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Expression of small leucine-rich extracellular matrix proteoglycans biglycan and lumican reveals oral lichen planus malignant potential
Get PDFOBJECTIVES:
The aim of this study was to examine molecular alterations on the protein level in lesions of oral lichen planus (OLP), oral squamous cell carcinoma (OSCC) and healthy mucosa. -----
MATERIALS AND METHODS:
Global protein profiling methods based on liquid chromatography coupled to mass spectrometry (LC-MS) were used, with a special emphasis on evaluation of deregulated extracellular matrix molecules expression, as well as on analyses of IG2F and IGFR2 expression in healthy mucosa, OLP and OSCC tissues by comparative semi-quantitative immunohistochemistry. -----
RESULTS:
Mass spectrometry-based proteomics profiling of healthy mucosa, OLP and OSCC tissues (and accompanied histologically unaltered tissues, respectively) identified 55 extracellular matrix proteins. Twenty among identified proteins were common to all groups of samples. Expression of small leucine-rich extracellular matrix proteoglycans lumican and biglycan was found both in OSCC and OLP and they were validated by Western blot analysis as putative biomarkers. A significant increase (p < 0.05) of biglycan expression in OLP-AT group was determined in comparison with OLP-T group, while lumican showed significant up-regulation (p < 0.05) in OLP-T and OSCC-T groups vs. adjacent and control tissue groups. Biglycan expression was only determined in OSCC-AT group. Immunohistochemical analysis of IGF2 and IG2FR expression revealed no significant difference among groups of samples. -----
CONCLUSION/CLINICAL RELEVANCE:
Biglycan and lumican were identified as important pathogenesis biomarkers of OLP that point to its malignant potential
HIV care in Central and Eastern Europe: how close are we to the target?
Get PDFOBJECTIVES:
The aim of this survey was to describe the current status of HIV care in the countries of Central and Eastern Europe and to investigate how close the region is to achieving the UNAIDS 2020 target of 90-90-90. ----- METHODS:
In 2014, data were collected from 24 Central and Eastern European countries using a 38-item questionnaire. ----- RESULTS:
All countries reported mandatory screening of blood and organ donors for HIV. Other groups subjected to targeted screening included people who inject drugs (PWID) (15/24, 62.5%), men who have sex with men (MSM) (14/24, 58.3%), and sex workers (12/24, 50.0%). Only 14 of the 24 countries (58.3%) screened pregnant women. The percentages of late presentation and advanced disease were 40.3% (range 14-80%) and 25.4% (range 9-50%), respectively. There was no difference between countries categorized by income or by region in terms of the percentages of persons presenting late or with advanced disease. The availability of newer antiretroviral drugs (rilpivirine, etravirine, darunavir, maraviroc, raltegravir, dolutegravir) tended to be significantly better with a higher country income status. Ten countries reported initiating antiretroviral therapy (ART) regardless of CD4+ T cell count (41.7%), five countries (20.8%) used the threshold of <500 cells/μl, and nine countries (37.5%) used the threshold of <350cells/μl. Initiation of ART regardless of the CD4+ T cell count was significantly more common among high-income countries than among upper-middle-income and lower-middle-income countries (100% vs. 27.3% and 0%, respectively; p=0.001). Drugs were provided free of charge in all countries and mostly provided by governments. There were significant discrepancies between countries regarding the follow-up of people living with HIV. -----
CONCLUSIONS:
There are major disparities in the provision of HIV care among sub-regions in Europe, which should be addressed. More attention in terms of funding, knowledge and experience sharing, and capacity building is required for the resource-limited settings of Central and Eastern Europe. The exact needs should be defined and services scaled up in order to achieve a standard level of care and provide an adequate and sustainable response to the HIV epidemic in this region
Health-related quality of life in children and adolescents with congenital diaphragmatic hernia: a cross-sectional study
Get PDFBACKGROUND:
Patients with congenital diaphragmatic hernia (CDH) have a high residual morbidity rate. We compared self-reported health-related quality of life (HRQoL) between patients with CDH and healthy children. ----- METHODS:
Forty-five patients with CDH who were born from January 1, 1990, through February 15, 2015, were matched to healthy, age-matched control participants at a 1:2 ratio. The health records of the study participants were reviewed to determine comorbid conditions, and HRQoL was assessed by both the participants and their parents with the Pediatric Quality of Life Inventory (PedsQL). The HRQoL scores of the patients with CDH and the control participants were compared by using analysis of variance to adjust for age group and sex. Among patients with CDH, analysis of variance was used to compare HRQoL scores across groups defined according to their characteristics at initial hospitalization, postdischarge events, and comorbid conditions. ----- RESULTS:
Compared with control participants, patients with CDH had lower mean PedsQL scores, as reported by the parent and child, for the physical and psychosocial domains (P < 0.001). Risk factors associated with lower parent-reported HRQoL included bronchopulmonary dysplasia, longer initial hospitalization, severe cognitive impairment, and orthopedic symptoms; among patients with CDH, low HRQoL was associated with chronic respiratory issues. ----- CONCLUSION:
Patients with CDH had lower HRQoL compared with healthy participants. Parent-reported HRQoL tended to be higher than child-reported HRQoL. Results were also inconsistent for the risk factors associated with HRQoL obtained by using child- and parent-reported scores. Therefore, when interpreting HRQoL in CDH survivors, a proxy report should not be considered a substitute for a child's self-report
Higher Sclerostin/SOST expression is associated with lower percentage of circulatory blasts and better prognosis in patients with myelofibrosis
Get PDFMethylisothiazolinone contact allergy in Croatia: epidemiology and course of disease following patch testing
Get PDFBackground: Methylisothiazolinone (MI) caused an epidemic of contact allergy in Europe, as shown by data from many countries, but no studies from Croatia exist. Also, data are lacking on the severity of allergic contact dermatitis (ACD) caused by MI, and its impact on quality of life and prognosis. -----
Objectives: To determine the frequency of MI contact allergy among Croatian dermatitis patients, identify causative exposures, assess the impact of disease, and study the prognosis. -----
Methods: Data were collected for consecutive dermatitis patients with MI contact allergy patch tested in Croatia between November 2, 2015 and November 3, 2016. -----
Results: MI contact allergy was diagnosed in 13.2% of 798 tested patients. The most frequent dermatitis locations were the hands (76%) and face (61%). In 89.3% of patients, MI contact allergy was found to be of current relevance. Considerable severity and impact on daily life of disease was found at the first consultation, but this significantly decreased until follow-up 3 months later. -----
Conclusions: Patch testing is the standard method for the diagnosis of ACD, and it has been shown to have an important beneficial effect on prognosis. The severity of MI ACD and the impact on daily life emphasize the need for prevention
Kvaliteta propisivanja i racionalnost izvanbolničke potrošnje kardiovaskularnih lijekova u Gradu Zagrebu [The Quality of Prescribing and Rational Outpatient Utilization of Cardiovascular Drugs in the City of Zagreb]
Get PDFAim of this retrospective study was to determine trend of outpatient utilization of cardiovascular drugs and to assess the quality and rationality of cardiovascular drug prescribing.
Methods: Based on data obtained from Zagreb Pharmacy on the number of packages for all prescription drugs indicators of DDD and number DDD/1000/day was calculated. The distribution of utilization for each particular drug by the generic name included in the CIHI Lists of Drugs during the twelve-year period, from 2001 till 2012, in the City of Zagreb was analysed. The quality and rationality of prescribing were evaluated using WHO „Drug utilization 90%“ (DU90%) method and the DU90% segment step adherence to guidelines for prescribing cardiovascular drugs in accordance with current professional guidelines.
Results: Besides increase in the total number of cardiovascular drugs, the number of drugs within DU90% segment also increased significantly. The index of compatibility with relevant professional guidelines increased from 0.86 in 2001 (12/14 drugs) to 0.95 in 2012 (21/22 drugs).
Conclusions: The utilization of cardiovascular drugs was concordant with the national and professional guidelines for most drugs within the DU90% segment. The quality and rationality of cardiovascular drug prescribing in the City of Zagreb were improved during the 2001-2012 period
Molecular Epidemiology of Hepatitis C virus in Prishtina region of Kosovo [Molekularna epidemiologija virusa Hepatitisa C u regiji Priština na Kosovu]
Get PDFAim: To determine genetic diversity of HCV among different population groups in Prishtina, Kosovo.
Methods: Anti-HCV positive samples of dialysis patients, IDUs, blood donors, and chronic HCV patients were HCV genotyped and sequenced. To better understand the underlying conditions of HCV infection, interviews were used with all groups.
Results: Anti-HCV positive findings were observed in 22% of dialysis patients in Prishtina, and as average among 53% of patients at dialysis centers of Kosovo, as well as in 48% of IDUs. HCV subtype 1a was most prevalent among dialysis patients in Prishtina (47%) and overall in Kosovo (62%), and among IDUs (64%), whereas genotype 1b was most prevalent among chronic HCV patients (42%) and blood donors (67%). The second most prevalent genotypes were 3a among IDUs (34%) and 4d among dialysis patients in Prishtina (44%) and overall at dialysis centers of Kosovo (33%). Phylogenetic trees of HCV subtypes 1a, 1b, 3a, and 4d showed phylogenetic clusters of samples related to dialysis centers or drug use. Duration of dialysis and receiving dialysis in different centers were factors associated with anti-HCV positivity among Kosovo dialysis patients, whereas specifically for Prishtina, in addition to the above, those factors included blood transfusion, age and knowledge about HCV among dialysis patients, while among IDUs those were age, duration of drug injection, lower educational level, drug injection in shooting galleries, and being in prison.
