Comparison of the effects of Puumala and Dobrava viruses on early and long-term renal outcomes in patients with haemorrhagic fever with renal syndrome.

AIM: The clinical course and outcome of patients with haemorrhagic fever with renal syndrome (HFRS) caused by Puumala (PUUV) and Dobrava viruses (DOBV) were analyzed and whether it left long-term consequences on kidney function after 10 years was evaluated. METHODS: Cross-sectional studies were conducted to test the kidney function and blood pressure of HFRS-affected patients and to follow them up 10 years after. Eighty-two PUUV- and 53 DOBV-induced HFRS patients and 14 and 31 participants 10 years after having contracted PUUV- and DOBV-related diseases, respectively were evaluated. RESULTS: Serum creatinine concentrations were 279.5 and 410 mcmol/L in PUUV and DOBV groups, respectively (P = 0.005). There were six and 13 anuric (P < 0.05), none and seven dialysis-dependant (P < 0.05), and nine and 18 hypotensive patients (P < 0.05) in PUUV and DOBV groups, respectively. After 10 years, glomerular filtration rates were 122.1 + or - 11.1 and 104.7 + or - 20.2 mL/min (P < 0.05) in PUUV and DOBV groups, respectively. CONCLUSION: During the acute phase, DOBV causes more severe renal impairment than PUUV infection. After 10 years follow up, renal function was found within normal limits, although after DOBV infection glomerular filtration rate (GFR) was significantly lower than after PUUV infection.

[Evaluation of diabetic nephropathy in older patients with diabetes mellitus type 2]. / Evaluacija dijabetesne nefropatije u starijih bolesnika sa dijabetes mellitus-om tip 2.

INTRODUCTION: Diabetes currently affects more than 170 million people world-wide, but the World Health Organization (WHO) expects that the number of patients will double within the next 20 years. Diabetic nephropathy (DN) is the leading cause of kidney disease in patients who need renal replacement therapy. It is defined by increased urinary albumin excretion in the absence of other renal diseases. The goal of the study is evaluation of DN in older patients with diabetes mellitus (DM) type 2. PATIENTS AND METHODS: Prospective study has been used to analyze 182 patients of old age with DM type 2 according to the criteria of WHO. According to the concentration of albumin in urine the patients were divided in 2 groups: the patients who have confirmed type 2 DM with DN and patients who have confirmed type 2 DM without DN. The following parameters were determined and compared in both groups of patients: age, sex, duration of diabetes, concentration of glucose in blood, microalbuminuria, blood pressure, smoking, obesity, and family history with kidney disease. Albumin/ creatinine ratio was calculated and concentration of albumin in urine was tested by specified albumin straps. RESULTS: The prevalence of type 2 DM in the health care center is 3.64% and prevalence of DN is 24.72%. Results show that duration of DM type 2 is significantly longer in patients with DN (p<0.0001) and concentration of albumin in urine is inreased (p<0.0001), and that significantly higher concentration of HbA1c (p=0.005) and increased creatinine in serum (p=0.04) is present when compared with patients without DN. This study did not find evidence of age, sex, blood pressure, smoking, obesity and family history with kidney disease as risk factors in genesis of DN. CONCLUSION: Duration of DM type 2, increased concentration of glycosyllated HbA1c, and increased creatinine in blood are the risk factors in genesis of DN in older patients with DM type 2.

[The obesity--a big health problem and large challenge for the health workers]. / Debljina--veliki zdravstveni problem i veliki izazov za zdravstvene radnike.

Food is prerequisite for development, growth, retain vigor and progress of one person. Food can be helpful in treatment of one person, but also it can be the cause of disease named "the obesity". The obesity today getting a epidemic form and become the most difficult problem in many countries for health workers. This problem has to be taken very seriously to be solved. This article is about what the obesity is, possible causes of it, which health problems the obesity provokes and how to treat it.

[The role of the team of family physician in prevention of changing risk factors important in development of arterial hypertension]. / Uloga tima porodicne medicine u prevenciji promjenjivih faktora rizika znacajnih u razvoju arterijske hipertenzije.

Arterial hypertension (AH) is one of the commonest noninfective chronic disease according to its important and the role in the morbidity and mortality, which is the reason for patients coming to the family phisician. Detection and treatment of high blood pressure are the major responsibility of physician in the primary care. If the family physician team (physician and nurse) make a good assessment of the risk factors which is important in development of arterial hypertension, the appearance of disease and its complications can be prevented or delayed. The most important for prevention of arterial hypertension is adoption a healthy lifestyle and it is nonseparate part of arterial hypertension treatment.

[Ultrasound findings on abdominal organs in the acute phase of hemorrhagic fever with renal syndrome]. / Ultrasonografski nalaz na abdominalnim organima u akutnoj fazi hemoragijske vrucice s bubreznim sindromom.

INTRODUCTION: There are significant changes in small blood vessels with increased permeability, edema of abdominal organs and ascites in the acute phase of hemorrhagic fever with renal syndrome (HFRS). We analyzed ultrasound changes of abdominal organs in patients with serologically verified HFRS, in order to assess the value of this method in the diagnosis of acute renal failure (ARF). METHODS: The study included 14 sporadic patients with ARF and suspicion of HFRS, treated in 2002. Ultrasonography of the liver, gallbladder, pancreas, spleen, kidneys, prostate and retroperitoneum was performed on a Toshiba 220 SSA. RESULTS: Parenchymal edema with increased echogenicity, sinus narrowing and enlargement of both kidneys were found in all 14 (100%) patients. Hepatosplenomegaly was found in seven (50%), ascites in four (28.6%), and pleural effusion in two (14.3%) patients. Increased thickness of the bladder wall was found in two (14.3%), gallbladder enlargement in one (7%), and edema of the pancreas in one (7%) patient. CONCLUSION: Ultrasound examination has a very important role in the diagnosis and follow-up of changes in the parenchymal organs in the acute acute phase of the disease.

[Obesity, physical activity and health]. / Debljina, fizicka aktivnost i zdravlje.

UNLABELLED: Obesity is one excess of body fat frequently resulting in a significant impairment of health. Lack of physical activity is one possible cause for obesity. GOAL: To exam relation between obesity and physical activity. MATERIAL AND METHODS: A sample with 154 randomized chosen patients make 48 (31.2%) men, and 106 (68.8%) women, 30-80 years old. Obesity is defined by bodymass index (BMI) over 30. Physical activity is defined by the modified scheme of Hanson and Ainsworth. RESULTS: Obesity was presented with 106 patients (68.84%). Lack of physical activity was present with 134 patients (87.01%). Physical activity was presented with 20 patients (16.91%), with 5 patients (25%) who are obese, and 15 patients (75%) who are no obese. CONCLUSION: Lack of physical activity plays role in creation of the obesity.