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Antiphospholipid syndrome associated with non-infective mitral valve endocarditis: a case report
No full textWe present a rare case of antiphospholipid syndrome associated with non-infectious thrombotic endocarditis of the mitral valve. The patient was admitted to hospital for examination because of skin lesions manifested through a discoid skin rash. During the hospitalization antiphospholipid syndrome was diagnosed along with ultrasound verification of vegetations on the mitral valve, including both leaflets, with moderate to severe mitral regurgitation. Adequate and opportunely introduced therapy led to regression of all symptoms, including endocarditis of the mitral valve on checkup ultrasound verifications, with a prevention of arterial and/or venous thrombosis in patient\u27s future
Antibiotic combinatorial approach utilized against extended spectrum beta-lactamase (ESBL) bacteria isolates from Enugu, South Eastern Nigeria
No full textIntroduction: Antibiotic options in the treatment of extended spectrum beta-lactamase (ESBL) producing bacteria are very limited. The purpose of this study was to analyze several commonly applied antibiotics in quite various novel combinations for use against ESBL-producing bacteria isolates.Methods: Total of 460 samples of urine, throat and anal swab were collected from volunteers and patients from nursery, primary and secondary schools and from other individuals in the community. Hospital and community isolates comprised of 65% and 35% respectively. The identification and characterization of the isolates were done by standard culturing and in vitro antibiotic sensitivity procedures.Results: The antibiotic combination studies showed that the combination of gentamicin with the other antibiotics had predominantly synergistic effects. The percentage synergistic effect for the combinations of gentamicin/pefloxacin was 69%, gentamicin/[Amoxicillin and clavulanic acid] 72%, gentamicin/ceftriaxone 68%, gentamicin/cefuroxime 81.9%, and gentamicin/ciprofloxacin 80.6%, against the community and hospital derived ESBL producing organisms of both Enterobacteriaceae and Pseudomonas species.Conclusion: Good antimicrobial monitoring exercise and corresponding antimicrobial screening activities should work towards a dynamic approach to generate effective treatment options using combination therapy
A Network for Eating and Nutrition as a platform for cooperation over the organisational borders between healthcare sectors in Sweden
Get PDFIntroduction: Requirements to implement scientific knowledge in practice within the Swedish health and social care sectors have increased during the last decades. One of these networks was the Network for Eating and Nutrition that began in 2003. The aim of this study was to retrospectively evaluate how the Network for Eating and Nutrition has functioned during a period of ten years and in what way it has affected work practice.Methods: This is a descriptive qualitative study. Data sources for this study were meeting records collected over 10 years and two evaluation surveys (at five and 10 years). Participants were members of the Network for Eating and Nutrition (n=12 at five years and n=10 at 10 years). The manifest qualitative content analysis was used.Results: The Network for Eating and Nutrition was seen as offering support for personal and organisational knowledge development. Further aspects of support from the workplaces of the members and the significance for the work places were described. Further the Network for Eating and Nutrition reached out to care receivers by using specifically tailored education programmes and material. The Network for Eating and Nutrition results and recommendations were described as important references for the development of nutrition routines.Conclusion: Networks between organisations with different professional backgrounds can form a basis for knowledge exchange both for focus on the specific topic but also on how to work with quality improvement, i.e. evidence based practice
Lymphangiogenesis in breast carcinoma is present but insufficient for metastatic spread
No full textIntroduction: The lymphatic vasculature is an important route for the metastatic spread of human cancer. However, the extent to which this depends on lymphangiogenesis or on invasion of existing lymph vessels remains controversial. The goal of this study was to investigate the existence of lymphangiogenesis in invasive breast carcinoma: by measuring the lymphatic vessels density (LVD) and lymphatic endothelial cell proliferation (LECP) and their correlation with various prognostic parameters in breast cancer, including lymphovascular invasion (LVI).Methods: Lymphatic vessels density was investigated in 75 specimens of invasive breast carcinoma by immunostaining for D2-40 using the Chalkley counting method. Endothelial proliferation in lymphatic vessels was analyzed by dual-color immunohistochemistry with D2-40 and Ki-67.Results: Decrease of intra and peritumoral LVD in invasive breast carcinoma compared to fibrocystic breast disease was detected (p=0.002). Lymphatic endothelial cell proliferation was significantly higher in invasive breast cancer (p=0.008) than in the fibrocystic breast disease. LECP showed a correlation with histological grade of the tumor (p=0.05). Involvement of axillary lymph nodes with metastatic tissue was in strong correlation only with existence of lymphatic vascular invasion (p=0.0001).Conclusion: These results suggest that development of breast cancer promotes proliferation of lymphatic endothelial cells whose level correlates with histological grade of tumor, but in a scope that is insufficient to follow growth of tumor tissue that invades them and destruct them. This might explain the decrease of lymphatic vessels density
