SERUM CATESTATIN CONCENTRATIONS AND LIPID STATUS IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA

Cilj istraživanja: Glavni ciljevi ovog istraživanja su bili usporediti serumske koncentracije katestatina i lipidih parametara u bolesnika s opstrukcijskom apnejom tijekom spavanja (OSA) i kontrolnih ispitanika te utvrditi moguću povezanost katestatina s polisomnografskim i lipidnim parametrima u populaciji OSA bolesnika. Ispitanici i metode: Ovo presječno kliničko istraživanje provedeno je u Centru za Medicinu spavanja Kliničkog bolničkog centra Split i Medicinskog fakulteta u Splitu tijekom razdoblja od prosinca 2016. do veljače 2018. godine, a uključilo je ukupno 75 odraslih novodijagnosticiranih bolesnika s OSA-om i 50 kontrolnih ispitanika usklađenih prema dobi, spolu i indeksu tjelesne mase. OSA je dijagnosticirana kontinuiranom cjelonoćnom laboratorijskom polisomnografijom (Alice 5LE, Philips Respironics, Eindhoven, Nizozemska) prema važećim praktičnim smjernicama. Svim ispitanicima uzeta je detaljna anamneza te izvršen fizikalni pregled i antropometrijsko mjerenje. Venski uzorci krvi su uzeti natašte za analizu lipidnih parametara i određivanje serumskih koncentracija katestatina metodom dvostrukog enzim-imunoadsorpcijskog testa humanog katestatina (Phoenix Pharmaceuticals, Burlingame, CA, SAD), prema uputstvima proizvođača. Rezultati: Serumske koncentracije katestatina su značajno više u OSA bolesnika u odnosu na kontrolnu skupinu (2,99 ± 0,14 vs. 1,37 ± 0,13 ng/mL; P<0,001). Katestatin je značajno pozitivno korelirao s AHI indeksom u podskupini OSA bolesnika koji nisu bili pretili (r=0,544; P=0,002 i β=0,481; P=0,022). Serumske koncentracije triglicerida su bile značajno više u OSA bolesnika u odnosu na kontrolnu skupinu (2,02 ± 0,88 vs. 1,51 ± 0,87 mmol/L; P<0,001) kao i frakcije non-HDL-kolesterola (4,98 ± 0,12 vs. 4,60 ± 0,15 mmol/L; P=0,048). Također, OSA bolesnici su imali značajno niže koncentracije HDL-kolesterola u usporedbi s kontrolnom skupinom (1,16 ± 0,03 vs. 1,42 ± 0,05 mmol/L; P<0,001) dok u koncentracijama ukupnog kolesterola i LDL-kolesterola nisu pronađene značajne razlike među skupinama. Utvrđena je statistički značajna negativna korelacija serumskih koncentracija katestatina i HDL-kolesterola u OSA bolesnika (r=-0,466; P<0,001 i β=-0,434; P<0,001). Kao dijagnostički test u detekciji OSA-e, serumski katestatin je postigao vrijednost područja ispod krivulje AUC=0,909, 95% CI 0,841-0,955; P<0,001. Zaključci: Serumske koncentracije katestatina su značajno više u OSA bolesnika u usporedbi s kontrolnom skupinom te negativno koreliraju sa HDL-kolesterolom, dok u podskupini OSA bolesnika koji nisu pretili katestatin pozitivno korelira s AHI vrijednosti. Konačno, serumski katestatin je demonstrirao visoke dijagnostičke performanse u detekciji OSA statusa.Objectives: The aims of the study were to compare serum catestatin concentrations between patients with obstructive sleep apnea (OSA) and control subjects and to determine potential associations of catestatin with polysomnographic and lipid parameters in OSA population. Patients and methods: This cross-sectional study was conducted at the Split Sleep Medicine Center from December 2016 to February 2018 and included a total of 75 adult newly-diagnosed patients with OSA and 50 control subjects that were body mass index/age/sex-matched. OSA was diagnosed by full-night in-laboratory polysomnography (Alice 5LE, Philips Respironics, Eindhoven, Netherlands) according to established guidelines. A detailed medical history interview along with physical examination and anthropometric measuring were undertaken in each enrolled subject. Venous blood samples were taken from fasting subjects and were used to determine serum catestatin concentrations and lipid profile parameters. Serum catestatin concentrations were determined by an enzyme-linked immunosorbent assay (ELISA) method by using a commercial kit for human catestatin (Phoenix Pharmaceuticals, Burlingame, CA, USA) according to manufacturer's instructions. Results: Serum catestatin concentrations are significantly higher in OSA patients than in control group (2.99 ± 0.14 vs. 1.37 ± 0.13 ng/mL; P<0.001) and positively correlate with AHI in non-obese OSA patient subgroup (r=0.544; P=0.002 i β=0.481; P=0.022). Serum concentrations of triglycerides and non-HLD-cholesterol fractions were significantly higher in OSA patients compared to control group (2.02 ± 0.88 vs. 1.51 ± 0.87 mmol/L; P<0.001 and 4.98 ± 0.12 vs. 4.60 ± 0.15 mmol/L; P=0.048, respectively). Furthermore, HDL-cholesterol was lower in OSA group when compared to control group (1.16 ± 0.03 vs. 1.42 ± 0.05 mmol/L; P<0.001) and correlated negatively with serum catestatin concentrations (r=-0.466; P<0.001 and β=-0.434; P<0.001). Both groups did not differ in respect to total cholesterol and LDL-cholesterol levels. Serum catestatin provided area under the curve (AUC) value of 0.909 (95% CI 0.841-0.955; P<0.001) for the detection of OSA status. Conclusions: Serum catestatin concentrations are significantly higher in OSA patients compared to control group and correlate negatively with HDL-cholesterol, while in the non-obese OSA patient subgroup, catestatin positively correlates with AHI values. Finally, serum catestatin demonstrated high diagnostic performance in detection of OSA status

