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Southeastern European Medical Journal : SEEMEDJ
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  This is an Open Access Journal Open Access journal
ISSN (Online) 2459-9484
Published by Josip Juraj Strossmayer University of Osijek Homepage  [3 journals]
  • Editorial

    • Authors: Ines Drenjančević
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.249
      Issue No: Vol. 6, No. 1 (2022)
       
  • Changing the Landscape of Hypertension Management With SGLT2i

    • Authors: Ines Bilić Ćurćić*, Vjera Ninčević, Silvija Canecki Varzic, Ivana Prpić Križevac, Jasminka Milas Ahić, Ivica Mihaljević
      Pages: 1 - 11
      Abstract: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a newer class of drugs that have primarily been used in the treatment of type 2 diabetes. However, as new findings from clinical trials have become available, their indication has been expanded to include treatment of heart failure and chronic kidney disease without the presence of diabetes. The pathophysiological mechanisms of extraglycemic effects of SGLT2i are still being unraveled, but one of the most prominent consequences is a decrease in blood pressure, which has implications for hemodynamics and arterial stiffness. Recent findings indicate that this class of drugs has a beneficial effect on lowering nocturnal blood pressure (BP), with special importance in type 2 diabetes (DMT2), since unregulated nocturnal hypertension is associated with an increased incidence of cardiovascular (CV) events. In this mini-review, we have summarized current knowledge about the effects of SGLT2i on blood pressure, including office, home, and ambulatory BP, and potential implications for treatment of hypertension in diabetic and non-diabetic individuals, with positive effects on cardiorenal outcomes.  
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.247
      Issue No: Vol. 6, No. 1 (2022)
       
  • Overview of Iodine Intake

    • Authors: Vanja Vasiljev*, Alen Subotić, Mihaela Marinović Glavić, Denis Juraga, Lovorka Bilajac, Bojan Jelaković, Tomislav Rukavina
      Pages: 12 - 20
      Abstract: Iodine is an essential element for human health. Food is the primary source of iodine, but the iodine content of local foods depends on the iodine content of the soil. Therefore, a low iodine concentration in soil and water results in plants and animals with low iodine content. Numerous effects of iodine deficiency on growth and development are known as iodine deficiency disorders. Iodine deficiency has been identified as the most common cause of brain damage in the world and is linked to its effects on infant and child growth and development. Supplementation of table salt with iodine was introduced in the 20th century. Croatia was one of the first countries to introduce the supplementation of table salt with potassium iodide at a concentration of 10 mg/kg in 1953 and 25 mg/kg in 1993. In 2003, the Croatian population reached iodine sufficiency, but given the excessive salt intake (11.6 g/day) and additional sources of iodine in the diet, the question arises, are we consuming too much iodine' This article gives a short overview of iodine intake.
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.241
      Issue No: Vol. 6, No. 1 (2022)
       
  • Association Between Common Comorbidities and Outcomes in COVID-19 Patients
           Hospitalised in General Hospital Našice – a Cross-Sectional Study

    • Authors: Lea Gvozdanović, Željka Dragila, Zvjezdana Gvozdanović, Denis Klapan, Nikolina Farčić, Hrvoje Šimić, Zrinka Mihaljević*
      Pages: 21 - 30
      Abstract: Aim: The aim was to define the impact of comorbidities, specifically hypertension as one of the most common chronic diseases, on the outcome and length of stay for COVID-19 patients. Methods: The cross-sectional study, carried out from October to December 2021, included 129 hospitalised COVID-19 patients who presented to the Emergency Department and were hospitalised and treated in the COVID ward in the General Hospital Našice. All patients tested positive for COVID-19 with a polymerase chain reaction (PCR) test. Clinical parameters were also recorded and they included demographic factors, comorbidities, type of antihypertensive therapy, new-onset hypertension, length of stay and the overall outcome. Results: The most common comorbidity was hypertension (86, 66.7%). Hypertension was associated with women (P = 0.03) and age over 65 years (P < 0.001). Length of stay was longer for patients with hypertension (P = 0.04) and/or diabetes mellitus (P = 0.04). Higher mortality was associated with age over 65 years (P < 0.001) and a higher number of comorbidities (P = 0.01). New-onset hypertension was recorded in three patients. There was no significant difference in the outcome in relation to antihypertensive therapy. Conclusion: Hypertension is the most common comorbidity in hospitalised COVID-19 patients. Although treated hypertension did not have a negative impact on the outcome, other potential risk factors, including a higher number of comorbidities and older age, are associated with mortality in COVID-19 patients.
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.236
      Issue No: Vol. 6, No. 1 (2022)
       
