Abstracts

• Dentistry
• Neurology
• All other (this page)

This study was conducted to detect and analyse the presence of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae associated with a nosocomial outbreak at a Croatian hospital. During 2007, 162 K. pneumoniae isolates with reduced susceptibility to third-generation cephalosporins were collected from various hospital units and patient specimens. Most of the strains were isolated from urine (61 %), followed by blood cultures (13 %), wound swabs (13 %), tracheal aspirates (5 %), intra-abdominal abscess aspirates (4 %), intravascular catheters (3 %) and cerebrospinal fluid (1 %). Medical wards were the most important source of the isolates (46 %); 21 % of the isolates originated from surgical intensive-care units. All patients had infections acquired during their stay in hospital. No community-acquired infections were reported. Sixty of these isolates were chosen for further analysis. A double-disc synergy test (DDST) was used to detect ESBLs. MICs were determined by the broth microdilution method according to CLSI guidelines. The transferability of ceftazidime resistance was tested by conjugation (broth mating method). PCR was used to detect alleles encoding ESBL enzymes. Plasmids encoding ESBLs were extracted with the Macherey Nagel Mini kit according to the manufacturer's recommendations. The genotypes of the strains were compared by analysis of banding patterns generated by PFGE of XbaI-digested genomic DNA. ESBLs were found by DDST in all isolates. All strains were resistant to cefuroxime, ceftazidime, cefotaxime, ceftriaxone, aztreonam, piperacillin/tazobactam and ciprofloxacin. There was variable susceptibility/resistance to cefepime and gentamicin. No resistance to ceftazidime/clavulanate and carbapenems was observed. Only six strains transferred resistance to an Escherichia coli recipient strain, with low frequency. All isolates yielded an amplicon of 545 bp with consensus MA primers. Multiplex PCR was positive for group 1 CTX-M beta-lactamases. Sequencing of selected amplicons revealed the presence of bla(CTX-M-15), with coding regions containing identical nucleotide sequences. Similarly to isolates from India, our isolates contained the ISEcpI insertion sequence located upstream of the bla(CTX-M-15) gene, which has recently been demonstrated to mobilize 3'-adjacent genes to transfer between DNA replicons. The isolates contained a large plasmid of approximately 150 kb. The isolates were assigned to five clusters (>85 % similarity), which contained subclusters. The results of this work provided insights into the molecular epidemiology of the spread of ESBLs in K. pneumoniae involved in an outbreak at a Croatian hospital. The hospital antibiotic policy resulted in ceftriaxone being the most heavily prescribed third-generation cephalosporin, which might be expected to select for cefotaximases such as CTX-M-15.

Global heating and increased solar ultraviolet irradiance have caused an increase in number of many diseases, particularly skin malignant diseases. Aim of this study was to investigate the influence of climate changes on the health of the population of the Primorsko-goranska and Istria Counties. We gathered and analyzed data about the frequency of skin malignant melanoma in the period of eight years (1998-2005). The data were collected from the Croatian cancer registry. The incidence of malignant skin cancer was estimated overall, by age group and gender. We found that the incidence of the skin melanoma was approximately the same in both counties during the period 1998-2005. However, significant increase has been noted when compared to the situation in the period 1977-1996 (p = 4.95 E-13) The incidence of malignant skin melanoma has risen during the last ten years. It is differently distributed between gender and age groups in Primorsko-goranska and Istria County. It can be related to climate changes, but also to different ways way of life between these two counties.

Southeastern Europe is a centre of European biodiversity, but very little is known about factors causing the observed richness. Here, we contribute to fill this gap by reconstructing the spatio-temporal diversification of the cytologically variable and taxonomically intricate complex of Veronica chamaedrys (Plantaginaceae s.l.), growing in open forests, forest edges and grasslands, with flow cytometry, molecular markers (AFLPs, plastid DNA sequences) and morphometry. Our results show that both diploid and tetraploid cytotypes are widespread, but diploids predominate on the southern Balkan Peninsula. Plastid sequences suggest a first split into three main lineages in the mid-Pleistocene and a continuous diversification during the last 0.4 my. Two of the identified plastid lineages coincide with geographically distinct AFLP clusters. Altogether, the genetic data suggest forest refugia on the southern-most Balkan Peninsula (Greece), in Bulgaria, Istria (Croatia and Slovenia) and maybe the southeastern Carpathians (Romania). Morphometric and genetic data show little congruence with current taxonomy. Copyright © 2010 Elsevier Inc. All rights reserved.

An epizootiological field study on tick-borne protozoan infections in foxes (Vulpes vulpes) was carried out in different parts of Croatia. Spleen samples of 191 carcasses of red foxes killed in sanitary hunting, were examined for the presence of hematozoa by polymerase chain reaction (PCR) and subsequent sequencing. The investigation revealed four species of hematozoa in 57 foxes (30%), namely Theileria annae, Theileria sp. 3182/05 and Hepatozoon canis. T. annae was found in 10 foxes (5%), Theileria sp. 3182/05 in a single animal (1%), H. canis in 44 (23%) and Hepatozoon sp. was detected in two foxes (1%). T. annae and H. canis were distributed through all the studied regions, while Theileria sp. 3182/05 and Hepatozoon sp. were restricted to the Zagreb and Zagorje, and Istria regions, respectively. Detection of T. annae in all regions of Croatia indicates the presence of the natural cycle of the parasite and raises the possibility of other vectors other than the proposed Ixodes hexagonus.

Breast cancer is the most frequent malignant tumour and leading cause of death in women aged 35 to 64 years in Istria County. The minimal invasive carcinoma and in situ carcinoma have a better prognosis so we try to find them during preventive exams. The aim of this study was to identify minimal breast cancers in fine needle aspiration biopsies of breast lesions made in Pula General Hospital between the years 2006 and 2008. There were 39 tumours with a maximal diameter of less than 10 mm in 1316 biopsies and 251 cytologically diagnosed breast cancers. In most cases, they were solitary, well differentiated neoplasms (48.7%). They were diagnosed in women aged 39 to 89 years and most frequently found in women aged 60 to 69 years. The most frequent histological type of operated minimal breast carcinomas was invasive ductal carcinoma. In that period, the minimal breast cancer percentage of all cytologically diagnosed breast cancers was 15.5% but in the first 6 months of 2009, the result was 48.7%.

