SAŽETAK
Bolesti srca i krvožilnog sustava najučestaliji su uzrok smrtnosti u Europi. Prema najnovijim podatcima, čak 10% više smrtnosti od kardiovaskularnih bolesti zastupljeno je kod žena u odnosu ...na muškarce, što znači da u Europi zbog kardiovaskularnih razloga godišnje umire 300.000 žena više nego muškaraca. U većini istraživanja menopauza je istaknuta kao primarni čimbenik koji doprinosi povećanju kardiovaskularnog rizika u žena, usprkos metodološkim ograničenjima u obliku razdvajanja kronološkog starenja i menopauze. Proaterogene promjene u lipidogramu tijekom menopauzalne tranzicije smatraju se najsnažnijom poveznicom između nastupa menopauze i porasta kardiovaskularnog rizika. Kohortne studije nisu našle uzročnu povezanost nastupa menopauze s promjenama krvnog tlaka te homeostazom glukoze i inzulina, odnosno s rizikom razvoja šećerne bolesti. Uloga estrogena u očuvanju kardiovaskularnog zdravlja, uza sve gore opisane izravne učinke na srce i krvne žile, uključuje mehanizme kojima se regulira profil lipida, inzulinska osjetljivost te monocitno-makrofagni sustav, a čiji ispadi funkcije doprinose multifaktorijalnom procesu ateroskleroze koji u znatnoj mjeri modulira kardiovaskularni rizik. Sinteza brojnih istraživanja o molekularnim mehanizmima ističe da je estrogenska protekcija krvožilja i srca posljedica neposrednog učinka estrogena na vazodilataciju, angiogenezu, unaprjeđenje mitohondrijalne funkcije i sniženje razine oksidativnog stresa te supresiju fibroze. Promatrajući sve znanstvene spoznaje o utjecajima hormonskog nadomjesnog liječenja na profil kardiovaskularnog rizika, bitno je znati da je razvoj HNL-a bitno proširio mogućnost optimizacije i individualizacije terapije, a time su dodatno reducirani potencijalni rizici. Uz transdermalni put primjene, terapijske režime s niskim i ultraniskim dozama hormona te primjenu prirodnoga mikroniziranog progesterona i didrogesterona, kardiovaskularno zdravlje žena u menopauzi može biti značajno unaprijeđeno.
Although available diagnostic criteria are intelligible, combination of OAB and anxiety in the same patient presents a perfect example of medical causality dilemma, commonly stated as the question: ..."which came first: the chicken or the egg?". The aim of this review article is to address available insights in bidirectional association between OAB and anxiety.
In this review article, we included different types of studies whose results are presented as relative risk (RR) or odds ratio (OR) with a 95% accuracy. A literature search was conducted with the use of the PubMed and EMBASE electronic databases focusing on identifying articles published in English between 1990 and 2020.
The electronic searches, after duplicate records removal, provided a total of 126 citations. Of these, 107 were excluded after title/abstract screening (not relevant to the review). We examined the full text of 19 publications remaining to summarize possible mechanisms between OAB and anxiety. According to examined literature, our result synthesis provides insight in epidemiology, pathophysiology, diagnostic and therapeutic approach of both conditions.
Temporal relationship between OAB and anxiety is not very well documented because available longitudinal cohort studies are limited. The limitation of the published literature is that most were population-based symptom studies demonstrating high risk of bias. Although data from analysed studies suggest that anxiety and OAB and anxiety might be casually related, studies provided on clinical population are warranted. In addition to the traditional urologic factors, we recommend that psychosocial factors such as anxiety should be assessed routinely in patients with OAB.
Women who delay childbearing are at increased risk for complications in pregnancy and delivery.
The aim of this study was to determine whether primiparas > or = 35 have worse perinatal outcome ...compared to primiparas aged 20-27.
The perinatal outcome of 240 primiparas who gave singleton birth at Mostar Clinical Hospital between January 1, 2002 and December 31, 2004 was analyzed. Observed group was formed by 120 primiparas aged > or = 35. The control group was formed in the manner that each primipara from the observed group was assigned the first primipara younger than 35 with a singleton gestation who was subsequently entered in the delivery room record book. The data were collected from the maternal and newborn medical records at Mostar Clinical Hospital within the observed period.
