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The Bank of Russia is the legal entity which, apart of the other organs of state authorities, acts as the organ of state governing with remarkable role in exibiting the functions of Russian state and insufficiently precisely determined status in accordance to the state authorities and law entities. In this work the investigation is directed to the relationship between the legal position of the Bank of Russia and its role in providing the economic sovereignty of the Russian Federation. The aim of the work is to explore the legal position of main bank in monetary system and its role in providing the economic sovereignty of the Russian Federation on the basis of systematization and reliable literature source norm analysis, applying the comparative-law method, as well as the method of legal exegesis and content analysis. The results of survey imply to the presence of different attitudes to the legal position of the Bank of Russia. Insufficiently determined legal position of the Bank of Russia brings to disballance of measures and activities of executive authorities and the Bank of Russia, which has a negative influence on providing the full economic sovereignty, self-developement of the country and greater social benefits, in spite of the fact that the Bank of Russia is mostly independent from the state authorities having a comfortable position in civil transit affairs.

Copyright of Journal for Languages & Literatures of the Faculty of Philosophy in Novi Sad / Zbornik za Jezike i Knjizevnosti Filozofskog Fakulteta u Novom Sadu is the property of Faculty of Philosophy, University of Novi Sad and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Chirurgica Iugoslavica is the property of Association of Yugoslav Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Chirurgica Iugoslavica is the property of Association of Yugoslav Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Chirurgica Iugoslavica is the property of Association of Yugoslav Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Chirurgica Iugoslavica is the property of Association of Yugoslav Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Chirurgica Iugoslavica is the property of Association of Yugoslav Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Chirurgica Iugoslavica is the property of Association of Yugoslav Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Recent literature data suggest that permanent or reversible hearing loss may occur after general anesthesia. The etiology varies, while hearing loss following middle ear surgery is attributed to exposure to nitrous oxide (N2O). The objective of our study was to measure, using tympanometry, the middle air pressure change caused by nitrous oxide during general anesthesia and to establish its emetogenic effects during the postoperative period. Material and Methods. This academic (non-commercial) prospective study included two groups of patients (a total of 58), with ASA status I, II and III. The study group (n 30) consisted of patients undergoing unilateral ear surgery. In this group, the intratympanic pressure was measured in the unoperated (healthy) ear before and during the surgery. The control group (n 28) patients underwent nose, throat or neck surgical interventions. This group underwent measurement of bilateral intratympanic pressure in healthy ears, before and during the surgery. Both groups were operated under general balanced anesthesia. Pain, nausea and antiemetics were monitored during the first 24 postoperative hours. Statistical analysis was performed using the Mann-Whitney-Wilcoxon test. Results. This perioperative study confirmed the following: highly significant (p<0.001) increase in intratympanic pressure in non-operated ears in the study group and significant (p<0.05) in controls. However, there was no statistical significance (p>0.05) between groups. Pain was more frequent in controls, and nausea in the study group, but without significant difference (p>0.05). Conclusions. Postoperative audiometry findings showed no conductive or sensorineural hearing loss after interventions. Nitrous oxide can be used in general balanced anesthesia with discontinuation 15 to 45 minutes before insertion of the tympanic membrane and completion of middle ear surgery. [ABSTRACT FROM AUTHOR]

Folk medicine is a traditional medical practice in the general population, especially in rural areas. Traditional medicine methods used herbal remedies as well as human and animal substances and minerals. The most commonly used drugs in the treatment of eye diseases were drugs of plant origin like chamomile, eyebright and greater celandine, then drugs of human and animal origin like breast milk, saliva, honey, animal bile, and copper sulfate from mineral origin. There is little information in the literature discussing the folk treatment of ocular diseases. The aim of this paper is to show how ocular diseases were treated in folk medicine in Dalmatia during the 19th century. Efforts were also made to explain the reasons for such empirical treatment that was passed from generation to generation. At the end of the 19th, and especially at the beginning of the 20th century, modern and scientific ophthalmology developed in Dalmatia, but also throughout Croatia, first in large cities. So gradually, folk medicine in the treatment of eye diseases became more and more forgotten.

The founder of the Vienna School of Ophthalmology was Prof. Dr. Georg Joseph Beer, who founded the First University Eye Clinic in the Vienna General Hospital in 1812. Prof. Ferdinand von Arlt led it for 27 years from 1856 to 1883. As the First Eye Clinic became too small, the Second University Eye Clinic was founded in 1883 at the same hospital in Vienna. Since 1885 it had been led for 30 years by Prof. Ernst Fuchs. Many well-known ophthalmologists were leading those Viennese eye clinics. However, Arlt and Fuchs were the main representatives of the Vienna School of Ophthalmology, which was always characterised by the high standards in the diagnosis and therapy of eye diseases. Many Croatian ophthalmologists were educated by them or their students, and later they established eye departments in the major cities in Croatia and transmitted acquired knowledge and experience. The first eye departments in Croatia were formed at the turn of the 19th and 20th century. The First University Eye Clinic in Croatia started to work in Zagreb in 1923. Our ophthalmologists transmitted the organisation of the clinics as they existed in Vienna, and that was the matrix form of all European clinics at that time. Therefore, the tradition of the Vienna School of Ophthalmology was passed on to the next generations. The paper also gives short biographies of Viennese and Croatian ophthalmologists and their mutual relations in education and work.

Introduction: The Croatian Association for Diabetes and Metabolic Disorders of the Croatian Medical Association has issued in 2011 the first national guidelines for the nutrition, education, self-control, and pharmacotherapy of diabetes type 2. According to the increased number of available medicines and new evidence related to the effectiveness and safety of medicines already involved in the therapy there was a need for update of the existing guidelines for the pharmacotherapy of type 2 diabetes in the Republic of Croatia., Participants: as co-authors of the Guidelines there are listed all members of the Croatian Association for Diabetes and Metabolic Diseases, as well as other representatives of professional societies within the Croatian Medical Association, who have contributed with comments and suggestions to the development of the Guidelines., Evidence: These guidelines are evidence-based, according to the GRADE system (eng. Grading of Recommendations, Assessment, Development and Evaluation), which describes the level of evidence and strength of recommendations., Conclusions: An individual patient approach based on physiological principles in blood glucose control is essential for diabetes' patients management. Glycemic targets and selection of the pharmacological agents should be tailored to the patient, taking into account the age, duration of disease, life expectancy, risk of hypoglyce- mia, comorbidities, developed vascular and other complications as well as other factors. Because of all this, is of national interest to have a practical, rational and applicable guidelines for the pharmacotherapy of type 2 diabetes.

