Biomedical subjects

Ines Brajac

Publications and source records attributed to Ines Brajac.

12 recordsLinked to original sources

PubMed2006

Apoptosis and immune response are responsible for the site-specific incidence of non-melanoma skin cancer.

UNLABELLED: Generally, the cumulative UV exposure correlates with the site-specific incidence of skin cancer but more detailed analysis showed that the frequency of BCC of some facial regions cannot be explained with site-specific UV exposure. Apoptosis plays a central role in cancer development due to suppressed process of programmed cell death. Anatomic localization, UV and senescence can influence expression of apoptosis related molecules resulting in advantage of cancer cells development and tumor progression. Anti-tumor immune response, as an important factor in elimination of cancer cells, is also modified by UV radiation and aging, further contributing to cancer progression and its development. HYPOTHESIS: UV radiation, senescence and proliferation intensity influence the expression of apoptosis related molecules in normal keratinocytes. Mutated cells express altered molecules with different degree of antigenicity. We propose that small differences in the expression of pro- and anti-apoptotic molecules in the keratinocytes in association with the local immune reaction (modulated also by UV radiation) determine the type of the non-melanoma skin cancer as well as their frequency (site-specific incidence). In vitro and in vivo models could explain how the modulation of UV can influence the apoptotic system and local immune reaction, while animal experiments could explain different site-specific incidence (frequency) of the same tumor. Better understanding of these mechanisms could lead to development of different therapeutic approaches for early elimination of cancer prone cells or cells in early stages of cancer development. The same model could be used to explain the site-specific localization of other types of cancer (i.e. melanoma) or benign tumors.

Aging↗

PubMed2006

Apoptosis mediated by cytolytic molecules might be responsible for maintenance of psoriatic plaques.

Psoriasis is a chronic hyperproliferative skin disease characterized by keratinocyte hyperproliferation and inflammation. It is generally considered as an autoimmune disease mediated by T cells. The precise mechanism of triggering keratinocyte hyperproliferation is as yet unknown. Apoptosis seems to be important in the maintenance of skin cell homeostasis as well as in the pathogenesis of some skin diseases. We hypothesize how apoptosis mediated by cytolytic mechanisms could be involved in initiating and maintenance of psoriatic plaque. Increased keratinocyte hyperproliferation might develop as a consequence of failure to remove self-reactive T cells by apoptosis that in other way cause significant keratinocyte damage. Apoptotic keratinocytes might trigger an injury response program causing regenerative hyperplasia of epidermal keratinocytes. Another possibility is that the failure to eliminate these abnormal keratinocytes could result in the persistence of chronic inflammatory conditions constantly recruiting specific T cells. Increased epidermal thickness in psoriasis could be also explained by imbalance between the expression of pro- and anti-apoptotic proteins. Epidermal keratinocytes have the ability to produce cytolytic molecules, thus they might also have the potential to protect the epidermis from T cell-mediated damage. In conclusion, hyperproliferation of psoriatic keratinocytes might be partly due to changes in the keratinocyte expression of pro- and anti-apoptotic genes, partly to the damaged keratinocytes triggering an inappropriate wound repair response and partly by the failure to eliminate these abnormal keratinocytes resulting in the persistence of chronic inflammation. Each of the proposed mechanisms might be a possible therapeutic target mainly by new immunomodulatory agents.

Apoptosis↗

PubMed2005

Epidemiology of monosymptomatic optic neuritis in Rijeka County, Croatia: meteorological aspects.

In order to analyze the meteorological factors possibly influencing the monosymptomatic optic neuritis in Rijeka County, northwestern part of Croatia, retrospective analysis of all cases diagnosed in Rijeka County in period from 1977 to 2001, was done. Meteorological data on monthly and yearly temperature, humidity, insolation in Rijeka County were collected from Croatian Meteorological and Hydrological Service. In the observed period there were 173 cases of monosymptomatic optic neuritis, female/male ratio was 1.66, and overall incidence was 2.18/100,000 inhabitants. There was no correlation of incidence with average yearly and monthly temperature, humidity, insolation, or month of birth. This is the first study on meteorological factors and optic neuritis in Croatia.

Adolescent↗

PubMed2005

Quality of screening for diabetic retinopathy in the Rijeka region of Croatia.

The aim of this study was to compare the quality of screening for diabetic retinopathy in cities of Rijeka and Zagreb, Croatia. Review of a random sample of 500 diabetic patient records and prospective ophthalmologic survey of 466 randomly selected diabetic patients in a secondary level diabetologic service in Rijeka (coastal region of Croatia). The main outcome measures were proportion of diabetic patient records with notes on ophthalmologic examination; rate of diabetic patients involved with screening for diabetic retinopathy; comparison with rates in Zagreb (Croatian capital). A total of 67% patients visited the ophthalmologist at least once after diagnosed with diabetes, and notes on ophthalmologic examination were found in only 28% patient records. Fifty percent of patients underwent an ophthalmologic examination within two years. Only one third of patients diagnosed with DM in last two years visited the ophthalmologist within this time, and 14% of patients older than 50 years never visited the ophthalmologist. Model of screening for diabetic retinopathy in Croatia works better in Zagreb than in Rijeka region, and needs certain improvements. The authors suggested modern methods of screening, the incorporation of the mechanisms of quality control, the obligatory reporting of newly diagnosed diabetic patients to the national registry, and the direct referral from diabetologist to ophthalmologist.