The aim of this study was to identify the incidence and prevalence of asbestos-related diseases in Croatia, based on the Hospital Morbidity Database and General Mortality Database of the Croatian National Institute of Public Health. Both databases cover a period from 2002 to 2007), and include information from the Register of Occupational Diseases. Diagnoses in focus were mesothelioma (C45), asbestosis, and pleural plaque (J61 and J92). Yearly rates of inpatients treated for mesothelioma, asbestosis, or pleural plaque that were higher than the Croatian average (2.1) were recorded in the Counties of Split-Dalmatia (5.0), Dubrovnik-Neretva (3.9), Istria (3.7), and Primorje-Gorski kotar (3.1 per 100,000 people). From 2002 to 2007, 649 occupational diseases were reported, out of which 11.7% were asbestos-related. The most frequent were pleural plaque with asbestosis (38 cases, 50.0%), pleural plaque (23 cases, 30.3%), and mesothelioma (6 cases, 7.9%). Mortality attributable to asbestos was assessed using official Croatian National Statistics Bureau reports for 2002 to 2007 at the county and national level. During that period, Croatia recorded 312 deaths with the average yearly rate of 1.2 per 100.000 people. Four counties had higher rates than the national average: Primorje-Gorski kotar (3.4), Split-Dalmatia (2.8), Istria (2.8), and S1. Brod-Posavina (1.5). The number of inpatients treated for asbestos-related diseases was higher than the national average in the counties of Split-Dalmatia, Dubrovnik-Neretva, and Primorje-Gorski Kotar. Mesothelioma incidence was above the national average in the counties of Split-Dalmatia, Primorje-Gorski Kotar, and Istria. The rates of occupational, asbestos-related diseases were higher than the national average in the counties of Split-Dalmatia and Primorje-Gorski Kotar. We were aware that the interpretation of data is somewhat limited by the relatively small absolute number of treated persons and deaths for the observed period, by the fact that crude rates have not been adjusted for total numbers and for regional differences in population distribution by age and gender. The real extent of asbestos-related burden in Croatian general population remains unknown, because only occupational exposure has been monitored. Therefore, the National Public Health Institute and county public health institutes should implement a specific monitoring programme in collaboration with government environmental bodies to assess asbestos exposure of the population living in the vicinity of asbestos plants. It is also necessary to establish the number of exposed persons who have developed an asbestos-related disease. Their health should be monitored and their environment inspected on a regular basis.

Koper stands out among Istrian towns of the nordeastern Adriatic coast for its highly advanced medicine. Communal service developed between the 13th and 15th century. Beside the hospital, almshouse and a quarantine, the city also boasted highly trained physicians, surgeons and barbers. Trade, crafts and navigation prospered and numerous town intellectuals established an academy whose most active members were medical doctors. The aim of this article is to give a chronological presentation of physicians related to Koper by their birth or work and of other scientists who contributed to the development of local medicine. These includes (about forty names) S. Santorio, Ser Benvenuto, P P. Vergerio, G. Nuzio, E Nuzio, P de Castaldi, I. de Albertis, L. Zarotti, B. Petronio, I. Bratti, Z. Zarotti, A.Valdera, G. Vergerio and C. Zarotti of whom some are well known. The author wishes to systematisize the bibliography, fill the gaps and show ways for further research in the archives and museums of Istria, Triest, Venice and Vienna.

The paper presents results of analysis of human skeletal remains recovered from Late Roman/Early Medieval cemetery of Novigrad (Istria). The "terminus post quem" for the site was established archaeologically as 5th or 6th century A.D. The aim of this work was detailed bioarchaeological analysis of each individual. It included determination of sex, age at the time of death, reconstruction of body height, and detailed description of pathological changes on bones and joint surfaces acquired during lifetime. The analysis provides limited information on demography, health and disease of the ancient inhabitants of Novigrad due to the limited sample size. Results show unusually high proportion of subadults, a life span range of women slightly lower compared to other contemporary populations, a high level of metabolic stress in childhood and a high level of skeletal indicators of physical stress suggesting that several of the analyzed individuals were exposed to heavy physical labor during their adulthood. See full article.

Copper accumulation was studied in native mussels, Mytilus galloprovincialis, Lmk., from the Limski Kanal, North West Yugoslavia (Peninsula Istria), from June 1979 to June 1980. The distribution of copper between different body parts of the mussels is correlated with the concentrations of the different physico-chemical forms of copper in the ambient seawater. Free and labile complexes of dissolved Cu were electrochemically determined in a sample at a natural pH of approximately 8, "total" dissolved Cu was determined in acidified samples (pH 2), and Cu after acid decomposition of the suspended particulate matter was collected on 0.45 micron Millipore filters. The copper content correlates with the weight of the organs and with enhanced gametogenetic activity in the mussels. The copper concentrations in the total soft part and in the various organs are highly correlated with the dissolved "ionic" copper content of the ambient water. The particulate matter in the water column influences copper accumulation and its distribution within organs of the mussel. This conclusion arises because the concentration of copper in the mussels is highly correlated with the quantity of particulate material. The copper concentration varies very significantly with condition factors of the foot. Therefore, as the foot can be easily dissected, we propose this organ as a "sentinel" part of the mussel's body for "mussel watch", in the global monitoring program for copper surveillance.

From June 1979 to June 1980 the accumulation of zinc by the mussel Mytilus galloprovincialis and the oyster Ostrea edulis, from the Limski Kanal on the west coast of Istria, SR Croatia, Yugoslavia, was determined. The distribution of zinc within tissues and organs of mussels and oysters of the same length was related to the zinc concentration in the ambient water. Three physico-chemical forms of zinc can be distinguished in seawater: "ionic" dissolved (Zn electrochemically determined at the natural pH of seawater); "total" dissolved (Zn determined after sample acidification to pH 2); and particulate Zn (bound to suspended particles with a diameter 0.45 micron). The zinc content of different tissues and organs of both species increased significantly with an increase in their condition factors. Zinc concentration decreased significantly in all body parts of the oyster, but, in the mussel, only the foot was affected. Zinc concentrations in organs that are directly involved in the reproductive cycle showed a seasonal variation. The zinc concentration in the mantle of mussels was significantly and positively correlated with the "ionic" and "total" dissolved zinc content of water. Elevated amounts of particulate material suspended in the ambient water increase the filtration rate, which resulted in an accelerated accumulation of zinc by mussels, but not by oysters. Differences in zinc concentration between samples suggest that the dynamics of accumulation and loss may differ during the year; first, mainly as a consequence of the reproductive cycle in bivalves and the concentration of stimulants for filtration in the surrounding water, and second, by coastal input of Zn and by the amount of metal remobilized from the sediment.

