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Introduction: Currently, just a few major parameters are used for cardiovascular (CV) risk quantification to identify many of the high-risk subjects; however, they leave a lot of them with an underestimated level of CV risk which does not reflect the reality.Material and methods: The submitted study design of the Kosice Selective Coronarography Multiple Risk (KSC MR) Study will use computer analysis of coronary angiography results of admitted patients along with broad patients' characteristics based on questionnaires, physical findings, laboratory and many other examinations.Results: Obtained data will undergo machine learning protocols with the aim of developing algorithms which will include all available parameters and accurately calculate the probability of coronary artery disease.Conclusions: The KSC MR study results, if positive, could establisha base for development of proper software for revealing high-risk patients, as well as patients with suggested positive coronary angiography findings, based on the principles of personalised medicine. [ABSTRACT FROM AUTHOR]

Aim: Knowledge of the causes of deaths in Slovakia is lacking. This is significant because diet and lifestyle factors are different in central Europe compared to Western, Northern and Southern Europe. This study aims to discern trends of age-adjusted mortality rates caused by various diseases in relation to demographic factors. The aim of our study was to find certain statistical aspects including trends of age-adjusted mortality rates caused by neoplastic (Chapter II) and circulatory diseases (Chapter IX) in the Slovak population in relation to available demographic factors (sex, region and calendar year of death).Methods: Dataset of individual deaths in Slovakia with certain demographic factors (sex, region and calendar year of death) during 1996-2013 were provided by the Slovak National Center of Health Informatics. Regression and correlation analyses and analyses of variance and of covariance were used to yield the level of significance.Results: We found significant differences of age-adjusted mortality rates between men and women, between Chapter II and Chapter IX and among Slovak regions. Age-adjusted mortality rates decline significantly in most regions for both sexes with the exception of stagnation in four regions in a group of Chapter II women (Košice, Nitra, Trenčín and Žilina) and one region in Chapter IX, also in group of women (Žilina).Conclusions: Mortalities caused either by Chapter II or Chapter IX diseases are significantly dependent on chapter, sex and region with mortalities either declining or stagnating. [ABSTRACT FROM AUTHOR]

Objectives: The objective of our study was to evaluate the influence of available demographic determinants on the number of deaths caused by circulatory system diseases as compared to deaths caused by neoplasms in Slovakia in 1996-2014.Methods: Mortality data were kindly provided by the National Health Information Centre in Slovakia. The first method was trend curve fitting of death ratios caused by circulatory system diseases (Chapter IX) and of deaths caused by neoplasms (Chapter II) as a function of age for both sexes. The second method comprised a decision tree for classification between deaths caused by Chapter IX and Chapter II diseases. Input variables were available demographic indicators: age, sex, marital status, region, and calendar year of death. Statistical data analyses were performed by IBM SPSS version 19 statistical software.Results: We found that the odds ratios of deaths caused by circulatory system diseases (Chapter IX) in comparison with deaths caused by neoplasms (Chapter II) were non-decreasing. At first, the values of odds ratios are constant until they reach a critical sex-dependent value with a subsequent steady increase. In the case of men the odds ratio was greater than in the 60 years age-group where the odds ratio value increased slowly (from 1.14 at age 60 to 7.25 at age 90 years). The relative increase was 6.36 (7.25/1.14). The odds ratio in the women group was smaller but increased more rapidly (from 0.81 at age 60 to 12.27 at age 90 years). The relative increase was 15.15 in women (12.27/0.81). Hence, the odds ratio of death caused by Chapter IX diseases vs. Chapter II was greater in the older women group (i.e. higher age values). Utilizing the decision tree model, we have found that the most significant demographic determinant of death counts in both ICD Chapters was the age of the deceased, followed by marital status and finally gender. The last two predictors (year and region) were relatively negligible though formally significant.Conclusions: The proposed method could be useful for prognostic classification of patients and primarily beneficial for hospitals in human or financial resources planning. [ABSTRACT FROM AUTHOR]

Carotenoids are a large class of compounds that are biosynthesized by condensation of isoprene units in plants, fungi, bacteria, and some animals. They are characteristically highly conjugated through double bonds, which lead to many isomers as well susceptibility to oxidation and other chemical modifications. Carotenoids are important because of their potent antioxidant activity and are the pigments responsible for color in a wide variety of foods. Human consumption is correlated to many health benefits including prevention of cancer, cardiovascular disease, and age-related disease. Extreme hydrophobicity, poor stability, and low concentration in biological samples make these compounds difficult to analyze and difficult to develop analytical methods for aimed towards identification and quantification. Examples in the literature frequently report the use of exotic stationary phases, solvents, and additives, such as ethyl acetate, dichloromethane, and methyl tert -butyl ether that are incompatible with liquid chromatography mass spectrometry (LC–MS). In order to address these issues, we implemented the use of LC–MS friendly conditions using a low-hydrophobicity cyano-propyl column (Agilent Zorbax SB-CN). We successfully differentiated between isomeric carotenoids by optimizing two gradient methods and using a mixture of 11 standards and LC–MS in positive ionization mode. Three complex biological samples from strawberry leaf, chicken feed supplement, and the photosynthetic bacterium Chloroflexus aurantiacus were analyzed and several carotenoids were resolved in these diverse backgrounds. Our results show this methodology is a significant improvement over other alternatives for analyzing carotenoids because of its ease of use, rapid analysis time, high selectivity, and, most importantly, its compatibility with typical LC–MS conditions. [ABSTRACT FROM AUTHOR]

Background and Objectives: Although single-pill, fixed-dose combinations (FDCs) are widely endorsed for the reduction of blood pressure and cardiovascular risk, studies to date have not evaluated the differences between FDCs and free associations using matched drugs and doses. The objective of this study was to determine whether switching from a free association of perindopril/amlodipine to the FDC formulation led to significant improvements in efficacy and tolerability. Methods: In this subanalysis of the previously published SYMBIO study, we looked at the effect of switching patients from a free association of perindopril/amlodipine to an equivalent dose of FDC ( N = 335). In the SYMBIO study, concomitant antihypertensive medications were allowed; however, they remained unchanged till the end of the study. Blood pressure was measured at baseline, 1, and 3 months. Targets were defined as blood pressure <140/90 mmHg or <130/80 mmHg for patients with type 2 diabetes mellitus or at high cardiovascular risk. Results: Compared to baseline, mean blood pressure decreased significantly after 1 and 3 months of treatment with FDC perindopril/amlodipine. Mean changes from baseline were −15.6 ± 14.3/−7.7 ± 9.1 mmHg at 1 month ( p < 0.0001) and −23.3 ± 16.4/−11.3 ± 9.8 mmHg at 3 months ( p < 0.0001). The percentage of patients who reached their blood pressure target increased from 16.0 % at baseline to 50.6 % at 1 month, to 75.9 % at 3 months. The incidence of ankle edema decreased from 14.9 % at baseline, to 9.9 % at 1 month, to 5.4 % at 3 months. The relative risk reduction for ankle edema was −37.5 % at 1 month (vs. baseline; p < 0.001) and −57.2 % at 3 months (vs. baseline; p < 0.001). Conclusions: These data suggest that switching from a free association of perindopril/amlodipine to the same dose of the FDC formulation led to significant improvements in efficacy and tolerability. [ABSTRACT FROM AUTHOR]