Dr Aleksandar Doršner (Trebinje, 1892 - Lima, 1967) was the first hospital otorhinolaryngologist in Split and Dalmatia. He graduated from the Faculty of Medicine in Prague in 1919, and specialized otorhinolaryngology in Graz and Vienna. He led and organized otorhinolaryngological service in Split Hospital from 1923 to 1934, and he also had a private practice. Temporarily he also worked outside Split in Dalmatian hinterland and in Šibenik, Zadar and Dubrovnik. Most frequently he performed the following otorhinolaryngological operations: tonsillectomies and adenoidectomies and operations of purulent middle ear inflammations with mastoiditis, nasal polyps, deviated nasal septum, maxillary sinus empyema and otorhinolaryngological trauma. In 1928 he became a member of Otorhinolaryngological section of Croatian Medical Chamber. He participated in the work of the first otorhinolaryngological congress of the former Yugoslavia in 1931, taken place in Zagreb. From 1928 he was a member of Oto-Neuro-Ophthalmological Society. From 1933 to 1937 he was a vice-president of the main board of Free Organization of Dalmatian Physicians in Split. In 1938 he left Split permanently and continued living with his family in Lima (Peru) where he died in 1967. He was an erudite. He lived for his profession which he liked very much and dedicated his life to. He is one of the most meritorious doctors in Split medical history, whom otorhinolaryngology service in Split Hospital started with.

Diagnosis of esophageal varices (EV) is based upon endoscopic examination, which is a rather unpleasant method that carries a certain risk of complications. For that reason, efforts have been made to develop noninvasive methods for characterization of EV. The aim of this study was to explore the value of platelet count to spleen size ratio (PSR) for noninvasive prediction and characterization of EV in patients with alcoholic liver cirrhosis (ALC). One hundred and seventeen patients (20 females and 97 males, mean age 60.7) with ALC were included in our research. All patients underwent endoscopic examination upon which the EV were classified as small (< 5 mm), large (> 5 mm), or absent. Spleen size (bipolar diameter in mm) was assessed by ultrasound. Platelet count to spleen diameter ratio was calculated and the values obtained were compared to the presence, size and risk of bleeding from EV as defined by endoscopy. No significant difference in PSR could be found between patients without and with EV (1.341 ± 0.725 vs. 1.053 ± 0.636, respectively; p = 0.06). The PSR was significantly different between the patients with small and large EV (1.103 ± 0.689 vs. 0.876 ± 0.314; p < 0.05) with a cut-off value of 1.141 (sensitivity 94.7%, specificity 38.2%, AUROC = 0.656; p = 0.042). The value of PSR below 1.182 pointed to patients at risk from variceal bleeding with 91.7% sensitivity and 38.5% specificity (AUROC = 0.625, p = 0.035). Based on our results, it is not possible to recommend the use of PSR as the exclusive noninvasive indicator for the presence, size and bleeding risk from EV due to its low specificity for these categories in patients with ALC.

Introduction: Research related to injuries of elite athletes is very demanding in comparison to research on injuries in team sports, and therefore, there are a lot fewer resources and data on injuries in track and field sports than in other sports. MATERIAL AND METHODS. The research included 78 athletes who were the members of junior and senior national track and field team of Serbia (34 women and 44 men), aged 15 to 32 years. The research was conducted in the official training camp for the national selection in Bar (Montenegro) by using a non-standardized survey research technique, an anonymous questionnaire. Out of the total number, 59 athletes reported incidence of injury and 19 athletes were without injury over the four-year cycle., Results: The majority of injuries were reported on the lower extremities, i.e. in 90.8% (n=158), the upper leg and the hamstring muscle having been injured in 99 cases (56.9%) and 61 cases (35.05%), respectively. The most common type of injuries were strains (n=74; 42.5%), followed by partial ruptures (n=30, 16.3%) and distortion (n=25; 14.4%). The most frequent diagnosis was hamstring strain (n=37; 21.3%)., Discussion and Conclusion: Inadequate procedures related to the extent and intensity of training, without prevention of injury, often lead to injuries in athletes. It is necessary to carry out continuous educational training, especially for coaches, whose effects should be reflected in the introduction of new knowledge and scientific achievements in the field of biomechanics, training technology, prevention and cure in the field of sports medicine. It is also very important to achieve adequate and constant cooperation between sports physicians and athletic clubs.

Introduction: Destructiveness in aggressive behavior is interpreted as having many causes, the psychiatric ones being of biological, social and psychopathological nature. This study was aimed at examining the differences among the perpetrators who have committed crimes and misdemeanors in Bosnia and Herzegovina in the period from January 1st, 2003 to December 31st, 2012., Material and Methods: This prospective, multicentric study used the following measuring instruments: list of general data. Hamilton Rating Scale, the Emotional Profile Index with descriptive and multivariate statistical analysis., Results: Multivariate regression analysis showed that the following variables were significantly associated with violence P=0.001: long treatments OR= 810 (95), CI 0.770 -1.110], migrations [OR=0.830 (95%), CI = 0.825 -1.125,], depression [OR=1.150 (95%); CI=0.790-0.990] and the destructiveness revealed by the Emotional Profile Index test. Misdemeanors were significantly related with the following variables: P =0.001: father's education [OR=0.910 (95%), CI=0.620-1.100]; living in a suburb [OR=0.850 (95%), CI = 0.930 -1.25, P<0.001], destructiveness [OR= 0.670 (95%), CI= 990-1.210, P<0.001]; incorporation and bias on Emotional Profile Index test., Conclusion: This study has confirmed the increase of destructiveness in aggressive behavior in Bosnia and Herzegovina, which is of great medical and legal significance. The study points to the social and psychopathological characteristics of aggression in Bosnia and Herzegovina.

Introduction of biologic therapy in clinical practice represented significant progress in the treatment of inflammatory bowel diseases (IBD) because of its proven efficacy and due to the fact that biologics are the first drugs used in the treatment of IBD that can change the natural course of this diseases. At the same time, biologics are very expensive drugs with complex mechanism of action and important side effects and their use requires evidence-based clinical guidelines. These were the reasons that Referral Center of the Croatian Ministry of Health for IBD and the IBD Section of the Croatian Society of Gastroenterology organised Croatian consensus conference that defined guidelines for the treatment of IBD with anti-TNF drugs. The text below includes definitions of IBD, general principles of IBD therapy, comments on the importance of mucosal healing, analysis of reasons for nonresponse and loss of response to anti-TNF drugs, recommendation for the duration of anti-TNF therapy, rules of screening for opportunistic infections prior to anti-TNF therapy, comments on the problems with reproduction in IBD and finally guidelines for the treatment of various phenotypes of IBD including extraintestinal manifestations with anti-TNF therapy.

