Triglyceride level as a potential marker of residual cardiovascular risk and its relation to HeartScore.

BACKGROUND: Atherosclerotic cardiovascular diseases (ASCVD) are still the leading cause of morbidity and mortality in Bosnia and Herzegovina. Elevated LDL-cholesterol is established as a strong marker of cardiovascular risk. Some researchers believe that measuring triglyceride levels gives a good assessment of the residual risk for ASCVD besides the measurement of LDL-cholesterol. OBJECTIVE: The aim of this study was to evaluate the overall prevalence of major risk factors for ASCVD, lipid profile and 10-year fatal cardiovascular risk using the HeartSCORE scoring system. Further, we want to evaluate the prevalence and relationship between elevated triglyceride levels and high 10-year fatal cardiovascular risk calculated as a HeartSCORE. METHODS: This is a cross-sectional study conducted on 832 volunteers aged between 40 and 65 years without a diagnosis of diabetes and without known preexisting cardiovascular disease, as a part of the preventive program conducted at the Family Medicine office. Data were collected for ASCVD risk factors and lipid panel (total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides). 10-year fatal cardiovascular risk was calculated using the HeartSCORE scoring system for countries with high CV risk. RESULTS: Among 832 participants included, 565 (67.9%) were female, and 267 (32.1%) were male. We found high prevalence of hypertension (27.7%), obesity (32.2%), and smoking (36.2%). All lipid parameters, except HDL-C, were not optimal. Only 17.4% of participants had normal estimated HeartSCORE risk, while more than one-third (33.9%) had high or very high estimated HeartSCORE risk. Although we found a higher percentage of participants with elevated triglycerides in groups with higher HeartSCORE, there was a very weak positive correlation between values of triglycerides and the 10-year risk of a fatal cardiovascular event (r= 0.249, p= 0.000). CONCLUSION: The high prevalence of major known risk factors and high estimated HeartSCORE risk indicate a high overall risk for ASCVD in the sample. The proportion of participants with elevated triglycerides was increased in patients with high HeartSCORE risk what implicates importance of triglyceride measurement.

[Agglutination as screening test in routine diagnostic of listeriosis]. / Aglutinacija kao skrining test u rutinskoj dijagnostici Listerioze.

INTRODUCTION: The persons with weakened immunity, newborn infants and pregnant women are very much sensitive on infection with bacteria Listeria monocytogenes. Listeria can readily invade the placenta and precipitate premature labor and fetal death. To confirm diagnosis is very difficult because listeriosis is disease very similar to the others acute diseases. Serum threshold values above 1: 320 confirm think about listeriosis when the relevant clinical symptoms are present. Of greater diagnostic relevance is the detection of a rise in titer. Therefore, it is always desirable to test a second sample (collected 2 to 3 weeks later) together with the first sample (stored in the deep-freeze). AIM: The aim of the study is to confirm the advance agglutination as a screening test in routine diagnostic Listeriae monocytogenes. MATERIAL AND METHODS: In testing were included 60 women in the reproductive age to divide in experimental group and control group. By agglutination serologic methods we researched if there is any antibody on Listeria monocytogenes with Listeria antigen. RESULTS AND DISCUSSION: From a total of 60 patients positive samples were 18 (60.00%) in experimental group (30) and 8 (26.70%) in control group (30). CONCLUSION: due to simple way of performing screening test of agglutination the same one are giving adequate antibiotic therapy in a case of positive serological response.

Listeria monocytogenes as the possible cause of the spontanous abortion in female of the fertile age.

Listeria monocytogenes is a Gram-positive, weakly pathogenic bacterium able to grow also at the temperature of 40 degrees C. A man most often gets affected by consuming contaminated food and water. Animals can carry bacteria although they have not to appear ill, then their meat and milk products are the source of infection of human being. The disease most often attacks with the weak immune system, newborns and pregnant women. That what is significant, listeria penetrates through the placenta and can lead to the fatal infection, which is characteristic by disseminated granulomatosis lesions of a newborn and micro abscess on the placenta. In a newborn can provoke the sepsis with the mortality of 50%. By the examination are encircled two groups of the reproductive age-totally 60. From these 30 had one or more spontaneous abortion, and 30 had no spontaneous abortion. By the serologic reaction the agglutination is discovered the presence of the antibodies in serum of the. The positive serologic answer was found in the first group in 18 (60%) and in that another group in 8 participants (26, 70%).

[Listeria monocytogenes in women of reproductive age]. / Zastupljenost Listerie monocytogenes kod zena fertilne dobi.

OBJECTIVE: Listeria monocytogenes (LM) is gram-positive bacteria linear shaped which grows good also at refrigerator temperature (4 degrees C). The bacteria is resistant on high and low temperatures. This bacteria can be found in the dirt, rotted vegetation, vegetables and fruit, milk and dairy products, and also in the meat and processed meat. This bacteria cause disease called Listeriosis. This bacteria attacks at first people with weak immune system like infants, pregnant women, people with chronic diseases, people with HIV and people who are 60 and over. Pregnant women can transfer Listeria through the placenta, from mother to child and that can cause premature delivery, premature birth, early rupture of placenta or still born. GOAL: Find out if there is serological respond by female patients in the reproductive age who had spontaneous abortion and female patients in the reproductive age who never had the spontaneous abortion. By agglutination serologic method it had been researched if there is any antibody on Listeria monocytogenes. RESULTS: Two groups were included in testing: experimental and control group with a total of 60 patients. In experimental group there were 18 (60%) positive samples. In control group there were 8 (26.70%) positive samples. CONCLUSION: The results investigations have shown that there is serological respond to Listeria monocytogenes in the women of reproductive age. The number of positive patients was greater in women who had spontaneous abortion compared to women who never had the spontaneous abortion.

