Menopausal hormone therapy is associated with having high blood pressure in postmenopausal women : observational cohort study

Background: The relationship between menopausal hormone therapy (MHT) and cardiovascular risk remains controversial, with a number of studies advocating the use of MHT in reducing risk of cardiovascular diseases, while others have shown it to increase risk. The aim of this study was to determine the association between menopausal hormone therapy and high blood pressure. Methods and Findings: A total of 43,405 postmenopausal women were included in the study. Baseline data for these women were sourced from the 45 and Up Study, Australia, a large scale study of healthy ageing. These women reported being postmenopausal, having an intact uterus, and had not been diagnosed with high blood pressure prior to menopause. Odds ratios for the association between MHT use and having high blood pressure were estimated using logistic regression, stratified by age (<56 years, 56-61 years, 62-70 years and over 71 years) and adjusted for demographic and lifestyle factors. MHT use was associated with higher odds of having high blood pressure: past menopausal hormone therapy use: <56 years (adjusted odds ratio 1.59, 99% confidence interval 1.15 to 2.20); 56-61 years (1.58, 1.31 to 1.90); 62-70 years (1.26, 1.10 to 1.44). Increased duration of hormone use was associated with higher odds of having high blood pressure, with the effect of hormone therapy use diminishing with increasing age. Conclusions: Menopausal hormone therapy use is associated with significantly higher odds of having high blood pressure, and the odds increase with increased duration of use. High blood pressure should be conveyed as a health risk for people considering MHT use

Agricultural Academy

Diversity of the fi sh species important for fi shery on the territory of Serbia has changed both spatially and temporally. Temporal changes are connected with historical and anthropogenic factors, while spatial changes are mostly the results of anthropogenic activity. Based on the analysis of the &quot;BAES-ex situ&quot; national database, there are two temporal and spatial periods. The fi rst period (from 1860 to 1950) is characterised by great diversity of the fi sh species important for fi shery in natural ecosystems, above all in rivers. The second period (from 1950 until today) is characterised by reduction in the diversity of the fi sh species important for fi shery, especially sturgeon species, in natural ecosystems, predominantly rivers, and the increasing diversity in anthropogenic water ecosystems. The increasing diversity in accumulations is predominantly related to Cyprinidae and Percidae species. The reduction in diversity in natural ecosystems is most often the result of irrational fi shery, habitat degradation, prominent anthropogenic infl uence and presence of introduced species. Many species important for fi shery are, according to the newest legal regulations of the Republic of Serbia, classifi ed in the category of strictly protected and protected species, and the permanent close hunting season or close season in certain periods and ban on hunting for individuals below prescribed size was declared for many of them. Taking into consideration prominent reduction in diversity, some of the fi sh species important for fi shery are also in &quot;The preliminary list of species for the Serbian red list of vertebrates&quot; because they are in danger of being extinct

Development of sperm vitrification protocols for freshwater fish (Eurasian perch, Perca fluviatilis) and marine fish (European eel, Anguilla anguilla)

[EN] Vitrification was successfully applied to the sperm of two fish species, the freshwater Eurasian perch (Perca fluviatilis) and marine European eel (Anguilla anguilla). Sperm was collected, diluted in species specific non-activating media and cryoprotectants and vitrified by plunging directly into liquid nitrogen without pre-cooling in its vapor. Progressive motility of fresh and vitrified-thawed sperm was evaluated with computer-assisted sperm analysis (CASA). Additional sperm quality parameters such as sperm head morphometry parameters (in case of European eel) and fertilizing capacity (in case of Eurasian perch) were carried out to test the effectiveness of vitrification. The vitrification method for Eurasian perch sperm resulting the highest post-thaw motility (14 +/- 1.6%) was as follows: 1:5 dilution ratio, Tanaka extender, 30% cryoprotectant (15% methanol + 15% propylene-glycol), cooling device: Cryotop, 2 mu l droplets, and for European eel sperm: dilution ratio 1:1, with 40% cryoprotectant (20% MeOH and 20% PG), and 10% FBS, cooling device: Cryotop, with 2 mu l of sperm suspension. Viable embryos were produced by fertilization with vitrified Eurasian perch sperm (neurulation: 2.54 +/- 1.67%). According to the ASMA analysis, no significant decrease in head area and perimeter of vitrified European eel spermatozoa were found when compared to fresh spermatozoa.The work was funded by the NKFI (previously OTKA) project number K-109847 and by a Short-term Scientific Mission awarded to E. Kasa by the COST Office (Food and Agriculture COST Action FA1205: Assessing and improving the quality of aquatic animal gametes to enhance aquatic resources. The need to harmonize and standardize evolving methodologies, and improve transfer from academia to industry; AQUAGAMETE). The work was supported by the project Research Center of Excellence - 9878-3/2016/FEKUT of the Ministry of Human Resources of Hungary and the project EUREKA_HU_12-1-2012-0056 (PERCAHATCH).Kása, E.; Bernáth, G.; Kollár, T.; Zarski, D.; Lujic, J.; Marinovic, Z.; Bokor, Z.... (2017). Development of sperm vitrification protocols for freshwater fish (Eurasian perch, Perca fluviatilis) and marine fish (European eel, Anguilla anguilla). General and Comparative Endocrinology. 245:102-107. https://doi.org/10.1016/j.ygcen.2016.05.010S10210724

Mortality after admission for acute myocardial infarction in Aboriginal and non-Aboriginal people in New South Wales, Australia: a multilevel data linkage study

