Davor Plavec

Prevalence of Vertigo, Dizziness, and Migrainous Vertigo in Patients With Migraine

Objective.— The aim of this study was to determine the lifetime prevalence of vertigo and dizziness in patients with migraine as compared with controls and to establish the lifetime prevalence of migrainous vertigo.

Validation of a multi-sensor activity monitor for assessing sleep in children and adolescents

OBJECTIVE To assess the validity of a multi-sensor activity monitor in estimating sleep and wake compared to polysomnography in children and adolescents. METHODS A total of 43 children and adolescents (29 boys, 14 girls), aged 7-17years (mean age [SD] = 11.0 [2.4] years) participated in the study. Participants wore the SenseWear Pro(3) Armband™ (SWA) body monitor (BodyMedia Inc) during an overnight polysomnographic assessment in a paediatric sleep laboratory. Sleep measures included sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST) and sleep efficiency (SE). RESULTS No systematic bias of the SWA was noted for any of the sleep measures assessed, but limits of agreement were wide and amounted to -76 to +58min for SOL, -75 to 102min for WASO, -109 to +99min for TST and -22 to +20% for SE. In addition, no effect of gender, age group (children versus adolescents) or overweight on the accuracy of the SWA was found. CONCLUSIONS The SenseWear Armband™ showed good agreement with polysomnography at the group level, while at the individual level rather, poor agreement between the two methods was observed. Consequently, at this point the use of the SWA in the clinical evaluation of sleep cannot be advocated.

Prevalence of Migraine, Probable Migraine and Tension-Type Headache in the Croatian Population

Background/Aim: Population-based epidemiological studies about headaches, especially migraine, have been carried out in many countries. The aim of this study was to assess the 1-year prevalence of migraine, probable migraine and tension-type headache (TTH) in the Croatian population. Methods: The design of the study was a cross-sectional survey of an adult population sample using a self-completed questionnaire. Results: The 1-year crude prevalence of migraine without and with aura in this study was 7.5%, of probable migraine 11.3%, and of TTH 21.2%. The 1-year age- and sex-adjusted prevalence of migraine was 6.2%, of probable migraine 8.8%, and of TTH 20.7%; the prevalence of migraine combined with probable migraine was 15.0%. Total crude prevalence of headache (combination of migraine, probable migraine and TTH) was 39.9%. Prevalence of migraine was higher in continental than in Mediterranean areas of Croatia. Multivariate regression analysis showed that the highest risk of suffering from any kind of headache is observed for the following people: living in Dubrovnik, being female, having elementary or high school education, being married, employed and living in an urban or suburban area. Conclusion: The prevalence of migraine and probable migraine is similar as in other Western countries. Certain demographic characteristics differ among patients with and without headache.

Differences in mite fauna between the continental and Mediterranean climates of Croatia: microscopy and Dustscreen test findings

Background:  The aim of this study was to evaluate the difference between the mite fauna in the inland and coastal Croatia.

Serial interferon‐γ release assay in children with latent tuberculosis infection and children with tuberculosis

Interferon‐γ (IFN‐γ) release assay (IGRA) is used for diagnosis of latent tuberculosis infection (LTBI), and for serial testing of active tuberculosis (TB). The aim of this study was to evaluate the results of IGRA for diagnosis and treatment monitoring of children with LTBI and children with TB. IGRA was performed in BCG vaccinated children before and six months after the beginning of treatment.

Effects of allergic diseases and age on the composition of serum IgG glycome in children

It is speculated that immunoglobulin G (IgG) plays a regulatory role in allergic reactions. The glycans on the Fc region are known to affect IgG effector functions, thereby possibly having a role in IgG modulation of allergic response. This is the first study investigating patients’ IgG glycosylation profile in allergic diseases. Subclass specific IgG glycosylation profile was analyzed in two cohorts of allergen sensitized and non-sensitized 3- to 11-year-old children (conducted at University of Aberdeen, UK and Children’s Hospital Srebrnjak, Zagreb, Croatia) with 893 subjects in total. IgG was isolated from serum/plasma by affinity chromatography on Protein G. IgG tryptic glycopeptides were analyzed by liquid chromatography electrospray ionization mass spectrometry. In the Zagreb cohort IgG glycome composition changed with age across all IgG subclasses. In both cohorts, IgG glycome composition did not differ in allergen sensitized subjects, nor children sensitized to individual allergens, single allergen mean wheal diameter or positive wheal sum values. In the Zagreb study the results were also replicated for high total serum IgE and in children with self-reported manifest allergic disease. In conclusion, our findings demonstrate no association between serum IgG glycome composition and allergic diseases in children.

The 3 mm skin prick test (SPT) threshold criterion is not reliable for Tyrophagus putrescentiae: the re-evaluation of SPT criterion to dust mites.

Background: The mean wheal diameter ≥ 3 mm is the usual criterion for positive skin prick test (SPT) reaction to dust mites. The study assessed the accuracy of this SPT criterion with respect to specific IgE values of above 0.35 kUA/l (+ sIgE).

