Long-Term Consequences of War Captivity in Military Veterans

Numerous studies on the health and functioning of veterans and former prisoners of war have shown that the experience of war captivity is one of the most difficult human experiences. Captivity is often characterized by extremely difficult and inhumane conditions, as well as exposure to various forms of both psychological and physical abuse. Such traumatic experiences can lead to serious psychological consequences that can last for years, even decades after release from captivity. The aim of this paper is to present a brief overview of research that points to the specifics of wartime captivity and the long-term psychological consequences in veterans of former camp detainees, as well as the consequences suffered by their families and factors that, apart from the intensity of the trauma, contribute to the emergence and persistence of psychological disorders. From the presented research, it can be concluded that former prisoners of the camp represent an extremely vulnerable group of the social community and require long-term appropriate treatment, while the needs of veterans' families should not be neglected, with the necessity of including spouses and children in psychological and psychosocial treatments.

Homeostasis and Dysbiosis of the Intestinal Microbiota: Comparing Hallmarks of a Healthy State with Changes in Inflammatory Bowel Disease

The gut microbiota, which represent a community of different microorganisms in the human intestinal tract, are crucial to preserving human health by participating in various physiological functions and acting as a metabolic organ. In physiological conditions, microbiota-host partnership exerts homeostatic stability; however, changes in intestinal microbiota composition (dysbiosis) are an important factor in the pathogenesis of inflammatory bowel disease and its two main disease entities: ulcerative colitis and Crohn's disease. The incidence and prevalence of these inflammatory conditions have increased rapidly in the last decade, becoming a significant problem for the healthcare system and a true challenge in finding novel therapeutic solutions. The issue is that, despite numerous studies, the etiopathogenesis of inflammatory bowel disease is not completely clear. Based on current knowledge, chronic intestinal inflammation occurs due to altered intestinal microbiota and environmental factors, as well as a complex interplay between the genetic predisposition of the host and an inappropriate innate and acquired immune response. It is important to note that the development of biological and immunomodulatory therapy has led to significant progress in treating inflammatory bowel disease. Certain lifestyle changes and novel approaches-including fecal microbiota transplantation and nutritional supplementation with probiotics, prebiotics, and synbiotics-have offered solutions for dysbiosis management and paved the way towards restoring a healthy microbiome, with only minimal long-term unfavorable effects.

Legionella pneumophila-Virulence Factors and the Possibility of Infection in Dental Practice

Legionella pneumophila is defined as a bacterium that can cause severe pneumonia. It is found in the natural environment and in water, and is often found in water tanks. It can be an integral part of biofilms in nature, and the protozoa in which it can live provide it with food and protect it from harmful influences; therefore, it has the ability to move into a sustainable but uncultured state (VBNC). L. pneumophila has been shown to cause infections in dental practices. The most common transmission route is aerosol generated in dental office water systems, which can negatively affect patients and healthcare professionals. The most common way of becoming infected with L. pneumophila in a dental office is through water from dental instruments, and the dental unit. In addition to these bacteria, patients and the dental team may be exposed to other harmful bacteria and viruses. Therefore, it is vital that the dental team regularly maintains and decontaminates the dental unit, and sterilizes all accessories that come with it. In addition, regular water control in dental offices is necessary.

A Cross-Sectional Study of Psychiatric Comorbidity in Croatian Homeland War Veterans Who Were Held as Prisoners of War and Are Affected by Posttraumatic Stress Disorder

BACKGROUND

As a extremely traumatic experience, captivity may cause other mental disorders in addition to posttraumatic stress disorder, which is highly prevalent among ex-prisoners of war, and which often occurs in comorbidity with at least one other mental disorder. This objective of this study is to identify the incidence of comorbid mental disorders in Homeland war veterans ex-prisoners of war affected by posttraumatic stress disorder, as well as to identify the factors that influenced psychiatric comorbidity.

SUBJECTS AND METHODS

The study sample comprised 264 subjects, all of whom were Croatian Homeland War veterans with combat experience in the defence of the Republic of Croatia, and all of whom fulfilled clinical criteria for posttraumatic stress disorder at the time of the study. The subjects were divided into two groups: the experimental group was composed of ex-prisoners of war, and the control group of veterans who had never been prisoners of war. The methods of sociodemographic questionnaire, posttraumatic stress disorder self-report checklist and the Harvard Trauma Questionnaire were used in the study. Psychiatric comorbidity data were retrieved from the subjects' anamnesis and medical records.

RESULTS

The results showed that ex-prisoners of war were exposed to a statistically much higher number of traumatic events, and had a significantly higher total number of psychiatric comorbidities (p<0.01) than the control group. The incidence of acute and transient psychotic disorders, generalized anxiety disorders and psychological and behavioural factors associated with disorders or diseases classified elsewhere was significantly higher among ex-prisoners of war. There was no statistically significant difference in overall posttraumatic stress disorder intensity between the two groups (p<0.05).

