1,720,999 research outputs found
The influence of non-alcoholic fatty liver disease on serum concentrations of transforming growth factor-beta in COVID-19
No full textNealkoholna masna bolest jetre (NAFLD) vodeći je uzrok kronične jetrene bolesti u razvijenom svijetu i prepoznata je kao rizični faktor za razvoj težih oblika COVID-19. Unatoč tome, imunološki mehanizmi kojima NAFLD pogoršava COVID-19 su i dalje nepoznati. Transformirajući čimbenik rasta beta 1 (TGF-β1) sa svojim imunomodulatornim i profibrotičkim djelovanjem ima važnu ulogu u NAFLD-u. Njegova uloga u COVID-19 je manje jasna, ali bi mogla biti patofiziološka poveznica između te dvije bolesti. Cilj ovog istraživanja parova bio je analizirati serumske koncentracije TGF-β1 u COVID-19 pacijenata ovisno o prisustvu NAFLD-a i težine bolesti. U istraživanje je uključeno 60 hospitaliziranih COVID-19 pacijenata (od kojih 30 je dijagnosticiran NAFLD) i 20 zdravih kontrola (od kojih 10 je dijagnosticiran NAFLD) koji se nisu razlikovali ovisno o dobi i spolu. Izmjerene su im serumske koncentracije TGF-β1 te su hospitalizirani pacijenti dodatno podijeljeni u podskupine ovisno o težini COVID-19 (srednje teški, teški i kritični). Oboljeli od COVID-19 imali su niže vrijednosti TGF-β1 u odnosu na zdrave kontrole. Prisustvo NAFLD-a bilo je povezano s višim koncentracijama TGF-β1 i u COVID-19 oboljelih i u zdravih kontrola. Nadalje, serumske razine TGF-β1 korelirale su s težinom COVID-19, a najviše su bile u kritično bolesnih. Iako su teži oblici bolesti bili praćeni višim koncentracijama TGF-β1, u non-NAFLD skupini, za razliku od NAFLD skupine, nije postojala statistički značajna razlika u razini TGF-β1 ovisno o težini COVID-19. Osim toga, koncentracije TGF-β1 pokazale su dobru diskriminativnu vrijednost u predikciji razvoja komplikacija i loših ishoda COVID-19 poput potrebe za naprednim mjerama respiratorne potpore, vremena oporavka, primitka u jedinicu intenzivnog liječenja (JIL), razvoja nozokomijalnih infekcija i smrtnosti. Zaključno, TGF-β1 bi mogao biti dobar prognostički biomarker za težinu bolesti i loše ishode COVID-19 u pacijenata s NAFLD-om.Non-alcoholic fatty liver disease (NAFLD), the leading cause of chronic liver disease in Western countries, was identified as a possible risk factor for COVID-19 severity. However, immunological mechanisms by which NAFLD exacerbates COVID-19 remain unknown. Transforming growth factor-beta1 (TGF-β1) has an important immunomodulatory and profibrotic role, which has already been well described in NAFLD. However, the role of TGF-β1 in COVID-19 remains unclear but could also be the pathophysiology link between these two conditions. The aim of this case-control study was to analyze the expression of TGF-β1 in COVID-19 patients depending on the presence of NAFLD and disease severity. Serum TGF-β1 concentrations were measured in 60 hospitalized COVID-19 patients (30 subsequently diagnosed with NAFLD) and 20 healthy controls (10 subsequently diagnosed with NAFLD). There were no differences in age and sex between the groups and the COVID-19 group was further divided into subgroups depending on disease severity (moderate, severe, and critical). The COVID-19 group had lower levels of TGF-β1 compared to healthy controls. NAFLD was associated with higher serum TGF-β1 concentrations in both the COVID-19 group and healthy controls. TGF-β1 concentrations also correlated with COVID-19 severity. However, unlike in the NAFLD group, there was no significant correlation between TGF-β1 concentrations and disease severity in the non-NAFLD group. Furthermore, admission TGF-β1 concentrations showed good discriminative accuracy in predicting the development of critical disease and COVID-19 complications (need for advanced respiratory support, ICU admission, time to recovery, development of nosocomial infections, and mortality). In conclusion, TGF-β1 could be an efficient biomarker for predicting disease severity and adverse outcomes in patients with NAFLD
Visceral leishmaniasis
