A retrospective patient record analysis of the Emergency Medial Service’s Rîga City Regional Centre was provided from January 2012 through December 2013. 1359 adult patients were CPR treated for out-of-hospital cardiac arrest according to ERC Guidelines 2010. A total of 490 patients were excluded from the study. The main outcome measure was survival to hospital admission. Of 869 CPR-treated patients, 60% (n = 521) were men. The mean age of patients was 66.68 ± 15.28 years. The survival rate to hospital admission was 12.9% (n = 112). 54 of survived patients were women. Mean patient age of successful CPR was 63.22 ± 16.21 and unsuccessful CPR 67.20 ± 15.09. At least one related illness was recorded with 63.4% (n = 551) patients. There were 61 survivors in bystander witnessed OHCA and nine survivors in unwitnessed OHCA. The rate of bystander CPR when CA (cardiac arrest) was witnessed was 24.8%. Ventricular fibrillation (VF) as initial heart rhythm was significantly associated with survival to hospital admission in 54 cases (p < 0.0001). Age and gender affected return of spontaneous circulation. Survival to hospital admission had rhythm-specific outcome. Presence of OHCA witnesses improved outcome compared to bystander CPR. The objective of this study was to report patient characteristics, the role of witnesses in out-of-hospital cardiac arrest (OHCA) and outcome of adult cardiopulmonary resuscitation
Biljana Miljković-Selimović, Marina Dinić, Jovan Orlović and Tatjana Babić
Considering a large number of pathogen factors that enable high virulence of a microorganism such as Staphylococcus aureus (S. aureus), it is essential to see them through the continuous adaptation to the newly acquired mechanisms of the host immune response and efforts to overcome these, allowing the bacteria a perfect ecological niche for growth, reproduction, and location of new hosts. Past efforts to create a vaccine that would provide effective protection against infections caused by S. aureus remained without success. The reasons for this stem from the outstanding adaptability skills of this microorganism to almost all environmental conditions, the existence of a numerous virulence factors whose mechanisms of action are not well known, as well as insufficient knowledge of the immune response to S. aureus infections. This review article deals with this issue from another perspective and emphasizes actual knowledge on virulence factors and immune response to S. aureus.
Peatland cores provide us with the potential to research aspects of atmospheric cycling of elements, such as metal pollutants, on timescales. Our study provides a better understanding of basic peat properties and their effects on trace and major element distributions in peat and its humic substances (HS). Humic substances isolated from an ombrotrophic bog peat profiles (Latvia) were used as study objects. Relations among peat depth, properties of peat and its HS (elemental composition), as well as element content, were studied.
Aleksandra Anđelković, Nada Barac and Goran Milovanović
Supply chain assumes a unique business process without inter-company boundaries. Each supply chain partner is important for achievement of customer requirements. On the one hand, supply chain is an inexhaustible source of competitive advantage, created by the companies, which constitute it. However, on the other hand, due to its complexness, supply chain is an easy target of numerous factors, which jeopardize its competitiveness. Some of those factors are: turbulence, deliberate threats, external pressures, resource limits, sensitivity, and supplier/customer disruptions. Successful dealing with those factors assumes establishment of mechanisms for increasing supply chain resilience. Many researches indicate that some factors have greater influence on supply chain disruption and discontinuance. If those factors can be isolated, it will be easier to manage them or to avoid their influence. Therefore, the objective of the research presented in this paper is identification of the most frequent causes of supply chain disturbances, as a first step for developing supply chain resilience. According to the research results, the authors suggest what should be a primary focus of supply chain management, dealing with issues of resilience. Also, the authors indicate which characteristics (capability factors) supply chains have to have in order to be considered resistant.
Thrombophilia is a multifactorial disorder, involving both genetic and acquired risk factors that affect the balance between procoagulant and anticoagulant factors and lead to increased thrombotic tendency. The severe forms of thrombophilia are caused by a deficiency of natural anticoagulants: antithrombin, protein C and protein S. The advances in DNA technology played an important role in the identification of the exact nature of these deficiencies and opened up new possibilities in genetic research and molecular diagnostics of thrombophilia. The major breakthrough came with the discovery of activated protein C resistance and the Factor V Leiden gene mutation. Shortly afterwards, a variant in the 3’ untranslated region of the Factor II gene (FII G20210A) associated with an increased concentration of Factor II in plasma was described. These two gene variants represent the most common thrombophilic genetic risk factors. Recently, a novel prothrombin mutation (c.1787G>T) was identified in a Japanese family with juvenile thrombosis. This mutation leads to impaired inhibition of mutant thrombin by antithrombin, proposing a new mechanism of thrombophilia named resistance to antithrombin. In the last decade, several prothrombotic genetic risk factors have been described, including gene variants associated with defects of natural coagulation inhibitors, increased levels of coagulation factors or their impaired inhibition and defects of the fibrinolytic system. However, most of them are not of diagnostic value, due to their minor or unknown impact on the thrombotic risk. Large-scale DNA analysis systems are now becoming available, opening a new era in the genetic studies of the molecular basis of thrombophilia.
Olgica Nedić, Judith Nikolić, Vesna Malenković and Ivona Baričević-Jones
Insulin-Like Growth Factors (Igfs) And Their Binding Proteins (Igfbps) As Biomarkers of Catabolism
The life of an organism depends on its capacity to maintain equilibrium. Disease induces acute adaptive responses specific to the stimulus and the organism achieves stability through change. These changes are associated with increased growth hormone resistance and activity of the hypothalamic-pituitary-adrenal axis, altered insulin response and cytokine synthesis and, closely related to all these events, alteration of the complex system interrelating insulin-like growth factors (IGFs), IGF-binding proteins (IGFBPs) and their receptors. This review aims to provide an overview of the results obtained in our laboratory from studies of the IGF system in patients with metabolic disturbances caused by infection, hepatobiliary and gastrointestinal diseases, open or laparoscopic surgery and postoperative sepsis.
