Monocyte related haematological indices in acute exacerbations of COPD - a new biomarker?

C-reactive protein (CRP) and leukocyte count are standard tools for recognising inflammation in COPD patients. This study aimed to find if there is a pattern in monocyte related haematological indices - monocyte to neutrophil ratio (MNR) and monocyte to lymphocyte ratio (MLR) - which could be helpful in differentiating COPD patients in need for hospitalization due to acute exacerbation of COPD or differentiating frequent COPD exacerbators from non-frequent COPD exacerbators. The study included 119 patients with COPD and 35 control subjects, recruited at the Clinic for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, Croatia.

ANDRIJA ŠTAMPAR AS PRESIDENT OF THE INTERIM COMMISSION OF THE WORLD HEALTH ORGANIZATION.

This paper provides an analysis of Andrija Štampar's activities after World War II on the establishment of effective international health. Analyzed archival materials have confirmed with numerous evidence that Štampar as the president of the Interim Commission of the World Health Organization (WHO) played a crucial role in the establishment of the ideological starting points and organization of the WHO system, which remain relevant to date. Apart from the strategic foundations, it has been shown that his principles regarding the need for practical action based on the best professional knowledge and experience have no alternatives.

Elastographic parameters of liver steatosis and fibrosis predict independently the risk of incident chronic kidney disease and acute myocardial infarction in patients with type 2 diabetes mellitus.

Aims: The aim of this prospective study was to examine the relationship between controlled attenuation parameter (CAP) and liver stiffness measurements (LSM) with the risk of developing a composite endpoint inclusive of incident acute myocardial infarction (AMI), cerebrovascular insult (CVI) or chronic kidney disease (CKD) in people with type 2 diabetes mellitus (T2DM).

Methods: This study included 238 T2DM outpatients without chronic liver diseases.

Results: The patient population was followed for a median period of 7.

Liver disease in the era of COVID-19: Is the worst yet to come?

The global social, economic and political crises related to coronavirus disease 2019 (COVID-19) presumably had more indirect than direct negative impacts on health systems. Drastic lifestyle changes, social isolation and distancing, and individual and global financial crises resulted in robust populations forfeiting healthy habits and seeking comfort in alcoholic beverages, drugs and unhealthy diets. The inevitable consequences are increases in the incidence of nonalcoholic fatty liver disease, viral hepatitis, acute alcoholic hepatitis, liver cirrhosis decompensation and ultimately liver-related mortality.

Significant liver fibrosis, as assessed by fibroscan, is independently associated with chronic vascular complications of type 2 diabetes: A multicenter study.

Aims: The aim of this study was to investigate whether controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), as assessed by vibration-controlled transient elastography (VCTE), are associated with chronic vascular complications of diabetes mellitus type 2 (T2DM).

Methods: We studied 442 outpatients with established T2DM, and who underwent VCTE and extensive assessment of chronic vascular complications of diabetes.

Results: A quarter of analyzed patients had a previous history of myocardial infarction and/or ischemic stroke, and about half of them had at least one microvascular complication (chronic kidney disease (CKD), retinopathy or polyneuropathy).

Impact of HER2 receptor status on axillary nodal burden in patients with non-luminal A invasive ductal breast carcinoma.

Background: Breast cancer (BC) is the most common malignancy in women.

Aim: To assess the impact of HER2 status on axillary lymph node (ALN) involvement in patients with invasive ductal carcinoma of no special type (IDC-NST) both at diagnosis and during the 4-year postoperative period.

Patients And Methods: We retrospectively included 375 women with an early clinical stage of non-luminal IDC-NST who between 2007 and 2013 underwent breast surgery at a clinical hospital.

Simple predictors of the re- occurrence of severe febrile neutropenia episode: a single-center retrospective cohort study in pediatric patients with malignant diseases.

Aim: To identify the risk factors of a repeated episode of severe febrile neutropenia (FN) and to build an accurate and easy-to-use predictive model.

Methods: This single-center retrospective cohort study conducted at the Clinical Hospital Center Children's Hospital Rijeka from January 1, 2008 to December 31, 2016 included pediatric patients with malignant diseases who experienced at least one FN episode. The association of the second severe FN episode appearance with relevant clinical and laboratory data was analyzed by logistic regression.

