Internistička patologija relativno je nov pojam koji obuhvaća dio patologije koji se bavi patohistološkom dijagnostikom pretežito netumorskih stanja, a u manjoj mjeri tumora, u različitim granama ...interne medicine, poput pulmologije, hematologije, nefrologije, gastroenterologije, dermatologije i imunologije. Uvidom u morfološke promjene bolesnih tkiva patolog postavlja dijagnozu koja se uz dodatne kliničke podatke dorađuje, međutim, patolog često odmah postavlja i definitivnu dijagnozu koja određuje daljnji tijek liječenja pacijenta. Internistička patologija obuhvaća vrlo složen i sofisticiran sustav dijagnostike u patologiji koji implementira bazičnu patohistološku dijagnostiku upotpunjenu histokemijskim, imunohistokemijskim, imunofluorescentnim i molekularnim tehnikama te elektronskomikroskopskom analizom. Oskudnost tkiva dobivenog pretežito tijekom različitih endoskopskih procedura te putem biopsije iglom jedna je od osobitosti ove grane patologije. Interpretacija promjena u analiziranim stanicama i tkivima često je ograničena dostupnošću kliničkih podataka o pacijentovu stanju, a korelacija morfoloških promjena s kliničkim podacima neophodna za ispravno postavljanje konačne dijagnoze. Iz navedenog se može zaključiti kako je internistička patologija dijagnostički vrlo zahtjevna i izazovna grana patologije koja koristi najsuvremenije pomoćne alate u cilju spoznaje patološkog supstrata bolesti, kako poznatih tako i novih internističkih entiteta.
Sport nosi nedvojbene zdravstvene prednosti fizičke aktivnosti, no veliki tjelesni napori vrhunskog sporta mogu prolazno, ali i trajno povećati rizik od bolesti mnogih organskih sustava. ...Profesionalni sportaši, posebno u sportovima izdržljivosti, mogu razviti neku bolest srca koju je ključno razlikovati od fizioloških prilagodbi srca (sportsko srce) za bavljenje vrhunskim sportom. U posljednje vrijeme u istraživanjima velik se naglasak stavlja na remodelaciju desne klijetke koja može dovesti do drugih zdravstvenih problema. U sportovima izdržljivosti češće su i neke supraventrikularne aritmije. U predisponiranih sportaša uslijed velikih napora može nastati iznenadna srčana smrt. Astma i bronhokonstrikcija iducirani naporom su klinički entiteti u kojima tjelesni napor uzrokuje bronhalnu preosjetljivost. Vjerojatno su uzrokovani gubitkom vode s površine respiratorne sluznice. U nekim sportovima i disciplinama (posebno u sportovima snage), osobito nakon umirovljenja iz profesionalnog sporta, uočena je veća učestalost pretilosti, inzulinske rezistencije i metaboličkog sindroma. Profesionalne sportašice mogu razviti poremećaje menstrualnog ciklusa, pa čak i ženski sportski trijas (niska dostupnost energije, poremećaji menstrualnog ciklusa i snižena mineralna gustoća kostiju). U sportaša su i češći poremećaji prehrane, u pravilu zbog prilagodbe tijela na određeni sport, bilo s posljedicama mršavljenja ili debljanja. Neumjerena tjelovježba može dovesti do rabdomiolize inducirane naporom, koja u najtežim slučajevima može rezultirati bubrežnim oštećenjem ili zatajenjem. Vrhunski sport, a posebice sportovi izdržljivosti, dokazano može uzrokovati deficijenciju željeza i sideropeničnu anemiju. Smatra se da produljeni periodi intenzivnog treninga koče apsorpciju i korištenje željeza u eritrocitopoezi
A finales del año pasado falleció en los Estados Unidos el médico colombiano Víctor Ferrans, quien dedicó su vida entera a la investigación en biología molecular.
“Vic” (como le decían sus ...contemporáneos norteamericanos) nació en Barranquilla en la década de los 30. Con raíces catalanas, se graduó de bachiller en el tradicional Colegio Biffi de los Hermanos Cristianos; viajó a New Orleans, donde se graduó de médico en la Universidad de Tulane e hizo su internado en el Charity Hospital de la misma ciudad.
En vez de proseguir con una tradicional residencia en campos clínicoquirúrgicos que le hubieran garantizado una vida sin aulagas, decidió sacar un doctorado en anatomía, en su misma Alma Mater.
