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Biomedical subjects

Josipa Kern

Publications and source records attributed to Josipa Kern.

18 recordsLinked to original sources
PubMed2005

Differentiation between Candida species isolated from diabetic foot by fatty acid methyl ester analysis using gas chromatography.

Gas chromatography (GC) was used to differentiate 100 isolates of Candida species (Candida parapsilosis, Candida albicans, Candida tropicalis, Candida famata and Candida glabrata) from 22 of 509 diabetic patients in whom the same species had been isolated from ulcer and interdigital spaces of the same and/or the other foot. All clinical isolates were identified by quantitative differences in the composition of six cell fatty acids (CFA). The values of the coefficients of variability (CV) of CFA show that the isolates from foot ulcers and interdigital spaces of the same diabetic patient probably belong to different chemotypes of the same Candida species.

Aged↗
PubMed2005

A naturalistic inquiry on the impact of interventions aiming to improve health and the quality of life in the community.

The goal of this study is to identify and describe variables contributing to the efficiency of health promotion interventions, and to assess whether these variables can serve as reliable and early indicators of the success of such interventions. The study sample includes 44 interventions selected through a network of key informants from five cities--Liverpool, Sandwell, Vienna, Pula, and Rijeka--by using a chain technique. Data on each intervention are collected through an in-depth interview with a program leader, the collection of project-related documents, and on-site observation. Qualitative analysis of data performed with content analysis and computer-assisted free-text analysis reveals different characteristics of interventions depending on whether they are initiated by the city government sector, health-care system, or citizens sector (independent of the city or country). The assessment of the efficiency of these three groups of interventions also differs because of varying features, scope (activity potentials) and impact they are able to accomplish. We have identified ways in which the efficiency of all three groups of interventions can be improved. The efficiency of the interventions within the city sector can be increased through an improved process of delegation to other sectors, higher involvement of user groups, and higher receptivity and organizational flexibility. The efficiency of the interventions within the citizens sector can be improved through professional, organizational, and financial support. Support from the professional community is important for citizens sector interventions in confirming the importance of the problem they address and legitimizing the actions they propose and undertake.

Adolescent↗
PubMed2005

[Informatics in the Croatian health care system].

Informatization process of the Croatian health care system started relatively early. Computer processing of data of persons not covered by health insurance started in 1968 in Zagreb. Remetinec Health Center served as a model of computer data processing (CDP) in primary health care and Sveti Duh General Hospital in inpatient CDP, whereas hospital administration and health service were first introduced to Zagreb University Hospital Center and Sestre Milosrdnice University Hospital. At Varazdin Medical Center CDP for health care services started in 1970. Several registries of chronic diseases have been established: cancer, psychosis, alcoholism, and hospital registries as well as pilot registries of lung tuberculosis patients and diabetics. Health statistics reports on healthcare services, work accidents and sick-leaves as well as on hospital mortality started to be produced by CDP in 1977. Besides alphanumeric data, the modern information technology (IT) can give digital images and signals. Communication in health care system demands a standardized format of all information, especially for telemedicine. In 2000, Technical Committee for Standardization in Medical Informatics was founded in Croatia, in order to monitor the activities of the International Standardization Organization (ISO) and Comite Européen de Normalisation (CEN), and to implement their international standards in the Croatian standardization procedure. The HL7 Croatia has also been founded to monitor developments in the communication standard HL7. So far, the Republic of Croatia has a number of acts regulating informatization in general and consequently the informatization of the health care system (Act on Personal Data Confidentiality, Act on Digital Signature, Act of Standardization) enacted. The ethical aspect of data security and data protection has been covered by the Code of Ethics for medical informaticians. It has been established by the International Medical Informatics Association (IMIA), and the Croatian Society of Medical Informatics (CSMI) has translated it into Croatian and published it on its website. Based on a survey of medical staff attitudes toward health care system informatization, the Croatian health system appears to be ready for informatization. The only requirement is that the present and future health care providers have appropriate medical informatics education, proper computer equipment at their workplace, and an opportunity to participate in the development and/or improvement of the health information system. One of the EU health strategy priorities is the improvement of health information and knowledge. It means that integrated health information systems are required, i.e. systems able to provide key information on health and health care system to the politicians, health professionals and public in general.