Contemporary ventilatory strategies for surgical patients.

Respiratory failure affects a significant percentage of critically ill children, necessitating both invasive and non-invasive respiratory support. As the outcomes of these patients have improved, children with higher acuity and more complex respiratory pathophysiology require mechanical ventilation. Despite growing understanding of lung-protective strategies and ventilation induced lung injury, certain patients still require harmful ventilatory settings with conventional mechanical ventilation (CMV).

Delayed Healing Associated with Silver Sulfadiazine Use for Partial Thickness Scald Burns in Children.

Burns are a leading cause of injury in children. Management principles vary widely, with no consensus about the best treatment. The purpose of this study was to compare outcomes of three different dressings for pediatric partial-thickness scald burns.

Hollow Fiber Oxygenator Composition Has a Significant Impact on Failure Rates in Neonates on Extracorporeal Membrane Oxygenation: A Retrospective Analysis.

In extracorporeal life support (ECLS), there are two main types of oxygenators in clinical use for neonates: polymethylpentene (PMP) hollow fiber and polypropylene (PP) hollow fiber. A retrospective study was performed on neonates (  = 44) who had undergone ECLS for noncardiac indications from 2009 to 2015. Between the two groups (PMP  = 21, PP  = 23), the PP oxygenators failed 91% of the time, whereas the PMP oxygenators failed 43% of the time (  < 0.

Validation of the Croatian version of CIVIQ quality of life questionnaire in patients with chronic venous disorders.

Aim: To test the psychometric properties of the Croatian version of the Chronic Venous Insufficiency Quality of Life (CIVIQ) Questionnaire and to assess the quality of life in patients with chronic venous disorders of all stages.

Methods: This cross-sectional study performed between 2014 and 2015 in a private family practice assessed the factorial validity, cross-sectional validity, and reliability of the Croatian CIVIQ 20-item questionnaire completed by 428 adult patients (78% women) with chronic venous disorders classified according to the Clinical-Etiologic-Anatomic-Pathophysiologic (CEAP) C classification as stages C1-C6.

Results: Median patient age was 52 years (5th-95th percentile, 30-77).

Management of mixed type congenital mesoblastic nephroma: Case series and review of the literature.

Congenital mesoblastic nephroma (CMN) is the most common renal tumor of infancy; however, it occurs infrequently with an incidence of 1 : 125,000. The cellular and classical variants are the most common subtypes of tumors, with a mixed variant occurring infrequently. We describe two cases of mixed variant CMN, which presented within days of each other differing in their clinical behavior.

Endothelial dysfunction as assessed with magnetic resonance imaging - A major determinant in chronic heart failure.

Chronic heart failure (CHF) is a clinical syndrome resulting from interaction of different structure and functional disturbances leading to decreased heart ability to ensure adequate supply of oxygenized blood to tissues and ensure adequate metabolic needs in the cases of normal or increased afterload. Endothelial dysfunction (ED) is a pathological condition characterized by general imbalance of all major endothelial mechanisms with key role in development and progression of atherosclerotic disease. ED has been associated with most cardiovascular risk factors.

Cardiac manifestations in alcoholic liver disease.

Alcoholic liver disease is the most prevalent cause of progressive liver disease in Europe. Alcoholic cirrhosis occurs in 8%-20% of cases of alcoholic liver disease. It has significant influence on cardiovascular system and haemodynamics through increased heart rate, cardiac output, decreased systemic vascular resistance, arterial pressure and plasma volume expansion.

Erectile function in cardiovascular patients: its significance and a quick assessment using a visual-scale questionnaire.

Purpose: The aim of this study was to investigate the connection between erectile dysfunction (ED) and cardiovascular diseases and to test a novel visual-scale questionnaire (VEF) we propose for the assessment of erectile function.

Subjects And Methods: Erectile function was assessed in 170 male cardiovascular patients under the age of 70 by the use of several self-administered questionnaires: the International Index of Erectile Function-5 (IIEF-5); the Massachusetts Male Aging Study questionnaires (MMAS Sexual Activity Questionnaire and MMAS Single Question), and finally, VEF.

