LIVER TRANSPLANTATION AND ALLERGY: TRANSPLANT-ACQUIRED FOOD ALLERGY

Transplant-acquired food allergy is a well known phenomenon especially linked to liver transplants. Risk factors lie both in transplant recipient and transplant donor - age of recipient and the maturity of immune regulatory mechanisms, family history of atopy in recipient, young age of the donor and atopic history in donor. The exact mechanism has not yet been established and there are many different explanations of this pathophysiologic process. Transplanted liver is a large and well perfused organ, rich in pluripotent hematopoietic stem cells and donor\u27s IgE antibodies that can alter immunological response in the host. Some studies suggest that post-transplant immunosuppression with tacrolimus is linked to an increased occurrence of IgE-mediated sensitization and manifestation of allergic disease. Research in the field of transplant-acquired food allergy is not important only for transplant patients and physicians involved but also for understanding the mechanism of food allergy development in general population and potentially reducing this global health concerning issue

LIVER TRANSPLANTATION AND ALLERGY: TRANSPLANT-ACQUIRED FOOD ALLERGY

Transplant-acquired food allergy is a well known phenomenon especially linked to liver transplants. Risk factors lie both in transplant recipient and transplant donor - age of recipient and the maturity of immune regulatory mechanisms, family history of atopy in recipient, young age of the donor and atopic history in donor. The exact mechanism has not yet been established and there are many different explanations of this pathophysiologic process. Transplanted liver is a large and well perfused organ, rich in pluripotent hematopoietic stem cells and donor\u27s IgE antibodies that can alter immunological response in the host. Some studies suggest that post-transplant immunosuppression with tacrolimus is linked to an increased occurrence of IgE-mediated sensitization and manifestation of allergic disease. Research in the field of transplant-acquired food allergy is not important only for transplant patients and physicians involved but also for understanding the mechanism of food allergy development in general population and potentially reducing this global health concerning issue

CORRELATION OF CLINICAL AND ENDOSCOPIC INDICES IN IBD PATIENTS IN UNIVERSITY CLINICAL HOSPITAL MOSTAR

Background: To explore correlation between clinical and endoscopic indices in inflammatory bowel disease (IBD) patients. Subjects and methods: There were 112 patients with inflammatory bowel disease. All patients with diagnosed IBD was established a degree of clinical and endoscopic disease activity. CDAI (Crohn\u27s disease activity index) was used as clinical and SESCD (Simplified Endoscopic Crohn Disease Index) as endoscopic index for Crohn\u27s disease. For ulcerative colitis Truelov & Witts index was used as clinical and Baron as endoscopic activity index. Correlation of clinical and endoscopic indices were compared in Crohn disease (CD) and ulcerative colitis (UC). Patients were analyzed by clinical entities - CD and UC, according to sex, age, parameters of anemia, duration of disease and education. Results: In the total of 112 IBD patients there were 69 patients diagnosed as ulcerative colitis (61.6%) and 43 as Crohn\u27s disease (38.4%). There were 58 (51.8%) women and 54 (48.2%) men. Comparison between endoscopic and clinical indices in CD and UC demonstrated no significant differences in ilnness activity. Endoscopic and clinical disease activity was associated with a higher inflammatory parameters (CRP and leucocytes, L) and lower parameters of hemoglobin (Hb) and MCV. Conclusion: Our research has established a good correlation between clinical and endoscopic index of disease activity in the CB and UC in inflammation. Clinical indices can be used for monitoring inflammation

Psychosocial and clinical characteristics of depressive patients with the diagnosis of metabolic syndrome

There is a growing quantity of data showing that mental illnesses affect the somatic health. Depression is a complex disease, connected with the disturbances of sleep-cycle, appetite, body weight and level of physical activity, all of which may represent the risk factors for the development of metabolic disturbances. In the depressive patients, there is a number of various physiological mechanisms and psychosocial factors which may influence the development of metabolic syndrome (MS), such as sex, age, smoking, stress levels, nutrition and level of physical activity. It is considered that chronic stress causes depression and the resulting bad life habits may lead to MS and finally KVB. Aim of this study was to investigate the psychosocial and clinical features of depressive patients with the diagnosis of MS. The cross-reference study has been done at the sample of 80 patients diagnosed with MS. Among the diagnostic instruments applied, we have used the structured socio-demographic questionnaire, MINI questionnaire, Hamilton Rating Scale for Depression (HAMD-17) and Clinical Global Impression (CGI). The diagnosis of metabolic syndrome had been established following the NCEP ATP criteria. Among the depressive patients, there were 38.8% who fulfilled the criteria for establishing the diagnosis of MS. There was a greater incidence of suicide among the depressive patients with the diagnosis of MS. The diagnose was more frequently established in depressive women, while an increased intake of carbohydrates represented a significant feature of both depression and MS. Further research is needed to explain the observed gender differences and to determine if the interventions aimed to treating the depression can also contribute to accepting the healthy life habits and as a consequence, indirectly reduce the incidence of MS