Croatia↗
PubMed2005

[Role of standardization in health care system computerization].

Standardization system includes development, publishing and promotion of standards, as well as their use in practice. Products, services and processes in a variety of human activities should be standardized. The goal of standardization is to achieve a high security level, a high quality, usefulness and effectiveness as well as limitation of variability, ensuring compatibility and replacement (of products), and to eliminate technical problems in the international exchange of people, work, products and services. The leading areas/objects of standardization in medical informatics are electronic health record, classification in health care, communication and message exchange as well as data security and protection of the whole health information system. Technical Committee for Standardization in Medical Informatics (TC215) has so far accepted fifteen standards and prestandards. The affiliate HL7 Croatia works on localization of communication standard HL7 and adaptation to the Croatian requirements.

Computer Security↗
PubMed2005

Seasonality of births in Croatia.

The aim of this paper was to investigate seasonal fluctuations of the number of births in Croatia. Vital registration data from the years 1970-2002 was used for analysis of the quarterly data (from the years 1970-1997), and monthly data (from the years 1998-2002). Both data sets were smoothed, using seasonal variation removal for quarterly data, and T4253H smoothing for monthly data. Edwards test and Ratchet circular scan tests were used in analysis. The results showed an increase in the summer birth proportion and decrease in the spring birth proportion, distorted during the wartime period (1991-1995). Monthly analysis reveals highest birth proportion in Croatia during July-September period, with peak date moving towards the end of summer, and reaching stability in the beginning of September during the years 2000-2002. This presumes highest conception rate during the beginning of the Christmas holiday season. Secondary peak in January was found in some years, which presumably sets second period of increased conception rate into the Easter holiday season, supporting the observation of the holiday-related birth peaks. Both quarterly and monthly data indicate a birth pattern that does not resemble either "European", or "American" seasonal pattern. Regional analysis showed lack of seasonality in the capital city of Zagreb and either intermittent or stable seasonality pattern in the rest of the country.

Adult↗
PubMed2004

Immunological and respiratory changes in tobacco workers.

BACKGROUND: Tobacco workers develop respiratory changes following occupational exposure to tobacco dust. METHODS: This study investigated 102 tobacco workers as well as a group of 30 matched control workers. Immunological testing, symptom questionnaire, and lung function measurements were performed in all workers. RESULTS: Increased total IgE was found in 12.7% of tobacco workers but in none of the controls (P < 0.05). Increased specific IgE (tobacco allergen) was recorded in 26.7% of tobacco workers with positive skin tests to tobacco extract but in none of the controls (P < 0.05). Regression analysis of ventilatory tests in female tobacco workers indicated a significant association of FEF75 to employment and smoking among workers with positive skin tests to tobacco. There were, however, no other associations between positive immunologic findings and lung function abnormalities and symptoms. CONCLUSIONS: Our study found increased immunological reactions in the tobacco workers. However, with the possible exception of lung function at low lung volume in female workers, these reactions do not appear to contribute significantly to the symptoms and lung function abnormalities seen in these workers. Am. J. Ind. Med. 45:76-83, 2004.

Adult↗
PubMed2004

Respiratory findings in pharmaceutical workers.

BACKGROUND: Pharmaceutical workers may be at risk for the development of respiratory problems as a result of their work environment. METHODS: This study investigated 163 female and 35 male workers, employed in a pharmaceutical plant processing different types of medication, primarily antibiotics, in order to characterize the risk of this environment. Chronic respiratory symptoms were recorded by using the British Medical Research Council questionnaire. Acute symptoms, which developed during the work shift, were also recorded. Ventilatory capacity was measured by recording maximum expiratory flow-volume (MEFV) curves on which FVC, FEV1, FEF50, and FEF25 were measured. Controls (113) were selected from a food packing facility. RESULTS: A significantly higher prevalence of chronic respiratory symptoms was recorded among workers (compared to controls), the highest being for sinusitis, nasal catarrh, and dyspnea. There was also a high prevalence of acute symptoms recorded during the workshift. Odds ratio showed that the most significant risk factors for these respiratory findings were smoking and length of time worked in the pharmaceutical industry, particularly in men. Pulmonary function testing demonstrated significantly decreased measured values in comparison to predicted European pulmonary function measurements (P < 0.01). This was particularly pronounced for FEF50 and FEF25, suggesting obstructive changes in smaller airways. CONCLUSIONS: Our data suggest that workers employed in the pharmaceutical industry may develop respiratory symptoms accompanied by ventilatory impairment.