No full textVisceralna lišmanioza spada u zanemarene tropske bolesti (eng. NTD, Neglected tropical disease) i gorući je javnozdravstveni problem u slabije razvijenim zemljama. Još se naziva i kala-azar, odnosno crna bolest na hindski, jer može dovesti do crnosivog obojenja kože. Budući da neliječena uzrokuje smrtnonost u preko 95% slučajeva, liječenje bolesti je imperativ. Posebnu problematiku predstavlja dermalna sekvela bolesti pod nazivom post kala-azar dermalna lišmanioza. Naime, nakon izliječene visceralne lišmanioze moguć je razvoj dermalnih simptoma s odmakom koji varira od nekoliko mjeseci do par godina. Nije u potpunosti jasno nastaje li kao posljedica perzistencije parazita ili reinfekcije, no pacijenti s ovim oblikom bolesti predstavljaju važan izvor infekcije i time otežavaju eliminaciju bolesti. Osim toga, bilježi se i porast HIV-VL koinfekcije koju karakteriziraju učestali relapsi i slabiji odgovor na terapiju. Iako je u nekim zemljama postignut značajan napredak u kontroli bolesti, klimatske promjene, siromaštvo i brojne migracije pogoduju opstanku Leishmania spp., stoga su potrebni daljnji napori ne bi li se spriječilo širenje bolesti i uspostavila kontrola u endemskim zemljama.Visceral leishmaniasis is categorized as a neglected tropical disease (NTD) and represents critical public health issue in less developed countries. It is also known as kala-azar, or black sickness in Hindi, because it can lead to black or gray discoloration of the skin. Due to the fact that untreated cases result in a mortality rate of over 95%, treating the disease is a necessity. Another important issue is the dermal sequela of the disease called post-kala-azar dermal leishmaniasis. After being cured of visceral leishmaniasis, dermal symptoms may develop, with an onset ranging from several months to a few years. It is still not clear whether this occurs as a result of persistent parasites or reinfection, but patients with this form of the disease represent an important source of infection and consequently complicating efforts to eliminate the disease. Moreover, rises in HIV-VL co-infection are being recorded, recognizible by frequent relapses and a poor outcome to treatment. Although meaningful progress has been made in some countries in controlling the disease, climate change, poverty, and numerous migrations favor the survival of Leishmania spp., further efforts are needed in order to stop the spreading of the disease and for gaining control over the disease in endemic countries
Frequency of metabolic syndrome components and fatty liver in patients with severe bacterial infection
No full textMetabolički sindrom i masna jetra česti su metabolički poremećaji koji nose značajan kardiovaskularni rizik te rizik za kroničnu jetrenu bolest. Ta dva entiteta isprepletena su u mreži patofizioloških mehanizama koji dovode do modulacije imunološkog odgovora, što bi mogla biti podloga za povećani rizik od infekcija. Cilj ovog rada bio je istražiti prevalenciju komponenata metaboličkog sindroma i masne jetre u hospitaliziranih bolesnika sa teškim bakterijskim infekcijama. Radi se o presječnom istraživanju na 319 ispitanika hospitaliziranih na Klinici za infektivne bolesti “Dr. Fran Mihaljević” u razdoblju od siječnja do prosinca 2022. godine. Osim bilježenja učestalosti navedenih stanja, ispitanici su grupirani prema dobi, spolu, kliničkom sindromu, stupnju steatoze i fibroze. Izračunate su ukupne prevalencije te prevalencije po kliničkim sinromima za pojedine komponente metaboličkog sindroma i NAFLD. Ispitanici su podijeljeni prema NAFLD statusu u dvije skupine koje su zatim uspoređivane s obzirom na prisutnost komponenata metaboličkog sindroma. Rezultati su naposlijetku stavljeni u kontekst dostupne literature.Metabolic syndrome and fatty liver are common metabolic disorders that carry significant cardiovascular risk and risk for chronic liver disease. These two entities are intertwined in a network of pathophysiological mechanisms that lead to modulation of the immune response, which could be the basis for an increased risk of infections. The aim of this study was to investigate this relationship and determine the prevalence of metabolic syndrome components and fatty liver in hospitalized patients with severe bacterial infections. This is a cross-sectional study conducted on 319 patients hospitalized at the Clinic for Infectious Diseases “Dr. Fran Mihaljević" from January to December 2022. In addition to recording the frequency of the mentioned conditions, the participants were grouped according to age, gender, clinical syndrome, degree of steatosis and fibrosis. Total prevalences and prevalences per clinical syndrome were calculated for individual components of metabolic syndrome and NAFLD. The participants were divided into two groups based on NAFLD status, which were then compared regarding the presence of metabolic syndrome components. The results were ultimately contextualised with the available literature