Extraintestinal manifestations occur in about 35% of patients with inflammatory bowel diseases (IBD). Most frequently affected are bones and joints, skin, eyes, liver and biliary ducts. Extraintestinal manifestations of IBD are divided in two groups: reactive manifestations which depend on activity of IBD--peripheral arthritis, erythema nodosum, aphthous stomatitis, episcleritis and other manifestations which are independent on activity of IBD--pyoderma gangrenosum, uveitis, axial arthropathy, primary sclerosing cholangitis (PSC). Most affected are bones and joints. Symptoms vary from mild arthralgia to severe arthritis with painful swallowing of joints. They occur in about 5-10% of patients with ulcerative colitis (UC) and in 10-20% of patients with Crohn's disease (CD). Both peripheral and axial joints can be affected. According to available data, most patients with active IBD and concomitant arthritis have benefit from infliximab therapy. Infliximab is also effective in maintenance of remission in group of patients with spondyloarthropathy. Adalimumab showed similar efficacy in treatment of ankylosing spondylitis, but there are still no data about efficacy of adalimumab in treatment of patients with IBD and concomitant arthritis. Primary sclerosing cholangitis, autoimmune hepatitis, cholestasis, cholelithiasis and elevation of aminotransferase are also considered to be extraintestinal manifestations of IBD. Most frequent is PSC which affects usually patients with UC (7.5% of patients). Course of liver disease is completely independent on activity of IBD, and destruction of biliary ducts is usually irreversible and refractory on treatment and most of the patients need liver transplantation. Anti-TNF therapy is also ineffective in treatment of PSC and has no impact on disease course and outcome. However, there is no contraindication for anti-TNF therapy of concomitant active IBD in this group of patients. Erythema nodosum (EN) and pyoderma gangrenosum (PG) are usual skin manifestations of IBD. Erythema nodosum occurs in about 3-20%, and pyoderma gangrenosum in about 0.5-20% of patients with IBD. Infliximab is proven to be effective in treatment of PG, but there is still not enough evidence on efficacy of anti-TNF drugs in treatment of EN and other rare skin manifestations of IBD. About 2-5% of patients with IBD have also some ophthalmological disorder. Symptoms vary from mild conjunctivitis to severe inflammation of eye membranes--iritis, episcleritis, scleritis and uveitis. It seems that infliximab and adalimumab can diminish uveitis and scleritis in patients with different autoimmune disorders and IBD. According to guidelines of American Gastroenterology Association (AGA), in group of patients with CD, infliximab is indicated in treatment of spondyloarthropathies, arthritis, arthralgia, pyoderma gangrenosum, erythema nodosum, uveitis and other ophthalmological manifestations of IBD except optical neuritis which can worse or be consequence of anti-TNF treatment. Similar indications exist for use of adalimumab except in case of erythema nodosum. In group of patients with extraintestinal manifestations of UC, infliximab is indicated in treatment of spondyloarthropathies and pyoderma gangrenosum. Complications of IBD are fistulas (perianal and non-perianal), stenosis and strictures, abscesses, bowel perforations, gastrointestinal bleeding and development of different malignomas. Anti-TNF drugs are proven to be effective and indicated only for treatment of perianal fistulas in patients with Crohn's disease. In group of patients with UC, there are only few case reports on beneficial effect of infliximab in treating chronic pouchitis and infliximab in treatment of these patients still cannot be recommended.

The aim was to investigate the effectiveness of the fixed drug combination dorzolamide 2%/timolol 0.5% as monotherapy, substitutive and as adjunctive therapy in patients with primary open angle glaucoma. 130 patients were divided in three different study groups and treated by the combination dorzolamide 2%/timolol 0.5% as monotherapy, substitutive therapy and additional therapy. After three months using fixed combination dorzolamide 2%/timolol 0.5%, the mean IOP decreased by 5.6 mmHg. After prescribing substitutive therapy with fixed drug combination dorzolamide 2%/timolol 0.5% for 3 months, the intraocular preassure increased by 0.13 mmHg. Three months after the treatment with fixed combination dorzolamide 2%/timolol 0.5% as an additional antiglaucomatous drug, we have noticed a decrease of the mean IOP of 3.28 mmHg. Itching and soarness were reported by 43% patients. In conclusion, glaucoma drug therapy with fixed drug combination dorzolamide 2%/timolol 0.5% achieves effective lowering of intraocular preassure levels as monotherapy or as adjunctive therapy. As a substitutive therapy, the combination had the same IOP lowering effect. Simple drug administration and good drug tolerance indicate the effectiveness of the same drug.

The working group of the Croatian Society of Endocrinology met in September 2011 to discuss the diagnostic and therapeutic dilemmas in patients with acromegaly. The group comprised 9 pituitary specialists including endocrinologists, neurosurgeons, and medical biochemistry specialist. After a critical analysis of published scientific papers the group has developed guidelines for the diagnosis and treatment of acromegaly.

At the end of the 19th and the beginning of the 20th century many famous persons stayed on the Croatian coast mostly because of touristic and health reasons, than because of natural beauties, scientific or political reasons. Most often they came from Austro-Hungary, Germany or Russia but also from our homelands. Among them were also many famous doctors, some known worldwide. The most distinguished were the surgeon Theodor Billroth, the bacteriologist and a Nobel prize winner Robert Koch, the pathologist Rudolf Virchow, and the psychiatrist Sigmund Freud. They left a deep impression and a big benefit at the area they stayed in.

As a religion based on the teaching of Jesus Christ, from the outset Christianity has developed a completely different attitude toward health and illness than the Old Testament. Health and illness are now viewed through the eyes of Jesus Christ the redeemer, who accepted each and every man. The history of Christianity has had its episodes of masochistic attitude toward illness, but today it clearly underscores the need to fight it with any means available, but it also teaches to accept what can not be changed. Saints are often patrons against diseases they had to endure. However, this is not their main role. To this day many seem to miss the main point their heritage, but see them as miracle healers. This misperception of miracle needs revising as well as the simplistic interpretation of the healing powers of relics (viewed as a demiurge of sort) and of the private vows and votive offerings.

