Risk Assessment of Transitional Economies by Multivariate and Multicriteria Approaches

This article assesses country-risk of sixteen Central, Baltic and South-East European transition countries, for 2005 and 2007, using multivariate cluster analysis. It was aided by the appropriate ANOVA (analysis of variance) testing and the multicriteria PROMETHEE method. The combination of methods makes for more accurate and efficient country-risk assessment.Country risk classifications and ratings involve evaluating the performance of countries while considering their economic and socio-political characteristics. The purpose of the article is to classify, and then find the comparative position of each individual country in the group of analyzed countries, in order to find out to which extent development of market economy and democratic society has been achieved.Country-risk, Transition countries, Multivariate cluster analysis, PROMETHEE method.

Maternal immune system adaptation to pregnancy - a potential influence on the course of diabetic retinopathy

<p>Abstract</p> <p>Background</p> <p>Progression of diabetic retinopathy occurs at least temporarily during pregnancy. Although the cause of this progression is not entirely understood, the immune phenomenon and chronic inflammation may play a significant role. During pregnancy in order to avoid fetus rejection, certain components of the immune system that are knowingly implicated in the pathogenesis of diabetic retinopathy are activated including generalized leukocyte activation and an increase in certain cytokine plasma levels. Activated leukocytes with up regulated adhesion molecules have an increased potential to bind to the endothelium cells of blood vessels. Leukocyte-endothelial interaction and the consequent leukostasis with capillary occlusion, ischemia and vascular leakage have a substantial role in the development of diabetic retinopathy. Furthermore, certain increased cytokines are known to cause blood-retinal-barrier breakdown whilst others promote angiogenic and fibrovascular proliferation and thereby can also be implicated in the pathogenesis of this diabetic complication.</p> <p>Presentation of the hypothesis</p> <p>We hypothesized that the activation of the immune system during gestation may have an influence on the course of retinopathy in pregnant diabetic women.</p> <p>Testing the hypothesis</p> <p>We suggest two prospective follow up studies conducted on women with type 1 diabetes mellitus. The first study would include a group of non-pregnant women and a group of diabetic women undergoing normal pregnancy matched for age and duration of diabetes. In the second study pregnant women would be divided into two groups: one with normal pregnancy and the other with preeclampsia. The procedure and data collection in both studies will be identical: a complete ophthalmological examination, glycaemic control, blood pressure measurement and venous blood samples for the determination of plasma levels of cytokines (TNF-alpha, IL-1beta, IL-6, IL-8) and adhesion molecules (ICAM-1, VCAM-1).</p> <p>Implications of the hypothesis</p> <p>Considering the present assumption, the gestational immune activation could be suggested as a potential risk factor for the development and progression of retinopathy in diabetic women. A better understanding of immunomodulatory effects of pregnancy on diabetic retinopathy pave the way for further investigations of the mechanism of its pathogenesis and could be essential for novel approaches to the treatment of this serious sight threatening complication of diabetes mellitus.</p

