Overview and management of different post-COVID conditions Janković Makek, Mateja; Babić, Zdravko; Barun, Barbara ...
Rad Hrvatske akademije znanosti i umjetnosti (1991). Medicinske znanosti,
06/2022, Letnik:
552, Številka:
58-59
Journal Article
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Coronavirus disease 2019 (COVID-19) pandemic resulted in global healthcare crises and strained health resources, both in the acute and chronic phase of the disease. Similarly to post-acute viral ...syndromes described in survivors of other virulent coronavirus epidemics, there are increasing reports of persistent and prolonged symptoms after acute COVID-19. These reports and studies have helped contribute to the recognition of post-COVID-19, a syndrome characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms. Here, we provide a comprehensive review of different manifestations of post-COVID conditions and propose a framework for the identification of patients at higher risk for post- COVID and their coordinated management through dedicated COVID-19 outpatient clinics.
Introduction: Chronic kidney disease (CKD) is an independent risk factor for cardiovascular (CV) disease and premature deaths. The worldwide prevalence of CKD in 2017 in the general population is ...9.1%. In this paper our primary aim was to present preliminary data on incidental, i.e., newly discov- ered CKD and the overall prevalence of CKD in the adult population in Croatia. Secondary aim was to compare these data with the data of the CKD prevalence of the adult population from the rural part of Croatia (results of the ENAH study).
Materials and Methods: This cross-sectional observational study included random, representative sample of general adults in Croatia, 781 subjects who were part of the large cohort from the EH-UH 2 study. The eGFR was calculated by creatinine-based CKD EPI equation. Albuminuria was determined from the albumin to creatinine ratio in urine (ACR) in 691 subjects.
Results: The overall prevalence of CKD in Croatia was 12.7%, of which 9.5% were newly discovered CKD, and only 3.2% were subjects with previously known CKD. According to the albuminuria level, 30.7% of the adult population belonged to the group with a moderate risk of CKD progression, and 7% had a high risk, while 2.5% of the study subjects had a very high risk. Predictors for newly discov- ered CKD are older age, higher urate and potassium, antihypertensive therapy, angina pectoris, atrial fibrillation, lower hemoglobin level.
Conclusions: These results continue in a pilot project of the Croatian Kidney Society and the Croatian Hypertension League on the implementation of an action plan to detect new kidney disease in the general population in real life, in a collaboration of primary care physicians and nephrologists.
Bolesnici s upalnim bolestima crijeva (inflammatory bowel disease, IBD) i manjkom vitamina D su pod povećanim rizikom hospitalizacije, operacije i gubitka odgovora na biološku terapiju, dok visoke ...serumske razine vitamina D predstavljaju zaštitni čimbenik. Cilj ove studije bio je istražiti učestalost neliječenih i nedovoljno liječenih bolesnika s IBD i manjkom vitamina D te čimbenike rizika. U ovoj presječnoj studiji mjerene su serumske razine vitamina D u slučajnom uzorku bolesnika s IBD bijele rase. Deficijencija je definirana kao razine <50 nmol/L, a insuficijencija kao 50-75 nmol/L. Nadoknada vitamina D je definirana kao uzimanje 800-2000 IJ vitamina D na dan. Neliječeni bolesnici su oni bez nadoknade, a nedovoljno liječeni oni s deficijencijom ili insuficijencijom usprkos nadoknadi. Uključeno je ukupno 185 bolesnika s IBD, tj. 126 (68,1%) s Crohnovom bolešću i 59 (31,9%) s ulceroznim kolitisom. Ukupno je 108 (58,4%) bolesnika imalo deficijenciju, a 60 (32,4%) insuficijenciju. Udio liječenih bolesnika s deficijencijom i insuficijencijom vitamina D iznosio je 14,8% (n=16) i 18,3% (n=11).
Udio neliječenih s deficijencijom iznosio je 81,7% (n=49), a s insuficijencijom 85,2% (n=92). Terapija inhibitorima faktora
tumorske nekroze alfa bila je povezana s višim razinama vitamina D. Niže razine vitamina D su zabilježene kod bolesnika s upalom u području ileuma i resekcijom ileuma ili ileokolona. U zaključku, niske serumske razine vitamina D su česta pojava kod bolesnika s IBD, a dodatno je udio neliječenih i nedovoljno liječenih također visok. Naša preporuka je kontinuirano praćenje razina vitamina D u serumu svih bolesnika s IBD uključujući i one na nadoknadi vitaminom D.
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