Clerkship in Croatia

A coincidence sent a second-year medical student to the Croatian countryside to survey farmers, and led her to an important hypothesis about food contamination.

By Julia C. Mead

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1 Every other year or so, except when the war intervened, health investigators visit a cluster of endemic villages to track the numbers of endemic nephropathy deaths and diagnoses and to screen for warning signs of the disease.

Bearing a lengthy questionnaire and the perlustracija list of patients in each village, Hranjec learned that in Croatia Aristolochia clematitis and wheat go to seed at the same time. She also learned that endemic nephropathy patients in Slavonski Brod baked bread from grain they'd grown themselves or bought flour milled from local wheat. The methods for sieving the grain failed to remove all the A. clematitis seeds before it was milled, even after the farmers exchanged their scythes for...

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