PIK3CA Mutations in Luminal, HER2 Negative Metastatic Breast Cancer

Ciljevi: U bolesnica s luminalnim, HER2 negativnim, metastatskim karcinomima dojke rezistentnim na endokrinu terapiju, liječenim u KBC Split u 2020. i 2021. godini, u uzorcima tkiva tumora odrediti udio i tip PIK3CA mutacija, te dobivene podatke usporediti s rezultatima iz registracijske studije SOLAR1 koja procjenjuje učinkovitost i sigurnost alpelisiba u kombinaciji s fulvestrantom kod bolesnika s uznapredovalim rakom dojke koji je napredovao tijekom ili nakon liječenja inhibitorima aromataze. Metode ( ispitanici i postupci ): Prikupljeni su podaci o 99 bolesnika s dijagnosticiranim luminalnim, HER2 negativnim, metastatskim karcinomima dojke u vremenskom periodu od 2020. do 2021. godine. To je retrospektivna analiza. Za potrebe izrade empirijskog dijela ovog diplomskog rada pristupljeno je medicinskoj dokumentaciji i elektroničkoj bazi podataka Kliničkog zavoda za patologiju, sudsku medicinu i citologiju Kliničkog bolničkog centra Split. U bazu podataka uvršteni su dob, spol, prisutnost PIK3CA mutacije i distribucija specifičnih mutacija. Uzorci tumorskog tkiva analizirani su primjenom lančane reakcije polimeraze u realnome vremenu (RT-PCR ) metode. Rezultati: Utvrđena je značajna razlika u zastupljenosti pacijenata prema spolu u uzorku od 99 pacijenata. Najveći broj pacijenata nalazi se u dobnoj skupini od 60 do 70 godina, dok srednja životna dob iznosi 67 godina. U 99 uzoraka tkiva pacijenata s metastatskim hormon receptor pozitivnim, HER2 negativnim karcinomom dojke , koji su rezistentni na endokrinu terapiju liječenih u KBC-u Split, u njih 50 je nađena PIK3CA mutacija (51,51%). U 17 uzoraka tkiva pozitivnih na PIK3CA mutaciju (N=50) utvrđena je mutacija H1047X na egzonu 20, te 14 mutacija na egzonu 9 (E542,545X i545K). Ove mutacije predstavljaju 62% svih PIK3CA mutacija, što odgovara rezultatima SOLAR-1 studije, u kojoj su mutacije također nađene najčešće na egzonima 9 i 20. Zaključak: Na temelju rezultata ove studije, usporedivih s rezultatima registracijske studije SOLAR-1, RT-PCR metodologija korištena za detekciju PIK3CA mutacija je efikasna, specifična i senzitivna metoda za odabir bolesnica za liječenje PI3K inhibitorom, koja se može implementirati u većem broju laboratorija uz redovite vanjske i unutarnje provjere kvalitete i točnosti testiranja.Objectives: In patients with luminal, HER2-negative, metastatic breast cancers resistant to endocrine therapy, treated at KBC Split in 2020 and 2021, the proportion and type of PIK3CA mutations in tumor tissue samples was determined, and the obtained data was compared with the results from the registration study SOLAR1, which evaluates efficacy and safety of alpelisib in combination with fulvestrant in patients with advanced breast cancer that progressed during or after aromatase inhibitor treatment. Subjects and methods: Retrospective analysis collected data on 99 patients diagnosed with luminal, HER2-negative, metastatic breast cancer in the period from 2020 to 2021. For the purposes of creating the empirical part of this thesis, the medical documentation and electronic database of the Clinical Institute for Pathology, Forensic Medicine and Cytology of the University Hospital of Split were accessed. Age, gender, presence of PIK3CA mutation and distribution of specific mutations were included in the database. Tumor tissue samples were analyzed using the RT-PCR method. Results: A significant difference in the representation of patients according to gender was found in the sample of 99 patients. The largest number of patients is in the age group of 60 to 70 years, while the average age is 67 years. In 99 tissue samples from patients with metastatic, hormone receptor-positive, HER2-negative breast cancer, who are resistant to endocrine therapy treated at the University Hospital of Split, PIK3CA mutation was found in 50 of them (51.51%). In 17 tissue samples positive for the PIK3CA mutation (N=50), the H1047X mutation on exon 20 and 14 mutations on exon 9 (E542,545X and 545K) were found. These mutations represent 62% of all PIK3CA mutations, which corresponds to the results of the SOLAR-1 study, in which mutations were also found most frequently in exons 9 and 20. Conclusion: Based on the results of this study, comparable to the results of the registration study SOLAR-1, the RT-PCR methodology used for the detection of PIK3CA mutations is an efficient, specific and sensitive method for selecting patients for PI3K inhibitor treatment, which can be implemented in a larger number of laboratories with regular external and internal checks on the quality and accuracy of testing

SOCIAL AND CULTURAL ASPECTS OF MUSICAL PREFERENCES OF PRE-SERVICE STUDENTS OF THE TEACHER TRAINING COLLEGE IN SPLIT

Autorice raspravljaju o sociokulturalnoj uvjetovanosti glazbe. Polazeći od premise da je cjelokupna glazba, uključujući i umjetničku, društveni konstrukt, te ju je, stoga, nužno promatrati i s društvenog i s kulturalnog aspekta, autorice razmatraju novu paradigmu kulturalne studije glazbe. Preferencije prema odreñenoj vrsti glazbe determinirane su interakcijom utjecaja različitih činitelja. Istraživane su glazbene preferencije studentica Visoke učiteljske škole Sveučilišta u Splitu, odnosno njihova sklonost prema popularnoj i umjetničkoj glazbi. Rezultati istraživanja potvrñuju hipoteze o usmjerenosti glazbenog ukusa mladih prema popularnom glazbenom idiomu, kao i njihovu pretežnu orijentiranost prema umjetničkoj glazbi ranijih stilskih razdoblja.The authors have discussed the sociocultural conditionality of music. Starting from the premise that the complete music, including the artistic one, is the social construct, so, because of that, it must be observed in consideration of the social and cultural aspects, the authors have considered the new paradigm of cultural study of music. Preferences towards specific musical quality are based on interaction between different factors. The musical preferences of the Teacher\u27s College University of Split – students, with reference to their tendency towards popular and art music have been researched. The result of our research verified the hypothesis about the musical taste of young people directed towards the popular musical idiom, as well as their predominant orientation towards the art music of earlier style periods