Frequency of metabolic syndrome components and fatty liver in patients with severe bacterial infection
No full textMetabolički sindrom i masna jetra česti su metabolički poremećaji koji nose značajan kardiovaskularni rizik te rizik za kroničnu jetrenu bolest. Ta dva entiteta isprepletena su u mreži patofizioloških mehanizama koji dovode do modulacije imunološkog odgovora, što bi mogla biti podloga za povećani rizik od infekcija. Cilj ovog rada bio je istražiti prevalenciju komponenata metaboličkog sindroma i masne jetre u hospitaliziranih bolesnika sa teškim bakterijskim infekcijama. Radi se o presječnom istraživanju na 319 ispitanika hospitaliziranih na Klinici za infektivne bolesti “Dr. Fran Mihaljević” u razdoblju od siječnja do prosinca 2022. godine. Osim bilježenja učestalosti navedenih stanja, ispitanici su grupirani prema dobi, spolu, kliničkom sindromu, stupnju steatoze i fibroze. Izračunate su ukupne prevalencije te prevalencije po kliničkim sinromima za pojedine komponente metaboličkog sindroma i NAFLD. Ispitanici su podijeljeni prema NAFLD statusu u dvije skupine koje su zatim uspoređivane s obzirom na prisutnost komponenata metaboličkog sindroma. Rezultati su naposlijetku stavljeni u kontekst dostupne literature.Metabolic syndrome and fatty liver are common metabolic disorders that carry significant cardiovascular risk and risk for chronic liver disease. These two entities are intertwined in a network of pathophysiological mechanisms that lead to modulation of the immune response, which could be the basis for an increased risk of infections. The aim of this study was to investigate this relationship and determine the prevalence of metabolic syndrome components and fatty liver in hospitalized patients with severe bacterial infections. This is a cross-sectional study conducted on 319 patients hospitalized at the Clinic for Infectious Diseases “Dr. Fran Mihaljević" from January to December 2022. In addition to recording the frequency of the mentioned conditions, the participants were grouped according to age, gender, clinical syndrome, degree of steatosis and fibrosis. Total prevalences and prevalences per clinical syndrome were calculated for individual components of metabolic syndrome and NAFLD. The participants were divided into two groups based on NAFLD status, which were then compared regarding the presence of metabolic syndrome components. The results were ultimately contextualised with the available literature
Visceral leishmaniasis
No full textVisceralna lišmanioza spada u zanemarene tropske bolesti (eng. NTD, Neglected tropical disease) i gorući je javnozdravstveni problem u slabije razvijenim zemljama. Još se naziva i kala-azar, odnosno crna bolest na hindski, jer može dovesti do crnosivog obojenja kože. Budući da neliječena uzrokuje smrtnonost u preko 95% slučajeva, liječenje bolesti je imperativ. Posebnu problematiku predstavlja dermalna sekvela bolesti pod nazivom post kala-azar dermalna lišmanioza. Naime, nakon izliječene visceralne lišmanioze moguć je razvoj dermalnih simptoma s odmakom koji varira od nekoliko mjeseci do par godina. Nije u potpunosti jasno nastaje li kao posljedica perzistencije parazita ili reinfekcije, no pacijenti s ovim oblikom bolesti predstavljaju važan izvor infekcije i time otežavaju eliminaciju bolesti. Osim toga, bilježi se i porast HIV-VL koinfekcije koju karakteriziraju učestali relapsi i slabiji odgovor na terapiju. Iako je u nekim zemljama postignut značajan napredak u kontroli bolesti, klimatske promjene, siromaštvo i brojne migracije pogoduju opstanku Leishmania spp., stoga su potrebni daljnji napori ne bi li se spriječilo širenje bolesti i uspostavila kontrola u endemskim zemljama.Visceral leishmaniasis is categorized as a neglected tropical disease (NTD) and represents critical public health issue in less developed countries. It is also known as kala-azar, or black sickness in Hindi, because it can lead to black or gray discoloration of the skin. Due to the fact that untreated cases result in a mortality rate of over 95%, treating the disease is a necessity. Another important issue is the dermal sequela of the disease called post-kala-azar dermal leishmaniasis. After being cured of visceral leishmaniasis, dermal symptoms may develop, with an onset ranging from several months to a few years. It is still not clear whether this occurs as a result of persistent parasites or reinfection, but patients with this form of the disease represent an important source of infection and consequently complicating efforts to eliminate the disease. Moreover, rises in HIV-VL co-infection are being recorded, recognizible by frequent relapses and a poor outcome to treatment. Although meaningful progress has been made in some countries in controlling the disease, climate change, poverty, and numerous migrations favor the survival of Leishmania spp., further efforts are needed in order to stop the spreading of the disease and for gaining control over the disease in endemic countries
Frequency of metabolic syndrome components and fatty liver in patients with severe bacterial infection
No full textMetabolički sindrom i masna jetra česti su metabolički poremećaji koji nose značajan kardiovaskularni rizik te rizik za kroničnu jetrenu bolest. Ta dva entiteta isprepletena su u mreži patofizioloških mehanizama koji dovode do modulacije imunološkog odgovora, što bi mogla biti podloga za povećani rizik od infekcija. Cilj ovog rada bio je istražiti prevalenciju komponenata metaboličkog sindroma i masne jetre u hospitaliziranih bolesnika sa teškim bakterijskim infekcijama. Radi se o presječnom istraživanju na 319 ispitanika hospitaliziranih na Klinici za infektivne bolesti “Dr. Fran Mihaljević” u razdoblju od siječnja do prosinca 2022. godine. Osim bilježenja učestalosti navedenih stanja, ispitanici su grupirani prema dobi, spolu, kliničkom sindromu, stupnju steatoze i fibroze. Izračunate su ukupne prevalencije te prevalencije po kliničkim sinromima za pojedine komponente metaboličkog sindroma i NAFLD. Ispitanici su podijeljeni prema NAFLD statusu u dvije skupine koje su zatim uspoređivane s obzirom na prisutnost komponenata metaboličkog sindroma. Rezultati su naposlijetku stavljeni u kontekst dostupne literature.Metabolic syndrome and fatty liver are common metabolic disorders that carry significant cardiovascular risk and risk for chronic liver disease. These two entities are intertwined in a network of pathophysiological mechanisms that lead to modulation of the immune response, which could be the basis for an increased risk of infections. The aim of this study was to investigate this relationship and determine the prevalence of metabolic syndrome components and fatty liver in hospitalized patients with severe bacterial infections. This is a cross-sectional study conducted on 319 patients hospitalized at the Clinic for Infectious Diseases “Dr. Fran Mihaljević" from January to December 2022. In addition to recording the frequency of the mentioned conditions, the participants were grouped according to age, gender, clinical syndrome, degree of steatosis and fibrosis. Total prevalences and prevalences per clinical syndrome were calculated for individual components of metabolic syndrome and NAFLD. The participants were divided into two groups based on NAFLD status, which were then compared regarding the presence of metabolic syndrome components. The results were ultimately contextualised with the available literature
Povezanost uporabe psihofarmaka i recidivirajućih Clostridioides difficile infekcija
No full textCilj istraživanja: Clostridioides difficile infekcije predstavljaju rastući globalni problem te
sukladno tome postoji potreba za pronalaskom novih potencijalnih pacijenata s povećanim
rizikom od infekcije. S obzirom na raširenu uporabu psihofarmaka te njihove raznovrsne
mehanizme djelovanja i učinke u gastrointestinalnom sustavu, cilj istraživanja je ispitati
povezanost upotrebe psihofarmaka i pojave recidivirajućih Clostridioides difficile infekcija.