Los colombianos éramos particularmente apreciados en aquel sitio, merced a programas como el “Tulane-Colombia” (ahora Cideim en Cali), orientado hacia el estudio de las enfermedades tropicales, y a la presencia de decenas de profesionales becados para hacer postgrados allí (que en nuestro país adquirirían luego el remoquete de los “Tulane boys”).
Numerosas personas saltan a mi memoria, entre las que se encuentran Eduardo Gaitán, Germán Beltrán, Eugenio González, Ramsés Hakim, Alfonso Villamil, Jorge León, su hermana María Amalia y los hermanos Alberto y Mario Bernal, Oscar Bolaños, Mario Hurtado y muchos otros, que pasamos por aquellos claustros y residimos en esa interesante ciudad. Yo lo hice entre 1965 y 1967, cuando compartí trabajo y amistad con mi paisano Ferrans.
Casado con la también barranquillera Gloria Grocer, Víctor se ubicó en el grupo del Profesor George E. Burch, jefe de Medicina Interna y eminente cardiólogo e investigador.
Sus primeros “papers” llevaron la co-autoría de Burch, entre los que recuerdo uno sobre la necesidad de tratar las cardiomiopatìas dilatadas que se observaban en situaciones como los embarazos, con reposo estricto y prolongado, hasta por seis meses. Como Burch exigía que todo médico vinculado al Departamento hiciera consulta externa y pasara revista (o “rounds”), así se dedicara a la investigación, allí los residentes y fellows veíamos a grandes científicos participando en jornadas de un corte eminentemente clínico, lo que a su vez enriquecía nuestro aprendizaje...
Provider: - Institution: - Data provided by Europeana Collections- Uvod: B-velikostanični limfom (B-LCL, od engl. B large cells lymphoma) najčešći je ne- Hodgkinov limfom. Prognoza ovisi o kliničkim ...značajkama, sažetima u tzv. međunarodnom prognostičkom indeksu (IPI, od engl. international prognostic index). Molekulski i imunohistokemijski prognostički bilježi su ili nepouzdani ili njihova cijena i tehnička ograničenja čine rutinsku primjenu nepraktičnom. Stoga je pronalaženje surogatnih biljega, koji mogu poslužiti kao prognostički čimbenik, važan doprinos procjeni individalnog rizika. Cilj istraživanja: odrediti prognostički značaj upalnih prognostičkih bodovnih sustava i širine distribucije eritrocita (RDW, od engl. red blood cell distribution width) u bolesnika s B- LCL-om. Bolesnici i metode: Retrospektivno smo analizirali podatke 81 bolesnika s B-LCL-om koji su dijagnosticirani u razdoblju od 2006. do 2013. godine u KBC-u Osijek. Promatrani su ishodi, ukupno preživljenje (OS, od engl. overall survival) i preživljenje bez događaja (EFS, od engl. event free survival). Korištena je univarijatna i multivarijatna (Coxova regresijska) statistička analiza. Rezultati: Medijan dobi bolesnika bio je 64 godine, 29 ispitanika bili su muškarci (36 %). Vrijednost NLR-a (od engl. neutrophil lymphocyte ratio - omjer neutrofila i limfocita) bila je veća u bolesnika s proširenom bolesti (stadij III i IV) nego u onih s lokaliziranom bolesti (stadij I i II) (medijan raspon 3,12 0,62 - 17,8 vs 2,38 0,56 - 7,5, P = 0,037) i u onih bolesnika koji nisu odgovorili na terapiju (2,64 0,56 - 11,29 vs 4 0,62 - 14,17, P = 0,011). Vrijednost PLR-a (od engl. platelet lymphocyte ratio - omjer trombocita i limfocita) bila je veća u bolesnika s proširenom bolesti (stadij III i IV) nego u onih s lokaliziranom bolesti (stadij I i II) (181,18 13,05 - 608,93 vs 132,24 67,44 - 521,37, P = 0,023), a nije bilo statistički značajne razlike u vrijednosti PLR-a između bolesnika koji su odgovorili na terapiju i onih koji nisu (P=0,151). Bolesnici s višim vrijednostima GPS-a bili su lošijeg općeg stanja (P = 0.002), većeg kliničkog stadija po Ann Arboru (P = 0.03) i imali su lošiji odgovor na terapiju (P < 0.001). Veće vrijednosti RDW-a (%) imali su pacijenti s proširenom bolešću (14,94±1,82 vs 13,55 ± 1,54, P = 0,001) i oni s lošim odgovorom na terapiju (14,94± 1,82 vs 13,55 ± 1,54, P = 0,001). Dvogodišnji OS i dvogodišnji EFS