Adult↗
PubMed2004

What was the lifestyle of people who died by cardiovascular diseases?

AIM: The aim of this study was to find out the nutrition pattern and lifestyle for people who died by CVD. DATA: Population included cohort from continental and island regions of Croatia characterized by different nutrition, especially considering fat and/or oil consumption. Three groups of respondents were analyzed: whole population (WP), population of people died by CVD, and at the beginning of the study they were not taking drugs (CVD-N), and population of people died by CVD, and at the beginning of the study they were taking drugs (CVD-Y). RESULTS: Group CVD-N was characterized by higher proportion of people taking less than three meals per day (25.1%) comparing with WP (15%) and CVD-Y (10.9%); they prepare their food primarily with animal fat - even more than the whole population. Group CVD-Y was characterized by higher proportion of people preparing their food with oil, especially for preparing vegetables (63.5% comparing with 24.9% in whole population, and 16.4% in CVD-N group). Most important is the fact that CVD-N group was not different from general population, but it was very different comparing with CVD-Y. The CVD-N group smokes, consumes animal fat, alcohol, and coffee more than CVD-Y group. Blood pressure, cholesterol and post load glucose showed a little bit lower, but not significantly different values in CVD-N group comparing with CVD-Y. However the whole population show about 20 mm Hg lower blood pressure, and about 10 mg lower post load glucose comparing with both CVD-N and CVD-Y groups. CVD-Y was older in average than others, especially comparing with general population (64.9 vs. 50.1). They were also with higher BMI, 27% comparing with 25.5% in both general population and CVD-N. Age of death was also higher in average than in other groups (75 in CVD-Y group comparing with 73 in CVD-N and 72.2 in general population).

Adult↗
PubMed2004

[New biochemical markers in the assessment of minor myocardial damage in critically ill patients].

UNLABELLED: The diagnosis of acute myocardial infarction (AMI) and unstable angina is based on typical clinical signs, electrocardiogram (ECG) changes, and serial measurements of characteristic serum enzymes, especially troponins. Today, newer biochemical markers are used in assessing these conditions, as well as minor myocardial damage (MMD). AIM: The aim of this study was to determine the existence of MMD by the analysis of new biochemical markers including cardiac troponin T (c-TnT), troponin I (c-TnI), CK-MB activity (CK-MBact), CK-MB mass (CK-MBmass), a conventional marker of total creatine kinase (CK), and 12-lead ECG monitoring in two groups of critically ill patients admitted to the intensive care unit (ICU). Group 1 (n=52) consisted of the patients with heart failure, unexplainable hypotension, chronic obstructive pulmonary disease in acute exacerbation, acute severe pancreatitis, sepsis, pulmonary embolism, diabetes with complications, liver cirrhosis, and tachycardia >120/min who suffered chest discomfort without evident ECG signs of AMI. Group 2 consisted of patients (n=73) with acute gastrointestinal bleeding, poisoning, and miscellaneous conditions without chest discomfort or ECG signs of AMI. RESULTS: Of the 52 critically ill patients, 21.2% were positive for troponin T and 11.5% for troponin I. Group 1 patients showed a prevalence of elevated total CK (28.8%), CK-MBact (7.7%), and CK-MBmass (32.7%). In group 2, positive troponin I was found in 19.7% of patients, troponin T was negative (0.00%), with elevated total CK (23.9%), CKMBact (7.0%), and CK-MBmass (2.3%). The mean concentrations of c-TnT, c-TnI, total CK, CK-MBact, CK-MBmass were higher in group 1 than in group 2, however, without statistical significance. The best positive correlation was recorded between CK-MBact and CK-MBmass (r=0.63). The c-TnI showed best discrimination and accuracy in the assessment of MMD under the ROC curves surface (0.84), while the accuracy was low for all other markers analyzed. Discrimination and accuracy were moderate for all markers analyzed. DISCUSSION AND CONCLUSION: CK-MBact (92.3%) showed the highest specificity, followed by c-TnI (88.5%) and c-TnT (75.6%). The sensitivity was low for all markers analyzed. Concerning specificity, CK-MBact proved to be the best biologic marker for the assessment of MMD, followed by c-TnI and c-TnT. Correct clinical assessment according to marker accuracy and discrimination can be achieved by use of c-TnI, however, with a moderate degree of accuracy and discrimination for the detection of MMD in critically ill patients admitted to ICU.