Photoremovable protecting groups are important for a wide range of applications in peptide chemistry. Using Fmoc-Cys(Bhc-MOM)-OH, peptides containing a Bhc-protected cysteine residue can be easily prepared. However, such protected thiols can undergo isomerization to a dead-end product (a 4-methylcoumarin-3-yl thioether) upon photolysis. To circumvent that photoisomerization problem, we explored the use of nitrodibenzofuran (NDBF) for thiol protection by preparing cysteine-containing peptides where the thiol is masked with an NDBF group. This was accomplished by synthesizing Fmoc-Cys(NDBF)-OH and incorporating that residue into peptides by standard solid-phase peptide synthesis procedures. Irradiation with 365 nm light or two-photon excitation with 800 nm light resulted in efficient deprotection. To probe biological utility, thiol group uncaging was carried out using a peptide derived from the protein K-Ras4B to yield a sequence that is a known substrate for protein farnesyltransferase; irradiation of the NDBF-caged peptide in the presence of the enzyme resulted in the formation of the farnesylated product. Additionally, incubation of human ovarian carcinoma (SKOV3) cells with an NDBF-caged version of a farnesylated peptide followed by UV irradiation resulted in migration of the peptide from the cytosol/Golgi to the plasma membrane due to enzymatic palmitoylation. Overall, the high cleavage efficiency devoid of side reactions and significant two-photon cross-section of NDBF render it superior to Bhc for thiol group caging. This protecting group should be useful for a plethora of applications ranging from the development of light-activatable cysteine-containing peptides to the development of light-sensitive biomaterials. [ABSTRACT FROM AUTHOR]

Compound identification by liquid chromatography–mass spectrometry (LC–MS) is a tedious process, mainly because authentic standards must be run on a user's system to be able to confidently reject a potential identity from its retention time and mass spectral properties. Instead, it would be preferable to use shared retention time/index data to narrow down the identity, but shared data cannot be used to reject candidates with an absolute level of confidence because the data are strongly affected by differences between HPLC systems and experimental conditions. However, a technique called “retention projection” was recently shown to account for many of the differences. In this manuscript, we discuss an approach to calculate appropriate retention time tolerance windows for projected retention times, potentially making it possible to exclude candidates with an absolute level of confidence, without needing to have authentic standards of each candidate on hand . In a range of multi-segment gradients and flow rates run among seven different labs, the new approach calculated tolerance windows that were significantly more appropriate for each retention projection than global tolerance windows calculated for retention projections or linear retention indices. Though there were still some small differences between the labs that evidently were not taken into account, the calculated tolerance windows only needed to be relaxed by 50% to make them appropriate for all labs. Even then, 42% of the tolerance windows calculated in this study without standards were narrower than those required by WADA for positive identification, where standards must be run contemporaneously. [ABSTRACT FROM AUTHOR]

Identification of small molecules by liquid chromatography–mass spectrometry (LC–MS) can be greatly improved if the chromatographic retention information is used along with mass spectral information to narrow down the lists of candidates. Linear retention indexing remains the standard for sharing retention data across labs, but it is unreliable because it cannot properly account for differences in the experimental conditions used by various labs, even when the differences are relatively small and unintentional. On the other hand, an approach called “retention projection” properly accounts for many intentional differences in experimental conditions, and when combined with a “back-calculation” methodology described recently, it also accounts for unintentional differences. In this study, the accuracy of this methodology is compared with linear retention indexing across eight different labs. When each lab ran a test mixture under a range of multi-segment gradients and flow rates they selected independently, retention projections averaged 22-fold more accurate for uncharged compounds because they properly accounted for these intentional differences, which were more pronounced in steep gradients. When each lab ran the test mixture under nominally the same conditions, which is the ideal situation to reproduce linear retention indices , retention projections still averaged 2-fold more accurate because they properly accounted for many unintentional differences between the LC systems. To the best of our knowledge, this is the most successful study to date aiming to calculate (or even just to reproduce) LC gradient retention across labs, and it is the only study in which retention was reliably calculated under various multi-segment gradients and flow rates chosen independently by labs. [ABSTRACT FROM AUTHOR]

Background: Obesity-induced metabolic syndrome is a multiple risk factor for cardiovascular (CV) risk factors and type 2 diabetes, and ethnic minorities seem to have unfavourable medical risk factors in general more frequently than majority populations. Objective: The aim of this study was to evaluate the prevalence of cardiovascular risk factors in relation to metabolic syndrome in the Roma population compared with the non-Roma population residing in the eastern part of Slovakia. Results: 123 Roma and 79 non-Roma patients with metabolic syndrome were evaluated. Men between 40-55 years of age had 4.76-times higher odds and women 5.26-times higher odds for metabolic syndrome compared with the younger population. We found statistically significant higher waist circumference in the Roma subpopulation and higher body mass index as well, although in selected population with metabolic syndrome. HDL cholesterol was significantly lower in both Roma men and women, and LDL cholesterol was not significant in men and women with metabolic syndrome. Triglycerides levels were significantly higher in non-Roma women only. High-sensitivity C-reactive protein (hsCRP) values were not in correlation with age but were associated with the increasing number of fulfilled criteria for metabolic syndrome in both subgroups (Roma, non-Roma), independently of gender. Conclusion: Our study confirmed higher prevalence of obesity, metabolic syndrome and other CV risk factors associated with metabolic syndrome among younger Roma population, which may be associated with increased cardiovascular disease (CVD) morbidity and mortality among elderly Roma compared with non-Roma. [ABSTRACT FROM AUTHOR]

Background: The metabolic syndrome (MS) is a clustering of cardiovascular risk. The high prevalence of metabolic syndrome among populations of lower socioeconomic status is a cause of concern and calls for an effective public health response. Objectives: The aim of this study was to determine the prevalence of metabolic syndrome in the Roma population compared with the non-Roma population in the eastern part of Slovakia and to determine the parameter which has the strongest association with metabolic syndrome. Results: 123 Roma and 79 non-Roma patients with metabolic syndrome were evaluated. In the subgroup of Roma men, we found that waist circumference conferred the highest chance of MS (more than 12-times), followed by triglycerides (TG) (3.670-times). In the subgroup of non-Roma men, we found that waist circumference conferred the highest chance of MS (more than 16-times), followed by high-density lipoprotein (HDL) (4.348-times increased risk per one unit decrease in HDL). In the subgroup of Roma women as well as non-Roma women, we found that serum TG conferred the highest chance of MS, followed by waist circumference for Roma women. Comparing non-classical risk factors for MS we found that only age (with OR 1.977) and high-sensitivity C-reactive protein (hsCRP) (OR 1.887) were significant and independent predictors of MS in Roma men. Among Roma women apolipoprotein B100 was also found to be an independent predictor of MS, besides age and hsCRP. Conclusion: Our study confirmed that the prevalence of metabolic syndrome is strongly associated with hypertriglyceridemic waist, besides other risk factors, a marker of the atherogenic metabolic triad among younger Roma population, which may be the reason for the increased cardiovascular (CV) morbidity and mortality in elderly Roma compared with non-Roma. In light of these results, better prevention of CV events for Roma minority settlements in Slovakia should be provided. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the possible benefits of coenzyme Q10 and selenium supplementation administered to patients with statin-associated myopathy (SAM). Sixty eligible patients entered the pilot study. Laboratory examination (CoQ10, selenium, creatin kinase) and intensity of SAM (visual scale) were performed at baseline, after 1 month, and at the end of study at month 3. Plasma levels of CoQ10 increased from 0.81 ± 0.39 to 3.31 ± 1.72 μmol/L in the active group of patients treated by CoQ10, compared with the placebo ( p = 0.001). Also, the symptoms of SAM significantly improved in the active group ( p < 0.001): the intensity of muscle pain decreased from 6.7 ± 1.72 to 3.2 ± 2.1 ( p < 0.01, -53.4 ± 28.2%); muscle weakness decreased from 7.0 ± 1.63 to 2.8 ± 2.34 ( p < 0.01, -60 ± 24.0%); muscle cramps decreased from 5.33 ± 2.06 to 1.86 ± 2.42, p < 0.01, -65 ± 28%); tiredness decreased from the initial 6.7 ± 1.34 to 1.2 ± 1.32 ( p < 0.01, -82 ± 22%). We did not observe any significant changes in the placebo group. In conclusion, supplementation of statin-treated patients with CoQ10 resulted in a decrease in the symptoms of SAM, both in absolute numbers and intensity. Additional selenium supplementation was not associated with any statistically significant decrease of SAM. However, it is not possible to draw any definite conclusions, even though this study was carried out in double-blind fashion, because it involved a small number of patients. [ABSTRACT FROM AUTHOR]

