Smjernice međunarodnih stručnih društava ukazuju da je povišena koncentracija lipoproteina(a)
Lp(a) u krvi dugoročni neovisni čimbenik rizika za razvitak aterosklerotske kardiovaskularne bolesti ...(ASKVB), kao i za kalcifikacijsku stenozu aortnih zalistaka. Cilj je ovog članka koji je rezultat konsenzusa nacionalnih stručnjaka iz tog područja predstaviti najnovije spoznaje o dijagnostici i sadašnjim mogućnostima liječenja bolesnika s povišenom koncentracijom Lp(a) u krvi koje su u ovom trenutku skromne, ali i naznačiti buduće mogućnosti liječenja koje su na pomolu. Zaključak koji se može postaviti na temelju dosadašnjih spoznaja upućuje da postoji neposredna korist za bolesnike u mjerenju koncentracije Lp(a), čak i ako potpuno učinkovito farmakološko liječenje još nije dostupno. Mjerenje Lp(a) olakšava bržu i pouzdaniju identifikaciju bolesnika s visokim kardiovaskularnim rizikom i bolje upravljanje tim rizikom, odnosno upućuje na potrebu intenzivnijeg smanjivanja i liječenja ostalih čimbenika rizika za ASKVB ako je Lp(a) značajnije povećan. Izražavanje koncentracije Lp(a) preporučuje se u nmol/L izmjerene metodama kalibriranim kalibratorima čija je koncentracija izražena u nmol/L.
Alcoholic liver disease is the most prevalent cause of progressive liver disease in Europe. Alcoholic cirrhosis occurs in 8%-20% of cases of alcoholic liver disease. It has significant influence on ...cardiovascular system and haemodynamics through increased heart rate, cardiac output, decreased systemic vascular resistance, arterial pressure and plasma volume expansion. Cirrhotic cardiomyopathy is characterised by systolic and diastolic dysfunction and electrophysiological abnormalities, if no other underlying cardiac disease is present. It is often unmasked only during pharmacological or physiological stress, when compensatory mechanisms of the heart become insufficient to maintain adequate cardiac output. Low-to-moderate intake of alcohol can be cardioprotective. However, heavy drinking is associated with an increased risk of cardiovascular diseases, such as alcoholic cardiomyopathy, arterial hypertension, atrial arrhythmias as well as haemorrhagic and ischaemic stroke. Alcoholic cardiomyopathy is characterised by dilated left ventricle (LV), increased LV mass, normal or reduced LV wall thickness and systolic dysfunction.
This paper provides an analysis of Andrija Štampar’s activities after World War II on the establishment of effective international health. Analyzed archival materials have confirmed with numerous ...evidence that Štampar as the president of the Interim Commission of the World Health Organization (WHO) played a crucial role in the establishment of the ideological starting points and organization of the WHO system, which remain relevant to date. Apart from the strategic foundations, it has been shown that his principles regarding the need for practical action based on the best professional knowledge and experience have no alternatives. The above is presented in the paper with the details of Štampar’s activities during the cholera epidemic in Egypt and associated with the experiences of the recent global crisis caused by the COVID pandemic.
Rad donosi pregled aktivnosti Andrije Štampara nakon Drugoga svjetskog rata i opisuje zatečeno stanje neaktivnih nacionalnih zdravstvenih organizacija. Obrađenom arhivskom građom brojnim je dokazima utvrđeno kako je upravo Andrija Štampar, kao predsjednik tzv. Prijelazne komisije Svjetske zdravstvene organizacije (SZO), tadašnjim intenzivnim djelovanjem presudno djelovao na uspostavu ideoloških polazišta i organizacije sustava SZO, koji ostaju aktualni do danas. Osim strateških osnova, pokazalo se da njegova načela potrebe praktičnog djelovanja utemeljenog na najboljim znanjima i iskustvima struke nemaju alternative. To je u radu ilustrirano detaljima Štamparova globalnog djelovanja tijekom epidemije kolere u Egiptu i povezano s iskustvima nedavne globalne krize uzrokovane COVID pandemijom.
Purpose The aim of this study was to investigate the connection between erectile dysfunction (ED) and cardiovascular diseases and to test a novel visual-scale questionnaire (VEF) we propose for the ...assessment of erectile function.
Subjects and methods Erectile function was assessed in 170 male cardiovascular patients under the age of 70 by the use of several selfadministered questionnaires: the International Index of Erectile Function-5 (IIEF-5); the Massachusetts Male Aging Study questionnaires (MMAS Sexual Activity Questionnaire and MMAS Single Question), and finally, VEF.
