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Objective: The study aimed to evaluate the clinical outcome of patients hospitalized for COVID-19 in two university hospitals in 2021-2022, define risk factors, and evaluate the effect of specific treatment procedures. Design: A multicentric retrospective study. Setting: Intensive care units. Material and methods: The study included all adult patients hospitalized for COVID-19. The demographic data, comorbidities, degree of vaccination, ventilatory support, and pharmacotherapy were recorded. The study aimed to determine the impacts of selected risk factors, pharmacotherapy, and vaccination against SARS-CoV-2 on the clinical outcome. Results: A total of 3,835 patients were included in the study; the median age was 71 years. 523 (13.6 %) patients died during hospitalization and 930 (24.3 %) patients died until 90 days after admission. Of patients treated with mechanical ventilation or ECMO, 53.4 % died until 90 days. Males had a higher mortality rate than women; 64.3 % died in the group with ventilatory support older than 65 years. Most patients (76.2 %) were not vaccinated against SARS-CoV-2; these patients accounted for 87.4 % of the deceased. Obesity, arterial hypertension, diabetes mellitus, coronary heart disease, and atrial fibrillation were the main risk factors for death, the risk increased with several comorbidities. The analyses showed a significant protective effect of vaccination against the risk of death, especially in the group of elderly patients with multiple comorbidities. The inconclusive impact of vaccination was apparent in the group of younger patients. Chronic pharmacotherapy with heparin, warfarin, antithrombotic agents, and corticoids increased the risk of death. Treatment with remdesivir and casivirimab/imdevimab reduced the risk of death in contrast to therapy with convalescent plasma and corticoids. Conclusion: The study demonstrated a significant protective effect of vaccination against severe course and death in hospitalized patients with COVID-19. In patients who developed a severe course of disease requiring mechanical ventilation and/or ECMO, the protective effect of vaccination is inconclusive. The main risk factors for an unfavourable clinical outcome were older age, male sex, and comorbidities (overweight, diabetes mellitus, hypertension, coronary artery diseases). [ABSTRACT FROM AUTHOR]

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Copyright of Remedia is the property of Medical Tribune CZ, s.r.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The results of the DELIVER (Dapagliflozin Evaluation to Improve the Lives of Patients with Preserved Ejection Fraction Heart Failure) trial were presented at the 2022 European Cardiology Congress. The trial tested the effect of dapagliflozin in patients with heart failure and preserved ejection fraction. A total of 6263 patients were randomised to placebo or dapagliflozin. Dapagliflozin significantly decreased worsening of heart failure or cardiovascular death rates. The latest data show that the mechanism of action of gliflozins is much broader than expected, especially the metabolic effect. This has been confirmed by the EMPEROR Preserved and DELIVER trials. Professor Braunwald called SGLT2 inhibitors the statins of the 21st century. [ABSTRACT FROM AUTHOR]

Background: Heart transplantation (HTx) is an established therapeutic method for a highly selected group of patients with terminal heart disease, unfavourable prognosis, and exploited options of pharmacological, device or surgical treatment. Morbidity and mortality of HTx recipients is determined by a variety of factors ranging from donor and recipient characteristics, peri-operative circumstances to risks of long-term immunosupressive treatment. There is a lack of data on survival and causes of death of HTx patients in the Slovak Republic. The aim of this paper was to analyse the survival and causes of death in patients who underwent HTx in the Slovak Republic. Patients and methods: The cohort consisted of 363 patients who underwent HTx at the National Cardiovascular Institute in Bratislava from March 21, 1998, to August 31, 2021. The patients are under a regular follow-up by the Centre, which keeps a registry of basic data. Recorded causes of death and selected indicators that are likely to influence the survival after HTx were analysed. Data that were not recorded in the registry were extracted from the available patient health records. Results: As of September 30, 2021, 144 (40%) of 363 patients died. Median survival of all HTx recipients was 14.8 (0 - 23) years. 30-day and one-year mortality rates were 9.6% and 17.1%, resp. The most common cause of death was non-specific graft failure (20%), followed by infection (15%) and sudden death (14%). Other causes included cardiac allograft vasculopathy (11%), malignancy (10%), and acute rejection (6%). In 24% of cases, the cause of death was represented by various and less common conditions (renal failure, bleeding, ileus, ischemic stroke, trauma, and other). In the early period (<30 days post-op, n = 35), graft failure, infection, and bleeding represented the main causes of death (57%, 14%, and 12%, resp.). From 30 days to 1 year (n = 27), infection and sudden death prevailed (44% and 19%, resp.). Sudden death, rejection, and malignancies were the dominant causes of death from 1 year to 5 years (n = 22; 50%, 23%, and 18%, resp.). After 5 years (n = 60), cardiac allograft vasculopathy, malignancies, and graft failure were responsible for most of the deaths (25%, 17%, and 11%, resp.). Recipients with a heart from donors = 40 years of age were statistically significantly less likely to survive than recipients with the graft from a younger donor (median 13.4 years vs. 14.5 years; p <0.05). No statistically significant differences in posttransplant survival depending on recipient's age, gender, primary diagnosis, pre-transplant left ventricular assist device implantation, and donor age and cause of death were found. Conclusion: Survival of the Slovak patients after HTx is comparable to international registries. The structure of causes of death is evolving with the time from surgery and reflects the dynamics of risk in particular periods after HTx. Our results document the high standard of long-term care of patients after HTx in the Slovak Republic. The main areas of potential improvement are immediate peri-operative graft and recipient care, prevention of sudden death, as well as prevention and early diagnosis of malignancies after HTx. [ABSTRACT FROM AUTHOR]