Salt intake contributes to the rise in blood pressure and prevalence of hypertension. In this interventional trial on 110 treated hypertensives over three months a permanently elevated sodium excretion was found, averaging 187.9 +/- 81.5 mmol/day (range 103-297), because of inappropriate salt intake. The treated hypertensives, despite opposite claims, consume large amounts of salt, which, in addition to noncompliance, is the leading cause of poor hypertension control. Dietary education is an important part of preventive care in family medicine, and legal measures to enforce salt labeling on alimentary products are mandatory.

Traumatic brain injury (TBI) is the most common cause of acquired disability and death in children. Retrospective analysis showed 350 children, 128 (36.6%) girls and 222 (63.4%) boys who were hospitalized for injury of neurocranium in a 5 year-period in Dr. Josip Bencević General Hospital in Slavonski Brod. Most of them had both contusion and commotion (46.8%), followed by just contusion of the head (12.5%) and fractures of the skull (10.5%). The haemorrhages and hemathomas were less common (epidural, subdural, SAH) (3.2%). The procedures performed showed that in almost all children X-rays had been performed (99.7%). The most commonly X-rays performed were those of the head (craniogram) and/or cervical spine, followed by CT, EEG, ultrasound and NMR. The occurence of complications was recorded in only 2% of injured children (seizure, syncopa, febrile convulsions). Analysis of treatment methods showed that in most children (89.6%) therapy was conservative. The injured children were hospitalizated mostly for 2 days (34.5%) or 3 days (32.5%), while longer hospitalization was less common. Regarding extra consultation of other specialists (besides neurosurgeons), the most commonly consulted were pediatrician, surgeon/traumatologist, specialist of ENT/maxilofacial surgery, neuropediatrician, pediatric surgeon, ophthalmologist and others. It can be said that the prognosis of TBI in children depends on the age, neurological status and kind of injury, and on the quality of care, which involves availability of neurosurgeons and other specialists.

Aims: The impact of the chronic obstructive pulmonary disease (COPD) severity on the number of exacerbations, and the interdependence of COPD and some concomitant diseases were studied in chronic pulmonary patients. In order to determine the actual influence of some risk factors and comorbidity on the course of COPD, we conducted a study in two family medicine consulting offices, one in the city of Split and the other on the island of Brac., Methods: This retrospective study included a sample of 64 subjects, mean age 64.43 years, divided into two groups of 32 subjects each (group 1 and group 2). After taking history data and clinical examination, spirometry was performed. The severity of COPD was determined on the basis of lung function tests., Results: There were 15 (46.9%) smokers in group 1, seven of them former smokers, and 20 (65.6%) smokers in group 2, eight of them former smokers. The groups differed significantly according to the mean number of annual exacerbations (1.3 in group 1 and 2.4 in group 2; p < 0.001). The frequency of exacerbations was higher in smokers and depended on the stage of COPD. If COPD was more severe, the exacerbations were more frequent and influenced the progression of irreversible functional changes on the lungs. Productive cough was more frequent in smokers. The correlation of concomitant diseases and degree of COPD was found in group 2 (hypertension, r = 0.305; p = 0.014). In group 1, there was correlation between patient age and concomitant disease (cardiac arrhythmias, r = 0.307; p = 0.013), whereas in group 2 it was significant in case of hypertension (r = 0.474; p < 0.001) and cardiomyopathy (r = 0.301; p = 0.016)., Discussion: Cigarette smoke causes chronic inflammatory changes in the lungs. In our study, the number of patients suffering from persistent cough accompanied by sputum was higher in group 2, which also comprised of more smokers, but differences between smokers and non-smokers according to this characteristic were not statistically significant. Study groups differed significantly according to the number of COPD exacerbations per year (with more exacerbations in the group with more smokers). In group 2, there was a correlation between COPD severity and hypertension., Conclusions: Comorbidity of COPD and cardiovascular diseases was confirmed, along with correlation between age and cardiovascular complications in patients with COPD.

Choroidal melanoma is the most common primary intraocular malignant tumour in adults. The aim of the study was to examine epidemiological characteristics of choroidal melanoma in Split-Dalmatia County from 1990 to 2009. In this retrospective study, data on 46 patients from medical documentation of the University Department of Ophthalmology, Split University Hospital Center, were analyzed. According to 2001 census, the Split-Dalmatia County population was 467,676 inhabitants. The incidence of choroidal melanoma was 0.49 per 100,000 inhabitants, which is somewhere in the middle of the incidence between south and north Europe. Choroidal melanoma most commonly appeared in the 7th decade of life. The average dimensions of choroidal melanoma (basis x height) were 13.4 x 8.0 mm. Histopathologic findings according to Callender classification showed the following types of melanoma: epithelioid cell type 8%, spindle cell type 40%, and mixed type 52%. The most common forms of therapy were enucleation 47.8% and brachytherapy 28.3%, which means that patients presented relatively late when choroidal melanoma advanced in size. The Split-Dalmatia County has 1/10 of the Croatian population, so it could be supposed that approximately 25 new cases of malignant melanoma of the choroid are discovered annually in Croatia. For early detection of the disease, regular and complete checkups are necessary, especially in presbyopic population. Study results enabled better evaluation of the disease and better planning of ophthalmologic service in the treatment of this serious eye disease.

Manuscripts containing collections of folk recipes for treatment of deseases were written mostly by Catholic priests especially Franciscians in Croatia in the past centuries. They were used as manuals for preparation of remedies and gave directions for their use. These writtings provide valuble data for etnographers and historians of ethnomedicine. The paper describes the manuscript "Many different remedies for headache treatment" written by unknown author probably in 18. century in Sinj, Dalmatia. The manuscript was found in the archives of Sinj Friary. The collection contains 16 recipes for headache treatment. Materia medica of the manuscript is composed of drugs of plant origin. Valuable information is given about the folk names for medicinal plants as well as descriptions of the ways of preparing remedies. Latin as well as contemporaly croatian names are attributed to the plants species mentioned in the manuscript. Use of the plants for treatment of the specific deseases were compared with their use in modern fitotherapy.

