Association of Hypertension with Long-Term Overweight Status and Weight Gain: the CroHort Study

Overweight is associated with hypertension, but longitudinal studies on the effect of weight gain on blood pressure are relatively rare. Aim of this study was to investigate association of long-term overweight status as well as of becoming overweight with hypertension. Odds of hypertension in 2008 were calculated for 1,383 respondents from Croatian Adult Health Cohort Study (CroHort) who had normal blood pressure in 2003. The results showed that for women both long-term overweight status and recently becoming overweight (in the last 5 years) were significantly associated with development of hypertension, while for men this was true only for long-term overweight. Prevention activities aimed at maintenance of normal body weight should be important part of primary prevention of hypertension

Informacijski sustav za nadzor nad zaraznim bolestima

Razvoj informacijskog sustava za praćenje i nadzor nad zaraznim bolestima ima za cilj primjeniti suvremene informacijsko-komunikacijske tehnologije u nadzoru nad zaraznim bolestima. U tijeku je razvoj elektronske prijave zaraznih bolesti i elektronske prijave epidemije koji čine prvu fazu sustava, dok će u drugoj fazi, na jedinstvenoj platformi, biti omogućeno pojačano praćenje pojedinih bolesti kao što su TBC, HIV, legioneloze, akutne mlohave kljenuti, Creutzfeldt Jakobove bolesti, meningitis/sepsa, morbili, parotitis i rubela, malarija, zbirno izvješče o gripi i virusni hepatitisi. U kasnijim fazama radit će se na povezivanju sa sustavom e-mikrobiološki laboratorij i e-nalaz.Centralni sustav elektronske prijave zaraznih bolesti povećat će kvalitetu i učinkovitost komunikacije uz osiguranje najviših standarda zaštite podataka. Sustav omogućava prihvat prijave zaraznih bolesti iz svih postojećih izvora informacija na primarnoj, sekundarnoj i tercijarnoj razini zdravstvene zaštite. Za sve prijavitelje nudi se web sučelje za prijavu zaraznih bolesti, a onima koji imaju informatička rješenja omogućena je razmjena elektroničkih paketa informacija prema propisanom standardu. Na zaprimljenim informacijama aktivnosti provode sve tri razine epidemiološke djelatnosti i to higijensko-epidemiološke ispostave (prema mjestu prebivališta oboljelog), te službe za epidemiologiju na županijskoj i nacionalnoj razini. Prijave prolaze svoj ciklus obrade i nakon njihovog potvrđivanja evidentiraju se u Registru zaraznih bolesti pri HZJZ.Forma elektroničke prijave usklađena je s nacionalnim zakonskim okvirom i međunarodnim smjernicama i definicijama ECDC-a. U tijeku su aktivnosti na usklađivanju postojeće e-prijave koja već više godina postoji u primarnoj zdravstvenoj zaštiti. Jedinstvena forma vrijedit će i za bolničke sustave (BIS). U tom smislu u tijeku su dogovori s predstavnicima CEZIH-a i Klinike za infektivne bolesti „dr Fran Mihaljević“.Novi sustav omogućit će prijavljivanje zarazne bolesti u realnom vremenu i pravovremene intervencije epidemiologa, kvalitetan nadzor i uvid u kretanje zaraznih bolesti.Sustav će omogućiti izvještavanje (na nacionalnoj razini i prema međunarodnim institucijama) prema svim prikupljanim parametrima.

Increased Odds of Metabolic Dysfunction-Associated Steatotic Liver Disease Are Linked to Reduced n-6, but Not n-3 Polyunsaturated Fatty Acids in Plasma

The increasing prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) underscores the need for better understanding of its complex pathogenesis. Lipid accumulation in hepatocytes is among principal mechanisms contributing to MASLD development. While routine lipid parameters are well studied, the profile of circulating fatty acids in MASLD patients remains less explored. This study aimed to assess relative proportions of individual fatty acids in plasma of MASLD patients and to explore their associations with other biochemical markers of MASLD. Ninety-one patients and 48 healthy individuals were enrolled. The relative proportions of fatty acids in plasma were determined using gas chromatography with FID detection. Proportions of total n-6 polyunsaturated fatty acids (PUFAs) and linoleic acid (LA) in plasma were lower in MASLD patients (p = 0.001 and p = 0.004, respectively), with no differences observed in n-3 PUFAs. Total plasma n-6 PUFAs correlated negatively with body mass index, hepatic steatosis indices, triglyceride concentration and coronary risk index. Decreased prevalence of n-6 PUFAs in plasma was independently associated with higher odds of MASLD (OR = 0.769; CI: 0.611–0.968; p = 0.025). Our findings indicate an altered circulatory fatty acid distribution in MASLD, characterized by a reduced amount of n-6 PUFAs, particularly LA, which may have significant implications for the prevention and treatment of MASLD

