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Favalli EG, Favalli A, Andrea G, Maioli G, Zagato E, Bombaci M, Pesce E, Donnici L, Gruarin P, Biggioggero M, Curti S, Manganaro L, Marchisio E, Bevilacqua V, Martinovic M, Fabbris T, Sarnicola ML, Crosti M, Marongiu L, Granucci F, Notabartolo S, Bandera A, Gori A, De Francesco R, Abrignani S, Caporali R, Grifantini R. POS0254 IMMUNE RESPONSE TO SARS-CoV-2 INFECTION IN PATIENTS WITH RHEUMATIC MUSCULOSKELETAL DISEASES: THE MAINSTREAM STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundRheumatic musculoskeletal diseases (RMD) are pathological conditions characterized by an impaired immunological system that is determinant both in the pathogenesis and in the inadequate response to infections. The use of disease-modifying anti-rheumatic drugs (DMARDs), which include conventional synthetic (cs) or biologic and targeted synthetic (b/ts) DMARDs, contribute to compromise immunological reactivity.ObjectivesTo analyze the immune response to SARS-CoV-2 in patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA) receiving treatment with DMARDs and to investigate the effect of the different classes of drugs on humoral and cellular response.MethodsPatients were tested for anti-SARS-CoV-2 IgG, IgM and IgA antibodies to nucleoprotein (N) and receptor-binding domain (RBD) through ELISA and neutralization assays. Then, we performed a flow cytometry analysis of monocytes, NK cells, B and T lymphocytes from PBMCs of serologically positive patients. We also included a cohort of non-RMD individuals recovered from COVID-19 as a reference group of non-immunosuppressed subjects. A first recruitment occurred in May-June 2020 (T1) and a second recruitment, 3-4 months after (T2), allowed to evaluate the persistence of the antibody response over time and to investigate the cellular immune response to SARS-CoV-2 in RMD patients having resolved the infection.ResultsDuring T1, 358 patients with RA (n=200) or SpA (n=158) were recruited. Mean age was 52.8, 64% were female. All patients were treated with DMARDs, 299 with b/tsDMARDs and 59 received csDMARDs alone. One third was also receiving corticosteroids (CS). At T2, 36 subjects were recruited. We found a seroprevalence rate of 18.4%, which did not significantly differ between RA and SpA groups, and between patients treated with b/ts-DMARD or csDMARDs, either alone or in combination with CS (Table 1). Antibody levels of RMD patients were lower than non-RMD individuals (Figure 1), with CTLA4-Ig-treated patients having the lowest IgG levels. This difference was less marked in symptomatic RMD patients. 72% of seropositive patients elicited neutralizing sera. Despite an overall decrease in anti-RBD and anti-N titers, more than two-third of patients maintained antibodies titers above positivity threshold at T2. Concerning cellular response, we found that CD8+ T-cells frequency was overall comparable between RMD and non-RMD convalescents, and did not differ in b- or cs-DMARD treated ones. Conversely, CD4+ T-cell frequencies were significantly lower in RMD patients, especially those treated with anti-IL6R and CTLA4-Ig. B-cell subpopulations (class-switched, memory, and IgG+ memory B-cells) had sustained frequencies in anti-TNFα treated patients, while they had a trend of reduction in patients treated with anti-IL6R and CTLA4-Ig.Table 1.Anti-RBD seroprevalenceTotalSeropositive, n(%)IgM (n)(%)IgG (n)(%)IgA (n)(%)COVID19 symptomatic772532.51924.71722.11722.1COVID19 asymptomatic2814114.6*238.2*134.6 *269.3*RA20036192311.520102713.5SpA15830191912106.31610.1b/ts-DMARD2995518.43511.72483612cs-DMARD591118.6711.9610.2711.9csDMARD+b/tsDMARD1122623.287.187.198a-TNFa1733721.42514.5169.12112.1a-IL-6R35822.9514.3617.1822.9CTLA4-Ig42511.937.112.447.1*P value < 0,005Figure 1.Magnitude of the anti-RBD and anti-N antibody responseConclusionOur data provide a comprehensive picture of the humoral and cellular immune responses to SARS-CoV-2 infection in RMD patients. We showed that DMARDs treatments did not alter a successful antibody response to the virus and did not hamper the antibody neutralizing ability. However, the magnitude of antibody response was slightly reduced compared to non-RMD individuals, especially in patients receiving CTLA4-Ig. We did not observe marked differences in the B- and T-cell populations between RMD patients compared to non-RMD individuals. However, in patients receiving anti-TNFα we found a higher relative abundance of effector adaptive population compared to other bDMARDs.AcknowledgementsThe project was co-financed by Lombardy 2014-2020 Operational Program under the European Regional Development Fund.Disclosure of InterestsNone declared
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Mikolasevic I, Rahelic D, Turk-Wensween T, Ruzic A, Domislovic V, Hauser G, Matic T, Radic-Kristo D, Krznaric Z, Radic M, Filipec Kanizaj T, Martinovic M, Jerkic H, Medjimurec M, Targher G. Significant liver fibrosis, as assessed by fibroscan, is independently associated with chronic vascular complications of type 2 diabetes: A multicenter study. Diabetes Res Clin Pract 2021; 177:108884. [PMID: 34082054 DOI: 10.1016/j.diabres.2021.108884] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/10/2021] [Accepted: 05/28/2021] [Indexed: 02/07/2023]
Abstract
AIMS The aim of this study was to investigate whether controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), as assessed by vibration-controlled transient elastography (VCTE), are associated with chronic vascular complications of diabetes mellitus type 2 (T2DM). METHODS We studied 442 outpatients with established T2DM, and who underwent VCTE and extensive assessment of chronic vascular complications of diabetes. RESULTS A quarter of analyzed patients had a previous history of myocardial infarction and/or ischemic stroke, and about half of them had at least one microvascular complication (chronic kidney disease (CKD), retinopathy or polyneuropathy). The prevalence of liver steatosis (i.e., CAP ≥ 238 dB/m) and significant liver fibrosis (i.e., LSM ≥ 7.0/6.2 kPa) was 84.2% and 46.6%, respectively. Significant liver fibrosis was associated with an increased likelihood of having myocardial infarction (adjusted-odds ratio 6.61, 95%CI 1.66-37.4), peripheral polyneuropathy (adjusted-OR 4.55, 95%CI 1.25-16.6), CKD (adjusted-OR 4.54, 95%CI 1.24-16.6) or retinopathy (adjusted-OR 1.81, 95%CI 1.62-1.97), independently of cardiometabolic risk factors, diabetes-related variables, and other potential confounders. Liver steatosis was not independently associated with any macro-/microvascular diabetic complications. CONCLUSIONS Significant liver fibrosis is strongly associated with the presence of macro-/microvascular complications in patients with T2DM. These results offer a new perspective on the follow-up of people with T2DM.
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Affiliation(s)
- I Mikolasevic
- Department of Gastroenterology, University Hospital Center Rijeka, Rijeka, Croatia; Department of Gastroenterology, University Hospital Merkur, Zagreb, Croatia; Faculty of Medicine, Rijeka, Croatia.