Background: Fixed-dose combination treatments using an angiotensin-converting enzyme (ACE) inhibitor, such as perindopril, plus a calcium channel blocker (CCB), such as amlodipine, have been endorsed by guidelines because they improve blood pressure control and cardiovascular outcomes in hypertensive patients, while being well tolerated and well adhered to by patients. Objective: This study aimed to assess the blood pressure-lowering effects of fixed-combination perindopril/amlodipine in patients previously treated with an ACE inhibitor and/or a CCB. Methods: This was a prospective, real-life, open-label, longitudinal, phase IV study conducted in 223 outpatient medical centres across Slovakia. 2132 previously treated patients whose hypertension was insufficiently controlled at baseline or who tolerated treatment poorly were included. Patients were treated for 3 months with fixed-combination perindopril/amlodipine 5mg/5mg, 5mg/10mg, 10mg/5mg and 10mg/10mg. The main outcome measure was a reduction in mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) and achievement of blood pressure targets (SBP/DBP <140/90mmHg or <130/80mmHg for patients with type 2 diabetes mellitus or high cardiovascular risk). Results: After 3 months of treatment, mean±SD SBP/DBP had decreased from 158.5±17.5/93.6±9.8mmHg to 132.9±10.6/80.7±6.2mmHg (p<0.0001). In patients with grade 3 hypertension, mean ±SD changes from baseline in SBP/DBP were -45.4±16.4/-20.0±11.5mmHg after 3 months (p<0.0001). Blood pressure targets were reached by 74% of the overall patient population, 84% of patients with grade 1 hypertension, and 52% of difficult-to-treat patients with grade 3 hypertension. This treatment was associated with a 58% reduction in the number of patients with amlodipine-related ankle oedema compared with baseline. Conclusion: Fixed-combination perindopril/amlodipine was well tolerated and resulted in statistically significant and clinically meaningful decreases in blood pressure. [ABSTRACT FROM AUTHOR]

Background: The objective of the FALCO FORTE programme was to demonstrate the efficacy and safety of 3 months of therapy with the fixed combination perindopril/indapamide in hypertensive patients in everyday medical practice. Design and methods: Patients with blood pressure >140/90mmHg or with blood pressure >130/85mmHg and three or more risk factors were prescribed perindopril/indapamide 2.5/0.625mg or 5/1.25 mg. Dosage could be increased to 10/2.5mg at any time during the study. Results: Of the 2327 patients included, 69% of patients had been unsuccessfully treated with other antihypertensives, 4.6% had not tolerated previous antihypertensive treatments, and 26.8% were newly diagnosed hypertensive patients. Roughly half the cohort was at high or very high cardiovascular risk. After 3 months of therapy, systolic blood pressure decreased from 156.9 ± 13.7 to 132.3 ± 10.6mmHg (p < 0.0001) and diastolic blood pressure from 94.9 ± 8.2 to 81.3 ± 6.3mmHg (p < 0.0001). Target blood pressure was reached by 87.1%of patients. Similar changes from baseline were observed in patients with diabetes mellitus, metabolic syndrome or left ventricular hypertrophy (p < 0.0001).When blood pressure decreases were analysed by dose, changes from baseline increased with increasing doses. Perindopril/indapamide was well tolerated with no significant changes in laboratory parameters being observed. Quality of life improved significantly. Conclusions: Therapy with fixed combination perindopril/indapamide was effective and well tolerated in a wide range of patients. [ABSTRACT FROM AUTHOR]

Background: Current evidence has established that statins are potent and effective agents with several pleiotropic effects in the treatment of coronary artery disease (CAD). Statins may have toxic effects, if given in higher doses and in combination. Design: Literature review. Methods : An Internet search and discussions with colleagues. Results : The 1990s have been called the 'statin decennial' and the Nobel laureates suggested 'CAD: eliminated with statins'. Statins were also proclaimed as wonder drugs, influencing a wide range of physiological, biochemical and biological functions. The list appears to be long and includes hypolipidaemic, vasodilative, antithrombotic, antioxidant, anti-inflammatory, antiproliferative, anticoagulant, angiogenic and bone formation inducing functions. In January 2002, the television network CNN announced in a dispatch from London that deaths resulting from the treatment of hypercholesterolaemia with cerivastatin (Baycol) have now exceeded 100. Concerned Americans discussed this issue in May 2002, and published advice with the intention of summarizing for professionals current knowledge about statin use, focusing on myopathy. The criteria for the diagnosis of myopathy are not concerned with the symptoms of patients in the absence of raised muscle enzymes. Coenzyme Q10 is not considered in prophylaxis because one study showed no decrease in coenzyme Q10 in muscles in the presence of toxicity, although some studies indicated a reduction in serum levels. Conclusion : Several studies have reported a significant reduction in serum coenzyme Q10 in patients taking statins. Such concern was also expressed by the International College of Cardiology at their meeting in April 2002; it was proposed that coenzyme Q10 should be considered in the prevention as well as the treatment of statin intoxication. [ABSTRACT FROM AUTHOR]

Looks into several factors in the pathogenesis of insulin resistance. Components of insulin resistance; Association of obesity with hyperinsulinaemia; Nutritional indicators of insulin resistence and metabolic syndrome.

