COVID-19 severity determinants – modulating effect of environmental factors

The new coronavirus that appeared in 2019 (SARS-CoV-2) caused the COVID-19 pandemic, which is responsible for over a million confirmed deaths in 2020, making it the most important event of the 21st century thus far and making SARS-CoV-2 the most scientifically studied virus. Most of those infected with the SARS-COV-2 virus (about 80%) recover quickly from the disease, showing minimal signs of inflammation, mostly similar to the common cold. We analyzed the possible explanations of this observation and demonstrated the association of relative humidity, temperature and IgG N-glycosylation with COVID-19 severity

Mesenchymal stem cells in orthopedics - a current perspective

Osteoarthritis is a common condition that can affect any joint in the body. It is encountered in all age groups, but with a higher incidence in the older population. There is no treatment currently available that would prevent the development or progression of osteoarthritis and the gold standard end-stage treatment is still total joint replacement surgery, which is not without its risks. Therefore, new approaches are considered daily to treat patients that are not yet at end-stage osteoarthritis, but still experience the most common symptoms of pain and joint dysfunction. Mesenchymal stem cell research offers new opportunities for osteoarthritis treatment as their paracrine effect exhibits clinical improvement in osteoarthritis patients, providing much-needed minimally invasive treatment options

Pharmacogenomics – the key to personalized medicine

Different rates of drug metabolism and the effect of commonly prescribed drugs are often seen in clinical practice. Some of these differences can be predicted if the patient’s genetic profile is known by pharmacogenomic analysis, which done once, provides lifetime benefits. In the United States, adverse drug reactions are the fourth leading cause of death, costing their healthcare system about $136 billion annually. By implementing pharmacogenomic testing early in clinical algorithms, debilitating and potentially life-threatening side-effects can be predicted and avoided, which is particularly important in settings of pain therapy and anesthesia. In St. Catherine Specialty Hospital, this approach is readily advocated for our patients. Through the use of the RightMed panel, 25 genes coding for enzymes and other proteins important for drug function, are analyzed, and a pharmacogenomic-driven approach is taken by selecting the right drug, in the right dose, for the right patient

Indications, protocols and pitfalls of whole-body magnetic resonance imaging

Magnetska rezonancija cijelog tijela (WB-MRI) neinvazivna je slikovno dijagnostička metoda koja u jednom snimanju pruža podatke o brojnim organima i organskim sustavima. Za razliku od drugih slikovnih testova, kao što su konvencionalne rendgenske i CT snimke, MRI, pa tako ni WB-MRI, ne koristi ionizirajuće zračenje, što ju čini sigurnijom opcijom za dugoročno praćenje bolesti. WB-MRI predmet je brojnih medicinskih istraživanja, ali u praksi već postoje smjernice za njezino korištenje, primjerice u pacijenata oboljelih od multiplog mijeloma, uznapredovalog karcinoma prostate, metastatskog melanoma, a koristi se i u praćenju pacijenata sa sindormima s predispozicijom za razvoj raka te u reumatologiji. Postoje studije o potencijalnoj koristi WB-MRI u dijagnostici i praćenju nekih drugih malignih bolesti kao što su karcinom dojke, kolorektalni karcinom, karcinom jajnika i limfom. Upotreba WB-MRI u screeningu za rak u asimptomatskoj općoj populaciji još uvijek je predmet diskusije te zasad ne postoje indikacije za njeno korištenje u ovoj populaciji. Postojeće smjernice definiraju jasne protokole snimanja WB-MRI, koja se mogu provesti unutar 30 do 45 minuta. Važno je naglasiti da postoje i određena ograničenja i zamke u snimanju i interpretaciji nalaza WB-MRI. Ograničenje u prikazivanju lezija manjih od 5 mm te mogućnost davanja lažno pozitivnih i lažno negativnih nalaza samo su neke od zamki. Potrebno je provesti dodatna istraživanja kako bi se jasno i nedvosmisleno definirale indikacije za korištenje ove slikovne metode.Whole-body magnetic resonance imaging (WB-MRI) is a non-invasive imaging diagnostic method that provides data on numerous organs and organ systems in a single imaging. Unlike other imaging tests, such as conventional radiograph and CT scans, MRI, including WB-MRI, does not use ionizing radiation, making it a safer option for long-term disease monitoring. WB-MRI is the subject of numerous medical studies, but certain guidelines for its use already do exist, for example in patients suffering from multiple myeloma, advanced prostate cancer, metastatic melanoma; it is also used in the monitoring of patients with cancer predisposition syndromes and in rheumatology. There are studies on the potential benefits of WB-MRI in the process of diagnosis and follow-up in other malignancies such as breast cancer, colorectal cancer, ovarian cancer and lymphoma. The use of WB-MRI in screening for cancer in the asymptomatic general population is still a topic of discussion and so far there are no indications for its use in this population. Existing guidelines define straightforward WB-MRI imaging protocols, which can be carried out within 30 to 45 minutes. It is important to emphasize that there are also certain limitations and pitfalls in the recording and interpretation of WB-MRI findings. The limitation in the presentation of lesions of less than 5 mm and the possibility of giving false positives and false negatives are just some of the pitfalls. Additional research should be carried out in order to clearly and unambiguously define the indications for the use of this imaging method