In this paper, the causes of death are presented of 322 foreign tourists that occured during summer holidays in County of Istria, Croatia, in the period from May to September, during 5 years (from 2000 to 2004). The aim of this study was to evaluate the frequency of the common causes of these deaths. Data about these cases were taken out of the archives of the Institute of Public Health of County of Istria in Pula. RESULTS: During this period of time there were 322 cases of deaths recorded. The rate was 3.2 deaths for 100 000 tourists. Heart attack occured in 126 cases (39%), and it was the leading cause of death. The highest number of deaths by the heart attack (n=31) was registered in 2002. The frequency of heart attack was six times higher in males than in females. The heart attack occurance was between 47% in 2000 to 30% in 2003. Drowning was the second leading cause of death with 10.5% of all cases of deaths recorded. Out of all victims (n=34), there were three times more males then females. Other causes of deaths were chronic ischaemic heart disease (8%), cardiac arrest (4%) and stroke (3.0%).

CONCLUSION: Heart attack and drowning were the leading causes of death among foreign tourists in Istria.

Analytical investigations were carried out on alteration crusts of "Pietra d'Istria" used for the construction of "Palazzo Papadopoli" in Venice. The chemical and mineralogical analyses of the microstructure showed that alteration process in mainly caused by the transformation of calcium carbonate into calcium sulphate and that the greatest damages are due to the subsequent detaching of sulphatic crusts according to a weakness surface. The isotopic analyses showed that sulphur present in the crust is mainly derived from the combustion of hydrocarbons. The investigations on the climatic conditions showed the meaningful importance of the climate parameters on described alterations.

Myotonic dystrophy (DM) is the most prevalent myopathy in adults. In Istria one of the highest prevalence rates of 18/100,000 has been reported. Two loci, the most prevalent 19q locus with mutations in the myotonin protein kinase gene and the second locus mapped to the 3q have been so far implicated in DM. The purpose of this study was to evaluate the molecular pathogenesis in the Istrian population by the analysis of (CTG) expansion in myotonin protein kinase gene. Additionally genotype--phenotype correlation was analysed, as well as the transmission of expanded trinucleotides through generations. We investigated 27 DM patients from the 10 families that were ascertained in Istria in our previous epidemiological study. Southern blot and polymerase chain reaction (PCR) techniques were used to evaluate the (CTG) expansion. In 9 of the 10 DM families an amplification was identified as the mechanism of mutation. A correlation between the size of the (CTG) expansion and phenotype was found. Among 10 parent-child transmission analysed, one reduction, 2 stable transmissions and 7 amplifications were observed, one through the affected father. The amplification of (CTG) in the myotonin protein kinase gene was identified in the majority of Istrian DM families. Direct mutation analysis is the method of choice for clinical and prenatal diagnosis of DM.

One of the world highest prevalence estimates of myotonic dystrophy (DM) has been reported in the Croatian region Istria. To analyse the population genetic characteristics of DM locus in Istria, two intragenic and three extragenic polymorphic markers were tested. The Southern blot technique was used for D19S63 locus analysis, whereas PCR analysis was performed for CKMM, Alu polymorphism, DMPK (G/T) intron 9/HinfI polymorphism, and D19S207 genetic markers. The compound haplotypes segregating with DM were established. A complete association between the DM mutation and D19S63, D19S207, intron 9/HinfI polymorphism and Alu polymorphism markers were found. In all DM chromosomes: D19S63 and Alu markers had the allele 1 in common; D19S207 had the allele 3 in common, DMPK (G/T) intron 9/HinfI marker had the allele 2 in common. The analysis of CKMM polymorphism revealed genotype heterogeneity; in DM chromosomes either allele 2 or allele 4 were found. The haplotype analysis in the population of Croatian Istria supports the linkage disequilibrium between the DM mutation and Alu polymorphism, intron 9/HinfI polymorphism, D19S63 and D19S207 markers as reported worldwide. The results of the haplotype analysis suggest a common origin of the mutation in Istrian population.

The present genetic study has been conducted on 29 patients with myotonic dystrophy. The diagnosis of Steinert-Batten-Gibbs disease was made by anamnestic, clinical and laboratory procedures. Six families from Istria were examined in which genealogical study was carried out through five generations. Consanguinity was observed in one family. The frequency of myotonic dystrophy, correlative features and mortality was determined for each family. The incidence of myotonic dystrophy and correlative features among the first-, second-, and third-degree relatives of patients examined was determined. We conclude that the disease occurred far more frequently in families of patients with myotonic dystrophy (8 to 33%) than in the population in general (0.017%) and that it is significantly maintained among the first-, second-, and third-degree relatives.

AIM: The aim of the study was to calculate the prevalence of smoking habit among Croatian population according to sex, age groups and country regions. The aim was also to analyze the use of health services by smokers and nonsmokers.

METHODS: Data collected during the 2003 Croatian Health Survey were used in the study. The sample was representative of particular regions. A total of 12,254 individuals aged 18 were interviewed.

RESULTS: According to data obtained in the survey, there were 27.4% of daily smokers in the population aged 18. There were great differences between the regions. The prevalence of smoking habit was found to be higher in the east regions of inland Croatia and north Adriatic region than in other regions (29% vs. 32%). The lowest prevalence was recorded in the City of Zagreb (23%). The prevalence of cigarette smoking was higher in men (33.8%) than in women (21.7%). The highest prevalence of cigarette smoking in men was recorded in the Slavonia (east) region and lowest in north region (40.1% vs. 28.5%). In women, the highest prevalence was recorded in north Adriatic region (Istria) and lowest in Zagreb (29.2% vs. 13.9%). The prevalence of daily smokers also differed between counties within the same region. The prevalence of cigarette smoking was higher in the young than in older individuals. In some counties (mostly in the east of Croatia), more than 40% of daily smokers were aged 18-20. The lowest prevalence was in central Croatia. The prevalence of cigarette smoking in young individuals was higher in south Adriatic than in north Adriatic region. According to the level of education, the highest prevalence of smokers was recorded among individuals with with secondary school. Considering the use o health services, smokers were found to have less primary health care visits but more frequent and longer hospitalizations. Nonsmoker more frequently used preventive check-ups for high blood pressure, prostate carcinoma screening and colorectal carcinoma, whereas female smokers more frequently used screening for cervical and breast cancer than female nonsmokers.

