Non-alcoholic fatty liver disease (NAFLD) is associated with a number of extrahepatic comorbidities and considerable cardiovascular morbidity and mortality, which is possibly related to coagulation changes associated with metabolic syndrome. Coagulation disorders are common in patients with liver disease of any etiology, and here we review possible alterations in coagulation cascade specific to NAFLD. We discuss derangements in the coagulation cascade and fibrinolysis, endothelial dysfunction, and platelet abnormalities as possible culprits for altered coagulation and explore the significance of these changes for potential treatment targets.

Gastric cancer is related to high mortality rates and advanced disease stage at the time of diagnosis. Its carcinogenesis is extensively studied and is associated with genetic and epigenetic changes, changed the interaction between tumor and adjacent stromal cells, and changes in the microenvironment molecule status. NEDD9 affects different signaling proteins and pathways, apoptosis, adhesion, cell migration, and invasiveness. Connexin-43 also assists in intercellular communications and has several channel-independent functions. Aberrant expression of those two gap junction proteins plays an essential role in metastatic processes. Our scope was to detect the expression of connexin-43 and NEDD9 in epithelial and stromal gastric cancer compartments and its relation to tumor progression and lymph node metastases. Cancer tissue from 53 cases of node-negative and 55 cases of node-positive primary gastric carcinoma patients was analyzed for connexin-43 and NEDD9 expression by immunohistochemical assay, and the results were correlated with the remaining clinical and pathological findings and survival. In our cohort of patients with lymph node metastases, we detected higher expression of epithelial connexin-43 in the primary tumor and stromal connexin-43 expression correlated with both epithelial NEDD9 (rho=0.453) and stromal NEDD9 (rho=0.484). Higher epithelial connexin-43 and NEDD9 expression were associated with higher mortality (HR 1.54, 95% CI 1.01 -2.37, p=0.048). Epithelial connexin-43 expression, both epithelial and stromal NEDD9 expression, T and N status were all independently associated with shorter survival. In summary, our findings suggest that increased expression of both epithelial and stromal NEDD9 and epithelial connexin-43 could potentially be used as prognostic gastric cancer biomarkers.

Background Although there have been revolutionary improvements in care of IBD patients, considering the effect of lifelong disease with numerous relapses, one of our goals is to recognise burden of chronic symptoms such as fatigue which can significantly interfere with performance of everyday activities, and negatively impact on quality of life (QoL). Methods Randomly selected IBD patients were invited to anonymously fulfil multiple mixed-methods (quantitave/qualitative) Quality of Life questionnaires (SF-36, IMPACT, SIDBQ, IBD disk) in order to evaluate prevalence of fatigue as well as the variables associated with an increased risk of fatigue (using the Fisher’s exact test). Results The study population included 70 patients (50.7% male, mean age 38.1 years, 55.7% Crohn’s disease). The prevalence of fatigue was 48.6% and variables associated with an increased risk of fatigue were: anxiety/depression (p = 0.002), lower perception of general well-being (p = 0.03), sleep disturbance (p = 0.02), inadequate interpersonal interactions (p = 0.03) and unsatisfactory performance in educational and professional daily activities (p = 0.01). The presence of joint pain as a common extraintestinal manifestation of IBD was not associated with fatigue (p = 0.06). Conclusion Chronic fatigue is a debilitating symptom among adult patients with IBD. Anxiety/depression, lower perception of general well-being, sleep disturbance, inadequate interpersonal interactions and unsatisfactory performance in educational and professional daily activities were associated with fatigue in this Croatian cohort of IBD patients.

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Purpose: While analyzing the group of patients implanted with a left ventricular assist device (LVAD) at our institution to verify which of the pre-and postoperative factors constitute the optimal survival outcome predictors, we determined a significant increase in postoperative pulmonary vascular resistance (PVR) values in the expired patients1. The aim of this study was to further analyze the data in order to determine which of the preoperative factors were related to the aforementioned increase in postoperative PVR values. Methods: For the 20 patients (18 M, 2 F; mean age 58.7±8.3 years) that have been implanted with an LVAD in our institution during the past 2 years, preimplantation echocardiography, right heart catheterization (RHC) and laboratory data were collected and compared according to the values of the postimplantation PVR. The groups were compared by using the adequate statistical test (t-test, Mann Whitney U test, statistical significance set at 0.05). Correlation analysis and linear regression were performed.