Cheese from the region of Livno

U radu je opisana važnost i mjesto Livanjskog sira kroz njegovu 117-godišnju proizvodnju. Najvažniji tehnološki parametri, osnovni kemijski sastav i organoleptička svojstva Livanjskog sira prikazana su na osnovi podataka iz literature. Između sireva koji se proizvode na tradicionalan način i sireva proizvedenih na industrijski način utvrđena je značajna kvalitativna razlika, što se objašnjava vrstom upotrijebljenog mlijeka, organizacijom proizvodnje i tehničkim mogućnostima. Prikazana organoleptička svojstva i tehnološki parametri, kao i vrijednosti kemijskog sastava, mogu poslužiti u svrhu standardizacije ovog sira, te eventualne zaštite njegove izvornosti ili zemljopisnog podrijetla.In this paper an importance of cheese from the region of Livno, through its 117-years of production is described. The most important technological parameters, basic chemical composition and organoleptic characteristics of Livno cheese are described on the basis of literature data. A significant quality difference, between traditionally and industrially manufactured cheeses, mainly due to milk used, production processes and technical abilities, is established. The presented organoleptic properties and technological parameters, as well as chemical composition, can be use to standardise this type of cheese. This will also enable eventual protection of its geographical origin

Carotid Endarterectomy Unexpectedly Resulted in Optimal Blood Pressure Control

Resistant hypertension is defined as hypertension that remains above 140/90 mmHg despite the provision of three or more antihypertensive drugs in a rational combination at full doses and including a diuretic. It is associated with adverse clinical outcome and therefore requires aggressive medical treatment. We present a case of 70-year-old woman who was treated for resistant hypertension with a diuretic, ACE-inhibitor, calcium channel blocker, and with centrally acting antihypertensive, moxonodine. Despite of aggressive medical treatment her blood pressure remained above 160/90 mmHg continuously. Large diagnostic workup excluded common causes of secondary hypertension, but revealed significant carotid stenosis present on left internal carotid artery. Carotid endarterectomy was performed in order to improve cerebrovascular prognosis, but unexpectedly resulted in optimal control of her blood pressure. Two months after operation patient was on only one antihypertensive drug, having blood pressure below 130/85 mmHg. We suggest that in selected patients resistant hypertension could be associated with carotid stenosis and carotid sinus baroreceptor dysfunction. For definite conclusions further studies are warranted

Interleukin-1beta gene promoter polymorphism is associated with higher liver fibrosis progression rate in Croatian patients with biochemically active chronic hepatitis C

Background and aims: Genetic polymorphisms of immune mediators have been associated with differences in the natural course of chronic hepatitis C (CHC). The aim of this study was to analyze the association of IL-1β gene polymorphism with the stage of liver fibrosis (LF), grade of necroinflammatory activity (NIA) and fibrosis progression rate (FPR) in CHC patients. Patients and methods: The study included 50 treatment-naive Croatian CHC patients (36 male and 14 female; age median 37.5 years) with elevated ALT. Diallele polymorphism (C/T) at locus -31 in the IL-1β gene promoter region was determined by restriction fragment length polymorphism (RFLP). Stage of LF and NIA were assessed from liver biopsy sample according to Ishak classification. Results: There was no difference in the stage of LF and NIA level between particular patient genotypes. However, patients with at least 1 C allele at locus -31showed significantly faster FPR than those with no C allele (0.4 vs. 0.258 Ishak\u27s units/year; p = 0.043). Higher stages of fibrosis were observed in older patients (p = 0.001) and those infected at an older age (p = 0.017). Conclusion: Our study demonstrated that the carriage of at least 1 C allele at -31 locus of IL-1β gene led to faster progression of LF in CHC patients with a biochemically active disease, but did not determine the final stage of fibrosis development. Combined with other risk factors, this finding may serve as a genetic marker to identify patients that require earlier introduction of therapy, since delay could hamper therapeutic success due to rapid disease progression

Carotid endarterectomy unexpectedly resulted in optimal blood pressure control [Karotidna endarterektomija neočekivano rezultirala optimalnom kontrolom tlaka]