Indications, protocols and pitfalls of whole-body magnetic resonance imaging

Magnetska rezonancija cijelog tijela (WB-MRI) neinvazivna je slikovno dijagnostička metoda koja u jednom snimanju pruža podatke o brojnim organima i organskim sustavima. Za razliku od drugih slikovnih testova, kao što su konvencionalne rendgenske i CT snimke, MRI, pa tako ni WB-MRI, ne koristi ionizirajuće zračenje, što ju čini sigurnijom opcijom za dugoročno praćenje bolesti. WB-MRI predmet je brojnih medicinskih istraživanja, ali u praksi već postoje smjernice za njezino korištenje, primjerice u pacijenata oboljelih od multiplog mijeloma, uznapredovalog karcinoma prostate, metastatskog melanoma, a koristi se i u praćenju pacijenata sa sindormima s predispozicijom za razvoj raka te u reumatologiji. Postoje studije o potencijalnoj koristi WB-MRI u dijagnostici i praćenju nekih drugih malignih bolesti kao što su karcinom dojke, kolorektalni karcinom, karcinom jajnika i limfom. Upotreba WB-MRI u screeningu za rak u asimptomatskoj općoj populaciji još uvijek je predmet diskusije te zasad ne postoje indikacije za njeno korištenje u ovoj populaciji. Postojeće smjernice definiraju jasne protokole snimanja WB-MRI, koja se mogu provesti unutar 30 do 45 minuta. Važno je naglasiti da postoje i određena ograničenja i zamke u snimanju i interpretaciji nalaza WB-MRI. Ograničenje u prikazivanju lezija manjih od 5 mm te mogućnost davanja lažno pozitivnih i lažno negativnih nalaza samo su neke od zamki. Potrebno je provesti dodatna istraživanja kako bi se jasno i nedvosmisleno definirale indikacije za korištenje ove slikovne metode.Whole-body magnetic resonance imaging (WB-MRI) is a non-invasive imaging diagnostic method that provides data on numerous organs and organ systems in a single imaging. Unlike other imaging tests, such as conventional radiograph and CT scans, MRI, including WB-MRI, does not use ionizing radiation, making it a safer option for long-term disease monitoring. WB-MRI is the subject of numerous medical studies, but certain guidelines for its use already do exist, for example in patients suffering from multiple myeloma, advanced prostate cancer, metastatic melanoma; it is also used in the monitoring of patients with cancer predisposition syndromes and in rheumatology. There are studies on the potential benefits of WB-MRI in the process of diagnosis and follow-up in other malignancies such as breast cancer, colorectal cancer, ovarian cancer and lymphoma. The use of WB-MRI in screening for cancer in the asymptomatic general population is still a topic of discussion and so far there are no indications for its use in this population. Existing guidelines define straightforward WB-MRI imaging protocols, which can be carried out within 30 to 45 minutes. It is important to emphasize that there are also certain limitations and pitfalls in the recording and interpretation of WB-MRI findings. The limitation in the presentation of lesions of less than 5 mm and the possibility of giving false positives and false negatives are just some of the pitfalls. Additional research should be carried out in order to clearly and unambiguously define the indications for the use of this imaging method