Influence of coffee consumption on bone mineral density in postmenopausal women with estrogen deficiency in menstrual history
Get PDFIntroduction: Complex etiology of osteoporosis include genetic, hormonal, environmental and nutritional factors. The aim of this study was to examine influence of coffee consumption on bone mineral density in postmenopausal women with estrogen deficiency in menstrual history.Methods: This prospective study included 100 postmenopausal women, aged 50-65 years living in Sarajevo area, with estrogen deficiency in their menstrual history. The controlled clinical trials were conducted. Two groups were formed (based on bone mineral density values). The examination group included 50 women who had osteoporosis, while the control group included 50 women without osteoporosis (osteopenia, normal bone mineral density). The lumbar spine and proximal femur bone mineral density was measured by Dual–Energy X–ray Absorptiometry using Hologic QDR-4000 scanner. Coffee drinking habits were assessed for each subject.Results: The average daily intake of coffee in women with estrogen deficiency in menstrual history was at 267.6 ml in the examination group and in the control group 111.6 ml. The difference in the average daily intake of coffee between the two groups was statistically significant (p < 0.001). There was registered significant correlation between intake of coffee and bone mineral density in examination (p < 0.01) and in control group (p < 0.05).Conclusion: This study indicates that coffee consumption is a risk factor for osteoporosis in postmenopausal women, aged 50-65 years living in Sarajevo area, with estrogen deficiency in their menstrual history. It was shown that the effects of coffee on bone mineral density are dose-dependent
Bilateral Epididymal Cyst in 14 year-old Boy: a case report
No full textBilateral epididymal cysts are rare in childhood. Clinically they may present as acute scrotum and should be differentiated from other pathologies. Here in, we report bilateral epididymal cysts in a 14-year-old boy. He was admitted to emergency department with symptoms of acute left scrotum. There was no history of trauma or infection. Blood analyses, including testis tumor markers were unremarkable. Bilateral epididymal cysts were diagnosed on ultrasonography evaluation. Medical treatment did not stop his scrotal pain. During scrotal exploration, there was no evidence of testicular torsion or any other pathology. An excision of cyst was performed. Histopathologically, the cyst wall was lined by columnar epithelia. As a result of these findings, a pathological diagnosis of epididymal cyst was made. The synchronized evaluation of clinical and ultrasonography findings with an appropriate histopathological evaluation can usually diagnose this rare pathology
The evaluation of B-type Natriuretic Peptide and Troponin I in acute myocardial infarction and unstable angina
Get PDFIntroduction: The diagnostic utility of B-type natriuretic peptide (BNP) has prompted interest in its use as an aid in the detection of early heart failure and assessment of diseases. The first objective of this study was measurement of BNP and troponin I (TnI) blood levels in patients with acute myocardial infarction (AMI) and unstable angina. The second objective of this study was to find a correlation between TnI and BNP in blood.Methods: The concentrations of BNP and TnI in 150 blood levels were determined using CMIA (chemiluminescent microparticle immunoassay) Architect and 2000 (Abbott diagnostics). The retrospective study included 100 patients who were hospitalized at the Department of Internal Medicine of the University Clinical Center Sarajevo and 50 healthy control. The reference blood range of BNP is 0-100 pg/mL and TnI is 0.00-0.4 ng/mL.Results: In the patients with AMI the mean value of BNP is 764.48 ± 639.52 pg/mL and TnI is 2.50 ± 2.28ng/mL. The patients with unstable angina have BNP 287.18 ± 593.20 pg/mL and TnI 0.10 ± 0.23 ng/mL. Our studies have shown that the correlation between BNP and TnI was statistically significant for p< 0.05 using Student t test with correlation coefficient r = 0.36. Conclusions: BNP and TnI levels can help to identify the patients with a high risk for cardiovascular diseases
The effects of education and training on self-esteem of nurse leaders
