Establishing association between mediterranean diet and acute coronary syndrome risk factors using "MedDiet" score

Uvod: Kardiovaskularne bolesti predstavljaju vodeći uzrok obolevanja i umiranja savremenog čoveka i vodeći su javno-zdravstveni problem u svetu i kod nas. Brojna istraživanja sugerišu da se mediteranski način ishrane povezuje sa smanjenjem rizika za nastanak i razvoj kardiovaskularnih bolesti i drugih masovnih nezaraznih bolesti kao i smanjenjem stope ukupnog mortaliteta. Cilj istraživanja: Utvrditi stepen pridržavanja mediteranskom načinu ishrane kod obolelih od akutnog koronarnog sindroma i kod osoba sa utvrđenim rizikom za nastanak kardiovaskularnih bolesti, upotrebom validovanog skora mediteranske ishrane – MedDiet skora. Takođe, cilj istraživanja je bio da se utvrdi da li postoji značajna razlika u vrednostima biohemijskih i kliničkih faktora rizika za razvoj kardiovaskularnih bolesti između dve posmatrane grupe ispitanika, kao i da se odredi granična vrednost MedDiet skora između poželjnog i rizičnog načina ishrane za nastanak akutnog koronarnog sindroma. Metod: Istraživanje je sprovedeno kao analitička studija preseka na uzorku od 294 ispitanika (146 žena i 148 muškaraca), starosti od 30 do 82 godine. Istraživanje je sprovedeno u vremenskom periodu od 07.02.2016. godine do 16.03.2017. godine. Prvu grupu činili su ispitanici kod kojih je  dijagnostikovan akutni koronarni sindrom, koji su hospitalizovani u Institutu za kardiovaskularne bolesti Vojvodine u Sremskoj Kamenici, dok su drugu grupu činili ispitanici kod kojih je utvrđeno prisustvo najmanje jednog faktora rizika za nastanak kardiovaskularnih bolesti, bez klinički manifestne koronarne bolesti, koji su se javili na pregled u Savetovalište za pravilnu ishranu, Instituta za javno zdravlje Vojvodine u Novom Sadu. Kod svih učesnika u studiji izvršena su: antropometrijska merenja, merenje arterijskog krvnog pritiska, odgovarajuće biohemijske analize, EKG i anketiranje upotrebom posebno pripremljenog upitnika, u čijem sastavu se nalazio i MedDiet skor – validovan skor system za procenu stepena zastupljenosti mediteranskog načina ishrane kod pojedinca. Rezultati istraživanja: Srednja vrednost MedDiet skora ispitanika bez akutnog koronarnog sindroma bila je 27,48±6,59, dok je srednja vrednost MedDiet skora ispitanika sa akutnim koronarnim sindromom bila 20,53±4,01. Razlika srednjih vrednosti MedDiet skora između dve grupe ispitanika bila je statistički značajna (p=0,029). Ispitivanjem prediktivnih vrednosti pojedinih varijabli utvrđeno je da su MedDiet skor i glikemija našte odlični markeri za akutni koronarni sindrom (AUROC=0,815, p22,5 ukazuju na smanjen rizik za nastanak akutnog koronarnog sindroma. Multivarijantnom regresionom analizom pokazano je da na pojavu akutnog koronarnog sindroma utiču sledeći faktori rizika: godine starosti 1,063 (1,270-1,819), muški pol 4,071 (1,901-8,719), pušenje 3,067 (1,322-7,114), indeks telesne mase 0,902 (0,839-0,970), sistolni pritisak 1,020 (1,003-1,037), glikemija našte 1,520 (1,025-1,101) i MedDiet skor 0,783 (0,722-0,849). Zaključak: Akutni koronarni sindrom predstavlja značajan javno-zdravstveni problem odraslog stanovništva u Republici Srbiji na šta ukazuju visoke prevalencije u populaciji. Rezultati sprovedenog istraživanja pokazuju da je i diskretnim povećanjem unosa namirnica koje predstavljaju osnovu mediteranskog načina ishrane moguće postići značajne zdravstvene koristi. Ovi rezultati mogu predstavljati okvir za razvoj lokalnog skoring sistema ishrane prikladnog za nemediteransko područje, kao i modela za procenu rizika za nastanak akutnog koronarnog sindroma u našoj populaciji.Introduction: Cardiovascular diseases are the leading cause of morbidity and mortality of a modern society and are major public health problem in our country and also worldwide. Numerous studies suggest that the Mediterranean diet is associated with a reduction in the risk of developing cardiovascular diseases and other non-communicable diseases, as well as reduction in the overall mortality rate. Aim: To determine the degree of Mediterranean diet complience in subjects with acute coronary syndrome and subjects with an established risk for developing cardiovascular diseases, using validated Mediterranean diet score - MedDiet. Also, the aim of the study was to determine whether there is a significant difference in the values of the  biochemical and clinical risk factors for the development of cardiovascular diseases between the two observed groups of subjects, and to determine the cut-off value of the MedDiet score between the favorable and unfavorable dietaty pattern for the development of acute coronary  syndrome. Method: The study was conducted as an analytical cross-sectional study with enrollment of 294 subjects (146 women and 148 men), 30 to 82 years of age. The research was conducted during the period from 02/07/2016 until 03/16/2017. The first group of subjects consisted of patients diagnosed with acute coronary syndrome who were hospitalized at the Institute for Cardiovascular Diseases Vojvodina in Sremska Kamenica. The second group was comprised of subjects with established at least one major risk factor for the development of cardiovascular diseases but without clinically manifest coronary artery disease, who came to the medical examination of the Counseling Center for Proper Nutrition, Institute of Public Health of Vojvodina in Novi Sad. Among all participants in the study the following examinations were conducted: anthropometric measurements, arterial blood pressure measurements, appropriate biochemical analysis, ECG and surveys using a specially prepared questionnaire, which included MedDiet score - validated score system for assessing the degree of compliance with Mediterranean dietary pattern among subjects. Results of the study: The average value of the MedDiet score among subjects without acute coronary syndrome was 27.48 ± 6.59, while the average value of MedDiet score among subjects with acute coronary syndrome was 20.53 ± 4.01. The difference in MedDiet average values between the two groups of subjects was statistically significant (p = 0.029). By examining the predictive values of individual variables, it was shown that MedDiet score and fasting blood sugar were excellent markers for acute coronary syndrome (AUROC = 0.815, p 22.5 indicated reduced risk for the development of acute coronary syndrome. Multivariate regression analysis showed that acute coronary syndrome is affected by the following risk factors: age 1,063 (1,270-1,819), male gender 4,071 (1,901-8,719), smoking 3,067 (1,322-7,114), body mass index 0,902 (0.839-0.970 ), systolic blood pressure 1.020 (1.003-1.037), fasting blood sugar 1.520 (1.025-1.101) and MedDiet score 0.783 (0.722- 0.849). Conclusion: Acute coronary syndrome is a major public health problem in the adult population of the Republic of Serbia, as indicated by its high prevalence. The results of the conducted research show that discrete increase in food intakes of foods which represent the basis of the Mediterranean diet, can lead to significant health benefits. These results can represent a framework for the development of a local scoring system for a non-mediterranean area, and also for creation of risk assessment model for acute coronary syndrome in our population