Significantly higher occurrence of cesarean section (p < 0.001; OR = 2.6; 95% CI 2.32-2.90), preterm delivery (p < 0.001; OR = 4.8; 95% CI 4.51-5.09), newborn of low birth weight < 2500 g (p < 0.034; OR = 2.6; 95% CI 2.34-2.92) and neonatal intensive care unit admission (OR = 2.7; 95% CI 2.47-3.05) were observed in primiparas aged > or = 35. The perinatal mortality was also significantly higher in the group of the older primiparas (p = 0.020; OR = 7.8; 95% CI 7.55-8.13).
The overall results and a significantly higher number of perinatal deaths in particular present a significant concern because of growing number of older primiparas over the last decades.
The present study aimed to determinate the effect of external progesterone (P4) supplementation on luteolysis in cows under heat stress. Forty-eight (n=48) dairy cows in the period from ...July–September 2018 were part of and at day 35±3 postpartum scored for BSC, synchronized using PG-3-G + Ovsynch protocol and randomly allocated into two treatments: PRID group (n=27) treated with external P4 device between G1 and PGF
and CON group (n=21) left without treatment. Collection of blood samples to assess P4 concentrations was done at Pre-PG, at G1, at PGF
, at 72 h after PGF
(at timed artificial insemination TAI) and at d 21 after TAI. The pregnancy diagnosis was done at d 21 and d 30 after TAI by ultrasound. The average temperature-humidity index (THI) was 79.5±0.6. At G1, the P4 was significantly lower in the PRID group (1.84±0.99 ng/mL) in comparison to the CON group (2.97±1.82 ng/mL). In contrast, at PGF
, there was a tendency (p=0.09) of increased P4 concentration in PRID group compared with the CON group (4.26±1.68 and 3.74±2.39 ng/mL), respectively. At TAI, more PRID cows (p=0.0001) had a lower P4 (0.06±0.03 ng/mL), in comparison to CON (1.28±2.41 ng/mL). At d 21 and d 30 after TAI, more PRID cows were predicted and diagnosed pregnant (16/27 or 59.25% and 13/27 or 48.14%) compared with the CON group (11/21 or 52.38% and 8/21 or 38.08%) respectively, but without any significant differences. Supplementation of the P4 during the Ovsynch protocol increases the P4 before TAI and reduces the incomplete luteolysis in heat stressed dairy cows.
The present study aimed to evaluate whether the induction and the formation of an accessory corpus luteum (CL) after AI might increase the pregnancy per AI (P/AI) in heat stressed dairy cows. ...Starting at d 50±3 post-partum, 113 lactating Holstein cows from one commercial herd during summer were scored for body condition, blood sampled and examined by ultrasound. Those bearing a CL>25mm and progesterone (P4) level>2ng/mL were synchronized using a double PGF
α injection given 12 h apart and AI-ed at detected estrus. In total 18 cows, there were not any signs of estrus (n=10) nor a P4 level <2ng/mL at the time of enrolment (n=8) and therefore they were excluded from the study, leading to 95 cows finally enrolled.. At d5 post-AI, cows were randomly allocated into 2 groups: control group (CON, n=45) without any additional treatment, and treatment group (GnRH, n=50), treated with 0.008 mg Buserelin – a GnRH agonist. Blood sampling and ultrasound examination were done at d5, d14 and at d21 after AI, whereas the pregnancy diagnosis was done at d21 and d30 after AI. Average daily temperature and relative humidity values were used to calculate the temperature-humidity index (THI). The average THI during the experiment was 79.5±0.6. At d5, no differences were observed neither between the number of the CL nor between the P4 level in both groups. At d14 and d21, 82% of the GnRH-treated cows had more than one CL versus 0% of the CON cows. Both at d14 and 21, GnRH-treated cows had higher P4 levels compared to the CON cows (p<0.05). In addition, P/AI were higher in the GnRH group than in the CON group (65% vs. 48.3%, p<0.05), whereas late embryonic losses were higher in CON in comparison to GnRH cows (10.6 vs. 4%, respectively). The BCS at the moment of insemination did not affect P/AI (p>0.05). In conclusion, the induction of an accessory CL at d 5 after AI might increase P/AI in heat stressed dairy cows.
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