[Detection of Chlamydia trachomatis in cervical smear samples with determined HPV]. / Detekcija chlamydia trachomatis u cervikalnim uzorcima sa dokazanim HPV.

OBJECTIVE: Chlamydia trachomatis (CT) causes infertility, ectopyc pregnancy, pelvic inflammatory disease (PID) and conjunctivitis. Human Papilloma Virus (HPV) is a virus with broad spectrum effects. This particularly refers to HPV of high oncogenic potential (HPV - HR) because of its participation in cervical oncogenesis. The authors wanted to determine correlation between cervical HPV infection and detection of CT taken from female patient's smear of different levels of cervical intraepithelial neoplasm (CIN I - III) and ASCUS (Atypical Squamous Cells of Uncertain Significance) modifications. METHODS: Cytological analysis was used for 94 cervical samples--Papanicolaou method. The samples were presented in accordance with valid Bethesda Classification. The samples were treated by HPV DNA assay (Digene Hybrid Capture II). RESULTS: Out of 64 HPV positive samples, detected CT was found in 24 (37.5%) samples. Out of 50 HPV positive group samples with high degree risk ( HPV - HR), 18 (36%) contained CT. Frequency of CT was registered in ASCUS modifications in 55.6%, CIN I 16.7%, CIN II 16.7% and CIN III 11.0% samples. We found 3 (10.0%) of detected CT in HPV negative control group. CONCLUSION: Research results showed correlation between HPV cervical infection and CT. The higher the level of cell dedifferentiation (ASCUS CIN I - III) is, the higher number of cervical infections with CT is.

Demonstration of different endocervical staining methods and their usefulness in the diagnosis of the chlamydial infection in exfoliated cells advantages and disadvantages.

Microscopic demonstration of chlamydial inclusions within cells offered the first laboratory procedure supporting the clinical diagnosis of chlamydial infection. Our aim is to evaluate the usefulness of different endocervical staining methods in diagnosis of Chlamydia trachomatis (CT) infection within exfoliated cells of the endocervix. The cytological test for the detection of chlamydial inclusions in genital tract infection, though not as sensitive and specific as isolation in the cell culture monolayers, is still of the diagnostic value. The present study discusses the collection of clinical smears for microscopic examination, their preparation; fixation and staining of slides by a variety of staining methods that have been used to detect Chlamydia in clinical smears and biopsies. Most of these methods such as Giemsa stain, Papanicolaou, iodine, and immunofluorescence (IF) using monoclonal antibodies, are based on the combination of dyes designed to obtain optimum differentiation of the various structures. The utilization of different endocervical smear stains together with the clinical information can be used to identify women at high risk for CT infection.

Significance of the interferon (IFN) in the therapy.

Interferons belong to the group of the regulatory glycoproteins, of low molecular mass. They are the products of infected cell-genome, but not virus, as a consequence of the cause answer by different inductors. Human IFN are divided on the sequence of amino-acids into three groups: Alpha, Beta and Gamma interferons. Recently are discovered new types of IFNs: Omega and Tau, but bigger than alpha molecules. Also, has been performed the division into two types: I and II. Besides the antiviral and antiproliferative effects, they have also the effect in the treatment of malignant diseases, and act protectively against the radiation.

[Diagnosis of chlamydial infections--personal experience]. / Dijagnostika klamidijskih infekcija--nasa iskustva.

OBJECTIVES: In this paper we evaluated the difference of analytic sensitivity, specificity and predictive values using immunoassays based on antigen detection of Chlamydia trachomatis (Ct) in endocervical swab specimens. PATIENTS AND METHODS: 120 fertile female patients were tested for the presence of Ct in the endocervix during two years. The patients represented two risk groups: moderate risk, and low risk group. Three endocervical swab specimens per each patient were collected and each of specimens was analyzed with: DFA-Direct Fluorescence Assay; RIA-Rapid Immunoassay, EIA-Enzyme Immunoassay RESULTS: Total 8 (6.67%) patients were positive on Ct. Out of that 5 (8.33%) were from moderate risk (DFA and EIA), and 3 (5%) from low risk group (DFA and EIA, RIA). 4 (6.67%) out of 5 patients were found positive from moderate risk group by RIA, and 3 (5%) from low risk group (DFA and EIA, RIA). DFA has some results as EIA: sensitivity and specificity are 100%. RIA has sensitivity 87.5% and specificity 100%. Predictive values (PPV, NPV): PPV is the same for the three test assays, and it is 100%. NPV for RIA is 99.1% and for DFA and EIA is 100%. Total prevalence for RIA is 5.83% and for DFA and EIA is 6.66%. CONCLUSION: It was proved that there was some significant difference in validity of applicable immunoassays (DFA and EIA, and RIA), particularly in analytic sensitivity (100% DFA versus 87.5% RIA). With difference to RIA and EIA, DFA does not request confirmation using another method (WHO), which is of great importance for us. Therefore we consider DFA as a method of choice for our conditions.