  • Hypertension in Association With Anxiety and Depression – A
           Narrative Review

    • Authors: Josipa Ivanušić-Pejić, Dunja Degmečić*
      Pages: 31 - 43
      Abstract: Hypertension is recognized as a multifactorial disorder. Anxiety disorders, depressive disorder, psychosocial stress and certain individual psychological characteristics can influence the development and course of hypertension. Likewise, certain antidepressants can impact blood pressure. Association of anxiety disorders and depression with hypertension is bidirectional, so hypertensive patients are at risk of anxiety or depression. Monitoring the blood pressure of patients with anxiety disorders and depression, screening for anxiety and depression in patients with arterial hypertension and understanding pathophysiological mechanisms is important for future prevention and treatment strategies. This narrative review will briefly summarize current knowledge about the association of anxiety and depression with the risk of development of hypertension. Likewise, certain psychological factors and pathophysiological mechanisms in stress that are of importance for the association of hypertension with anxiety and depression are pointed out in this review, and effects of commonly used antidepressants are also considered.
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.216
      Issue No: Vol. 6, No. 1 (2022)
       
  • Investigating the Relationship between Alcohol Use and Patterns of Blood
           Pressure Change Due to Examination Stress among Adekunle Ajasin University
           Academic Staff

    • Authors: Olasunkanmi Rowland Adeleke
      Pages: 44 - 52
      Abstract: Aim: This study examined the relationship between alcohol use and patterns of blood pressure changes due to examination stress among academic staff at the Adekunle Ajasin University (AAUA). Methods: It involved using concurrent mixed methods with quantitative and qualitative approaches. Both the questionnaire and the blood pressure and pulse rate reading were used as instruments in data collection. The examined population includes all academic staff of AAUA. Multistage sampling techniques were used to select participants for the study. In stage one, a simple random sampling technique was used to select five faculties of the university. In stage two, systematic sampling techniques were used to select participants for the study; academic staff in every 5th academic staff office at the selected faculties were selected as a sample frame. Two instruments were used in gathering information for this study. The instruments were a self-constructed questionnaire and an electronic sphygmomanometer. Data were analyzed using mean and standard deviation at alpha level of 0.05. Results: Findings revealed that there is a significant difference in the pattern of blood pressure before – F (3, 46) = 4.260, P < 0.05; during – F (3, 46) = 3.570, P < 0.05; and after the examination period – F (3, 46) = 3.131, P < 0.05, based on the respondents’ level of alcohol intake. Conclusions: It is recommended that academic staff should be educated on the detrimental health consequences of consuming alcohol to avoid high blood pressure before, during and after the examination period. 
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.235
      Issue No: Vol. 6, No. 1 (2022)
       
  • MicroRNAs and Hypertension

    • Authors: Nikolina Kolobarić, Ines Drenjančević*
      Pages: 53 - 67
      Abstract: MicroRNAs (miRNAs) are non-coding, highly conserved RNAs found in all biological fluids, that are emerging as master regulators of gene expression, consequently impacting a variety of biological processes in both healthy and diseased environments. There are still certain limitations regarding analysis of circulating miRNAs, specifically concerning standardisation and accuracy of obtained data. However, there is an indisputable therapeutic and diagnostic potential, confirmed by recent research. Hypertension, as one of the leading causes of death in modern world, has been in the focus of scientific society for several decades now. So, it is of outmost importance to investigate and pinpoint appropriate miRNAs for early indication and diagnosis of hypertension in general population. More in vivo and clinical research is necessary in animal and human models in order to exploit the full potential of this novel technology.
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.244
      Issue No: Vol. 6, No. 1 (2022)
       