Ispitanici i metode: Provedeno je retrospektivno kohortno istraživanje u koje su uključeni
ispitanici stariji od 60 godina, a koji su hospitalizirani u Klinici za infektivne bolesti „Dr. Fran
Mihaljević“ u Zagrebu u razdoblju od 2016. do 2019. godine radi prve epizode CDI. Kohorta
ispitanika je podijeljena u dvije skupine: bolesnici koji nisu rehospitalizirani radi rCDI unutar
tri mjeseca od otpusta i oni koji jesu hospitalizirani radi rCDI unutar tri mjeseca od prve
epizode. Prikupljeni su potrebni klinički, laboratorijski i mikrobiološki podatci o bolesnicima
iz kartona bolesnika, a psihofarmaci su u svrhu ovog istraživanja podijeljeni u šest skupina.
Rezultati: U studiju je bilo uključeno ukupno 305 ispitanika, od kojih su 180, tj., 59% žene,
prosječne dobi 78 godina (IQR (interquartile range) 71- 83 godine). Unutar cijele kohorte, 106
(34,8%) pacijenata je razvilo recidivirajuću CDI unutar 90 dana od hospitalizacije ili od
završetka terapije za prvu epizodu (ukupno je zabilježeno 171 epizoda CDI). Od navedenih
pacijenata, 76 je razvilo rCDI do 28., a 99 do 90. dana. Psihofarmake u kroničnoj terapiji
upotrebljava značajan broj pacijenata od ukupnog broja ispitanika (59,8% naspram 62,3%),
podjednako i u jednoj i u drugoj skupini. Nije utvrđena razlika u upotrebi psihofarmaka između
bolesnika koji su razvili rCDI u usporedbi s onima koji su imali samo jednu epizodu CDI.
Zaključak: Ovo istraživanje nije pronašlo statistički značajnu povezanost uporabe
psihofarmaka i recidivirajućih C. difficile infekcija, međutim, psihofarmaci su vrlo kompleksna
skupina lijekova čija je uporaba iznimno raširena, a nova saznanja o utjecaju mikrobioma na
središnji živčani sustav i obrnuto upućuju na važnost novih istraživanja.Objectives: Clostridioides difficile infections represent a growing global problem, and
accordingly there is a need to find new potential patients with an increased risk of infection.
Considering the widespread use of psychotropic drugs and their various mechanisms of action
and effects in the gastrointestinal system, the aim of the study is to examine the connection
between the use of psychotropic drugs and the occurrence of recurrent Clostridioides difficile
infections.
Patients and Methods: A retrospective cohort study was conducted, which included subjects
over the age of 60, who were hospitalized at the Clinic for Infectious Diseases "Dr. Fran
Mihaljević" in Zagreb in the period from 2016 to 2019 for the first episode of CDI. The patient
cohort consists of patients in two groups: those who were not rehospitalized for rCDI within
three months of discharge and those who were hospitalized for rCDI within three months of the
first episode. The necessary clinical, laboratory and microbiological data on the patients were
collected from the patient records, and psychotropic drugs were divided into six groups for the
purpose of this research.
Results: A total of 305 subjects were included in the study, of which 180, i.e., 59% were
women, with an average age of 78 years (IQR (interquartile range) 71-83 years). Within the
entire cohort, 106 (34.8%) patients developed recurrent CDI within 90 days of hospitalization
or completion of therapy for the first episode (a total of 171 CDI episodes). Of these patients,
76 developed rCDI by day 28, and 99 by day 90. Psychopharmaceuticals are used in chronic
therapy by a significant number of patients out of the total number of respondents (59.8% vs.
