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Smoking behaviors in Kosova: results of Steps survey
Get PDFINTRODUCTION:
Tobacco use continues to be the leading global cause of preventable death. Most of these deaths occur in low and middle-income countries, and this trend is expected to widen further over the next several decades. The overall objective of the study is to describe and analyse the smoking behaviours of adults in Kosova. -----
METHODS:
According to the STEPs methodology, 6,400 respondents, aged 15 - 64 years, are selected randomly within each sex and 10-year age-group. Out of 6,400 participants, 6,117 were selected, which is approximately 95.6%. -----
RESULTS:
The prevalence of smoking was higher among males (37.4%) compared with females (19.7%). In all age groups, the prevalence of smoking was higher among males compared with females. Regarding the age group of 15 - 24 years, the prevalence of smoking was 16.0%, but in the age group of 25 - 34 years, it nearly doubled to the rate of 31.9%. We have a smaller increase in the age group of 35 - 44 years, and after the age of 45, it falls gradually. -----
CONCLUSIONS:
The prevalence of smoking in Kosova is high compared with other countries in Eastern Europe. In future decades, Kosova will face a high probability of an increased burden of smoking-related diseases
Chemokine signals are crucial for enhanced homing and differentiation of circulating osteoclast progenitor cells
Get PDFBACKGROUND:
The peripheral blood (PB) monocyte pool contains osteoclast progenitors (OCPs), which contribute to osteoresorption in inflammatory arthritides and are influenced by the cytokine and chemokine milieu. We aimed to define the importance of chemokine signals for migration and activation of OCPs in rheumatoid arthritis (RA) and psoriatic arthritis (PsA). -----
METHODS:
PB and, when applicable, synovial fluid (SF) samples were collected from 129 patients with RA, 53 patients with PsA, and 110 control patients in parallel to clinical parameters of disease activity, autoantibody levels, and applied therapy. Receptors for osteoclastogenic factors (CD115 and receptor activator of nuclear factor-κB [RANK]) and selected chemokines (CC chemokine receptor 1 [CCR1], CCR2, CCR4, CXC chemokine receptor 3 [CXCR3], CXCR4) were determined in an OCP-rich subpopulation (CD3-CD19-CD56-CD11b+CD14+) by flow cytometry. In parallel, levels of CC chemokine ligand 2 (CCL2), CCL3, CCL4, CCL5, CXC chemokine ligand 9 (CXCL9), CXCL10, and CXCL12 were measured using cytometric bead array or enzyme-linked immunosorbent assay. Sorted OCPs were stimulated in culture by macrophage colony-stimulating factor and receptor activator of nuclear factor-κB ligand, and they were differentiated into mature osteoclasts that resorb bone. Selected chemokines (CCL2, CCL5, CXCL10, and CXCL12) were tested for their osteoclastogenic and chemotactic effects on circulatory OCPs in vitro. -----
RESULTS:
The OCP population was moderately enlarged among PB cells in RA and correlated with levels of tumor necrosis factor-α (TNF-α), rheumatoid factor, CCL2, and CCL5. Compared with PB, the RANK+ subpopulation was expanded in SF and correlated with the number of tender joints. Patients with PsA could be distinguished by increased RANK expression rather than total OCP population. OCPs from patients with arthritis had higher expression of CCR1, CCR2, CCR4, CXCR3, and CXCR4. In parallel, patients with RA had increased levels of CCL2, CCL3, CCL4, CCL5, CXCL9, and CXCL10, with significant elevation in SF vs PB for CXCL10. The subset expressing CXCR4 positively correlated with TNF-α, bone resorption marker, and rheumatoid factor, and it was reduced in patients treated with disease-modifying antirheumatic drugs. The CCR4+ subset showed a significant negative trend during anti-TNF treatment. CCL2, CCL5, and CXCL10 had similar osteoclastogenic effects, with CCL5 showing the greatest chemotactic action on OCPs. -----
CONCLUSIONS:
In our study, we identified distinct effects of selected chemokines on stimulation of OCP mobilization, tissue homing, and maturation. Novel insights into migratory behaviors and functional properties of circulatory OCPs in response to chemotactic signals could open ways to new therapeutic targets in RA
Psihosocijalne odrednice zadovoljstva bolničkom skrbi u odraslih bolesnika s uznapredovalim rakom [Psychosocial determinants of the satisfaction with hospital care in adult patients suffering from advanced metastatic cancer]
Get PDFDirect and indirect relationships between socio-demographic (age, gender, education level, life partner, income and length of treatment), psychological (HADS) variables and satisfaction with hospital care (EORTC INPATSAT32) in adult patients, suffering from advanced cancer, were investigated.