Adult↗
PubMed2003

Respiratory findings in tobacco workers.

OBJECTIVES: To screen for respiratory symptoms and lung function impairment in workers occupationally exposed to tobacco dust in a tobacco-processing plant. PARTICIPANTS: One hundred twenty-one tobacco workers (97 women and 24 men) were included in the study. In addition, a group of 98 control workers (73 women and 25 men) were studied. METHODS: Acute and chronic respiratory symptoms were recorded in all tobacco workers. Lung function was measured by recording the maximum expiratory flow-volume curves on which FVC, FEV(1), and flow rates at 50% of FVC (FEF(50)) and the last 25% of FVC (FEF(25)) were read. RESULTS: There was a high prevalence of chronic respiratory symptoms among these workers, and this prevalence was significantly higher in exposed female workers than in female or male control workers (p < 0.01 and p < 0.05, respectively). Occupational asthma was recorded in 6 female tobacco workers (6.2%) and in none of the control subjects (p < 0.05). None of the male workers were found to have occupational asthma. There was also a high prevalence of acute symptoms that were noted during the work shift (particularly for nose and throat dryness, as well as eye irritation). Among these tobacco workers, the odds ratios for respiratory symptoms were frequently significant for employment and smoking among male tobacco workers but were not significant in general for female tobacco workers. The ventilatory capacity data in tobacco workers showed statistically significant reductions in FEV(1), FEF(50), and FEF(25) in relation to predicted values. These reductions were demonstrated in smokers as well as in nonsmokers. Regression analysis suggested that there were significant changes according to employment status for FVC, FEV(1), and FEF(25) in female tobacco workers. Measurements of ventilatory capacity during the course of the work shift in 38 female tobacco workers demonstrated significant mean acute reductions in FEV(1) (-5.7%), in FEF(50) (-15.7%), and in FEF(25) (-23.4%). CONCLUSIONS: Our data indicate that tobacco workers may develop respiratory disorders related to tobacco dust in their work environment.

Acute Disease↗
PubMed2003

Fatality risk factors for bicyclists in Croatia.

AIM: To present the epidemiology of fatal bicyclist injuries in traffic accidents in Croatia. METHODS: Between January 1, 1997 and December 31, 2000, there were 253 bicyclist fatalities in Croatia. The data were collected from the police reports of the Department of Traffic Police, Ministry of the Interior, written at the place of the accident. The data were processed by descriptive epidemiology and compared by tests of significance. RESULTS: The percentage of bicyclist fatalities among total road fatalities showed a decreasing trend over the years, from 11.6% in 1998 to 8.2% in 2000. The most frequent type of accident involving bicyclist fatalities were accidents in car-bicycle collisions (lowest: 74.7% in 1998; and highest: 81.3% in 1997). Most accidents occurred at the beginning and at the end of the bicycle season--months of April and October. Elderly people were involved in accidents occurring mainly in the morning hours--from 6 to 12 a.m., whereas the youngest and the middle-aged got injured or killed mainly in the evening - 6 to 9 p.m. This association between the age and the part of day when the accident happened was statistically significant (chi square=36.51, p<0.0001). CONCLUSION: Bicycle-related fatal injuries as a part of total road fatalities showed a gradual decrease. Regulation of bicycle traffic, more stringent protection measures and their implementation, as well as preventive measures regarding the time of day are needed to further decrease bicyclist fatalities in traffic.

Accidents, Traffic↗
PubMed2003

Ventilatory functions in Croatian population in comparison with European reference values.

