المؤلفون: Martina, Matovinović, Katarina Ivana, Tudor, Filip, Mustač, Andrej, Kovačević, Zrinka, Vuksan-Ćusa, Maja, Baretić, Ervina, Bilić

المصدر: Psychiatria Danubina. 32(Suppl 4)

مصطلحات موضوعية: Adult, Male, Sex Characteristics, Croatia, Urinary Bladder, Overactive, Middle Aged, Sneezing, Young Adult, Cross-Sectional Studies, Urinary Incontinence, Cough, Lower Urinary Tract Symptoms, Surveys and Questionnaires, Hypertension, Humans, Female, Obesity, Exercise, Aged

الوصف: Patients with obesity may experience lower urinary tract symptoms (LUTS). Little is known about these symptoms in obese patients in Croatia. The aim of this study was to asses LUTS in this group of patients.This cross-sectional study was carried out in a tertiary healthcare centre. 111 participants were included (81 women and 30 men, age 23-78 years), with BMI30 kg/mOn ICIQ-OAB patients most often reported:UI (46.85% (N=52)), nocturia (42.34% (N=47)) and increased frequency of urination (34.23% (N=38)), and on ICIQ-UI SF: UI when coughing and sneezing (44.44% (N=32)), urgency UI (43.06% (N=31)) and UI during exercise/physical activity (22.22% (N=16)). Women were found to be more significantly affected by OAB symptoms (p0.05). Significant correlations were found between the overall results on ICIQ-OAB and hypertension (r=0.32).The results of this study confirm that obese patients in Croatia experience LUTS as well. A higher incidence of LUTS was found among women and gender-independent among hypertensive obese patients.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid________::55c4edfb813fec1ddb766eac273d9cadTest
https://pubmed.ncbi.nlm.nih.gov/33212464Test

المؤلفون: Draško Pavlović, Željko Reiner, Mario Laganović, Maja Baretić, Darko Počanić, Ana Jelaković, Ivana Kraljević, Margareta Fištrek Prlić, Hrvoje Tiljak, Majda Vrkić Kirhmajer, Davor Miličić, Robert Likić, Martina Lovrić Benčić, Bojan Jelaković, Tatjana Željković Vrkić, Maja Čikeš, Živka Dika, Jelena Kos

المصدر: Cardiologia Croatica
Volume 12
Issue 11-12

مصطلحات موضوعية: hypertension, guidelines, diagnosis, arterijska hipertenzija, smjernice, dijagnostika, Cardiology and Cardiovascular Medicine