  • Dehydroepiandrosterone Sulfate and Arterial Hypertension

    • Authors: Juraj Jug*, Martina Matovinović
      Pages: 68 - 73
      Abstract: Dehydroepiandrosterone sulfate (DHEAS) is a steroid molecule whose function and mechanism of action in the human body are still inadequately researched. A potential protective function for the cardiovascular system can be explained by activation of nitric oxide production, impact on endothelial and mitochondrial function, and inhibition of proinflammatory cytokine production (IL-6 and TNF-α). Some research shows the beneficial effects of DHEA/DHEAS on many bodily functions, especially in the cardiovascular and the neurological systems. However, we need to be careful with interpretation of the results because of different criteria used for defining arterial hypertension, the race that was observed, and reproductive status of women, as these factors can change the conclusion. Due to a lack of evidence, DHEAS supplementation is still not recommended. We need multicentric prospective and randomized studies on DHEAS to examine its potential impact on blood pressure regulation and cardiovascular risk.
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.228
      Issue No: Vol. 6, No. 1 (2022)
       
  • Arterial Hypertension and Risk of Mortality

    • Authors: Nikolina Bukal, Melanija Kolarić, Ines Golubić, Josipa Josipović, Vedran Premužić, Ana Jelakovic, Sandra Karanović*, Nikolina Bašić Jukić, Bojan Jelaković
      Pages: 74 - 82
      Abstract: COVID-19 is currently a major global health concern. Among many unanswered questions related to COVID-19, some of the most debated ones are those concerning arterial hypertension. Arterial hypertension is a major risk factor for mortality worldwide and its importance has been emphasised even further in light of COVID-19. The most common antihypertensive drugs are ACE inhibitors and angiotensin II type-I receptor blockers. SARS-CoV-2 utilises the angiotensin-converting enzyme-2 (ACE2) for cell entry and therefore has a direct effect on the renin–angiotensin system (RAS). In terms of arterial hypertension and COVID-19, there are three main issues which have been the focus of extensive debates. First, is arterial hypertension a predisposing factor for COVID-19 infection' Second, does arterial hypertension affect the severity of COVID-19 infection and increase the risk of all-cause and cardiovascular mortality' And finally, how important is the interaction of COVID-19 infection and the renin–angiotensin system for clinical outcomes' Is RAS blockade beneficial or harmful' The aim of this brief review was to provide substantiated answers to these questions.
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.239
      Issue No: Vol. 6, No. 1 (2022)
       
  • Physical Activity as Prediction of Functional Ability among Elderly

    • Authors: Lovorka Bilajac*, Dorotea Šulavjak, Kristijan Zulle, Vanja Vasiljev, Denis Juraga, Mihaela Marinović Glavić, Tomislav Rukavina
      Pages: 83 - 91
      Abstract: Aim: Falling can have serious consequences for older persons, but fear of falling is also a current problem. The aim of the study is to assess the incidence of falls and fear of falling among older adults, as well as to study the connection of falls and fear of falling with functional ability, body mass index (BMI) and age. Methods: The participants of this study are older persons ( > 60 years) who live in the city of Rijeka, are mobile and have no symptoms of dementia. The relationship between falls, fear of falling, body mass index (BMI) and functional ability was measured using various indicators. Assessment of physical functioning and pain relief was made using the COOP/WONCA questionnaire. Falls and fear of falling were assessed using questions with different response options. Results: The results of the study showed that participants who reported experiencing fear of falling (FoF) had a higher BMI (p = 0.018) and did not feel physically healthy (70%). Participants who lived with a partner reported experiencing FoF at a lower rate (36.4%). The most frequently reported functional problems were visual problems (46.2%) and walking difficulties (40.0%). Conclusions: A large percentage of older persons struggle with the effects of aging, which include various health problems that can increase the risk of falling and FoF. Prescription of physical activity and engaging in it could improve functional ability and have an important effect on healthy aging. This could be the starting point from which key stakeholders can plan different types of public health interventions, prescribing physical activity to maintain functional ability that enables well-being in old age.
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.242
      Issue No: Vol. 6, No. 1 (2022)
       