| | - D Rahelic
- Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia; University of Zagreb Faculty of Medicine, Zagreb, Croatia; University of Osijek Faculty of Medicine, Osijek, Croatia
| | - T Turk-Wensween
- Faculty of Medicine, Rijeka, Croatia; Center for Diabetes, Endocrinology and Cardiometabolism, Thallassotherapia, Opatija, Croatia
| | - A Ruzic
- Faculty of Medicine, Rijeka, Croatia; Clinic for Cardiology, University Hospital Center Rijeka, Rijeka, Croatia
| | - V Domislovic
- Department for Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb, Croatia
| | - G Hauser
- Department of Gastroenterology, University Hospital Center Rijeka, Rijeka, Croatia; Faculty of Medicine, Rijeka, Croatia; Faculty of Health Studies, Rijeka, Croatia
| | - T Matic
- Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia
| | - D Radic-Kristo
- University of Zagreb Faculty of Medicine, Zagreb, Croatia; Department of Hematology, University Hospital Merkur, Zagreb, Croatia
| | - Z Krznaric
- University of Zagreb Faculty of Medicine, Zagreb, Croatia; Department for Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb, Croatia
| | - M Radic
- University of Zagreb Faculty of Medicine, Zagreb, Croatia
| | - T Filipec Kanizaj
- Department of Gastroenterology, University Hospital Merkur, Zagreb, Croatia; University of Zagreb Faculty of Medicine, Zagreb, Croatia
| | - M Martinovic
- Department of Hematology, University Hospital Merkur, Zagreb, Croatia
| | - H Jerkic
- Department of Cardiology, University Hospital Merkur, Zagreb, Croatia
| | | | - G Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Italy
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Favalli EG, Maioli G, Bombaci M, Biggioggero M, Favalli A, Agape E, Andrea G, Pesce E, Zagato E, Fabbris T, Martinovic M, Marchisio E, Abrignani S, Grifantini R, Caporali R. POS0048 SEROPREVALENCE OF ANTI-SARS-COV-2 ANTIBODIES IN RHEUMATIC PATIENTS TREATED WITH BIOLOGICAL AND TARGETED THERAPY LIVING IN LOMBARDY, ITALY (MAINSTREAM PROJECT). Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Emerging observational data have shown that rheumatic patients seem not to be more susceptible to SARS-CoV-2 infection neither to worse outcomes. However, the true prevalence of COVID19 is still unknown due to the high proportion of subclinical infection. In this scenario, measuring the seroprevalence of SARS-CoV-2 may be crucial to improve the knowledge about the impact of COVID19 in rheumatic patients.Objectives:To estimate in a COVID19 high-endemic area (Lombardy, Italy) the prevalence of anti-SARS-CoV-2 antibodies in a large cohort of patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA) treated with biologic (b-) or targeted synthetic (ts-) disease modifying drugs (DMARDs).Methods:A seroprevalence cross-sectional study was conducted in the period between 4th May and 16th June 2020, including patients with confirmed RA or SpA treated with b- or tsDMARDs. Patients were tested for anti-SARS-CoV-2 IgG, IgM and IgA antibodies against main viral antigens (nucleoprotein [N], spike 1 [S1], receptor-binding domain [RBD]) using ELISA. These data were compared with those observed in the healthy population in the same period and region. Patients also answered a questionnaire on history of symptoms consistent with COVID19, risk factors and comorbidities. Serological response to RBD was evaluated according to symptom severity (asymptomatic, minor, or major [respiratory and fever >37.5°C] symptoms).Results:The study population included 300 patients (62% females, mean age 53 years, 20% over 65 years old) diagnosed with RA (56%), psoriatic arthritis (23%), or ankylosing spondylitis (21%), treated with anti-TNF (57%), abatacept (20%), anti-IL6 (11%), or JAK inhibitors (5%). Four patients (1.3%) referred a prior diagnosis of COVID19 defined by nasopharyngeal swab. Immunoglobulin titers were evaluated resulting in 9%, 13.6%, and 13.3% positive patients for IgG, IgM and IgA, respectively (Table 1), with no significant difference to the healthy population. Among seropositive patients, 55.3% were asymptomatic, 16% had minor and 19.6% major symptoms, 7.1% were hospitalized. No deaths or admission to intensive care