The cervical spine involvement in patients with psoriatic arthritis

Psoriatic arthritis (PsA) is a systemic disease and cervical spine can be affected. The data regarding cervical spondylitis are very rare and diverse in literarture. The aim of study was to assess the prevalence of cervical spine involvement in patients with PsA. Between totally 41 patients with PsA we confirmed the incidence of 68% (29 patients) with symptomatic cervical spine disease and 29% (12 patients) with radiological evidence of inflammatory involvement. The most frequent radiological findings were apophyseal joint changes, rarely ligamentous calcification and syndesmophytes. Only one patient had subaxial subluxation. The most common type of PsA was axial disease with or without peripheral arthritis (46%) and the least common was oligoarthritis (22%). There was no statistically significant difference between any type of PsA and cervical involvement. CONCLUSION: inflammatory cervical spine changes are not common radiographic finding in patients with PsA and apophyseal joint affection is the most common radiologic sign.     

A naturalistic inquiry on the impact of interventions aiming to improve health and the quality of life in the community

The goal of this study is to identify and describe variables contributing to the efficiency of health promotion interventions, and to assess whether these variables can serve as reliable and early indicators of the success of such interventions. The study sample includes 44 interventions selected through a network of key informants from five cities--Liverpool, Sandwell, Vienna, Pula, and Rijeka--by using a chain technique. Data on each intervention are collected through an in-depth interview with a program leader, the collection of project-related documents, and on-site observation. Qualitative analysis of data performed with content analysis and computer-assisted free-text analysis reveals different characteristics of interventions depending on whether they are initiated by the city government sector, health-care system, or citizens sector (independent of the city or country). The assessment of the efficiency of these three groups of interventions also differs because of varying features, scope (activity potentials) and impact they are able to accomplish. We have identified ways in which the efficiency of all three groups of interventions can be improved. The efficiency of the interventions within the city sector can be increased through an improved process of delegation to other sectors, higher involvement of user groups, and higher receptivity and organizational flexibility. The efficiency of the interventions within the citizens sector can be improved through professional, organizational, and financial support. Support from the professional community is important for citizens sector interventions in confirming the importance of the problem they address and legitimizing the actions they propose and undertake.     

Odontogenic sinus tract to the neck skin: a case report

We describe a 22-year-old woman with neck skin sinus tract that developed as a consequence of dental infection. The patient was treated twice in an inappropriate way with recurrence of the sinus tract. We opted for an extraction of the tooth. This case illustrates the need for cooperative diagnostic referrals between physicians and dentists.     

Respiratory function and immunological reactions in sisal workers

A cross-sectional study of respiratory function was performed in 50 sisal textile workers in 1972. Twenty of the 50 sisal workers still employed in the sisal mill were reexamined 19 years later. At the time of the initial study there were higher prevalences of all chronic respiratory symptoms in sisal compared with control workers. By the time of the follow-up study a significant increase had occurred in almost all chronic respiratory symptoms among the 20 sisal workers. At the time of the initial study there were similar and statistically significant across-shift reductions of forced vital capacity (FVC) and the 1-s forced expiratory volume (FEV₁) on Monday and the following Thursday of the work week. Across-shift reductions in FVC and FEV₁ in the 20 sisal workers at the follow-up study were larger than at the first measurement. Two sisal workers out of 20 (10.0%) had a positive skin test reaction to an extract sisal; both related symptoms of occupational asthma. In two sisal workers (10.0%) increased IgE was measured; one of these had symptoms of occupational asthma. Our data suggest that exposure to sisal dust in the textile industry may, in some workers, cause the development of respiratory difficulties. Immunological testing may be of value in identifying such workers at risk for occupational asthma.     

Direct Induced Effects of Standard and Modified Radiotherapy Protocol on Surface Structure of Hard Dental Tissue

IntroductionRadiotherapy is used to treat neo plasmatic lesions and the common side effects of this process are pain, swelling and sensitivity of mucous membranes in domain of radiation, reduced salivation, caries, and periodontal disease and, in total, low life quality. The purpose of this research was to estimate the outcome of direct irradiation on physical and surface characteristics of hard dental tissues.Materials and methodsTwenty, caries free third molars were involved in the research. Prior to different submission protocols, tooth halves were randomly assigned to subject and control groups by using a draw method. The first group (n=20) was submitted to conventional irradiation protocol (2 Gy for 35 days), second group (n=20) was submitted to one powerful, exploratory dose of 70 Gy. Each sample served as its own control. Radiation was performed with a linear accelerator radiotherapy unit. The surface microhardness and roughness were measured at the beginning (initially), and upon completion of irradiation procedure. The average change in microhardness and roughness after different treatments was compared by t-test for independent samples. Normality was tested by the Shapiro-Wilk test.ResultsSignificant differences were found after the standard radiation protocol and the exploratory dose of 70 Gy, with decreased mean microhardness and increased mean roughness (p<0.001) of both hard dental tissues. Enamel and dentin surface microhardness and roughness did not vary notably with regards to different irradiation protocols.ConclusionHead and neck conventional irradiation protocol leads to possible breakdown of enamel and dentin with reduced microhardness and increased surface roughness regardless of used irradiation protocol.     