Establishing association between mediterranean diet and acute coronary syndrome risk factors using "MedDiet" score

Uvod: Kardiovaskularne bolesti predstavljaju vodeći uzrok obolevanja i umiranja savremenog čoveka i vodeći su javno-zdravstveni problem u svetu i kod nas. Brojna istraživanja sugerišu da se mediteranski način ishrane povezuje sa smanjenjem rizika za nastanak i razvoj kardiovaskularnih bolesti i drugih masovnih nezaraznih bolesti kao i smanjenjem stope ukupnog mortaliteta. Cilj istraživanja: Utvrditi stepen pridržavanja mediteranskom načinu ishrane kod obolelih od akutnog koronarnog sindroma i kod osoba sa utvrđenim rizikom za nastanak kardiovaskularnih bolesti, upotrebom validovanog skora mediteranske ishrane – MedDiet skora. Takođe, cilj istraživanja je bio da se utvrdi da li postoji značajna razlika u vrednostima biohemijskih i kliničkih faktora rizika za razvoj kardiovaskularnih bolesti između dve posmatrane grupe ispitanika, kao i da se odredi granična vrednost MedDiet skora između poželjnog i rizičnog načina ishrane za nastanak akutnog koronarnog sindroma. Metod: Istraživanje je sprovedeno kao analitička studija preseka na uzorku od 294 ispitanika (146 žena i 148 muškaraca), starosti od 30 do 82 godine. Istraživanje je sprovedeno u vremenskom periodu od 07.02.2016. godine do 16.03.2017. godine. Prvu grupu činili su ispitanici kod kojih je  dijagnostikovan akutni koronarni sindrom, koji su hospitalizovani u Institutu za kardiovaskularne bolesti Vojvodine u Sremskoj Kamenici, dok su drugu grupu činili ispitanici kod kojih je utvrđeno prisustvo najmanje jednog faktora rizika za nastanak kardiovaskularnih bolesti, bez klinički manifestne koronarne bolesti, koji su se javili na pregled u Savetovalište za pravilnu ishranu, Instituta za javno zdravlje Vojvodine u Novom Sadu. Kod svih učesnika u studiji izvršena su: antropometrijska merenja, merenje arterijskog krvnog pritiska, odgovarajuće biohemijske analize, EKG i anketiranje upotrebom posebno pripremljenog upitnika, u čijem sastavu se nalazio i MedDiet skor – validovan skor system za procenu stepena zastupljenosti mediteranskog načina ishrane kod pojedinca. Rezultati istraživanja: Srednja vrednost MedDiet skora ispitanika bez akutnog koronarnog sindroma bila je 27,48±6,59, dok je srednja vrednost MedDiet skora ispitanika sa akutnim koronarnim sindromom bila 20,53±4,01. Razlika srednjih vrednosti MedDiet skora između dve grupe ispitanika bila je statistički značajna (p=0,029). Ispitivanjem prediktivnih vrednosti pojedinih varijabli utvrđeno je da su MedDiet skor i glikemija našte odlični markeri za akutni koronarni sindrom (AUROC=0,815, p22,5 ukazuju na smanjen rizik za nastanak akutnog koronarnog sindroma. Multivarijantnom regresionom analizom pokazano je da na pojavu akutnog koronarnog sindroma utiču sledeći faktori rizika: godine starosti 1,063 (1,270-1,819), muški pol 4,071 (1,901-8,719), pušenje 3,067 (1,322-7,114), indeks telesne mase 0,902 (0,839-0,970), sistolni pritisak 1,020 (1,003-1,037), glikemija našte 1,520 (1,025-1,101) i MedDiet skor 0,783 (0,722-0,849). Zaključak: Akutni koronarni sindrom predstavlja značajan javno-zdravstveni problem odraslog stanovništva u Republici Srbiji na šta ukazuju visoke prevalencije u populaciji. Rezultati sprovedenog istraživanja pokazuju da je i diskretnim povećanjem unosa namirnica koje predstavljaju osnovu mediteranskog načina ishrane moguće postići značajne zdravstvene koristi. Ovi rezultati mogu predstavljati okvir za razvoj lokalnog skoring sistema ishrane prikladnog za nemediteransko područje, kao i modela za procenu rizika za nastanak akutnog koronarnog sindroma u našoj populaciji.Introduction: Cardiovascular diseases are the leading cause of morbidity and mortality of a modern society and are major public health problem in our country and also worldwide. Numerous studies suggest that the Mediterranean diet is associated with a reduction in the risk of developing cardiovascular diseases and other non-communicable diseases, as well as reduction in the overall mortality rate. Aim: To determine the degree of Mediterranean diet complience in subjects with acute coronary syndrome and subjects with an established risk for developing cardiovascular diseases, using validated Mediterranean diet score - MedDiet. Also, the aim of the study was to determine whether there is a significant difference in the values of the  biochemical and clinical risk factors for the development of cardiovascular diseases between the two observed groups of subjects, and to determine the cut-off value of the MedDiet score between the favorable and unfavorable dietaty pattern for the development of acute coronary  syndrome. Method: The study was conducted as an analytical cross-sectional study with enrollment of 294 subjects (146 women and 148 men), 30 to 82 years of age. The research was conducted during the period from 02/07/2016 until 03/16/2017. The first group of subjects consisted of patients diagnosed with acute coronary syndrome who were hospitalized at the Institute for Cardiovascular Diseases Vojvodina in Sremska Kamenica. The second group was comprised of subjects with established at least one major risk factor for the development of cardiovascular diseases but without clinically manifest coronary artery disease, who came to the medical examination of the Counseling Center for Proper Nutrition, Institute of Public Health of Vojvodina in Novi Sad. Among all participants in the study the following examinations were conducted: anthropometric measurements, arterial blood pressure measurements, appropriate biochemical analysis, ECG and surveys using a specially prepared questionnaire, which included MedDiet score - validated score system for assessing the degree of compliance with Mediterranean dietary pattern among subjects. Results of the study: The average value of the MedDiet score among subjects without acute coronary syndrome was 27.48 ± 6.59, while the average value of MedDiet score among subjects with acute coronary syndrome was 20.53 ± 4.01. The difference in MedDiet average values between the two groups of subjects was statistically significant (p = 0.029). By examining the predictive values of individual variables, it was shown that MedDiet score and fasting blood sugar were excellent markers for acute coronary syndrome (AUROC = 0.815, p 22.5 indicated reduced risk for the development of acute coronary syndrome. Multivariate regression analysis showed that acute coronary syndrome is affected by the following risk factors: age 1,063 (1,270-1,819), male gender 4,071 (1,901-8,719), smoking 3,067 (1,322-7,114), body mass index 0,902 (0.839-0.970 ), systolic blood pressure 1.020 (1.003-1.037), fasting blood sugar 1.520 (1.025-1.101) and MedDiet score 0.783 (0.722- 0.849). Conclusion: Acute coronary syndrome is a major public health problem in the adult population of the Republic of Serbia, as indicated by its high prevalence. The results of the conducted research show that discrete increase in food intakes of foods which represent the basis of the Mediterranean diet, can lead to significant health benefits. These results can represent a framework for the development of a local scoring system for a non-mediterranean area, and also for creation of risk assessment model for acute coronary syndrome in our population