units occurred. IgM, IgG and IgA titers to RBD were higher in patients with both minor and major symptoms compared with asymptomatic ones (Figure 1). No differences were found between seronegative and seropositive patients in relation to age, sex, rheumatic diagnosis, and treatments with b- or tsDMARDs. A relative lower risk of seropositivity was observed in patients receiving concomitant methotrexate (RR 0.49, 95% CI 0.25-0.94; p 0.04), while an increased risk was associated with obesity (RR 2.33, 95% CI 1.26-3.79; p 0.019) and presence of at least 2 comorbidities (RR 1.94, 95% CI 1.11-3.15; p 0.037). Corticosteroids use was numerically more frequent in seropositive than seronegative patients (18% vs 14%).Conclusion:This study confirms that, even in a cohort of rheumatic patients, the spread of SARS-CoV-2 infection is much greater than that observed by capturing only swab-diagnosed COVID19 cases. The underlying rheumatic disease and ongoing therapy with b/ts-DMARDs do not seem to impact SARS-CoV-2 antibody positivity, which conversely seems to be proportional to the intensity of COVID19 symptoms and less frequent in patients receiving concomitant methotrexate. The project was co-financed by Lombardy Region 2014-2020 Regional Operational Programme under the European Regional Development Fund.Table 1.Prevalence of specific anti-SARS-CoV-2 antibodies.AntibodiesPosivite(n)Seroprevalence (%)(95% CI)IgG279%(6.2 – 12.7)IgG anti-N268.6%(5.9 – 12.3)IgG anti-RBD206.6%(4.3 – 10)IgG anti-S1186%(3.8 – 9.2)IgM4113.6%(10.2 – 18)IgM anti-N3511.6%(8.5 – 15.7)IgM anti-RBD258.3%(5.7 – 12)IgA4013.3%(9.9 – 17.6)IgA anti-N3712.3%(9.0 – 16.5)IgA anti-RBD258.3%(5.7 – 12)IgG+IgM237.6%(5.1 – 11.2)IgG+IgM+IgA227.3%(4.9 – 10.5)IgG+IgA248%(5.4 – 11.6)IgG/IgM/IgA5618.6%(14.6 – 23.4)Figure 1.Antibody levels (S/Co) against SARS-CoV-2 RBD.Disclosure of Interests:None declared.
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Kasper JC, Bale SD, Belcher JW, Berthomier M, Case AW, Chandran BDG, Curtis DW, Gallagher D, Gary SP, Golub L, Halekas JS, Ho GC, Horbury TS, Hu Q, Huang J, Klein KG, Korreck KE, Larson DE, Livi R, Maruca B, Lavraud B, Louarn P, Maksimovic M, Martinovic M, McGinnis D, Pogorelov NV, Richardson JD, Skoug RM, Steinberg JT, Stevens ML, Szabo A, Velli M, Whittlesey PL, Wright KH, Zank GP, MacDowall RJ, McComas DJ, McNutt RL, Pulupa M, Raouafi NE, Schwadron NA. Alfvénic velocity spikes and rotational flows in the near-Sun solar wind. Nature 2019; 576:228-231. [PMID: 31802006 DOI: 10.1038/s41586-019-1813-z] [Citation(s) in RCA: 216] [Impact Index Per Article: 43.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/17/2019] [Indexed: 11/09/2022]
Abstract
The prediction of a supersonic solar wind1 was first confirmed by spacecraft near Earth2,3 and later by spacecraft at heliocentric distances as small as 62 solar radii4. These missions showed that plasma accelerates as it emerges from the corona, aided by unidentified processes that transport energy outwards from the Sun before depositing it in the wind. Alfvénic fluctuations are a promising candidate for such a process because they are seen in the corona and solar wind and contain considerable energy5-7. Magnetic tension forces the corona to co-rotate with the Sun, but any residual rotation far from the Sun reported until now has been much smaller than the amplitude of waves and deflections from interacting wind streams8. Here we report observations of solar-wind plasma at heliocentric distances of about 35 solar radii9-11, well within the distance at which stream interactions become important. We find that Alfvén waves organize into structured velocity spikes with duration of up to minutes, which are associated with propagating S-like bends in the magnetic-field lines. We detect an increasing rotational component to the flow velocity of the solar wind around the Sun, peaking at 35 to 50 kilometres per second-considerably above the amplitude of the waves. These flows exceed classical velocity predictions of a few kilometres per second, challenging models of circulation in the corona and calling into question our understanding of how stars lose angular momentum and spin down as they age12-14.