Abstract: Of 54 patients with acute coronary artery disease (CAD) that were included in this study, 41 patients had acute myocardial infarction (AMI), five patients possible MI, four patients unstable angina and the remaining four angina pectoris. The control subjects (n=85) were randomly selected from the general population of the city of Moradabad of similar age range after exclusion for CAD (n=9), diabetes (n=6) and excess intake of trans fatty acids (n=20). The incidence of lipoprotein(a) excess (>30 mg/dl; 42.6 vs 24.7%; P&#60;0.05) and mean concentration of lipoprotein(a) (Lp[a], 6.4 mg/dl, 95% confidence interval: 2.8–10.5; P&#60;0.05) was significantly greater in the acute CAD group compared with control subjects. Mean total cholesterol and triglycerides were significantly higher and mean nitrite level lower in the study group as compared with the control group. There was a significant greater incidence of cardiac events in the second quarter of the day compared with the fourth quarter. Lp(a), triglycerides, blood glucose, plasma insulin, malondialdehyde, diene conjugates, TBARS and TNF-alpha and IL-6 levels, which were significantly greater during the acute phase, showed a significant decline and serum nitrite and coenzyme Q demonstrated an increase at 4 weeks of follow-up when the acute reactions evoked by MI had been controlled. Large breakfasts were a predisposing factor for cardiac events in the second quarter of the day and it was significantly associated with metabolic reactions. The findings indicate that acute reactions as a result or as circadian rhythms appear to be important in the pathogenesis of AMI-associated complications and that a large breakfast in association with nitrite deficiency may further trigger the circadian rhythms. However, more studies in a larger number of subjects would be necessary in order to confirm our findings. [Copyright &y& Elsevier]

Abstract: Acute myocardial infarction (AMI) is a highly dynamic event, which is associated with marked neuroendocrinological dysfunction in addition to cardiac damage. The immediate trigger for AMI is not precisely known. Studies conducted by Lown, Braunwald, Halberg, Otsuka and our group have demonstrated a marked increase in sympathetic activity, oxidative stress, and magnesium and potassium deficiency during AMI. Clinical studies have reported an increased incidence of AMI, sudden death and ischemia during first quarter of the day when there is a rapid withdrawal of vagal activity and increase in sympathetic tone. In one case-control study of 202 patients with AMI, there was a significant (P&#60;0.02) increase in cardiac events in the second quarter of the day compared to other quarters, respectively (16.8%, 41.0%, 13.8%, 28.2% per quarter). This characteristic remained prevalent in both men and women and among patients with and without known AMI (n=52), diabetes (n=53) or hypertension (n=75). Triggers of AMI were noted among 162 (82.2%) of the patients. Neuropsychological mechanisms were observed as follows: emotional stress (45.5%), sleep deprivation (27.7%), cold climate (29.2%), hot climate (24.7%), large meals (47.5%) and physical exertion (31.2%). These triggering factors are known to enhance sympathetic activity and decrease vagal tone, resulting in an increased secretion of plasma cortisol, noradrenaline, aldosterone, angiotension-converting enzyme (ACE), interleukin (IL)-1, -2, -6, -18, and tumor necrosis factor-alpha (TNF-alpha), all of which are are proinflammatory agents. There is also a deficiency in the serum levels of vitamin A, E, and C and magnesium, potassium, melatonin, and IL-10 (an anti-inflammatory agent). In our study, we found a decrease in magnesium, potassium, vitamin A, E, C and beta carotene combined with an increase in thiobarbituric acid-reactive substances (TBARS), MDA and diene conjugates, TNF-alpha and IL-6, all of which are indicators of oxidative damage and proinflammatory activity, respectively. [Copyright &y& Elsevier]

Abstract: The various mechanisms that may explain the association between brain dysfunction and the pathogenesis of metabolic syndrome (MS) leading to cardiovascular disease and type 2 diabetes have been reviewed. A Medline search was conducted until September 2003, and articles published in various national and international journals were reviewed. Experts working in the field were also consulted. Compelling evidence was found that saturated and total fat and low dietary n-3 fatty acids and other long-chain polyunsaturated fatty acids (PUFAs) in conjunction with sedentary behavior and mental stress combined with various personality traits can enhance sympathetic activity and increase the secretion of catecholamine, cortisol and serotonin, all of which appear to be underlying mechanisms involved in MS. Excess secretion of these neurotransmitters in conjunction with underlying long-chain PUFA deficiency may damage the neurons in the ventromedial hypothalamus and insulin receptors in the brain, in particular during fetal life, infancy and childhood, and lead to their dysfunction. Since 30–50% of the fatty acids in the brain are long-chain PUFAs, especially omega-3 fatty acids which are incorporated in the cell membrane phospholipids, it is possible that their supplementation may have a protective effect. Omega-3 fatty acids are also known to enhance parasympathetic activity and to increase the secretion of anti-inflammatory cytokines as well as acetylecholine in the hippocampus. It is possible that a marginal deficiency of long-chain PUFAs, especially n-3 fatty acids, due to poor dietary intake during the critical period of brain growth and development in the fetus, and later in the infant and also possibly in the child, adolescent and adult may enhance the release of tumor necrosis factor-alpha (TNF-α) interleukin (IL)-1, 2 and 6 and cause neuronal dysfunction. Experimental studies indicate that ventromedial hypothalamic lesions in rats induce hyperphagia, resulting in glucose intolerance and insulin resistance. Treatment with neuropeptide Y abolished hyperphagia and ob mRNA (leptin mRNA) in this animal model. Long-term infusion of norepinephrine and serotonin into the ventromedial hypothalamus impaired pancreatic islet function inasmuch as ventromedial hypothalamic norepinephrine and serotonin levels were elevated in hyperinsulinemic and insulin-resistant animals. Treatment with insulin was associated with restoration of hypothalamic neurotransmitter abnormalities, indicating that ventromedial hypothalamus dysfunction can impair pancreatic beta cells resulting in metabolic abnormalities consistent with MS. Treatment with omega-3 fatty acids, beta blockers, ACE inhibitors, estrogen, and meditation may have a beneficial effect on insulin receptors and ventromedial hypothalamic dysfunction. However, no definite or precise insight into the pathophysiological link between MS, brain function and nutrition is available. Despite this, epidemiological studies and intervention trials indicate that treatment with n-3 fatty acids may be adopted in clinical practice and used to direct therapy for prevention of type 2 diabetes, hypertension, coronary artery disease (CAD), and atherosclerosis, thereby indicating that MS may also respond to this treatment. [Copyright &y& Elsevier]

Chronic heart failure (CHF) has different stages and includes pre‐HF (PHF), a state of high risk of developing myocardial dysfunction and advanced CHF. Some major behavioral risk factors of PHF might predispose to biological risk factors such as obesity, diabetes mellitus, dyslipidemia, hypertension, myocardial infarction, and cardiomyopathy. These risk factors damage the myocytes leading to fibrosis, apoptosis, cardiac hypertrophy, along with alterations in cardiomyocyte' size and shape. A condition of physiological subcellular remodeling resulting into a pathological state might be developed, conducting to PHF. Both PHF and heart failure (HF) are associated with the activation of phospholipases and protease, mitochondrial dysfunction, oxidative stress and development of intra‐cellular free Ca2+ [Ca2+]i overloading to an elevation in diastolic [Ca2+]i. Simultaneously, cardiac gene expression is activated leading to further molecular, structural and biochemical changes of the myocardium. The sub‐cellular remodeling may be intimately involved in the transition of cardiac hypertrophy to heart failure. 2D‐ and 3D‐speckle tracking echocardiography (STE) have been used to quantify regional alterations of longitudinal strain and area strain, through their polar projection, which permits a further assessment of both sites and degrees of myocardial damage. The examination of strain can identify sub‐clinical cardiac dysfunction or cardiomyocyte remodeling. During remodeling of the myocardium cardiac strain is attenuated, therefore it is an indicator of disease assessment. [ABSTRACT FROM AUTHOR]

