Family physicians (FPs) are exposed to high amounts of stress, and could be susceptible to the development of mental health disorders (MHD), especially after the emergence of the COVID-19 pandemic. ...The aim of the current study was to assess MHD history, attitudes toward MHDs and stress-coping strategies in FPs. An additional goal was to estimate their comprehensive well-being and investigate connections with resilience and a healthy lifestyle. A total of 483 FPs submitted their responses via online survey. MHD attitudes were assessed with the according questionnaires, while burnout levels, healthy lifestyle, resilience, job and life satisfaction were estimated with validated scales. Results have shown that 32.5% of FPs disclosed positive MHD history, while 68.7% used professional help. Resilience and healthy lifestyle levels were significantly higher in MHD negative FPs (
< 0.001), while burnout levels were lower (
< 0.001). Moreover, healthy lifestyle (β = 0.03,
< 0.001) was an independent correlate of resilience, while healthy lifestyle (β = -0.35,
< 0.001, and resilience (β = -1.82,
< 0.001) were of burnout levels. Finally, resilience (OR = 0.387,
< 0.001) and healthy lifestyle (OR = 0.970,
= 0.021) were shown as independent predictors of positive MHD history status. Strong promotion and education of FP population regarding resilience and healthy lifestyle should be utilized in practice in order to alleviate the possibility of mental health disturbances and the according consequences.
The prevalence and incidence of gout doubled from 1990 to 2017. Therefore, we can expect that a number of doctors have come across a patient with gout in their daily practice. Hence, we wanted to ...investigate how familiar our medical students, as future medical professionals, are with gout. This cross-sectional survey included Medical Studies students from the two largest universities in Croatia: the University of Split School of Medicine, and the University of Zagreb School of Medicine, and included a total of 221 fifth or sixth year medical students. Most students gave correct answers to questions about treatment approach and non-pharmacological interventions in asymptomatic hyperuricemia (>80%). Less than 3% of all students agreed they knew enough about care for patients with asymptomatic hyperuricemia, whereas almost 15% thought they were well familiar with care for gout patients. Less than 8% of students considered their school education adequate on both topics, and less than 2% were aware of the existence of EULAR guidelines. Physicians lacking in the latest knowledge on the pathophysiology of gout, the influence of lifestyle, and genetic factors limits their ability to properly manage gout. With increasing prevalence, gout should be more represented in medical students' education.
Purpose
Primary aim of the study was to investigate the status of different health-related quality of life (HRQoL) domains in postmenopausal women with osteoporosis and osteopenia, and to explore ...possible associations with bone microarchitecture and nutritional status.
Methods
This was a single-center cross-sectional study that included 232 postmenopausal women, from which they were divided into three groups—osteoporosis (OP,
N
= 63), osteopenia (OPIA,
N
= 123), and control group (
N
= 46). Detailed medical history data and anthropometric measurements were taken from all women. Bone structure parameters were taken with DXA device, with additional analysis of bone microarchitecture status with Trabecular Bone Score (TBS). Nutritional status was assessed with Mini Nutritional Assessment (MNA) questionnaire, and HRQoL with Medical Outcomes Study Short Form-36 (SF-36) questionnaire.
Results
Nutrition evaluation analysis have shown that patients in OP group had significantly lower values of MNA score compared to the OPIA group and control group (
P
= 0.005). Furthermore, a significant positive correlation was found between all of the SF-36 domains and MNA scores, while significant positive correlation was found between TBS values and Physical functioning (
P
< 0.001), Bodily pain (
P
= 0.027), Social functioning (
P
= 0.029), and Vitality domains (
P
= 0.041) in total investigated population. Further analyses were performed only in OP and OPIA groups, and TBS score showed significant positive correlation with Physical functioning (
r
= 0.248,
P
< 0.001) and Bodily pain domains as well (
r
= 0.180,
P
= 0.014), while MNA score positively correlated with each of the SF-36 domains. Multiple regression models have shown that MNA score retained significant association with each SF-36 domains, and TBS value with Physical functioning (
P
= 0.003), Social functioning (
P
= 0.012), and Vitality domains (
P
= 0.014).