62.3%), equally in one and the other group. No difference was found in the use of psychotropic
drugs between patients who developed rCDI compared to those who had only one episode of
CDI.
Conclusion: This research did not find a statistically significant association between the use of
psychotropic drugs and recurrent C. difficile infections, however, psychotropic drugs are a very
complex drug group whose use is extremely wide, and new knowledge about the influence of
the microbiome on the central nervous system and vice versa points to the importance of new
research
Visceral leishmaniasis
No full textVisceralna lišmanioza spada u zanemarene tropske bolesti (eng. NTD, Neglected tropical disease) i gorući je javnozdravstveni problem u slabije razvijenim zemljama. Još se naziva i kala-azar, odnosno crna bolest na hindski, jer može dovesti do crnosivog obojenja kože. Budući da neliječena uzrokuje smrtnonost u preko 95% slučajeva, liječenje bolesti je imperativ. Posebnu problematiku predstavlja dermalna sekvela bolesti pod nazivom post kala-azar dermalna lišmanioza. Naime, nakon izliječene visceralne lišmanioze moguć je razvoj dermalnih simptoma s odmakom koji varira od nekoliko mjeseci do par godina. Nije u potpunosti jasno nastaje li kao posljedica perzistencije parazita ili reinfekcije, no pacijenti s ovim oblikom bolesti predstavljaju važan izvor infekcije i time otežavaju eliminaciju bolesti. Osim toga, bilježi se i porast HIV-VL koinfekcije koju karakteriziraju učestali relapsi i slabiji odgovor na terapiju. Iako je u nekim zemljama postignut značajan napredak u kontroli bolesti, klimatske promjene, siromaštvo i brojne migracije pogoduju opstanku Leishmania spp., stoga su potrebni daljnji napori ne bi li se spriječilo širenje bolesti i uspostavila kontrola u endemskim zemljama.Visceral leishmaniasis is categorized as a neglected tropical disease (NTD) and represents critical public health issue in less developed countries. It is also known as kala-azar, or black sickness in Hindi, because it can lead to black or gray discoloration of the skin. Due to the fact that untreated cases result in a mortality rate of over 95%, treating the disease is a necessity. Another important issue is the dermal sequela of the disease called post-kala-azar dermal leishmaniasis. After being cured of visceral leishmaniasis, dermal symptoms may develop, with an onset ranging from several months to a few years. It is still not clear whether this occurs as a result of persistent parasites or reinfection, but patients with this form of the disease represent an important source of infection and consequently complicating efforts to eliminate the disease. Moreover, rises in HIV-VL co-infection are being recorded, recognizible by frequent relapses and a poor outcome to treatment. Although meaningful progress has been made in some countries in controlling the disease, climate change, poverty, and numerous migrations favor the survival of Leishmania spp., further efforts are needed in order to stop the spreading of the disease and for gaining control over the disease in endemic countries
Povezanost uporabe psihofarmaka i recidivirajućih Clostridioides difficile infekcija
No full textCilj istraživanja: Clostridioides difficile infekcije predstavljaju rastući globalni problem te
sukladno tome postoji potreba za pronalaskom novih potencijalnih pacijenata s povećanim
rizikom od infekcije. S obzirom na raširenu uporabu psihofarmaka te njihove raznovrsne
mehanizme djelovanja i učinke u gastrointestinalnom sustavu, cilj istraživanja je ispitati
povezanost upotrebe psihofarmaka i pojave recidivirajućih Clostridioides difficile infekcija.
Ispitanici i metode: Provedeno je retrospektivno kohortno istraživanje u koje su uključeni
ispitanici stariji od 60 godina, a koji su hospitalizirani u Klinici za infektivne bolesti „Dr. Fran
Mihaljević“ u Zagrebu u razdoblju od 2016. do 2019. godine radi prve epizode CDI. Kohorta
ispitanika je podijeljena u dvije skupine: bolesnici koji nisu rehospitalizirani radi rCDI unutar
tri mjeseca od otpusta i oni koji jesu hospitalizirani radi rCDI unutar tri mjeseca od prve
epizode. Prikupljeni su potrebni klinički, laboratorijski i mikrobiološki podatci o bolesnicima
iz kartona bolesnika, a psihofarmaci su u svrhu ovog istraživanja podijeljeni u šest skupina.