Results Patients' mean age was 55.65 ± 9.97 y. The most common indications for hospitalization were coronary artery disease (CAD) (n = 82, 48%), and decompensated chronic heart failure (n = 30, 18%). The prevalence of ED as determined by IIEF-5 was 58% (n = 99). Patients with ED were on average 5.7 years older (P = 0.0001), had a higher frequency of diabetes (by 19%, P < 0.01), and a somewhat higher level of uric acid (by 72 μmol/l, P < 0.01). Results of the VEF correlated significantly with those of other questionnaires. Three different machine learning algorithms demonstrated a greater accuracy of VEF than IIEF-5 and MMAS Sexual Activity Questionnaire in predicting ED severity.
Conclusion ED is highly prevalent among cardiovascular patients. The Visual Scale Erectile Function questionnaire (VEF) is a simple and valid tool, suitable for quick screening of this condition.
To elucidate the mechanisms involved in apoptosis of psoriatic keratinocytes by examining the expression of pro-apoptotic (Bak, Bax) and anti-apoptotic (Bcl-2, Bcl-X) Bcl-2 family of proteins, as ...well as the expression of p53 and Ki-67 proteins in normal skin, and uninvolved and involved psoriatic skin.
A total of 90 skin samples (30 cases of involved and uninvolved psoriatic skin and normal skin) were examined immunohistochemically to determine the protein expression of p53, Ki-67, Bcl-2, Bcl-X, Bax, and Bak. The results were quantified and expressed as a percentage of positive keratinocytes.
There was a significant increase in Ki-67 (17.05 vs 3.65; P<0.001), Bcl-X (40.21 vs 13.97; P<0.001), Bak (89.46 vs 73.36; P<0.001), and Bax (50.00 vs 29.25; P<0.001) expression and a decrease in Bcl-2 (3.23 vs 6.25; P=0.008) expression in involved psoriatic skin, as well as an increase in Bcl-X (25.13 vs 13.97; P<0.001) expression in uninvolved psoriatic skin, when compared to normal skin. Samples with higher percentage of Ki-67 positive cells showed a higher percentage of p53 positive cells (correlation coefficient r=0.75 in involved psoriatic samples, P<0.001; r=0.88 in uninvolved psoriatic samples, P<0.001; and r=0.85 in normal skin samples, P<0.001). Samples with higher percentage of p53 positive cells expressed pro-apoptotic Bak and Bax in higher percentage of cells; the correlation coefficients were r=0.74 and r=0.68 in involved psoriatic samples (P<0.001 for both), r=0.75 and r=0.69 in uninvolved psoriatic samples (P<0.001, for both), and r=0.87 and r=0.70 in normal skin samples (P<0.001, for both).
Increased expression of Bcl-X protein was associated with psoriatic epidermal hyperplasia. Strong Bax and Bak expression in involved psoriatic skin are probably inhibitory mechanisms counteracting intensive proliferation.
Acute coronary syndrome (ACS) presents today the leading group of post-operative cardiovascular complications, while endothelial dysfunction (ED) is one of the key elements in its development. The ...chronic ED represents thus the basis for the gradual development of atherosclerotic changes, while its sudden aggravation leads to ACS. The persistent ED occurs due to the effects of chronic cardiovascular risk factors, while according to the available studies it can also develop or aggravate under the impact of different acute events. We have directed this study to the investigation of the dynamic of endothelial function before and after a major orthopaedic surgical intervention. This randomised prospective study included 19 patients that underwent the intervention of total knee replacement and 20 healthy examinees of the adequate age and gender High-resolution ultrasound test based on the flow mediated dilatation of the brachial artery is what at we carried out at the beginning of the research, respectively 12, 24, 48 and 72 hours, as well as 7 days after the surgical intervention. The starting values of the FMD test were within the normal range in both groups, although the ability of dilatation upon stimulus was significantly lower in the investigated group. The FMD percentage change in the total sample was negatively connected with the body weight, not having shown additional connections with other cardiovascular risk factors. During the early post-operative period, a significant transitory lowering of the FMD percentage change was recorded, having reached the lowest value 24 hours after the surgery. During the seven-day prospective surveillance, no significant cardiovascular complications were recorded. Further research is necessary in order to confirm these results as well as the testing of the possible connection of the described post-operative transitory endothelial dysfunction with the development of cardiovascular complications and the adverse event.
At a time when the Internet has become an inseparable part of the everyday lives in the population of developed countries, the awareness of the need for its use in health promotion and disease ...prevention is continuously increasing. Although there are numerous studies in this field that are still in progress, at the time being we have more open questions than safe answers. Health issues are on the internet dominated largely by unfounded commercial promotions and sales campaigns, while professional content tends to be limited to the official web site of professional societies. Promotion health campaigns that are based on proven and effective -- evidence based platforms are still sporadic. Because of its specificity and longevity, the prevention and treatment of obesity is area of a special interest. It seems that the Internet-based education, practical materials, web -- medical and psychological counseling, and controlled support groups within social networks represent the next major step in the development of effective therapeutic strategies for obesity.