Introduction: In the absence of a European standardized postmarketing food supplement surveillance system (nutrivigilance), some member states and companies have developed their own approaches to monitoring potential adverse reactions to secure a high level of product safety. This paper describes the use of a nutrivigilance system in monitoring the incidence of spontaneously reported suspected adverse reactions associated with food supplements containing red yeast rice (RYR).Material and Methods: We report the data from a widely used product marketed under the trademark Armolipid/Armolipid Plus. Postmarketing information was collected in a voluntary nutrivigilance system established by the manufacturing company (Meda Pharma SpA, a Viatris Company, Monza, Italy). From 1st October 2004 to 31st December 2019, this system captured cases of suspected adverse reactions spontaneously reported by consumers, healthcare professionals, health authorities, regardless of causality.Results: The total number of case reports received mentioning the RYR food supplement product line was 542, in which 855 adverse events (AEs) were reported. The total reporting rate of AEs was estimated to be 0.037% of 2,287,449 exposed consumers. Of the 542 cases, 21 (0.0009% of exposed consumers) included suspected serious adverse events (SAEs). After careful investigation, 6 cases (0.0003% of consumers exposed) and 6 AEs were assessed by the manufacturer as serious and potentially related to exposure to the above-mentioned RYR-based nutraceutical.Conclusions: This nutrivigilance-derived data analysis clearly demonstrates a low prevalence of suspected adverse events associated with the red yeast rice product line. Consumer safety of food supplements could be generally improved by raising awareness of the importance of following the indications and warnings detailed in a food supplement's labeling. [ABSTRACT FROM AUTHOR]

Cardiovascular comorbidities are independent risk factors for mortality in dialysis patients. MicroRNA signaling has an important role in vascular aging and cardiac health, while physical activity is a primary nonpharmacologic treatment for cardiovascular comorbidities in dialysis patients. To identify the relationships between muscle function, miRNA signaling pathways, the presence of vascular calcifications and the severity of cardiovascular comorbidities, we initially enrolled 90 subjects on hemodialysis therapy and collected complete data from 46 subjects. A group of 26 subjects inactiv group (INC) was monitored during 12 weeks of physical inactivity and another group of 20 patients exercise group (EXC) was followed during 12 weeks of intradialytic, moderate intensity, resistance training intervention applied three times per week. In both groups, we assessed the expression levels of myo‐miRNAs, proteins, and muscle function (MF) before and after the 12‐week period. Data on the presence of vascular calcifications and the severity of cardiac comorbidities were collected from the patients' EuCliD® records. Using a full structural equitation modelling of the total study sample, we found that the higher the increase in MF was observed in patients, the higher the probability of a decrease in the expression of miR‐206 and TRIM63 and the lower severity of cardiac comorbidities. A reduced structural model in INC patients showed that the higher the decrease in MF, the higher the probability of the presence of calcifications and the higher severity of cardiac comorbidities. In EXC patients, we found that the higher the increase in MF, the lower the probability of higher severity of cardiovascular comorbidities. [ABSTRACT FROM AUTHOR]

Background: Clinical trials remain key to the development of evidence‐based medical practice. However, they are becoming increasingly complex, mainly in a multinational setting. To address these challenges, the European Union (EU) adopted the Clinical Trial Regulation EU No. 536/2014 (CTR). Once in force, the CTR will lead to more consistent rules and simplification of procedures for conducting clinical trials throughout the EU. Existing harmonization initiatives and "research infrastructures" for clinical trials may facilitate this process. This publication offers a snapshot of the current level of harmonization activities in academic clinical research in Europe. Methods: A survey was performed among the member and observer countries of the European Clinical Research Infrastructure Network (ECRIN), using a standardized questionnaire. Three rounds of data collection were performed to maximize completeness and comparability of the received answers. The survey aimed to describe the harmonization of academic clinical research processes at national level, to facilitate the exchange of expertise and experience among countries, and to identify new fields of action. Results: Most scientific partners already have in place various working groups and harmonization activities at national level. Furthermore, they are involved in and open to sharing their know‐how and documents. Since harmonization was mainly a bottom‐up approach up until now, the extent and topics dealt with are diverse and there is only little cross‐networking and cross‐country exchange so far. Conclusions: Currently, the ECRIN member countries offer a very solid base and collaborative spirit for further aligning processes and exchanging best practices for clinical research in Europe. They can support a smooth implementation of the EU CTR and may act as single contact with consolidated expertise in a country. [ABSTRACT FROM AUTHOR]

Introduction: The long-term effect of potato consumption on mortality and cardiovascular (CV) and cardiometabolic risk factors is still largely unknown. Using the National Health and Nutrition Examination Surveys (NHANES) 1999-2010, we evaluted the long-term impact of potato intake on total and cause-specific (cardiovascular disease (CVD), cerebrovascular disease and cancer) mortality, and the results were next validated in a systematic review and meta-analysis of cohort studies investigating pooled associations of potato consumption with all-cause and cause-specific death.Material and Methods: Vital status up to December 31, 2011 was ascertained in NHANES. Cox proportional hazards were applied to determine the hazard ratios (HRs) and 95% confidence intervals (95% CI) of mortality for each quartile of the potato intake, with the lowest quartile (Q1 - with the lowest intake) used as a reference. In the meta-analysis we used adjusted Cox regression to determine the risk ratio (RR) and 95% CI, as well as random effects models and generic inverse variance methods to synthesize quantitative and pooled data, followed by a leave-one-out method for sensitivity analysis.Results: Among 24,856 participants included, 3433 deaths occurred during the mean follow-up of 6.4 years. In multivariate adjusted models, total (42%), CVD (65%), cerebrovascular (26%) and cancer (52%) mortality risk was greater in individuals with higher potato consumption than those with the lowest intake (p < 0.001 for all comparisons). However, this link disappeared after adjustment for confounding factors. Results from pooling current prospective studies revealed a non-significant association between total (RR = 1.25, 0.98-1.60, p = 0.066), CVD (RR = 0.99, 0.90-1.08, p = 0.845) and stroke mortality (RR = 0.94, 0.85-1.03, p = 0.214) with potato consumption. Individuals with a higher potato intake had a less favorable profile of cardiometabolic factors, including greater waist circumference (97.2 vs. 99.5 cm, p < 0.001) and a less favorable profile of systolic and diastolic blood pressure, levels of triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C) and TG/HDL-C ratio (p < 0.001 for all comparisons).Conclusions: Our results revealed no significant effects of potato intake on long-term mortality rates, whereas higher potato consumption was adversely related to cardiometabolic risk factors. These findings should be taken into consideration for public health strategies, establishing the position for potatoes in the food pyramid. [ABSTRACT FROM AUTHOR]