Rezultati: U studiju je bilo uključeno ukupno 305 ispitanika, od kojih su 180, tj., 59% žene,
prosječne dobi 78 godina (IQR (interquartile range) 71- 83 godine). Unutar cijele kohorte, 106
(34,8%) pacijenata je razvilo recidivirajuću CDI unutar 90 dana od hospitalizacije ili od
završetka terapije za prvu epizodu (ukupno je zabilježeno 171 epizoda CDI). Od navedenih
pacijenata, 76 je razvilo rCDI do 28., a 99 do 90. dana. Psihofarmake u kroničnoj terapiji
upotrebljava značajan broj pacijenata od ukupnog broja ispitanika (59,8% naspram 62,3%),
podjednako i u jednoj i u drugoj skupini. Nije utvrđena razlika u upotrebi psihofarmaka između
bolesnika koji su razvili rCDI u usporedbi s onima koji su imali samo jednu epizodu CDI.
Zaključak: Ovo istraživanje nije pronašlo statistički značajnu povezanost uporabe
psihofarmaka i recidivirajućih C. difficile infekcija, međutim, psihofarmaci su vrlo kompleksna
skupina lijekova čija je uporaba iznimno raširena, a nova saznanja o utjecaju mikrobioma na
središnji živčani sustav i obrnuto upućuju na važnost novih istraživanja.Objectives: Clostridioides difficile infections represent a growing global problem, and
accordingly there is a need to find new potential patients with an increased risk of infection.
Considering the widespread use of psychotropic drugs and their various mechanisms of action
and effects in the gastrointestinal system, the aim of the study is to examine the connection
between the use of psychotropic drugs and the occurrence of recurrent Clostridioides difficile
infections.
Patients and Methods: A retrospective cohort study was conducted, which included subjects
over the age of 60, who were hospitalized at the Clinic for Infectious Diseases "Dr. Fran
Mihaljević" in Zagreb in the period from 2016 to 2019 for the first episode of CDI. The patient
cohort consists of patients in two groups: those who were not rehospitalized for rCDI within
three months of discharge and those who were hospitalized for rCDI within three months of the
first episode. The necessary clinical, laboratory and microbiological data on the patients were
collected from the patient records, and psychotropic drugs were divided into six groups for the
purpose of this research.
Results: A total of 305 subjects were included in the study, of which 180, i.e., 59% were
women, with an average age of 78 years (IQR (interquartile range) 71-83 years). Within the
entire cohort, 106 (34.8%) patients developed recurrent CDI within 90 days of hospitalization
or completion of therapy for the first episode (a total of 171 CDI episodes). Of these patients,
76 developed rCDI by day 28, and 99 by day 90. Psychopharmaceuticals are used in chronic
therapy by a significant number of patients out of the total number of respondents (59.8% vs.
62.3%), equally in one and the other group. No difference was found in the use of psychotropic
drugs between patients who developed rCDI compared to those who had only one episode of
CDI.
Conclusion: This research did not find a statistically significant association between the use of
psychotropic drugs and recurrent C. difficile infections, however, psychotropic drugs are a very
complex drug group whose use is extremely wide, and new knowledge about the influence of
the microbiome on the central nervous system and vice versa points to the importance of new
research
Povezanost uporabe psihofarmaka i recidivirajućih Clostridioides difficile infekcija
No full textCilj istraživanja: Clostridioides difficile infekcije predstavljaju rastući globalni problem te
sukladno tome postoji potreba za pronalaskom novih potencijalnih pacijenata s povećanim
rizikom od infekcije. S obzirom na raširenu uporabu psihofarmaka te njihove raznovrsne
mehanizme djelovanja i učinke u gastrointestinalnom sustavu, cilj istraživanja je ispitati
povezanost upotrebe psihofarmaka i pojave recidivirajućih Clostridioides difficile infekcija.