Novel paradigms linking salt and health

Although sodium is an essential nutrient, conclusive scientific evidence suggests the association between excessive salt intake and various negative health outcomes. One of the health consequences with the greatest public health impact is the increase in population blood pressure with a consequent increase of cardiovascular disease risk. There is ample evidence linking high salt intake with other health outcomes: stomach cancer, impaired renal function, osteoporosis, obesity, severity of asthma, but also with novel health risks established with advanced molecular and metagenomics technology: autoimmunity, immunity in various organs and systems. Some recent studies have reported that a high salt diet modulates the gut microbiome, interacting with both the hosts gastrointestinal tract environment and its genome and metabolism. The newest evidence indicates possible novel pathophysiological mechanisms of obesity, including high fasting ghrelin in healthy individuals consuming a high-salt diet, as well as endogenous fructose production and leptin resistance in mice. This revealing new evidence links high salt intake with obesity and consequently, with further metabolic complications. As a country with high prevalences of obesity and hypertension, and high salt intake, Serbia would greatly benefit from adopting and implementing a national sodium reduction program that minimize risks through education, regulation, and enforcement

SARS-COV-2 ANTIGEN SCREENING DURING THE FIRST POST-LOCKDOWN MAJOR MUSIC FESTIVAL IN NOVI SAD, SERBIA, IN JULY 2021

Many countries have resumed mass gathering events like music festivals, despite potential risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmissions. This study aimed to examine the frequency of SARS-CoV-2 infection among visitors to a mass event, the EXIT festival, in relation to the proposed preventive measures. A total of 466 visitors were included in this longitudinal study conducted in Novi Sad, Serbia, during July, 2021. All subjects were tested with RDT-Ag test for the presence of SARS-CoV-2 virus at the beginning of the study and seven days after. Basic socio-demographic and epidemiological data were collected through a questionnaire. The average age of participants was 28.34 ± 8.87 years with the majority of men (53.7%). There were 170 (36.5%) vaccinated participants. A 97.1% in vaccinated and 92.2% in unvaccinated group, reported to regularly wear a protective mask (p=0.029). At the second cross-sectional testing, 354 subjects were tested, of which 150 (42.4%) were vaccinated. There was no statistically significant difference in application of preventive measures during and after the festival, in respect to vaccination status of the participants. Twenty participants (5.6%) reported some of the COVID-19-like symptoms in the first seven days after visiting the festival, but no COVID-19 infection was confirmed at the RDT-Ag testing. Despite the potential effectiveness of applied preventive measures such as RDT-Ag screening, mask-wearing and vaccination, additional caution is needed when holding these events during a period of high SARS-CoV-2 transmission, as well as when the new virus variants emerge in community

The impact of obesity on early mortality after coronary artery bypass grafting

Background/Aim. It had been suggested that elevated body mass index (BMI) is a beneficial and preventive factor when it comes to the outcome for patients undergoing coronary artery bypass grafting (CABG). At the same time, obesity is strongly associated with coronary artery disease development. The aim of this study was to determine the significance of the obesity paradox in patients referred for CABG and to examine if a relationship exists between obesity and early coronary surgery outcome. Methods. This study comparised 791 patients who had undergone isolated CABG over one year period (year 2010). The average age of patients was 62.33 ± 8.12 years and involved 568 (71.8%) male and 223 (28.2%) female patients, while the mean logistic EuroSCORE was 3.42%. The patients were categorized into three distinct groups based on their BMI: I - BMI 30 kg/m2. Regression analysis was conducted to determine whether BMI was an independent predictor of early mortality after CABG. Results. The majority of the cohort could be categorized as overweight (49%) or obese (30%). There was no association between BMI and gender (p = 0.398). The overall early mortality was 2.15% (1.85% in the group I, 2.06% in the group II and 2.51% in the group III; p = 0.869). Univariate analysis showed that obesity cannot be regarded as an independent risk factor for early mortality following CABG (odds ratio 1.021, 95% confidence interval 0.910-1.145, p = 0.724). Duration of in-hospital period following the surgery was comparable within the BMI groups (p = 0.502). Conclusion. Compared to non-obese patients, overweight and obese individuals have similar early mortality rate following CABG. This study can substantiate the presence of obesity paradox only in terms that elevated BMI patients have comparable outcome with non-obese. Further research is needed to delineate potential underlying mechanisms that set off obesity to protective factor for coronary surgery

Short-term health effects of air quality changes during the COVID‑19 pandemic in the City of Novi Sad, the Republic of Serbia

