The heterogeneous cellular landscape of atherosclerosis: Implications for future research and therapies. A collaborative review from the EAS young fellows.

Single cell technologies, lineage tracing mouse models and advanced imaging techniques unequivocally improved the resolution of the cellular landscape of atherosclerosis. Although the discovery of the heterogeneous nature of the cellular plaque architecture has undoubtedly improved our understanding of the specific cellular states in atherosclerosis progression, it also adds more complexity to current and future research and will change how we approach future drug development. In this review, we will discuss how the revolution of new single cell technologies allowed us to map the cellular networks in the plaque, but we will also address current (technological) limitations that confine us to identify the cellular drivers of the disease and to pinpoint a specific cell state, cell subset or cell surface antigen as new candidate drug target for atherosclerosis.

Cardiac biomarkers and left ventricular systolic function in acute myocardial infarction with ST- segment elevation in diabetes mellitus type 2 patients.

Aim To determine a status of systolic function in patients with diabetes mellitus (DM) type 2 with ST-segment elevation acute myocardial infarction (STEMI), to determine values of cardiac biomarkers in patients with DM type 2 with STEMI and correlate the parameters with ejection fraction of left ventricle (EFLV). Methods A total of 80 patients were divided into two groups, the study group (group I) consisting of 40 patients admitted with the diagnosis of DM type 2 and STEMI, and a control group (group II) with 40 patients with STEMI without diagnosed DM type 2. Cardiac biomarkers - creatine kinase MB fraction (CKMB), and troponin I were monitored. The EFLV was evaluated echocardiographically (using Simpson method) five days after primary percutaneous coronary intervention (pPCI). Results In the group I the EFLV five days after pPCI was significantly correlated with troponin values (with a minimum r = -0.47; p=0.002, a maximum r = -0.339; p = 0.032, as well as with an average value of r = -0.389; p=0.013), and with an average CK value (r = -0.319; p=0.045). In the group II there was a significant negative correlation of EFLV with the maximum value of troponin (r = -0.309; p=0.05). Conclusion Troponin values have an effect on the EFLV after STEMI, and thus on the left ventricular status, as well as on the pharmacological modality itself.

A one-year review of macrosomic births at the Cantonal Hospital Zenica, Bosnia and Herzegovina.

Aim To identify a rate of macrosomic births in a one-year review, associated maternal characteristics and pregnancy outcome. Methods This one-year retrospective review included all macrosomic deliveries at the Department of Obstetrics and Gynaecology at the Cantonal Hospital Zenica between 1 January 2018 and 31 December 2018. The data were collected from maternal and newborn medical records. A total of 361 singleton normal birth weight term newborns (birth weight <4000 g, but not small for gestational age) who were delivered in the same period, represented the control group. Results Among the total of 2758 women who gave birth, 360 (13.05%) macrosomic infants (birth weight more than 4000 g) were delivered. Mean birth weight was 4258.90 g (maximum 5460g); nine (0.33%) were >5000g. Male macrosomic infants were more frequently represented, 245 (68,1%) comparing to the control group (p<0.01); in the control group female infants were more frequently represented (p<0.01). The overall Cesarean section rate, including elective Cesarean delivery was 23.2%, and 76.1% underwent an attempt of labour delivered vaginally. Conclusion Macrosomia represents a risk for adverse outcome for the mother and neonate, with a higher risk for the operative mode of delivery.

The effect of functional insulin therapy on glycaemic parameters in children with diabetes mellitus type 1.

Aim The aim of the study is to evaluate the effect of a prospectively conducted interactive 5-day education programme based on Düsseldorf model on glycated haemoglobin (A1C), and total daily dose of insulin in type 1 diabetes patients. Methods A total of 67 type 1 diabetes patients was analysed; mean age of 11±0.68 years, 43 females and 24 males. The programme was led by a trained team of diabetes specialist doctors and nurses. All subjects and their parents completed a knowledge test about diabetes at beginning, and at the end of education, and after 12 months (30 questions). Subjects were evaluated for total daily insulin, and HbA1c at baseline, as well as 3, 6, 9 and 12 months after the end of the education programme. Results Results of the knowledge test after the education have shown higher knowledge at baseline. At the end of the education programme an average of total daily insulin dose was significantly lower. There was a 3.17% reduction in HbA1c values over 9 months, and 1.8% over 12 months in the comparison to the baseline values (p<0.001). Conclusions Structured education programme of functional insulin therapy was associated with improved glycaemic control in type 1 diabetes patients and their parents. It motivated patients and parents to improve glycaemic control. One year after the follow up, glycaemic control was worsening, due to lack of patients' motivation, therefore, there is a need for yearly re-education.