bili su značajno lošiji u bolesnika s NLR > 2,63 (rezna vrijednost izračunata ROC, od engl. receiver operating characteristic, analizom) (65,8 % vs 86,6 % za dvogodišnji OS, P = 0,007; 58,2 % vs 86,6 % za dvogodišnji EFS, P = 0,001) i u bolesnika s RDW > 15 % (rezna vrijednost izračunata ROC analizom) (42,2 % vs 91,7 % za dvogodišnji OS, P < 0,001; 42,9 % vs 83,3 % za dvogodišnji EFS, P < 0,001), dok PLR nije bio značajan za preživljenje. Dvogodišnji OS za pacijente s GPS-om (od engl. Glasgow prognostic score - Glasgowski prognostički bodovni sustav) = 0, GPS = 1 i GPS = 2 bila je 89,6 %, 65,8 % i 36,4 % (P = 0,002). Dvogodišnji EFS bio je 81,6 % za pacijente s GPS = 0, 63,2 % za one s GPS = 1 i 36,4 % za pacijente s GPS = 2 (P = 0,014). Multivarijatna analiza utvrdila je da je RDW > 15 % bio neovisan prognostički čimbenik za OS (HR, od engl. hasard ratio - omjer rizika, 8,873, 95 % CI, od engl. confidence interval - interval pouzdanosti, 2,065-38,132, P = 0,003) i EFS (HR 5,755, 95 % CI 1,733-19,11, P = 0.004), dok je NLR bio prognostički značajan samo za EFS (HR 5,973, 95 % CI 1,832-19,481, P = 0,003). Zaključak: U bolesnika s B-LCL-om naše je istraživanje potvrdilo NLR kao koristan prognostički biljeg, dok PLR i GPS nisu pokazali neovisnu prognostičku vrijednost za preživljenje. Visoka početna vrijednost RDW-a bila je povezana s lošijim ishodom. RDW bi mogao biti lako dostupan, jeftin prognostički biljeg za stratifikaciju bolesnika u rizične skupine.- Background: B-large cell lymphoma (B-LCL) is the most common non-Hodgkin's lymphoma. The prognosis depends primarily on clinical features, summarized in the so-called International Prognostic Index (IPI). There are certain molecular and immunohistochemical prognostic markers in patients with B-LCL, but their cost and technical constraints make such an application in routine impractical and expensive. Therefore, finding surrogate markers that may serve as a prognostic factor is an important contribution to the establishment of individual risk assessment. Objectives: The aim of this study was to analyze the prognostic significance of inflammation based prognostic scores and red blood cell distribution width (RDW) in B-LCL patients. Patients and methods: We retrospectively analyzed data from 81 B-LCL patients diagnosed from 2006 to 2013 at the University Hospital Center Osijek, Osijek, Croatia. We evaluated disease outcome, overall survival (OS) and event-free survival (EFS), and demographic, clinical and laboratory factors affecting outcome. Univariate analysis and Cox regression analysis were used. Results: The median age of patients was 64 years, 29 were men (35.8 %). Higher neutrophil to lymphocyte ratio (NLR) was found in patients with an advanced disase (median range 3.12 0.62 - 17.8 vs 2.38 0.56 - 7.5, P = 0.037 and a poorer response to therapy (median range 2.64 0.56 - 11.29 vs 4 0.62 - 14.17, P = 0.011). Higher platelet to lymphocyte ratio (PLR) was found in patients with an advanced disase (median range 181,18 13,05 - 608,93 vs 132,24 67,44 - 521,37, P = 0,023), values of PLR were not significant for response to treatment. Patients with higher GPS were in poorer general condition (P = 0.002), advanced disease stage (P = 0.03), and a poorer response to therapy (P < 0.001). Higher RDW levels (%) were found in patients with advanced Ann Arbor clinical stage (14.94±1.82 vs 13.55± 1.54, P = 0.001) and in those with poor response to therapy (14.94±1.82 vs 13.55± 1.54, P = 0.001). Patients with NLR values of > 2.63 (cutoff value calculated by receiver-operating characteristic) had a significantly worse two-year OS (65.8 % vs 86.6 %, P = 0.007) and two-year EFS (58.2 % vs 86.6 %, P = 0.001). PLR values were not significant for survival. The two-year OS rates for patients with Glasgow prognostic score (GPS) = 0, GPS = 1, and GPS = 2 were 89.6 %, 65.8 % and 36.4 % (P = 0.002) and EFS rates were 81.6 %, 63.2 %, and 36.4 %, respectively (P = 