Adult↗

PubMed2004

Acne vulgaris: myths and misconceptions among patients and family physicians.

The objective of the study was to evaluate the health beliefs and knowledge about acne among acne patients and family physicians. A total of 100 patients referred to a dermatologist for management of acne vulgaris and 120 family physicians completed questionnaires. The questionnaires consisted of questions about health beliefs, the natural course of the disease, the causes of acne, and a set of questions about the knowledge of acne therapy. Acne was considered as a trivial and transitory condition by 52% of the acne patients and 44% of the family physicians. The overall score of correct answers pertaining to the causes of acne among the acne patients and family physicians was 11 and 15%, respectively. The percentage of correct answers regarding the natural course of the disease was 6% for both subsets of subjects. Acne was believed to be curable by 96% of acne patients. Most patients (66%) believed that acne would improve immediately after the first treatment. The knowledge of isotretinoin teratogenecity was reasonable among family physicians (55% correct answers), but it was much lower for other side effects (9%). The overall score of correct answers regarding antibiotic therapy among family physicians was only 21%. Impact of the disease was underestimated by family physicians and also by acne patients. Overall knowledge pertaining to the causes, natural course and therapy was very low. Myths and misconceptions still exist among patients but also among family physicians.

Acne Vulgaris↗

PubMed2004

Psoriasis treatment--yesterday, today, and tomorrow.

In this historical review the authors investigated the treatment of psoriasis through the centuries. There are numerous obstacles in search for the description of psoriasis vulgaris in the works of the great physicians in the antiquity. Most remedies have been developed empirically. During the last two centuries, innumerable drugs have been employed in the treatment of psoriasis. Today dermatologists use the rotational treatment to diminish adverse drug events. In the future psoriasis will probably be cured with the new biological agents.

Forecasting↗

PubMed2004

Cost of treating preventable minor ocular injuries in Rijeka, Croatia.

AIM: To determine the cost of medical services for the treatment of preventable minor ocular injuries in Rijeka, Croatia. METHODS: We analyzed data on 3,755 outpatients (3,363 men and 392 women) treated for eye injuries at the Department of Ophthalmology, Rijeka University Hospital, from April 2002 to March 2003. Median age of patients was 37 years (range, 26-47 years). Data were collected with a questionnaire designed for the study, which included sociodemographic data, type of injury, time and place of injury, and preventability. We carried out cost analysis of the procedures and determined the length of hospital stay. RESULTS: Out of 5,143 emergencies, minor eye injuries comprised 3,755 cases (73%). Minor injuries were potentially preventable in 90% of cases, as they resulted from nonuse or misuse of obligatory protection devices. Total one-year cost of preventable eye injuries was 135,529.55 Euros. CONCLUSION: Preventable minor eye injuries in Rijeka, Croatia, cause a serious medical and economic burden. Stricter adherence to the use of protection devices should be promoted.

Accidents, Occupational↗

PubMed2004

Interleukin-2 receptor alpha-chain expression in patients with alopecia areata.

Interleukin-2 (IL-2) is a lymphokine produced by activated T-cells. Its receptor, IL-2R, is expressed on T-cells. Several clinical and experimental findings point towards IL-2 as a crucial mediator inducing immunologic reaction against human follicle in alopecia areata. The objective of our study was to analyze the expression of IL-2R as a sign of T-cell activation in scalp biopsies of patients suffering from alopecia areata. An immunohistochemical analysis was used to determine the difference in cytokine-regulated expression of IL-2R between 45 patients with active and stable phase of alopecia areata and 23 healthy control subjects. In the patients with alopecia areata in active phase, the expression of IL-2R in scalp biopsies was significantly stronger than that in the patients with stable disease and in controls. The increase of IL-2R+ cells in early phase of the disease could suggest that T-lymphocyte activation with IL-2 secretion and IL-2R expression may initiate the immune inflammatory mechanism of alopecia areata.

Adult↗

PubMed2003

Dermatomycoses in the Rijeka area, Croatia, before, during and after the war 1990-1999.