Aim: The aim of this study was to investigate the values of the Work Ability Index (WAI) and to analyze the factors that may be associated with work ability among hospital health care professionals., Methods: A total of 1856 health care professionals employed at 5 Zagreb hospitals participated in this cross-sectional study. Data were collected using the Work Ability Index Questionnaire and Occupational Stress Assessment Questionnaire for hospital health care professionals., Results: The average WAI of all participants was 38.68+/-6.28, indicating very good work ability. WAI was significantly higher in men than in women, 40.43+/-5.81 and 38.27+/-6.32, respectively (p<0.001). Younger participants had greater WAI compared with those of older age groups (p<0.001). There was a substantial difference in the proportions of participants in the categories of WAI (poor, good, very good and excellent) between physicians and nurses (p<0.001). Although physicians were considerably older than nurses (p<0.001), the proportion of those with excellent WAI was greater among physicians than among nurses, suggesting that the jobs of highly educated participants, which are characterized by broad decision-making latitude and promotion possibilities maintain work ability better in comparison with low decision-making latitude jobs and low control jobs. About 5 percent of all participants had poor WAI. We identified the following significant predictors of suboptimal WAI among health care professionals: female sex, age, service accrual, and stressors related to organization and financial issues (p<0.001), risks and hazards (p=0.040), and shift work (p=0.001)., Conclusion: The average WAI of all participants indicated very good work ability, but small percent of them had poor WAI. Our results suggest the need of preventive measures that would target maintenance of work ability at an organizational and individual level. The organizational level should include the provision of a sufficient number of workers, adequate financial resources for work and adequate salaries, less paperwork, positive collaboration with the public, especially media, and education of medical staff on the risks and hazards at work. The individual level should include individual assessment of sensitivity to night work and shift work considering age and health status, and training in stress management techniques.

The aim of the study was to show the relationship between phacoemulsification and extracapsular cataract extraction at University Department of Ophthalmology, Split University Hospital Center (assessing the length of postoperative hospital stay and postoperative visual acuity), during the 1997-2009 period. We also wanted to explore the tendency of using different types of intraocular lenses. The study was designed as a retrospective analysis of operative records. Data were collected on all patients operated for cataract at our Department during the study period. We compared the mean duration of postoperative hospital stay and mean postoperative visual acuity between 1997/1998 (more than 90% were treated with ECCE technique) and 2007/2008 (more than 90% were treated with PHACO technique). Information was also collected on the type of lenses implanted. The rate of cataract extraction by phacoemulsification was less than 10% in 1997/1998, then progressively rising to reach 99.2% in 2009. The mean hospital stay was 5.73 (range 2-19) days in 1997/1998 as compared with 1.99 (range 0.02-1) days in 2007/2008. The mean uncorrected postoperative visual acuity was 0.71 (range 0.01-1.0) in 2007/2008. In conclusion, the number of cataract patients operated on by the phacoemulsification technique progressively and significantly increased during the 1997-2009 period, confirming the method as the most acceptable and less traumatic technique that is applicable in most of cataract patients.

The paper describes the life and work of an ophthalmologist, Juraj Curin (Gdinj, 1887 - Split, 1947). In 1921, he founded Department of Ophthalmology in Split, although permanent ophthalmologic service had existed at the Old City Hospital in Split from 1902. Dr. Juraj Curin headed Department of Ophthalmology from 1921 till 1936. He graduated from the Prague School of Medicine in 1914 and served residency in ophthalmology in Zagreb in 1921. In 1923, he attended the course on biomicroscopy at University Department of Ophthalmology in Zagreb, organized by Professor L. Koeppe and Professor A. Botteri. Dr. Curin performed a vast range of ophthalmologic surgeries for cataract, glaucoma, strabismus, oculoplastic surgery, dacryocystectomy, retinal detachment, etc. Dr. Curin was also head of trachoma service he founded in 1923. He wrote a scientifically instructive booklet on trachoma and several other papers. From 1923 till 1935, he was the only ophthalmologist in Split. Until 1926, he occasionally was going to Dubrovnik for his private practice there. Between two World Wars, he was working at the Institute of Public Health, Social Insurance Eye Service, for active population in Split. During World War II, he was active in the National Liberation Movement. In 1925, he was treasurer of the Doctors' Free Organization of Dalmatia, and in 1931 auditor at the main board of the Croatian Medical Chamber in Split. Besides his doctor practice, he was also very active in social and political life.

A case of ocular dirofilariasis in a female patient is presented. The zoonosis caused by parasites of the genus Dirofilaria is relatively rare in humans, with a higher incidence in south and central Europe, Asia and Africa. In Europe, dirofilariasis is mostly caused by the species Dirofilaria repens. In the past 50 years, the number of individuals involved has been on an increase, with about 780 cases reported in the literature to date. Dirofilaria is a parasite found in the dog, cat, racoon and bear. The parasite replicates in the animal's body and enters circulation in the form of microfilariae. These microfilariae reach the insect's digestive tract and are transmitted to another animal or human with subsequent mosquito bites. When transmitted to humans, the parasite is found in the skin and subcutaneous tissue, mucous membranes, and less frequently visceral organs. Concerning ocular involvement, infections of the eye and adnexa oculi and tumorous noninfectious growth of eyelid or orbit have been described to date. The symptoms of the disease vary and include local pain, proptosis, diplopia, palpebral and conjunctival edema, redness, feeling of foreign body, and impaired vision. The diagnosis is generally made by histologic identification of the parasite micro- and macroscopic characteristics, Dirofilaria DNA analysis by the method of polymerase chain reaction, and serology (ELISA) demonstrating the presence of Dirofilaria antibodies in serum. Treatment includes surgical excision of the parasite as an appropriate and efficient therapeutic procedure. A 76-old-female patient presented to outpatient ophthalmology clinic for occasional sensation of pain, rubbing and redness in her right eye. Initial therapy was introduced, resulting in short-lasting improvement. In two weeks, the patient was re-examined for recurrence of discomforts. Slit lamp examination performed temporally revealed a whitish motile, live parasite under the injected and chemotic bulbar conjunctiva. Upon surgical extirpation of the parasite, the diagnosis of dirofilariasis was verified by microbiologic identification.

Aged population dominates in developed countries. Centenarians are a select group, and only one in 7,000 to 10,000 reach that age. Factors of longevity are numerous and include genetic predisposition (a locus on chromosome 4), environment, healthy lifestyle (hypocaloric diet, regular physical and mental exercise), accessible health services, and efficient health protection at old age. Centenarians are well adapted to the new life and compensate for the loss of functions with age. The limits of human life are extended, so that nowadays the oldest person has reached the age of 128. Some geographic areas are characterised by higher numbers of centenarians. This article mentions a few individuals who outlived 100 years in the world, Croatia, and neighbouring countries. Although some argue that the limits of human life cannot be extended over the age of 120 years, for now we cannot predict the actual limits of human life.