الوصف: Arterijska je hipertenzija glavni neovisni čimbenik rizika za kardiovaskularni pobol i smrtnost. Prevalencija hipertenzije u većini zemalja pokazuje tendenciju rasta. Unatoč dostupnosti svih razreda antihipertenziva, kontrola liječenih hipertoničara nije zadovoljavajuća, za što postoji niz razloga i objašnjenja. Jedan od razloga jest i jaz između smjernica koje se temelje na činjenicama te mogućnostima njihova provođenja u stvarnome životu, što kao posljedicu ima lošu kontrolu hipertenzije i velik broj prijevremenih kardiovaskularnih događaja i smrti. Prvi korak u zbrinjavanju hipertoničara jest racionalna dijagnostika, što znači da pri tako masovnoj kroničnoj bolesti nepotrebnim pretragama ne povećavamo troškove, a s druge strane da pristupom na najmanju mjeru smanjimo propuste. Svrha je ovih smjernica za dijagnosticiranje arterijske hipertenzije da budu praktične i korisne u svakodnevnome radu. U njima je naglasak na konkretnim postupcima i podatcima s točno navedenim graničnim vrijednostima. Budući da je cilj smjernica ne samo usmjeriti i olakšati razmišljanja u svakodnevnome kliničkome radu nego i educirati, uz postupnike podsjećamo na neka temeljna znanja. U smjernicama ima nekoliko posve novih elemenata (upute o frekvenciji srca, mjesto i uloga mjerenja centralnoga arterijskoga tlaka i brzine pulsnoga vala, procjena bubrežne funkcije, zatim informatička tehnologija, tj. telemonitoriranje, primjena aplikacija za „pametne mobitele“). Na kraju smjernica uvršteno je nekoliko dodataka koji mogu biti korisni u svakodnevnome kliničkome radu, kao što su npr. upitnici za sindrom apneje u snu, upitnik o erektilnoj i seksualnoj disfunkciji, upitnik o kognitivnoj disfunkciji i drugi. U ovim smo smjernicama željeli biti praktični, precizni i realni s obzirom na mogućnosti koje nam pruža sredina u kojoj živimo. Svrha je bila na jednome mjestu obuhvatiti i prikazati što više konkretnih postupaka i podataka koji će biti korisni u radu, tako da liječnik ne mora gubiti vrijeme tražeći podatke bilo u samim smjernicama bilo u literaturi.
Arterial hypertension is the main independent risk factor for cardiovascular morbidity and mortality. The prevalence of hypertension is increasing in most countries. Despite the availability of all classes of antihypertensive drugs, the rate control in hypertension treatment is insufficient, for which there are abundant explanations. One of the main reasons is the gap between evidence-based guidelines and their applicability in practice, a gap which leads to poor rate control in hypertension and increases the number of premature cardiovascular events and death. The first step in the management of a hypertensive patient is rational diagnosis, i.e., to avoid increasing the expenses of treating this mass chronic disease by unnecessary tests and to minimize errors. The aim of these practical guidelines for diagnosis of hypertension is for them to be practical and useful in everyday practice. There is an emphasis on particular procedures and data with exact cut-off values. The aim of these guidelines is not only to guide and simplify our decision-making process in everyday work, but also to educate. We thus provide reminders on some fundamental knowledge. There are some novel elements (instructions of heart rate, place and role of central blood pressure and pulse wave velocity measurement, estimation of renal function, IT e.g. telemonitoring, and the use of smartphone apps). At the end of the guidelines, we provide several appendices which could be useful in everyday clinical work, such as questionnaires for sleep apnea syndrome, questionnaires for erectile and sexual dysfunction, cognitive dysfunction questionnaires, and others. In these guidelines, we wanted to be practical, precise, and realistic given the options available in our work setting. The objective was to show and cover as many specific facts and procedures as possible that we find useful in everyday work, so that the clinician does not have to waste time searching the guidelines or literature.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3d0e86cd815981fb96467b6b85ef5814Test
https://doi.org/10.15836/ccar2017.413Test

المؤلفون: Rea Levicki, Tomislav Mutak, Lada Bradić, Filip Mustač, Ines Vinković, Barbara Barun, Bojan Jelaković, Maja Baretić, Martina Lovrić Benčić, Martina Matovinović, Ana Jelaković, Juraj Jug

المصدر: Cardiologia Croatica
Volume 14
Issue 9-10

مصطلحات موضوعية: Obstructive sleep apnea, Pediatrics, medicine.medical_specialty, obstructive sleep apnea, obesity, STOP-Bang questionnaire, business.industry, medicine, Hypertension obesity, Stop bang, Cardiology and Cardiovascular Medicine, medicine.disease, business, Obesity, hypertension, cardiovascular risk