  • Trends in Transfusion-Transmissible Infections Among Blood Donors at the
           National Blood Transfusion Service, Guyana

    • Authors: Francine Leitch, Letisha Pooran, Rajini Kurup*, Pedro Lewis, Cecil Boston
      Pages: 92 - 104
      Abstract: Aim: The most adverse effect of blood transfusion is the acquisition of transfusion-transmissible infections (TTIs), which poses a serious threat in developing countries. This study aims to identify the trends of transfusion-transmissible infections among blood donors. Materials and Methods: This study was a laboratory-based retrospective study conducted using blood donors’ records from January 2015 to December 2018, collected at the National Blood Transfusion Service, Guyana (NBTS). Analysis of data was performed using the Statistical Package for the Social Sciences (SPSS) version 22.0 software and the results were presented in tables and graphs. Chi-square and logistic regression were used to identify trends and influencing factors. Results: A total of 39,308 blood donors were included in this study, of whom 2,418 (6.2%) donors tested positive to at least one pathogen. Among those donors, 4.4% were coinfected with at least one of the sixteen dual infection combinations. The overall seroprevalence of HIV, HTLV, syphilis, HBV, HCV, Chagas, microfilaria, and malaria was 0.8%, 0.8%, 0.6%, 1.5%, 1.3%, 1.2%, 0.0%, and 0.0%, respectively. Trends of transfusion-transmissible infections showed an overall increase from the lowest prevalence, 5.1%, in 2015 to 7% in 2016, followed by decreases in 2017 (6.8%) and 2018 (5.8%). Conclusions: Even though 98.6% of the donor population are volunteers, this study has shown that a significant percentage of blood donors harbour transfusion-transmissible infections. Stringent screening and preventive measures are very important to ensure the safety of the transfusion recipient.
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.232
      Issue No: Vol. 6, No. 1 (2022)
       
  • The Correlation between Iron Deficiency and Recurrent Aphthous Stomatitis:
           A Literature Review

    • Authors: Antonija Mišković*, Nikica Marinić, Zvonimir Bosnić, Karolina Veselski, Domagoj Vučić, Ivana Pajić Matić
      Pages: 105 - 112
      Abstract: Aphthous lesions of the oral mucosa are a very common symptom and can be seen in both family medicine practice, dental medicine practice, and dermatology or otorhinolaryngology clinics. Some patients develop a chronic recurrent condition, which is clinically known as recurrent aphthous stomatitis (RAS). These ulcers are round, clearly defined, and can be visible on the movable part of the oral mucosa, with variations in size. A prodromal symptom like the burning or stinging sensation can precede the appearance of lesions. The main reason why patients seek medical help is oropharyngeal pain with lack of appetite. The exact etiopathogenesis of RAS remains unknown. Immune disorders, nutritional deficiencies, allergies, mechanical injuries, and even psychological disorders are being studied as potential causes of this condition. Some authors claim that iron deficiency may be a possible causative factor of RAS due to its role in DNA synthesis, mitochondrial function, and enzymatic activity. In iron deficiency, epithelial cells turn over more rapidly and produce an immature or atrophic mucosa. Such mucosa is vulnerable and can be a fertile soil for chronic inflammation and development of aphthae. Finally, our goals were to describe the clinical aspects and etiology of RAS, as well as to determine whether RAS may be related to iron deficiency, in order to identify potential patients with iron deficiency in everyday work.
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.225
      Issue No: Vol. 6, No. 1 (2022)
       
