ABSTRACT
COVID-19 requires a complex assessment of disease progression. We aimed to assess the prognostic value of biochemical and complete blood count (CBC) parameters and their indexes in the progression of COVID-19 in patients with Diabetes mellitus (DM). Data from 784 patients hospitalized at the University Clinical Center Nis were assessed. Patients were divided into the control and DM groups. Disease progression was defined as a lethal outcome or intensive care treatment requirement. Patients' laboratory data upon admission was observed. There were 163 subjects (20.8%) with DM and 621 (79.2%) controls. In 52.8% of DM patients and 45.6% of controls, progression was observed. The ANOVA test showed significance between progression and IL-6 (P < 0.05), neutrophil-lymphocyte ratio (NLR) (P < 0.05), and CRP-IL-6 ratio (P = 0.02) in both groups. In controls, CRP (P = 0.012) and LDH (P = 0.000) were also highlighted. ROC analysis showed the best results for IL-6 (AUC = 0.77 and 0.64). There was a significant positive correlation of CRP, NLR, and CRP-IL-6 ratio (P = 0.05) with progression, while IL-6 correlated more significantly (P = 0.01) in DM patients. In controls, all correlations were of high significance (P = 0.01). Commonly assessed CBC and biochemistry parameters showed a more significant link to progression in controls than in DM patients, whereas the most highlighted marker was IL-6.
ABSTRACT
Peripheral artery disease (PAD) is an occlusive disease of extremities, which used to be diagnosed and treated as an isolated disease of the limbs or other parts of the body. Nowadays, the role of PAD transcends the affected limb;instead, the cardiovascular system must be observed as a whole, with PAD having a prognostic role. About 200 million people are affected by PAD worldwide. The prevalence of PAD is likely to increase steadily in the future due to the global aging of the population and the predominantly sedentary lifestyle, along with the expected universal increase in the major PAD risk factors such as smoking habit, diabetes mellitus, dyslipidemia and hypertension. Patients with PAD are at a higher risk of coronary disease and cardiovascular events in comparison to healthy control subjects. The severity of PAD correlates with the development and complications of cardiovascular disease. In PAD patients, percutaneous coronary intervention is more demanding, associated with more comorbidities, more complex lesions, and poorer procedural success as compared with PAD-free patients. For a year now, the use of antiplatelet therapy with acetylsalicylic acid in combination with low (vascular) dose of a direct oral anticoagulant has been recommended for cardiovascular and lower limb protection in PAD patients. In the future, we expect a better understanding of atherosclerotic disease, stronger modulation of systemic inflammation, and the discovery of new therapies. In the meantime, it is necessary to identify the risk population and aggressively treat the classic factors – control of blood pressure, glycemia and lipids with antiplatelet and new anticoagulant therapy. The goal is to protect the limb and preserve the cardiovascular continuum. The negative consequences of COVID-19 on treatment CVD will be estimated in the following years. © 2021, Croatian Anthropological Society. All rights reserved.
ABSTRACT
COVID-19 pandemic has changed everyday life and medical supervision of chronically ill patients. Epidemiological measures, social distancing, and limited access to medical care impair glycemic control in patients with diabetes. Also, type 2 diabetes is a risk factor for more severe form of coronavirus disease. A large proportion of diabetic patients are placed in foster families who also adapt to the new situation. The purpose of this study was to examine the manner and frequency of glycemic control in patients with type 2 diabetes who are placed in foster families in the region of Brod-Posavina County. We established contact with patients suffering from type 2 diabetes situated in foster families and their caregivers. Measurement of glycemia was performed several times a day with regular notes and the data were supple-mented by an insight into the medical documentation of patients in the hospital information system. The study included 33 patients with type 2 diabetes. The relationship between HbA1C with fasting and postprandial glycemia was linear. There were no statistically significant differences in HbA1C regulation by type of therapy. There was a significant differ-ence in the number of complications according to the level of HbA1C (Hi square test = 25.982, p <.001). The number of complications generally increased as HbA1C regulation was poorer. During current COVID-19 pandemic, care for patients with type 2 diabetes is significantly limited. Improved medical care for patients can be achieved by establishing coopera-tion and daily communication between caregivers, family physicians and, if necessary, diabetologists, especially through the use of online platforms and telephone communication, all with the aim of early detection of diabetes complications and adequate treatment of patients in current conditions. © 2021, Croatian Anthropological Society. All rights reserved.
ABSTRACT
The paper presents the guidelines made by the Multidisciplinary Team for Osteoporosis for patients in the General Hospital “Dr.Josip Benčević”, Slavonski Brod and general practitioners in the Brod-Posavina County in order to inform them properly about the COVID-19 pandemic and the recommendations of the National Civil Protection Committee, as well as to help them reduce their fear and to improve their cooperation with their general practitioners. A system of record-ing new fractures in the county was maintained since the onset of the epidemic. The recommendations for patients with osteoporosis include their lifestyle, medical treatment and balanced nutrition, following the advices of the International Osteoporosis Foundation, the Croatian Osteoporosis Society and the British Royal Osteoporosis Society. Living with osteoporosis demands balanced nutrition, regular exercise and taking prescribed medications. As in the present conditions of COVID-19 epidemic outdoor physical activities are temporarily limited it is necessary to ensure the availability of calcium-rich food and vitamin D supplies. As medical treatment of osteoporosis does not increase risk of COVID-19 infec-tion it is recommended for patients to continue their prescribed therapy in consultation with their general practitioner. © 2020, Croatian Anthropological Society. All rights reserved.