Dr. Erwin Treu (Kotor, 1875-Skopje, 1937) was the first permanent ophthalmologist in Split, Croatia. He finished his ophthalmological specialization at the Eye Clinic in Prague in 1900 at W.P. Czermak. He originates from Tirol. Dr. Treu led and organized ophthalmological service in Split and worked from 1902 to 1921 in the Split Hospital, and had a private practice until 1923. From 1904 to 1910 he temporarily worked outside Split, in Sibenik, Zadar, Dubrovnik, Kotor and Cetinje. During the First World War he was a military doctor in Split and Trogir. He performed ophthalmological operations, cataracts, glaucomas (iridectomy), strabismus (tenotomies), ocular adnexa, injuries, trachoma etc. In 1923 he left for Skopje where he at first worked as a medical major in Military Hospital, and after that as a primarius in Civil Hospital at the Department of Ophthalmology till the end of his life.

Color Doppler Ultrasound (CDUS) is a valuable method for evaluation of morphological and hemodynamic changes of liver circulation occurring in various pathological conditions. In some of these conditions CDUS has a decisive diagnostic role, thus making further, potentially harmful invasive diagnostic procedures unnecessary. Except for the analysis of vascular liver diseases, as well as repercussions of circulatory impairment to the liver, utilization of CDUS provides valuable information for characterization of diffuse parenchymal and focal liver lesions. CDUS has advantages as compared to the other imaging modalities as it is widely available and noninvasive. The possible disadvantage is not related to the method itself, but is due to lack of expertise, i.e. training of the operator. In this article we review the present position of CDUS in evaluation of impairment of liver circulation: disorders of the venous outflow from the liver (Budd-Chiari syndrome, right-sided heart diseases, veno-occlusive disease), disorders of/in liver parenchyma (vascular anomalies-fistulae, solid tumors, circulatory changes that occur in diffuse liver diseases) and obstruction of the blood inflow to the liver (stenosis and thrombosis of hepatic artery and portal vein).

Introduction: The use of video capsule endoscopy (VCE) started in late 2001 when it was approved by the Food and Drug Administration (FDA). Since then, we are able to visualize small bowel mucosa with a minimally invasive technique, very comfortable for patients, with very few complications and without the need of hospitalization. At Dubrava University Hospital, we have been using VCE since October 2006, and by February 2008 we examined 30 patients., Aim: The aim of the study was to present our preliminary results in the use of VCE during a period of one year and five months. We also report indications and contraindications for VCE, and patient preparation., Methods: In this retrospective study we reviewed records on 30 patients that had undergone VCE at Dubrava University Hospital, Zagreb, Croatia, between October 2006 and February 2008. The indications for VCE were restricted to the investigation of obscure gastrointestinal bleeding (OGIB) (n = 10), iron deficiency anemia (n = 2), suspected Crohn's disease (n = 1), assessment of known small bowel Crohn's disease (n = 5), unexplained diarrhea (n = 6), chronic abdominal pain (n = 3), suspected ganglioneurinoma (n = 1) and suspected polyposis syndrome (n = 2). To be eligible for VCE, patients had to have previously undergone usual diagnostic methods of upper endoscopy, colonoscopy and small bowel follow-through, without discovering the cause of their symptoms. Before swallowing the capsule, patients were instructed not to eat anything the day before VCE and to drink 4 L of liquids, and additional 2 L magnesium sulfate. In all patients we used Olympus EndoCapsule Software (Tokyo, Japan). Results were interpreted by one specialist, gastroenterologist., Results: Definitive diagnosis was made in 15 patients. Suspect findings were noted in 2 patients, whereas no diagnosis could be established in 13 patients. According to our experience, VCE is a promising new method that has a high diagnostic yield in patients with OGIB and known Crohn's disease. Use of VCE enabled definitive diagnosis to be made in 6 of 10 patients with OGIB after all previously used diagnostic methods had failed to reveal any pathological finding. In the group of OGIB patients, angiodysplasia was the most common findings (4 of 10 patients). In the group of patients with Crohn's disease, progression of the disease to neotherminal ileum was recorded in 3 of 5 patients. Our experience also confirmed the VCE to be a very safe method; capsule retention was recorded in only one patient., Discussion: Although VCE enabled us to visualize the small bowel mucosa and therefore helped us establish the diagnosis in cases where other diagnostic methods had failed, it still has some important limitations, the major one being the impossibility to take biopsies and to perform any therapeutic procedures. However, it has a high diagnostic yield in cases of OGIB and Crohn's disease, is very comfortable for patients, and has a low incidence of complications (capsule retention). When making definitive diagnosis, one should always consider patient's history and physical examination findings as well as other possible causes of small bowel mucosal impairment., Conclusion: VCE is a promising new technique that has a high diagnostic yield in patients with OGIB and Crohn's disease. However, more studies need to be done to establish definitive indications, cost-effectiveness and the best way of patient preparation for VCE.

Aim: Due to high metabolic activity and oxygen demands, ischemia of gastroduodenal (GD) mucosa is an important factor in the pathogenesis of its impairment. Comparing the degree of coronary atherosclerosis, for evaluation of severity of atherosclerosis, with the prevalence and severity of GD mucosal lesions, we wanted to investigate the possible ischemia of GD mucosa could contribute to its impairment., Patients and Methods: This prospective study included 150 coronary artery disease (CAD) patients, 109 (72.7%) male and 41 (27.3%) female, average age 62.61 +/- 10.23 years. We noted clinical and anthropometric parameters, standard laboratory findings, treatment until inclusion into the study and standard cardiovascular risk factors. The severity of CAD was assessed by several parameters: 1) number of coronary arteries affected with atherosclerosis, 2) modified Gensa score, and 3) number of coronary arteries with stenosis > 50%. The severity of GD mucosal lesions was assessed by modified Lanza score, and Helicobacter pylori infection was confirmed by biopsy and pathohistological analysis of GD mucosa. Predictive value of different independent factors regarding the presence of GD mucosal lesions was assessed by multivariate analysis., Results: The severity of CAD in patients with or without GD mucosal lesions did not differ by any of used scoring methods: 1) number of coronary arteries affected by atherosclerosis (2.15 +/- 0.85 vs. 2.00 +/- 0.87, p = 0.292), 2) modified Gensa score (71.22 +/- 51.78 vs. 69.89 +/- 54.18, p = 0.881), 3) number of coronary arteries with stenosis > 50% (3.89 +/- 2.05 vs. 3.47 +/- 2.25, p = 0.244). We also noticed that there had been no correlation between severity of CAD and severity of GD mucosal lesions. Correlation of number of coronary arteries affected with atherosclerosis with Lanza score resulted in r = 0.029, p = 0.721, correlation of Genza score with Lanza score resulted in r = 0.019, p = 0.082, and correlation of the number of coronary arteries with stenosis > 50% with Lanza score resulted in r = 0.079, p = 0.337., Conclusion: According to available method for evaluating the severity of CAD, in CAD patients ischemia has no or very minor role in pathogenesis of GD mucosa impairment.

