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The aim of the study was to determine the incidence of acute angle-closure attacks among residents of the Split-Dalmatia County, Croatia, during a 6-year period. In this retrospective, interventional case series study, hospital records of 53 consecutive patients (33 female, mean age 71.7 +/- 16.6 and 20 male, mean age 66.2 +/- 23.2) with acute angle-closure attacks, treated at University Department of Ophthalmology, Split University Hospital Center, Split, Croatia, from January 2002 to December 2007 were reviewed. The annual incidence of acute angle-closure attacks was 2 cases per 100,000 (95% CI, 0-3.4). The incidence of acute angle-closure was 0.6 (95% CI, 0-1.4) cases/100,000 per year. The incidence of acute angle-closure glaucoma was 1.5 (95% CI, 0-2.8) cases/100,000 per year. The incidence was 1.5 (95% CI, 0-3.4) cases/100,000 per year in males and 2.3 (95% CI, 0-4.6) in females. Nine (17%) patients were treated by medicamentous therapy, peripheral iridectomy was performed in 19 (36%) patients and laser iridotomy in 16 (30%) patients, whereas nine (17%) patients underwent filtering surgery. Median time between the onset of symptoms to presentation at the hospital was two days (range 1-21 days). There was no statistically significant association between the acute angle-closure attacks and seasonal variation (chi2-test = 4.6; p = 0.20). In conclusion, the number of patients with acute angle-closure attacks in the Split-Dalmatia County is relatively small; however, the significant incidence of acute angle-closure glaucoma could pose a social and health care problem in the County.

The aim of the study was to evaluate the results of phacoemulsification in eyes with posterior polar cataract and to assess the risk factors for posterior capsular rupture during phaco surgery. This prospective study included 13 patients (14 eyes) undergoing phacoemulsification surgery with intraocular lens implantation. Intact posterior capsule was present in 10 (71.5%) eyes, posterior capsular rupture in 4 (28.5%) eyes, one of them with vitreal loss and requiring anterior vitrectomy. Of the eyes with intact posterior capsule, 5 (35%) had capsular plaque which was removed by gentle aspiration; in one case posterior capsulorrhexis was performed to remove the plaque; and postoperative capsule was clear in 4 (28.5%) eyes. In 3 eyes with capsular rupture, there was soft nucleus and capsular opacification greater than 3 mm in diameter, and the patients were under 40 years old. One capsular rupture occurred in dense cataract. The incidence of posterior capsular rupture in our study was 28.5%; other authors reported the incidence between 7.1% and 36%. Many different techniques have been described by other surgeons to avoid capsular rupture; however, in our opinion, posterior capsular rupture could not be avoided in some cases. In our study, the risk factors for capsular rupture in posterior polar cataract were soft nucleus with large capsular opacification and younger patient age. Our results of visual acuity after phacoemulsification in posterior polar cataracts are consistent with those reported by other authors: in 9 eyes, visual acuity was 0.8 or more (Snellen chart), and in 5 eyes there was no satisfactory improvement of visual acuity, probably due to amblyopia because the majority of the cataracts were unilateral. Accordingly, phacoemulsification in posterior polar cataracts, when done carefully, leads to good postoperative results and good visual improvement in most cases.

Purpose: To assess the safety and efficacy of changing antiglaucoma therapy to the travoprost 0.004%/timolol 0.5% (TTFC) fixed combination from previous monotherapies., Methods: Prospective, open-label, observational, multicenter cohort. A change was done from prior monotherapy at day 0 to TTFC dosed once a day, regardless in the evening or in the morning, without washout period. Active evaluation of systemic and local tolerability (adverse events), and efficacy. i.e., intraocular pressure (IOP) lowering was done at control 1 (day 30), control 2 (day 90) and control 3 (day 120)., Results: 40/155/170 patients (79/309/339 eyes) completed the study (120 days/ 90 days/baseline, respectfully). At control 1 excluded were patients with low tolerability (severe hyperemia (6 patients), discomfort (4), chest pain (1)) and non responders (IOP lowering less than 15% from baseline IOP or target IOP >18 mmHg (4 patients)). Mean IOP at control 1 was 15.92 +/- 1.85 mm Hg (21.66% reduction) for 155 patients (non responders excluded), at control 2 was for 155 patients 15.67 +/- 2.17 mm Hg (21.14% reduction), and at control 3 for 40 patients 16.28 +/- 1.59 mm Hg (19.86% reduction). At control 2 analysis of IOP reduction by 4 groups of previous monotherapy (timolol 0,5% (N = 33/66), latanoprost 0.005% (N = 49/98), betaxolol 0.5% (N = 30/60), and travoprost 0.004% (N = 43/85) was performed. 40 patients/79 eyes endured to control 3 (after day 90 free samples were not available for all patients). Analysis of IOP reduction by 4 groups of previous monotherapy medications was performed (timolol 0.5% (N = 7/14), latanoprost 0.005% (N = 14/28), betaxolol 0.5% (N = 7/14), travoprost 0.004% (N = 12/23))., Conclusions: Changing patients from prior monotherapy to TTFC can provide on average a further reduction in IOP, while demonstrating a favorable safety profile.

