The gender and age perspectives of allostatic load.

The role of chronic stress in the development of chronic diseases, especially multimorbidity, through the pathways of increasing allostatic load, and finally, allostatic overload (the state when a compensatory mechanism is likely to fail) is being emphasized. However, allostatic load is a dynamic measure that changes depending on sex, gender, age, level and type of stress, experience of a stressful situation, and coping behaviors. Many other factors such as race, ethnicity, working environment, lifestyle, and circadian rhythm of sleep are also important.

Putting Functional Gastrointestinal Disorders within the Spectrum of Inflammatory Disorders Can Improve Classification and Diagnostics of These Disorders.

The spectrum, intensity, and overlap of symptoms between functional gastrointestinal disorders (FGIDs) and other gastrointestinal disorders characterize patients with FGIDs, who are incredibly different in their backgrounds. An additional challenge with regard to the diagnosis of FGID and the applicability of a given treatment is the ongoing expansion of the risk factors believed to be connected to these disorders. Many cytokines and inflammatory cells have been found to cause the continuous existence of a low level of inflammation, which is thought to be a basic pathophysiological process.

The Association between Functional Dyspepsia and Metabolic Syndrome-The State of the Art.

Functional dyspepsia is a common functional disorder of the gastrointestinal tract that is responsible for many primary care visits. No organic changes have been found to explain its symptoms. We hypothesize that modern lifestyles and environmental factors, especially psychological stress, play a crucial role in the high prevalence of functional dyspepsia and metabolic syndrome.

Influence of Age, Gender, Frailty, and Body Mass Index on Serum IL-17A Levels in Mature Type 2 Diabetic Patients.

BACKGROUND The cytokine IL-17A is emerging as a marker of chronic inflammation in cardio-metabolic conditions. This study aimed to identify relevant factors that in older primary care patients with type 2 diabetes (T2D) could influence serum IL-17A concentrations. The results have a potential to improve risk stratification and therapy options for these patients.

Immunomodulatory Effects of SGLT2 Inhibitors-Targeting Inflammation and Oxidative Stress in Aging.

Given that the increase in the aging population has grown into one of the largest public health issues, inflammation and oxidative stress, which are closely associated with the aging process, became a focus of recent research. Sodium-glucose co-transporter 2 (SGLT2) inhibitors, a group of drugs initially developed as oral antidiabetics, have shown many beneficial effects over time, including improvement in renal function and cardioprotective effects. It has been shown that SGLT2 inhibitors, as a drug class, have an immunomodulatory and antioxidative effect, affecting endothelial function as well as metabolic parameters.

A Critical Appraisal of the Diagnostic and Prognostic Utility of the Anti-Inflammatory Marker IL-37 in a Clinical Setting: A Case Study of Patients with Diabetes Type 2.

Background: The role of the cytokine interleukin-37 (IL-37) has been recognized in reversing inflammation-mediated metabolic costs. The aim was to evaluate the clinical utility of this cytokine as a diagnostic and prognostic marker in patients with type 2 diabetes (T2D).

Methods: We included 170 older (median: 66 years) individuals with T2D (females: 95) and classified as primary care attenders to assess the association of factors that describe patients with plasma IL-37 levels (expressed as quartiles) using multinomial regression models.

Patterns of the physical, cognitive, and mental health status of older individuals in a real-life primary care setting and differences in coping styles.

Background: Physical frailty and cognitive decline are two major consequences of aging and are often in older individuals, especially in those with multimorbidity. These two disorders are known to usually coexist with each other, increasing the risk of each disorder for poor health outcomes. Mental health disorders, anxiety and depression, are common in older people with multimorbidity, in particular those with functional or sensory deficits, and frailty.

Cross-Talk between the Cytokine IL-37 and Thyroid Hormones in Modulating Chronic Inflammation Associated with Target Organ Damage in Age-Related Metabolic and Vascular Conditions.

Chronic inflammation is considered to be the main mechanism contributing to the development of age-related metabolic and vascular conditions. The phases of chronic inflammation that mediate the progression of target organ damage in these conditions are poorly known, however. In particular, there is a paucity of data on the link between chronic inflammation and metabolic disorders.

Low Psychological Resilience in Older Individuals: An Association with Increased Inflammation, Oxidative Stress and the Presence of Chronic Medical Conditions.

The term resilience, which has been present in science for almost half a century, stands for the capacity of some system needed to overcome an amount of disturbance from the environment in order to avoid a change to another stable state. In medicine, the concept of resilience means the ability to deal with daily stress and disturbance to our homeostasis with the intention of protecting it from disturbance. With aging, the organism becomes more sensitive to environmental impacts and more susceptible to changes.

Clusters of Physical Frailty and Cognitive Impairment and Their Associated Comorbidities in Older Primary Care Patients.