Urates in exhaled breath condensate as a biomarker of control in childhood asthma

Abstract Objective: The aim of this study was to (1) investigate the possibility to use urates in exhaled breath condensate (EBC) as a biomarker of airway inflammation and control in childhood asthma and (2) explore their association with other biomarkers of airway inflammation and clinical indices of asthma control (Asthma Control Test [ACT], quality of life [PAQLQ], lung function, prn beta-agonist use, time from last exacerbation [TLE]. Methods: This cross-sectional study comprised 103 consecutive patients (age 6–18 years) divided in groups of uncontrolled ([NC], n = 53) and controlled asthma ([C], n = 50). Measured lung function and biomarkers included: spirometry, eosinophilic cationic protein (ECP), high-sensitivity C-reactive protein (hs-CRP), exhaled NO (FENO), pH and urates in EBC and exhaled breath temperature (EBT). Results: Statistically significant differences were found between groups for EBC urates, EBC pH and EBT (NC versus C: EBC urates, median [IQR], µmol/L; 10 [6] versus 45 [29], p < 0.001; EBC pH, mean [SD], 7.2 [0.17] versus 7.33 [0.16], p = 0.002; EBT mean [SD], °C; 34.26 [0.83], versus 33.90 [0.60], p = 0.014). EBC urates showed significant association with TLE and FENO (r = 0.518, p < 0.001; r = 0.369, p = 0.007, respectively) in NC, and EBC pH (r = 0.351, p < 0.001), FEV1 (r = 0.222, p = 0.024), ACT (r = 0.654, p < 0.001), PAQLQ (r = 0.686, p < 0.001) and prn salbutamol use (r = −0.527, p < 0.001) in all asthmatics. Conclusion: In our study, EBC urates were found to be the best single predictor of asthma control and underlying airway inflammation. Our results provide evidence supporting the potential utility to use EBC urates as an additional non-invasive biomarker of control in childhood asthma.

Prevalence and clinical characteristics of headache in adolescents: a Croatian epidemiological study.

Background Headaches are often under-diagnosed in adolescents. The aim of this study was to examine the one-year prevalence of primary headaches among high school students in the city of Zagreb, the capital of Croatia. Methods This was a population-based, cross-sectional study. A total of 2350 questionnaires consisting of questions on demographic data, the presence and clinical characteristics of headaches were distributed among students in eight high schools; 2057 (87.5%) questionnaires were eligible for analysis. Results The mean age of the students was 17.2 ± 1.2 years; 50.2% were female. The prevalence of recurrent headache was 30.1% (620/2057), girls 35.1%, boys 25.2%. Among students with headache, 291 (46.9%) had migraine, and 329 (53.1%) had tension-type headaches (TTHs). The mean frequency of headaches was 5.66 per month in girls and 4.42 in boys; mean duration of a headache attack was 8.94 hours in girls and 8.37 hours in boys (NS). Unilateral headache was present in 31.6%, throbbing quality in 22.6%, dull in 34.4% of students; 22.4% had severe intensity and 70.3% moderate. Nausea was present in 4.0% always and in 14.7% frequently (girls 18.8%), photophobia in 41.3%, phonophobia in 63.2%, osmophobia in 23.9% (NS among genders). Almost 30% of students were disabled and stayed at home, more frequently boys. Girls (33.4%) were more likely to take drugs for every attack; number per month was 3.7. The results of this study showed that the prevalence of migraine among adolescents in Croatia was 16.5% for girls and 11.8% for boys; the prevalence of TTH was 18.4% for girls and 13.4% for boys. Conclusions The prevalence of self-reported headache among high school students in Zagreb is relatively high. Significant gender differences in frequency and clinical characteristics were observed. Primary headaches among adolescents are an important public health problem and should receive more attention from school and health authorities.

Detection of testosterone esters in blood

Injections of synthetic esters of testosterone are among the most common forms of testosterone application. In doping control, the detection of an intact ester of testosterone in blood gives unequivocal proof of the administration of exogenous testosterone. The aim of the current project was to investigate the detection window for injected testosterone esters as a mixed substance preparation and as a single substance preparation in serum and plasma. Furthermore, the suitability of different types of blood collection devices was evaluated. Collection tubes with stabilizing additives, as well as non-stabilized serum separation tubes, were tested. A clinical study with six participants was carried out, comprising a single intramuscular injection of either 1000 mg testosterone undecanoate (Nebido(®)) or a mixture of 30 mg testosterone propionate, 60 mg testosterone phenylpropionate, 60 mg testosterone isocaproate, and 100 mg testosterone decanoate (Sustanon(®)). Blood was collected throughout a testing period of 60 days. The applied analytical method for blood analysis included liquid-liquid extraction and preparation of oxime derivatives, prior to TLX-sample clean-up and liquid chromatography-tandem mass spectrometry (LC-MS/MS) detection. All investigated testosterone esters could be detected in post-administration blood samples. The detection time depended on the type of ester administered. Furthermore, results from the study show that measured blood concentrations of especially short-chained testosterone esters are influenced by the type of blood collection device applied. The testosterone ester detection window, however, was comparable.