SERUM CATESTATIN CONCENTRATIONS AND LIPID STATUS IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA

Cilj istraživanja: Glavni ciljevi ovog istraživanja su bili usporediti serumske koncentracije katestatina i lipidih parametara u bolesnika s opstrukcijskom apnejom tijekom spavanja (OSA) i kontrolnih ispitanika te utvrditi moguću povezanost katestatina s polisomnografskim i lipidnim parametrima u populaciji OSA bolesnika. Ispitanici i metode: Ovo presječno kliničko istraživanje provedeno je u Centru za Medicinu spavanja Kliničkog bolničkog centra Split i Medicinskog fakulteta u Splitu tijekom razdoblja od prosinca 2016. do veljače 2018. godine, a uključilo je ukupno 75 odraslih novodijagnosticiranih bolesnika s OSA-om i 50 kontrolnih ispitanika usklađenih prema dobi, spolu i indeksu tjelesne mase. OSA je dijagnosticirana kontinuiranom cjelonoćnom laboratorijskom polisomnografijom (Alice 5LE, Philips Respironics, Eindhoven, Nizozemska) prema važećim praktičnim smjernicama. Svim ispitanicima uzeta je detaljna anamneza te izvršen fizikalni pregled i antropometrijsko mjerenje. Venski uzorci krvi su uzeti natašte za analizu lipidnih parametara i određivanje serumskih koncentracija katestatina metodom dvostrukog enzim-imunoadsorpcijskog testa humanog katestatina (Phoenix Pharmaceuticals, Burlingame, CA, SAD), prema uputstvima proizvođača. Rezultati: Serumske koncentracije katestatina su značajno više u OSA bolesnika u odnosu na kontrolnu skupinu (2,99 ± 0,14 vs. 1,37 ± 0,13 ng/mL; P<0,001). Katestatin je značajno pozitivno korelirao s AHI indeksom u podskupini OSA bolesnika koji nisu bili pretili (r=0,544; P=0,002 i β=0,481; P=0,022). Serumske koncentracije triglicerida su bile značajno više u OSA bolesnika u odnosu na kontrolnu skupinu (2,02 ± 0,88 vs. 1,51 ± 0,87 mmol/L; P<0,001) kao i frakcije non-HDL-kolesterola (4,98 ± 0,12 vs. 4,60 ± 0,15 mmol/L; P=0,048). Također, OSA bolesnici su imali značajno niže koncentracije HDL-kolesterola u usporedbi s kontrolnom skupinom (1,16 ± 0,03 vs. 1,42 ± 0,05 mmol/L; P<0,001) dok u koncentracijama ukupnog kolesterola i LDL-kolesterola nisu pronađene značajne razlike među skupinama. Utvrđena je statistički značajna negativna korelacija serumskih koncentracija katestatina i HDL-kolesterola u OSA bolesnika (r=-0,466; P<0,001 i β=-0,434; P<0,001). Kao dijagnostički test u detekciji OSA-e, serumski katestatin je postigao vrijednost područja ispod krivulje AUC=0,909, 95% CI 0,841-0,955; P<0,001. Zaključci: Serumske koncentracije katestatina su značajno više u OSA bolesnika u usporedbi s kontrolnom skupinom te negativno koreliraju sa HDL-kolesterolom, dok u podskupini OSA bolesnika koji nisu pretili katestatin pozitivno korelira s AHI vrijednosti. Konačno, serumski katestatin je demonstrirao visoke dijagnostičke