  • Postoperative Corneal Edema After Phacoemulsification

    • Authors: Martina Liovic Milec*, Sandra Sekelj, Slavica Konjevic-Pernar
      Pages: 113 - 120
      Abstract: Aim: To determine the effect of nuclear opalescence (NO) on intraoperative parameters during phacoemulsification using the WhiteStar Signature® PRO and to show the impact of preoperative and intraoperative parameters on postoperative corneal edema. Methods: This prospective study included 267 patients selected to undergo phacoemulsification using the WhiteStar Signature® PRO system at the Department of Ophthalmology of the General Hospital “Dr Josip Benčević”, Slavonski Brod, Croatia. NO was graded using the Lens Opacities Classification System III. Preoperative parameters were age, sex, NO and preoperative central corneal thickness. Intraoperative parameters of phacoemulsification included in the study were ultrasound time (UST), phaco time using Ellips FX technology (EFX) and average phaco power (AVG). Patients were followed up on postoperative days 1 and 7 and after two months. The state of the cornea was noted in each follow-up. Results: There was a statistically significant increase of intraoperative parameters with NO. Postoperative corneal edema depended on all measured intraoperative parameters (UST, EFX and AVG, all p < .001), patient’s age (p < .05) and NO (p < .001) on postoperative day 1, while on postoperative day 7, it depended on UST (p = .011) EFX (p = .012) and NO (p < .05). Conclusion: Older patients, higher grade of NO and amount of energy consumed during phacoemulsification using the WhiteStar Signature® PRO are predictive factors for severity of transient corneal edema. We found this information important for better preoperative planning of phacoemulsification, as well as for better postoperative results.
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.230
      Issue No: Vol. 6, No. 1 (2022)
       
  • Aspiration During Vaccination: Evidence for SARS-CoV-2 Vaccination

    • Authors: Josip Kajan*, Marko Sablić, Marija Heffer
      Pages: 121 - 128
      Abstract: Aspiration has always been performed during intramuscular vaccine injections to ensure that the needle does not puncture one of the blood vessels. However, at the beginning of the twenty-first century, this procedure became debatable. Using an advanced search builder and logical operators, we searched the PubMed database for all articles about aspiration guidelines. The deltoid blood vessels are large and diverse, with potentially dangerous changes occurring in certain groups such as athletes or people with connective tissue diseases. The pharmacokinetics and reported side effects of improperly applied vaccines differ. Some reported vaccine-related injuries, such as subacromial bursitis, can be avoided by using the aspiration technique. We discussed experiments that provide evidence that intravenous administration of mRNA vaccines can cause myopericarditis. Aspiration during vaccination is not technically demanding and does not require much time. Previous arguments against aspiration were based on efforts to make the procedure of vaccinating children less painful. In response to public concern about vaccine-induced thrombotic thrombocytopenia as a possible side effect, Denmark issued a guideline on mandatory aspiration during vaccination in March 2021. Guidelines vary by country, and there is a need for an updated and globally applicable instruction manual. Countries should carefully document vaccine side effects so that they could be compared between countries that aspirate and those who do not. More focused research experiments are needed to determine the relationship between aspiration and side effects. We propose a randomized study to compare the effectiveness of aspiration.
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.237
      Issue No: Vol. 6, No. 1 (2022)
       
  • Deep Ecology

    • Authors: Sandra Mijač, Goran Slivšek*, Anica Džajić
      Pages: 129 - 139
      Abstract: Deep ecology emphasizes the importance of the ecological problems as a practical issue, and its importance is in changing the human understanding of everything, including even man’s understanding of who he is. The aim of this paper was to present deep ecology, what it represents and how it has become a significant ecological movement of the 20th century and to indicate the connection between bioethics as new environmental ethics and deep ecology, as well as other environmental movements which, in the contextualization of bioethics, emphasize changing the outlook on life, giving a better knowledge of it, and allowing questioning of social actions and looking at events from different aspects. The idea is to emphasize that man is not only an active, but also a responsible being which is capable of making a paradigm shift in responsibility, and therefore, taking responsibility for all life on Earth. Content analysis and comparative method were introduced and applied for the requirements of making this review. Based on the obtained results, the review points to the need to create new ethics which could introduce a general value system for all living and non-living things - a paradigm shift involving man as part of nature and not opposed to it, and to successfully address these complex issues. It will take a profound shift in human consciousness to fully comprehend that it is not only plants and animals that need a safe habitat - because they can live without humans, but humans cannot live without them.
      PubDate: 2022-04-27
      DOI: 10.26332/seemedj.v6i1.219
      Issue No: Vol. 6, No. 1 (2022)
       
 
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