Razlike u kvaliteti života ovisnika o heroinu liječenih u metadonskom programu i ovisnika liječenih u programu terapijske zajednice

Aim of the study was comparing the quality of life of addicts treated in frame of methadone substitution programs and addicts undergoing the rehabilitation on the frame of therapeutic community. We have done a crossover study in the Center for Prevention and Out-patient Treatment in Mostar. We have included 60 subjects in our study. All of them were heroin addicts, referred to the Center for Prevention and Out-patient Treatment in Mostar, who satisfied the DSM-IV criteria for the addiction disease. The subjects have been divided in three groups: 1) group of just-admitted patients (N=20), 2) group of patients who had spent six months in methadone program (N=20) and 3) group of patient who had spent six months in the therapeutic community program (N=20). In this study, we have gathered data for social-demographic variables such as age, education, marital and professional status and variables related to the addiction, such as duration of addiction, manner of drug administration, alcohol use and presence of HCV, HBV or HIV viral infections. For the estimation of quality of life, we have used the “Quality of life index”, to measure the perception of the important areas of life, such as health and functioning in the fields of social, economic, psychological and spiritual domains. A majority of subjects from this sample had achieved the secondary school education and were of similar age, unmarried, mostly unemployed and only a smaller number of them were living alone, out of their primary families. The groups tested have not significantly differed considering those living conditions which reflect the quality of life. The results of addiction variables had showed that a majority of subjects administered the drug intravenously, there were no significant differences concerning the duration of addiction and the most of the subjects had drunk no alcohol. We have not detected any cases of HIV infection, while a significant number of subjects had been infected with hepatitis B virus. This study revealed significant differences in quality of life between the groups tested. The groups of subjects who had undergone the methadone program and the group of those treated in the frame of therapeutic community showed significantly higher scores on quality of life scales compared to the group of just-admitted patients, while there were no such differences between the group of subjects who had undergone the methadone program and the group of those treated in the frame of therapeutic community. The data obtained indicate that the methadone treatment is similarly effective concerning the quality of subjects’ life as the treatment in the frame of therapeutic communityCilj istraživanja bio je usporediti kvalitetu života ovisnika liječenih u supstitucijskom metadonskom programu i ovisnika na rehabilitaciji u terapijskoj zajednici. Provedeno je presječno istraživanje u Centru za prevenciju i izvanbolničko liječenje ovisnosti u Mostaru. U istraživanje je uključeno 60 ispitanika. Svi su ovisnici o heroinu koji su se javili u Centar za prevenciju i izvanbolničko liječenje ovisnosti u Mostaru, a koji zadovoljavaju DSM-IV kriterije za dijagnozu ovisnosti. Ispitanici su podijeljeni u tri skupine: 1) skupinu tek primljenih pacijenata (N=20), 2) skupinu pacijenata koji su proveli 6 mjeseci u metadonskom programu (N=20) i3) skupinu pacijenta koji su proveli 6 mjeseci u programu terapijske zajednice (N=20). U istraživanju su prikupljane socidemografske varijable kao što su dob, edukacija, bračni i radni status, te varijable vezane za ovisnost kao što su dužina ovisničkog staža, način uzimanja droge, uporaba alkohola te prisutnosti infekcije virusima HCV, HBV i HIV. Za procjenu kvalitete života koristio “Quality of life index” kojim se mjerila percepcija važnih životnih područja kao što su zdravlje i funkcioniranje, socijalno i ekonomsko, psihološko i spiritualno, te obiteljsko područje. Većina ispitanika u uzorku je bila srednjoškolski obrazovana, podjednake dobi, neoženjeni, najveći dio je bio bez posla, a samo mali broj je živio sam van primarne obitelji. Ispitivane skupine se nisu značajno razlikovale prema uvjetima življenja koji su pokazatelji kvalitete života. Rezultati istraživanja ovisničkih varijabli pokazuju da je većina ispitanika drogu uzimala intravenskim putem, nije bilo razlika u trajanju ovisničkog staža među skupinama, te ih većina nije pila alkohol. Nije nađen nijedan slučaj infekcije HIV-om, a veći broj ispitanika u uzorku su bili zaraženi virusom hepatitisa C, dok je vrlo mali broj ispitanika bio zaražen virusom hepatitisa B. U ovom istraživanju su nađene značajne razlike u kvaliteti života među ispitivanim skupinama. Skupine ispitanika liječenih u metadonskom programu i u programu terapijske zajednice pokazale su značajno veće rezultate na skalama kvalitete života u odnosu na skupinu tek primljenih pacijenata, a između skupine ispitanika koji su bili u metadonskom programu liječenja i skupine u terapijskoj zajednici nije bilo takvih razlika. Dobiveni podaci ukazuju na činjenicu da je liječenje metadonom podjednako djelotvorno kao i boravak u terapijskoj zajednici po utjecaju na promjene u kvaliteti života ispitanika