Conclusion
This study highlights the associations that TBS has with some domains of HRQoL in postmenopausal women with osteoporosis and osteopenia. Moreover, nutritional status could play a role in the complex interplay between TBS and HRQoL.
Abstract
Study Objectives
The aim of this study was to investigate differences in dual-energy X-ray absorptiometry (DXA) parameters, trabecular bone score (TBS), bone turnover markers and inactive ...matrix Gla protein (dp-ucMGP) between patients with obstructive sleep apnea (OSA) and healthy controls.
Methods
This study enrolled 53 male patients diagnosed with OSA, and 50 age- and body mass index (BMI)-matched control subjects. All participants underwent DXA imaging, TBS assessment and blood sampling for biochemical analysis of bone metabolism markers.
Results
Mean apnea–hypopnea index (AHI) score of OSA patients was 43.8 ± 18.8 events/h. OSA patients had significantly higher plasma dp-ucMGP levels in comparison to controls (512.7 ± 71.9 vs. 465.8 ± 50.9 pmol/L, p < 0.001). OSA and control group did not significantly differ regarding standard DXA results, while TBS values were significantly lower in the OSA group (1.24 ± 0.17 vs. 1.36 ± 0.15, p < 0.001). AHI score was a significant independent correlate of plasma dp-ucMGP levels (β ± SE, 1.461 ± 0.45, p = 0.002). In addition, TBS retained a significant relationship with dp-ucMGP values (β ± SE, −93.77 ± 38.1, p = 0.001).
Conclusions
dp-ucMGP levels are significantly higher in patients with OSA and correlate with disease severity. In addition, TBS values in OSA patients are lower in comparison with the control group and decrease with disease severity.
During the coronavirus disease 2019 (COVID-19) outbreak, family physicians (FPs) are the backbone of the healthcare system with considerable impact on the general population, and their well-being is ...of great importance. The aim of this investigation was to assess FPs mental health, as well as knowledge, attitudes and practices (KAPs) regarding the pandemic, and opinions on non-communicable disease (NCD) health care provided to patients. A cross-sectional study was carried out with a sample of 613 FPs. Anxiety and depression levels were estimated with the Hospital Anxiety and Depression Scale, subjective perceived stress with the Perceived Stress Scale, while trauma-related symptoms were assessed using the Impact on Event Scale-COVID19. KAPs toward the pandemic and opinions regarding NCD patients were evaluated with questionnaires accordingly. Results have shown that age (β = -0.02,
= 0.013) and personal risk of COVID‑19 (β = 1.05,
< 0.001) were significant independent correlates of the knowledge score. A total of 87.7% FPs expressed moderate/high perceived stress, 45.2% moderate/severe trauma-related symptoms, 60.4% borderline/abnormal anxiety levels, and 52.4% borderline/abnormal depression levels. Knowledge score was an independent predictor of perceived stress (β = -0.33,
= 0.023) and anxiety (β = -0.31,
= 0.006) levels. Limited accessibility to healthcare services and decreased number of newly-diagnosed NCD cases were mostly agreed on. The pandemic puts a considerable strain on FPs mental health, as well as on public health measures, due to the decreased overall quality of NCD patient health care. Educational programs may bridge the gaps between FPs' knowledge. Thus lowering anxiety and improving patient care.
