Institute Of Public Health Dr Andrija Stampar

Zagreb, Croatia

Institute Of Public Health Dr Andrija Stampar

Zagreb, Croatia

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Matkovic Puljic V.,University of Zagreb | Matkovic Puljic V.,Institute Of Public Health Dr Andrija Stampar | Matkovic Puljic V.,National Institute of Public Health
PloS one | Year: 2014

HIV testing plays a critical role in preventing the spread of the virus and identifying infected individuals in need of care. Voluntary counseling and testing centers (VCTs) not only conduct testing but they also provide counseling. Since a proportion of people who test negative for HIV on their previous visit will return for retesting, the frequency of retesting and the characteristics of those who retest may provide insights into the efficacy of testing and counseling strategies. In this cross-sectional, retrospective study of 1,482 VCT clients in Croatia in 2010, 44.3% had been tested for HIV before. The rate of repeat HIV testing is lower in Croatia than in other countries. Men who have sex with men (MSM) clients, those with three or more sexual partners in the last 12 months, consistent condom users with steady partners, and intravenous drug users were more likely to be repeat testers. This finding suggests that clients presenting for repeat HIV testing are those who self-identify as being at a higher risk of infection. Our data showed that testing positive for HIV was not associated with repeat testing. However, the effects of repeat testing on HIV epidemiology needs to be explored.


Ranogajec A.,Institute Of Public Health Dr Andrija Stampar | Smit Z.,Institute Of Public Health Dr Andrija Stampar
Journal of Separation Science | Year: 2010

The retention characteristics of five stationary phases were tested by using a selection of 5′-mononucleotides and nucleosides with the aim to develop a simple, rapid and sensitive reversed-phase liquid chromatography method without ion-pair reagent usage. The method was optimized by changes in temperature, pH and ionic strength on a column showing a superior performance. The mobile phase consisted of a mixture of 0.05M phosphate buffer and methanol, delivered at a flow rate of 0.4 mL/min and based on a gradient program. UV detection was used at a 254 nm wavelength. The method was validated for a quantitative analysis of 5′-mononucleotides and nucleosides in wild edible mushrooms. For all nucleosides and nucleotides, the LOD and LOQ were less than 0.02 and 0.07 μg/mL, respectively. Validation parameters yielded recovery rates between 68.6 and 98.2%, with a precision expressed as a relative standard deviation of 7.6-15.3%. The content of 5′-mononucleotides and nucleosides was determined for 10 samples of wild edible mushrooms found in Croatia and, accordingly, the equivalent umami concentrations were calculated. © 2010 Wiley-VCH Verlag GmbH & Co. KGaA.


Krmpotic D.,University of Zagreb | Luzar-Stiffler V.,University of Zagreb | Rakusic N.,University of Zagreb | Stipic Markovic A.,University of Zagreb | And 2 more authors.
International Archives of Allergy and Immunology | Year: 2011

Background: Environmental factors play an important role in asthma morbidity, although the contribution of individual pollutants or pollens in exacerbating asthma is not completely elucidated. Despite the evidence of importance of the hornbeam pollen in inducing allergic sensitization, its role in provoking asthma exacerbation has not been evaluated. The aim of the present study was to investigate effects of traffic pollutants on adult asthma hospitalization adjusting for pollens including hornbeam. Methods: During a 3-year period, health and environmental data were collected and analyzed. Daily asthma hospitalizations were regressed on pollutants and potential confounding variables using an autoregressive Poisson model. Results: The risk of asthma hospitalization was associated significantly with the 95th to 99th percentile increase in levels of nitrogen dioxide (RR = 1.22; 95% CI: 1.05-1.40), carbon monoxide (RR = 1.25; 95% CI: 1.01-1.55) and hornbeam pollen (RR = 1.21; 95% CI: 1.11-1.30). The effect of nitrogen dioxide was delayed by 5 days. No statistically significant increase in the risk of asthma hospitalization was found for PM 10 particles. A comparison among the standardized regression coefficients and their respective p values indicates that the most important risk factor for asthma hospitalization is associated with hornbeam pollen levels. No statistically significant interactions between pollutants and pollens were detected. Conclusions: The current results suggest that traffic-related air pollution is associated with increased risk of adult asthma hospitalization. Nonetheless, the most significant risk for asthma hospitalization is associated with hornbeam pollen levels in the city of Zagreb. Copyright © 2011 S. Karger AG, Basel.