AIM: To compare ventilatory capacity of Croatian population with the ventilatory function values predicted by conventional equations based on measurements among European populations. METHODS: Ventilatory capacity and respiratory symptoms were determined in a group of 2,482 healthy non-smokers (1,162 men and 1,320 women). The measurements were performed with a pneumotach spirometer. Maximum expiratory flow volume curves (MEFV) were registered, and forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and flow rates at 50% (MEF50) and the last 25% of the vital capacity (MEF25) were recorded. Anthropometric data were also noted. Reference values were calculated using multiple linear regressions. RESULTS: Comparisons of our values with the prediction summary equations issued by the European Community for Steel and Coal (ECSC) and the European Respiratory Society (ERS) showed that healthy Croatians had consistently lower values of FVC (92.1-/+14.0% of the predicted volume for men and 86.2-/+11.7% for women) and FEV1 (93.7-/+14.8% of the predicted values for men and 95.3-/+13.1% for women), but higher values of MEF50 (107.8-/+30.1% of the predicted values for men and 103.4-/+22.8% for women) and MEF25 (117.3-/+41.0% of the predicted values for men and 117.9-/+34.0% for women) than the ECSC/ERS recommendations. The comparison was also made with the most commonly used North American reference standards based on populations of European origin, with similar findings. On the basis of the results of multiple linear regressions, we constructed prediction equations for ventilatory function in Croatian population. CONCLUSION: The ECSC/ERS recommendations are not satisfactory for the Croatian population.

Adult↗
PubMed2002

How to find out burning problem of telemedicine?

Sample of 177 cited papers from Current Contents in year 2001 containing word 'telemedicine' as a keyword, and/or in title and/or in abstract. Most of papers were coming from Journal of Telemedicine & Telecare, International Journal of Medical Informatics and Telemedicine Journal & E-Health. Titles and abstracts were analysed statistically by using Sphinx Lexica as a tool and lexical statistics and lexical analysis as methods. Environment/neighbourhood of words potentially reflecting evaluation in telemedicine, enabled to make synthesis: evaluation or similar words were mentioned in connections with programs and plans of telemedicine application in the whole, with economic issue (minimizing, low-cost, reducing cost), with ICT evaluation, quality, and scarcely with methodology and criteria for evaluation.

Medical Informatics↗
PubMed2002

Consistency and reproducibility of attribute extraction by different machine learning systems.

Machine learning systems as tools for intelligent data analysis are used for extracting attributes relevant for prediction of defined outcomes. The aim of the paper was to compare two machine learning (ML) systems and propose method for intra- and inter-testing of consistency and reproducibility in attributes extracted from real dataset. See5 and FMLS extracted relevant attributes from real medical dataset. Comparison of results of both systems shows that: accuracy and sensitivity are nearly the same for both FMLS and See5 when FMLS was forced by attributes extracted by See5, and little bit lower when FMLS used its own extracted attributes; specificity is nearly the same for both FMLS and See5 when FMLS was forced by attributes extracted by See5, and much more higher when FMLS used its own extracted attributes; both of ML systems show intra-testing consistency and does not show any inter-testing consistency.

Artificial Intelligence↗
PubMed2002

Data mining server--on-line knowledge induction tool.

The aim of this paper is to present an on-line data mining tool and illustrate its use on example of real medical data. Data from the Laboratory for in-vitro Thyroid diagnostics at the Sisters of Charity University Hospital in Zagreb were used. Preparation of the data set and one session of knowledge induction is described.

Croatia↗
PubMedDate not supplied

[Effects of organic aerosols on the respiratory system in occupational exposure].

The effects of organic dusts on the respiratory system of workers employed in food processing, in textile workers, as well as in agricultural and livestock farmers are reported. Deposition and elimination of particles from the lung as well as the possible mechanisms of the organic dust effects on respiratory system are described. Separately are presented results of our investigations on the prevalence of respiratory symptoms and diseases as well as lung function tests as indicators of the condition of the respiratory system. Data on the experimental studies with aqueous extracts of organic dusts on smooth muscle of isolated guinea pig trachea suggest that the bronchoconstrictive effects in humans can be reproduced in nonsensitized guinea pigs. The preventive measures in the development of respiratory impairments in subjects occupationally exposed to organic dusts are described.

Agricultural Workers' Diseases↗