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.

The aim of the study was to compare the efficacy of travoprost 0.004% eye drops added to therapy with timolol 0.5%. The study included 40 patients (80 eyes) with open angle glaucoma and intraocular pressure (IOP) above 18 mm Hg treated with topical beta blocker (timolol 0.50% twice a day). Travoprost 0.004% was added to timolol 0.5% therapy once daily in the evening. Follow up examinations were scheduled at 7 days, one month and three months. IOP lowering was achieved in all patients. Substantial lowering of 2.42 mm Hg was achieved after the first week of treatment. Further lowering and stabilization of IOP was recorded at three months, with total IOP decrease of 3.97 mm Hg; the difference was statistically significant (chi2=6.7743; p<0.01). At three months, target IOP was recorded in 64 eyes (16.4+/-0.7 mm Hg) and failed to be achieved in 16 eyes (21.1+/-2.3 mm Hg). Mild hyperemia was found in two patients and discrete hyperemia in 26 patients. Burning sensation associated with the use of travoprost 0.004% eye drops was reported by 68 patients. In conclusion, the use of travoprost 0.004% eye drops resulted in successful lowering of IOP and achievement of target IOP.

Aim: To use data mining methods in assessing diagnostic symptoms in posttraumatic stress disorder (PTSD). METHODS. The study included 102 inpatients: 51 with a diagnosis of PTSD and 51 with psychiatric diagnoses other than PTSD. Several models for predicting diagnosis were built using the random forest classifier, one of the intelligent data analysis methods. The first prediction model was based on a structured psychiatric interview, the second on psychiatric scales (Clinician-administered PTSD Scale--CAPS, Positive and Negative Syndrome Scale--PANSS, Hamilton Anxiety Scale--HAMA, and Hamilton Depression Scale--HAMD), and the third on combined data from both sources. Additional models placing more weight on one of the classes (PTSD or non-PTSD) were trained, and prototypes representing subgroups in the classes constructed., Results: The first model was the most relevant for distinguishing PTSD diagnosis from comorbid diagnoses such as neurotic, stress-related, and somatoform disorders. The second model pointed out the scores obtained on the CAPS scale and additional PANSS scales, together with comorbid diagnoses of neurotic, stress-related, and somatoform disorders as most relevant. In the third model, psychiatric scales and the same group of comorbid diagnoses were found to be most relevant. Specialized models placing more weight on either the PTSD or non-PTSD class were able to better predict their targeted diagnoses at some expense of overall accuracy. Class subgroup prototypes mainly differed in values achieved on psychiatric scales and frequency of comorbid diagnoses., Conclusion: Our work demonstrated the applicability of data mining methods for the analysis of structured psychiatric data for PTSD. In all models, the group of comorbid diagnoses, including neurotic, stress-related, and somatoform disorders, surfaced as important. The important attributes of the data, based on the structured psychiatric interview, were the current symptoms and conditions such as presence and degree of disability, hospitalizations, and duration of military service during the war, while CAPS total scores, symptoms of increased arousal, and PANSS additional criteria scores were indicated as relevant from the psychiatric symptom scales.

Neovascular glaucoma (NVG) is a pathological condition of the eye with fast deterioration, accompanied with eyeball pain and loosing sight. The aim of the study was to examine the efficacy of cryotherapy in the treatment of NVG which is resistant to medical and surgical therapy, concerning intraocular pressure (IOT) and eyeball pain immediately after the treatment and 6 months after. In the Department of Ophthalmology, Split University Scool of Medicine, during three years 70 patients with NVG, which were resistant to medical and surgical treatment, were included in the prospective study. There were 50 males and 21 women, average age 74 +/- 6.94 (45-87). The patients were treated with transconjuctival cyclocryocoagulation, machine ERBOKRYIO AE-ERBE was used. The average value of IOT was: at admission 44.8 mmHg, 7 days after the treatment 30.7 mmHg with the tendency of falling down 30 and 90 days later, to finally 19.9 mmHg 180 days after the treatment. The IOT was significantly lower after the treatment. At admission, the average value of eyeball pain intensity was high (4.2), 7 days after the treatment it was 2.1 with the tendency of falling down to finally 1.1 180 days after the treatment. The eyeball pain intensity was significantly lower after the treatment. Cyclocryocoagulation is a method of choice in the treatment of NVG resistant to medical and surgical treatment. Cyclocryocoagulation, as a treatment of noncontrolled progressive NVG, does not have any effect on the improvement of sight in these patient.