0.014). Patients with RDW>15 % (cut-off was calculated by receiver operating characteristics) had a significantly worse two-year OS (42.2 % vs 91.7 %, P < 0.001) and two-year EFS (42.9 % vs 83.3 %, P < 0.001). Cox regression analysis showed that RDW > 15 % was an independent prognostic factor for OS (hazard ratio HR 8.873, 95 % confidence interval CI 2.065-38.132, P = 0.003) and EFS (HR 5.755, 95 % CI 1.733-19.11, P = 0.004) while NLR values of > 2.63 were an independent prognostic factor only for EFS (HR 5.973, 95 % CI 1.832-19.481, P = 0.003) Conclusion: Our research confirmed NLR as a useful independent prognostic marker for survival. PLR and GPS did not show an independent prognostic value. High baseline RDW is an independent prognostic marker of poor outcome in patients with DLBCL. RDW could be an easily available and inexpensive marker for the risk stratification in patients with B-LCL.- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Provider: - Institution: - Data provided by Europeana Collections- Uvod i cilj istraživanja Nedostatak vitamina D predstavlja veliki javnozdravstveni problem. Procjenjuje se da se prevalencija ...nedostatka vitamina D u populaciji odraslih Europljana kreće između 2 i 30%. Cilj ovog rada bio je ispitati odnos serumske koncentracije 25(OH)D-a u bolesnika akutnim koronarnim sindromom (AKS), težinom koronarografskog nalaza i prognozom pacijenata kroz tri godine praćenja. Ispitanici i metode U istraživanje je ukupno uključeno 120 pacijenata. Eksperimentalnu skupinu je činilo 60 bolesnika (od toga 40 muškaraca (67%), sa srednjom dobi od 58 godina) hospitaliziranih na kardiologiji sAKS-om između ožujka i listopada 2012. godine. U kontrolnu skupinu je u istom razdoblju uključeno 60 pacijenata (od toga 38 muškaraca (63%), sa srednjom dobi od 58,5 godina) bez AKS-a i s barem jednim poznatim čimbenikom rizika za kardiovaskularnu bolest (KVB). Svim pacijentima su učinjene laboratorijske pretrage i određena koncentracija 25(OH)D-a i PTH. Pacijentima s AKS-om učinjena je koronarografija i praćeni su kroz 36 mjeseci. Rezultati Pacijenti s AKS-om imali su statistički značajno nižu razinu 25(OH)D-a u odnosu na kontrolnu skupinu (35,19 nmol/l prema 58,08 nmol/l, p<0.001). Dijabetičari s AKS-om su imali najnižu serumsku koncentraciju 25(OH)D-a (30,45 nmol/l). Pacijenti s AKS-om su s obzirom na težinu koronarne bolesti podijeljeni u tri podskupine, te se serumska koncentracija 25(OH)D-a smanjivala s porastom težine koronarne bolesti (36,44 nmol/l, 33,65 nmol/li 31,70 nmol/l). Šezdeset posto pacijenata s preboljelim AKS-om kroz 36 mjeseci praćenja nije doživjelo veliki neželjeni kardijalni događaj (MACE). Pacijenti koji su doživjeli MACE imali su nižu serumsku koncentraciju 25(OH)D-a, ali ta razlika nije bila statistički značajna (32,64 nmol/l prema 37,01 nmol/l). Zaključak Serumska koncentracija vitamina D je smanjena kod bolesnika s akutnim koronarnim sindromom. Smanjena koncentracija vitamina D u bolesnika sa šećernom bolesti može upućivati na dodatno povećanje rizika za razvoj akutne koronarne bolesti. Smanjena serumska koncentracija vitamina D je povezana s težinom koronarne bolesti, ali ne utječe na prognozu. Snižena serumska koncentracija vitamina D mogući je biomarker visokog kardiovaskularnog rizika.- Background and aim Vitamin D deficiency represents a major public health problem. It is estimated that the prevalence of vitamin D deficiency in adult Europeans is between 2 and 30%. The objective of this study was to determine the relationship of 25(OH)D serum concentration and the extent of coronary artery disease at coronarography as well as with prognosis of patients with acute coronary syndrome (ACS) during a three-year follow up period. Subjects and Methods The study included 60 ACS patients hospitalized at cardiology department for ACS between March 2012 and October 2012 and 60 matched controls without ACS. Standard laboratory testing and vitamin D