However, statin therapy may be not sufficient to reduce significantly the CV risk in high and very-high CV, and especially ultra/extremely high risk patients [[7]], and consequentially there may be an indication to use a statin in combination with other non-statin lipid-lowering drugs, such as ezetimibe, acting through a different mechanism of action. For most (even 95%) of those who experienced statin-associated muscle symptoms (SAMS) it is still possible to use statins by modifying the dose and type of statin, apply alternate-day statin therapy, or alternatively a non-statin dug or specific nutraceuticals with lipid-lowering properties can be considered [[38]]. Our recommendation is that only subjects with low CV risk, without overt characteristics of eligibility for statin therapy, or having conditions/risk factors that may predispose to an increased risk of statin-associated SAMS, may be advised to use RYR, and physicians should discuss with the patients the possible benefit as well as adverse events associated with RYR use. • In case of reluctance of your patient to take classical statins, clarify the exact reason: (1) adverse effect (intolerant patient), (2) specific worries about the chemical nature of a drug (the patients prefer natural medicine) or (3) worries about the statin administration in general. [Extracted from the article]

Graphical abstract Abstract Recently, concerns regarding the safety of red yeast rice (RYR) have been raised after the publication of some case reports claiming toxicity. Since the previous meta-analyses on the effects of RYR were mainly focused on its efficacy to improve lipid profile and other cardiovascular parameters, we carried out a meta-analysis on safety data derived from the available randomized controlled clinical trials (RCTs). Primary outcomes were musculoskeletal disorders (MuD). Secondary outcomes were non-musculoskeletal adverse events (Non-MuD) and serious adverse events (SAE). Subgroups analyses were carried out considering the intervention (RYR alone or in association with other nutraceutical compounds), monacolin K administered daily dose (≤3, 3.1–5 or >5 mg/day), follow-up (>12 or ≤12 weeks), with statin therapy or statin-intolerance and type of control treatment (placebo or statin treatment). Data were pooled from 53 RCTs comprising 112 treatment arms, which included 8535 subjects, with 4437 in the RYR arm and 4303 in the control one. Monacolin K administration was not associated with increased risk of MuD (odds ratio (OR) = 0.94, 95% confidence interval (CI) 0.53,1.65). Moreover, we showed reduced risk of Non-MuD (OR = 0.59, 95%CI 0.50, 0.69) and SAE (OR = 0.54, 95%CI 0.46, 0.64) vs. control. Subgroups analyses confirmed the high tolerability profile of RYR. Furthermore, increasing daily doses of monacolin K were negatively associated with increasing risk of Non-MuD (slope: -0.10; 95%CI: -0.17, -0.03; two-tailed p < 0.01). Based on our data, RYR use as lipid-lowering dietary supplement seems to be overall tolerable and safe in a large kind of moderately hypercolesterolaemic subjects. [ABSTRACT FROM AUTHOR]

Introduction: Many studies have highlighted the important role of PCSK9 in the development of cardiometabolic changes and its possible function as a biomarker of myocardial infarction or ischemic heart disease. This study aimed to determine the relationship between circulating PCSK9 levels and subclinical vascular changes in the group of low risk patients without manifest cardiovascular diseases. Methods: In this study, 120 healthy patients, free of manifest cardiovascular diseases, diabetes mellitus, and without lipid-lowering therapy, were divided into three groups based on BMI: normal weight ( N = 50), overweight ( N = 30), and obese ( N = 40). Biochemical parameters, including basic lipid and non-lipid ones, were analyzed. PCSK9 levels were measured by ELISA, vascular changes were quantified by carotid ultrasound (carotid artery intima-media thickness, cIMT), and arterial stiffness parameters (pulse wave velocity, PWV; augmentation index, AI; stiffness parameter, β) were measured by an echo-tracking method. Results: Plasma levels of PCSK9 significantly increased in obese (172.78 ± 51.67 ng/mL) in comparison with overweight (120.14 ± 37.64, p < 0.001) and normal weight groups (114.92 ± 35.87, p < 0.001). Differences between the overweight and normal weight groups were not significant ( p = 0.85). The level of PCSK9 significantly correlated with values of BMI ( p < 0.001, r = 0.38). In addition to increase in laboratory parameters associated with moderate metabolic changes, significant increase in cIMT and parameters of vascular changes ( β, AI, PWV) were detected in groups with elevated BMI. Significant positive linear correlation of PCSK9 concentrations and cIMT ( p < 0.001, r = 0.39), PWV ( p < 0.001, r = 0.31), and β ( p < 0.001, r = 0.3) were found. In multivariable regression analysis after adjusting for gender, age, BMI, and LDL, the impact of PCSK9 on cIMT, β, and PWV remained significant ( p = 0.006, 0.03, and 0.002, respectively). Conclusion: PCSK9 plasma levels significantly correlated with subclinical vascular changes and their values were significantly elevated in obese subjects. We assume that PCSK9 could be used as a predictor of early vascular involvement, prior to the existence of manifest atherosclerosis. These results also highlight the role of anti-PCSK9 treatment in primary prevention. [ABSTRACT FROM AUTHOR]

In recent years, there has been growing interest in the possible use of nutraceuticals to improve and optimize dyslipidemia control and therapy. Based on the data from available studies, nutraceuticals might help patients obtain theraputic lipid goals and reduce cardiovascular residual risk. Some nutraceuticals have essential lipidlowering properties confirmed in studies; some might also have possible positive effects on nonlipid cardiovascular risk factors and have been shown to improve early markers of vascular health such as endothelial function and pulse wave velocity. However, the clinical evidence supporting the use of a single lipid-lowering nutraceutical or a combination of them is largely variable and, for many of the nutraceuticals, the evidence is very limited and, therefore, often debatable. The purpose of this position paper is to provide consensus-based recommendations for the optimal use of lipid-lowering nutraceuticals to manage dyslipidemia in patients who are still not on statin therapy, patients who are on statin or combination therapy but have not achieved lipid goals, and patients with statin intolerance. This statement is intended for physicians and other healthcare professionals engaged in the diagnosis and management of patients with lipid disorders, especially in the primary care setting. [ABSTRACT FROM AUTHOR]

Background. Pulmonary arterial dissection with chronic pulmonary arterial hypertension as its major cause is a very rare but life-threatening condition. In most cases the main pulmonary trunk is the affected site usually without involvement of its branches. Segmental or lobar pulmonary artery dissection is extremely rare. Case Presentation. We report a unique case of left lower lobe pulmonary artery dissection in a 70-year-old male, with confirmed chronic pulmonary hypertension. To confirm dissection MDCT pulmonary angiography was used. Multiplanar reformation (MPR) images in sagittal, coronal, oblique sagittal, and curved projections were generated. This case report presents morphologic CT features of rare chronic left lobar pulmonary artery dissection associated with chronic pulmonary hypertension at a place of localised pulmonary artery calcification. CT pulmonary angiography excluded signs of thromboembolism and potential motion or flow artefacts. Conclusion. To the best of our knowledge, no case of lower lobe pulmonary artery dissection with flap calcification has been reported yet. CT imaging of the chest is a key diagnostic tool that is able to detect an intimal flap and a false lumen within the pulmonary arterial tree and is preferred in differential diagnosis of rare complications of sustained pulmonary arterial hypertension. [ABSTRACT FROM AUTHOR]