LncRNAs as Regulators of Atherosclerotic Plaque Stability

Current clinical data show that, despite constant efforts to develop novel therapies and clinical approaches, atherosclerotic cardiovascular diseases (ASCVD) are still one of the leading causes of death worldwide. Advanced and unstable atherosclerotic plaques most often trigger acute coronary events that can lead to fatal outcomes. However, despite the fact that different plaque phenotypes may require different treatments, current approaches to prognosis, diagnosis, and classification of acute coronary syndrome do not consider the diversity of plaque phenotypes. Long non-coding RNAs (lncRNAs) represent an important class of molecules that are implicated in epigenetic control of numerous cellular processes. Here we review the latest knowledge about lncRNAs’ influence on plaque development and stability through regulation of immune response, lipid metabolism, extracellular matrix remodelling, endothelial cell function, and vascular smooth muscle function, with special emphasis on pro-atherogenic and anti-atherogenic lncRNA functions. In addition, we present current challenges in the research of lncRNAs’ role in atherosclerosis and translation of the findings from animal models to humans. Finally, we present the directions for future lncRNA-oriented research, which may ultimately result in patient-oriented therapeutic strategies for ASCVD

Markeri redoks statusa kod pacijenata sa nealkoholnom masnom bolešću jetre

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, present in up to 30% of the adult population worldwide (1). Triglycerides accumulation in hepatocytes (steatosis) represents the root cause of NAFLD and is associated with oxidative stress, which could further lead to fibrosis and cell death of hepatocytes (2). The aim of this research was to identify redox status markers for predicting the risk of developing steatosis. 158 participants were included. Steatosis was confirmed by ultrasound in 101 subjects, while the remaining 57 were in the control group. The following markers of redox status were determined in serum and plasma samples of all subjects: superoxide dismutase 1 (SOD1), paraoxonase (PON1), malondialdehyde (MDA) and superoxide anion (O2.-). For this purpose, spectrophotometric methods and enzyme immunosorbent assays were used. SOD1 was statistically significantly higher (P<0.001), while O2 .- was significantly lower in the patient group (P<0.001). SOD1 was significantly negatively correlated with O2.- (ρ= -0.494, P<0.001) and MDA (ρ= -0.242, P=0.002). Univariate binary logistic regression analysis showed a positive association between SOD1 and the presence of steatosis (OR=1.018, 95% CI 1.005-1.031; P=0.005), as well as a negative association between O2 .- and the presence of steatosis (OR=0.959, 95% CI 0.941-0.978; P<0.001). Multivariate analysis singled out SOD1 (OR=1.024, 95% CI 1.006-1.041; P=0.007) and O2.- (OR=0.965, 95% CI 0.942-0.989; P=0.004) as independent predictors for the presence of steatosis in our subjects. The redox status parameters, SOD1 and O2, respectively, showed a positive and negative prediction of the presence of statosis in our subjects.Nealkoholna masna bolest jetre (eng. nonalcoholic fatty liver disease, NAFLD) je najčešće hronično oboljenje jetre, prisutno i u do 30% adultne populacije širom sveta (1). Značajnu ulogu u nastanku NAFLD ima akumulacija triglicerida u hepatocitima – steatoza, koja je povezana sa oksidativnim stresom, a koji dalje vodi fibrozi i ćelijskoj smrti hepatocita (2). Cilj ovog istraživanja bio je identifikacija markera redoks statusa za predviđanje rizika za nastanak steatoze. Studija je obuhvatila 158 ispitanika iz Kliničko bolničkog centra Zemun. Steatoza je potvrđena ultrazvukom kod 101 ispitanika, dok je preostalih 57 činilo kontrolnu grupu. U uzorcima seruma i plazme svih ispitanika određeni su sledeći markeri redoks statusa: superoksid dismutaza 1 (SOD1), paraoksonaza (PON1), malondialdehid (MDA) i superoksidni anjon (O2.-). U tu svrhu korišćene su spektrofotometrijske metode i enzimski imunosorbentni testovi. SOD1 je bila statistički značajno viša (P<0,001), dok O 2.- značajno niži u grupi pacijenata (P<0,001), dok se PON1 i MDA nisu značajno razlikovali između grupa. SOD1 je bila u značajnoj negativnoj korelaciji sa O 2.- (ρ=-0,494, P<0,001) i MDA (ρ= - 0,242, P=0,002). Univarijatna binarna logistička regresiona analiza je pokazala pozitivnu asocijaciju između SOD1 i prisustva steatoze (OR=1,018, 95% CI 1,005-1,031; P=0,005), kao i negativnu asocijaciju između O 2.- i prisustva steatoze (OR=0,959, 95% CI 0,941-0,978; P<0,001). Multivarijantna analiza je izdvojila SOD1 (OR=1,024, 95% CI 1,006-1,041; P=0,007) i O2.- (OR=0,965, 95% CI 0,942-0,989; P=0,004) kao nezavisne prediktore za prisustvo steatoze kod naših ispitanika. Parametri redoks statusa, SOD1 i O 2.- redom, su pokazali pozitivnu, odnosno negativnu predikciju prisustva statoze kod naših ispitanika.VIII Kongres farmaceuta Srbije sa međunarodnim učešćem, 12-15.10.2022. Beogra