determination were performed in all study patients. In addition, ACS patients underwent coronarography and were followed-up for 36 months for ACS for major adverse cardiac event (MACE). Results Patients with ACS had a statistically significantly lower mean 25(OH)D level as compared with control group (35,19 nmol/l vs. 58,08 nmol/l, p<0.001). The lowest mean level of 25(OH)D was recorded in diabetic patients with ACS (30,45 nmol/l). After coronarography, ACS patients were divided into three subgroups regarding coronary artery disease severity: single, double and multiple vessel disease with 25(OH)D serum levels of 36,44 nmol/l, 33,65 nmol/l and 31,70 nmol/l, respectively. Event free survival rate at 36 months in the ACS group was 60%. Patients with a MACE had lower average 25(OH)D level, but the difference was not statistically significant (32,64 nmol/l vs. 37,01 nmol/l in event-free patients). Conclusion Serum vitamin D concentration is low in ACS. Decreased levels of vitamin D in diabetic patients increases the risk of ACS. Low vitamin D levels correlated with the severity of coronary artery disease, but does not influence prognosis in ACS patients. Low vitamin D serum concentration can be used as a biomarker connected with ACS as a cardiovascular disease.- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Provider: - Institution: University of Zagreb. School of Dental Medicine. Chair of Internal Medicine. - Data provided by Europeana Collections- Ovo je prospektivno istraživanje utjecaja metaboličkoga ...sindroma (MetS), dijagnosticiranog revidiranim National Cholesterol Education Program Adult Treatment Panel III kriterijima, i antropometrijskih parametara (indeks tjelesne mase (BMI), opseg struka (WC), omjer opsega struka i bokova (WHR)) na težinu i prognozu akutnoga infarkta miokarda sa ST-elevacijom (STEMI), te po prvi puta na zahvaćenost koronarnih segmenata (KS) signifikantnom stenozom i duljinu bolovanja. Provedeno je na 250 bolesnika s akutnim STEMI, liječenih primarnom perkutanom koronarnom intervencijom u Zavodu za kardiovaskularne bolesti KBC-a Sestre Milosrdnice, od rujna 2011. do rujna 2012. godine. Bolesnici sa i bez MetS, te oni s različitim BMI, WC i WHR kategorijama, evaluirani su prema osnovnim (medicinski, demografski), te prema parametrima težine (klinički, laboratorijski, ehokardiografski, koronarografski, bolničke komplikacije) i prognoze (glavni neželjeni kardiovaskularni događaji (MACE) (reinfarkt, koronarna restenoza i/ili nova stenoza, kardiogeni i/ili nekardiogeni uzroci rehospitalizacije, moždani udar, hitno aortokoronarno premoštenje, smrtnost, ukupni MACE) i duljina bolovanja tijekom 12 mjeseci) akutnog STEMI. MetS povećava rizik ukupnih bolničkih komplikacija i značajnih stenoza 2 koronarnih arterija. Bolesnici imaju dulju hospitalizaciju, šire stentove, učestalije značajno stenozirane proksimalne/srednje KS i dulje bolovanje. Hiperglikemija povećava rizik srčane insuficijencije. BMI <25.0 kg/m2 povećava, a BMI 25.0-29.9 kg/m smanjuje rizik dispneje. Bolesnici sa BMI 30.0 kg/m2 imaju dulju hospitalizaciju i šire stentove, dok oni s povišenim WHR imaju učestalije signifikantno stenozirane proksimalne/srednje KS. Konačno, broj signifikantno stenoziranih koronarnih arterija povećava rizik ukupnog MACE. Zaključno, MetS je superioran u odnosu na njegove komponente i antropometriju u predviđanju težine akutnog STEMI, ali bez značajnih razlika među njima u predviđanju prognoze. MetS bolesnici imaju dulje bolovanje, što je vrlo bitno u budućem planiranju njihove rehabilitacije.