Prevalence of diabetic retinopathy in the Dubrovnik-Neretva County.

OBJECTIVE: Diabetic retinopathy is one of the leading causes of blindness. We estimated the prevalence of diabetic retinopathy among a diabetic population in the Dubrovnik-Neretva County in the Republic of Croatia and searched for potential risk factors. METHODS: A prospective study was performed with 600 diabetic patients from different parts of the Dubrovnik-Neretva County who attended regular medical and ophthalmological check-ups at the General Hospital Dubrovnik from September 2014 to September 2015. Patients underwent a complete medical assessment by two ophthalmologists. Retinal examination included evaluation of the presence of diabetic retinopathy. Any retinopathy present was graded as mild non-proliferative retinopathy, moderate-severe non proliferative retinopathy or proliferative retinopathy. RESULTS: Retinopathy was present in 44.5% of the study sample. 20.7% had the mild form of diabetic retinopathy, 18.8% had the moderate-severe form, and 5.0% had proliferative diabetic retinopathy. The mean duration of diabetes was 12.94 years ± 6.85; 12.89 years ± 9.18 in men, 12.94 ± 6.54 in women. The mean BMI was 27.14 ± 2.98; for diabetics without diabetic retinopathy 26.19 ± 2.75; for those with the mild form 28.06 ± 3.01; for those with the moderate-severe form 28.49 ± 2.54; for those with proliferative diabetic retinopathy 28.79 ± 3.16. 168 (28%) patients were treated by laser and 22 (3.7%) by vitrectomy. CONCLUSION: The prevalence of diabetic retinopathy in the Dubrovnik-Neretva County is 44.5%. Regular screening to detect diabetic retinopathy is highly recommended as timely intervention can prevent most diabetic causes of blindness.

Environmental stress factors affecting survival and virulence of Campylobacter jejuni.

Enteric pathogens are constantly exposed to stressful conditions in their natural habitat in the host and even more in the extra-host environment, including food processing. The aim of this study was to evaluate the effect of selected environmental stress factors: temperature shift, starvation and atmospheric oxygen concentration on culturability/viability of two Campylobacter jejuni isolates. Additionally, after stress exposure, in an in vitro cell culture model using Caco-2 cells, the adhesion, invasion and intracellular survival of C. jejuni were studied. Nutrient insufficiency was the most powerful stress factor which significantly affected C. jejuni culturability and viability, as well as, adhesion and invasion properties. Temperature elevation induced a transient growth arrest, and temporary loss of pathogenic potential as indicated by impaired adhesion and invasion efficiency of C. jejuni. However, bacteria recovered within 24-48h inside the Caco-2 cells. Oxidative stress neither affected C. jejuni growth nor reduced the binding and invasion into Caco-2 cells. Only 5h oxygen exposure increased the invasion capability and intraepithelial survival of the clinical isolate. Modulation of C. jejuni virulence in response to environmental stress factors may have further implications in the pathogenesis of campylobacteriosis.