Obesogens – new global health problem? Ćurić, Melany; Klobučar Majanović, Sanja; Detel, Dijana ...
Periodicum biologorum,
07/2022, Volume:
123, Issue:
3-4
Journal Article
Open access
Obesity is a serious global public health problem. It is a complex disease caused by a combination of several factors including overeating and a sedentary lifestyle, genetic susceptibility and ...environmental factors. Substantial scientific evidence indicates that increase in obesity prevalence correlates with increase in production and human exposure to environmental chemicals, suggesting that a long list of chemical compounds that can be found all around us may play a role in the etiology of obesity.Endocrine disrupting compounds (EDCs) are chemicals that can interfere with the function of endocrine system. A subclass of EDCs that can disrupt a great number of metabolic processes including normal development of adipose tissue and balance of lipid metabolism thus leading to obesity are called obesogens. They can be found in electronics, plastics, furniture, clothes, cosmetics and also in the air, water and food that people consume. Persistent organophosphate pesticides, flame retardants, nicotine and plastics have all been linked to obesity particularly if exposure occurs during early life (in utero, newborns). Early development is the most vulnerable period for obesogen exposure leading to epigenetic changes that persist throughout life.Current knowledge on obesogens is probably just „the tip of the iceberg“ and future research is needed as well as increasing public awareness of this problem and its implications to human health. It is important to establish control over obesogens and try to prevent or at least limit the exposure of people, especially children and pregnant women, to these dangerous and harmful chemical compounds.
To identify the risk factors of a repeated episode of severe febrile neutropenia (FN) and to build an accurate and easy-to-use predictive model.
This single-center retrospective cohort study ...conducted at the Clinical Hospital Center Children's Hospital Rijeka from January 1, 2008 to December 31, 2016 included pediatric patients with malignant diseases who experienced at least one FN episode. The association of the second severe FN episode appearance with relevant clinical and laboratory data was analyzed by logistic regression.
Out of 45 patients with one FN episode, 25 (56%) had severe FN and 11 (24%) had repeated severe FNs. Significant predictors of a repeated severe FN episode were the first FN episode duration of 9 or more days and red blood cells ≤3.0×1012/L. The predictive model constructed by crossing these two indicators had the accuracy of 87% (95% confidence interval CI 73%-94%), sensitivity of 82% (95% CI 53%-97%), and specificity of 88% (95% CI 79%-93%).
The first FN episode duration and anemia are significantly associated with the risk for severe FN re-occurrence. These factors may be useful in the identification of children with cancer who are at high risk for adverse outcome at any future fever onset and may benefit from early intensive treatment.
To test the psychometric properties of the Croatian version of the Chronic Venous Insufficiency Quality of Life (CIVIQ) Questionnaire and to assess the quality of life in patients with chronic venous ...disorders of all stages.
This cross-sectional study performed between 2014 and 2015 in a private family practice assessed the factorial validity, cross-sectional validity, and reliability of the Croatian CIVIQ 20-item questionnaire completed by 428 adult patients (78% women) with chronic venous disorders classified according to the Clinical-Etiologic-Anatomic-Pathophysiologic (CEAP) C classification as stages C1-C6.
Median patient age was 52 years (5th-95th percentile, 30-77). The distribution according to the clinical stages of chronic venous disorders was as follows: C1 (n=78, 18%), C2 (n=192, 45%), C3 (n=53, 12%), C4 (n=44, 10%), C5 (n=13, 3%), and C6 (n=48, 11%). The CIVIQ-20 factorial structure was unstable, and six items were excluded from the analysis to test the psychometric properties of the shortened version (CIVIQ-14). CIVIQ-14 has three dimensions (physical, psychological, and pain). Internal consistency reliability is high for the entire CIVIQ-14 (Cronbach α=0.92) and for all CIVIQ-14 dimensions (α≥0.80). The median quality of life significantly decreased with higher CEAP C stages as follows: C1/C2 (86, 50-100); C3/C4 (75, 36-98); C5/C6 (67, 31-95) (P<0.001). Post-hoc analysis showed a higher quality of life in C1/C2 than in other groups (P<0.001).
The shortened CIVIQ-14 version is useful for assessing the quality of life in patients with chronic venous disorders in everyday clinical practice. To achieve a stable validated instrument, we recommend a cross-cultural validation of items that have loadings on more than one factor.
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