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The therapeutic potential of nanoparticles to reduce inflammation in atherosclerosis
Get PDFChronic inflammation is one of the main determinants of atherogenesis. The traditional medications for treatment of atherosclerosis are not very efficient in targeting atherosclerotic inflammation. Most of these drugs are non-selective, anti-inflammatory and immunosuppressive agents that have adverse effects and very limited anti-atherosclerotic effects, which limits their systemic administration. New approaches using nanoparticles have been investigated to specifically deliver therapeutic agents directly on atherosclerotic lesions. The use of drug delivery systems, such as polymeric nanoparticles, liposomes, and carbon nanotubes are attractive strategies, but some limitations exist. For instance, nanoparticles may alter the drug kinetics, based on the pathophysiological mechanisms of the diseases. In this review, we will update pathophysiological evidence for the use of nanoparticles to reduce inflammation and potentially prevent atherogenesis in different experimental models
Primopredaja i prijelaz bolesnika [Patient handover and transition]
Get PDFPatient handover is considered to be one of the most delicate medical procedures as well as the most
preventable cause of medical error. It takes place at primary, secondary and tertiary healthcare, with specificities
at every level of healthcare. Improvement in the quality of patient handover is therefore essential for good medical
practice. Accurate and comprehensive communication between medical staff is required for patient safety and
continuous adequate healthcare. In this article, we describe recommendations for successful and efficient patient
handover and highlight communication errors during the process. Special attention is given to handover of rheumatological
patients and transition from pediatric to adult healthcare. Also, we emphasize the necessity of education.
Medical staff should be competent in sharing and exchanging relevant information when the patient transfers
to another medical care provider. Teaching communication skills has been part of undergraduate and postgraduate
curriculum in medical schools. At the University of Zagreb School of Medicine we have introduced a
longitudinal six-year course Fundamentals of Medical Skills where special attention is given to communication
skills. Nevertheless, medical specialty training still lacks educational contents specialized in patient handover and
safe patient discharge
Prijelomi podlaktice u zagrebačke djece [Forearm fractures in Zagreb children]
Get PDFForearm fractures are the most common fractures of childhood. Fall on the extended arm is the main
mechanism of injury. High incidence and possible poor outcomes of treatment justify the questioning of preventative
measures in the occurrence of these injuries. The aim of this paper is to investigate the sites and ways of
forearm fracture of in a group of Zagreb children. This retrospective study included 395 children from the city of
Zagreb who were hospitalized in the UHC Zagreb from January 1, 2014 to October 19, 2017. The examined group
included 265 boys (67.1%) and 130 girls (32.9%). The average life expectancy was 9.1 years. Girls were on average
16 months younger than boys . The highest number of children was 175 (44.3%) in the age group 5-9 years.
One hundred and four (26%) children had fractures of only the distal part of the radius, 104 (26%) of the distal
part of both forearm bones, and 94 (23.6%) diaphyseal fracture of both bones. The leading cause of fractures in
our children group was fall (248 - 62.8%). Transport caused 61 (15.4%), and blow 86 (21.8%) fractures in the
group of our children. There were eight (2%) fractures on the roads, 25 (6.3%) at home, 37 (9.3%) at school, and
271 (68.7%) in extracurricular activities and leisure time. Out of these, there were 69 fractures on the playground
or in the park (26.2%), 54 (13.7%) in bike ride , and 46 (11.7%) during football. Of the 69 children who had
forearm fracture on the playground or in the park, 39 (56.5%) suffered a break on a swing, toboggan and trampoline.
Boys often fall, almost three times more on same level, and twice more from low hight than girls. Girls are
more often injured by falling from the bike. In conclusion, boys are more often at risk, and the dominant mode of
injury is falling. Mostly, they are children of pre-school and early school age. Special community engagement
should focus on these children during their recreational and sporting activities (cycling and football). In Zagreb,
children’s play areas and parks are the most common places of forearm fracture occurrence
Nutritional considerations of cardiovascular diseases and treatments
Get PDFNutritional considerations of many chronic diseases are not fully understood or taken into consideration in everyday clinical practice. Therefore, it is not surprising that high proportion of hospitalized patients with cardiovascular diseases remains underdiagnosed with malnutrition. Malnourished patients have increased risk of poor clinical outcomes, complications rate, prolonged hospital stay, more frequent rehospitalizations, and lower quality of life. The purpose of this review is to recapitulate recent data on nutritional considerations in cardiovascular medicine
Effect of fenofibrate on plasma apolipoprotein C-III levels: a systematic review and meta-analysis of randomised placebo-controlled trials
Get PDFOBJECTIVES:
This meta-analysis of randomised placebo-controlled clinical trials aimed to assess the effect of fenofibrate on apolipoprotein C-III (apo C-III), a key regulator of triglyceride metabolism. -----
MATERIALS AND METHODS:
Randomised placebo-controlled trials investigating the impact of fenofibrate treatment on apo C-III levels were searched in PubMed-Medline, Scopus, Web of Science and Google Scholar databases from inception to 18 August 2017. Quantitative data synthesis was determined by a random-effects model and generic inverse variance method. Sensitivity analysis was conducted using the leave-one-out method. A weighted random-effects meta-regression was performed to evaluate glycaemic parameter confounders. -----
RESULTS:
Meta-analysis of 10 clinical trials involving 477 subjects showed fenofibrate therapy decreased apo C-III levels (weighted mean difference (WMD) -4.78 mg/dL, 95% CI -6.95 to -2.61, p200 mg/day (p=0.006), with no significant difference between the subgroups. -----
CONCLUSION:
This meta-analysis found that fenofibrate therapy significantly decreases apo C-III levels, an effect evident with both short-term treatment and doses less than 200 mg/day
Utjecaj kroničnoga stresa i starenja na lipidne splavi moždanih stanica u štakora [Influence of chronic stress and aging on lipid rafts in rat brain cells]
Get PDFThe main hypothesis of this thesis proposed that aging and stress combined lead towards changes in lipid rafts composition of brain and trigger neurodegeneration mediated by location shift of lipid raft proteins in hippocampus – insulin and leptin receptor.