Glavni cilj ovog istraživanja bio je ispitati razlikuju li se stavovi o cijepljenju protiv bolesti COVID-19 studenata medicine i liječnika obiteljske medicine u Splitsko-dalmatinskoj županiji. ...Provedeno je presječno istraživanje u kojem je sudjelovalo 176 studenata medicine, 47 studenata dentalne medicine, te 100 liječnika obiteljske medicine. Ispitanici su rješavali anketni upitnik putem Google forms internetske aplikacije tijekom lipnja 2021. Korištena je peterostupanjska Likertova skala koja je sadržavala 27 tvrdnji. Prikupljeni podaci obrađeni su u programima STATISTICA 14 i Python. Utvrđeno je da pozitivan stav o svim cjepivima protiv bolesti COVID-19 ima statistički značajno više liječnika u odnosu na studente (P=0,038). Zadovoljstvo organiziranošću cijepljenja protiv bolesti COVID-19 statistički je značajno veće u liječnika nego studenata (P=0,006). Iako u procijepljenosti između studenata i liječnika nema statistički značajne razlike, ona je pronađena između studenata pretkliničkih i kliničkih godina studija (P=0,005). Udio cijepljenih veći je u studenata kliničkih godina (67%). Također, utvrđeno je, sa statistički značajnom razlikom, da su ispitanici koji su cijepljeni protiv gripe spremniji i na cijepljenje protiv COVID-19 bolesti (P=0,001), te da se značajno više liječnika nego studenata odlučilo na cijepljenje protiv gripe ove ili prethodnih sezona (P<0,001). Studijom je dokazano da su opći stavovi studenata medicinskog fakulteta i liječnika obiteljske medicine o cijepljenju pozitivni. Naime, poznato je da se stavovi pojedinca prema primjeni cjepiva uvelike odražavaju na procijepljenost i incidenciju zaraznih bolesti u populaciji, te je jako važno da i studenti, koji će biti aktivni sudionici zdravstvenog sustava i liječnici obiteljske medicine, koji su najdostupniji sudionici zdravstvenog sustava, imaju jednake stavove o najučinkovitijoj metodi zaštite populacije od širenja zaraznih bolesti.
The main goal of this research was to examine whether the attitudes about vaccination against the COVID-19 disease distinguish between medical students and family medicine doctors in the County of Split. In this cross-sectional study 176 medical students participated, 47 students of dental medicine and 100 family medicine doctors. The respondents answered a questionnaire via the Google forms internet application during June 2021. A five-point Likert scale containing 27 statements was used. The collected data were processed in STATISTICA 14 and Python programs. It was found that statistically significantly more doctors had a positive attitude about all vaccines against the COVID-19 disease than students (P=0.038). Satisfaction with the organization of vaccination against the COVID-19 disease was statistically significantly higher in doctors than in students (P=0.006). Although there was no statistically significant difference in vaccination between students and doctors, it was found between students in the preclinical and clinical years of study (P=0.005). The proportion of those vaccinated was higher in students of clinical years (67%). It was also determined, with a statistically significant difference, that respondents who had been vaccinated against the influenza were more willing to be vaccinated against the COVID-19 disease (P=0.001) and that significantly more doctors than students decided to get vaccinated against the influenza this season than in previous seasons (P<0.001). The study proved that the general attitudes of medical school students and family medicine doctors concerning vaccination are positive. To be specific, it is known that an individual's attitude towards the use of vaccines are largely reflected in the vaccination rate and incidence of infectious diseases in the population. It is very important that both students, who will be active participants in the health system and family medicine doctors, who are the most accessible participants in the health system, have equal views on the most effective method of protecting the population from the spread of infectious diseases.
Glavni cilj ovog istraživanja bio je ispitati razlikuju li se stavovi o cijepljenju protiv bolesti COVID-19
studenata medicine i liječnika obiteljske medicine u Splitsko-dalmatinskoj županiji. ...Provedeno je presječno
istraživanje u kojem je sudjelovalo 176 studenata medicine, 47 studenata dentalne medicine, te 100 liječnika
obiteljske medicine. Ispitanici su rješavali anketni upitnik putem Google forms internetske aplikacije
tijekom lipnja 2021. Korištena je peterostupanjska Likertova skala koja je sadržavala 27 tvrdnji. Prikupljeni
podaci obrađeni su u programima STATISTICA 14 i Python. Utvrđeno je da pozitivan stav o svim
cjepivima protiv bolesti COVID-19 ima statistički značajno više liječnika u odnosu na studente (P=0,038).
Zadovoljstvo organiziranošću cijepljenja protiv bolesti COVID-19 statistički je značajno veće u liječnika
nego studenata (P=0,006). Iako u procijepljenosti između studenata i liječnika nema statistički značajne
razlike, ona je pronađena između studenata pretkliničkih i kliničkih godina studija (P=0,005). Udio
cijepljenih veći je u studenata kliničkih godina (67%). Također, utvrđeno je, sa statistički značajnom
razlikom, da su ispitanici koji su cijepljeni protiv gripe spremniji i na cijepljenje protiv COVID-19 bolesti
(P=0,001), te da se značajno više liječnika nego studenata odlučilo na cijepljenje protiv gripe ove ili
prethodnih sezona (P<0,001).
