Toxic metals in freshwater fish from the Zagreb area as indicators of environmental pollution

The aim of this investigation was to determine the levels of heavy metals and metalloids in freshwater fish from the Zagreb area. A total of 216 freshwater fish samples from 5 sites were examined: Sava river upstream from Zagreb, Sava river at Zagreb, Sava river downstream from Zagreb, Jarun Lake, and 5 "ecologic" fishponds from the Zagreb surroundings. The metals lead, cadmium, mercury and the metalloid arsenic were determined by the method of atomic absorption spectrometry. The mean pooled levels of lead, cadmium and arsenic in all fish samples were 112.3 +/- 95 micrograms/kg, 8.5 +/- 11 micrograms/kg and 23.5 +/- 36 micrograms/kg, and did not exceed the allowed levels of 1,000 mg/kg, 100 micrograms/kg and 200 micrograms/kg, respectively. In 4 fish samples, the levels of mercury exceeded the allowed limit of 500 micrograms/kg (509, 596, 605 and 788 micrograms/kg), however, the pooled mean level of mercury was 127.8 +/- 90 micrograms/kg. There was no major difference in the levels of heavy metals between the two fish families observed, although the levels of lead, cadmium and mercury were higher in the family Ictaluridae (144 vs. 107 micrograms/kg, 10.4 vs. 8.2 micrograms/kg, and 153 vs. 124 micrograms/kg, respectively), whereas the level of arsenic was higher in the family Cyprinidae (23.8 vs. 21.8 micrograms/kg). Although the Sava river at Zagreb is the main recipient of sewage and wastewater in the Republic of Croatia, the levels of heavy metals were within the allowed limits in all groups of freshwater fish samples, with the exception of 4 samples that contained moderately elevated levels of mercury. Study results suggest that only mercury could be considered a good indicator of environmental pollution, because higher levels of mercury were measured in the fish from the Sava river than in the fish from the Jarun Lake and fishponds from the Zagreb surroundings, considering both pooleded and fish family specified data.     

Functional ability of the elderly in institutional and non-institutional care in Croatia

Gerontology-public health indicators of functional ability of the elderly in institutional and non-institutional health care in Croatia were determined by use of expert methodology developed at Department of Gerontology, Dr. Andrija Stampar Institute of Public Health in Zagreb, with the aim to upgrade the Program of Health Care Measures and Procedures in Health Care of the Elderly. Comparison of functional ability between the users of selected Old People's Homes (institutional care; N = 5030) and Gerontology Centers (non-institutional care; N = 2112) yielded highest between-group difference in the proportion of "fully movable" and "fully independent" categories in favor of the latter, thus steering the program of health care for the elderly accordingly. In addition, study results showed greater difference in the proportion of categories describing mental status of institutional and non-institutional care users as compared with the categories describing their physical status, suggesting that mental status plays a more important role than physical status in the geriatric user's stay in non-institutional care versus institutional care. This issue requires additional studies. The results obtained by this indicator analysis pointed to the preventive and geroprophylactic measures to ensure efficient health care for the elderly and to develop the program of mental health promotion and preservation. According to 2007 estimate, there were 759,318 (16.9%) persons aged > or = 65 in Croatia. Data collected at gerontology database kept at Department of Gerontology, Dr. Andrija Stampar Institute of Public Health (September 2008) showed 2% of the elderly (N = 14807) to be accommodated at Old People's Homes, which is below the European average of 4%.     