Vilibic-Cavlek T.,University of Zagreb | Kaic B.,Croatian National Institute of Public Health | Barbic L.,University of Zagreb | Pem-Novosel I.,Croatian National Institute of Public Health | And 8 more authors.
Infection | Year: 2014

Purpose: We report on first evidence of simultaneous occurrence of West Nile virus (WNV) and Usutu virus (USUV) neuroinvasive infection in humans in Croatia during the transmission season 2013. Methods: From June to December 2013, a total of 95 patients with clinically suspected WNV infection (WNV fever and neuroinvasive disease) were tested for WNV IgM/IgG antibodies using enzyme-linked immunosorbent assay. Twenty-six reactive samples were further tested by virus neutralization test for confirmation. Results: WNV neuroinvasive infection was confirmed in 20 patients, while in three patients USUV neutralizing antibodies were detected. Cases occurred during the 11-week interval (from 24 July to 07 October 2013). Both WNV and USUV cases were distributed in three north-western Croatian counties. In addition to human cases, recent asymptomatic WNV infection (detection of IgM antibodies) was recorded in 9/3,460 (0.3 %) tested sentinel horses. Infected animals were recorded in two eastern and one north-western county. Conclusions: Our results indicate co-circulation of WNV and USUV in Croatia. WNV infection could be misdiagnosed with other emerging infectious diseases presenting with neurological symptoms such as USUV infection. © 2014 Springer-Verlag.


Beluhan S.,University of Zagreb | Ranogajec A.,Institute Of Public Health Dr Andrija Stampar
Food Chemistry | Year: 2011

The chemical composition (dry matter, crude protein, crude fat, total carbohydrates, and ash) and non-volatile components content (soluble sugars, free amino acids, and 5'-nucleotides) of 10 popular Croatian wild edible mushroom species (Agaricus campestris, Boletus edulis, Calocybe gambosa, Cantharellus cibarius, Craterellus cornucopioides, Entoloma clypeatum, Flammulina velutipes, Macroleptiota procera, Morchella elata, and Pleurotus ostreatus) were determined. All investigated mushrooms were found to be good sources of proteins and total carbohydrates, with contents varying in the ranges of 27.95-38.89, and 42.62-66.78. g/100. g, respectively. In addition, the fat contents were very low 1.34-6.45. g/100. g. B. edulis (19.87. mg/g) showed the highest concentration of essential amino acids and M. elata (14.25. mg/g) the lowest concentration. Monosodium glutamate-like components and total flavour 5'-nucleotides were the highest in C. cornucopioides (45.85 and 13.88. mg/g, respectively), and lowest in F. velutipes (7.63 and 1.05. mg/g, respectively). Equivalent umami concentration values in 10 Croatian wild edible mushrooms ranged from 73.78 to 1186.45. g MSG/100. g dry weight, and overall, all these mushrooms possessed highly umami taste. © 2010 Elsevier Ltd.


Niseteo T.,University of Zagreb | Komes D.,University of Zagreb | Belscak-Cvitanovic A.,University of Zagreb | Horzic D.,University of Zagreb | Budec M.,Institute Of Public Health Dr Andrija Stampar
Food Chemistry | Year: 2012

Coffee is one of the most popular beverages in the world, prepared and consumed in many different ways. Taste, aroma and composition of the coffee brew vary depending on the preparation method. Therefore, this study investigates the effect of different brewing methods on the polyphenol and methylxanthine composition and antioxidant capacity of thirteen different coffee brews. The content of total phenols and flavonoids was determined spectrophotometrically and the content of chlorogenic acid derivates (3-CQA, 4-CQA and 5-CQA) and caffeine using the high performance liquid chromatography (HPLC-PDA). Antioxidant capacity of coffee brews was evaluated by using the ABTS (2,2-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid)) and FRAP (ferric-reducing antioxidant power) assays. Instant coffee brews showed the highest values in content of total phenols, chlorogenic acid derivates, caffeine and antioxidant capacity, which significantly decreased by milk addition. The antioxidant capacity of coffee brews was in compliance with the total phenol content and content of chlorogenic acid derivates. © 2012 Elsevier Ltd. All rights reserved.