Pharmacological therapy for heart failure (HF) shows the strongest evidence in patients with reduced ejection fraction (HFrEF). The four drug pillars with proven mortality benefit in patients with HFrEF are as follows: a renin-angiotensin-aldosterone blocker (angiotensin receptor – neprilysin inhibitor should be preferred), a beta-blocker, a mineralocorticoid receptor antagonist, and a sodium-glucose cotransporter-2 inhibitor (SGLT2i). Furthermore, their early prescription reduces mortality more markedly. Optimally, they should be prescribed during hospitalization, after hemodynamic stabilization. The goal is to initialize all four drugs but strategy of drug selection, sequence of application and dosage adjustment should follow the individual patient profile. For the treatment of patients with HF with mildly reduced ejection fraction (EF) the same drugs as for HFrEF can be used, in spite of a weaker evidence of benefit. It has been confirmed recently that SGLT2i reduce mortality and hospitalization for HF in patients with HF with preserved ejection fraction. SGLT2i (dapagliflozin and empagliflozin) are drugs with prognostic benefit in patients with HF regardless of the left ventricular EF. Renin-angiotensin-aldosterone blockers, beta-blockers, and mineralocorticoid antagonists show weak evidence of benefit in patients with HF with preserved EF. Diuretics are indicated in all patients with HF and congestion to alleviate symptoms and to maintain euvolemic state. In patients with improved EF, including asymptomatic patients, as well as patients with normalized EF and chamber geometry, continuation of disease- modifying therapy is recommended to avoid relapse of the disease. [ABSTRACT FROM AUTHOR]

Aim: To assess the set of patients with infective endocarditis (IE) in Complex Cardiovascular Center (CCC) in Pilsen and evaluate changes in microbial spectrum and prognosis of patients. Methods: We used a retrospective analysis to identify 109 patients with the diagnosis of IE according to modified Duke criteria, who were hospitalised in CCC in Pilsen from May 2011 to April 2019. This eight-year time period was divided into two four-year intervals to compare the changes in the set of patients. Results: The study included 85 men and 24 women. 56 patients (51 %) had native valve endocarditis (NVE), 35 patients (32 %) had prosthetic valve endocarditis (PVE) and 18 patients (17 %) had cardiac device related infective endocarditis (CDRIE). In the PVE group, 8 mechanical and 27 biological prosthesis (including 2 cases of IE after transcatheter aortic valve implantation – TAVI) were affected. When comparing the periods of May 2011 to April 2015 with May 2015 to April 2019, we found out a 14 % increase in the number of patients with IE. The number of patients with NVE decreased significantly (35 vs. 21, p = 0,001), while the number of patients with PVE (10 vs. 25, statistically significant, p = 0,0131) and CDRIE (6 vs. 12, statistically non-significant, p = 0,3017) increased. Staphylococcus aureus remains the dominant pathogen in NVE and CDRIE group (32 % and 33 %, respectively), while in PVE patients there were more often identified coagulase negative Staphylococci as a causative microbial agent (31 %). The overall in-hospital mortality rate was 23 %, relatively lower in patients with NVE (16 %), on the contrary, significantly higher in patients with PVE (31 %) a CDRIE (28 %). Conclusion: This retrospective study confirms an increase of total incidence of infective endocarditis. The number of patients with NVE decreased significantly, while the number of patients with PVE and CDRIE increased. Patients with PVE and CDRIE also show higher mortality. The dominant pathogens are Staphylococcus aureus, coagulase negative Staphylococci and Enterococcus faecalis. [ABSTRACT FROM AUTHOR]