This review gives a summary of all colour vision disorders (dyschromatopsias) and diagnostic methods and tests. Colour vision is inadequately treated in current literature with regard to the choice of diagnostic methods and the interpretation of results for a single disorder, which contributes to wrong dyschromatopsia diagnosing seen every day in specialist practice. Examination for colour disorders is usually outpatient and is carried out by ophthalmology or neurology departments or occupational health services under the supervision of an ophthalmologist to prevent misinterpretation of results and wrong occupational choices. The problem is very serious, and proper education should be able to provide guidelines for correct and early diagnosis of dyschromatopsia. As the examination is not well defined, it is very important to set unique criteria in diagnosing any single colour vision disorder.

Aim: To assess the knowledge and attitudes regarding sleep medicine among second-year medical students and physicians., Methods: A total of 112 respondents were surveyed for their attitude and knowledge regarding sleep medicine and hypertension. The respondents were divided into three groups: 1) second-year medical students (46 or 41%); 2) physicians at postgraduate study program (26 or 23%); and 3) specialists in different fields (40 or 36%). The questionnaire was composed of the sleep medicine attitude test, sleep medicine knowledge test, and hypertension knowledge test. Differences among the groups were statistically analyzed with ANOVA, and differences within each group were analyzed with Wilcoxon test., Results: Postgraduate students and specialists showed better knowledge in hypertension than in sleep medicine (p=0.001 and p<0.001, respectively). In the student group, no difference was found between the knowledge in hypertension and sleep medicine (p=0.192). Differences in sleep medicine knowledge were not found between medical students and specialists (p=0.228) or between postgraduates and specialists (p=0.647). Sleep medicine attitude score was similar in all groups (p=0.470). In general, there was a positive correlation between sleep medicine knowledge and attitude (p=0.002), and between hypertension knowledge and sleep medicine attitude (p=0.019)., Conclusion: Medical students, postgraduate physicians, and specialists showed poor knowledge but positive attitude toward sleep medicine. This finding points to the need for better education in the field of sleep medicine in medical schools.

The evaluation of tissue copper concentration is essential for the diagnosis of Wilson's disease. It is characterized by symptoms of the damages to parenchymatous organs, primarily liver and brain, due to chronic copper intoxication. The paper presents the autopsy tissue analysis of a 39-year-old patient diagnosed to suffer from the Wilson's disease while still alive. The patient died from sepsis due to burns caused by direct flame exposure. The standard histochemical staining of tissue samples failed to demonstrate the presence of copper but it was qualitatively proved by line spectrum-based mass spectrography. The copper concentrations in the liver, brain, and kidney (240, 73.8, and 30 micrograms/g wet tissue weight, respectively), measured by flame-atomic absorption spectrometry, were significantly elevated. In this study, the Wilson's disease was verified by a postmortem determination of increased copper concentration in the tissues. The results obtained contribute to the understanding of this rare disease.

Since the beginning of the war in Croatia, the number of drug addicts and of fatal intoxications in the Split region has increased. Drug-related fatalities (n = 25) were investigated over a 12-month period in 1995. Data about the cause of death were based on the information from police reports, autopsy findings and toxicological analyses. The main drug involved was heroin. Other drugs were rarely reported. Blood tests for alcohol were performed in all cases. Alcohol consumption increased the risk of heroin overdosing.

The paper deals with the results of analysis of fatal poisonings in the city of Zagreb from 1981 to 1990. The work is an extension of earlier analyses for the same area that were carried out from the foundation of the Department for Forensic Medicine and Criminology, School of Medicine, University of Zagreb in 1934 to 1967, and from 1968 to 1980. Comparative analysis of all data shows that despite the increasing rate of poisoning the number of cases of fatal poisoning has been steadily diminishing--from 11 cases per 100,000 population in the 1934-1967 period and eight cases between 1968 and 1980 to five cases in the latest period 1981-1990.