Bone mineral density is not associated with homocysteine level, folate and vitamin B12 status.

PURPOSE: The relationship of homocysteine (Hcy), folate and vitamin B(12) with bone mineral density (BMD) has been studied in various populations but still remains inconsistent. The aim of this study was to test whether the levels of plasma Hcy, serum and red blood cell folate, and vitamin B(12) are related to BMD in the group of adult Croatian women regardless of menopausal status. Some other lifestyle and dietary habits like smoking, physical activity and alcohol consumption were also observed in relation to BMD. METHODS: One-hundred and thirty-one women, aged 45-65 years participated in the study. BMD was measured using dual-energy X-ray absorptiometry. Measurements were made at the lumbar spine (L1-L4), left femoral neck, total femur and distal third of the radius. Plasma total Hcy, serum folate, red blood cell folate and serum vitamin B(12) were also determined. RESULTS: No significant correlations were found between Hcy, folate and/or vitamin B(12) and BMD of measured skeletal sites. Body mass index (BMI), age, as well as alcohol consumption were significantly correlated with BMD at the lumbar spine. Positive significant correlation was found between BMI and BMD at the femoral neck and total femur while BMI and age were significant predictors of BMD at the radius (multiple regression analysis). When only postmenopausal women were included, significant predictors of BMD at the lumbar spine were age, BMI, alcohol consumption and intake of hormone replacement therapy. CONCLUSION: Results of this study suggest that Hcy, folate or vitamin B(12) levels were not related to BMD in population of healthy Croatian women aged 45-65. In the group of postmenopausal Croatian women, beside BMI and age, alcohol consumption was significant positive predictor of BMD at the lumbar spine.

[Performance Assessment Tool for Quality Improvement in Hospitals (PATH): first experiences in Croatia]. / Alat za ocjenu rada u cilju poboljsanja kvalitete u bolnicama: prva iskustva u provodenju programa PATH u hrvatskim bolnicama.

PATH (Performance Assessment Tool for Quality Improvement in Hospitals), a project of the World Health Organization (WHO) for Europe offers hospitals a comprehensive and standardized tool (a set of indicators) to evaluate their own performance and development of measures for quality improvement. PATH Program was launched in Croatia in 2008, and it was conducted in 2009 in hospitals that have voluntarily decided to be involved. Here we present the results of the first phase of pilot experience of establishing the program, based on data collected in 22 Croatian hospitals. Analysis of the first results indicated the existence of marked differences among the hospitals that have taken the example of the percentage of cesarean sections ranging from 1.1% to 21.4%. The mortality rate of myocardial infarction ranged from 1.9 to 21.4%, while the mortality of stroke ranged from 12.5 to 45.5%. The highest percentage of needle-stick injuries reported for physicians was 16.2% of entire hospital staff in one year, 6.1% for nurses and 4.6% for the supportive staff. The result suggests the existence of many problems and limitations in data collection at hospital level, limitations in their analysis and creates recommendations for quality improvements, which must be taken into account when hospitals are compared on the national or international level.

Immunohistochemical localization of CD31, NOTCH1 and JAGGED1 proteins in experimentally induced polycystic ovaries of immature rats.

We analyzed histomorphometrical changes and blood vessel immunohistochemical staining of CD31, NOTCH1 and JAGGED1 in induced polycystic ovaries of immature female Wistar rats, as well as serum hormone levels. The rats were randomly divided into control (n=18) and treated (n=18) groups. Treated animals received intramuscularly testosteronenantat weekly (0.1mg/g). Controls received the same amount of ricinus oil. Rats were weighed daily. Control and treated subgroups (6 rats per subgroup) were subsequently sacrificed after 21, 28 and 35 days of treatment. In ovaries of treated rats we found large cystic follicles, thick stromal tissue, many atretic preantral follicles, no ovulation and a thinner granulosa cell layer. CD31 stained blood vessels in the theca layer were reduced, with reduced JAGGED1 and NOTCH1 immunostaining. In controls, preantral and antral follicles were larger than in the treated group. Treated animals showed statistically significant lower progesterone and higher testosterone levels. They gained more weight than controls. Reduced immunostaining for NOTCH1 and JAGGED1 of reduced blood vessels of the theca layer was found in all stages of folliculogenesis with a distinct reduction in cystic and atretic follicles. Our results provide evidence of intrinsic abnormality during all stages of folliculogenesis in polycystic ovaries and this may result from crosstalk between circulating gonadotropins and follicular angiogenesis.