- Objective: Investigation the influence of metabolic syndrome (MetS) and anthropometric parameters on clinical severity and prognosis in patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). Patients and Methods: We prospectively analysed 250 patients with acute STEMI treated with primary PCI, between September 2011-2012, in Department for Cardiovascular Diseases, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia. MetS was diagnosed by the revised National Cholesterol Education Program Adult Treatment Panel III criteria. Patients were divided in two groups (with/without MetS) which were compared by their baseline (medical history, demographic) and parameters of severity (clinical, laboratory, echocardiography, coronary angiography and in-hospital complications data) and prognosis (major adverse cardiovascular events (MACE) (reinfarction, coronary arteries restenosis and/or new stenosis, cardiac and/or non-cardiac rehospitalization, cerebrovascular insult, urgent coronary artery bypass graft, mortality, and total MACE) and sick leave duration during 12 months follow-up period). Additionally, patients were divided according to the anthropometric parameters in three groups as follows: body mass index (BMI) (<25.0, 25.0-29.9 and 30.0 kg/m), waist circumference (WC) (<102/88 and 102/88 cm for males/females) and waist-to-hip ratio (WHR) (<0.90/0.85 and 0.90/0.85 for males/females). They were analysed and compared by the same baseline and parameters of severity and prognosis. Results: There were 136 (54.4%) and 114 (45.6%) patients with and without MetS, respectively. MetS patients had longer hospitalization (9.0 vs. 8.0 days), higher rates of total in-hospital complications (47.8% vs. 34.2%), higher number of significant stenosed coronary arteries (2 vs. 1), wider stents diameter (3.5 vs. 3.0 mm), higher rate of significant stenosed proximal/middle coronary arteries segments (94.1% vs. 86.7%), and longer sick leave duration (16 vs. 10 weeks) (p<0.05). MetS was independently associated with higher risk of total in-hospital complications (Odds ratio (OR) 1.76, Confidence interval (CI) 1.05-2.94, p=0.031) and with higher risk of 2 significant stenosed coronary arteries (OR 1.72, CI 1.04-2.84, p=0.034). Among the same 250 patients, there were 72 (28.8%), 149 (59.6%) and 222 (88.8%) patients with BMI 30.0 kg/m, WC 102/88 cm and WHR 0.90/0.85, respectively. Patients with BMI <25.0 kg/m had highest rates of dyspnea, those with BMI 30.0 kg/m2 had longer hospitalization and wider diameter of stents, and those with WHR 0.85/0.90 had higher rates of significant stenosed proximal/middle coronary arteries segments (p<0.05). BMI <25.0 kg/m2 was independently associated with higher (OR 2.0, CI 1.10-3.67, p=0.025) and BMI 25.0-29.9 kg/m2 with lower risk of dyspnea (OR 0.51, CI 0.29-0.90, p=0.020). Finally, number of significantly stenosed coronary arteries was independently associated with total MACE (OR 1.79, CI 1.17-2.77, p=0.008). Conclusion: MetS in acute STEMI is an independent predictor of total in-hospital complications and severity of coronary arteries disease, but not for other parameters of severity and prognosis. BMI is an independent predictor for some components of severity (but not prognosis) in acute STEMI, while WC and WHR seems to be inferior in that prediction with no impact on both severity and prognosis in these patients.- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Provider: - Institution: - Data provided by Europeana Collections- Cilj istraživanja: utvrditi incidenciju i prevalenciju upalnih bolesti crijeva (Crohnova bolest i ulcerozni kolitis) u pučanstvu ...Zadarske županije u razdoblju od 2000 - 2010 godine, analizirati fenotipove obje bolesti, ustanoviti učestalost komlikacija, te istražiti utjecaj potencijalnih čimbenika rizika okoliša. Nacrt studije: retrospektivno – prospektivna epidemiološka studija Ispitanici i metode: u studiju je uključeno 397 pacijenata s upalnim bolestima crijeva, 243 muškarca i 154 žene, koji svi žive na području Zadarske županije. Za procjenu čimbenika rizika je formirana kontrolna skupina od 1000 zdravih dobrovoljaca koji također žive na području Zadarske županije. Za svakog oboljelog ispunjena su dva protokola, za incidenciju i prevalenciju upalnih bolesti crijeva. Fenotip Crohnove bolesti i ulceroznog kolitisa određen je