DISCUSSION: Croatia is an average European country. Now the situation is better than it was in the past. A survey conducted in 1972 showed the prevalence of daily cigarette smoking to be 56.9% in male and 10.1% in female population. Since then, smoking habit has decreased in men and increased in women.

CONCLUSION: The differences recorded according to regions, sex and age groups are high. War situation and socioeconomic conditions (war, unemployment, low income) could influence the differences among regions and counties. The data collected can be used as a guidance on planning intervention measures.

Sebastian is only one of the many saints honored in the Catholic world and invoked against different illnesses and misfortunes. The cult of this martyr who lived in the 3rd century A.D. appeared in Istria probably in the early Middle Ages and became a part of the popular "arsenal" against plague. In time, it was replaced by the cult of another late medieval saint, Rochus. Therefore, probably today's traces of the cult of St. Sebastian in Istria (three churches, frescos, paintings and statues) represent only meager remains of a once rich expansion. [Full article]

Deboleza is a behavioural construct among the inhabitants of Istria (a peninsula in the Adriatic Sea which belongs mainly to Croatia); it has peculiar social, ethno-psychological and historical characteristics because it is a relatively small region which has been the intersection of various cultures and civilizations. In this research the concept is analysed from the psychomedical point of view. As deboleza does not have the status of an illness, it functions as a culture-bound syndrome which, because of its emotional expressions, belongs to the 'shame' family. This interesting construct should be thoroughly studied not only in a peculiar and dynamic Croatian culture and in Croatian psychiatry, but also within European culture and psychiatry.

Publication Types: PMID: 9239793 [PubMed - indexed for MEDLINE]

Related article:

• Unique Neurosis Grips Yugoslav Coastal Area, Biomedical News, March 1972

"The paper analyses the quantitative aspect of emigration [from Croatia] to European and overseas countries in the period from the middle of the 19th century till 1981 (the time of the last census). Analysing various sources and studies, the author presents data on emigration form individual Croatian lands (Istria, civil Croatia, Dalmatia) in relation to individual emigration flows (to Europe, overseas) and periods (before World War I, the inter-war period, the post-war period), and at the same time he examines external migration as an effect of the two world wars." (SUMMARY IN ENG)

In the last two decades the classic typhoid and paratyphoid A and B became rare also in Istria being substituted by infections of salmonellas of the "minor group". Basing on observations on 418 patients (1970-1979) it was established that in 48.5% of them a significant increase of titers of antibodies, not only for group antigens but also for phasis antigens developed. This, together with positive hemocultures and urine cultures in a number of them, did lead the authors to the conclusion that the invasitivity of these salmonellas (e.g. S. enteritidis, typhi murium, hadar, agona, abony) is greater than previously presumed and that the diagnosis "Salmonella-Fever" or "Paratyphoid" also in infections of these salmonellas is more justified.

AIM: To establish the incidence of tumors of the central nervous system (CNS) in the population of Labin area in Istria, Croatia, characterized by very little population migration.

METHOD: We retrospectively analyzed data on 175 patients (102 men and 73 women) diagnosed with CNS tumor according to the World Health Organization's diagnostic criteria in the period 1974-2001. Patient data were retrieved from multiple sources: files of general practitioners in Labin area; registers of admissions and discharges of the Pula General Hospital and Rijeka University Hospital Center; and medical records of the Hospital Departments of Neurology, Surgery, Neurosurgery, Oncology and Radiotherapy, and Pathology. Annual incidence, anatomic location, and pathohistological classification of CNS tumors were determined, as well as age at disease onset.

RESULTS: Out of 175 subjects, 95 had primary CNS tumors and 80 had metastases. Intracranial tumors were found in 88.4% of patients with primary CNS tumors (annual incidence, 11.8/100000 population) and intraspinal in 11.6% of patients (annual incidence, 1.6/100000). Similar distribution was observed for CNS metastases (70 intracranial vs 10 intraspinal), with annual incidence of 9.9 and 1.4/100000, respectively. The most frequent intracranial tumors were those of neuroepithelial tissue, accounting for 58.3% of all CNS neoplasms (annual incidence, 6.9/100000 population). The most frequent intraspinal tumors were tumors of the meninges (54.5%). There was no particular temporal clustering of CNS tumors. The age at disease onset corresponded with that reported in the literature: 50.5+/-17.0 years for primary intracranial tumors, and 59.7+/-12.2 years for primary intraspinal tumors.

CONCLUSION: Primary CNS tumors showed high, but temporally stable incidence in population of Labin area over the last 27 years, indicating that the alleged increase in CNS tumors incidence was not true.

Malignant pleural mesotheliomas are rare tumors. Their occurrence is often associated with the exposure to asbestos. Asbestos is widely used in various industries as well as for many types of products in everyday use. In Croatia in the period from 1989 to 1998, the rate of incidence was 0.4-1.1/100,000. The highest rate of incidence was in the Districts of Istria (2.9) and Split-Dalmatia (2.5). It is more frequent among males than among females with a ratio of 3.2:1. It rarely occurs before the age of 40 and most of the patients suffering from the disease are more than 65 years old. About 12% of mesotheliomas metastasize into regional lymph nodes and 17% of them into distant organs. The disease unavoidably leads to death and, according to the data obtained in Croatia in the period from 1989 to 1998 the mortality and incidence are very close.

AIM: This investigation was performed at Department of Virology, Croatian National Institute of Public Health, the same diagnostic laboratory using the same serologic method as in earlier studies (in 1982 and 1992) to determine the incidence of the most common agents of atypical pneumonia in Croatia between January 1 and December 31, 2002.

PATIENTS AND METHODS: The study included 630 patients from nearly all regions of Croatia with a clinical diagnosis of atypical pneumonia based on epidemiologic data, clinical symptoms, laboratory findings and chest X-rays. Most of them were from Zagreb (n = 370), followed by those from Slavonia, Istria, northwest Croatia, and Dalmatia. In all of them paired sera were collected at an interval of two weeks or more and tested for complement-fixing (CF) antibodies against the most common causative agents of the atypical pneumonia syndrome using CF test (micromethod).

