Individuals chronically exposed to low-level ionising radiation (IR) run the risk of harmful and long-term adverse health effects, including gene mutations and cancer development. The search for reliable biomarkers of IR exposure in human population is still of great interest, as they may have a great implementation potential for the surveillance of occupationally exposed individuals. In this context, and considering previous literature, this study aimed to identify mutations in the human interferon alpha-2b (hIFNα-2b) as a potential biomarker of occupational chronic low-dose IR exposure linking low-IR exposure to the effects on haematopoiesis and reduced immunity. The analysis was performed in the genomic DNA of 51 uranium miners and 38 controls from Kazakhstan, and in 21 medical radiology workers and 21 controls from Italy. hIFNα-2b gene mutations were analysed with the real-time polymerase chain reaction (PCR) or Sanger sequencing. However, none of the investigated workers had the hIFNα-2b mutation. This finding highlights the need for further research to identify biomarkers for early detection of health effects associated with chronic low-dose IR exposure.
Hülya Türkan, Bensu Karahalil, Ela Kadıoğlu, Kenan Eren, Defne Tamar Gürol and Ali Esat Karakaya
Susceptibility to addiction has a complex genetic basis that includes genes associated with the action and metabolism of drugs of abuse. One important gene in that respect is OPRM1, which codes for the μ-opioid receptor and has an important role in mediating the rewarding effects of addiction substances. The aim of our study was to assess the prevalence of the OPRM1 A118G polymorphism (rs1799971) in Turkish population and to investigate its association with opioid and other substance addiction. In addition, we examined the association of rs1799971 in addicted patients who were also diagnosed with psychiatric disorders. The study included 103 patients addicted to opioids, cocaine, ecstasy, alcohol, lysergic acid diethylamide (LSD), cannabis, and sedative/hypnotic substances and 83 healthy volunteers with similar demographic features as controls. rs1799971 polymorphisms were identified with the polymerase chain reaction restriction fragment length polymorphism method (PCR-RFLP). The genotype frequencies were significantly higher in the addicted patients than controls (32.0 % vs 16.9 %, respectively; p=0.027). The prevalence of the G allele was 16.1 % in the addicted group and 8.4 % in the control group (p=0.031). Our study confirmed the association between the rs1799971(G) allele frequency and opioid and other substance addiction, but not with psychiatric disorders.
Ioan Mihai Japie, Radu Rădulescu, Adrian Bădilă, Ecaterina-Maria Japie, Alexandru Papuc, Traian Ciobanu, Adrian Dumitru and Cătălin Cîrstoiu
Introduction. Bisphosphonates (BPs) represent the main therapy in patients with osteoporosis, although a long-term treatment can lead to atypical fractures.
Material and methods. We conducted a retrospective study between 2008 and 2017 and included 23 female patients with atypical femoral fractures (AFFs). The mean period of BPs therapy administration was 5.2 years. We included 7 subtrochanteric fractures and 18 femoral shaft fractures. Two of the total patients presented bilateral femoral fractures. 18 patients presented prodromal symptoms from 2 to 18 months before the diagnosis of fractures, all of them following low energy trauma. All the patients included in our study underwent surgery with intramedullary nail or gamma nail. The postoperative mean follow-up was 2 years. Results. Of all 23 female patients with a total of 25 fractures – 10 underwent osteosynthesis with gamma nail and 15 underwent osteosynthesis with intramedullary nail. From the total number of patients: 13 patients achieved complete union, 6 presented delayed union and 3 non-union (2 intramedullary nail and one gamma nail), whereas in one patient treated previously with gamma nail we observed implant failure.
Conclusion. The treatment of AFFs after BPs therapy administration represents a challenge for orthopaedic surgeons regarding both surgical technique and postoperative follow-up.
Marija Srbinoska, Zoran Kavrakovski, Vesna Rafajlovska and Jana Simonovska
The use of electronic cigarettes or vaping has been gaining momentum among Macedonian smokers but has also raised great many concerns about the toxicity of liquid refills and its aerosols, especially as the nicotine levels in refill liquids (e-liquids) are not required to be declared accurately or at all by current regulations. The aim of this study was therefore to determine nicotine levels in fifteen samples of e-liquids purchased in specialised shops in Macedonia using gas chromatography. Nicotine concentrations deviated from manufacturer’s declarations in nine of the twelve samples: in five they were higher and in four lower than declared, ranging from −16.7 % to +30.0 %. These significant discrepancies between the actual and declared nicotine concentrations in the analysed e-liquids call for closer attention of the healthcare and the regulating authorities.
Issues of education quality have acquired special relevance since the beginning of the 20th century. Implementation of the idea of quality in the educational organisation is promoted by use of the international ISO standards regulating quality of the management system. Certification of a quality management system in an organisation ensures its sustainable development. Experience of such work exemplified by additional medical education organisation is presented in the article.