Health-related quality of life in elderly patients hospitalized with chronic heart failure

Background: Chronic heart failure is a very common condition in the elderly, characterized not only by high mortality rates, but also by a strong impact on health-related quality of life (HRQOL). Previous studies of HRQOL in elderly heart failure subjects have included mostly outpatients, and little is known about determinants of HRQOL in hospitalized elderly population, especially in Serbia. In this study, we tried to identify factors that influence HRQOL in elderly patients hospitalized with chronic heart failure in Serbia. Methods: The study population consisted of 136 patients aged 65 years or older hospitalized for chronic heart failure. HRQOL was assessed using the Minnesota Living with Heart Failure questionnaire. Predictors of HRQOL were identified by multiple linear regression analysis. Results: Univariate analysis showed that patients with lower income, a longer history of chronic heart failure, and longer length of hospital stay, as well as those receiving aldosterone antagonists and digoxin, taking multiple medications, in a higher NYHA class, and showing signs of depression and cognitive impairment had significantly worse HRQOL. Presence of depressive symptoms (P lt 0.001), higher NYHA class (P=0.021), lower income (P=0.029), and longer duration of heart failure (P=0.049) were independent predictors of poor HRQOL. Conclusion: Depressive symptoms, higher NYHA class, lower income, and longer duration of chronic heart failure are independent predictors of poor HRQOL in elderly patients hospitalized with chronic heart failure in Serbia. Further, there is an association between multiple medication usage and poor HRQOL, as well as a negative impact of cognitive impairment on HRQOL. Hence, measures should be implemented to identify such patients, especially those with depressive symptoms, and appropriate interventions undertaken in order to improve their HRQOL

Međunarodna suradnja na području nadzora i kontrole zaraznih bolesti

Zarazne bolesti kao i moguće prijetnje vezane uz zarazne bolesti ne poznaju granice. Danas kad je prisutan intenzivan međunarodni promet ljudi i roba, očekivan je brži i jednostavniji prijenos i širenje već nam poznatih zaraznih bolesti, no također i pojava novih zaraznih bolesti. Time se postavljaju novi izazovi u sprečavanju i suzbijanju zaraznih bolesti, što je prepoznato od strane kako međunarodnih stručnih i znanstvenih institucija, tako i od domaćih.Sprečavanje i suzbijanje zaraznih bolesti predstavlja javnozdravstveni prioritet u Europi (Direktiva Europskog parlamenta iz 1998. Godine, br. 2/19/98/EC), kako u zakonodavstvu Europske unije, tako i u dokumentima Europske regije Svjetske zdravstvene organizacije (WHO Grottaferatta 2000 Consensus Meeting on Surveillance of Infectious Diseases, Lyon 2002. Natural and intentional epidemic risks in Europe: Strengthening alert mechanism). Ovo je područje prioritet i u zakonodavstvu Republike Hrvatske, a rad i organizacija Službe za epidemiologiju Hrvatskog zavoda za javno zdravstvo utvrđeni su Zakonom o zdravstvenoj zaštiti i Zakonom o zaštiti pučanstva od zaraznih bolesti te drugim zakonskim aktima. Služba za epidemiologiju sa Službom za mikrobiologiju čini dio europske mreže epidemiološkog nadzora nad zaraznim bolestima

Health-related quality of life in elderly patients hospitalized with chronic heart failure

Background: Chronic heart failure is a very common condition in the elderly, characterized not only by high mortality rates, but also by a strong impact on health-related quality of life (HRQOL). Previous studies of HRQOL in elderly heart failure subjects have included mostly outpatients, and little is known about determinants of HRQOL in hospitalized elderly population, especially in Serbia. In this study, we tried to identify factors that influence HRQOL in elderly patients hospitalized with chronic heart failure in Serbia. Methods: The study population consisted of 136 patients aged 65 years or older hospitalized for chronic heart failure. HRQOL was assessed using the Minnesota Living with Heart Failure questionnaire. Predictors of HRQOL were identified by multiple linear regression analysis. Results: Univariate analysis showed that patients with lower income, a longer history of chronic heart failure, and longer length of hospital stay, as well as those receiving aldosterone antagonists and digoxin, taking multiple medications, in a higher NYHA class, and showing signs of depression and cognitive impairment had significantly worse HRQOL. Presence of depressive symptoms (P<0.001), higher NYHA class (P=0.021), lower income (P=0.029), and longer duration of heart failure (P=0.049) were independent predictors of poor HRQOL. Conclusion: Depressive symptoms, higher NYHA class, lower income, and longer duration of chronic heart failure are independent predictors of poor HRQOL in elderly patients hospitalized with chronic heart failure in Serbia. Further, there is an association between multiple medication usage and poor HRQOL, as well as a negative impact of cognitive impairment on HRQOL. Hence, measures should be implemented to identify such patients, especially those with depressive symptoms, and appropriate interventions undertaken in order to improve their HRQOL.publishedVersio