RESULTS: An etiologic diagnosis was established in 25% (158/630) patients (81 male and 77 female). Respiratory viruses were the most frequently demonstrated pathogens in 2002, accounting for 72% of cases (adenoviruses 47%, parainfluenza viruses 14%, influenza viruses 9% and respiratory syncytial virus (RSV) 2%). These were followed by Chlamydophila (C.) psittaci; (19%), Mycoplasma (M.) pneumoniae; (6%) and Coxiella (C.) burnetii (3%). There were 3 cases of double infection: a combination of adenovirus and M. pneumoniae, of RSV and parainfluenza virus, and of RSV and M. pneumoniae in one patient each. Adenoviral, mycoplasmal and psittacosal pneumonia occurred throughout the year; influenza and most of RSV pneumonias occurred in winter months. Parainfluenza viruses caused pneumonias throughout the year but were more common in winter months. CF test does not distinguish type-specific antibodies to parainfluenza viruses. In March, a small epidemic of psittacosis (11 patients) was registered in the Split area while was responsible for the high incidence of psittacosal pneumonia in 2002. While M. pneumoniae-caused pneumonia occurred mainly in children and adolescents, viral pneumonias were distributed across all age groups. Psittacosal pneumonia occurred in only one child but was more common in adolescents and especially adults. Q-fever pneumonia occurred only in adults.

High prevalence of myotonic dystrophy (DM) of 18.1 per 100,000 has been found in Croatian region Istria, a region where a great mixture of nations occurred over the last three centuries. The objective of this study was to test the hypothesis of common ancestry in Istrian DM families. Pedigrees were constructed on the basis of extensive family history obtained from the patients in all Istrian DM families. Church records were consulted in order to improve genealogical reconstruction. Additionally, we performed haplotype analyses with two intragenic and three extragenic DNA polymorphic markers. A common ancestor couple for three of nine nucleus families was found eight generations backward, which was supported by haplotype analysis. In spite of finding an evidence of common ancestry in Croatian Istria we argue that the phenomenon of founder effect is not sufficient to explain the high DM prevalence in Istria.

OBJECTIVES: We evaluated epidemiology of myotonic dystrophy in Istria, Croatia including direct mutation analysis as an additional, specific diagnostic criterion.

MATERIAL AND METHODS: Patients were ascertained in the period 1980-1994 from multiple sources under established clinical criteria with a special reference to congenital and minimal forms of the disease. Additionally, patients and their relatives were evaluated by direct mutation analysis. The prevalence, corrected for underascertainment, was estimated on July 1, 1989.

RESULTS: A total of 33 DM patients from nine families were ascertained. In all families the diagnosis was confirmed by mutation analysis of the DM gene. After correction for underascertainment the prevalence of 18.1/100,000 was calculated.

CONCLUSION: One of the highest prevalence estimates of DM in the populations without evidence of founder effect or genetic isolation was found. Our results imply the importance of ascertainment of patients with all forms of DM and utilization of specific diagnostic tests for estimation of genetic epidemiology in DM.

Prof. Franjo Gruber, MD, PhD Buzetska 2 HR-51000 Rijeka, Croatia; franjo.gruber1@ri.t-com.hr.

SUMMARY In 1790, an infectious disease appeared in the village of Skrljevo near Rijeka, and spread to the nearby villages and then to Istria, Slovenia and other parts of Croatia. In 1800, the nature of the disease was first investigated by the protomedicus Massich, who believed it was a combination of syphilis and scabies. After him, the protomedicus of the region G. B. Cambieri, who graduated in Pavia and came to Rijeka in 1797, studied the illness, gave a description of the disease and believed it was a morbus sui generis, and termed it morbus of Scherlievo. He was a gifted physician, used all his knowledge, skills and organization capabilities to arrest the disease, and published his works in Italian journals (in 1812 and 1819). Cambieri studied the disease in thousands of patients in local hospitals, and took the initiative to open a new Civic Hospital with a department of syphilidology. He divided the disease into four stages and with permission of the authorities he tried different therapies. With time, he found the disease to be a form of syphilis and treated it with mercury compounds. After his death in 1838, he left his money to the Hospital of Holy Spirit in Rijeka (Cambieri Foundation), which permitted its development.

In the past, gout was well known in these places, from Istria to Dubrovnik. Our very first dictionaries also witness about gout. Old doctors from Krapinske Toplice had also written about gout. Dr Edmund Mai, in his article published in "Lijecnicki vjesnik" in 1904 mentions "171 cases of uric arthritis". But, after that, for long 60 years there wasn't even a word about our patients, except surprise on very high incidence of the disease in the past. Even our handbooks had claimed that uric arthritis is not common in our country. In 1964 after 60 years of silence, the first article about our patients with uric arthritis, was published in "Lijecnicki vjesnik". These patients were medically treated for average of 13 years, and still were misdiagnosed. After that article, the numbers of patients with gout and articles on uric arthrit is permanently rise. Today, the incidence of gout in Croatia is similar to that in other European countries.

Malaria as a disease of miasmatic origin was known of as early as in the Ancient times. The first written documents on malaria in Croatia date from the 16th century, and concern Istria [Ed. note: which was not part of the Croatian state until 1947]. Until the end of the 16th century, malaria was spread on almost the whole territory of Croatia. The first studies of the disease were performed as early as in the 18th century. The first piece of work on malaria in Croatia "De morbo Naroniano tractatus" (on the "Neretva disease") was written by Paduan professor Giusepe Antonio Pujati (1701-1760). The term "malaria" (after the Italian mala-aria, meaning bad air) was first mentioned in the gazette "Danica Ilirska" in 1837. During the 19th century, the sanitization of malaric areas in Istria and the Neretva valley was carried out with the aim of eradication of the disease. However, the first significant results were not achieved until the beginning of the 20th century following the arrival of Dr. Robert Koch and his associates to the Islands of Brijuni. They managed to eradicate malaria by systematic quininisation of the whole population and a number of other procedures like land-improvement or population education. Robert Koch's method of eradication of malaria showed outstanding results in 1903. According to physician Mauro Gioseffi's report from 1932 there haven't been significant outbreaks of malaria since those times. [Ed. note: this Summary neglects to mention the book by the Istrian physician and research scientist, Bernardo Schiavuzzi: La malaria in Istria.]