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Affiliation(s)
- J C Kasper
- Climate and Space Sciences and Engineering, University of Michigan, Ann Arbor, MI, USA. .,Smithsonian Astrophysical Observatory, Cambridge, MA, USA.
| | - S D Bale
- Physics Department, University of California, Berkeley, CA, USA.,Space Sciences Laboratory, University of California, Berkeley, CA, USA.,The Blackett Laboratory, Imperial College London, London, UK
| | - J W Belcher
- Kavli Center for Astrophysics and Space Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - M Berthomier
- Laboratoire de Physique des Plasmas, CNRS, Sorbonne Université, Ecole Polytechnique, Observatoire de Paris, Université Paris-Saclay, Paris, France
| | - A W Case
- Smithsonian Astrophysical Observatory, Cambridge, MA, USA
| | - B D G Chandran
- Department of Physics and Astronomy, University of New Hampshire, Durham, NH, USA.,Space Science Center, University of New Hampshire, Durham, NH, USA
| | - D W Curtis
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - D Gallagher
- Heliophysics and Planetary Science Branch ST13, Marshall Space Flight Center, Huntsville, AL, USA
| | - S P Gary
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - L Golub
- Smithsonian Astrophysical Observatory, Cambridge, MA, USA
| | - J S Halekas
- Department of Physics and Astronomy, University of Iowa, IA, USA
| | - G C Ho
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - T S Horbury
- The Blackett Laboratory, Imperial College London, London, UK
| | - Q Hu
- Department of Space Science and Center for Space Plasma and Aeronomic Research, University of Alabama in Huntsville, Huntsville, AL, USA
| | - J Huang
- Climate and Space Sciences and Engineering, University of Michigan, Ann Arbor, MI, USA
| | - K G Klein
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ, USA.,Department of Planetary Sciences, University of Arizona, Tucson, AZ, USA
| | - K E Korreck
- Smithsonian Astrophysical Observatory, Cambridge, MA, USA
| | - D E Larson
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - R Livi
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - B Maruca
- Department of Physics and Astronomy, University of Delaware, Newark, DE, USA.,Bartol Research Institute, University of Delaware, Newark, DE, USA
| | - B Lavraud
- Institut de Recherche en Astrophysique et Planétologie, CNRS, UPS, CNES, Université de Toulouse, Toulouse, France
| | - P Louarn
- Institut de Recherche en Astrophysique et Planétologie, CNRS, UPS, CNES, Université de Toulouse, Toulouse, France
| | - M Maksimovic
- LESIA, Observatoire de Paris, Université PSL, CNRS, Sorbonne Université, Université de Paris, Meudon, France
| | - M Martinovic
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ, USA
| | - D McGinnis
- Department of Physics and Astronomy, University of Iowa, IA, USA
| | - N V Pogorelov
- Department of Space Science and Center for Space Plasma and Aeronomic Research, University of Alabama in Huntsville, Huntsville, AL, USA
| | - J D Richardson
- Kavli Center for Astrophysics and Space Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - R M Skoug
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | | | - M L Stevens
- Smithsonian Astrophysical Observatory, Cambridge, MA, USA
| | - A Szabo
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - M Velli
- Department of Earth, Planetary and Space Sciences, University of California, Los Angeles, CA, USA
| | - P L Whittlesey
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - K H Wright
- Universities Space Research Association, Science and Technology Institute, Huntsville, AL, USA
| | - G P Zank
- Department of Space Science and Center for Space Plasma and Aeronomic Research, University of Alabama in Huntsville, Huntsville, AL, USA
| | - R J MacDowall
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - D J McComas
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ, USA
| | - R L McNutt
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - M Pulupa
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - N E Raouafi
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - N A Schwadron
- Department of Physics and Astronomy, University of New Hampshire, Durham, NH, USA.,Space Science Center, University of New Hampshire, Durham, NH, USA