Continental-Mediterranean and rural-urban differences in cardiovascular risk factors in Croatian population

Aim

To compare the distribution of cardiovascular disease (CVD) factors between continental and Mediterranean areas and urban and rural areas of Croatia, as well as to investigate the differences in achieving treatment goals by the general practitioners (GP) in different settings.

Methods

A multicenter prospective study was performed on 2467 participants of both sexes ≥40 years old, who visited for any reason 59 general practices covering the whole area of Croatia (May-July 2008). The study was a part of the Cardiovascular Risk and Intervention Study in Croatia-family medicine (CRISIC-fm) study. Patients were interviewed using a 140-item questionnaire on socio-demographics and CVD risk factors. We measured body mass index (BMI) and waist circumference and determined biochemical variables including blood pressure, total, high-density lipoprotein-, and low-density lipoprotein-cholesterol, triglycerides, glycemia, and uric acid.

Results

Participants from continental rural areas had significantly higher systolic and diastolic blood pressure (P < 0.001), obesity (P = 0.001), increased waist circumference (P < 0.001), and more intense physical activity (P = 0.020). Participants from coastal rural areas had higher HDL-cholesterol, participants from continental rural and coastal urban areas had higher LDL-cholesterol, and participants from rural continental had significantly higher BMI and waist circumference.

Conclusion

Prevalence of CVD risk factors in Croatian population is high. Greater burden of risk factors in continental region and rural areas may be partly explained by lifestyle differences.Cardiovascular disease (CVD) is the major cause of death in the developed world but also an increasingly important cause in developing and underdeveloped countries that are adopting the Western way of life (1). In Europe, there was an increase in CVD mortality from north to south, but recently an increase from west to east has been observed. Still, the lowest mortality rates are mainly found in the Mediterranean countries (2). Although Croatia is geographically a Mediterranean country, its CVD mortality rate is significantly higher than in other Mediterranean countries, and in fact it is closer to Central and Eastern Europe (Croatian paradox) (2,3). CVD is a leading cause of death in Croatia and contributes to nearly 50% of total mortality cases (4).Only a few epidemiological studies on CVD risk factors in general population of Croatia have been performed over the last 50 years. A study performed in 1995-1997 did not investigate anthropometric data on central obesity (5), while Croatian Adult Health Survey performed in 2003 did not include a laboratory analysis of important CVD risk factors (6).Although there was one prevalence study on hypertension in Croatian general population (7), two studies on risk factors on hospitalized patients with CVD (8,9), and one small survey on high risk persons as a part of a large multinational study (10), there has been no comprehensive study of the CVD risk factors and total CVD risk in a representative sample of the adult general population in Croatia. There was also only one study comparing CVD risk factors in different regions of Croatia but it was performed on hospitalized patients with CVD eight years ago (11).The aim of our study was to investigate the distribution and possible differences among CVD risk factors (elevated blood pressure, dyslipidemia, hyperglycemia, hyperuricemia, smoking, overweight, obesity and central obesity, physical activity, alcohol consumption, total CVD risk calculated by SCORE and by Framingham) between different parts of Croatia (continental-inland and Mediterranean-coastal) and different settlement sizes (urban/rural), as well as to determine whether the target values of CVD risk factors (blood pressure, serum lipids, blood glucose) according to the guidelines (12) are achieved in the primary and secondary CVD prevention.     

DNA hypermethylation in somatic cells correlates with higher reprogramming efficiency

The efficiency of somatic cell reprogramming to pluripotency using defined factors is dramatically affected by the cell type of origin. Here, we show that human keratinocytes, which can be reprogrammed at a higher efficiency than fibroblast [Nat Biotechnol 2008;26:1276-1284], share more genes hypermethylated at CpGs with human embryonic stem cells (ESCs) than other somatic cells frequently used for reprogramming. Moreover, pluripotent cells reprogrammed from keratinocytes (KiPS) are more similar to ESCs than those reprogrammed from fibroblasts (FiPS) in regard to DNA methylation levels, mostly due to the presence of genes that fail to acquire high levels of DNA methylation in FiPS cells. We propose that higher reprogramming efficiency correlates with the hypermethylation of tissue-specific genes rather than with a more permissive pluripotency gene network.