The aim of study was to analyze epidemiological features of central nervous system (CNS) tumors diagnosed in Istria County, Croatia, with a particular emphasis on incidence dynamics during the wartime (1991-1995). The data were extracted from the medical records of patients with CNS tumors admitted to the Department of Neurology of Pula General Hospital in the period from the 1st January 1986 to the 31st December 2000, N = 364. For calculation of rates, we used data from the 2001 Croatian consensus. Data are presented as counts and incidence rates (IRs) per 100,000 persons-years in the case of annual rates. Annual incidence rates are shown as "raw" incidence rates and smoothed 5-year rolling average rates. The examined patient-related variables were: sex, age, occupation, premorbidity and comorbidity, with a particular emphasis on psychosomatic disorders and negative habits. The analyzed tumor-related variables included clinical manifestation, localization, and applied diagnostic and therapeutic methods. Primary tumors were separated from the metastatic, and the latter were analysed with respect to their site of origin. The lowest incidence of CNS tumors (10 patients) was reported in 1990, and the highest (42 patients) in 1993. The incidence dynamics of CNS tumors showed a rapidly progressive increase over the 1991-1995 period, followed by the return to average values. The access to a better and more readily available diagnostics may only partially explain this phenomenon. Therefore, we analyzed other factors that may have contributed towards the rapid increase in the number of CNS tumors, such as its coincidence with the war or psychotrauma. The results confirm the observational clinical hypothesis of an extreme increase in the number of CNS tumors during the period under consideration.

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.

An epidemiological research of multiple sclerosis (MS) in Istria, Yugoslavia, was made in the period of 1980-1981. After examining all the sources of health care information, 125 potential MS patients were found in the investigated area. According to the diagnostic criteria by Schumacher et al., 47 affected were recognized and accepted as clinically definite MS patients. The MS prevalence rate in Istria on March 31st, 1981 amounted to 25.0/10(5) inhabitants (CI: 19.9-38.9). Such rates classify Istria in the middle between the medium and high risk zones for the disease in Europe and in the world. The onset age of MS in Istria was about 30 years, the female/male sex ratio was 2.13. The average duration of MS in Istria up to the prevalence day was 16.5 years. The average annual incidence rate was 1.5/10(5) inhabitants.

Note: Licia Antonelli is a cousin of Marisa Ciceran.

AIM. To determine the presence and concentration of ochratoxin A in wheat and corn from Slavonski Brod surroundings, the area of endemic nephropathy allegedly caused by ochratoxin.

METHODS. Thin-layer chromatography was used to determine ochratoxin A concentrations in 92 wheat and 51 corn samples from the surroundings of Slavonski Brod, Osijek, Hrvatsko Zagorje, Istria, and Celje (Slovenia).

RESULTS. Ochratoxin A was present in 74 of 92 (75.8%) wheat samples and 17 of 51 (33.3%) corn samples, in a concentration range of 0.02-160.00 mg/kg in wheat and 0.02-40.00 mg/kg in corn. Wheat samples from the Slavonski Brod surroundings contained the highest level of ochratoxin A (38.8 +/- 27.2 mg/kg), followed by Osijek (8.7 +/- 8.3 mg/kg). Ochratoxin A levels in the wheat from Hrvatsko Zagorje, Istria, and Celje were considerably lower (2.1 +/- 1.5, 1.3 +/- 2.6 and 0.2 +/- 0.5 mg/kg, respectively). Wheat samples from Slavonski Brod significantly differed from all other sample groups (p < 0.001), and wheat samples from Osijek differed from those from Hrvatsko Zagorje, Istria, and Celje (p < 0.001, p = 0.003, p < 0.001, respectively). Ochratoxin A level was the highest in the corn samples from the Slavonski Brod surroundings (20.0 +/- 14.8 mg/kg) and considerably lower in samples from Osijek, Celje, Hrvatsko Zagorje, and Istria (0.8 +/- 1.4, 0.7 +/- 1.9, 0.4 +/- 0.4, and 0.4 +/- 0.8 mg/kg, respectively). A statistically significant difference was also observed between the Slavonski Brod samples and all other corn samples (p < 0.001).

CONCLUSION. Irrespective of the real association between ochratoxin A and endemic nephropathy, our data clearly demonstrate their geographical overlap.

Plasma protein genetic polymorphisms (HP; TF and GC subtypes) were studied in two different areas (Friuli Venezia Giulia and Istria). The results are discussed and compared with those reported by literature on other Italian and ex-Yugoslav population samples. [Excerpt reprinted from Medline, per above hyperlink.]

The distribution of pollen antigens of an area depends on geographic situation, climatic factors and vegetation. Geographic situation of examined area is in latitude from 42.5 degrees (Dubrovnik) to 45.5 degrees north (Rijeka), the climate is Mediterranean and botanically it is Eumediterranean area. In allergologic out-patient departments of Dubrovnik, Split, Sibenik, Zadar, Pula and Rijeka, 300 patients with pollinosis have been tested by the application of the prick method of group allergens of grass, tree and weed pollen, particularly of Parietariae (pellitory) pollen.

The object of the investigation was to find out which pollen antigen is actual for the Adriatic area and distribution of Parietariae pollen, regarding the fact that it was almost the only cause of pollinosis in the south part of the Adriatic coast (Dubrovnik), Ninety healthy persons were also examined, 15 in each out-patient department, being the control. The results show that grass pollen is actual allergen in the north and middle Adriatic area, while in the south Adriatic it is without any importance. The number of people oversensitive to trees and weeds pollen is low. The oversensitiveness to Parietariae pollen appears all along the coast, its number decreasing from the south to the north. It is concluded that grass pollen is the main cause of pollinosis, in the area of the Croatian littoral and Istria, important in south and central Dalmatia and almost without importance in south Dalmatia. Parietariae pollen is actual allergen all along the coast, being almost the only cause of pollinosis in south Adriatic area. [Excerpt reprinted from Medline, per above hyperlink.]

Seven erythrocyte enzyme polymorphisms (ACP1, ADA, ESD, GLO1, PGD, PGM1 and PGM2) were investigated in a sample of 673 unrelated adult individuals from Friuli Venezia Giulia (or Friuli) and Istria. The gene frequencies found in the four provincial samples of Friuli and Istria fall within the range previously reported for Italy, showing a genetic homogeneity among the considered samples. However, comparisons with data from ex-Yugoslavian samples--using the chi 2 test--showed rather marked differences, probably due to a real different genetic structure of the compared samples. A significant association was found assuming a linear relation between the ADA*2 allele frequencies and longitude (r = +0.5503) and between the PGD*C frequencies and latitude (r = -0.6483), suggesting the existence of a clinal trend for these allele frequencies in Italy. These results seem to disagree with foregoing conclusions stated by other authors, probably because these studies were carried out in an area either rather narrow from the geographical point of view or affected by small size migration movements.