Get PDFIntroduction: A successful leader must have high self-esteem. The main aims of this study were to identify changes in the self-esteem of nurse leaders in Slovenia from 2001 to 2011 and to determine homogeneous groups of leaders with similar personal characteristics.Methods: The study used a version of a personal characteristics questionnaire with 16 self-descriptive statements. Two surveys were conducted among nurse leaders in Slovenian public hospitals, one in 2001 and the other in 2011. Relationships between variables were analysed using chi-square tests for categorical variables and the one-way analysis of variance for quantifiable variables. Factor analysis was used to determine groups of leaders with similar personal characteristics.Results: A total of 327 nurse leaders participated in the survey in 2001 and 296 filled in questionnaires in 2011. The analysis showed that the level of self-assessment of personal characteristics among nurse leaders in Slovenian public hospitals was significantly higher in 2011 than in 2001, and that differences among individual leaders decreased in most areas. Based on the assessments of personal characteristics, four groups of nurse leaders were established: task-oriented, knowledge and creativity oriented, relationship oriented and extroverted nurse leaders. In the 2011 data, the groups of personal characteristics were much more clearly defined. These groups were established in accordance with leadership theory and research from other fields.Conclusions: The positive effects of better education and training are visible in nurse leaders in terms of both their higher self-esteem and in the establishment of more homogeneous groups of leaders
The role of natural supplement of apple vinegar and syrup in the management of type 2 diabetes mellitus
Get PDFIntroduction: The increased risk of coronary artery disease in diabetics could be explained by the lipoprotein irregularities associated with diabetes mellitus. The primary aim of this study is to examine the role of apple vinegar and syrup in the management of type 2 diabetes mellitus.Methods: The interventional study included 500 participants (195 men and 305 women) with dyslipidemia and prediabetes or type 2 diabetes mellitus, aged 50-70 years, living in Sarajevo area. Patients were recruited from 5 outpatient diabetes counselling departments and treated with natural apple vinegar and syrup supplementation over a period of five weeks. The patients have been evaluated before treatment and 5 weeks after the treatment. During the study, dosage of drugs for diabetes or prediabetes was not changed.Results: After 5 weeks of supplementation with apple vinegar and syrup waist circumference (p=0.016), total cholesterol (p=0.01), low density lipoprotein (LDL) cholesterol (p=0.008) and triglycerides (p=0.019) were significantly reduced, as well as blood pressure (-14%). Study results show decrease of mean fasting blood levels of glucose, but statistically not significant (p=0.058). The body mass index also decreased insignificantly (p=0.089). The high density lipoprotein cholesterol level was not increased significantly after supplementation (p=0.26).Conclusion: According to our results, apple vinegar has important role in reduction of total cholesterol levels, triglycerides, LDL cholesterol and waist circumference in patients with type 2 diabetes. Also, it has positive effect on blood pressure
Effect of Costus igneus: The insulin plant, on prediabetes and diabetes in neonatal streptozotocin rats
Get PDFIntroduction: Pre-diabetes is a condition that persists for a considerable duration before progressing into type 2 diabetes mellitus (T2DM). Development of resistance to insulin is the underlying cause of pre-diabetes, preventive measures such as diagnosis, treatment and exercise will preclude its development into T2DM. The present study aims at studying the effect of pre-treatment and post-treatment with isolated fraction of Costus igneus on pre-diabetes and diabetes in neonatal streptozotocin (STZ) induced T2DM.Methods: Neonatal rats were treated with STZ and differentiated for pre-treatment and post-treatment. Rats of pre-treated group were treated with isolated fraction of Costus igneus (CIF) from 4th week after STZ administration and after 12th week in non-treated rats of post-treatment group. The antihyperglycemic was studied on 7th and 12th week after STZ treatment using oral glucose tolerance test and the hypoglycemic effect was studied on day 1, 7, 14 and 21 of treatment after 12th week of STZ treatment in both pre and post treated groups.Results: Oral glucose tolerance test on 7th and 12th week had shown a protective effect against increase in blood glucose levels in pre-treated groups whereas, no such significant decrease was observed in non-treated groups. In the effect on hypoglycemia, a reduction in blood glucose levels was observed on treatment with CIF in both pre and post treated rats on 14th and 21st day.Conclusions: Treatment with CIF in pre-diabetic stage could reduce the chances of progression into T2DM and is also beneficial in diabetic rats, which could be due to increase in the peripheral utilization of glucose and the insulin mimetic effect of Costus igneus