Background - Heart disease is a leading cause of the gap in burden of disease between Aboriginal and non-Aboriginal Australians. Our study investigated short- and long-term mortality after admission for Aboriginal and non-Aboriginal people admitted with acute myocardial infarction (AMI) to public hospitals in New South Wales, Australia, and examined the impact of the hospital of admission on outcomes. Methods - Admission records were linked to mortality records for 60047 patients aged 25–84 years admitted with a diagnosis of AMI between July 2001 and December 2008. Multilevel logistic regression was used to estimate adjusted odds ratios (AOR) for 30- and 365-day all-cause mortality. Results - Aboriginal patients admitted with an AMI were younger than non-Aboriginal patients, and more likely to be admitted to lower volume, remote hospitals without on-site angiography. Adjusting for age, sex, year and hospital, Aboriginal patients had a similar 30-day mortality risk to non-Aboriginal patients (AOR: 1.07; 95% CI 0.83-1.37) but a higher risk of dying within 365 days (AOR: 1.34; 95% CI 1.10-1.63). The latter difference did not persist after adjustment for comorbid conditions (AOR: 1.12; 95% CI 0.91-1.38). Patients admitted to more remote hospitals, those with lower patient volume and those without on-site angiography had increased risk of short and long-term mortality regardless of Aboriginal status. Conclusions - Improving access to larger hospitals and those with specialist cardiac facilities could improve outcomes following AMI for all patients. However, major efforts to boost primary and secondary prevention of AMI are required to reduce the mortality gap between Aboriginal and non-Aboriginal people

Health, ageing and private health insurance: baseline results from the 45 and Up Study cohort

Correction to Banks E, Jorm L, Lujic S, Rogers K. Health, ageing and private health insurance: baseline results from the 45 and Up Study cohort. ANZ Health Policy 2009; 6: 16

Case report of ewing sarcoma of the chest wall

© 2017, Serbian Medical Society. All rights reserved. Ewing Sarcoma, a highly malignant and poorly differentiated tumor, is composed of small round cells. Being the second most frequent tumor, it most commonly occurs in children and adolescents, with the gender ratio being 1.5:1 in favor of males. Location-wise, it most often occurs in the area of pelvis, knee, femur and humerus, whereas it is considerably less common in other bones, bones of the head, clavicle or ribs. According to EICESS studies, the forecast, along with adequate treatment, depends on the occurrence of distant metastases. Three-year survival rate of 66% was reported in patients in whom there were no secondary diseases. The emergence of a large volume tumor, which is primarily localized in the pelvis or the chest, has a poor prognosis. In 2013, a boy born in 2005 presented with a pain in the chest. Upon performed biopsy and verified diagnosis, the case was presented to the Sarcoma Conference, and preoperative chemotherapy was conducted in accordance with the Euro Ewing 2008 protocol. As decided by the Sarcoma Conference, the resection was performed in 2013. The patient is regularly controlled and still without metastatic disease; fully rehabilitated. The abovementioned case report can lead us to conclude that a serious approach to all symptoms suffered by patients, some of which are often non-specific, is essential. All types of pain should be taken seriously and all necessary diagnostic testing should be immediately performed: to X-ray the affected area, and then, in case of suspected findings, to do a CT of the affected region, as well as skeletal scintigraphy. Tumors of the chest wall are rarely seen in children. Consistent application of the diagnostic system is not less important than the subsequent approach to complete treatment. Surgical therapy must be aggressive to healthy resection surfaces, especially in relapses. Recurrence is not rare, and therefore surgical technique requires special attention. Ewing’s sarcoma serves as an example proving that only a multidisciplinary approach can result in an adequate diagnosis and treatment, as well as in providing patients with higher possibilities of final recovery

Inequalities in potentially preventable hospitalisation rates between Aboriginal and non-Aboriginal children in New South Wales, Australia

ObjectiveOur study aimed to quantify potentially preventable hospital (PPH) admission rates for acute, chronic and vaccine- preventable conditions, and the inequality in these rates, in large whole-of-population cohort of Aboriginal and non-Aboriginal children living in Australia's most populous state, New South Wales (NSW).ApproachWe conducted a retrospective cohort study using linked hospital and mortality records for NSW from July 1, 2000 to December 31, 2008. A cohort of 653,575 children (2.6% Aboriginal) born in a NSW hospital between July 1, 2000, and December 31, 2007, were included in the analysis. The study outcome was PPH admissions. Admission rates per 1000 person-years were calculated with 95% confidence intervals (CIs) for acute, chronic and vaccine-preventable conditions, and stratified by demographic and birth characteristics (i.e. age, sex, low birth weight, prematurity, private patient/health insurance status, geographical remoteness and socioeconomic status).ResultsThere were 103,569 PPH admissions among the cohort during the study period, of which 5% were in Aboriginal children. The PPH admission rate was 63.9 and 33.4 per 1000 person-years in Aboriginal and non-Aboriginal children, respectively. Acute conditions accounted for almost two thirds of PPH admissions, and rates were highest in younger children. The size of the inequality was largest among 0-1 year olds for acute, chronic and vaccine-preventable PPH admissions. PPH admission rates were higher among more socioeconomically disadvantaged children, and the inequality between Aboriginal and non- Aboriginal children was largest among the most disadvantaged. Although PPH admission rates were higher in more remote areas regardless of Aboriginality, there was a significant inequality between Aboriginal and non-Aboriginal children in major cities, regional and remote areas.ConclusionThere is potential to achieve substantial health gains for Aboriginal children, and to reduce hospital admissions, through improved access, availability and culturally appropriate provision of preventative and primary care to Aboriginal communities, and through broader initiatives to address the entrenched disadvantage experienced by Australian Aboriginal people