Hospitalized participant were recruited at Clinical Hospital Centre Zagreb (N=46; January 2015) and Clinical Hospital Centre ‘Sisters of Mercy’ (N=29; April 2015). Inclusion criteria: 1. advanced stage of disease without metastasis and/or primar malignoma in CNS, 2. receiving treatment without curative intent, 3. ECOG 0 or 1, 4. without acute psychosis, dementia, delirium or psychoorganicum syndrome; 5. ≥ 26 scores on MoCA test.
Statistically non significant correlations are found between demographic factors and HADS (p>0,05), but there are statistically significant (p<0,05) negative correlations between HADS and all satisfaction variables. Gender and the income appeared as the significant (p<0,05) moderator variables in the relationship between HADS and the satisfaction with nurses availability and general satisfaction.
Emotionally disturbed male respondents are more satisfied with the availability of nurses / technicians and have higher general level of satisfaction with hospital care; emotionally disturbed subjects who have higher income have lower satisfaction availability of nurses / technicians and lower general satisfaction with hospital care
Emergence of different Acinetobacter baumannii clones in a Croatian hospital and correlation with antibiotic susceptibility
Get PDFOBJECTIVES:
During routine diagnostic laboratory work, the clinical microbiologist observed an increase of Acinetobacter baumannii isolates with three different carbapenem susceptibility patterns: susceptible, intermediate and resistant. Isolates belonging to the same carbapenem susceptibility phenotype exhibited identical susceptibility/resistance patterns to non-β-lactam antibiotics. This prompted us to analyse the mechanisms of carbapenem-resistance and the molecular epidemiology of the isolates. A total of 59 A. baumannii isolates were analysed and grouped according to their susceptibility to imipenem: group 1 were susceptible (N=24), group 2 were intermediate (N=8) and group 3 were resistant (N=27) to imipenem. -----
MATERIAL AND METHODS:
PCR and sequencing was used to detect resistance genes. Genotyping of the isolates was performed by PFGE and MLST. -----
RESULTS:
Out of 27 resistant isolates, 20 harboured blaOXA-40-like and 7 blaOXA-23-like genes. ISAba1 was found upstream of blaOXA-51 and blaOXA-23 genes. PFGE genotyping demonstrated the existence of three major A. baumannii clones in GH Pula and determination of sequence groups showed that the isolates belonged to international clones commonly associated with multidrug-resistance. MLST (performed on six isolates) showed diverse population structure of isolates belonging to the same cluster, including ST 195, ST 231, ST 775 and ST 1095. -----
CONCLUSIONS:
A previous study conducted in 2009-2010 showed that reduced susceptibility to carbapenems in GH Pula was only associated with upregulation of the intrinsic OXA-51 β-lactamase. In this study a shift to isolates with acquired oxacillinases, belonging to two major clones was reported
Učinkovitost koštanoga morfogenetskoga proteina BMP1-3 u procesu cijeljenja kosti
Get PDFMembers of the astacin superfamily of zinc-dependent metalloproteinases regulate morphogenesis by processing precursors to mature functional extracellular matrix proteins as well as several growth factors such as TGFβ, BMP2, BMP4 and GFD8. It has been recently discovered that BMP1-3 isoform of the Bmp-1 gene circulates in the human plasma and is significantly increased in acute bone fractures. Circulating BMP1-3 regulates collagen deposition in the process of bone callus formation.