Environmental disasters are common phenomena caused by human factors. Disaster episodes may be the result of climatic changes such as global warming, which can lead to floods or drought. Greenhouse gases, and especially the ozone, represent a special problem. Atmospheric pollutions are the result of fire, storm dusts, winds, acid rain, etc. Underwater earthquakes very often end in tsunami with waves of up to 30 meters. Disasters described in the territory of Croatia include atmospheric pollutions, fires, floods, and droughts. All disasters affect the health of the population, particularly of the elderly. This most often includes the cardiovascular and respiratory systems, allergic reactions, and carcinogenic effects, resulting in increased mortality.

Volcanoes pose a threat to almost half a billion people; today there are approximately 500 active volcanoes on Earth, and every year there are 10 to 40 volcanic eruptions. Volcanic eruptions produce hazardous effects for the environment, climate, and the health of the exposed persons, and are associated with the deterioration of social and economic conditions. Along with magma and steam (H2O), the following gases surface in the environment: carbon dioxide (CO2) and sulphur dioxide (SO2), carbon monoxide (CO), hydrogen sulphide (H2S), carbon sulphide (CS), carbon disulfide (CS2), hydrogen chloride (HCl), hydrogen (H2), methane (CH4), hydrogen fluoride (HF), hydrogen bromide (HBr) and various organic compounds, as well as heavy metals (mercury, lead, gold).Their unfavourable effects depend on the distance from a volcano, on magma viscosity, and on gas concentrations. The hazards closer to the volcano include pyroclastic flows, flows of mud, gases and steam, earthquakes, blasts of air, and tsunamis. Among the hazards in distant areas are the effects of toxic volcanic ashes and problems of the respiratory system, eyes and skin, as well as psychological effects, injuries, transport and communication problems, waste disposal and water supplies issues, collapse of buildings and power outage. Further effects are the deterioration of water quality, fewer periods of rain, crop damages, and the destruction of vegetation. During volcanic eruptions and their immediate aftermath, increased respiratory system morbidity has been observed as well as mortality among those affected by volcanic eruptions. Unfavourable health effects could partly be prevented by timely application of safety measures.

Inhibitors of carboanhydrase (ICA) in the form of dorzolamide 2% drops and brinzolamide 1% drops are in use for 8-10 years, with a significant intraocular pressure (IOP) lowering effect. The goal of the present study was to obtain precise data on the efficacy of local ICA in conjunction with timolol 0.5% drops, and to evaluate the incidence of side effects. This was a prospective study that lasted 2 years and included 110 patients. Initial IOP values, before therapy with ICA, amounted to 19 +/- 8.4 mm Hg in group A and 20.5 +/- mm Hg in group B. Although the results obtained demonstrated statistically significant lowering of IOP (in group A by 4.5 +/- 2.4 mm Hg, and in group B by 4.6 +/- 2.1 mm Hg) after therapy with ICA, the difference between the groups was not found. Dorzolamide more frequently caused local side effects like aching, itching and pain in the eye. Aditional lowering of lOP in our patients was somewhat greater than reported before (4.6:4.3). Side effects (itching, aching, pain) were three times more frequent in the group treated with dorzolamide than reported by other authors; this difference could be due to patient age, as our patients were mostly elderly people and the data are subjective. The results of this study suggested the effectiveness of additional local therapy with ICA in patients with open angle glaucoma.

Aim: The aim was to investigate regional distribution of drinking habit and its relation to the prevalence of cardiovascular risk factors., Subjects and Methods: Nine thousand and seventy participants older than 18 questioned during THE 2003 Croatian health Survey were analyzed and weighted data extrapolated to the adult Croatian population. Study group included subjects reporting regular intake of any type of alcohol drink (liquor, wine or beer) during the past year. Alcohol abstainers surved as a control group., Results: The highest prevalence of alcohol drinking was recorded in south Croatia (32.3%, n= 215529). Alcohol drinkers were mostly men (72%). In all Croatian regions there was a rather uniform distribution of liquor drinking (6-7 glasses, 0.033 L per day). Subjects from west Croatia and the City of Zagreb mostly reported drinking wine (4-5 glasses, 0.2 L per day). A mixture of wine and water predominated in south and north Croatia (7 glasses, 0.2 L per day), whereas subjects that mainly took beer were from east and central Croatia (10 bottles, 0.33 L per day). The highest prevalence of arterial hypertension (56.6%) was found in regular alcohol drinkers from west Croatia. The highest prevalence of acute myocardial infarction (6.7-7.0%) and angina pectoris (8.2-8.6%) was observed in subjects from northn Croatia and the City of Zagreb. However, the occurrence of acute myocardial infarction was more common in regular alcohol drinkers, and of angina in abstainers. The lowest prevalence of acute myocardial infarction was recorded in regular drinkers from central Croatia (1.4%). The prevalence of stroke was generally lower in regular drinkers, with lowest prevalence in west Croatia (0.9%)., Conclusion: Drinking habit varies among regions of the Republic of Croatia, according to the prevalence, quantity and type of alcohol beverage, and so does the distribution of cardiovascular risk factors. On comparing regional distribution of cardiovascular risk factors between regular consumers and abstainers we observed a divergent influence of alcohol consumption, especially on the occurrence of arterial hypertension and stroke.

Unlabelled: Diabetic retinopathy (DR) is the most common cause of blindness in the active population of industrialized countries. Panretinal argon laser photocoagulation (PRP) is used in the treatment of proliferative diabetic retinopathy. Despite its usefulness, the mentioned treatment has some side effects such as permanent visual field damage. The treatment was performed with two PRP techniques, peripheral panretinal photocoagulation (PPRP) and central panretinal photocoagulation (CPRP). Peripheral visual fields defects were assesed with Vaughans method. The aim of the study was to determine the extent of visual field defects entailed by the two different PRP techniques., Results: Visual field loss in percentage was greater in the group treated with PPRP (mean 9.09 +/- 6.36%) than in group treated with CPRP (mean 4.9 +/- 4.5%) (p = 0.000037). The initial functional DR severity and presence of risk factors that influence DR severity were similar in the two treatment groups. Different results were mostly attributable to the PRP techniques employed, being significantlly less favorable with PPRP.