Background: Sodium-glucose cotransporter 2 inhibitors reduce the risk of hospitalisations for heart failure and reduced ejection fraction, but their effects in patients with heart failure and preserved ejection fraction are uncertain. The EMPEROR-Preserved study tested the effect of empagliflozin in patients with preserved ejection fraction. Methods: In this double-blind trial, we randomly assigned 5,988 patients with NYHA class II-IV heart failure and an ejection fraction > 40% to receive empagliflozin (10 mg once daily) or placebo in addition to recommended therapy. The primary outcome was a composite of cardiovascular death and hospitalisation for heart failure. Results: The median follow-up was 26.2 months, and the primary outcome occurred in 415 of 2,997 patients (13.8%) in the empagliflozin group and in 511 of 2,991 patients (17.1%) in the placebo group (p < 0.001). This effect was mainly related to a 29% decrease in the risk of hospitalisation for heart failure. The effect of empagliflozin on the primary outcome was consistent in patients with an ejection fraction < 50%, 50% to 60%, and ≥ 60%, regardless of the presence or absence of diabetes mellitus. The total number of hospitalisations for heart failure was lower in the empagliflozin group than in the placebo group (p < 0.001). The mortality rate was not affected. Conclusion: Empagliflozin reduced the hospitalisation rate for heart failure in patients with heart failure and preserved ejection fraction, regardless of the presence or absence of diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background. Heart failure affects about 64 million people worldwide, and despite the economic resources employed to improve its prognosis, mortality is still alarming. The aim of this study was to investigate the impact of patients' characteristics on survival probability during one-year follow-up after an index hospitalization for heart failure. Study design. A three-year retrospective study was conducted on the records of the Hospitals belonging the Local Health Unit of L'Aquila, a Healthcare Facility located in the centre of Italy. Methods. Patients admitted to hospital with a heart failure event as main diagnosis were selected and followed up for one year after their discharge to obtain data for survival analysis. Results. During the observational period for 1,929 patients hospitalized with a Heart failure index event, 1,655 (85.8%) of them were discharged alive and followed up for one year after the discharge. Fourteen percent of patients (n = 232) died for reasons related to Heart failure during the follow-up period. Fifty percent of them (n = 116), died within three months from the index hospitalization discharge. Age =75 years (HR 3.192, 95% CI 1.964-5.188), discharging to home (HR 0.399, 95% CI 0.297-0.536), length of stay =8 days during the index hospitalization (HR 1.533, 95% CI 1.163-2.019), and high education level (HR 0.517, 95% CI 0.273-0.977), were found to be associated with the survival probability. Conclusion. Study results indicate that older patients, especially those with a low educational level, those with longer index hospitalization, and those not sent directly to home, deserve more care and attention after discharge. [ABSTRACT FROM AUTHOR]

Background. Hip fracture injury is one of the principal health problems affecting the elderly. Patients reporting hip fractures often show relevant comorbidities leading to prolonged hospital stay, significant complications and higher mortality rates. This study aims to assess the risk factors associated with prolonged hospitalization after hip fracture, in-hospital mortality and transfers to other facilities. Study design. Retrospective cross-sectional study. Methods. The study considered all admissions performed between 2006 and 2015 in Abruzzo region, Italy. Logistic regression analyses were performed to evaluate odds ratios for each risk factor as predictor of in-hospital mortality, length of stay, and transfer to other facilities. Results. Age over 85 (OR=5.38) and cancer (OR=3.62) were identified as the strongest risk predictors for in hospital mortality; diabetes (OR=2.24) and heart failure (OR=1.57) were identified as predictors of prolonged length of stay and age over 85 (OR=1.38) and atrial fibrillation (OR=1.69) were identified as predictors of transfer to other facilities. Conclusions. With the rising incidence of hip fractures, identification of modifiable factors may help to reduce morbidity and mortality. [ABSTRACT FROM AUTHOR]

Introduction: Pigs without intestinal receptors for F4 fimbriae are congenitally resistant to F4 fimbriae-bearing enterotoxigenic Escherichia coli (ETEC F4). In general, 50 % and 100 % of piglets born to resistant (RR) sows crossed with hetero- or homozygous susceptible (SR, SS) boars, respectively, are susceptible but do not receive colostral antibodies against F4 fimbriae unless the sows have been vaccinated. The question arises as to whether resistant sows produce protective amounts of F4 antifimbrial antibodies after vaccination. The serum and colostrum antibody titres of 12 resistant and 12 susceptible vaccinated gilts were compared. The effect of the receptor status of the dam and sire on the preweaning performance of 5027 piglets was evaluated using Agroscope's recordings. The sows of the experimental herd, where ETEC F4 was circulating, were vaccinated against ETEC twice during the first pregnancy and once during each following pregnancy. The log2 transformed F4 antibody titres in the serum obtained after the second vaccine injection as well as in the colostrum of the 12 resistant animals were lower than the titres of the susceptible animals (serum: F4ab 11,19 ± 1,44 vs. 12,18 ± 1,33, P = 0,096; F4ac 10,03 ± 1,58 vs. 11,59 ± 1,43, P = 0,019; colostrum: F4ab 12,20 ± 2,41 vs. 14,02 ± 1,31, P = 0,033; F4ac 10,93 ± 2,46 vs. 13,03 ± 5,21, P = 0,006). The heat labile enterotoxin (LT) antibody titres after vaccination did not differ between susceptible and resistant animals (p > 0,10). Preweaning mortality in the offspring of RR sows × SS boars was slightly lower than in the offspring of SS sows × RR boars (P = 0,04), suggesting that the disease risk of susceptible piglets born to vaccinated resistant sows was not increased, even though they received colostrum with a slightly reduced content of antibody against F4 fimbriae.