ObjectivesThe objective of this research is to determine the change in outdoor air quality during the COVID‑19 related state of emergency resulting in a lockdown and the potential health benefits for the urban population.Material and MethodsDuring 53 days of the COVID‑19 related state of emergency with a lockdown (March 15–May 6, 2020) in the Republic of Serbia, as well as in the corresponding periods of 2018 and 2019, data on the daily sulfur dioxide (SO2), nitrogen dioxide (NO2), ground-level ozone (O3) and particulate matter (PM10 and PM2.5) concentrations were analyzed. The total mortality data were analyzed to estimate the impact of the COVID‑19 related lockdown measures on the burden of health in a given population, attributed to the outdoor air quality in the City of Novi Sad, using AirQ+ software.ResultsThe average daily concentrations of PM2.5, NO2, PM10 and SO2 were reduced by 35%, 34%, 23% and 18%, respectively. In contrast, the average daily concentration of O3 increased by 8%, even if the primary precursors were reducing, thus representing a challenge for air quality management. In the City of Novi Sad, a reduction in the average daily PM2.5 concentration of 11.23 μg/m³ was significant, which resulted in a quantified number of avoided deaths.ConclusionsAir pollution in the City of Novi Sad had a chance to be improved due to some preventive measures related to the infectious disease (the COVID‑19 related lockdown), which in turn was the mitigation measure to air pollution with positive public health effects. The confirmed positive effects of the improved air quality on public health could also include raising collective resistance to mass non-communicable and infectious diseases such as COVID‑19 and reducing economic costs

Hygiene status of food contact surfaces in public school canteens in the city of Novi Sad, Serbia

Background/Aim. Establishing a food safety control sys-tem is extremely important in preventing diseases associated with foodborne pathogens. The aim of this study was to ex-amine the hygiene status of food contact surfaces and the ap-plication of good hygiene practices by food handlers in school canteens. Methods. A total of 10,366 swabs were tak-en from food contact surfaces, including food handler's hands from public school canteens in Novi Sad, Serbia, over ten years (2008-2017), covering voluntary good hygiene prac-tices and obligatory Hazard Analysis Critical Control Points (HACCP) implementation periods. Results. Statistically sig-nificant differences (p < 0.05) in aerobic colony counts (ACCs) on surfaces between two examined periods were found. A general positive trend regarding the reduction of microbial contamination of food contact surfaces was ob-served. The percentage of surfaces swabs with ACCs above 2.48 log CFU/cm2 significantly decreased (R2 = 0.453) during the study period, and the percentage of coagulase-positive Staphylococcus in the swabs also decreased, but not significantly (R2 = 0.264), and average annual Enterobacteriaceae counts above the established limit values on surfaces significantly de-creased (R2 = 0.442) over the years. A significantly higher (p < 0.05) percentage of workers' hands harbored ACCs, coagu-lase-positive Staphylococcus, and Enterobacteriaceae above the es-tablished limits than the equipment or work surfaces. Con-clusion. The results obtained showed the proper implemen-tation of good hygiene practices concerning food contact sur-faces, but the implementation of good personal hygiene prac-tices needs enhanced supervision.Uvod/Cilj. Uspostavljanje sistema kontrole bezbednosti je izuzetno važno u prevenciji bolesti povezanih sa patogenima koje se prenose hranom. Cilj ovog istraživanja bio je da se utvrdi higijenski status kontaktnih površina i primena dobre higijenske prakse pri rukovanju hranom u školskim kantinama. Metode. Ukupno 10 366 briseva uzeto je sa površina koje dolaze u kontakt s hranom i ruku osoblja zaposlenog u školskim kantinama u Novom Sadu u desetogodišnjem periodu (2008–2017). Istraživanje je uključivalo dva perioda: a) dobrovoljnu primenu dobre higijenske prakse i b) obaveznu implementaciju sistema Hazard Analysis Critical Control Points (HACCP). Rezultati. Statistički značajna razlika (p < 0,05) utvrđena je u ukupnom broju aerobnih bakterija (aerobic colony counts -ACCs) na površinama. Primećen je opšti pozitivni trend u pogledu smanjenja mikrobiološke kontaminacije površina koje dolaze u kontakt s namirnicama. Učestalost nalaza briseva sa utvrđenim ukupnim ACCs iznad 2,48 log CFU/cm2 smanjivala se statistički značajno (R2 = 0,453) tokom perioda ispitivanja; učestalost prisustva koagulaza pozitivnih stafilokoka se takođe smanjivala, ali ne statistički značajno (R2 = 0,264), dok se prosečan broj enterobakterija iznad utvrđenih graničnih vrednosti na površinama statistički značajno smanjio tokom godina (R2 = 0,442). Na brisevima ruku ispitanog osoblja utvrđena je statistički značajno viša (p < 0,05) učestalost prisustva ukupnog ACCs, koagulaza pozitivnih stafilokoka i enterobakterija iznad utvrđenih granica u odnosu na briseve uzete sa opreme ili radnih površina. Zaključak. Dobijeni rezultati pokazuju pravilnu primenu dobre higijenske prakse kada su u pitanju površine koje dolaze u kontakt s hranom, dok implementacija prakse dobre lične higijene zaposlenih zahteva pojačan nadzo