In experiments performed in this thesis diminished memory in older females was observed and was followed by reduced expression of insulin and AMPA receptors in hippocampus of older animals. Leptin receptor was activated upon stress in older animals and could be a potential neuroprotection activator. Also, it was determined that both – insulin and leptin receptors are not located inside lipid rafts of hippocampus and cerebellum as considered up to now by peripheral tissue analysis.
Lipid content changes of lipid rafts upon stress were noticed as GM1 ganglioside expression increase in CA1 and dentate gyrus of hippocampus of young animals and increase of GD1a expression in CA1 region of hippocampus in all chronically stressed animal groups. Also, colocalization of amyloid precursor protein and GD1a was observed in hippocampus of older females as a result of chronic stress response.
If insulin and leptin receptors expression is decreased, AMPA receptor and neuroplastin follow this trend. It implies a connection of leptin and insulin signalling pathways with pathways involved with neuroplasticity.
During experimental part of this thesis, a unique animal model of sex and age specific chronic stress was developed that implies strong chronic stress resistance of young animals. It was observed that chronic stress had the strongest impact in older females and that stress regulation in the brain is sex and age specific
Successful separation of xypho-omphalopagus conjoined twins with extrauterine twin-twin transfusion syndrome: a case report
Get PDFConjoined twining is a rare medical phenomenon, with an overall prevalence of 1.47 per 100 000 births. This report describes a successful separation of xypho-omphalopagus conjoined twins complicated by unbalanced blood shunting through the porto-systemic anastomoses within the shared liver parenchyma. Significant extrauterine twin-twin transfusion syndrome caused by unbalanced shunting is an extremely rare, and probably under-recognized, hemodynamic complication in conjoined twins necessitating urgent separation. Progressive deterioration with a poor outcome can be prevented if the condition is recognized in a timely manner
Učinak produljenoga radnoga vremena na aktivaciju hemostatskoga sustava [The effect of prolonged working time on activation of hemostatic system ]
Get PDFThe workplace stress leads to the activation of the hemostatic system and can also
generate proinflammatory mediators. The aim of this study was to examine the effect of the 24-
hour shift on coagulation tests of PV, INR, APTV, TV, D-dimers, fibrinolysis, fibrinogen,
activity of factor VIII and vWF, TAT and PAP complexes and on CRP as an acute inflammatory
agent.
Sixty physicians (residents) between age of 25 and 35 at Clinical Hospital Centre “Sestre
milosrdnice” in the Center for Emergency Reception participated (30 participants in the
experimental and 30 participants in control group). Blood samples were collected on three
occasions at the same points in both groups: shortly before the 24 hour shift, twelve hours after
and at the end of the shift.
The results showed statistically significantly higher values of CRP in all three
measurements in the experimental group (P=0,024, P=0,020, P=0,030). There was a statistically
significant difference in factor VIII (P=0,029) and vWF (P=0.042) activity dynamics between the
groups. There was no statistically significant difference in the values of other factors.
Thus, only the CRP values were statistically significantly higher in the experimental
group. Factor VIII was initially higher in subjects but decreased at the end of 24 hour shift, while
surprisingly other indicators of hemostatic system have not demonstrated blood procoagulant
state in doctors who worked 24 hour shift or have even shown hypocoagulant state at the end of
24 hour shift (lower VWF activity, trend of lower D-dimers and reduction of factor VIII activity)
Povezanost antropometrijskih osobina, motoričkih sposobnosti, zdravih životnih navika i samopoštovanja studenata medicine [Relationship between anthropometric characteristics, motor abilities, healthy habits and self-esteem among medical students]
Get PDFAim is to examine the anthropometric characteristics and body composition, motor abilities, healthy lifestyle habits and their connection with self-esteem among the medical students at first two years of study. -----
Subjects and methods: The final number of analysed data includes 941 medical students. Health-promoting lifestyle, level of physical activity and self-esteem were analysed using survey method, while adequate measure procedures were used to determine anthropometric characteristics and body composition as well as motor abilities. -----
Results were used to analyse data of 673 students, of which 254 are young men and 429 are young women.
Female students of first and second year care more about interpersonal relationships and health responsibility, while students maintain a higher level of physical activity and are more successful in dealing with stress. Significant gender differences are noted in the physical activity, where male students score higher results than female students. Male medical students score higher results in self-esteem level compared to female students.
The greatest predictive value of self-esteem amongst both gender of medical students is represented by the domain of the health-promoting lifestyle, self-actualization. -----
Conclusion: Hypothesis that better anthropometric characteristics and motor abilities, healthy lifestyle habits (regular physical activity, dietary habits, health responsibility, interpersonal relationships, self-actualization and stress management) create a condition for greater self-esteem with medical students has been confirmed