Population Pharmacogenomics in Croatia: Evaluating the PGx Allele Frequency and the Impact of Treatment Efficiency

Background: Adverse drug reactions (ADRs) are a significant cause of mortality, and pharmacogenomics (PGx) offers the potential to optimize therapeutic efficacy while minimizing ADRs. However, there is a lack of data on the Croatian population, highlighting the need for investigating the most common alleles, genotypes, and phenotypes to establish national guidelines for drug use. Methods: A single-center retrospective cross-sectional study was performed to examine the allele, genotype, and phenotype frequencies of drug-metabolizing enzymes, receptors, and other proteins in a random sample of 522 patients from Croatia using a 28-gene PGx panel. Results: Allele frequencies, genotypes, and phenotypes for the investigated genes were determined. No statistically significant differences were found between the Croatian and European populations for most analyzed genes. The most common genotypes observed in the patients resulted in normal metabolism rates. However, some genes showed higher frequencies of altered metabolism rates. Conclusions: This study provides insights into the allele, genotype, and phenotype frequencies of drug-metabolizing enzymes, receptors, and other associated proteins in the Croatian population. The findings contribute to optimizing drug use guidelines, potentially reducing ADRs, and improving therapeutic efficacy. Further research is needed to tailor population-specific interventions based on these findings and their long-term benefits

Vitamin D supplementation in patients with atopic dermatitis, chronic urticaria and contact irritant and allergic dermatitis – possible improvement without risk

Abstract Introduction: There has been a lot of talk lately about the importance of reduced serum vitamin D levels and their supplementation for patients with inflammatory skin diseases such as atopic dermatitis (AD) and other allergic diseases. Serum vitamin D values are associated with a number of factors such as limited sunlight exposure (modern lifestyle, extended indoor stay, enhanced sun protection, etc.) which can affect different diseases. Aim: To evaluate serum vitamin D values in patients with inflammatory skin diseases, comparing them on the basis of other parameters (age, gender/sex, residential areas, total serum IgE), and establishing whether vitamin D supplementation would affect the improvement of the clinical picture of the disease. Patients and methods: A total of 157 patients participated in this prospective study: 51 patients with AD, 55 with chronic urticaria (CU) and 51 with contact dermatitis (CD): 38 with irritant CD (ICD) and 13 with allergic CD (ACD). In all patients, the values of serum vitamin D were determined by chemiluminescence microparticle immunoassay (CMIA) and compared by diagnosis, age, sex, living environment, values of total IgE. In patients with reduced values of vitamin D, its supplementation for 3 months was recommended, after which the second evaluation of D vitamin values and disease status were determined and compared with an untreated/unsupplemented group with normal vitamin D values. Results: Vitamin D deficiency was often observed in patients with AD, CU and CD, most frequently in the ICD group, and least frequently in the ACD group. No significant differences were found in terms of age, gender or living environment, nor was any correlation with total IgE found. In the subjects supplemented with vitamin D, their levels increased significantly and, after its supplementation, improvement of the clinical condition was more common than in the untreated group; however, the differences were not statistically significant (69.8 vs. 58.1, p=0.428). Conclusions: Although serum vitamin D levels of the groups did not differ significantly, the supplementation of vitamin D in patients with prominent vitamin D deficiency may be useful and crucial for improving the prognosis of the disease