Tkalec M.,University of Zagreb | Stefanic P.P.,University of Zagreb | Cvjetko P.,University of Zagreb | Sikic S.,Institute Of Public Health Dr Andrija Stampar | And 2 more authors.
PLoS ONE | Year: 2014

The objective of the present study was to investigate the effects of cadmium-zinc (Cd-Zn) interactions on their uptake, oxidative damage of cell macromolecules (lipids, proteins, DNA) and activities of antioxidative enzymes in tobacco seedlings as well as roots and leaves of adult plants. Seedlings and plants were exposed to Cd (10 μM and 15 μM) and Zn (25 μM and 50 μM) as well as their combinations (10 μM or 15 μM Cd with either 25 μM or 50 μM Zn). Measurement of metal accumulation exhibited that Zn had mostly positive effect on Cd uptake in roots and seedlings, while Cd had antagonistic effect on Zn uptake in leaves and roots. According to examined oxidative stress parameters, in seedlings and roots individual Cd treatments induced oxidative damage, which was less prominent in combined treatments, indicating that the presence of Zn alleviates oxidative stress. However, DNA damage found in seedlings, and lower glutathione reductase (GR) and superoxide dismutase (SOD) activity recorded in both seedlings and roots, after individual Zn treatments, indicate that Zn accumulation could impose toxic effects. In leaves, oxidative stress was found after exposure to Cd either alone or in combination with Zn, thus implying that in this tissue Zn did not have alleviating effects. In conclusion, results obtained in different tobacco tissues suggest tissue-dependent Cd-Zn interactions, which resulted in activation of different mechanisms involved in the protection against metal stress. © 2014 Tkalec et al.


Zokalj I.,County Hospital Cakovec | Marotti M.,University of Zagreb | Kolaric B.,University of Rijeka | Kolaric B.,Institute Of Public Health Dr Andrija Stampar
International Urology and Nephrology | Year: 2014

Purpose: We conducted a retrospective study to evaluate the influence of different tumor enhancement measurement approaches on the ability of computed tomography (CT) to differentiate between solid forms of clear cell renal cell carcinoma (RCC), other RCC histologic subtypes and oncocytomas. Different RCC subtypes have a diverse range of malignant potential; consequently, the information about RCC subtype obtained using minimally invasive imaging method before the treatment could allow the more accurate therapy planning. Differentiation of ccRCCs from oncocytomas is important because oncocytomas are usually benign tumors which could be treated conservatively. Methods: CT images of 113 patients with 118 solid renal tumors were evaluated. The imaging protocol consisted pre-contrast and post-contrast images during the arterial and nephrographic phases. Renal tumor attenuation values were measured using region of interest covering as much of the solid enhancing tumor tissue as possible. Tumor attenuation values and tumor enhancement ratios were correlated with histologic subtype. One hundred of tumors were diagnosed as clear cell RCC, nine as non-clear cell RCC and nine as oncocytoma. Results: Tumor attenuation values of >74 HU on the arterial phase scans significantly correlated with clear cell RCC (Az 0.73). The tumor-to-aorta enhancement ratios calculated on tumor attenuation values measured on the arterial phase scans had a cutoff value of >0.29, which significantly correlated with clear cell RCC (Az 0.79). All ROC curves for differentiating the clear cell RCC from oncocytomas have area under the curve too small (0.5 or less) to have chose cutoff value with sensitivity and specificity that could be applied in clinical work. Conclusion: Enhancement measurements of renal carcinomas on CT images in the arterial phase can be used as an auxiliary method in the pretreatment differentiation of solid forms of the most frequent RCC subtypes in patients not suitable for core biopsy but who are suitable for minimally invasive treatment methods and/or targeted therapy. © 2013 Springer Science+Business Media.