Cardiovascular Mortality in Hemodialysis Patients: Clinical and Epidemiological Analysis
Cardiovascular diseases are the leading cause of death in hemodialysis (HD) patients. The annual cardiovascular mortality rate in these patients is 9%, with left ventricular (LV) hypertrophy, ischemic heart disease and heart failure being the most prevalent causes of death. The aim of this study was to determine the cardiovascular mortality rate and estimate the influence of risk factors on cardiovascular mortality in HD patients. A total of 115 patients undergoing HD for at least 6 months were investigated. Initially a cross-sectional study was performed, followed by a two-year follow-up study. Beside the standard biochemical parameters, C-reactive protein (CRP), homocysteine, cardiac troponins (cTn) and the echocardiographic parameters of LV morphology and function (LV mass index, LV fractional shortening, LV ejection fraction) were determined. Results were analyzed using Cox regression analysis, Kaplan-Meier and Log-Rank tests. The average one-year cardiovascular mortality rate was 8.51%. Multivariate Cox regression analysis identified increased CRP, cTn T and I, and LV mass index as independent risk factors for cardiovascular mortality. Patients with cTnT > 0.10 ng/mL and CRP > 10 mg/L had significantly higher cardiovascular mortality risk (p < 0.01) than patients with cTnT > 0.10 ng/mL and CRP ≤ 10 mg/L and those with cTnT ≤ 0.10 ng/mL and CRP ≤ 10 mg/L (p < 0.01). HD patients with high cTnT and CRP have a higher cardiovascular mortality risk.
We assessed the prevalence and socioeconomic and behavioural correlates of hypertension in the young to middle-aged population of Albania, a transitional post-communist country in the Western Balkans. We analysed a sample of 2,837 men and 3,580 women aged 15 to 49 from the 2008/2009 Albanian Demographic and Health Survey. Hypertension was defined as SBP≥140 mm Hg, or DBP≥90 mm Hg, or if the subjects were under treatment for hypertension. Data on demographic and socioeconomic characteristics and behavioural factors were also collected. Logistic regression was used to assess the association of hypertension with covariates. Hypertension was significantly higher among men (27.3 %) than women (20.0 %), and significantly increased with age. The harmful effect of excessive weight and obesity on hypertension was stronger among women than among men and this effect increased with age, especially in women. Smoking and alcohol were risk factors for hypertension in men, but not women. Education had a protective effect on hypertension in women but not in men.
Background: Cardiovascular disease (CVD) is a major cause of mortality and morbidity in many populations, especially in developed countries. The aim of the study was to analyze the lipid status in a student population at increased risk for CVD in comparison with students who are not at increased risk for CVD.
Methods: This study included 238 students from the University of Novi Sad of both sexes (126 men and 112 women), with a mean age of 22.32±1.85 years. According to the body mass index (BMI) lower and higher than 25 kg/m2 and waist circumference (WC) of less and more than 94 cm (80 cm for females) the whole group of 238 students was divided into 2 subgroups: the group at increased risk for CVD (Group 1) and the group at lower risk for CVD (Group 2). Total cholesterol - TCH, triglycerides - TG, high density lipoprotein cholesterol - HDL-c, low density lipoprotein cholesterol - LDL-c, very low-density lipoprotein cholesterol - VLDL-c concentrations were determined and the index of atherosclerosis (IA), established risk factors RF-TCH/HDL-c ratio and non-HDL-c/HDL-c ratio were mathematically calculated.
Results: The values of TCH, LDL-c, non-HDL-c, VLDL-c and TG were significantly higher in Group 1 compared to Group 2 (P<0.001). IA, non-HDL-c/HDL-c and RF-TCH/HDL-c ratio were also significantly higher (P<0.001), while HDL-c was significantly lower (p<0.01) in Group 1 compared to controls. These results were not influenced by gender in both groups of subjects.
Conclusions: The data suggest that increased anthropometric parameters are followed by increased lipoprotein status in the group of students at increased risk for CVD and screening of the lipid status is necessary in students, especially in those who are at increased risk for CVD.
Tatjana Roš, Branislava Gajić, Milana Ivkov-Simić and Zorica Gajinov
Basal cell carcinoma is a slow-growing, malignant epidermal tumor predominantly affecting sun exposed areas in Caucasians, accounting for up to 80% of all diagnosed skin cancers, with a rising incidence. Chronic UV radiation, in association with constitutional factors, plays the main role in its etiology. Inappropriate activation of the hedgehog signaling pathway seems to be a key pathogenesis mechanism. Basal cell carcinoma metastases are extremely rare, but it is a locally invasive tumor that can cause significant destruction of the surrounding tissues, with their functional and esthetic impairment. There are four main clinical types of basal cell carcinoma, although clinical classification is of poor prognostic significance. Preselection of suspicious lesions and treatment planning include noninvasive diagnostic techniques: dermoscopy, confocal microscopy and ultrasoud imaging, yet histopathology remains the “gold standard” of basal cell carcinoma diagnosis. In terms of the histological growth pattern, which is essential for the prognosis, basal cell carcinoma may be divided into circumscribed or diffuse types. Surgical excision is considered to be a first line treatment option, but there are numerous less invasive treatment modalities for low-risk basal cell carcinoma. Prevention strategies are focused on behavioral modifications, regular follow up and use of chemopreventive agents in high-risk patients.