CONCLUSIONS

The results of the study confirm our hypothesis that the incidence of psychiatric comorbidity is higher in ex-prisoners of war.

Mental Health and Physical Activity in Health-Related University Students during the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic led to increased negative emotional states among students. Physical activity is known to have positive impacts on mental health and well-being. However, due to the closure of gyms and other recreational facilities as a restrictive measure, students' physical activity levels may decrease. This cross-sectional study aimed to determine the prevalence of depression, anxiety, and stress symptoms and physical activity among health-related students during the second partial COVID-19 lockdown. The study included 823 students from the Faculty of Dental Medicine and Health of the University of Osijek in Croatia. The Depression Anxiety Stress Scale-21 (DASS-21) and the Godin-Shephard Leisure Time Questionnaire for Physical Activity (GSLTPAQ) questionnaires were used to assess the prevalence of depression, anxiety, and stress symptoms as well as physical activity. Two-thirds (59.2%) of students in health-related fields were insufficiently active, while the prevalence of depression (50.8%), anxiety (50.9%), and stress (49.9%) symptoms were high. Also, female respondents had significantly higher levels of depression, anxiety, and stress than their male counterparts. Graduate students had higher levels of all three negative emotional states, but only anxiety levels were significant. This study shows that students in health-related fields had reduced physical activity and a high prevalence of negative emotional conditions (depression, anxiety, and stress) during the second partial lockdown. The resulting symptoms were mostly of mild intensity; however, we consider this a significant mental health issue during the COVID-19 pandemic. Hence, it is crucial to control and support students' mental health, especially in more affected female individuals, in order to reduce the pandemic's negative impact.

The Role of Perceived Social Support in Assessing Posttraumatic Stress Disorder and Mental Health-Related Quality of Life in Veterans

This study aims to establish the effect of self-perceived social support on the intensity of Post-Traumatic Stress Disorder (PTSD) symptoms and Mental Health-Related Quality of Life (MHRQoL) in veterans more than two decades after exposure to trauma in the Homeland War in Croatia, which took place from 1990 to 1995. The sample comprised 259 Croatian Homeland War veterans diagnosed with PTSD, with at least 6 months of combat experience. Among them, 90 subjects had also experienced imprisonment in enemy prison camps (at least 1 month of captivity). The subjects were evaluated using the questionnaire on self-perceived social support, sociodemographic questionnaire, PTSD self-report checklist (PCL-5) and Short Form (SF-36) Health Survey questionnaire. A general regression model analysis was performed to determine whether social support affected patients' MHRQoL and intensity of the PTSD symptoms. The obtained results showed that veterans who had a more positive perception of social support after the events of the war had less intense PTSD symptoms and better MHRQoL. Furthermore, captivity and socioeconomic status were shown to be important predictors of PTSD and MHRQoL. The nonimprisoned veteran group was more likely to develop more severe PTSD symptoms and have poorer MHRQoL compared to the group of former prisoners of war (ex-POWs). This could be due to better post-war care and social support, which ex-POWs received after their release from captivity.

Health-Related Quality of Life of Ex-Prisoners of War Affected by Posttraumatic Stress Disorder 25 Years After Captivity

BACKGROUND

War captivity is one of the most difficult human experiences and can cause long-lasting effects on mental and physical health. Posttraumatic Stress Disorder (PTSD), as one of the frequent consequences of war trauma, is often associated with the psychiatric and/or somatic comorbidity. Therefore, PTSD results in impaired Health-Related Quality of Life (HRQoL). This study aimed to investigate the HRQoL in the Croatian Homeland War ex-POWs affected by PTSD, regarding the intensity of PTSD symptoms, sociodemographic characteristics and somatic comorbidity, and to identify predictors of poor HRQoL.

SUBJECTS AND METHODS

The study sample consisted of two groups (45 participants each) based on whether they were POWs or not (control group). All study participants were diagnosed with PTSD according to the ICD-10 criteria and had combat experience as active participants in defence of the Republic of Croatia during the Homeland War. The subjects were evaluated using the sociodemographic questionnaire, PTSD self-report checklist (PCL-5) and Short Form (SF-36) Health Survey questionnaire. The data on participants' physical diseases were collected from medical anamnesis and medical records in the last five years.

RESULTS

In relation to ex-POWs, the control group had significantly smaller number of retirees, more unemployed persons, smaller number of married subjects, and higher number of divorced persons. Low socioeconomic status and intensity of PTSD symptoms has been confirmed as a significant predictor of impaired HRQoL in both subject groups. The most commonly PTSD associated physical diseases were musculosceletal, cardiovascular, and gastrointestinal diseases. Endocrine and metabolic diseases were more frequent in the ex-POWs' group.