Copyright of Giornale Italiano di Medicina del Lavoro ed Ergonomia is the property of Giornale Italiano di Medicina del Lavoro ed Ergonomia Editorial Board and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Remedia is the property of Medical Tribune CZ, s.r.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

According to recently published data, the incidence of infective endocarditis (IE) has been increasing, up to 15 cases per 100,000 population. Due to the still extremely high rate of complications and mortality, the diagnosis and treatment of IE require a comprehensive multidisciplinary approach, hence the role of the “Endocarditis Team” in the treatment of this disease is essential. The use of computed tomography (CT), magnetic resonance imaging (MRI), and nuclear imaging methods (18-FDG PET/CT and SPECT) plays an important role, as these imaging modalities have become part of the diagnostic criteria. Blood culture-negative endocarditis is documented in the Czech population in up to 25.5% of all IE cases and deserves further evaluation. Cardiac device- related infective endocarditis (CDRIE) is associated with significant mortality, morbidity, and financial burden. Due to the exponential growth of percutaneous interventions, we have also witnessed a significant increase in transcatheter aortic valve implantation-related IE (TAVI-IE) which is associated with a mortality rate of up to 36%. The POET trial has changed the view on the paradigm of antibiotic (ATB) treatment for IE, as it showed that, after the initial phase of intravenous treatment, as many as 25% of patients can complete IE treatment with oral ATB therapy at home. The importance of early surgery for patient survival is indisputable; failure to perform surgery in patients who meet the indication criteria for its performance is an independent predictor of overall mortality. [ABSTRACT FROM AUTHOR]

Copyright of Studia Pneumologica et Phthiseologica is the property of TRIOS, spol. sr.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: A pandemic caused by a new coronavirus particularly threatens the high risk groups of patients, incuding those with pulmonary arterial hypertension. We evaluated the occurrence of COVID-19 in the group of patients with pulmonary arterial hypertension (PAH), course of disease, mortality and the attitude of patients to vaccination. Data collection. During the period of two weeks before May 15th 2021 we collected, by analysis of documentation and telephone survey, data on adult patients managed from 01.03. 2020 to 15.05.2021 in 3 centers for PAH and the Children's Cardiac Centre. Information on deceased patients was provided by medical staff from the particular PAH centre. Results: Out of the total number of 168 adult patients (mean age of 54 ± 22 years, 121 females) 32 (19%) had COVID-19 infection during the first or second wave of the epidemic in Slovakia. During this time period 12 patients died and 1 one lung transplantation was performed. 3 of the 12 patients who died suffered from COVID-19 infection. Of the 32 patients infected 7 (21%) were hospitalized, 10 needed oxygen, one artifitial ventilation, and 3 (9%) patients died. Only 74 (47.7%) were vaccinated to date of data collection, although the availability of vaccination for this group of patients was not limited. Conclusion: Despite the fact that PAH is a severe lung and heart disease with a poor prognosis, the course of the disease and mortality were better than could be expected. Results are limited by low patient numbers, but 6% mortality in people with a mean age of 54 years may still be considered high. Vaccination is low despite good access to the vaccine and clear recommendations. Tab. 2, Ref. 15, on-line full text (Free, PDF) www.cardiologyletters.sk [ABSTRACT FROM AUTHOR]

Suspended particulate matter (PM) contributes significantly to airborne pollution, represents a significant risk of disease or premature death as confirmed by epidemiological studies and is also associated with economic losses in society. The review provides a comprehensive view of the physico-chemical characteristics of PM, the mechanism of its effects on the human body and summarises current information from exposure studies, epidemiological studies and experimental studies on animals. The article also summarises current possibilities and approaches available to international and national institutions as regards population health protection from the effects of particulate matter pollution, the expected further reduction of health-justified reference values and subsequent reduction of limits in the national legislation of individual states. [ABSTRACT FROM AUTHOR]