The frequency of dermatomycoses as well as the spectrum of causative agents in the Rijeka area, northwestern part of Croatia, in the periods before and during the war (1990-1994) and in the postwar period (1995-1999) were analyzed. A total of 20 463 patients with clinically suspected dermatomycoses referred to the Department of Dermatovenerology, Clinical Hospital Center Rijeka, was examined. In the period from 1990 till 1994, 2462 samples were positive, compared with 2250 positive samples during the period from 1995 to 1999. The most frequently isolated dermatophytes were in both periods Trichophyton mentagrophytes and Microsporum canis, followed by Microsporum gypseum, Epidermophyton floccosum, Trichophyton verrucosum and in the first period T. rubrum. An intensive change in composition of the flora was observed in the postwar period, mainly connected to the migration of population from other regions to the Rijeka area. This was demonstrated by a disappearance of T. verrucosum and T. rubrum and by an eruptive occurrence of Trichophyton violaceum. This antropophilic species became third representative in the postwar period, followed by M. gypseum, and E. floccosum. Our data were compared with those obtained in the same area in previous studies, and with results obtained in other countries.

Croatia↗

PubMed2003

Roles of stress, stress perception and trait-anxiety in the onset and course of alopecia areata.

Clinical observations suggest that the nervous system, including psychological factors, can influence the onset and course of alopecia areata (AA). The aim of this study was to determine whether stressful life events, stress perception, and trait-anxiety are risk factors in the onset and course of AA. A group of 45 patients diagnosed with AA and a group of 45 healthy controls were participants in the study. The patients with AA were divided into two subgroups: patients with a first episode of AA and patients with recidivism of the disease. All participants completed questionnaires addressing sociodemographic, clinical and psychological aspects of their disorder. The frequency and types of stressful life events experienced over the previous six months were recorded. Lemyre and Tessier's Mesure de Stress Psychologique was used to measure emotional, cognitive, behavioral, and physiological aspects of distress. Anxiety was evaluated by the Spielberg's Trait Anxiety Inventory. The subgroups of AA and the control group, using the same numbers of subjects matched for age and sex, education level, marital and employment status, were statistically compared. The number of patients with four stressful life events over the previous 6 months was significantly higher in the group of AA patients with recidivism of disease compared to the control group (P=0.004). There were no differences among the other groups with respect to the frequency of life events. Examination of the relationships between the two groups regarding anxiety, as well as perceived distress, revealed that the groups differed significantly with respect to psychosocial variables studied. A significantly higher degree of trait-anxiety and perceived distress were observed among patients in both AA subgroups (first onset and recidivism of AA) than in the healthy control group. The highest scores for anxiety and stress perception among examined groups were obtained in the group with recidivism of AA (33.42 +/- 12.71 and 90.32 +/- 50.74, respectively). Trait-anxiety and stress perception constitutes risk factors that may influence the onset and exacerbation of AA. The present study does not provide evidence of a significant role of stress in the onset of AA. Life events may play an important role in triggering of some episodes.

Adult↗

PubMed2003

Protein p53--structure, function, and possible therapeutic implications.

Cell cycle is driven by a number of positive and negative regulatory phosphorylation and dephosphorylation events that ultimately influence the activity of transcription factors. Normal skin architecture depends on the regulation mechanisms of cell proliferation and differentiation and on apoptosis. Complex interaction of different factors in the regulation of these mechanisms, aimed at maintaining constant desquamation, is often changed in skin diseases. The main difference between normal cells and tumor cells results from discrete changes in specific genes important for cell proliferation control mechanisms and tissue homeostasis. These genes are mainly proto-oncogenes or tumor-suppressor genes, and their mutation could play a role in cell hyperproliferation and carcinogenesis. Tumor-suppressor genes normally function as a physiological barrier against clonal expansion or mutation accumulation in the genome. They also control and arrest growth of the cells that hyperproliferate due to oncogene activity. Alteration or DNA damage in tumor-suppressor genes and oncogenes are considered key events in human carcinogenesis. Tumor-suppressor protein p53 is an important transcription factor, which plays a central role in the cell cycle regulation mechanisms and cell proliferation control, and its inactivation is considered a key event in human carcinogenesis. The role of p53 protein in the cell cycle, high proportion of tumors with mutated p53 gene, and accumulation of significant amount of knowledge on molecular biology of this protein make this molecule especially attractive for development of new therapeutic approaches. Main strategies for development of new antineoplastic therapies are based on "wild-type" p53 protein acting as a tumor suppressor, selective apoptosis inductor, and a protein able to arrest cell cycle.

Genes, p53↗

PubMedDate not supplied

Hyalinosis cutis et mucosae: a 30 year follow up of a female patient.

Hyalinosis cutis et mucosae is an inherited disease, characterized by deposition of a hyaline-like substance in the dermis and internal organs. In the present study, we report a 30 year follow up in a female patient with hyalinosis cutis et mucosae treated using dermabrasion and oral retinoids. In our opinion, the lesion on uncovered body areas should be corrected as soon as possible to enable a normal psychophysical development. The lesions on skin and oral mucosa may be successfully removed without remission with dermabrasion in early childhood. In addition, oral retinoids in adulthood may produce some improvement.

Administration, Oral↗