Semen quality and reproductive endocrine function with regard to blood cadmium in Croatian male subjects

In 123 Croatian men with no occupational exposure to metals, the influence of cadmium on reproductive parameters was examined after adjusting for age, smoking, alcohol, and biomarkers of lead, copper, zinc, and selenium. The following variables were measured: blood cadmium (BCd), blood lead (BPb), activity of -aminolevulinic acid dehydratase (ALAD), erythrocyte protoporphyrin, serum copper (SCu), serum zinc (SZn), serum selenium (SSe), activity of glutathione peroxidase (GPx) in blood, testis size, semen quality (including sperm concentration, motility, viability, and morphology), indicators in seminal fluid (the lactate dehydrogenase isoenzyme LDH-C₄, fructose, zinc, acid phosphatase, and citric acid), and hormones in serum (follicle-stimulating hormone – FSH, luteinizing hormone, prolactin, testosterone, and estradiol). The median and range BCd values were 2.94 (0.49-11.93) g/L in 61 smokers and 0.59 (0.20-3.71) g/L in 62 nonsmokers (p<0.0001). Smoking habits (cigarettes/day) highly significantly correlated with BCd (p<0.0001). After adjusting for potential confounding variables by multiple regression, BCd was significantly associated with a decrease in testis size (p<0.03) and an increase in serum estradiol (p<0.005), FSH (p<0.03), and testosterone (p<0.04). Smoking was significantly associated with a decrease in serum prolactin (p<0.006) and LDH-C₄ in seminal fluid (p<0.03). Several reproductive parameters were significantly associated with BPb and ALAD, biomarkers of lead, and/or with SCu, SZn, SSe, and GPx. The necessity of controlling for various metals, and other potential confounders when assessing the influence of a particular metal on reproductive function in men, is emphasized.     

Angiomyoma--angioleiomyoma of the cheek

The authors present the case of an angiomyoma--angioleiomyoma of the cheek in a 58-year-old man. The tumour was palpable, although clinically not visible, and the only case of a tumour of smooth muscle treated in the Clinical Department of Oral Surgery over the last 40 years. The operation was performed in the Outpatient Department by intraoral procedure. The postoperative course passed without complications. Current literature on leiomyomas is cited in the Introduction, followed by presentation of the case and histological characteristics of the tumour The example is presented as a rarity and one of the differential diagnostic possibilities in the diagnostics of soft tissue tumours in the oral cavity.     

The prevalence of depression and anxiety in seafarers type 2 diabetic patients

Depression and anxiety are co-morbid condition in diabetes as disease-related psychological reactions on this chronic metabolic illness. This study was aimed to determine the occurrence of depression and anxiety in seafarer's type 2 diabetic patients. A random sample of 52 diabetic seafarers treated with diet and oral glucose lowering agents, and 56 healthy seafarers were screened for depression with The Beck Depression Inventory (BDI) and for anxiety with State-Trait Anxiety Inventory (STAI 1, STAI 2). Depression (BDI > 18.5) and anxiety (STAI < 28.5) was significantly higher in the group of diabetic seafarers than in control group (more than 30%). Significant correlation was noted between depression and duration of diabetes mellitus, degree of obesity and poor glycaemic control (HbA1C > 8%) and longer duration of shipping routes (over 6 months). The proportion of depression and anxiety was found higher in seafarer's type 2 diabetic patients than in the healthy seafarers.     

Serum calcium, zinc, and copper in relation to biomarkers of lead and cadmium in men

The influence of exposure to lead and cadmium on serum concentrations of calcium, zinc, and copper was examined in 299 healthy Croatian men 20-55 years of age, including 143 workers in a lead battery factory and 156 control subjects. The interrelationship of blood lead, activity of delta-aminolevulinic acid dehydratase, erythrocyte protoporphyrin, blood cadmium, age, smoking habits, and alcohol consumption with respect to serum calcium, zinc, and copper levels was calculated by forward stepwise multiple regression. The results showed that chronic moderate exposure to lead decreased serum zinc, calcium and, to a lesser extent, copper levels. Exposure to cadmium occurred mostly through smoking and seemed to contribute to a decrease of serum zinc. All changes in serum concentrations of these essential elements were significant but remained within the normal range. The results suggest possible mechanisms of lead- and/or cadmium-induced adverse health effects in humans.     