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Parkinson's disease (PD) is a neurodegenerative disease manifested by the triad of hypokineticrigid syndrome, postural instability and resting tremor. As a consequence of the aging of population, the incidence and prevalence of PD are increasing, and as the disease progresses, motor and autonomic symptoms and neuropsychiatric complications are increasing. Demographic description of the population in order to evaluate the reported hospitalization reasons and possible co-morbidities in a selected group of patients with the main diagnoses according to the International Classifi cation of Diseases (ICD-10): G20 (Parkinson's disease), G23.1, G23.2, G23.3 (Other degenerative diseases of basal ganglia) and G31.8 (Other specifi ed degenerative diseases of the nervous system) was the aim of this study. Methods: Retrospective data analysis using data from the National Health Information System (NZIS) and the National Register of Reimbursed Health Services (NRHZS). Analysis of epidemiological data to determine hospitalization reasons and possible co-morbidities in a selected group of patients with established diagnoses. Results: A total of 78,453 cases were identifi ed from the national registers in 2012-2018. From all hospitalizations of patients with follow-up diagnoses, the majority (58.1%) in 2017 were due to their main neurological diagnosis. From the other recurrent hospital admissions diagnosed upon admission, the most common were Other urinary tract diseases (N39) in 2.1% of patients. In 2012-2018, 39.5% of patients (N = 30,974) died because of the main follow-up diagnoses and, coronary heart disease was the most frequently reported cause of death in PD patients (20.4%). Conclusion: According to available data from the NZIS register, hospitalization reasons and causes of death reported according to ICD-10 in patients with Parkinson's disease were identifi ed. In 2017, most (58.1%) patients were admitted with a major neurological diagnosis. The most frequently reported cause of death between 2012 and 2018 in patients with PD was coronary heart disease (20.4%). [ABSTRACT FROM AUTHOR]

The National Registry of Cardiovascular Interventions (NRKI) is a prospective multicentre registry that collects data on all percutaneous coronary interventions (PCIs) performed from all PCI centers in the Czech Republic, prospectively since 2005. In the period 2005-2017, it is noticeable (approx. 14 %) an increase in the number of patients treated and PCIs performed. The proportion of men and women does not change substantially (70 : 30), the average age of patients is increasing, more for men than for women. PCI for ACS has been around 50 % in the long term, with primary PCI in the acute phase of STEMI around 6,000 patients annually - even the number of these procedures has not decreased by 2018. The most frequently intervened artery is LAD and then RCA, increasing is the number of interventions of the left main coronary artery. A gratifying fact is dominant transradial access to PCI (75 %) and usage of drug - eluting stents (over 95 % in 2018). The data on the overall mortality of patients (30 day and 1-year) are objectivized, with clinical manifestation of the disease (STEMI vs NSTE-AKS vs chronic CHD) and age of the patients playing the dominant role. [ABSTRACT FROM AUTHOR]

The article brings the results of a comparative study on the death toll of the Spanish influenza pandemic between September 1918 and April 1919. The study is based on the data of parish death registers. The analysis of the social aspect of the pandemic employed the classification of historical occupations (HISCO) and historical social classification (HISCLASS) schemes, developed by the International institute of social history in Amsterdam. After brief introduction of the two mentioned schemes the article continues with a discussion of the obtained r esults. The results display a good amount of conformance across the four locations under study as far as age specific mortality is concerned. The highest death toll shares have been observed among the populations of children and adults between 20 and 40 years of age. As far as social status is concerned, we were able to compare only three of the four locations, due to constraints of non-existing data. Blue-collar occupations have been more severely impacted as white collar occupations. Among blue-collar occupations a fair amount of variation across the three locations has been observed. The most noticeable in this regard has been the high portion of peasants in Koper in comparison to Ljubljana and Pula. [ABSTRACT FROM AUTHOR]