Resistant hypertension is defined as hypertension that remains above 140/90 mmHg despite the provision of three or more antihypertensive drugs in a rational combination at full doses and including a diuretic. It is associated with adverse clinical outcome and therefore requires aggressive medical treatment. We present a case of 70-year-old woman who was treated for resistant hypertension with a diuretic, ACE-inhibitor, calcium channel blocker, and with centrally acting antihypertensive, moxonodine. Despite of aggressive medical treatment her blood pressure remained above 160/90 mmHg continuously. Large diagnostic workup excluded common causes of secondary hypertension, but revealed significant carotid stenosis present on left internal carotid artery. Carotid endarterectomy was performed in order to improve cerebrovascular prognosis, but unexpectedly resulted in optimal control of her blood pressure. Two months after operation patient was on only one antihypertensive drug, having blood pressure below 130/85 mmHg. We suggest that in selected patients resistant hypertension could be associated with carotid stenosis and carotid sinus baroreceptor dysfunction. For definite conclusions further studies are warranted

Karotidna endarterektomija neočekivano rezultirala optimalnom kontrolom tlaka

Resistant hypertension is defined as hypertension that remains above 140/90 mmHg despite the provision of three or more antihypertensive drugs in a rational combination at full doses and including a diuretic. It is associated with adverse clinical outcome and therefore requires aggressive medical treatment. We present a case of 70-year-old woman who was treated for resistant hypertension with a diuretic, ACE-inhibitor, calcium channel blocker, and with centrally acting antihypertensive, moxonodine. Despite of aggressive medical treatment her blood pressure remained above 160/90 mmHg continuously. Large diagnostic workup excluded common causes of secondary hypertension, but revealed significant carotid stenosis present on left internal carotid artery. Carotid endarterectomy was performed in order to improve cerebrovascular prognosis, but unexpectedly resulted in optimal control of her blood pressure. Two months after operation patient was on only one antihypertensive drug, having blood pressure below 130/85 mmHg. We suggest that in selected patients resistant hypertension could be associated with carotid stenosis and carotid sinus baroreceptor dysfunction. For definite conclusions further studies are warranted.Rezistentna hipertenzija definirana je kao povišeni krvni tlak iznad 140/90 mmHg unatoč liječenju sa tri ili više antihpertenziva u racionalnoj kombinaciji uz uključeni diuretik. Asocirana je sa nepovoljnom kliničkom prognozom i zahtjeva agresivno liječenje. Prezentiramo slučaj 70-godišnje bolesnice koja je liječena od rezistentne hipertenzije sa diuretikom, ACE-inhibitorom, blokatorom kalcijskih kanala uz centralno djelujući antihipertenziv, moksonidin. Unatoč agresivnom liječenju njezin je tlak bio kontinuirano iznad 160/90 mmHg. Opsežna dijagnostička obrada isključila je uobičajene uzroke sekundarne hipertenzije, ali je otkrila značajnu stenozu lijeve karotide. Učinjena je karotidna endarterektomija sa ciljem da se poboljša cerebrovaskularna prognoza bolesnice, a kao neočekivani postoperativni nalaz javila se normotenzija bolesnice. Na temelju kliničke opservacije sugeriramo da u selekcioniranih bolesnika rezistentna hipertenzija može biti asocirana sa stenozom karotide i disfukcijom karotidnih baroreceptora. Za definitivne zaključke potrebne su kliničke studije

Interleukin-1beta gene promoter polymorphism is associated with higher liver fibrosis progression rate in Croatian patients with biochemically active chronic hepatitis C

Background and aims: Genetic polymorphisms of immune mediators have been associated with differences in the natural course of chronic hepatitis C (CHC). The aim of this study was to analyze the association of IL-1β gene polymorphism with the stage of liver fibrosis (LF), grade of necroinflammatory activity (NIA) and fibrosis progression rate (FPR) in CHC patients. Patients and methods: The study included 50 treatment-naive Croatian CHC patients (36 male and 14 female; age median 37.5 years) with elevated ALT. Diallele polymorphism (C/T) at locus -31 in the IL-1β gene promoter region was determined by restriction fragment length polymorphism (RFLP). Stage of LF and NIA were assessed from liver biopsy sample according to Ishak classification. Results: There was no difference in the stage of LF and NIA level between particular patient genotypes. However, patients with at least 1 C allele at locus -31showed significantly faster FPR than those with no C allele (0.4 vs. 0.258 Ishak\u27s units/year; p = 0.043). Higher stages of fibrosis were observed in older patients (p = 0.001) and those infected at an older age (p = 0.017). Conclusion: Our study demonstrated that the carriage of at least 1 C allele at -31 locus of IL-1β gene led to faster progression of LF in CHC patients with a biochemically active disease, but did not determine the final stage of fibrosis development. Combined with other risk factors, this finding may serve as a genetic marker to identify patients that require earlier introduction of therapy, since delay could hamper therapeutic success due to rapid disease progression