ANXIETY, DEPRESSION AND PERSONALITY TYPES IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: COMPARISONS WITH PEPTIC ULCER AND THE GENERAL POPULATION

Background: To explore corellation of anxiety, depression ant type of personality in inflammatory bowel disease (IBD) and compare with peptic ulcer (PU). Subjects and methods: In this study, prevalence of anxiety, depression and type of personality was investigated in 362 cases divided into three groups: 112 of IBD patients, 122 of peptic ulcer patients and 128 of control group who didn\u27t have any gastrointestinal or psychic complaints. IBD and peptic ulcer diagnosis were established by standard diagnostic procedures (anamnesis, clinical manifestations, laboratory, endoscopy and biopsy in IBD and upper endoscopy in peptic ulcer). Anxiety and depression were established by Hamilton anxiety rating scale (HAM-A) and Hamilton rating test for depression (HAM-D). Type of A/B personality was established by Bortner scale and D type of personality by Denollet scale (DS14). Results: Anxiety was found in 47 (41.9%) and depression in 44 (38.3%) of a total of 112 IBD cases. In group with peptic ulcer anxiety was found in 40 (32.8%) and depression aalso in 40 (32.8%) of total 122 cases. In control group anxiety was diagnosed in 21 (16.4%) and depression in 20 (15.6%) of total 128 cases. Anxiety and depresson were significantly higher in both groups than in control group but anxiety and depression were significantly higher in IBD group than peptic ulcer group. D type of personality was statistically significant in peptic ulcer group. Conclusion: Anxiety and depression in IBD and peptic ulcer cases have a greater prevalence compared to the normal population and surprisingly are higher in IBD than peptic ulcer group. D type of personality is associated with peptic ulcer

THE HISTORICAL USE OF MEDICINAL PLANTS IN TRADITIONAL AND SCIENTIFIC MEDICINE

There is a strong connection between man and nature, ever since his first origins, the man discovered the benefits of the plant kingdom, which he used to feed himself, to heal and to survive. Following the use of eatable, medicinal and poisonous plants takes us into the distant past. The man’s first knowledge about plants passed from generation to generation. The ancients Chinese, Egyptians, Indians, Greeks, Romans and the Old Slavs knew a large number of medicinal plants. That knowledge was carried over to other nations as well. Thanks to its geographical location and climate condition, our country is abundant and very rich in variety of species of medicinal plants. In the Middle Ages, there were written many herbal manuals that described the use and procedures in healing with medicinal plants. Many plants were known by the oldest civilizations and they were used by the people for thousands of years. Moreover, today’s science has confirmed their effectiveness in the treatment of different diseases

THE HISTORICAL USE OF MEDICINAL PLANTS IN TRADITIONAL AND SCIENTIFIC MEDICINE

There is a strong connection between man and nature, ever since his first origins, the man discovered the benefits of the plant kingdom, which he used to feed himself, to heal and to survive. Following the use of eatable, medicinal and poisonous plants takes us into the distant past. The man’s first knowledge about plants passed from generation to generation. The ancients Chinese, Egyptians, Indians, Greeks, Romans and the Old Slavs knew a large number of medicinal plants. That knowledge was carried over to other nations as well. Thanks to its geographical location and climate condition, our country is abundant and very rich in variety of species of medicinal plants. In the Middle Ages, there were written many herbal manuals that described the use and procedures in healing with medicinal plants. Many plants were known by the oldest civilizations and they were used by the people for thousands of years. Moreover, today’s science has confirmed their effectiveness in the treatment of different diseases