Ispitanici i metode: Provedeno je retrospektivno kohortno istraživanje u koje su uključeni
ispitanici stariji od 60 godina, a koji su hospitalizirani u Klinici za infektivne bolesti „Dr. Fran
Mihaljević“ u Zagrebu u razdoblju od 2016. do 2019. godine radi prve epizode CDI. Kohorta
ispitanika je podijeljena u dvije skupine: bolesnici koji nisu rehospitalizirani radi rCDI unutar
tri mjeseca od otpusta i oni koji jesu hospitalizirani radi rCDI unutar tri mjeseca od prve
epizode. Prikupljeni su potrebni klinički, laboratorijski i mikrobiološki podatci o bolesnicima
iz kartona bolesnika, a psihofarmaci su u svrhu ovog istraživanja podijeljeni u šest skupina.
Rezultati: U studiju je bilo uključeno ukupno 305 ispitanika, od kojih su 180, tj., 59% žene,
prosječne dobi 78 godina (IQR (interquartile range) 71- 83 godine). Unutar cijele kohorte, 106
(34,8%) pacijenata je razvilo recidivirajuću CDI unutar 90 dana od hospitalizacije ili od
završetka terapije za prvu epizodu (ukupno je zabilježeno 171 epizoda CDI). Od navedenih
pacijenata, 76 je razvilo rCDI do 28., a 99 do 90. dana. Psihofarmake u kroničnoj terapiji
upotrebljava značajan broj pacijenata od ukupnog broja ispitanika (59,8% naspram 62,3%),
podjednako i u jednoj i u drugoj skupini. Nije utvrđena razlika u upotrebi psihofarmaka između
bolesnika koji su razvili rCDI u usporedbi s onima koji su imali samo jednu epizodu CDI.
Zaključak: Ovo istraživanje nije pronašlo statistički značajnu povezanost uporabe
psihofarmaka i recidivirajućih C. difficile infekcija, međutim, psihofarmaci su vrlo kompleksna
skupina lijekova čija je uporaba iznimno raširena, a nova saznanja o utjecaju mikrobioma na
središnji živčani sustav i obrnuto upućuju na važnost novih istraživanja.Objectives: Clostridioides difficile infections represent a growing global problem, and
accordingly there is a need to find new potential patients with an increased risk of infection.
Considering the widespread use of psychotropic drugs and their various mechanisms of action
and effects in the gastrointestinal system, the aim of the study is to examine the connection
between the use of psychotropic drugs and the occurrence of recurrent Clostridioides difficile
infections.
Patients and Methods: A retrospective cohort study was conducted, which included subjects
over the age of 60, who were hospitalized at the Clinic for Infectious Diseases "Dr. Fran
Mihaljević" in Zagreb in the period from 2016 to 2019 for the first episode of CDI. The patient
cohort consists of patients in two groups: those who were not rehospitalized for rCDI within
three months of discharge and those who were hospitalized for rCDI within three months of the
first episode. The necessary clinical, laboratory and microbiological data on the patients were
collected from the patient records, and psychotropic drugs were divided into six groups for the
purpose of this research.
Results: A total of 305 subjects were included in the study, of which 180, i.e., 59% were
women, with an average age of 78 years (IQR (interquartile range) 71-83 years). Within the
entire cohort, 106 (34.8%) patients developed recurrent CDI within 90 days of hospitalization
or completion of therapy for the first episode (a total of 171 CDI episodes). Of these patients,
76 developed rCDI by day 28, and 99 by day 90. Psychopharmaceuticals are used in chronic
therapy by a significant number of patients out of the total number of respondents (59.8% vs.
62.3%), equally in one and the other group. No difference was found in the use of psychotropic
drugs between patients who developed rCDI compared to those who had only one episode of
CDI.
Conclusion: This research did not find a statistically significant association between the use of
psychotropic drugs and recurrent C. difficile infections, however, psychotropic drugs are a very
complex drug group whose use is extremely wide, and new knowledge about the influence of
the microbiome on the central nervous system and vice versa points to the importance of new
research
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