Balen B.,University of Zagreb | Tkalec M.,University of Zagreb | Sikic S.,Institute Of Public Health Dr Andrija Stampar | Tolic S.,Institute Of Public Health Dr Andrija Stampar | And 3 more authors.
Ecotoxicology | Year: 2011

The effects of 5 μM cadmium (Cd), a non-essential toxic element and 25 and 50 μM zinc (Zn), an essential micronutrient, were investigated in aquatic plant Lemna minor L. after 4 and 7 days of exposure to each metal alone or to their combinations. Both metals showed tendency to accumulate with time, but when present in combination, they reduced uptake of each other. Cd treatment increased the lipid peroxidation and protein oxidation indicating appearance of oxidative stress. However, Zn supplementation in either concentration reduced values of both parameters, while exposure to Zn alone resulted in elevated level of lipid peroxidation and protein oxidation but only on the 7th day. Enhanced DNA damage, which was found on the 4th day in plants treated with Cd alone or in combination with Zn, was reduced on the 7th day in combined treatments. Higher catalase activity obtained in all treated plants on the 4th day of experiment was reduced in Zn-treated plants, but remained high in plants exposed to Cd alone or in combination with Zn after 7 days. Cd exposure resulted in higher peroxidase activity, while Zn addition prominently reduced peroxidase activity in the plants subjected to Cd stress. In conclusion, Cd induced more pronounced oxidative stress and DNA damage than Zn in applied concentrations. Combined treatments showed lower values of oxidative stress parameters-lipid peroxidation, protein oxidation and peroxidase activity as well as lower DNA damage, which indicates alleviating effect of Zn on oxidative stress in Cd-treated plants. © 2011 Springer Science+Business Media, LLC.


Luksic I.,Institute of Public Health Dr Andrija Stampar | Mulic R.,University of Split | Falconer R.,University of Edinburgh | Orban M.,Institute of Public Health Dr Andrija Stampar | And 2 more authors.
Croatian Medical Journal | Year: 2013

Aim: To estimate global morbidity from acute bacterial meningitis in children. Methods: We conducted a systematic review of the PubMed and Scopus databases to identify both community-based and hospital registry-based studies that could be useful in estimation of the global morbidity from bacterial meningitis in children. We were primarily interested in the availability and quality of the information on incidence rates and casefatality rates. We assessed the impact of the year of study, study design, study setting, the duration of study, and sample size on reported incidence values, and also any association between incidence and case-fatality rate. We also categorized the studies by 6 World Health Organization regions and analyzed the plausibility of estimates derived from the current evidence using median and inter-quartile range of the available reports in each region. Results: We found 71 studies that met the inclusion criteria. The only two significant associations between the reported incidence and studied covariates were the negative correlation between the incidence and sample size (P < 0.001) and positive correlation between incidence and case-fatality rate (P <0.001). The median incidence per 100 000 childyears was highest in the African region-143.6 (interquartile range [IQR] 115.6-174.6), followed by Western Pacific region with 42.9 (12.4-83.4), the Eastern Mediterranean region with 34.3 (9.9-42.0), South East Asia with 26.8 (21.0-60.3), Europe with 20.8 (16.2-29.7), and American region with 16.6 (10.3-33.7). The median case-fatality rate was also highest in the African region (31.3%). Globally, the median incidence for all 71 studies was 34.0 (16.0-88.0) per 100 000 child-years, with a median case-fatality rate of 14.4% (5.3%-26.2%). Conclusions: Our study showed that there was now sufficient evidence to generate improved and internally consistent estimates of the global burden of acute bacterial meningitis in children. Although some of our region-specific estimates are very uncertain due to scarcity of data from the corresponding regions, the estimates of morbidity and casefatality from childhood bacterial meningitis derived from this study are consistent with mortality estimates derived from multi-cause mortality studies. Both lines of evidence imply that bacterial meningitis is a cause of 2% of all child deaths.

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