Marjeta Mišigoj Duraković

Human Lifespan: To Live and Outlive 100 Years?

Ljudski vijek: doživjeti i nadživjeti 100 godina? Starenje populacije je dominantno demografsko obilježje razvijenih zemalja. Stogodišnjaci su selekcionirana skupina i samo jedna od 7.000 do 10.000 osoba dosegne tu dob. Čimbenici dugovječnosti vjerojatno su brojni i uključuju gensko predodređenje (lokus na 4. kromosomu), zdrav okoliš i zdrave životne navike (prehrana s malo kalorija), redovita tjelesna i psihička aktivnost, kao i dostupnost te učinkovitost zdravstvene zaštite s primjenom geroprofilakse. Stogodišnjaci se adaptiraju na novi život i na gubitak tjelesnih funkcija koji bivaju postupno sve izraženiji kako se dob povisuje. Granice ljudskog života produžuju se - do sada najstarija poznata osoba doživjela je 128 godina. Pojedina zemljopisna područja bilježe izrazito veći broj stogodišnjaka. Navedene su i neke dugovječne osobe s više od 100 godina u svijetu i na području Republike Hrvatske i nekih susjednih zemalja. Iako se uglavnom smatra da se granica trajanja života čovjeka ne može produžiti iznad 120 godina, za sada je ipak teško predvidjeti gdje su njezine granice. Human Lifespan: To Live and Outlive 100 Years? Aged population dominates in developed countries. Centenarians are a select group, and only one in 7,000 to 10,000 reach that age. Factors of longevity are numerous and include genetic predisposition (a locus on chromosome 4), environment, healthy lifestyle (hypocaloric diet, regular physical and mental exercise), accessible health services, and efficient health protection at old age. Centenarians are well adapted to the new life and compensate for the loss of functions with age. The limits of human life are extended, so that nowadays the oldest person has reached the age of 128. Some geographic areas are characterised by higher numbers of centenarians. This article mentions a few individuals who outlived 100 years in the world, Croatia, and neighbouring countries. Although some argue that the limits of human life cannot be extended over the age of 120 years, for now we cannot predict the actual limits of human life.

Re-initiating professional working activity after myocardial infarction in primary percutaneous coronary intervention networks era

OBJECTIVES To investigate the aspects of return to work, socio-economic and quality of life aspects in 145 employed patients under 60 years of age treated with primary percutaneous coronary intervention for acute ST-elevation myocardial infarction. MATERIAL AND METHODS During hospital treatment demographic and clinical data was collected. Data about major adverse cardiovascular events, rehabilitation, sick leave, discharge from job and retirement, salary, major life events and estimation of quality of life after myocardial infarction were obtained after follow-up (mean: 836±242 days). RESULTS Average sick leave was 126±125 days. Following myocardial infarction, 3.4% of patients were discharged from their jobs while 31.7% retired. Lower salary was reported in 17.9% patients, major life events in 9.7%, while 40.7% estimated quality of life as worse following the event. Longer hospitalization was reported in patients transferred from surrounding counties, those with inferior myocardial wall and right coronary artery affected. Age, hyperlipoproteinemia and lower education degree were connected to permanent working cessation. Significant salary decrease was observed in male patients. Employer type was related to sick leave duration. Impaired quality of life was observed in patients who underwent in-hospital rehabilitation and those from surrounding counties. Longer sick leave was observed in patients with lower income before and after myocardial infarction. These patients reported lower quality of life after myocardial infarction. CONCLUSIONS Inadequate health policy and delayed cardiac rehabilitation after myocardial infarction may lead to prolonged hospitalization and sick leave as well as lower quality of life after the event, regardless of optimal treatment in acute phase of disease.

Swimming - Trigerred Acute Cardiovascular Complications in Elders

Background: Our aim was to analyze the prevalence and causes of sudden death due to recreational swimming in the elderly in Croatia in a 15-year period and to analyze what complications could we determine due to recreational swimming in elders, compared to other age groups. Methods: In this period 22 persons from Croatia died suddenly due to recreational swimming in a summer time. In all of them forensic medicine autopsy was done. The data are a part of a retrospective study, collected from the whole population consisting of 4,500.000 persons from the registry of the Forensic Medicine Services, the Public Health Registry and from sport’s clubs in Croatia. Results: Nine of those suddenly deceased persons were aged 65-84: eight men and one woman. All have suffered from coronary atherosclerosis, myocardial fibrosis or myocardial scars, one of them had rupture of the thoracic aorta, and six of them had left ventricular hypertrophy. Ten were aged 30-64: seven of them have suffered from coronary atherosclerosis and seven had left ventricular hypertrophy. Three were aged 18-29: one had hypertrophic cardiomyopathy, the other had chronic myopericarditis, and the third had cardiomegaly and blood alcohol level of 1.7%. In Croatia, the death rate during swimming in men aged 65-82 is significantly higher than in other age groups: in men aged 30-64 and 18-29. Conclusion: In Croatia in all eight elderly persons died suddenly, and in 7/10 middle aged, coronary heart disease was a leading cause of sudden death due to swimming. Left ventricular hypertrophy was found in 6/9 elders and in 7/10 middle aged persons. The death rate due to swimming in men aged 65-84: 2.10/1,000.000, is significantly higher than in those aged 30-64: 0.65/1,000.000 (p=0.0209), and in men aged 18-29: 0.44/1,000.000 (p=0.0244), and in two groups aged 18-64 put together: 0.59/1,000.000 (p=0.0064).