BACKGROUND: Association of asthma and obesity has been demonstrated in numerous epidemiological studies. However, the underlying mechanisms of the association are not well understood. Both conditions are characterised by chronic tissue inflammation, which includes numerous different inflammatory markers, and possible atopy. AIM: The study aimed to investigate the association between asthma and obesity in children and assess several of potential underlying mechanisms, including the parameters of systemic inflammation (CRP, fibrinogen) and the mechanical effect of obesity on the respiratory system through parameters of lung function. An additional aim was to examine the role of atopy in overweight children with asthma and to investigate the type of respiratory inflammation. MATERIAL AND METHODS: This prospective study included 72 patients in the age group of 7-15 years, including 38 with high body mass index (BMI), 16 with asthma and normal BMI, and 18 with asthma and high BMI for sex and age. Non-specific inflammatory markers (fibrinogen, CRP), eosinophilia, and total serum IgE were investigated. The patients underwent a skin prick test (SPT) with standard inhalant allergen extracts, measurement of fractional exhaled nitric oxide Fe (NO), and an assessment of lung function. RESULTS: In overweight groups of children we determined significantly higher values (p < 0.001) of both acute inflammatory reactants, CRP and fibrinogen, with no difference between children with and without asthma. There was a significant increase in eosinophilia, total IgE, and positive SPT in the asthmatic groups compared to the group of non-asthmatic patients (p < 0.001 for the three parameters). Compared to the group composed of overweight patients without asthma, the asthmatic patients had higher NO values (p < 0.001). No significant difference in the lung function parameters was found between the three groups (p > 0.05). CONCLUSION: A positive association between asthma and obesity with inflammation as an underlying mechanism, eosinophilic one in asthmatic patients and non-eosinophilic one in overweight patients, was determined. It seems that the lung function parameters did not differ between asthmatic patients and overweight patients. No influence of atopy in the association between asthma and obesity was verified. Further analyses of specific inflammatory markers, for an in-depth evaluation of the mechanisms leading to the association of obesity and asthma, are warranted.
There is a need to improve the current level of patient-provider relationship and communication, as well as that of hospital environment, while special efforts should be made to address the problem of patient waiting time and hospital bureaucracy.
Морталитетната статистика по причини за смрт е основен показател на здавствената состојба на населението во една земја. Нејзината валидност во целост е базирана на точноста на Лекарските извештаи за причина на смрт (ЛИПС) што претставуваат нејзин основен извор на податици. Цел на ова истражување е да се утврди точноста на лекарските извештаи со впишано КВЗ (I10 - I50) како основна причина за смрт во Градската општа болница „8ми Септември“ во Скопје. Материјал и методи: Истражувањето представува квантитативна аналитичка студија на пресек имплементирана во Градската општа болница „8ми Септември“ - Скопје во периодот од јануари 2015 до декември 2016 година. Во истражувањето беа анализирани ЛИПС-овите кои согласно МКБ10 беа со впишано КВЗ (I10 - I50) како основна причина за смрт. Опфатени беа 121 пациент на возраст од 24 до 84 години кои починале во периодот 0 - 28 дена од хоспитализацијата и тоа независно од полот и другите социо-демографски карактеристики. Анализата на точноста на ЛИПС-овите, беше направена согласно стандардизиран образец од MONICA проектот. Резултати: Просечната возраст на починатите во целиот примерок изнесуваше 72,41±9,14 [95% CI (70.71-74,11)] години. Tочно пополнети ЛИПС-ови биле 67 (56,3%), неточно 22 (18,5%) и делумно точно 30 (25,2%). Нема сигнификантна асоцијација (p>0,05) меѓу полот на испитаниците и точноста на впишување на примарната причина за смрт. Утврдена е сигнификантно (p<0,05) поточно е впишана секундарна причина за смртта кај лицата од машки пол. Заклучок: Со извесна лимитација поради малиот број на случаи истражувањето укажува на неусогласеност помеѓу податоците превземени од болничката документација и причината за смрт впишана во ЛИПС-овите. Постои реална потреба да се превземат адекватни мерки за подобрување на квалитетот на ЛИПС.
Background: Rhabdomyolysis is caused by the release of enzymes from skeletal muscles into the blood, which leads to systemic complications with diverse etiologies. This study evaluated the serum aminotransferases in patients with rhabdomyolysis following acute intoxication with either psychotropic drugs or other chemical agents. Methods: This study randomly recruited 140 patients suffering from rhabdomyolysis. They were divided into two groups affected by either psychotropic drugs or chemical agents. Rhabdomyolysis was defined as having serum creatine kinase (CK) levels greater than 250 U/L, based on the poisoning severity score. Results: On day 1, the CK/AST correlation was significantly stronger in the psychotropic than the chemical group (P=0.0009). On day 5, patients in the psychotropic group had significantly higher AST (P=0.0138) and ALT (P=0.0129) than those poisoned with other chemicals. The difference in the strength of the CK/ALT correlation between the two groups was insignificant. Between the two groups, the differences between the CK levels and the following serum parameters were insignificant: Alkaline phosphatase; gamma-glutamyl transferase; prothrombin time; total bilirubin; and albumin. Conclusion: The elevated aminotransferases in patients with rhabdomyolysis due to acute psychotropic toxicity might have resulted from the skeletal muscle injury rather than hepatotoxicity. In rhabdomyolysis patients poisoned with other chemicals, the elevated serum aminotransferases are likely due to liver toxicity arising from the consumed substances. These patients are likely to manifest clinically severe long-term multi-organ failure. Intoxications with typical agents, such as herbicides, petroleum distillates, and corrosives were responsible for the rhabdomyolysis in the second group.
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