The gradient produced by an HPLC is never the same as the one it is programmed to produce, but non-idealities in the gradient can be taken into account if they are measured. Such measurements are routine, yet only one general approach has been described to make them: both HPLC solvents are replaced with water, solvent B is spiked with 0.1% acetone, and the gradient is measured by UV absorbance. Despite the widespread use of this procedure, we found a number of problems and complications with it, mostly stemming from the fact that it measures the gradient under abnormal conditions (e.g. both solvents are water). It is also generally not amenable to MS detection, leaving those with only an MS detector no way to accurately measure their gradients. We describe a new approach called “Measure Your Gradient” that potentially solves these problems. One runs a test mixture containing 20 standards on a standard stationary phase and enters their gradient retention times into open-source software available at www.measureyourgradient.org . The software uses the retention times to back-calculate the gradient that was truly produced by the HPLC. Here we present a preliminary investigation of the new approach. We found that gradients measured this way are comparable to those measured by a more accurate, albeit impractical, version of the conventional approach. The new procedure worked with different gradients, flow rates, column lengths, inner diameters, on two different HPLCs, and with six different batches of the standard stationary phase. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to compare socioeconomic characteristics of the Roma population living in Roma settlements with the majority population. Moreover, it was aimed to assess socioeconomic differences in health and health-related behaviour within the population living in Roma settlements. Methods: Data from the cross-sectional HepaMeta study conducted in Slovakia in 2011 were used. The sample consisted of 452 Roma (mean age = 34.7; 35.2% men) and 403 non-Roma (mean age = 33.5; 45.9% men) respondents. Roma in selected settlements were recruited by local Roma community workers. Respondents from the major population were randomly selected from a list of patients from general practitioners. Data were collected via questionnaire, anthropometric measures and analysed blood samples. Differences in socioeconomic characteristics between the population living in Roma settlements and the majority population were tested using the chi-square test. The contribution of selected socio-economic characteristics on health and health-related behaviour of the population living in Roma settlements was assessed by logistic regression models adjusted for age and gender. Results: The population living in Roma settlements is characterised by significantly lower socioeconomic standards, and the living conditions are significantly worse compared with the majority. With few exceptions, the study did not confirm any significant association between socioeconomic indicators and health and health-related behaviour within the population living in Roma settlements. Conclusions: The deteriorating effect of living in Roma settlement on health and health-related behaviour seems to be immense regardless differences in socioeconomic characteristics or living condition within the settlement population. [ABSTRACT FROM AUTHOR]

Background: Viral hepatitis B and C prevalence in the Roma population of eastern Slovakia is largely unknown. This study aimed to explore the prevalence and associated risk factors of chronic viral hepatitis B and C among Roma living in segregated communities in eastern Slovakia. Methods: Data from the cross-sectional HepaMeta study conducted in Slovakia in 2011 among Roma living in rural communities were used. Participants were tested for the presence of HBsAg, anti-HBc IgG and anti-HCV. The risk factors were assessed mainly via a structured question- naire/interview. Results: Altogether 452 Roma were screened, and 11 were excluded due to missing data. A total of 441 patients were included (mean age 34.7 ± 9.14 years; 35.2% men). 12.5% of participants were HBsAg positive, 40.4% anti-HBc IgG positive while negative for HBsAg and 47.2% of participants were negative for all serological markers of hepatitis B. Hepatitis C prevalence was very low (0.7%), while 2 out of 3 anti-HCV positive participants were coinfected with hepatitis B. Risk factors for hepatitis B infection were male sex, higher age, tattoo, and previous imprisonment. No difference was found in intravenous drug use, blood transfusions and sexual behaviour. Conclusion: More than half of the Roma residing in eastern Slovakia have been infected at one point in life with the hepatitis B virus, and 12.5% are HBsAg positive. Hepatitis C prevalence is very low, which is probably due to very low intravenous drug use. [ABSTRACT FROM AUTHOR]

Background: The simultaneous presence of chronic hepatitis B (CHB) and metabolic syndrome (MS) in the high-risk Roma community constitutes a high risk for liver cirrhosis and potentially hepatocellular carcinoma. This study aims to explore the relationship between MS and CHB. Methods: Data from the cross-sectional HepaMeta Study conducted in Slovakia in 2011 among Roma living in rural communities were used. Participants were tested for the presence of MS, and lipid levels - total cholesterol, high density lipoproteins (HDL), low density lipoproteins (LDL), triglycerides (TG), apolipoprotein B100, and CHB HBsAg and anti-HBc IgG were also monitored. Viral load was measured in HBsAg-positive patients. Results: A total of 452 patients were screened; MS was diagnosed in 29.6% of patients, and 12.5% had CHB. Anti-HBc IgG antibodies were present in 52.8% of patients. CHB patients had lower levels of total cholesterol (5.45 ± 1.21 vs. 4.71 ± 1.23 mmol/I; p = 0.035), LDL cholesterol (median 2.2 mmol/l, interquartile range 0.88 mmol/l vs. 2.5 mmol/l, interquartile range 0.9 mmol/l; p = 0.01) and apolipoprotein B100 (median 0.66 mmol/l, interquartile range 0.26 mmol/l vs. 0.74 mmol/l, interquartile range 0.29 mmol/l; p = 0.025). Patients diagnosed with MS had a higher HBV DNA load than patients without MS (1,728.2 ± 14.33 IU/ml vs. 12,779.1 ± 20.9 IU/ml; p=0.037). CHB patients with TC and apolipoprotein B100 within the reference range had a lower hepatitis B DNA (HBV DNA) load than patients with high or low values of TC or apolipoprotein B100. Conclusion: The prevalence of chronic hepatitis B and simultaneous presence of MS was high among Roma. HBsAg-positive patients had lower levels of total and LDL cholesterol along with decreased apolipoprotein B100. The viral load of chronic hepatitis B patients with MS was higher than in patients without MS. [ABSTRACT FROM AUTHOR]

Background: Elevated gamma-glutamyl transpeptidase (GGT) is present approximately in half of all patients with non-alcoholic fatty liver disease (NAFLD). NAFLD is the liver manifestation of metabolic syndrome (MS). This study aimed to explore the relationship between GGT and MS or proinflammatory parameters. Methods: Data from the cross-sectional HepaMeta study conducted in Slovakia in 2011 among Roma living in rural communities were used. Participants (n =446) were divided into 2 groups; those with elevated GGT and those with normal GGT levels. MS was diagnosed according to the International Diabetes Federation criteria; presence of central obesity and low density lipoproteins (LDL) or high density lipoproteins (HDL), high triglycerides, hypertension, glucose intolerance or type 2 diabetes. Participants were tested for the presence of MS and its components, and biochemical tests for lipid levels (total cholesterol, HDL, LDL, TG) and inflammatory parameters (high sensitivity C-reactive protein - hs-CRP and ferritin) were performed. Results: Of 446 Roma participants, only 29 (6.5%) had GGT levels above the normal value. After exclusion of patients with viral hepatitis and alcohol abuse, patients with elevated GGT suffered from MS more often (p < 0.001), and patients with more MS components had a higher risk of elevated GGT. We found a significant association between GGT and the individual MS components, except HDL (waist circumference ≥ 94cm in men or 80 cm in women: p < 0.01; BMI > 30: p < 0.001; fasting glucose-> 5.6 mmol/l: p < 0.001; arterial hypertension: p < 0.05, and TAG > 1.7 mmol/l: p < 0.001). Patients with elevated GGT levels had also significantly higher hs-CRP (hs-CRP > 2 mg/l: p < 0.001; hs-CRP > 3 mg/l: p < 0.001) and ferritin (ferritin > 300 mg/l: p < 0.01) levels. Conclusion: Patients with MS have more significantly elevated levels of GGT. There is a significant association of GGT with individual MS components, except HDL and inflammatory parameters (hs-CRP, ferritin). [ABSTRACT FROM AUTHOR]