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Haghikia A, Martinovic M, Jacobs S, Moter A, Lauten A. Infektiöse Endokarditis. Z Herz- Thorax- Gefäßchir 2018. [DOI: 10.1007/s00398-018-0208-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Martinovic M, Belojevic G, Evans GW, Kavaric N, Asanin B, Pantovic S, Jaksic M, Boljevic J. Hypertension and correlates among Montenegrin schoolchildren-a cross-sectional study. Public Health 2017; 147:15-19. [PMID: 28404491 DOI: 10.1016/j.puhe.2017.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 02/01/2017] [Accepted: 02/06/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVES In one of the few national studies of children in a former Eastern bloc country emerging as a Western democracy and the first such study ever in Montenegro, this study establishes the prevalence and correlates of childhood hypertension (CH). STUDY DESIGN A cross-sectional national study. METHODS The study was conducted with 3254 children aged 7-13 years (50.3% male) from 39 elementary schools. We used a structured questionnaire to gather sociodemographic information as well as data on factors potentially related to CH. Children's nutritional status was assessed using the criteria of the International Obesity Task Force. Waist circumference was also measured. Blood pressure was measured in schools using an oscillometric monitor. CH was defined as an average systolic blood pressure and/or diastolic blood pressure greater than or equal to the 95th percentile for sex, age, and height. RESULTS The prevalence of CH was 10.4% with no differences between boys and girls. Multiple regression revealed that the odds for child hypertension were lowered by 10% for each year of age. On the other hand, rural environment and child obesity raised the odds of hypertension by 38% and 68%, respectively. CONCLUSIONS We found hypertension in one out of ten Montenegrin schoolchildren, with no gender differences. Obesity and rural areas may be unfriendly to children's blood pressure.
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Affiliation(s)
- M Martinovic
- Medical Faculty, Department for Pathophysiology and Laboratory Medicine, University of Montenegro, Podgorica, Montenegro.
| | - G Belojevic
- Faculty of Medicine, Institute of Hygiene and Medical Ecology, University of Belgrade, Belgrade, Serbia.
| | - G W Evans
- Department of Design and Environmental Analysis, Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, USA; Department of Human Development, Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, USA.
| | - N Kavaric
- Public Health Center, Podgorica, Montenegro.
| | - B Asanin
- Medical Faculty, Neurosurgery Clinic, University of Montenegro, Podgorica, Montenegro.
| | - S Pantovic
- Medical Faculty, Department of Biochemistry, University of Montenegro, Podgorica, Montenegro.
| | - M Jaksic
- Clinical Centre of Montenegro, Centre for Laboratory Diagnostics, Podgorica, Montenegro.
| | - J Boljevic
- Clinical Centre of Montenegro, Centre for Laboratory Diagnostics, Podgorica, Montenegro.
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Stojakovic M, Stojakovic B, Pandzic V, Vukadinovic S, Subotic M, Martinovic M, Marin R. Depression in War-related Post Traumatic Stress Disorder and the Enduring Personality Change After Catastrophic Experience (F62.0) a 15-year Follow-up. Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)71503-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective:This study was a 15-year follow-up examination. Many patients with F 62.0 and post traumatic stress disorder (PTSD) have symptoms of depression. The authors’ objective is to analyze symptoms of depression in F 62.0 and PTSD.Method:The subjects were 200 male psychiatric patients at a Clinic of psychiatry medical center Banjaluka and psychiatry department of with war-related PTSD. Post traumatic stress syndrom-PTSS scale and 21-item Hamilton Rating Scale for Depression-HAMD was used to assess state measures of symptom severity; from 3 months to 15 years after returning from the war.Results:The symptoms of prolonged PTSS (with duration between six moths and two years) had been founded at 54%, and 32% of patients had no diagnosis PTSD. The enduring personality change after catastrophic experience (F 62.0) had been found at 14% patients (with duration more than two years), 19% met HAMD Diagnostic Criteria for major depressive disorder.The enduring personality exchange F 62.0 had been found at 8% patients and 16% met HAMD Diagnostic Criteria for major depressive disorder 15 years after returning from the war.Conclusions:The statistical relationship between level of combat exposure and PTSD symptoms at 15 years, suggests that it may take time for the consequences of traumatic exposure to become apparent. Moreover, degree of exposure may be important in predicting the eventual development of symptoms and precipitation of F 62.0 enduring personality exchange. Continued follow-up will address the evolution of PTSD symptoms in war related PTSD.
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