الوصف: Introduction: Breathing-related sleep disorders (out of them, especially obstructive sleep apnea (OSA)) are often present in obese patients. Significant correlation between conditions such as OSA or metabolic syndrome and some anthropometric measures, most notably neck circumference (NC) has been found1. Our goal was to examine the difference in STOP-Bang questionnaire score in obese patients depending on presence of hypertension and to see whether the use of it can be useful as a screening test for OSA. Patients and Methods: This cross-sectional study was carried out in a tertiary healthcare centre in an outpatient clinic for treatment of obesity. 49 participants (BMI >30kg/m2) were included. Welch t-tests were used to compare STOP-Bang questionnaire scores to our researched subjects. Results: Mean age was 50.29±11.91 years. Overall mean BMI was 44.64±8.12 kg/m2. There was not significant correlation between STOP-Bang questionnaire score and sex: t(9.486)=-2.17; p=.06, diabetes mellitus: t(7.821)=-2.07; p=.07 nor prediabetes: t(19.696)=-0.92; p=.37. However, patients with hypertension (Figure 1) had significantly higher score on STOP questionnaire than patients without hypertension: t(24)=-3.32; p=.003. Conclusion: Our results showed that obese patients with hypertension have higher score on the STOPBang questionnaire and consequently higher chance of OSA. Bakhai et al. have also shown that hypertension is an independent risk factor for OSA2. Thus, the STOP-Bang questionnaire could be an effective tool in obese hypertensive patients as a screening test to increase the percentage of newly diagnosed OSA and initiate timely treatment.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::292aa0d1778ded13299467e45c1accd2Test
https://doi.org/10.15836/ccar2019.237Test

المؤلفون: Ana Reschner, Maja Baretić, Ivo Planinc

المصدر: J Clin Hypertens (Greenwich)

مصطلحات موضوعية: Adult, medicine.medical_specialty, Intra-Abdominal Fat, business.industry, Endocrinology, Diabetes and Metabolism, visceral fat, bioelectrical impedance, prehypertension, Gastroenterology, Prehypertension, Normal weight, Internal medicine, Hypertension, Body Composition, Electric Impedance, Internal Medicine, medicine, Humans, Letters to the Editor, Cardiology and Cardiovascular Medicine, business, Bioelectrical impedance analysis, Visceral fat

الوصف: Our aim was to determine a possible relation between blood pressure values and body composition in patient without elements of metabolic syndrome. Fourteen participants of normal weight (6 males, 8 females ; median age 33 years, median body mass index 22.84 kg/m2) were included in the small study. Participants were healthy as determined by fasting routine blood parameters also including aldosterone, plasma renin activity, antidiuretic hormone, N‐ terminal pro‐brain natriuretic peptide, oral glucose tolerance test, 24‐hour urine protein excretion. Evaluation included bioelectrical impedance analysis (total body water, fat percentage, fat mass, muscle mass, and visceral fat rating). Blood pressure was estimated by 24‐hour monitoring ; median diastolic blood pressure was 71 mm Hg (range 42‐80), and median systolic blood pressure was 115 mm Hg, range (103‐137). Participants were divided into two groups according to the systolic blood pressure ; cutoff value was the median systolic blood pressure of all the participants. In the first group (three males, four females) had an average systolic blood pressure (estimated by 24‐hour monitoring) higher than 115 mm Hg and the second one (three males, four females) lower than mentioned value. The systolic blood pressure values of the first group were approximately in the range of high/normal blood pressure (115‐137 mm Hg), which could be defined as prehypertension. Data were analyzed using two‐sample t test. Characteristics that were significantly different between the groups were body mass index (24.4 ± 2.7 vs 21.5 ± 1.9 kg/m2 P = 0.02) and visceral fat rating (5.3 ± 2 vs 2.2 ± 1.6 P = 0.009). Our findings support that body composition estimated by bioelectrical impedance analysis, even in normal weight individuals, influences the level of systolic blood pressure within normal ranges. People with normal weight approaching the overweight limit and/or having higher visceral fat rate estimated by bioelectrical impedance analysis have higher risk for development of prehypertension.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4ef601ca0b87be0cf64697b29b26015aTest
https://doi.org/10.1111/jch.13508Test

المؤلفون: Lang, V. B., Maja Baretić, Pavić, E.