In this paper medical texts--supplications, exorcisms, prayers and recipes from the Croatian Glagolitic manuscripts are analyzed. These manuscripts from the northern coastal region of Croatia (i.e. Istria, Primorje and Northern Dalmatia) date from the 14th until the 19th century. The occurrence of the most common diseases in the said region is studied from medicohistorical and philological standpoints. The approach of medieval authors to therapeutic procedures was polyvalent (religious and empirical), and the way in which they sought to establish medical terminology is also reviewed in the paper. The results of this study show that the analyzed manuscripts are a valuable source for research of medical history and of the Croatian Glagolitic cultural heritage.

At the end of the 18th century, an epidemic of allegedly unknown disease characterized by inconsistent symptoms broke up in Istria, Croatia. The disease was called Skrljevo disease after the village Skrljevo, near Rijeka, where it first emerged. We critically evaluated archive material, books, and papers on this disease published during the last 200 years. According to these records, the "illness" spread quite rapidly, affecting around 13000 people at its peak around the mid-19th century. Dozens of papers, books, and dissertations were written, trying to elucidate the nature and cause of the "epidemic." By the end of the 19th century, the "disease" had mostly disappeared, but the questions it had raised did not. We believe that this "disease" was not a real epidemic, but actually the rise (and fall) of a "fashionable diagnosis" [syphilis?]. We recognized certain similarities in ethical and popular aspects between the story of the Skrljevo disease and acquired immunodeficiency syndrome.

The sea anemone Anemonia sulcata is the clinically most important Actinaria in the Adriatic Sea. Between 1965 and 1980, 55 patients stung by this cnidarian were seen at the Pula Medical Center in Istria, Yugoslavia. The majority of injuries were inflicted upon the upper extremities, chest, or abdomen. Pain and the appearance of small blanched papules surrounded by slightly reddened and edematous bases were the usually initiating manifestations. Linear lesions were sometimes seen. Vesicles, sometimes filled with serous fluid, localized discoloration, and the formation of bullae sometimes followed. Somnolence, dizziness, nausea, vomiting, muscle aches, and lid edema were reported in some cases. The treatment of these injuries in the northern Adriatic Sea and elsewhere is discussed.

For the identification of host species of blood-sucking parasites, the suitability of disc-electrophoresis of the stomach contents was tested. Mammalian blood in the stomach of the medicinal blood leech Hirudo medicinalis gave satisfactory results. In the case of mixed blood samples from H. medicinalis, the identification of the host according to the electrophoretic patterns of the stomach contents failed as compared with an immunological method such as the Ouchterlony test. Medicinal blood leeches (H. medicinalis) collected in Istria Croatia, or bought in a pharmacy contained blood from cattle, horses, or frogs in their stomachs. Specimens of H. medicinalis from Lake Neusiedl or from the Seewinkel Austria, had sucked blood from mallards or frogs. Blood of cattle, mallards, and frogs was found in the stomachs of H. medicinalis coming from the National Park Kiskunsag Hungary. For the first time, horses were established as hosts for free-living specimens of H. medicinalis. A comparison of the weights of H. medicinalis bought in a pharmacy revealed that specimens containing frog blood in their stomachs weighed significantly less than those containing horse blood. These results confirmed the reports from Ssynewa (1944) concerning the breeding experiments. Probably, there is a change in hosts from the frog to warm-blooded animals during the life cycle of H. medicinalis. There were also significant differences in the weights of leeches as revealed by a comparison of the population from the Neusiedlersee with the leeches bought in the pharmacy.

Between 1995 and 2002, a massive appearance of black widow (Latrodectus mactans tredecimguttatus, Rossi 1790) was recorded along the Croatia coast. This paper gives a historical review of latrodectism and observations from Istria and Dalmatia, paying particular attention to the spider's habitat. There are several reasons for the black widow to appear in a new habitat such as the introduction of leguminous plants, watermelons and melons where crops were grown earlier. Black widow can also be found near buildings and gardens. Human contacts with the spider are usually without consequences for humans, thanks to education and a relatively good visibility of the spider. The authors describe their experience in fighting black widow and emphasise the importance of education in preventing lactrodectism.

In the introductory part, the authors present several patrons/patronesses of the eyes and sight, as well as the protectors from eye diseases. In addition, presented is a short hagiography of St. Lucia, the most famous among the patrons of the eyes. The second part is dedicated to the cult of St. Lucia, which has existed among the Croats from the 10th century until present day. Testimonies to this are numerous churches, chapels, altars, paintings, sculptures, processions, pilgrimage, prayers, votive gifts, and many other forms of folk piety. By reviewing several characteristic examples from Istria and the region of Kvarner, the importance of this veneration is indicated, for general and religious tradition as well as for the history of medicine, especially the history of ethno-ophthalmology.

An ethnobotanical field study was conducted among the Croatians living in Cićarija in northern Istria and a very restricted folk pharmacopoeia (of approximately only 30 remedies) was recorded. This finding suggests that a remarkable process of erosion of Traditional Knowledge (TK) may have taken place. The collected data were compared with the ethnobotanical findings of a field study previously conducted among the Istro-Romanians living in the nearby village of Zejane, who probably migrated there around the 14th Century. It was found that more than half of the botanical taxa were being used medicinally across the two communities, and that approximately one third of the actual medicinal plant uses were recorded in both communities. Correspondence analysis carried out comparing the same data with those of the ethnobotanical literature of Istria and Friuli-Venezia Giulia in North-Eastern Italy showed that the folk phytotherapy of the diverse ethnic populations living in multi-cultural Istria appears to be very similar.

In Croatian archives a rich collection of registers is preserved. Among the oldest and best-conserved collections of such valuable sources in Europe, are those from the territory of Istria. Investigating these sources we focused our attention on three recipes for treatment of calculi and cuts found on pages of Kastel baptismal's record (1749-1815) in Istria. Similar to other recipes found in various other recipe collections they mirror interlace of folk experience and theurgical views of healing which was detected unexpectedly sometimes on unconventional places, have survived on Croatian territory throughout centuries.