Objective: Presentation of the current knowledge of hypernatremia in terms of their causes, frequency and pathobiochemical connections in the development and treatment of these ion dysbalances. Study type: Synoptic Settings: Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine and General University Hospital, Prague Material and Methods: Based on the study of available literature, this survey describes the frequency, causes and risks of hypernatremia in critically ill. Some studies evaluate hypernatremia regardless of the time when it developed. Other differentiate whether it developed before hospitalization or later, during intensive care. Compensation of hypernatremia is described as well as the treatment. Results: The frequency of hypernatremia in three large cohorts of patients admitted to ICU of various specializations was between 2.0% and 6.9%. Its value is given by the increase in the relationship between Na+ supply and water in extracellular fluid (ECF). Hypernatremia causes an increase in osmolality in ECT. The following shift of intracellular fluid to ECF causes the dehydration of cells. These changes in brain cells cause a number of serious subjective and objective neurological symptoms. The brain compensates the disturbance by increasing the content of ions and small organic molecules in the cells. Binding of water to these particles enables at least partly to restore the size of brain cells and ameliorates the symptoms of the disturbance. The causes of hypernatremias developed before hospitalization as well as during intensive care are mentioned. Laboratory investigations enabling to differentiate the causes of the state are described. The effects of hypernatremia on metabolism and organ functions are presented. Significant relation of hypernatremia to many clinical complications and comorbidities is described as well as its causes in the elderly are mentioned. Therapeutic procedures and correction time limits are described. Conclusion: Although hypernatremia is often in relation to many other severe clinical situations and organ dysfunctions, it is a significant, independent predictor of mortality. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Central European Agriculture is the property of Journal of Central European Agriculture and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The effect of different light conditions (100%, 50-60% and 20-30% of full light) and different irrigation regimes (480, 360, 240 and 120 mm during vegetation season) on the emergence, growth, survival and root characteristics of Scots pine (Pinus sylvestris L.) seedlings of 5 Czech provenances was investigated. Full-light conditions resulted in the lowest survival rates (10-25%) across all irrigation variants, while the highest survival rates (50-70%) were found in semi-shade conditions for all considered provenances. Generally, the root lengths, shoot dry mass and root dry mass were the highest in full-light conditions, on the contrary the shoot-root ratios for boThthe above and below ground plant lengths (0.19-0.35 in full-light versus 0.70-0.83 in full-shade conditions; F(11, 108) = 92,6; p < 0,001) and dry mass (1.1-2.1 in full-light versus 3.3-4.9 in full-shade conditions; F(11, 108) = 146.1; p < 0,001) were the lowest. Conditions resembling shelterwood regeneration were more favourable for seedling emergence, root characteristics were more favourable in conditions simulating clear-cutting. [ABSTRACT FROM AUTHOR]

The aim of this work was to evaluate the development of production characteristics and healThstatus of young spruce stand in the area of the Nízký Jeseník Mts. (Czech Republic). Research was conducted in the period 2016-2018 on 12 sub-plots established in the spruce stand at the age of 19 years. Diameter and height increments and derived production characteristics were monitored along wiThdefoliation, biotic damage and mortality rates. In addition, a prediction of stand development was carried out using a linear regression model. Between 2016 and 2018, the decrease of the stand basal area was recorded from 24.7 to 24.1 m2/ha. Annual diameter increments slowed down from 0.5 cm to 0.4 cm and height increments from 0.59 to 0.24 m. Volume increments decreased from 6.86 to 3.12 m3/ha. Cumulative mortality reached 24.1% in 2018, which means an increase of 13.9% compared to 2015. Defoliation increased from 25.8% in 2016 to 30.5% in 2018. The terminal mortality factor causing the current dieback of mature spruce stands in the Northern Moravia is bark beetle (Ips sp.). In the case of younger stands, decline can occur as a result of the effect of phytopathogens, especially Armillaria sp. that fundamentally affects the functionality of the root system and disturbs an uptake of water and nutrients. This effect is currently intensified by drought episodes. Changes in the tree species composition aimed at increase of the proportion of improving and stabilizing tree species in combination wiThchemical amelioration are a way to preserve the production function of the forest on sites currently severely damaged. [ABSTRACT FROM AUTHOR]

The ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes after an Acute Coronary Syndrome during Treatment with Alirocumab) study compared alirocumab with placebo in 18 924 patients after acute coronary syndrome, where all patients had excellent secondary preventive treatment (maximum-tolerated statin treatment included). Alirocumab reduced the first occurrence of the primary composite endpoint [first cardiovascular (CV) events/mortality]. In this analysis the benefit of alirocumab treatment was evaluated on all CV events/mortality. These events were included: nonfatal myocardial infarction, non-fatal stroke, unstable angina pectoris with hospitalization, heart failure with hospitalization, ischemia-driven coronary revasculatization. The joint semiparametric model was used for analysis, as it allows us to evaluate the occurrence of many non-fatal CV events in a given patient, while simultaneously adjusting for possible informative censoring of the non-fatal event process by death. Results: a) There were 3064 "first" CV events/deaths and in the alirocumab treatment arm these were 190 less than in the placebo arm. b) There were 5425 "total" CV events/deaths and in the alirocumab treatment arm there were 385 events less. c) Alirocumab reduced total non-fatal CV events by the relative risk (RR) of 0.87 (CI: 0.82 - 0.93) and d) deaths by RR 0.83 (CI: 0.71 - 0.97). e) There was a strong association between non-fatal and fatal risk events. In the ODYSSEY OUTCOMES study there was a total occurrence of CV events/deaths twice as frequent as the occurrence of first events/deaths. The benefit of alirocumab treatment is better evaluated here when we focus more on total CV events/deaths. [ABSTRACT FROM AUTHOR]

