Sex and age differences and outcomes in acute coronary syndromes

Background: There is conflicting information about sex differences in presentation, treatment, and outcome after acute coronary syndromes (ACS) in the era of reperfusion therapy and percutaneous coronary intervention. The aim of this study was to examine presentation, acute therapy, and outcomes of men and women with ACS with special emphasis on their relationship with younger age ( lt = 65 years). Methods: From January 2010 to June 2015, we enrolled 5140 patients from 3 primary PCI capable hospitals. Patients were registered according to the International Survey of Acute Coronary Syndrome in Transitional Countries (ISACS-TC) registry protocol (ClinicalTrials.gov: NCT01218776). The primary outcome was the incidence of in-hospital mortality. Results: The study population was constituted by 2876 patients younger than 65 years and 2294 patients older. Women were older than men in both the young (56.2 +/- 6.6 vs. 54.1 +/- 7.4) and old (74.9 +/- 6.4 vs. 73.6 +/- 6.0) age groups. There were 3421 (66.2%) patients with ST elevation ACS (STE-ACS) and 1719 (33.8%) patients without ST elevation ACS (NSTE-ACS). In STE-ACS, the percentage of patients who failed to receive reperfusion was higher in women than in men either in the young (21.7% vs. 15.8%) than in the elderly (35.2% vs. 29.6%). There was a significant higher mortality in women in the younger age group (age-adjusted OR 1.52, 95% CI: 1.01-2.29), but there was no sex difference in the older group (age-adjusted OR 1.10, 95% CI: 0.87-1.41). Significantly sex differences in mortality were not seen in NSTE-ACS patients. Conclusions: In-hospital mortality from ACS is not different between older men and women. A higher short-term mortality can be seen only in women with STEMI and age of 65 or less

First isolation of methicillin-resistant Staphylococcus aureus from pigs’ clinical samples in Serbia

Methicillin-resistant Staphylococcus aureus is a highly important human pathogen that is also a significant concern in veterinary medicine. Despite the high prevalence of colonization, clinical infections with methicillin-resistant Staphylococcus aureus appear to be rare in pigs. Methicillin-resistant Staphylococcus aureus was isolated from a sow with endometritis and her five piglets with dermatitis originating from a Serbian farm. Identification of the strains was done by automated system and confirmed by polymerase chain reaction for mecA and nuc genes. Detection of Staphylococcal Cassette Chromosome mec type was performed by multiplex polymerase chain reaction. Antimicrobial susceptibility testing on erythromycin, clindamycin, gentamicin, kanamycin, tobramycin, ciprofloxacin, tetracycline, trimethoprim/sulfamethoxazole and vancomycin was done by disc diffusion method. Six isolated strains from the infected sow and her piglets showed resistance only to tetracycline beside resistance to all beta-lactam antibiotics. In the tested methicillin-resistant Staphylococcus aureus isolates, Staphylococcal Cassette Chromosome mec type V was present. To our knowledge, this finding is the first documented detection of methicillin-resistant Staphylococcus aureus from pigs’ clinical samples in Serbia. The results of our study indicate the emergence of methicillin-resistant Staphylococcus aureus in a pig farm in Serbia highlighting the threat of this antibiotic-resistant microorganism as a pathogen causing both animal and human infections

The influence of coating with aminopropyl triethoxysilane and CuO/Cu2O nanoparticles on antimicrobial activity of cotton fabrics under dark conditions

A novel impregnation process for the fabrication of cotton nanocomposite with strong antimicrobial activity against antibiotics-resistant bacteria and yeast was developed. The impregnation process includes the sol-gel treatment of fabric with (3-aminopropyl)triethoxysilane in the first step, and synthesis of the CuO/Cu2O nanoparticles (NPs) on the fabric surface in the second step. The in situ synthesis of the CuO/Cu2O NPs was based on the adsorption of Cu2+-ions by the introduced amino groups of the sol-gel coating. The adsorbed Cu2+-ions are subsequently reduced in the alkaline solution of NaBH4. X-ray diffraction measurements confirmed the formation of CuO/Cu2O NPs. Scanning electron microscopy and atomic absorption spectrometry analyses indicate that the particle size, agglomeration, and amounts of synthesized NPs were highly affected by the initial concentration of CuSO(4)solution. The toxicity of nanocomposites to human keratinocytes (HaCaT) and antimicrobial activity against Gram-negativeEscherichia coliATCC 25922,E. coliATCC BAA 2469, andKlebsiella pneumoniaeATCC BAA 2146, and Gram-positive bacteriaStaphylococcus aureusATCC 25923,S. aureusATCC 43300 and yeastCandida albicansATCC 24433 strongly depended on the copper content. In addition to excellent antimicrobial activity, controlled release of Cu2+-ions from the fabrics into physiological saline solution was obtained