Studijom je dokazano da su opći stavovi studenata medicinskog fakulteta i liječnika obiteljske medicine
o cijepljenju pozitivni. Naime, poznato je da se stavovi pojedinca prema primjeni cjepiva uvelike
odražavaju na procijepljenost i incidenciju zaraznih bolesti u populaciji, te je jako važno da i studenti, koji
će biti aktivni sudionici zdravstvenog sustava i liječnici obiteljske medicine, koji su najdostupniji sudionici
zdravstvenog sustava, imaju jednake stavove o najučinkovitijoj metodi zaštite populacije od širenja
zaraznih bolesti.
With the rising global burden of inflammatory bowel disease (IBD) and the rising costs of novel biological drugs, there is an increasing need for dietary approaches and functional foods that could ...modulate the course of IBD. The Mediterranean diet has proven to be efficacious in managing chronic inflammatory diseases, and recent studies have also shown its benefits in the setting of IBD. Since olive oil and its compounds have been shown to provide a considerable anti-inflammatory effect, in this review, we aim to discuss the latest evidence concerning the impact of olive oil and its bioactive compounds on IBD. Numerous preclinical studies have exhibited solid evidence on the mechanisms by which polyphenol-rich extra-virgin olive oil (EVOO) or specific polyphenols like hydroxytyrosol (HT) provide their anti-inflammatory, antioxidative, antitumour, and microbiota-modulation effects. Accordingly, several human studies that explored the effects of olive oil on patients with IBD further confirmed the evidence brought forward by preclinical studies. Nevertheless, there is a need for larger-scale, multicentric, randomized control trials that would finally elucidate olive oil's level of efficacy in modulating the course of IBD.
With the rising prevalence of Inflammatory bowel disease (IBD) worldwide, and the rising cost of treatment with novel biological drugs, there is an increasing interest in various diets and natural ...foods as a potential way to control/modulate IBD. As recent data indicates that diet can modify the metabolic responses essential for the resolution of inflammation, and as wine compounds have been shown to provide substantial anti-inflammatory effect, in this review we aimed to discuss the current evidence concerning the impact of biological compounds present in wine on IBD. A number of preclinical studies brought forth strong evidence on the mechanisms by which molecules in wine, such as resveratrol or piceatannol, provide their anti-inflammatory, anti-oxidative, anti-tumor, and microbiota-modulation effects. However, concerning the effects of alcohol, it is still unclear how the amount of ethanol ingested within the framework of moderate wine consumption (1–2 glasses a day) affects patients with IBD, as human studies regarding the effects of wine on patients with IBD are scarce. Nevertheless, available evidence justifies the conductance of large-scale RCT trials on human subjects that will finally elucidate whether wine can offer real benefits to the IBD population.
Primarily a consequence of sedentary lifestyle, atherosclerosis has already reached pandemic proportions, and with every year the burden of it is only increasing. As low-density lipoprotein ...cholesterol (LDL-C) represents a crucial factor in atherosclerosis formation and progression, stringent lipid-lowering therapy could conceivably be the key to preventing the unfavorable outcomes that arise as a consequence of atherosclerosis. The use of statins in lipid-lowering is often burdened by adverse events or is insufficient to prevent cardiovascular events as a monotherapy. Therefore, in the present review, the authors aimed to discuss the underlying mechanisms of dyslipidemia and associated atherosclerotic cardiovascular disease (ASCVD) and preclinical and clinical trials of novel therapeutic approaches to its treatment, some of which are still in the early stages of development. Apart from novel therapies, a novel change in perspective is needed. Specifically, the critical objective in the future management of ASCVD is to embrace emerging evidence in the field of atherosclerosis, because clinicians are often burden by common practice and personal experience, both of which have so far been shown to be futile in the setting of atherosclerosis.
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