Conclusion: High levels of HCV infection at dialysis center in Prishtina and overall at Kosovo dialysis centers and among IDUs are present in Kosovo, with HCV subtype 1a being most prevalent. This situation reiterates the need for strict adherence to infection control practices at dialysis centers and implementation of harm reduction activities among IDUs
Smjernice za neinvazivnu mehaničku ventilaciju pri liječenju kronične respiracijske insuficijencije [Guidelines for noninvasive mechanical ventilation for treatment of chronic respiratory failure]
Get PDFThe use of noninvasive ventilation (NIV) has been markedly increased over the past two decades, as an effective method of managing acute and chronic respiratory failure. Patients suffering from chronic respiratory failure can be introduced to home NIV. The most frequent diseases leading to chronic respiratory failure are chronic obstructive pulmonary disease (COPD), obesity hypoventilation syndrome (OHS), restrictive thoracic diseases and neuromuscular diseases (NMD). NIV application improves blood gases, symptoms, quality of life and prolongs survival of these patients. Nowadays, noninvasive ventilation is mostly performed by positive pressure ventilators and bilevel positive airway pressure (BiPAP) is the most common mode used. The choice of appropriate interface is the key to successful application of noninvasive ventilation. Home NIV must be introduced through specialized centers. The physicians are responsible for indicating home NIV, choosing the type of ventilator, the ventilation mode and ventilation parameters. The objective of this document is to provide clinicians with information on technical aspects of home NIV, to establish diagnostic and therapeutic strategies for initiating home NIV, indications, contraindications and recommended settings for each group of diseases
Smjernice za kliničku prehranu kod upalnih bolesti crijeva [Guidelines for clinical nutrition in inflammatory bowel disease]
Get PDFDiet therapy and clinical nutrition have a significant place in the treatment of patients with inflammatory bowel disease (IBD). Nutritional support is an important component of medical therapy in patients with IBD, and in-cludes the prevention and treatment of all forms of malnutrition. Confirmed malnutrition in patients with in-flammatory bowel disease should be treated adequately as it exacerbates prognosis, degree of complications, mortality and quality of life of a patient. Enteral nutrition is an extremely important part of nutritional therapy in inflammatory bowel diseases, and in some situations it has the meaning of primary therapy. Parenteral nutri-tion has its place in nutrition therapy of inflammatory bowel disease, both in acute and chronic treatment of patients with short bowel syndrome. Representatives of the Croatian Society of Clinical Nutrition Croatian Medical Association, Croatian Society of Mucosal Immunology Croatian Medical Association, Croatian Society of Gastroenterology and Croatian Society of Nutritionists and Dietitians participated in the development of these guidelines. They are evidence-based, according to the GRADE (Grading of Recommendations, Assess-ment, Development and Evaluation) system which, with the strength of evidence, also describes the level of recommendation. The basic conclusions of these guidelines relate to the assessment of malnutrition in this group of patients, the determination of nutritional needs, the replacement of key nutrients and pharmaconutrients, the application of various artificial nutrition modalities and the specificities of perioperative nutrition
Takotsubo cardiomyopathy after the first electroconvulsive therapy regardless of adjuvant beta-blocker use: a case report and literature review
Get PDFTakotsubo cardiomyopathy (TC) is a rare complication of electroconvulsive therapy (ECT), an effective and safe treatment for severe cases of depression and psychosis. There are reports on 16 patients who developed TC after ECT, and these were predominantly female patients treated with antidepressants for depressive disorder. We describe a case of a 40-year-old male patient, with a history of schizophrenia and heavy caffeine and nicotine use, treated for acute psychotic episode with haloperidol and clozapine. Propranolol was administered because of clozapine-induced tachycardia. After 8 weeks without therapeutic response, the patient was referred for standard ECT procedure, which included premedication and bifrontotemporal stimulation. Two hours later, the patient experienced gastric pain and had increased troponin and natriuretic peptide levels and ST-elevation. After inotrope and anticoagulant treatment and replacement of antipsychotics, the patient remained stable. Contrary to common opinion, previous adrenergic blockade in this patient did not prevent TC occurrence. TC pathophysiology remains unclear although it has been related to the burst of norepinephrine neurons. Psychosis has also been associated with catecholamine dysfunction, and excessive psychological stress with long-term norepinephrine dysfunction. Animal models have shown that ECT, clozapine, and nicotine and caffeine use could considerably increase catecholamine levels. Clinical understanding of rare cardiac ECT complications could improve early recognition of patients at risk for TC and ensure safe ECT protocols