performanse u detekciji OSA statusa.Objectives: The aims of the study were to compare serum catestatin concentrations between patients with obstructive sleep apnea (OSA) and control subjects and to determine potential associations of catestatin with polysomnographic and lipid parameters in OSA population. Patients and methods: This cross-sectional study was conducted at the Split Sleep Medicine Center from December 2016 to February 2018 and included a total of 75 adult newly-diagnosed patients with OSA and 50 control subjects that were body mass index/age/sex-matched. OSA was diagnosed by full-night in-laboratory polysomnography (Alice 5LE, Philips Respironics, Eindhoven, Netherlands) according to established guidelines. A detailed medical history interview along with physical examination and anthropometric measuring were undertaken in each enrolled subject. Venous blood samples were taken from fasting subjects and were used to determine serum catestatin concentrations and lipid profile parameters. Serum catestatin concentrations were determined by an enzyme-linked immunosorbent assay (ELISA) method by using a commercial kit for human catestatin (Phoenix Pharmaceuticals, Burlingame, CA, USA) according to manufacturer's instructions. Results: Serum catestatin concentrations are significantly higher in OSA patients than in control group (2.99 ± 0.14 vs. 1.37 ± 0.13 ng/mL; P<0.001) and positively correlate with AHI in non-obese OSA patient subgroup (r=0.544; P=0.002 i β=0.481; P=0.022). Serum concentrations of triglycerides and non-HLD-cholesterol fractions were significantly higher in OSA patients compared to control group (2.02 ± 0.88 vs. 1.51 ± 0.87 mmol/L; P<0.001 and 4.98 ± 0.12 vs. 4.60 ± 0.15 mmol/L; P=0.048, respectively). Furthermore, HDL-cholesterol was lower in OSA group when compared to control group (1.16 ± 0.03 vs. 1.42 ± 0.05 mmol/L; P<0.001) and correlated negatively with serum catestatin concentrations (r=-0.466; P<0.001 and β=-0.434; P<0.001). Both groups did not differ in respect to total cholesterol and LDL-cholesterol levels. Serum catestatin provided area under the curve (AUC) value of 0.909 (95% CI 0.841-0.955; P<0.001) for the detection of OSA status. Conclusions: Serum catestatin concentrations are significantly higher in OSA patients compared to control group and correlate negatively with HDL-cholesterol, while in the non-obese OSA patient subgroup, catestatin positively correlates with AHI values. Finally, serum catestatin demonstrated high diagnostic performance in detection of OSA status

Higher S2PLIT-UG scores at index admission are associated with a higher functional disease burden and increased biomarkers of myocardial injury and ventricular overload among patients with acutely decompensated heart failure