المصدر: Scopus-Elsevier
Acta medica Croatica : Časopis Akademije medicinskih znanosti Hrvatske
Volume 70
Issue 4-5

مصطلحات موضوعية: diabetes mellitus, nephropathy, family physician, šećerna bolest, oštećenje bubrega, liječnik obiteljske medicine, Physician-Patient Relations, General Practitioners, Hypertension, Disease Progression, Quality of Life, Humans, Diabetic Nephropathies, Renal Insufficiency, Chronic, Physician's Role

الوصف: Unatoč svim dostupnim modalitetima liječenja incidencija i progresija šećerne bolesti je u stalnom porastu. Bubrežno oštećenje kod ovih bolesnika je posebno devastirajuća komplikacija budući da je povezana i s kraćim trajanjem života i sa smanjenom kvalitetom života. Uz dijabetičku nefropatiju, kod oboljelih od šećerne bolesti prisutni su i drugi oblici bubrežnog oštećenja kao što je ishemijsko oštećenje povezano s oštećenjem krvnih žila i hipertenzijom, ali i drugi oblici oštećenja koji nisu povezani s dijabetesom. Nakon detaljnog pretraživanja literature dostupne na PubMed-u u ovom članku ukratko opisujemo ključne trenutke u kojima je posebno bitna uloga liječnika obiteljske medicine (LOM). Tijekom skrbi za oboljele od šećerne bolesti posebnu pozornost zahtijeva probir bubrežnog oštećenja, ispravno praćenje i liječenje i pravodobno upućivanje nefrologu. Na osobu usmjeren holistički pristup karakterističan za rad LOM prepoznat je kao poseban izazov u praćenju ovih bolesnika.
The alarming rates of diabetes mellitus incidence and progression continue despite deployment of all current treatments. Kidney disease can be a particularly devastating complication, as it is associated with signifi cant reductions in both length and quality of life. A variety of forms of kidney disease can be seen in people with diabetes, including diabetic nephropathy, ischemic damage related to vascular disease and hypertension, as well as other renal diseases that are unrelated to diabetes. Following an extensive PubMed search, this review provides a brief view on the screening for chronic kidney disease (CKD) in people with diabetes, how to treat them to slow down the progression of CKD and when to refer them to specialist care. This review also emphasizes the basic challenge in treating diabetic patients, which is to shift the main criterion from the disease-oriented to person-centered approach in the context of treating the patient as a whole.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::2fa0ad3705d78ab19bb02b3c67681b32Test
https://pubmed.ncbi.nlm.nih.gov/29087628Test

المؤلفون: Darjan Ranilović, Tea Vukić, Maja Baretić, Martina Matovinović

المصدر: Journal of human hypertension. 32(1)

مصطلحات موضوعية: 0301 basic medicine, medicine.medical_specialty, Blood Pressure, 030204 cardiovascular system & hematology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, Internal Medicine, medicine, Vitamin D and neurology, Humans, Sarcopenic obesity, Vitamin D, Randomized Controlled Trials as Topic, medicine.diagnostic_test, business.industry, medicine.disease, Vitamin D Deficiency, Angiotensin II, Hypertension, Muscle mass, 030104 developmental biology, Blood pressure, Endocrinology, chemistry, Dietary Supplements, Calcium, Metabolic syndrome, Lipid profile, Cholecalciferol, business, Body mass index