Objectives: Ethnic differences in the prevalence of various chronic diseases, including end-stage renal disease, have been previously reported. Surprisingly, data focusing on the lower grade of chronic kidney disease (CKD) are scarce. Thus, the aim of this study was to explore differences in the prevalence of nephropathy between the Roma and non-Roma populations. Methods: Data from the cross-sectional population based HepaMeta study conducted in Slovakia were used. Nephropathy was defined as: a known history of any kidney disease; or the presence of proteinuria/hematuria; or glomerular filtration rate (GFR) < 60 ml/min. The odds ratio for the prevalence of nephropathy was calculated using binary logistic regression. Results: In an age-adjusted model, Roma females had OR of 1.56 for having nephropathy over non-Roma females (OR 1.56; 95 % CI 1.01-2.42; p<0.05). In addition, Roma females had a significantly lower GFR (mean difference 3.4 ml/min, t=-3.58, p<0.001); all female patients with proteinuria were Roma. Conclusions: This cross-sectional study on the young general population found that Roma females have half-higher odds for nephropathy than non-Roma females. Therefore, to prevent risks we should focus on searching for ethnic, social and medical determinants of CKD. Interventions to decrease the incidence of CKD in the target population should also address ethnic inequalities as well as female gender. [ABSTRACT FROM AUTHOR]

Background: We aimed to study the occurrence of Chlamydia trachomatis infection in the population living in Roma settlements and to compare the obtained results with the prevalence in the majority population. Methods: We examined 340 people for the presence of bacterium C. trachomatis, 208 of them were Roma (66 men, 142 women) and 132 were from the majority population (75 men, 57 women). Respondents were aged 18-55 years (mean age = 33.44, STD = 9.57). The occurence of C. trachomatis was detected by direct proof of the pathogen by polymerase chain reaction (PCR). Results: Of 340 respondents included in the study, 22 (6.5%) showed positivity for C. trachomatis infection, 15 of them were Roma (7.2%) and 7 non-Roma (5.3%). The highest positivity was detected in Roma women (8.5%), while positivity in both non-Roma women and men was 5.3%, and in Roma men 4.5%. We did not confirm any significant contribution of age, gender or ethnicity to the occurrence of C. trachomatis infection. Conclusions: Despite the increased number of people with risk factors in the Roma community, no significant difference in the occurrence of C. trachomatis infection was found. Neither age nor gender contributes to the probability of C. trachomatis infection. Nevertheless, there are other health consequences which might be more pronounced among the population living in Roma settlements due to barriers to the health care and their lower ability to benefit from health care services provided. [ABSTRACT FROM AUTHOR]

Background: Obesity and overweight are major contributors to the global burden of chronic diseases and disability in both majority and minority populations. Methods: Data from the cross-sectional population-based HepaMeta study conducted in Slovakia in 2011 were used. The sample comprised a total of 452 Roma. Measurements of special bioactive mediators were taken in final groups consisting of 63 male Roma respondents (mean age = 32.59; SD = 8.63) and 117 female Roma respondents (mean age = 34.55; SD = 8.35). Respondents were divided into three groups: those with normal weight, those with overweight and obese. Values for anthropometric parameters, lipids parameters, C-reactive protein, TNF-α, IL-6, leptin, and adiponectin were determined. Results: 27.6% of examined Roma females and 26.9% of males were overweight. Obesity (BMI > 30.0 kg/m² appeared in a higher proportion of males (28.8%) compared with female (26.5%). Mean levels of total cholesterol, triacylglycerol and LDL-cholesterol were significantly elevated in the overweight and obese subjects compared to normal-weight Roma respondents. The relation was reversed for HDL-C level, with significantly decreased levels in both male and female obese Roma (p < 0.001). The concentration of adiponectin was significantly lower in obese subjects of both genders versus non-obese (Roma male p < 0.001, Roma female p < 0.05). Plasma levels of leptin, IL-6, hs-CRP as well as TNF-α increased in Roma significantly with increasing BMI. Conclusion: The study is the first one to provide data about selected biomarkers. Results may be useful in predicting obesity and its related diseases in the Roma population from the eastern part of Slovakia. [ABSTRACT FROM AUTHOR]

Background: Several studies have revealed a high prevalence of risk factors associated with unhealthy lifestyle among individuals with lower socioeconomic status. In Slovakia, one of the most socially and health-disadvantaged groups is the Roma minority. The aim of this study is to explore differences in physical activity, smoking and alcohol consumption between the population living in Roma settlements and the majority population in Slovakia. Methods: Data from the cross-sectional epidemiological HepaMeta study conducted in Slovakia in 2011 were used. The sample consisted of 452 Roma (mean age = 34.7; 35.2% men) and 403 non-Roma (mean age = 33.5; 45.9% men) respondents. The differences in health-related behaviour between the population living in Roma settlements and the majority population were analysed using logistic models separately for males and females. Results: These data show a clear difference between the population living in Roma settlements and the majority population with regard to leisure-time physical activity (only in women) and smoking, although not alcohol consumption. The prevalence of leisure-time physical activities such as walking or some other type of sport was significantly lower among Roma women than among non-Roma women. Men and women living in Roma settlements are more likely to smoke on a daily basis and they are heavier smokers in comparison with the majority population. HepaMeta study did not find differences in alcohol consumption between the Roma and non-Roma men. However, Roma women reported less frequent recent drinking and binge-drinking of 6 or more doses of alcohol on a single occasion. Conclusion: The higher prevalence of unhealthy lifestyle activities among Roma seem to contribute to these inequalities in cardiovascular diseases morbidity and mortality in comparison with the majority population. [ABSTRACT FROM AUTHOR]

Background: Roma represent one of the largest and oldest minorities in Europe. Health of many of them, particularly those living in settlements, is heavily compromised by poor dwelling, low educational level, unemployment, and poverty rooted in generational poverty, segregation and discrimination. The cross-sectional population-based study using community based approach aimed to map the prevalence of viral hepatitis B/C and metabolic syndrome in the population living in separated and segregated Roma settlements and to compare it with the occurrence of the same health indicators in the majority population, considering selected risk and protective factors of these health indicators. Methods: The sample consisted of 452 Roma (mean age = 34.7; 35.2% men) and 403 non-Roma (mean age = 33.5; 45.9% men) respondents. Data were collected in 2011 via questionnaire, anthropometric measures and analysed blood and urine samples. A methodology used in the study as well as in the following scientific papers is described in the Methods section (i.e. study design, procedures, samples, methods including questionnaire, anthropometric measurements, physical measurements, blood and urine measurements). Conclusions: There are regions of declining prosperity due to high unemployment, long-term problems with poverty and depleted resources. Populations living in these areas, i.e. in Central and Eastern Europe in Roma settlements, are at risk of poverty, social exclusion and other factors affecting health. Therefore, we should look for successful long-term strategies and tools (e.g. Roma mediators, terrain work) in order to improve the future prospects of these minorities. [ABSTRACT FROM AUTHOR]