In this paper role of BMP1-3 in the process of bone healing in vivo and in vitro has been evaluated. When administred systemically to rats with a femur fracture and locally to rabbits with critical size defect of ulna, recombinant BMP1-3 enhanced healing. On the opposite side, neutralization of the BMP1-3 by specific polyclonal antibody resulted in a
delayed union or bone non-union. In vitro, BMP1-3 increased the expression of collagen type I and osteocalcin in MC3T3E1 osteoblast-like cells and enhanced mineralized bone modules formation from bone marrow mesenchymal stem cells. This paper shows the importance of BMP1-3 in the process of bone healing and its potential as a novel bone biomarker. By developing BMP1-3 specific assays we could monitor specific variations of its level in plasma, which could reflect on the possibility of a wide local implemantation of BMP1-3 in combinantion with other morphogens
Važnost mjesta osteotomije pri planiranju korektivnih osteotomija loše srasloga prijeloma palčane kosti u tipičnoj zoni [Importance of osteotomy line in planning corrective osteotomies of malunited distal radius fractures]
Get PDFCorrective osteotomy is the method of choice for treating distal radius fracture malunion in active patients. It has previously been demonstrated that there is a correlation between the quality of anatomical restauration and overall wrist function. However, surgical correction can be difficult because of the often complex anatomy associated with this condition. Clinical outcomes largely depend on the preoperative planning looking to restore normal wrist anatomy.
Virtual corrective osteotomies, based on wrists CT scans, where done for forty patients with dorsaly angulated distal radius fractures malunion to analize the influence of different osteomy lines on postoperative bone shape. Results showed that there is no need for osteotomy line inclination. Our computer-assisted planning method can find optimal osteotomy line for restauration of normal distal radius anatomy. Shifting of osteotomy line around this level does not change the anatomical outcome significantly, so use of this line can tolerate minor surgical mistakes. Computer defined osteotomy line and most frequently used osteotomy line (2,5 cm proximal from the ulna level, parallel to the radius articular surface in sagital plane) were compared. Computer defined line achived better postoperative radial bone form.
3D computer-assisted determining of individual osteotomy line, that results in nearly normal bone shape, should be a part of corrective osteotomy planning methods
Korelacija debljine sloja živčanih vlakana te makularnoga područja mrežnice i oštećenje vidnoga polja kod unilateralne ambliopije [The correlation between the thickness of the layer of nerve fibers and the macular area of the retina and changes in the visual field, with unilateral amblyopia]
Get PDFIn Croatia, it has been estimated that as many as 200 thousand people are amblyopic. It is the most common cause of decreased unilateral visual acuity among children and younger adults with the expected incidence of 1.6 – 3.6% although the incidence can be higher within the population with inadequate health care. It is believed that amblyopia is primarily a cortical phenomenon, caused by the unequal competitive input signal which arises from each eye and travels to the primary visual cortex. Up until now, opinions on structural retinal change are divided.
The aim of this study is to investigate the presence of structural and functional changes in the macula and the nerve fiber layer of the amblyopic eye. If such changes are present, is there a certain correlation between structural and functional changes. 60 subjects with unilateral amblyopia were included in the study. The subjects were divided into two groups based on the severity of amblyopia; the subjects with severe amblyopia (visual acuity 0.1 – 0.4) and the subjects with a mild form of amblyopia (visual acuity 0.5 – 0.8). All the subjects underwent OCT imaging of the macular field and the optic nerve head, as well as automated perimetry of the amblyopic and the unaffected eye.