Anthropometric and growth characteristics of schoolchildren in Novi Sad

Introduction/Objective. Growth, development and maturation are periods marked with individual physical characteristics, which provide the insight into the health status together with anthropometric indicators and physical appearance of an individual. The aim was to determine body height and body weight of a representative sample of schoolchildren from Novi Sad, to make a comparative analysis in relation to age and gender, and to determine the beginning of accelerated growth. Methods. Sample included 11,676 pupils aged 6–15 years, from Novi Sad, Serbia. The basic anthropometric measurements (body height and body weight) were performed according to recommended methodology. Results. The average values of boys’ body height ranged from 125.39 cm in those aged up to six years, to 175.09 cm for boys aged 15, and in girls from 124.07 cm at the age of six, to 165.77 cm for the oldest examined girls. The average values of boys’ body weight ranged from 25.58 kg at the age of six to 61.38 kg at the age of 15, and in girls from 23.94 kg in youngest to 54.46 kg, at the age of 15. The analysis of body weight and body height relation in the sample of boys and girls showed significant differences in all age groups, being most significant in boys aged from 11 to 13 years and in girls aged from nine to 12 years, marking the beginning of the rapid growth period. Conclusion. Having analyzed two basic anthropometric characteristics, i.e. body height and body weight, the authors found significant differences in the increase of these characteristics among the age groups of the study sample. In addition, the results of this research are in accordance with those reported in literature, which suggest that a sudden ponderal and statural growth starts earlier in girls than in boys

Purple Urine Bag Syndrome in a Home-Dwelling Elderly Female with Lumbar Compression Fracture: A Case Report

Purple urine bag syndrome (PUBS) is an uncommon, but usually benign, underrecognized clinical condition with the distressing presentation of purple, blue or reddish discoloration of a patient’s catheter bag and tubing in the setting of catheter-associated urinary tract infections (UTIs). PUBS is the result of the complex metabolic pathway of the dietary essential amino acid tryptophan. Its urinary metabolite, indoxyl sulfate, is converted into red and blue byproducts (indirubin and indigo) in the presence of the bacterial enzymes indoxyl sulfatase and phosphatase. The typical predisposing factors are numerous and include the following: female gender, advanced age, long-term catheterization and immobilization, constipation, institutionalization, dementia, increased dietary intake of tryptophan, chronic kidney disease, alkaline urine, and spinal cord injury (SCI). Here, we present a case of PUBS in a home-dwelling elderly female patient with a history of long-term immobility after a pathological spinal fracture, long-term catheterization, constipation, and malignant disease in remission. Urine culture was positive for Proteus mirabilis. This state can be alarming to both patients and physicians, even if the patient is asymptomatic. Healthcare professionals and caregivers need to be aware of this unusual syndrome as an indicator of bacteriuria in order to initiate proper diagnostics and treatment