerosol had no significant effect on the level of non-specific bronchial reactivity irrespective of its pH. Eight out of 12 subjects tested again after pretreatment with propranolol and with no significant change in the heart rate showed no change in non-specific bronchial reactivity in comparison with the 4 subjects who reacted with a significant decrease in the heart rate (>10%), as well as in non-specific bronchial reactivity (p=0.023). CONCLUSION: Inhalation of acid aerosol in healthy subjects induced a bronchial spasm, but had no effect on non-specific bronchial reactivity except in subjects under systemic adrenergic inhibition.
Adrenergic beta-Antagonists↗
Results of clinical-toxicological assessments performed in the Poison Control Centre in Zagreb over a 10-year period.
The aim of this study was to see which harmful substances and which occupational settings most often required toxicological assessment, to evaluate exposure data provided by employers and to see to what extent could this assessment rely on actual measurements of harmful substances in a working environment. We reviewed the documentation that was submitted for toxicological assessment in all patients referred from occupational health physicians between 1992 and 2001. From 1992 to 2001, the Poison Control Centre performed a total of 260 toxicological evaluations of occupational exposure to harmful chemicals. In 162 cases (62%), measurements of harmful substance concentrations in the working environment would have been of primary significance for the best comparison of potential adverse effects and the level of exposure. The most frequent was exposure to organic solvents in the production line and the use of various paints and varnishes, adhesives and thinners in shoe, chemical and metal-processing industry. Follows exposure to respiratory irritants, mostly in plastic and metal processing. However, measurement data of harmful substances in the working environment were available only in 24 cases, that is, in 9% of all documents submitted for toxicological assessment. Exposure to organic solvents is characteristic for a large number of work places in industry and small enterprises in Croatia, and it is necessary to carry out a more comprehensive study about the real levels of exposure and modes of effective control. It is important because the EU regulations on the indicative occupational exposure limits (OELs) of harmful substances in the working environment, that will soon be implemented into Croatian legislation, recommend a reduction of maximum allowable concentrations (MAC) for commonly used solvents.
Croatia↗
Exposure levels and skin reactivity to German cockroach (Blattella germanica) in Croatia.
AIM: To evaluate German cockroach (Blattella germanica) allergen levels in house dust and skin reactivity to German cockroach in adult atopic and non-atopic subjects in inland areas of Croatia. METHODS: Blattella germanica group 2 (Bla g 2) allergen was measured using the enzyme-linked immunosorbent assay (ELISA) on test strips (Dustscreen(TM) test, Heska AG, Switzerland) in 94 house dust samples collected from living room and bedroom floors, 35 from rural and 59 from urban areas. Skin prick testing with common inhalatory allergens, Blatella germanica, storage mites Lepidoglyphus destructor and Tyrophagus putrescentiae (ALK-Abello, Denmark) was performed in 187 adult outpatients, 131 from urban and 56 from rural areas. Total serum IgE levels were measured using the ELISA method. Subjects with relevant respiratory and/or skin symptoms, at least one positive skin prick test, and/or increased total IgE were considered atopic. RESULTS: Positive skin prick test to cockroach was observed in 18/187 subjects (9.6%). The frequency of skin prick test positive subjects to cockroach was higher in atopic than in non-atopic subjects, but not significantly (12.2% vs. 4.7%; p=0.098). Of 15 atopic subjects with positive skin prick test to cockroach, 14 also had positive skin prick test to storage mites, 8 to house dust mites, 1 to pollens, and none to cockroach only. Positive skin prick test to storage mites was the only factor which significantly increased the risk for having positive skin prick test to cockroach (n=187; odds ratio, 109.82; 95% confidence interval, 2.06- 5853.5; p= 0.020). In all 94 house dust samples, Bla g 2 was not detectable. CONCLUSIONS: Our results suggest that there is no relevant exposure to cockroach allergen in house dust samples from inland areas of Croatia. Consequently, positive skin prick test to cockroach is rare in adult subjects, even in atopics. Positive skin prick test to cockroach in atopics is in the majority of cases related to positive skin prick test to storage mites, probably due to cross-reactivity.
Adult↗
[Bronchial reactivity in patients with seasonal allergic rhinitis].
The allergic rhinitis (AR) is an important risk factor for the development of asthma. In significant number of patients with AR, the non-specific bronchial hyperresponsiveness (BHR) could be demonstrated. It has been anticipated that these patients were at the greater risk for asthma. This study was aimed to determine the frequency and intensity of BHR in patients with seasonal AR (SAR) due to Wall pellitory allergy. The patients who were sensitized solely to Parietaria officinalis (Wall pellitory) pollen allergen were recruited in the study, namely patients with SAR (n = 26), SAR with seasonal asthma (n = 23) as well as healthy volunteers (n = 10). In all subjects the clinical check-up, spirometry and bronchial challenge test with metacholine were performed before, during the peak, and after the peak of pollination of pellitory. Comparing to initial findings (23%), in patients with SAR the prevalence of BHR significantly increased during the peak of pollination (50%, p = 0.0039), and remained increased thereafter (43%, p = 0.0319). In patients with SAR and asthma prevalence and intensity of BHR was even higher with the similar seasonal variations. Comparing to initial findings (83%), the prevalence of BHR significantly increased during the peak of season (100%, p = 0.0001), and remained increased thereafter (87%, p = 0.061). In both groups of patients the intensity of BHR (median PC20) increased as well: 4.8, 2.05, and 2.45 mg/mL in patients with SAR, and 0.35, 0.16, and 0.20 mg/mL in patients with SAR and asthma. In healthy volunteers no significant BHR was observed. The results of the present study confirm significant prevalence of BHR in patients with SAR due to pellitory allergy. It is important to determine BHR in patients with SAR and without asthma because the appropriate pharmacotherapeutic and preventive measures (anti-inflammatory medication and specific immunotherapy) could prevent the development of asthma in these patients.
Adult↗
[Allergic disorders of the respiratory system and skin as a public health problem].
The prevalence of allergic diseases is rapidly increasing over the last 40 years, especially in most industrialized countries of the world. Manifestations of allergic diseases are observed in about 35% of the general population. In this paper, the most frequent allergic respiratory and skin diseases are described (rhinitis, asthma, atopic eczema/dermatitis syndrome, contact eczema/dermatitis, urticaria). The most important individual and environmental factors involved in the occurrence of allergic diseases are described: genetic predisposition, exposure to allergens, environmental pollution and modern life style are discussed. The results of our investigations related to the prevalence of allergy markers in general and working population are presented. The preventive measures concerning allergic diseases are considered.
Dermatitis, Allergic Contact↗