Goals: Outcomes following acutely decompensated heart failure (ADHF) are poor and associated with increased mortality and morbidity. Various risk stratification systems have been developed in the past to predict mortality and rehospitalizations in this population. The S2PLiT-UG score was recently introduced to stratify ADHF patients in three risk categories in respect to all-cause mortality during 1-year post-discharge period.1 I n t his w ork, w e a imed to d etermine a ssociations o f S 2PLiT-UG score with functional disease burden estimated by NYHA class and biomarkers including high sensitivity cardiac troponin I (hs-cTnI), NT-proBNP and C-reactive protein (CRP). Patients and Methods: A cohort of 106 consecutive ADHF patients enrolled at the Cardiology Department during 2018-2019 were included in the study. S2PLiT-UG score calculation and laboratory analyses were performed for each patient at index admission. Results: Fifty-six (52.8%) patients were designated as low, 24 (22.6%) as intermediate, and 26 (24.6%) as high risk according to S2PLiT-UG score stratification. Patients significantly differed (p=0.021) in respect to their NYHA class with mean values of 2.85±0.57, 3.10±0.61, and 3.33±0.56 for low, intermediate, and high-risk group, respectively. Troponin values were significantly higher in high risk compared to intermediate and low-risk groups (148.4±72 vs. 68.2±48 vs. 42.2±24 ng/L; p=0.025, respectively). Similarly, NT-proBNP levels were highest in the high-risk group (13740±7884 pg/mL) followed by intermediate (7811±5668 pg/mL) and low-risk group (4195±1632 pg/mL), p=0.002. Finally, CRP values differed across groups with the high-risk group exhibiting highest CRP value (21.8±14.8 mg/L) compared to intermediate and low-risk group (17.5±15.8 and 12.2±11.3 mg/L, respectively), however, this result was not significant (p=0.327). S2PLiT-UG score positively correlated with NYHA class (r=0.300, p=0.004), hs-cTnI (r=0.303, p=0.009), NT-proBNP (r=0.353, p=0.001) and CRP (r=0.203, p=0.069). Conclusion: Among ADHF patients, higher S2PLiT-UG score values, calculated at index admission, are associated with higher functional disease burden and increased levels of circulating biomarkers reflecting myocardial injury and ventricular overload, but not systemic inflammation

VIOLENCE WITHOUT A FACE: THE ANALYSIS OF TESTIMONIES OF WOMEN WHO WERE SEXUALLY ASSAULTED DURING THE WAR IN CROATIA AND BOSNIA AND HERZEGOVINA

Background: This study examined testimonies of women who were sexually assaulted multiple times by multiple unknown offenders. In these testimonial narratives, it is possible to detect specific modalities of traumatic event expression. This expression lacks any spatial, temporal, auditory or emotional determinants of the event. Subjects and methods: These fourteen women (out of 17) were imprisoned and forcefully isolated in detention camps or private houses in the occupied territories of Croatia and Bosnia and Herzegovina, during the war. At the same time, some of these women were raped by the offenders that were previously known to them. The average length of detention was 141 days among the seventeen victims (range of 7 to 395 days), while the average time from the first day of imprisonment to the first day of testimony was 311 days (range of 30 to 889 days). Results: Based on the narrative descriptions of the events acquired from these testimonies, our analysis showed that these expressions differed when the offender was known to the victim, contrasted to the situation when the offender was completely unknown. This finding has a significant implication in victim\u27s testimony at judicial hearings. Specifically, women that were raped by unknown perpetrator(s) were often unable to provide persuasive testimony and their recollection of the events was deemed insufficient for the further prosecution. Testimonies in these cases substantially lacked in vividness and were devoid of visuospatial determinants of the rape event. Consequently, this often resulted in the case’s dismissal. Conclusion: The unusual and problematic expression of these traumatic memories might indicate that these events were not properly stored in the conceptual form of memory. Ultimately, victims could not make any coherent recollection or reconstruct the cascade of events by using perceptual information. We argue that this could be due to an aberrant mechanism of memory storage and difficulties that emerge on the level of sensory input. This problem needs to be further examined and correspondingly accounted for since it can exert significant influence on judicial outcomes in the domain of sexual assault cases worldwide

THE IMPORTANCE OF INDIVIDUAL’ MENTAL STATUS FOR THE TRUE VALUE OF FUNCTIONAL SELF-REPORTED QUESTIONNAIRES USED IN MEDICAL REHABILITATION

The physical and mental health are inseparable and integral components of one\u27s health and as such should always be addressed during the process of medical rehabilitation. It should be an obvious fact that the state of individual\u27 mental health can influence and even more, modify, the outcomes of medical rehabilitation. Furthermore, the state of mental status has an effect in determining the reliability of functional self-reported questionnaires that are frequently used in medical rehabilitation. In conclusion, the evaluation and assessment of the individual\u27s mental health status need to be incorporated as a regular part of the comprehensive and holistic approach to medical rehabilitation