The present paper addresses approaches to implementation of the following quality management principles: customer focus; leadership; involvement of people; process approach; continuous improvement; evidence-based decision making; relationship management; system approach to management. The structure of processes in the medical education institution is presented including the major process “Professional training and retraining in the field of health care”, main (core) processes: “Educational activities” and “Scientific activities”; management processes: “Strategic planning”, “Documentation management”, “Records management”, “Internal audits”, “Nonconformity management”, “Corrective and preventive actions”, “Monitoring and measurement of processes and educational services”, “Quality management system analysis by senior management”; supporting processes: “Personnel management”, “Work environment management and information support”, “Financial and economic support”, “Library services”, “Methodical support of the educational process and training for teachers”, “Publishing activities”. All processes are designated in a consistent model with special codes, which helps to streamline the document management system in the organisation.
Ivana Huljev Šipoš, Slavica Labor, Iva Jurić, Davor Plavec, Kristian Vlahoviček, Siniša Bogović, Justinija Pavkov Vukelić and Marina Labor
Exhaled breath temperature (EBT) is a biomarker of inflammation and vascularity of the airways already shown to predict incident COPD. This cross-sectional study was aimed to assess the potential of EBT in identifying “healthy” smokers susceptible to cigarette smoke toxicity of the airways and to the risk of developing COPD by analysing the dynamics of EBT after smoking a cigarette and its associations with their demographics (age, smoking burden) and lung function. The study included 55 current smokers of both sexes, 29–62 years of age, with median smoking exposure of 15 (10–71.8) pack-years. EBT was measured at baseline and 5, 15, 30, 45, and 60 min after smoking a single cigarette. Lung function was measured with spirometry followed by a bronchodilator test. To compare changes in EBT between repeated measurements we used the analysis of variance and the area under the curve (EBTAUC) as a dependent variable. Multivariate regression analysis was used to look for associations with patient characteristics and lung function in particular. The average (±SD) baseline EBT was 33.42±1.50 °C. The highest significant increase to 33.84 (1.25) °C was recorded 5 min after the cigarette was smoked (p=0.003), and it took one hour for it to return to the baseline. EBTAUC showed significant repeatability (ICC=0.85, p<0.001) and was significantly associated with age, body mass index, number of cigarettes smoked a day, baseline EBT, and baseline FEF75 (R2=0.39, p<0.001 for the model). Our results suggest that EBT after smoking a single cigarette could be used as early risk predictor of changes associated with chronic cigarette smoke exposure.
Adrijana Košćec Bjelajac, Jasminka Bobić, Jelena Kovačić, Veda Marija Varnai, Jelena Macan and Šime Smolić
The aim of this study was to examine mental health and cognitive functions in older Croatian workers (50–65 years) taking into account their employment status, self-assessed health, and a set of demographic characteristics. We analysed the data collected on 650 older workers (71 % employed) in the Wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE). Unemployed workers reported symptoms of loneliness more often than the employed, while in rural areas unemployment was additionally associated with more pronounced symptoms of depression. Feeling of loneliness was also higher in those living without a partner in the household and in those with poorer health. In urban residents symptoms of depression were more severe in women, respondents with higher education, those living without a partner, and those who rated their health as poorer. As for cognitive functions, unemployment significantly predicted poorer subtraction in the rural subsample. Women in general showed less efficient numerical abilities. In the urban subsample poorer numerical abilities were also associated with lower education and living without a partner in the household. Better verbal recall was predicted by higher education and better self-rated memory. Higher scores in verbal fluency were predicted by urban residency and better self-rated health. Our results indicate that the protective factors for good mental health and cognitive functioning in older Croatian workers are being employed, having more education, living with a partner in the household, and being healthier. These findings stress the importance of implementing broader social policy strategies covering employment, education, and health.
Teodora Serban, Iulia Satulu, Ioana Cretu, Oana Vutcanu, Mihaela Milicescu and Mihai Bojinca
Background: Osteoarthritis (OA) and rheumatoid arthritis (RA) can overlap and the presence of OA can interfere with the evaluation of patients with RA.
Objectives: The aim of this study was to evaluate the possible impact of OA on the clinical, laboratory and ultrasound parameters currently evaluated in patients with early RA (ERA).
Methods: We have evaluated the data obtained from patients with ERA referred to our Early Arthritis Research Center (EARC). Only data from patients who fulfilled EULAR/ ACR 2010 criteria for RA and had symptom duration of less than 12 months were analyzed. All patients underwent clinical examination, laboratory tests and ultrasound (US) examination.
Results: There was a clear predominance of women (62.8%). The mean age was 55.47±13.71 years. At baseline, 21 patients (48.8%) were diagnosed with OA. Hand OA did not influence the values of any of the parameters assessed (p>0.05). For patients with knee OA, significantly higher values were observed only for DAS28 at baseline (p=0.018) as well as after 12 months of observation (p=0.031).
Conclusions: Significantly higher values of DAS28 were observed in patients with ERA who associated knee OA, while the values of SDAI were not influenced, suggesting that SDAI may be superior to DAS28 in evaluating patients with ERA and knee OA. The values of patient’s VAS were not influenced by the presence of hand or knee OA suggesting that these types of OA do not influence the patients’ perception of the disease activity. Moreover, the values of ultrasound scores were not influenced by the presence of OA.