Prevalence of and contributing factors to overweight and obesity among the schoolchildren of Podgorica, Montenegro

Introduction/Objective. Childhood obesity is an emerging public health problem. The national prevalence of child overweight/obesity in Montenegro has increased by one third in the last decade. As the overwhelming majority of Montenegrin population is urban, investigation of obesity and correlates among urban children is of special public health interest. The aim of this study was to investigate the prevalence of and contributing factors to obesity among schoolchildren of Podgorica. Method. The sample included 1,134 schoolchildren (49.8% boys) aged 7–12 years, from 10 elementary schools in Podgorica. We measured children’s body mass, body height, and waist circumference to calculate body mass index (BMI) and waist-to-height ratio. The research instrument was a closed type of the original questionnaire. Nutritional status was assessed according to the criteria recommended by the American Centers for Disease Control and Prevention, World Health Organization and International Obesity Task Force. Results. Among the investigated children there were 21.2% and 6% overweight and obese children, respectively. Obesity was more frequent among boys (7.6%) compared to girls (4.4%). In a multiple regression, childhood obesity was positively related to the following: male gender, younger age, lower number of siblings, parental obesity, and low physical activity. Conclusion. One out of five urban Montenegrin schoolchildren is overweight/obese, with obesity being twice as frequent among boys compared to girls. A program against obesity among urban Montenegrin children should focus on the revealed contributing factors

Genetic Profiling and Comparison of Human and Animal Methicillin-Resistant Staphylococcus aureus (MRSA) Isolates from Serbia

The aim of this study was to characterize a collection of methicillin-resistant Staphylococcus aureus (MRSA) isolates of human and animal origin from Serbia. In total, 36 MRSA isolates—30 obtained from humans and six from companion animals—were investigated by PCR for the presence of antibiotic and biocide resistance determinants and virulence genes (PVL—Panton–Valentine leukocidin, ETs—exfoliative toxins, TSST—toxic shock syndrome toxin, SEs—staphylococcal enterotoxins, and MSCRAMMs—microbial surface components recognizing adhesive matrix molecules and biofilm). Isolates were analyzed by staphylococcal cassette chromosome mec (SCCmec), spa, and dru typing, as well as by multiple locus variable number of tandem repeat analyses (MLVA), multilocus sequence typing (MLST), and subsequently, eBURST. The majority of human MRSA isolates were resistant to gentamicin, erythromycin, clindamycin, and ciprofloxacin. Different antibiotic resistance genes were detected: aac-aphD, ant(6′)-Ia, erm(A), erm(B), erm(C), tet(K), tet(M), fexA, and catpC221. All isolates were susceptible to teicoplanin and linezolid. SCCmec type III was prevalent in human isolates, while SCCmec elements in animals were mostly nontypeable. t037 was the predominant spa type in human and t242 in animal MRSA isolates. The prevalent dru type was dt11c in human and dt10a in animal MRSA isolates. MRSA isolates exhibited 27 different MLVA types. ST239 was predominant in human, while ST5 was prevalent in canine MRSA isolates. PVL was found in two, while tsst-1 was detected in three human isolates. Human-associated clones belonging to ST5, ST45, and ST239 MRSA clones were discovered in companion animals, which suggests anthropozoonotic transmission

Dilemmas in the Choice of Adequate Therapeutic Treatment in Patients with Acute Pulmonary Embolism—From Modern Recommendations to Clinical Application

Pulmonary thromboembolism is a very common cardiovascular disease, with a high mortality rate. Despite the clear guidelines, this disease still represents a great challenge both in diagnosis and treatment. The heterogeneous clinical picture, often without pathognomonic signs and symptoms, represents a huge differential diagnostic problem even for experienced doctors. The decisions surrounding this therapeutic regimen also represent a major dilemma in the group of patients who are hemodynamically stable at initial presentation and have signs of right ventricular (RV) dysfunction proven by echocardiography and positive biomarker values (pulmonary embolism of intermediate–high risk). Studies have shown conflicting results about the benefit of using fibrinolytic therapy in this group of patients until hemodynamic decompensation, due to the risk of major bleeding. The latest recommendations give preference to new oral anticoagulants (NOACs) compared to vitamin K antagonists (VKA), except for certain categories of patients (patients with antiphospholipid syndrome, mechanical valves, pregnancy). When using oral anticoagulant therapy, special attention should be paid to drug–drug interactions, which can lead to many complications, even to the death of the patient. Special population groups such as pregnant women, obese patients, patients with antiphospholipid syndrome and the incidence of cancer represent a great therapeutic challenge in the application of anticoagulant therapy. In these patients, not only must the effectiveness of the drugs be taken into account, but great attention must be paid to their safety and possible side effects, which is why a multidisciplinary approach is emphasized in order to provide the best therapeutic option