Objective: To describe the sociodemographic profile and investigate the habits of elderly patients attending family medicine offices in central Istria, Croatia. Patients and Methods:This was a retrospective study, conducted in central Istria. Data were obtained by a physical examination, extraction from a recorded history of disease, and using an administered questionnaire. The patients were stratified into three groups: young (65-74 years), middle (75-84 years), and older old age (>85 years). Groups were compared about education, marital status, body mass index, frequency of visits to a family doctor, and habitual activities such as physical activity, smoking, coffee and alcohol consumption, and vitamins/dietary supplements intake, and hobbies. Results: Overall, 191 patients were included, of which 93 young (49%), 82 middle (43%), and 16 older old (8%). The age groups differed statistically with regard to education and marital status. In the young old group, 53% of subjects had a high school/university diploma, in the middle old 19%, and in the oldest old 12% (p<0.001). The proportion of widowed subjects in the young, middle, and oldest old groups were 16%, 40%, and 50%, respectively (p=0.005). The most common diagnoses were cardiovascular diseases (76-83%), diabetes (41-56%), vision and hearing problems (13-31%), and musculoskeletal disorders (6-29%). The majority of responders were not physically active (59.2%) and had a body mass index ≥ 25 kg/m2 (50-77%). Conclusion: Understanding the profile of elderly patients is paramount in order to preserve the dignity of living by meeting their health, social, and economic needs.
Introduction: This study is aimed at assessing the use of various types of urinary catheters, appropriateness of catheter placement and factors associated with antibiotic use in a population of chronically catheterized patients in Istria County. Materials and Methods: This cross-sectional study, conducted between March and June 2017 in Istria County, Croatia, was initiated through a network of general family medicine offices. Data were collected from general practitioners (GPs) and from medical managers in nursing homes. Participants were asked to review medical records of their patients and to complete a 10-item questionnaire designed to retrieve information on patients with urinary catheter. Results: All GPs in the county were surveyed. We identified 309 patients with urinary catheter: 216 men (70%) and 93 women (30%). The overall prevalence of individuals with urinary catheters was 0.18%: 4.7% in nursing home population and 0.1% among non-institutionalized adult population. Most common indication for catheterization was chronic urinary retention (52%). One hundred eighty-six patients (60.4%) reported antibiotic usage in the previous 3 months for treating urinary infection. Conclusions: In Istria County, the prevalence of indwelling urinary catheters is highest in males, especially among patients in nursing homes. There is a need for focused education among GPs regarding urinary catheter maintenance and antibiotic prescription for suspected urinary tract infections.
Post-traumatic torsion of wondering spleen is extremely rare cause of acute abdominal pain in children with only few cases reported. We report a case of a 9-year-old boy with wandering spleen torsion after bike crash and subacute clinical presentation. After a bicycle crash and a period of persistent fever family physician performed an ultrasound of abdomen which showed a round focal lesion of 10 x 12 cm in size, a spleen-like echogenicity in the middlelower abdominal position and in the small pelvis, which raised suspicion of ectopic (wandering) spleen. The abdominal MSCT confirmed the diagnosis of wandering spleen, Numerous immunologic, hematological, radiological, infectious, endocrinological, chromosomal and cytological tests and markers confirmed a diagnosis of the splenic malformation. A surgeon arranged to perform splenopexy after checking the vaccination status. Laparotomy was initiated. The splenic artery and vein, which was in a triple twist, was released and due to the resulting path, the spleen itself was larger than the CT finding. The spleen was placed under the left ribs and splenopexy was performed. At the fifteen-day and two-month follow ups, the patient felt good, was painless, afebrile and the spleen gradually decreased. Wondering spleen should be considered as a possible cause of acute abdominal pain when the spleen is not seen in its usual position. The treatment of choice is surgery, with the goal of preservation of the organ whenever possible.
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