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Copyright of Collected Papers of the Law Faculty of the University of Rijeka / Zbornik Pravnog Fakulteta Sveučilišta u Rijeci is the property of Pravni fakultet Sveucilista u Rijeci and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Medicina del Lavoro is the property of Mattioli 1885 SpA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Il DOPPS (Dialysis Outcomes and Practice Patterns Study) - ampio studio internazionale, prospettico, osservazionale – è iniziato nel 1996 per raccogliere i dati di un vasto campione di pazienti emodializzati con l'obiettivo di migliorare la terapia, la pratica dialitica ed ovviamente la loro qualità di vita. Lo studio DOPPS ha mostrato come i pazienti emodializzati presentino una qualità di vita molto inferiore rispetto ai soggetti di pari età, in tutte le sue diverse componenti (fisica, mentale e legata alla malattia renale cronica), oltre che una maggior prevalenza di sintomatologia depressiva. È inoltre emerso come alcuni fattori socioeconomici (tra cui la disoccupazione, un ridotto livello di formazione, uno scarso supporto sociale familiare e di staff dialitico) e medici (quali l'utilizzo di un catetere venoso centrale, bassi livelli di emoglobina ed albumina, una scarsa qualità del sonno) siano associati a una più bassa qualità della vita. Il DOPPS ha messo in evidenza l'associazione tra più bassi indici di qualità della vita e peggiori outcome clinici, in termini di ospedalizzazione e mortalità, permettendo pertanto di individuare i soggetti “più fragili” dal punto di vista fisico, sociale e clinico su cui intervenire in maniera specifica. Oggigiorno il DOPPS rappresenta, anche nel campo della valutazione della qualità della vita, un importante riferimento scientifico, che dimostra come uno studio osservazionale, eseguito in accordo ad adeguati criteri metodologici, possa diventare uno strumento informativo, credibile e capace di suggerire nuove ipotesi da testare in successivi studi clinici controllati.

Copyright of La Medicina del Lavoro is the property of Mattioli 1885 SpA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Elevated LDL cholesterol (LDL-C) concentration is an independent risk factor for cardiovascular morbidity and mortality aimed at by numerous therapeutic interventions. However, despite maximum possible treatment with statins, a wide range of patients fail to reach satisfactory control. It is these patients who can now be offered modern treatment with proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors. The FOURIER trial involved 27,564 patients with established cardiovascular disease treated with a maximum tolerated statin dose who were randomized to receive evalocumab or placebo. The reduction in LDL cholesterol levels with evalocumab was 59 %, from a median of 90 mg/dL to 30 mg/dL, i.e. approximately 0.8 mmol/L. The primary end point (myocardial infarction, stroke, hospitalization for angina pectoris, revascularization and/or death) was reduced from 14.6 % to 12.6 % (p < 0.0001), and the key secondary end point (death, myocardial infarction, and stroke) from 9.9 % to 7.9 % (p < 0.0001). There was no effect on all-cause mortality (2.5 % vs. 2.4 %); there was a significant reduction in myocardial infarction rate (4.4 % vs 6.3 %) and stroke rate (2.2 % vs. 2.6 %). It made no difference whether patients received one dose in 2 weeks or one in 4 weeks. No significant differences between adverse effects were reported. The Ebbinghaus substudy showed no negative effect on neurocognitive function. [ABSTRACT FROM AUTHOR]

Copyright of Summa, Animali da Reddito is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Medicina del Lavoro is the property of Mattioli 1885 SpA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction and aim of study: The Czech perinatal care centers created in 2015 the Czech Neonatal Network within the international neonatal network eNewborn. This network is based on the database system into which data on a group of high-risk newborns are entered. The aim of this work was to determine survival and neonatal morbidity in extremely premature neonates born between 22 and 27 gestational weeks in the Czech Republic. Methods: Evaluation of individual data from the eNewborn database on mortality and morbidity in newborns with gestational age )27+6 from years 2015 and 2016. Results: During study period, 728 live births were evaluated in the 22 to 27 gestational weeks. Study group mortality was 23%, ranging from 77% in the 22 gestational week to 4% in the 27 gestational week. At discharge from hospital, 20% of surviving children had a moderate or severe BPD and 8% had a severe retinopathy of prematurity. The combined outcome of a moderate or severe BPD and death rate was 43% across the group, but severity of individual morbidities increased significantly with declining gestational age. Conclusion: The nationwide outcomes of a group of extremely preterm newborns point to the heterogeneity of this group where the risk of both death and serious complications is most strongly associated with the decreasing gestational age. [ABSTRACT FROM AUTHOR]