Migration of phthalates from plastic products to model solutions

The aim of this investigation was to determine the level and rate of migration of phthalates, compounds used as plastic softeners, from various plastic products into model solutions and to assess the possible adverse effects of the phthalate amounts released on human health, thus to contribute to harmonization of the opinions on the maximal allowed human exposure to these compounds through environmental factors. Nine specimens of plastic toys, 16 specimens of plastic food containers and 10 specimens of other plastic consumer goods were analyzed. The specimens of plastic products were submitted to 10-day action of model solutions. Three model solutions were used: distilled water, 10% ethyl alcohol, and 3% acetic acid. Identification and quantification of the phthalates released were performed by the method of gas chromatography on days 1, 5 and 10 of exposure, at a detection limit of 0.005 microgram/kg. On day 10, the highest level of released phthalates (54.5 mg/kg) was measured in distilled water, followed by 44.4 mg/kg in 3% acetic acid and 32.3 mg/kg in 10% ethyl alcohol. According to plastic product categories, the highest pooled level of phthalates released to all three solutions was recorded for plastic toys (66.2 mg/kg), followed by food containers (37.6 mg/kg) and other consumer goods (27.4 mg/kg). According to plastic product categories, toys showed the most rapid phthalate release, with 65.4% (43.3 of 66.2 mg/kg) of the pooled level of phthalates released to all three solutions recorded on day 1. As indicated by the study results, the levels of phthalates released would not present a hazard for human health, not even over a prolonged period of time. However, data on the highest and fastest pooled phthalate release from plastic toys, and this especially to distilled water simulating salivary action, point to the need of continuous evaluation and amendments of the legislation on phthalates in consumer goods.     

Lifestyle habits and the risk of head and neck cancer in Zagreb region

In 2002, International Agency for Research on Cancer launched a multicentric case-control study of head and neck cancer in 15 centres in 11 European countries, Croatia included. The Alcohol-related Cancers and Genetic Susceptibility in Europe (ARCAGE) study database with approximately 2500 case-control pairs is currently the largest head and neck cancer patients database in Europe. The aim of the present study was to estimate the risk of smoking and alcohol consumption in head and neck cancer patients from Zagreb region recruited in scope of the ARCAGE study. The cases (45 males, 9 females) and the controls (37 males, 9 females) were recruited from University Hospital Dubrava and Merkur University Hospital. A blood sample and a lifestyle questionnaire were collected from all study subjects. Data were analysed by logistic regression analysis. The distribution of cases was: 43 oral, 9 pharyngeal and 2 laryngeal cancer cases. Ever-smokers had a 4-fold higher cancer risk (adjusted OR 4.3 (CI 1.20-15.4)) compared to never-smokers. The adjusted odds ratio for alcohol consumption more than once a week was 4.1 (CI 1.5-11.2). The results are in keeping with previously published data from other countries.     

Calcifying odontogenic cyst--Gorlin's cyst--report of two cases

The authors present two cases of calcifying odontogenic cysts, which were confirmed by histological examination. In the first case the radiographic findings and clinical status did not indicate the presence of a calcifying odontogenic cyst. In the second case, differential diagnosis included COC. The histopathological findings showed that what appeared to be simple cases of bone translucencies was in fact an unusual odontogenic lesion. The two cases point out the possibility of incorrect assessment of deceptively banal cases in daily specialist practice.     

Presence of N-nitrosamines in canned liver patty

The presence of N-nitrosamines was determined in samples of industrially manufactured liver patty stored at different temperatures for a variable period of time. Sample preparation included steam distillation and extraction of redistilled samples with dichlormethane. The extracts were analyzed by a gas chromatography--mass spectrometry system (GC-MS-SIM). Study results expressed as total N-nitrosamines, including methylethyl-, diethyl- and dibutyl-N-nitrosamines, ranged from 0.0008 to 2.997 mg/kg, which significantly exceeded the recommended value of 0.002 mg/kg. The increase in the formation of N-nitrosamines was directly dependent on the length and temperature of product storage.