Carotid-cavernous fistula is uncommon consequence of craniocerebral trauma. Earlier recognition of the patients with carotid-cavernous fistula and shorter time of delay in treatment could save patients from complications and vision loss. A 27-year-old man presented with severe craniocerebral injury after an car accident. He required emergent craniotomy for an open depressed cranial fractures, haemostasis and epidural hematoma. Three months later, the patient began to exhibit progressive chemosis and proptosis of left eye. Computed tomography and cerebral angiography revealed findings consistent with a carotid-cavernous fistula. Angiography revealed a fistula between carotid artery and the cavernous sinus. The patient was treated by transarterial embolization resulting in immediate and permanent occlusion of the fistula and improved visual acuity after six months follow-up. Posttraumatic carotid-cavernous fistula may be treated successfully with the use of transarterial coil embolization.

During the last 20 years endoscopic ultrasound (EUS) has been established as a highly accurate method in the diagnosis of digestive tract diseases. This method enables analysis of the lesions within the bowel wall, pancreas, and biliary system with utmost precision. Good results have also been achieved in evaluation of regional lymphadenopathy in staging of malignant diseases. Principal limitations of this method originate from its low accesibility and technical complexity which requires well trained sinologist and scientific evaluation of results in order to achieve adequate level of skill. Complications occur rarely with numbers comparable to other endoscopic procedures. With new software and hardware device introduced, computerized tomography (CT) (this refers in the first place to multidetector row CT) has been tremendously upgraded approaching the EUS in diagnostic accuracy in mentioned indications, and overcoming it in detection of distant metastases. Implementation of 3D reconstruction techniques allowed CT to enter the area of classic endoscopy, as in the case of virtual gastroscopy and/or colonoscopy. CT is a noninvasive method, very acceptable to majority of patients, and therefore popular and more prevalent compared to EUS. Although comparable in diagnostic accuracy in majority of indications, endosonography retains advance in evaluation of lesions within GI tract wall (including the early stages of carcinoma), detection of small biliary stones and small pancreatic tumors. Moreover, EUS is indespensable in therapeutic indications. Experiences with fine needle aspiration, punctions and drainage of cysts and abscesses, celiac plexus neurolysis and creation of digestive anastomosis confirm its place and value among the minimally invasive procedures which minimize the need for surgical intervention, patients' trauma and treatment costs.

Aims: The aim was to assess the incidence of isolation of individual fungal species and interpret the meaning of fungal isolates from foot ulcers of 509 diabetic outpatients using mycologic and histopathologic methods. Another aim was to explore risk factors for the development of fungal infections in foot ulcer., Methods: Fungus isolation was made on selective media and their identification by standard mycologic methods. Histopathologic diagnosis of fungal ulcer infections was made on PAS-stained histopathologic preparations and imprint preparations (PAS and Papanicolaou staining) of foot wound biopsy specimens., Results: Fungal and mixed foot ulcer infections were found in 14.9% of diabetic patients. In 33.8% of patients, these infections were confirmed by a finding of fungal elements in histopathologic preparations of ulcer biopsy specimens, as follows: in 16.9% of patients, by finding fungal elements in imprint preparations of ulcer biopsy specimens and by isolation fungus from the swab of the same ulcer; in 2.3% by fungus isolation from ulcer biopsy specimens; in 36.9% by fungus isolation from ulcer swabs in pure culture and/or in a large number of colonies and/or from several ulcers on the foot of the same patient. More than 89% of patients had a single foot ulcer with fungal or mixed infection, big toe and the plantar-metatarsal region in one foot or both feet being the most common sites of ulcer. Fifteen species from the genera Candida, Cryptococcus, Trichosporon and Rhodotorula were the causative agents of fungal and mixed foot ulcer infections. C. parapsilosis (in 61.5% of patients), and C. albicans and C. tropicalis (in 10.8% of patients each) were the most common causes of these infections. The presence of yeasts and/or dermatophytes in the toe web of the same or other foot, or of both feet, did not influence the incidence of fungal and mixed foot ulcer infections. Patient sex and age, type and length of diabetes, or clinical picture of diabetic foot did not affect it either. In IDDM patients, the risk factor for the development of fungal and mixed foot ulcer infections was ulcer infection lasting for more than 13 weeks, whereas in NIDDM patients the length of ulcer infection did not contribute to the incidence of fungal and mixed foot ulcer infection., Discussion: Our results and other reports suggest that Candida species are the most common fungal isolates (between 93.2% and 100% of all fungal isolates) from diabetic foot ulcer, with C. parapsilosis being the most common causative agent of fungal and mixed infection. From diabetic foot ulcer, bacterial isolation was 5 times as common as that of yeasts (327 vs. 65 patients). Nevertheless, this investigation showed fungal isolates, originating not only from a primarily sterile ulcer sample (biopsy specimen) but also from foot ulcer swabs to be the causative agents (not ulcer colonizers or contaminants) of the foot ulcer infection. The pathogen c effect of yeasts in foot ulcer is indicated by the severity of clinical finding, chronic course of infection, and infection progression despite antibiotic therapy. Equally indicative are microbiologic diagnostic parameters (isolation in pure culture, and/or isolation in a large number of colonies, and/or isolation from several ulcers in the foot of the same patient)., Conclusions: In diabetic patients at highest risk of developing fungal and mixed foot ulcer infections (IDDM patients with ulcer infection persisting for more than 13 weeks, and NIDDM patients with the clinical picture of deep ulcer and abscess in the plantar region, irrespective of the duration of ulcer infection), routine bacteriologic diagnosis should be supplemented with targeted mycologic and histopathologic methods.

Argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT) are effective treatment modalities for intraocular pressure (IOP) lowering in open angle glaucoma patients. SLT and ALT produce equivalent IOP reduction. The choice of either option will depend on the state of glaucoma, previous and current treatment, side effects and patient's reference. Preservation of the angle trabecular meshwork structures and effective retreatment for IOP lowering after ALT has failed, offer some theoretical advantage of SLT.