Udio turmoske strome kao loš prognostički čimbenik kod karcinoma debelog crijeva

High stroma proportion appears to be a very important prognostic factor in esophageal and breast cancer. Previous researches have shown that it might have a similar effect on colorectal cancer. The aim of this study was to determine whether tumor stroma proportion influenced patient survival. This retrospective study included 236 patients with colorectal cancer having undergone surgery in 2006 and 2007 at Osijek University Hospital Center. Location with the highest stroma proportion at the site of deepest tumor invasion was determined. Patients were divided into the groups with high stroma proportion (>50%) and low stroma proportion (≤50%). Stroma proportion showed a statistically significant correlation with tumor stage. Kaplan-Meier survival curves yielded a statistically significant difference in patient overall survival (Cox ph model p=0.016) and progressionfree survival (Cox ph model, p=0.0188) according to stroma proportion. Study results showed a statistically significantly shorter overall survival and progression-free survival in patients with high stroma proportion.Dokazano je da je visok udio strome značajan prognostički čimbenik kod karcinoma jednjaka i karcinoma dojke. Prethodna istraživanja su pokazala da bi isti utjecaj stroma mogla imati i kod kolorektalnog karcinoma. Cilj istraživanja je bio utvrditi je li udio tumorske strome povezan s preživljenjem bolesnika s kolorektalnim karcinomom. Provedeno je retrospektivno istraživanje u 236 bolesnika koji su operirani na Klinici za kirurgiju Kliničkoga bolničkog centra Osijek. Određeno je područje s najvećim udjelom strome u području najdubljeg prodora tumora. Bolesnici su podijeljeni u dvije skupine: onu s visokim udjelom strome (>50%) i onu s niskim udjelom strome (≤50%). Udio tumorske strome bio je statistički značajno povezan sa stadijem tumora. Kaplan-Meierova analiza je pokazala statistički značajnu razliku u ukupnom preživljenju (Cox ph model p=0,016) i preživljenju do progresije (Cox ph model, p=0,0188) bolesnika u odnosu na udio strome. Rezultati su pokazali statistički značajno kraće ukupno preživljenje i preživljenje do progresije bolesti kod bolesnika s visokim udjelom strome

Impact of Hemoglobin Concentration on Plasma B-type Natriuretic Peptid Level and Left Ventricle Echocardiographics Characteristics in Chronic Kidney Disease Patients

Anemia is common in patients with chronic kidney disease (CKD) and contributes to cardiovascular alterations. Recent findings suggest that B-type natriuretic peptide (BNP) is a sensitive biomarker for left ventricular dysfunction, but relationship between hemoglobin and BNP in CKD patients is unclear. Hemoglobin, plasma BNP and serum creatinine levels were measured in 49 patients with CKD (without heart failure), divided in two groups according to the hemoglobin status (cut-off point 110 g/L). All patients underwent echocardiography in order to assess left ventricular (LV) morphology and function. The results showed that in the group of patients with hemoglobin levels under 110 g/L BNP levels were significantly elevated (p<0.001), as well as left ventricular mass index (p<0.001). Systolic and diastolic LV function were significantly better in patients with hemoglobin levels above 110 g/L (p<0.001). Hemoglobin levels were inversely related to BNP values (r=–0.451, p<0.001). Significantly negative correlation between BNP level and creatinine clearance (p=0.009), and significantly positive correlation between BNP level and left ventricular mass index (LVMI) were established. A similar but positive relationship was observed between hemoglobin levels and creatinine clearance (p<0.01). We established statistically significant negative correlation between hemoglobin levels and LVMI (r=–0.564, p<0.001). In conclusion, BNP and hemoglobin levels depend on the renal function. Anemia may contribute to elevated BNP levels in CKD patients, and may represent an important confounder of the relationship between BNP and cardiac alteration in these patients

The Role of Inflammation and Endothelial Dysfunction in the Pathogenesis of Diabetic Retinopathy

The pathogenesis of diabetic retinopathy (DR) is insufficiently understood and presumed to possibly involve inflammation and endothelial dysfunction. The aim of the study was to investigate the relationship between inflammation markers, other markers of endothelial dysfunction and anthropometric parameters and their association with DR in patients with type 2 diabetes, divided into three groups: no retinopathy (N=65), mild / moderate nonproliferative diabetic retinopathy (NPDR; N=19) and severe NPDR / proliferative diabetic retinopathy (PDR; N=23). The groups did not differ in the levels of inflammation markers, other markers of endothelial dysfunction and anthropometric parameters. C-reactive protein was correlated with fibrinogen, HbA1c, LDL-cholesterol, BMI, WC, WHR and C index. HbA1c was correlated with cholesterol, LDL-cholesterol, BMI and WC. Logistic regression analysis showed that diabetes duration and HbA1cmedian were the main predictors of retinopathy. The study demonstrated that the association between obesity, inflammation and other risk factors plays an important role in endothelial impairment involved in the pathogenesis of DR