The combination sacubitril/valsartan is the first drug from the angiotenzin receptor blocker and neprilysin inhibitor group (ARNI). The PARAGIM‑HF study is the largest study ever in patients with heart failure with reduced left ventricle ejection fraction. The ARNI was superior to enalapril not only in the primary outcome of the study - cardiovascular mortality and hospitalization for heart failure but also in total mortality and other followed parameters. The new treatment is well tolerated and changes the natural course of heart failure. The new knowledge was implemented in guidelines for heart failure. [ABSTRACT FROM AUTHOR]

BACKGROUND: The harmful use of alcohol causes almost 6% of deaths worldwide and is related to more than 200 diseases. The most frequent causes of death in people with alcohol use disorders are diseases of the gastro-intestinal tract and cancer. External causes are particularly common among men. These persons die prematurely in comparison with the general population. AIMS: To analyse the structure of the mortality of persons hospitalised for alcohol use disorders in 1994-2013 and to calculate these persons' potential years of life lost. METHODS: A database-linkage study of data from the National Registry of Hospitalised Patients and from the Deaths Information System was performed. In the National Registry of Hospitalised Patients, 204,807 hospitalisations of 90,376 persons with the primary diagnosis F10 were identified in the period 1994-2013. Of those, 25,815 people died. RESULTS: Almost 83% of those 25,815 patients were economically active. The most frequent causes of death in this group included liver diseases (18%), diseases of the circulatory system (15%), malignant neoplasms (7%), and disorders caused by the use of alcohol (3%). External causes (24%) most often involved random accidents (13%). Suicides were also high in numbers. The potential years of life lost (PYLL) indicator showed that 24.2 years were lost in one economically active person. CONCLUSION: Most persons who died were economically active. Liver diseases, cardiovascular diseases, tumours, and external causes were the most frequent causes of death. More than 24 years were lost in one economically active person. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Spatial distribution of mortality from pleural mesothelioma (which in the ICD-10 Revision has a specific code: C45.0) in Italy for the period 2003-2009 is described. Previous mortality studies at national level employed the topographic code "Malignant neoplasms of pleura", because of unavailability of a specific code in ICD-9 Revision for pleural mesothelioma. METHODS: Standardized mortality ratios were computed for all municipalities, using each regional population as reference; for municipalities in Regions with rate higher than the national rate, the latter has been used as reference. SMRs were computed specifically also for each Italian Polluted Sites "of national concern for environmental remediation" (IPS) with asbestos exposure sources, composed by one or more municipalities, using regional rate as reference. Spatial Scan Statistics procedure, using SatScan software, was applied in cluster analysis: the country was divided into geographic macro-areas and the relative risks (RR) express the ratio of risk within the cluster to the risk of the macro-area outside the cluster. Clusters with p-value < 0.10 were selected. RESULTS: The national standardized annual mortality rate was 1.7 cases per 100 000. Several areas with evident burden of asbestos-related disease were detected. Significant clusters were found in correspondence to asbestos-cement industries (e.g. Casale Monferrato, women: RR = 28.7), shipyards (e.g. Trieste, men: RR = 4.8), petrochemical industries (e.g. Priolo, men: RR = 6.9) and a stone quarry contaminated by fluoro-edenite fibres (Biancavilla, women: RR = 25.9). Some of the increased clusters correspond to IPS. CONCLUSIONS: The results may contribute to detect asbestos exposure and to set priorites for environmental remediation.

The objective of the thesis was to describe the trend of patients suffering from Idiopathic Pulmonary Fibrosis being treated with Pirfenidone at the regional reference center for rare lung diseases of the AOUS. All patients with IPF treated with Pirfenidone were retrospectively enrolled at the Siena Regional Reference Center from 2011 to 2019. Serial examinations, performed every 12 months, of all clinical and functional parameters and, if available, the parameters of the pulmonary function test 1 year before the start of antifibrotic therapy. A systematic review was performed on survival, causes of mortality, and treatment-related side effects of patients with IPF. A decrease greater than or equal to 10% of the FVC was considered as functional loss. A total of 139 patients were included in the study. On average, lung function at baseline showed a restrictive deficit in lung volumes with a moderate reduction in Dlco, the latter available for 105 patients who were able to perform the test and not treated with oxygen therapy. 13 patients had advanced disease stage (FVC <50% and / or DCLO <35%). The retrospective study in a real setting shows that the drug reduces progression and improves life expectancy with acceptable tolerability even in subjects with severe functional impairment. [ABSTRACT FROM AUTHOR]