CONCLUSIONS

PTSD was associated with the HRQoL, whether the veterans were ex-POWs or not. The hypothesis that exposure of ex-POWs to the trauma of captivity experience impaired HRQoL to a greater extent, compared to the non-detained veterans, was not confirmed. Low socioeconomic status has proved to be the most significant predictor of poorer HRQoL.

Malaria: The Past and the Present

Malaria is a severe disease caused by parasites of the genus Plasmodium, which is transmitted to humans by a bite of an infected female mosquito of the species Anopheles. Malaria remains the leading cause of mortality around the world, and early diagnosis and fast-acting treatment prevent unwanted outcomes. It is the most common disease in Africa and some countries of Asia, while in the developed world malaria occurs as imported from endemic areas. The sweet sagewort plant was used as early as the second century BC to treat malaria fever in China. Much later, quinine started being used as an antimalaria drug. A global battle against malaria started in 1955, and Croatia declared 1964 to be the year of eradication of malaria. The World Health Organization carries out a malaria control program on a global scale, focusing on local strengthening of primary health care, early diagnosis of the disease, timely treatment, and disease prevention. Globally, the burden of malaria is lower than ten years ago. However, in the last few years, there has been an increase in the number of malaria cases around the world. It is moving towards targets established by the WHO, but that progress has slowed down.

Flexible intramedullary nailing for treatment of proximal humeral and humeral shaft fractures in children: A retrospective series of 118 cases

BACKGROUND

The aim of this study was to analyze outcomes of treatment and complications in children treated with flexible intramedullary nailing (FIN) due to humeral fracture.

HYPOTHESIS

The FIN for treatment of humeral fractures in children would allow an early functional and cast-free follow-up with a quick pain reduction and low complication rate.

PATIENTS AND METHODS

From May 2002 until May 2016 case records of all children who underwent fixation with titanium intramedullary nails because of humeral fracture were retrospectively reviewed. The study included 118 patients treated with FIN for proximal humeral or humeral shaft fracture. The average age at the time of trauma was 12 years. Mean follow-up was 77 months. Left hand was affected in 51% of patients. The most common mechanism of injury was fall (n=58), followed by sports injuries, road traffic accidents, pathological fractures, motorbike accidents and bicycle riding.

RESULTS

There were no residual valgus/varum deformities. All patients achieved complete radiographic healing at a mean of 7.5 weeks. Nine complications were recorded: 1 humeral shaft fracture in patient with osteogenesis imperfecta, 4 entry site skin irritations, 2 skin infections and 2 radial nerve injuries. There were no cases of delayed union, nonunion or mal-union. After removal of the nails, all patients regained full function and all complications resolved.

DISCUSSION

The FIN for humeral fractures is a minimally invasive, simple and well reproducible technique with very low complication rate.

CONCLUSION

The FIN for treatment of humeral fractures shows very good functional and cosmetic results. It allows an early functional and cast-free follow-up with a quick pain reduction.

LEVEL OF EVIDENCE

Level IV - retrospective study.

Myocardial bridging as one of the causes of atypical chest pain in young women

Introduction

Myocardial bridging is congenital anomaly which usually has benign prognosis but there are also reports suggesting that it can be associated with ischemic clinical syndromes presenting with chest pain. Coronary computed tomography angiography is a well-established method for detecting myocardial bridging. However, clinical significance of this anomaly still remains unclear.

Methods

We studied 977 patients who presented with recurrent typical or atypical chest pain in outpatient clinic. All patients have undergone detailed clinical examination, ECG stress testing and coronary computed tomography angiography.

Results

Highest positive prediction for having myocardial bridging was for patients presenting with atypical chest pain with negative ECG stress test and who were younger women.

Conclusion

Coronary computed tomography angiography may be preferable method for evaluation of chest pain in younger women presenting with atypical chest pain.

Synthesis of 4-aryl-1,2,3-triazolyl appended natural coumarin-related compounds with antiproliferative and radical scavenging activities and intracellular ROS production modification

Diverse natural coumarin-based compounds linked to aryl via a 1,2,3-triazole spacer with antiproliferative activity against K562 cells, radical scavenging activity and a decrease of ROS production were provided.

[Determination of blood volume in pulmonary capillaries in patients with chronic obstructive lung disease]

The subjects were divided into four groups, three of which consisted of patients with various degrees of lung obstruction, while the fourth was the control group. The patients were divided according to the spirometric values: VC, FEV1, FEV1/VC%. The diffusing capacity was determined on the basis of the single breath method and graphical separation of the diffusion components was performed. It was found that the diffusing lung capacity was slightly lower in patients with mild to severe obstructive lung disease. The capillary blood volume was also slightly lower. Correlations between the degree of obstruction of the respiratory system and the diffusing lung capacity or the lung capillary blood volume was not statistically significant (p greater than 0.5). In studying patients with obstructive lung disease we were unable to establish which of the diffusion components significantly affected the value of the total diffusing lung capacity.