(1) Objectives: We aimed to identify clusters of physical frailty and cognitive impairment in a population of older primary care patients and correlate these clusters with their associated comorbidities. (2) Methods: We used a latent class analysis (LCA) as the clustering technique to separate different stages of mild cognitive impairment (MCI) and physical frailty into clusters; the differences were assessed by using a multinomial logistic regression model. (3) Results: Four clusters (latent classes) were identified: (1) highly functional (the mean and SD of the "frailty" test 0.

Alopecia in preexisting autoimmune thyroid disease in family medicine practice: can hyperprolactinemia induce hair loss? A case report.

Management of hair loss in women presents several challenges for general practitioners, who are the first in identifying its cause and consequences in everyday clinical practice. It is usually associated with multiple secondary factors, including endocrine disorders, drug side effects, and physical or emotional stress. We report a possible pathophysiological link between hyperprolactinemia and alopecia in a patient with preexisting autoimmune thyroid disease, which has not been documented in a significant number in the literature.

Neutrophil-to-Lymphocyte Ratio as a Cardiovascular Risk Marker May Be Less Efficient in Women Than in Men.

Cardiovascular disease (CVD) is the leading cause of death in women, although traditionally, it has been considered as a male dominated disease. Chronic inflammation plays a crucial role in the development of insulin resistance, diabetes type 2 and CVD. Since studies on women were scarce, in order to improve diagnosis and treatment of CVD, there is a need to improve understanding of the role of inflammation in the development of CVD in women.

AI and Big Data in Healthcare: Towards a More Comprehensive Research Framework for Multimorbidity.

Multimorbidity refers to the coexistence of two or more chronic diseases in one person. Therefore, patients with multimorbidity have multiple and special care needs. However, in practice it is difficult to meet these needs because the organizational processes of current healthcare systems tend to be tailored to a single disease.

Cluster Analysis of the Associations among Physical Frailty, Cognitive Impairment and Mental Disorders.

BACKGROUND Physical frailty, cognitive impairment, and symptoms of anxiety and depression frequently co-occur in later life, but, to date, each has been assessed separately. The present study assessed their patterns in primary care patients aged ≥60 years. MATERIAL AND METHODS This cross-sectional study evaluated 263 primary care patients aged ≥60 years in eastern Croatia in 2018.

Prescribing Analgesics to Older People: A Challenge for GPs.

Background: Due to population aging, there is an increase in the prevalence of chronic diseases, and in particular musculoskeletal diseases. These trends are associated with an increased demand for prescription analgesics and an increased risk of polypharmacy and adverse medication reactions, which constitutes a challenge, especially for general practitioners (GPs), as the providers who are most responsible for the prescription policy.

Objectives: To identify patterns of analgesics prescription for older people in the study area and explore associations between a long-term analgesic prescription and comorbidity patterns, as well as the prescription of psychotropic and other common medications in a continuous use.

The Effect of Hypertension Duration and the Age of Onset on CV Risk Factors Expression in Perimenopausal Women.

Background: The impact of hypertension duration and the time of onset on the expression of metabolic syndrome (MS) and other CV risk factors, in perimenopausal women, have not been studied so far. Methods. A total of 202 women, old 47-59 years, and diagnosed with hypertension, were recruited from primary care practices in eastern Croatia.

Clustering of Mental and Physical Comorbidity and the Risk of Frailty in Patients Aged 60 Years or More in Primary Care.

BACKGROUND This study aimed to identify the clustering of comorbidities, cognitive, and mental factors associated with increased risk of pre-frailty and frailty in patients ≥60 years in a primary healthcare setting in eastern Croatia. MATERIAL AND METHODS There were 159 patients included in the cluster analysis who were ≥60 years and who underwent four-month follow-up. The first cluster contained 50 patients, the second cluster contained 74 patients, and the third cluster contained 35 patients.

Seasonality of the Cardiac Biomarker Troponin in the Eastern Croatian Population.

Background: The seasonality of acute myocardial infarction and progressive heart failure has been well established so far. Cardiac troponins (cTns) are organ-specific, not disease-specific, biomarkers. The seasonality of cTns has not been reported before.

Colorectal cancer early detection program integrated in practice of family physicians.

Aim: To present preliminary results of the colorectal cancer early detection program, a part of the project called "A Model of Early Cancer Detection Integrated in a Practice of a Family Physician", carried out by the Department of Family Medicine of the Osijek University School of Medicine and the Health Centre of Osijek, Croatia.

Methods: The strategy of the project, based on the central role of a family physician in the implementation of the early cancer detection programs, was described and preliminary results of the colorectal cancer early detection program are presented and compared with the same issues of the National Program, centrally conducted and supplied by public services.

Results: From the beginning of April unil the end of May 2009, a total number of 516 testing cards on occult faecal blood were delivered to patients from two target groups (aged 45-50 and 75-79).

Prediction of influenza vaccination outcome by neural networks and logistic regression.

The major challenge in influenza vaccination is to predict vaccine efficacy. The purpose of this study was to design a model to enable successful prediction of the outcome of influenza vaccination based on real historical medical data. A non-linear neural network approach was used, and its performance compared to logistic regression.