الوصف: We have read ‘Effects of calcium plus vitamin D supplementation on blood pressure: a systematic review and meta-analysis of randomised controlled trials’ and have shared our experiences with vitamin D and hypertension. We retrospectively analysed data of 33 obese patients attending a structural educational programme at the Department of Endocrinology, Internal Medicine Clinic, University Hospital Centre Zagreb, Croatia. Two groups were included. Group 1: 16 patients with hypertension (3 males ; 13 females ; average body mass index (BMI), 38 kg/m2 ; median age, 40 years) and Group 2: 17 patients without hypertension (4 males ; 13 females ; average BMI, 45 kg/m2 ; median age, 45 years). Secondary causes of obesity were excluded (normal values of thyroid-stimulating hormone and cortisol after overnight suppression with 1 mg dexamethasone), and no participant took vitamin D supplements. Body composition was estimated by bioelectrical impedance analysis (fat percentage, fat mass, muscle mass and visceral fat rating). Statistical analysis was performed on the age, sex, BMI, body composition, glucose, lipid profile and vitamin D level. Both groups had low vitamin D levels. In Group 1, the median vitamin D level was 40 nmol/l (20–69) and in Group 2, it was 36 nmol/l (12– 76). A two-sided t-test revealed no significant difference in vitamin D levels between the two groups (P = 0.343). In Group 1, vitamin D levels positively correlated with muscle mass (Spearman’s correlation coefficient, r = 0.68) ; however, this correlation was insignificant in Group 2 (r = −0.32). Whether this finding was accidental or some pathophysiological explanation existed, i.e., were there connectors linking vitamin D action, hypertension and muscle mass remains unknown. Vitamin D influences muscles by the following pathways: (a) genetic, mediated by a receptor present in muscle cells and (b) nontranscriptional, which cannot be explained by a slow genetic pathway. Vitamin D promotes mitogen-activated protein kinase (MAPK) signalling pathway activation, resulting in myogenesis initiation, cell proliferation, differentiation and apoptosis. MAPK is activated by various stimuli, including angiotensin II. MAPK signalling plays a bigger role in adipogenesis ; after stimulation, transcriptional pathways are initiated to ensure terminal differentiation of precursors into adult white or brown adipocytes. Vitamin D is associated with metabolic syndrome, hypertension and muscle mass, probably by MAPK signalling pathway. Postreceptor pathways mediated by vitamin D influence both metabolic syndrome and body composition elements (hypertension and muscle mass). For obese hypertensive patients, assessing only BMI is not enough because it does not reveal sarcopenic obesity. Hitherto, the type of patients with hypertension and low vitamin D level who would benefit from vitamin D substitution therapy has not been determined. In an analysis of 92 subjects with low baseline vitamin D levels (

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::aff57fcfed52bf9322fcc638f1ed101bTest
https://pubmed.ncbi.nlm.nih.gov/28230063Test

المؤلفون: Maja Baretić, Pavlic-Renar, I., Aganovic, I., Korsic, M., Kastelan, D., Giljevic, Z., Jelcic, J., Dusek, T.

المساهمون: Tesar, Vladimir

المصدر: Web of Science

مصطلحات موضوعية: hypertension, GLP-1, diabetes mellitus, endocrine system, digestive, oral, and skin physiology, hormones, hormone substitutes, and hormone antagonists

الوصف: Glucagon-like peptide-1 (GLP 1) is an incretin, a gastrointestinal hormone secreted from the gut after a meal. The positive glucoregulatory properties of GLP 1 are well known: it inhibits glucagon release, delays gastric emptying and augments satiety with the consequence of weight loss. The incretin mimetic exenatide, a pharmacological agent with a structure similar to that of GLP 1, has all the above properties of endogenous GLP 1. We examined 40 patients with type 2 diabetes mellitus unable to achieve adequate glycemic control with sulphonylurea and/or metformin. Patients were without antihypertensive therapy, or on stable one. Exenatide was added to therapy for 52 weeks: 5 mg of exenatide BID for the first 4 weeks, and then till the end of the study 10 mg BID. At the end of the trial, statistically significant mean reduction in both systolic blood pressure −4.65 mmHg ; p = 0.008582) and diastolic blood pressure (−1.48 mmHg ; p = 0.006286) was observed. GLP 1 receptors are found all over the body, as well as in the kidneys. Both GLP 1 and exenatide enhance sodium excretion, and their diuretic properties could explain the lowering of blood pressure. Do we have a drug that influences three elements of the metabolic syndrome: diabetes, obesity, and hypertension?

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=dedup_wf_001::f6bd2b8af09fc4ababef5e0ed6373cdbTest
https://www.bib.irb.hr/523303Test