Results: Patients’ mean age was 55.

Comparative Study of Intragastric Balloon and Cognitive-Behavioral Approach for Non-Morbid Obesity.

Background/aims: Intragastric balloon (IGB) and cognitive-behavioral therapy (CBT) are possible options for weight reduction. The aim of our study was to compare their effectivness in inducing weight loss and metabolic changes accompanying weight loss in non-morbidly obese patients.

Methodology: Subjects were required to be between 18 and 55 years old and to have a BMI between 30 and 45 to be eligible.

Persistent endothelial dysfunction turns the frequent exacerbator COPD from respiratory disorder into a progressive pulmonary and systemic vascular disease.

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in developed countries of the world, while the main cause of mortality and morbidity in COPD patients are acute exacerbations and cardiovascular diseases. With regard to the frequency of exacerbations the phenotype "frequent exacerbators" has been defined, which, besides a more severe clinical course and a significantly higher total mortality, is also characterised by an elevated risk of cardiovascular mortality, as some indicators show us. It is notable that during the exacerbation of COPD, next to other changes, a significant aggravation of endothelial function occurs while the ED and COPD relationship seems very complex and is still in greater part unknown.

[Volume assessment in the acute heart and renal failure].

Acute kidney injury (AKI) is an important clinical issue, especially in the setting of critical care. It has been shown in multiple studies to be a key independent risk factor for mortality, even after adjustment for demographics and severity of illness. There is wide agreement that a generally applicable classification system is required for AKI which helps to standardize estimation of severity of renal disfunction and to predict outcome associated with this condition.

Detection of myocardial ischemia in diabetic patients: the limitations of myocardial perfusion imaging.

In the study of 286 patients with suspected coronary artery disease and recent exercise single photon emission computed tomography (SPECT) test, we performed coronary angiography with coronary fractional flow reserve (FFR) measurement and tested the differences between diabetic (103) and non-diabetic (183) patients in ischemia detection by this two methods. The diabetic patients had a higher prevalence of hypertension, higher BMI and cholesterol levels, as well as longer duration of hospitalization than non-diabetic patients. There was no difference found between groups according to the exercise SPECT test, but, there were significantly more negative results in the non-diabetic group than in the diabetic group according to the FFR test, also, the percentage of stenosis was higher in diabetic patients.

Can we assess an acute myocardial infarction in patients with acute coronary syndrome according to diagnostic accuracy of heat shock proteins?

Heat shock proteins (HSPs) have changed very little with evolution, suggesting that they play important role(s) in cellular survival. Specifically, HSPs protect cells from induced cell death. Their expression is triggered by heat or other stress, such as ischemia.

Total knee replacement surgery is followed by transitory endothelial dysfunction.

Acute coronary syndrome (ACS) presents today the leading group of post-operative cardiovascular complications, while endothelial dysfunction (ED) is one of the key elements in its development. The chronic ED represents thus the basis for the gradual development of atherosclerotic changes, while its sudden aggravation leads to ACS. The persistent ED occurs due to the effects of chronic cardiovascular risk factors, while according to the available studies it can also develop or aggravate under the impact of different acute events.

Harmful immune reactions during acute myocardial infarction.

Acute coronary syndrome, including myocardial infarction, can occur as a result of ischaemia-reperfusion injury caused by acute occlusion of the coronary vessel/s following the rupture of an atherosclerotic plaque. Superimposed thrombosis at the lesion obstructs blood supply to the myocardium causing myocardial necrosis and ischaemic inflammation. Although not fully described, researchers believe that this process is initiated by a dysfunctional endothelium that activates the nearby leukocytes in the blood stream, thus attracting them to the arterial wall and initiating a cascade of complex mechanisms that lead to myocardial infarction.

Regular dog-walking improves physical capacity in elderly patients after myocardial infarction.

Various positive effects of pet ownership on cardiovascular health are well known. The aim of this prospective and controlled longitudinal study was to determine the effects of everyday dog-walking on physical capacity in elderly patients during the first year after myocardial infarction. Regularly dog-walking for at least 15 minutes three times a day is related to significantly higher work load on the bicycle exercise test (72.