prema Montrealskoj klasifikaciji upalnih bolesti crijeva. Rezultati: Pokazana je blaga predominacija ulceroznog kolitisa nad Crohnovom bolesti, te veći broj oboljelih muškaraca kod obje bolesti. Godišnja stopa incidencije za razdoblje 2000-2010 za ulcerozni kolitis iznosi 8,1/100.000 stanovnika, a za Crohnovu bolest 8,3/100.000. Prevalencija na kraju 2010 godine za ulcerozni kolitis iznosi 128,39/100.000 stanovnika, a za Crohnovu bolest 106,5/100.000 stanovnika. Bolesnici s Crohnovom bolesti su mlađi (31,9 godina) od bolesnika s ulceroznim kolitisom (42,4 godine) u trenutku postavljanja dijagnoze. Kod bolesnika s ulceroznim kolitisom najčešće je zahvaćeno cijelo debelo crijevo (fenotip E3). Bolesnici s Crohnovom bolesti su najčešće stari između 17 i 40 godina (fenotip A2), najčešće je zahvaćen terminalni ileum (L1), te imaju nekomplicirani tijek bolesti (B1). Komplikacije bolesti su češće kod Crohnove bolesti. Nađena je statistički značajna povezanost upalnih bolesti crijeva i pušenja, apendektomije i cijepljenja protiv ospica, dok te povezanosti ne postoji s tonzilektomijom, uzimanjem oralnih kontraceptiva i preboljelim ospicama. Pušenje utječe na učestalost komplikacija kod bolesnika s Crohnovom bolesti. Statistički je značajna obiteljska agregacija upalnih bolesti crijeva. Zaključak: epidemiologija upalnih bolesti crijeva se najbolje uklapa u europski „model zapad-istok“. Dobiveni su točni brojčani podatci za jednu dalmatinsku županiju, koji mogu temelj za daljnja istraživanja.- Aim of study: To determine the incidence and prevalence of inflammatory bowel disease (Crohn's disease and ulcerative colitis ) in the population of Zadar County in the period 2000-2010 , to analyse phenotypes of both diseases, to determine the frequency of complication, and explore the impact of potential enviromental risk factors. Study design : retrospective – prospective epidemiological study Patients and Methods : The study included 397 patients with inflammatory bowel disease , 243 men and 154 women , who all live in Zadar County . To assess risk factors formed a control group of 1,000 healthy volunteers who also live in Zadar County. For each patient met the two protocols , the incidence and prevalence of inflammatory bowel disease. Phenotype of Crohn`s disease and ulcerative colitis is determined by the Montreal classification of inflamatory bowel disease. Results : The higher the incidence of ulcerative colitis compared to Crohn's disease. In both diseases is increasing the number of male patients.. The annual incidence rate for the period 2000-2010 for ulcerative colitis is 8.1 / 100,000 inhabitans , while Crohn's disease is 8.3 / 100,000 . Prevalence at the end of 2010 for ulcerative colitis is 128,39 / 100,000 inhabitans , while Crohn's disease is 106,5/100.000 inhabitants. Patients with Crohn's disease were younger (31.9 years) than patients with ulcerative colitis (42.4 years) at the time of diagnosis. Patients with ulcerative colitis usually affected the entire colon (phenotype E3) . Patients with Crohn's disease are usually aged between 17 and 40 (phenotype A2) , the most affected is terminal ileum (L1), and have uncomplicated disease course (B1) . Complications of the disease are more common in Crohn's disease. Discovered connection between inflammatory bowel disease and smoking, appendectomy, and vaccination against measles, while not a proven link with tonsillectomy, oral contraceptives an measles in history . Smoking affects the incidence of complications in patients with Crohn's disease. There is a statistically significant family agggregation of inflamatory bowel disease. Conclusion: The epidemiology of inflammatory bowel disease can best fit into the European " model west-east ." Obtained are accurate numerical data for one Dalmatia County, which can be the basis for further research.- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
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