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How to allocate intensive care resources during the COVID-19 pandemic: medical triage or a priori selection?
Get PDFPrognostički čimbenici vaskulitisa povezanih s antineutrofilnim citoplazmatskim protutijelima koji zahvaća bubreg [Prognostic factors in antineutrophyllic cytoplasmatic antibodies associated vasculitis with kidney involvement]
Get PDFIntroduction: ANCA associated vasculitis with renal involvement are heterogeneous
diseases. Some clinical, laboratory and pathohistological parameters determine
severity as well as prognosis and outcomes of the disease. -----
Patients and methods: This study included 108 patients diagnosed with pauciimmune glomerulonephritis between 2003 and 2016. All the patients met the Chapell
Hill consensus conference criteria for ANCA associated vasculitis. Patient follow up
was minimum one year, until death or loss in follow up or until December 2018.
Patients were categorized in clinical, serological and histopathological phenotypes
based on gathered clinical, laboratory and pathohistological data. We determined
predictors for combined ESRD and mortality outcome (ESRDD) as well as individual,
mortality, ESRD and relapse rates. -----
Results: Using Cox regression analysis we found lower hemoglobin levels, leukocyte
number, C3 staining in blood vessels and IFTA >50% to be independent negative
predictors for ESRDD. We found age, hemoglobin levels and BVAS score to be
significant negative predictors for death. Significant negative predictors for ESRD in
multivariate analysis were a need for renal replacement therapy and IFTA >50%.
Negative predictors of relapse were age, serum creatinine levels, diastolic blood
pressure and a need for renal replacement therapy. Interestingly ATO was shown to
be or had a strong tendency to be a significant negative predictor in univariate
analysis for all the outcome except for relapse. -----
Conclusion: The results of this research proved our hypothesis and showed the
importance of detailed multidisciplinary approach to AAV patients, detailed laboratory
work-up and correlations of laboratory and clinical findings with pathohistological
findings. This study was among few or even the first to show hemoglobin concentrations to be not only clinical aspect of AAV but also the independent
predictor of outcomes. Results of our study also pointed out to the need to modify
current histopathological classification of AAV associated renal damage to include
IFTA since we have shown IFTA >50% to be an independent negative predictor for
ESRDD, ESRD. We have also shown that the acute tubular damage is significant
negative predictor for all the outcomes except for the relapse, in univariate analysis
Comparison of sonoelastographic values of breast tissue with mammographically and ultrasonically assessed density: a cross-sectional study
Get PDFAim: To determine the relationship between breast stiffness assessed with sonoelastography (elasticity) and breast tissue density assessed with mammography (MG) and ultrasound (US). -----
Methods: This cross-sectional study involved 100 women who underwent MG, gray-scale US, and shear-wave sonoelastography during 2013. Mammographic density was categorized into four groups and sonographic density into three groups according to Breast Imaging-Reporting and Data System criteria. The stiffness of breast parenchymal and adipose tissue in all breast quadrants was quantified by shear-wave sonoelastography. Mean elastographic estimates were compared with MG- and US-derived density estimates. -----
Results: Parenchymal and adipose tissue elasticity positively correlated with MG- and US-derived breast density (for parenchyma: for MG Kendall's tau b 0.522; Jonckheere-Terpstra test P<0.001 and for US Kendall's tau b 0.533; Jonckheere-Terpstra test P<0.001); the higher was the breast density on MG and US, the higher was the elastographic stiffness. -----
Conclusion: Sonoelastographic breast stiffness strongly positively correlated with breast density. Thus, sonoelastography may have a potential for estimating the breast cancer risk, which allows a novel application of this technique in routine clinical practice
Povezanost polimorfizama gena za serotoninski transportni sustav s fenotipom Crohnove bolesti
Get PDFIn this retrospective case-control study we analyzed the potential association of the promoter (5-HTTLPR and rs25531) and intronic Stin2 VNTR polymorphic regions of the SLC6A4 gene with the incidence of Crohn's disease (CD). The study included 192 CD patients and 157 healthy control subjects (age and gender matched with patients group). Genotyping was performed by polymerase chain reaction and correlation of polymorphic SLC6A4 gene variants with CD and its clinical subtypes was analyzed by chi-square and Fisher's exact test, binary logistic regression and haplotype analysis. The results confirmed similar gender (CD: 88 (45.8%) female, 104 (54.2%) male; HC: 84 (53.5%) female, 73 (46.5%) male; χ2 = 2.03, df =1, P = 0.154) and age (CD: 41.34±12.789; HC: 41.68±8.789; P = 0.091) distribution among CD and HC groups involved in the study. Significant difference was observed in STin2 genotype (CD: χ2=15.86, df = 4, P = 0,003; females: χ2 = 15.33, df = 4, P = 0.004) and allele (CD: χ2 = 12.03; df = 2, P = 0.002; females: χ2 = 9.85, df = 2; P = 0.007) distribution between CD and HC and between corresponding female subgroups, with significant negative association (CD: P = 0.013, OR adjusted by age and gender = 0.5, 95% CI=0.29-0.86; females: P = 0.006, OR adjusted by age = 0.32, 95% CI=0.14-0.72) of biallelic ss (STin2.9 and Stin2.10) STin2 genotype with CD, and significantly higher S-STin2.12 ( 5-HTTLPR/rs25531: S-STin2: STin2.12) haplotype distribution (P = 0.004, OR=1.62, 95 % CI=1.16-2.26) in CD. There was no significant association between 5-HTTLPR and rs25531 genotype or allele frequencies and CD or between any SLC6A4 polymorphic loci among different clinical subtypes of Crohns disease classified according to Montreal consensus. In conclusion, STin2 VNTR polymorphism of SLC6A4 gene may contribute to the pathogenesis of CD
Mitochondrial unfolded protein response, mitophagy and other mitochondrial quality control mechanisms in heart disease and aged heart
Get PDFMitochondria are involved in crucial homeostatic processes in the cell: the production of adenosine triphosphate and reactive oxygen species, and the release of pro-apoptotic molecules. Thus, cell survival depends on the maintenance of proper mitochondrial function by mitochondrial quality control. The most important mitochondrial quality control mechanisms are mitochondrial unfolded protein response, mitophagy, biogenesis, and fusion-fission dynamics. This review deals with mitochondrial quality control in heart diseases, especially myocardial infarction and heart failure. Some previous studies have demonstrated that the activation of mitochondrial quality control mechanisms may be beneficial for the heart, while others have shown that it may lead to heart damage. Our aim was to describe the mechanisms by which mitochondrial quality control contributes to heart protection or damage and to provide evidence that may resolve the seemingly contradictory results from the previous studies
The use of infrared technology as a novel approach for studies with female laboratory animals
Get PDFAim To determine the changes in skin temperature and brown adipose tissue (BAT) activity throughout the estrous cycle as well as the regularity of the estrous cycle in mice. -----
Methods We assessed the differences in the duration of the estrous cycle and its phases between 3- and 8-month-old female mice (n = 18). Skin temperature and BAT activity were measured by infrared technology and compared with human menstrual cycle. -----
Results Young and old female mice did not differ significantly in the estrous cycle length. However, young animals had longer diestrus and shorter proestrus phase. In contrast with women, mice showed age-dependent changes in body temperature and BAT activity during the estrus cycle. -----
Conclusion Establishing the pattern of temperature and BAT activity changes could be used to determine the estrous cycle phase before performing experiments without disturbing the animal. However, since the regulation of BAT activity during the estrous cycle was age-dependent, very complex, and varied significantly from women, further studies are needed to develop a non-invasive method for determining the phase of the estrous cycle