Bioactive Compounds and Antioxidant Activity of Red and White Wines Produced from Autochthonous Croatian Varieties: Effect of Moderate Consumption on Human Health.

Moderate wine consumption is often associated with healthy lifestyle habits. The role of wine as a healthy drink is mainly due to its bioactive compounds, which differ according to various viticultural and enological factors. The aim of the present study was to observe the differences in bioactive compounds of white and red autochthonous Croatian wines, differing in terms of the grape variety and production technology. Our further aim was to explore the effect of their moderate consumption (200 mL per day) over the course of six weeks on some aspects of health in sixty-six healthy individuals. Participants were divided into eight groups depending on the wines consumed, while one group formed a non-consuming control group. Medical examination and laboratory tests were performed before the start and at the end of the consumption period. Systolic and diastolic blood pressure, total cholesterol, and LDL concentrations decreased. Additionally, an increase in HDL concentrations, and serotonin and dopamine levels, was observed. ALT, ALP, and GGT levels did not significantly increase in consumer groups, although alcohol concentration was relatively high in all the wines. Such results support the beneficial effects of wine-derived bioactive compounds on some health aspects resulting from moderate white and red wine consumption.

A simple prognostic model for assessing in-hospital mortality risk in patients with acutely decompensated heart failure.

Background An assessing of the in-hospital mortality risk for an emergency hospitalized patient with acutely decompensated heart failure (ADHF) is challenging task. Simple formula can help. Methods On the base of six indicators identified in derivation group, simple formula for assessing the risk for in-hospital mortality of ADHF patients was derived and later tested in validation group. Results The retrospective analysis of a derivation group (533 survivors, 121 deceased) identified six risk indicators: age, heart rate (HR), systolic blood pressure (SBP) and serum concentrations of urea, sodium (Na) and uric acid (UA). The final formula was created ([age/10]2 × HR/SBP)+(Urea-Na/10)+UA/100 and formula result of 53 was established as cut-off result. In the derivation group, at the cut-off point of 53, area under the ROC curve (AUC) was 0.741 (95% CI 0.701-0.776); with sensitivity 54% and specificity 83%. The discriminative capacity of the formula was significantly higher than each of its components. In the validation group of 591 patients (527 survived, 64 died) AUC was also 0.741 (95% CI 0.706-0.774), sensitivity was 66% and specificity 76%. Positive predictive value (PPV) of the developed formula was modest (34%), but negative predictive value (NPV) was 95%. N-terminal pro-B type natriuretic peptide and troponin I were determined, but not included into formula. Conclusions The developed formula enables simple, rapid and inexpensive risk assessment, but its disadvantage is a low PPV. However, a high NPV permits the identification of patients with a low risk of in-hospital mortality, which could lead to a more rational patient treatment.

Prognostic factors for in-hospital mortality of patients hospitalized for acutely decompensated heart failure.

Objectives Despite improved treatment during last 20 years, prognosis for patients hospitalized for acutely decompensated heart failure (ADHF) is poor and mortality rates reported for these patients are high. Laboratory results can assist clinicians in evaluation and triaging of patients on hospital admission, and are important for the medical decision-making and prognosis assessments. Recently, new guidelines for the diagnosis and treatment of acute and chronic HF patients were published introducing a new group of patients with mid-range left ventricular ejection fraction (LVEF). Methods In order to explore the prognostic value for the in-hospital mortality of ADHF patients we analyzed laboratory test results for 165 emergency hospitalized patients regarding the survival and LVEF. Results In-hospital mortality was 16%. Patients who died were older than survivals (p = 0.003). There were no differences in LVEF between survivals and non-survivals. Patients who survived had significantly lower N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT), uric acid, urea, creatinine, and red blood cell distribution width (RDW) than patients who died (p < 0.001). All these tests had a good discrimination power between survivals and non-survivals (p < 0.001), but their incremental addition to NT-proBNP didn't improve its overall prognostic value. There was only a very weak correlation between NT-proBNP concentrations and LVEF. Groups with different LVEF status showed significant difference in number of erythrocytes, RDW and hemoglobin concentrations. Conclusions NT-proBNP had the best discriminatory power between survivals and non-survivals. Some routine laboratory test results, like RDW, uric acid, urea, and creatinine, have potentially significant value.

Can the difference in serum concentration of urea and cystatin C be used in diagnosis and prognosis of heart failure?

Changes in renal function are an important diagnostic and prognostic indicator in patients with heart failure (HF). They are caused by decreased renal perfusion and consequently decreased glomerular filtration rate (GFR), or by the effect of increased neurohormonal activity (sympathetic nervous system [SNS], rennin-angiotensin-aldosterone system [RAAS] and arginine vasopressin [AVP]). However, the increase of serum concentration of urea, creatinine and other metabolites is not specific for HF. Therefore, it is not possible to distinguish HF from renal diseases solely based on the increase of their concentration, since the increase of their concentration caused by the decrease of GFR cannot be differentiated from the increase due to neurohormonal activity. Urea and cystatin C (Cys C) have different mechanisms of renal elimination, so it can be assumed that in HF their concentrations will not be increased proportionally, what can be used for diagnostic and prognostic purposes. After glomerular filtration Cy C undergoes proximal tubular reabsorption and breakdown, without returning to the blood flow. Since it is not secreted, its serum concentration depends only on GFR. In contrast to Cys C, urea is filtered in glomerulus and subsequently reabsorbed in proximal tubules and collecting duct. Reabsorption of urea is modified by effects of SNS, RAAS and AVP. Therefore its serum concentration depends upon GFR and neurohormonal effect on the tubular function. Since the increase of serum concentration of Cys C is caused only by the effect of the decreased renal perfusion on GFR, while the increase of urea is a result from both decreased GFR and tubular effects of increased neurohormonal activity, the paper hypothesis is that in HF the increase of urea will be significantly higher than the increase of serum Cys C, while in the patients with renal diseases their increase would be mostly proportional. It can be assumed that the disproportion between the increase of Cys C and urea would indicate an increased neurohormonal activity in patients with HF and correlate with its activity. If this hypothesis is proved correct, this parameter could be used in HF diagnosis and risk stratification of such patients.

Primary spontaneous pneumothorax and mitral valve prolapse are not associated.

BACKGROUND: Mitral valve prolapse (MVP) is a common diagnosis in patients with primary spontaneous pneumothorax (PSP). This description assumes that MVP and PSP might be manifestations of a systemic connective tissue abnormality. The purpose of this study was to determine the prevalence of MVP in PSP patients of Croatian origin and evaluate their relationship with connective tissue disorders. We also examined the prevalence of PSP in patients with primary MVP. METHODS: Thirty-two patients with PSP and without underlying pulmonary disease or connective tissue disease underwent two-dimensional transthoracic echocardiography performed by a certified cardiologist. Echocardiography and demographic features were analyzed using descriptive statistics. We also examined the medical records of 60 patients with primary MVP. RESULTS: MVP was found in none of the 32 patients suffering from PSP. The age, sex, smoking status, body mass index, side, rate, and family history were similar to previous investigations. Likewise, none of the 60 patients with primary MVP ever had PSP. CONCLUSION: By applying an updated definition of MVP, we found no MVP case among PSP patients of Croatian origin. We also found no PSP in the primary MVP group. Ethnicity may influence the occurrence of MVP in PSP patients, and PSP in primary MVP patients.