The main result of the study is that the structural changes of the macula in the amblyopic eye are present in the form of thickening. Thickening of the macula was found in all 9 observed areas. Severe amblyopia has significantly affected the increased macular thickening in the area of foveola, the central area within 1 mm, and the inner part of macular ring (within 3 mm). The changes in thickness of the nerve fiber layer have not been recorded neither in amblyopic nor in the unaffected eye. By examining the correlation between the parameters obtained by the OCT and the visual field, it was established that the measured mean values of the macula and the RNFL thickness of normal and amblyopic eye do not have the expected positive correlation with MD and sLV, nor do they have a negative correlation with the value of MS. According to our results, we assume that the changes in visual field of amblyopic and healthy eyes are more affected by the strength of the input signal and the changes in the visual cortex and the lateral geniculate body rather than by the thickness of the macular area
Giant desmoplastic cutaneous squamous cell carcinoma of the gluteal region
Get PDFCutaneous squamous cell carcinoma (cSCC) is the most common type of skin tumour with the ability of metastatic spread. It represents about 20% of all malignancies diagnosed worldwide each year. Despite increased knowledge regarding the causes of skin cancer, the incidence of cSCC rises. The disease originates from epidermal keratinocytes, but it may occur on all areas of the body. It has an invasive nature and the potential to metastasise. We report unusual case of a giant metastatic desmoplastic cSCC of the gluteal region in a patient with previously resected desmoplastic cSCC presenting 8 months later with multiple liver and lung metastases
Postural orthostatic tachycardia predicts early conversion to multiple sclerosis after clinically isolated syndrome
Get PDFBACKGROUND/AIMS:
There have been suggestions that interactions exist between the autonomic nervous system (ANS) and the immune system functions in multiple sclerosis (MS). We aimed to evaluate the ANS dysfunction, more specifically postural orthostatic tachycardia syndrome (POTS), as a possible predictor of conversion to MS in patients with clinically isolated syndrome (CIS). -----
METHODS:
In this observational, prospective, longitudinal study, 84 patients were enrolled (56 females, mean age 32.9 ± 8.9 years). Disease activity during a 6-month period was monitored (relapses and/or MRI disease activity indicated by new T2 or T1 enhancing lesions), and the following predictors analyzed: age, Expanded Disability Status Scale, MRI midbrain, pontine or medulla oblongata lesions, and POTS on the head up tilt test. -----
RESULTS:
POTS was identified in 8 (9.5%) patients. Of 84 patients, 62 (73.8%) completed the 6-month follow-up, and 28 (45.2%) patients converted to MS. Results of the multivariate regression analysis revealed age (10-year increase) and POTS as significant predictors of early conversion to MS (OR 2.34, 95% CI 1.15-4.78, p = 0.019 and OR 12.40, 95% CI 1.13-136.62, p = 0.040). The logistic model was statistically significant, χ2 (6) = 13.885, p = 0.031. -----
CONCLUSION:
POTS may be an indicator of a more active disease course in CIS patients and possibly be used as a prognostic factor
Cortisol in schizophrenia: no association with tobacco smoking, clinical symptoms or antipsychotic medication
Get PDFCigarette smoking is associated with higher cortisol levels in healthy subjects. In schizophrenia this relationship is not clear. There are divergent results on the association between cortisol with smoking, clinical symptoms and medication in schizophrenia. This study evaluated this association in 196 Caucasian inpatients with schizophrenia (51.30±26.68years old), subdivided into 123 smokers and 73 non-smokers. Basal salivary cortisol levels were measured twice, at 08.00 and 09.00AM, 90-120min after awakening. The effect of smoking on cortisol was evaluated according to current smoking status, the number of cigarettes/day and the nicotine addiction intensity. The influence of clinical symptoms and/or antipsychotic medication on cortisol was determined using the Positive and Negative Syndrome Scale (PANSS), and chlorpromazine equivalent doses. Non-smokers were older, received lower doses of antipsychotics, had higher PANSS scores, and had longer duration of illness than smokers. Salivary cortisol was similar in schizophrenic patients subdivided according to the smoking status, the number of cigarettes/day and nicotine addiction intensity. No significant correlation was found between salivary cortisol and PANSS scores, chlorpromazine equivalent doses, age of onset or the duration of illness. The findings revealed no association between salivary cortisol and smoking, nicotine addiction intensity, or clinical symptoms. Our preliminary data showed no correlation between salivary cortisol and chlorpromazine equivalent doses and/or antipsychotic medication. Our findings suggest that smoking does not affect the cortisol response in schizophrenic patients as it has been shown in healthy individuals. Future studies should investigate a possible desensitization of the stress system to smoking