In the current article, two paintings related to the topic of reimplantation from Croatian sacral patrimony are presented. The first one is "The Kiss of Judas," the fresco by Vincent of Kastav (1474) in Beram in Istria--a Gospel scene with Jesus performing reimplantation of the ear to Malchus after it was cut off by Apostle Peter. The second one is an old oil on canvas from the island of Rab, presenting St. Anthony of Padua performing reimplantation of a boy's amputated foot. Although in both cases the primary function of the painting is to convey a moral message, they are interesting from the medical-historical point of view for their view of universal popular imagination and the conception of healing severe wounds during the absence of modern medical knowledge.

AIM: To establish the frequency of Y chromosome microdeletions in an unselected group of infertile Croatian men.

METHODS: An unselected group of 105 patients (male partners of infertile couples), both with idiopathic and non-idiopathic infertility, consecutively referred to the outpatient infertility clinic, gynecology department, General Hospital Pula, Istria County, Croatia, was examined for the presence or absence of Y chromosome microdeletions by polymerase chain reaction analysis.

RESULTS: One of the 105 men (0.95%, 95% CI = 0.17-5.2%) was found to have a microdeletion.

CONCLUSION: A low frequency of Y chromosome microdeletions was found in the group of unselected infertile Croatian men.

The only stable iodine isotope is 127I and the natural 129I/127I ratio in the biosphere has increased from 10(-15)-10(-14) to 10(-10)-10(-9), mainly due to emissions from nuclear fuel reprocessing plants. In Europe they are located at La Hague (France) and Sellafield (England), where the ratio of 129I/127I is up to 10(-4). The marine environment, i.e. the oceans, is the major source of iodine with average concentrations of around 60 mirogL(-1) iodine in seawater. Brown algae accumulate iodine at high levels of up to 1.0% of dry weight, and therefore they are an ideal bioindicator for studying the levels of 127I and 129I in the marine environment. A radiochemical neutron activation analysis (RNAA) method, developed at our laboratory, was used for 129I determination in the brown alga Fucus virsoides (Donati) J. Agardh, and the same technique of RNAA was used for total 127I determination. The samples were collected along the coast of the Gulf of Trieste and the West coast of Istria in the North Adriatic Sea in the period from 2005 to 2006. Values of the 129I/127I ratio up to 10(-9) were found, which is in agreement with the present average global distribution of 129I. The levels of stable iodine found were in the range from 235 to 506 microg g(-1) and the levels of 129I from 1.7 to 7.3 x 10(-3)Bq kg(-1) (2.6-10.9 x 10(-7) microg g(-1)), on a dry matter basis.

In the last two decades the classic typhoid and paratyphoid A and B became rare also in Istria being substituted by infections of salmonellas of the "minor group". Basing on observations on 418 patients (1970-1979) it was established that in 48.5% of them a significant increase of titers of antibodies, not only for group antigens but also for phasis antigens developed. This, together with positive hemocultures and urine cultures in a number of them, did lead the authors to the conclusion that the invasitivity of these salmonellas (e.g. S. enteritidis, typhi murium, hadar, agona, abony) is greater than previously presumed and that the diagnosis "Salmonella-Fever" or "Paratyphoid" also in infections of these salmonellas is more justified. PMID: 7023127, UI: 81278005. [Excerpt reprinted from Medline, per above hyperlink.] 

Plasma protein genetic polymorphisms (HP; TF and GC subtypes) were studied in two different areas (Friuli Venezia Giulia and Istria). The results are discussed and compared with those reported by literature on other Italian and ex-Yugoslav population samples. [Excerpt reprinted from Medline, per above hyperlink.]

The distribution of pollen antigens of an area depends on geographic situation, climatic factors and vegetation. Geographic situation of examined area is in latitude from 42.5 degrees (Dubrovnik) to 45.5 degrees north (Rijeka), the climate is Mediterranean and botanically it is Eumediterranean area. In allergologic out-patient departments of Dubrovnik, Split, Sibenik, Zadar, Pula and Rijeka, 300 patients with pollinosis have been tested by the application of the prick method of group allergens of grass, tree and weed pollen, particularly of Parietariae (pellitory) pollen.

The object of the investigation was to find out which pollen antigen is actual for the Adriatic area and distribution of Parietariae pollen, regarding the fact that it was almost the only cause of pollinosis in the south part of the Adriatic coast (Dubrovnik), Ninety healthy persons were also examined, 15 in each out-patient department, being the control. The results show that grass pollen is actual allergen in the north and middle Adriatic area, while in the south Adriatic it is without any importance. The number of people oversensitive to trees and weeds pollen is low. The oversensitiveness to Parietariae pollen appears all along the coast, its number decreasing from the south to the north. It is concluded that grass pollen is the main cause of pollinosis, in the area of the Croatian littoral and Istria, important in south and central Dalmatia and almost without importance in south Dalmatia. Parietariae pollen is actual allergen all along the coast, being almost the only cause of pollinosis in south Adriatic area. [Excerpt reprinted from Medline, per above hyperlink.]

Stings by the sea anemone Anemonia sulcata in the Adriatic Sea. Am J Trop Med Hyg 1983 Jul;32(4):891-6. Maretic Z, Russell FE. PMID: 6136192, UI: 83280507.

The sea anemone Anemonia sulcata is the clinically most important Actinaria in the Adriatic Sea. Between 1965 and 1980, 55 patients stung by this cnidarian were seen at the Pula Medical Center in Istria, Yugoslavia. The majority of injuries were inflicted upon the upper extremities, chest, or abdomen. Pain and the appearance of small blanched papules surrounded by slightly reddened and edematous bases were the usually initiating manifestations. Linear lesions were sometimes seen. Vesicles, sometimes filled with serous fluid, localized discoloration, and the formation of bullae sometimes followed. Somnolence, dizziness, nausea, vomiting, muscle aches, and lid edema were reported in some cases. The treatment of these injuries in the northern Adriatic Sea and elsewhere is discussed.  [Excerpt reprinted from Medline, per above hyperlink.]

Main Menu

This page compliments of Marisa Ciceran

Created: Friday, December 17, 1999; Last Updated: Saturday, November 19, 2011
Copyright © 1998 IstriaNet.org, USA