Abstract Idiopathic dilatation of the right atrium is a rare condition with an unknown etiology. It is characterized by a significant enlargement of the right atrium without the presence of other valvopathies, intracardiac shunts, or pulmonary hypertension. This report presents the case of a 50-year-old woman with a significantly enlarged right atrium that was identified at birth; however, a definitive diagnosis was made later in life. The patient did not have any genetic diseases. Through the help of regular follow-up, anticoagulant therapy, previous radio-frequency ablation, and antiarrhythmic medications, she was able to carry a pregnancy to full term and live a regular life.

AIMS The aim of this study was to estimate cutoff values of mid-upper arm circumference (MUAC) and calf circumference (CC) for reduced muscle mass and analyze their accuracy in identifying malnutrition among individuals of 65 years of age or older in Bosnia and Herzegovina. MATERIALS AND METHODS The study is a secondary analysis dataset assessing nutritional risk and malnutrition among 446 community-dwellers and nursing home residents in Bosnia and Herzegovina. Malnutrition assessment included phenotypic criterions (weight loss, low body mass index, and reduced muscle mass) and etiologic criterions (inadequate food intake, disease-related inflammation, or albumin levels) according to recommendations of the Global Leadership Initiative on Malnutrition (GLIM). Receiver operating curves were used to calculate MUAC and CC's cutoff values as compared to the Mini Nutritional Assessment (MNA). RESULTS The optimal cutoff value for MUAC in men was 24 cm (AUC = 0.910, sensitivity 100%, specificity 77%), and in women 23 cm (AUC = 0.792, sensitivity 64%, specificity 83%). Optimal cutoff value of CC in men was 31 cm (AUC = 0.818, sensitivity 100%, specificity 67%) and in women 29 cm (AUC = 0.882, sensitivity 86%, specificity 74%). Two hundred fifty nine elderly individuals were categorized as malnourished/at risk for malnutrition per MNA. The prevalence of malnutrition based on GLIM criteria ranged from 19% to 30%. CONCLUSIONS The study suggested that MUAC and CC may be used as the alternative indicators of muscle mass when other assessment methods are unavailable. Future validation and reliability studies for GLIM using anthropometric parameters as a proxy of reduced muscle mass are needed.

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29–39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance. Analysis of HbA1c and FPG levels across 117 population-based studies demonstrates regional variation in prevalence of previously undiagnosed screen-detected diabetes using one or both measures and suggests that use of elevated FPG alone could underestimate diabetes prevalence in low- and middle-income countries.

This study aimed to investigate the effect of lifestyle intervention (LSI) on diagnosed infertility in overweight and obese women. A systematic review and meta-analysis were conducted. A literature search was performed on the following databases from September 2022 to December 2022: PubMed, Web of Science, and SPORTDiscus. The inclusion criteria were the following: women between 18 and 45 years of age, BMI over 25.0 kg/m2, diagnosed with infertility, a weight loss intervention, and control group part of RCTs. In total, 15 studies were identified and included. The meta-analysis shows a beneficial effect of LSI on reducing weight, waist circumference, and BMI and increasing infertility. A significantly beneficial effect of lifestyle intervention on weight reduction was observed for participants who initially had a higher BMI, while a non-significant effect was observed for individuals with a BMI above 35 kg/m2. The meta-analysis showed a beneficial effect of lifestyle intervention on ovulation incidence and sex hormone-binding globulin. The lifestyle intervention group had 11.23 times more ovulatory incidence than the control group, which in turn increased the ability to conceive. As robust evidence for the effect of lifestyle interventions on infertility in obese and overweight women was found, it is advised to integrate similar interventions into future infertility treatment processes.

Šumske ceste kao trajni građevinski objekti zahtijevaju ispunjene minimalno propisane kvalitete i standarda tijekom izgradnje. Prema dostupnim podacima prosječni troškovi gradnje šumskih cesta u F BiH za 2019. godinu iznosili su 22.282,19 € po dužnom kilometru (Anon 2019a). Ovako niski troškovi gradnje nameću opravdano pitanje kvalitete novoizgrađenih šumskih cesta i potrebno mu je posvetiti odgovarajuću pozornost. Na području F BiH, zbog niza razloga, sve se više grade prilazne ili tzv. tehnološke šumske ceste, koje se zbog činjenice da se radi o vrsti šumskih cesta bez izvedene kolničke konstrukcije mogu koristiti samo po suhom vremenu te zbog toga ne ulaze u obračun klasične otvorenosti šuma. Osim toga, zbog nedostatka odvodnih jaraka i prevelikog uzdužnog nagiba nivelete na ovim cestama mogu nastati nesagledive ekološke posljedice. S obzirom da postojeća otvorenost šuma u F BiH nije na zadovoljavajućoj razini, cilj svih šumarskih poduzeća je njeno povećanje. Kako se gradnjom šumskih cesta bez izvedene kolničke konstrukcije ne utječe na povećanje otvorenosti, količina cesta koju je potrebno izgraditi za dostizanje ciljane klasične otvorenosti ostaje nepromijenjena. Kao rješenje za riješavanje navedene situacije, u praksi se u posljednje vrijeme sve više grade šumske ceste s elementima koji čine kombinaciju sporednih i prilaznih šumskih cesta. U ovom radu je izvršena analiza tehničkih i konstruktivnih elemenata za novoizgrađenu šumsku cestu „Braćinac - Doljanske stijene“ stacionaže 1,72 km. Na osnovi dobivenih rezultata, došlo se do saznanja o elementima koje na ovoj cesti treba unaprijediti kako bi se ista očuvala, odnosno kako bi se omogućilo njeno dugogodišnje korištenje. S tim u vezi evidentirana su odstupanja uzdužnog nagiba nivelete u odnosu na propisane veličine na 41% od ukupne dužine, na 26% od ukupne dužine nagibi škarpi usjeka nisu prilagođeni kategoriji materijala u kojoj su izgrađene, duž cijele šumske ceste nisu izgrađeni odvodni kanali. Navedena odstupanja daju za rezultat propadanje kolničke konstrukcije, s obzirom da su na 24% evidentirana manja, a na 9% veća oštećenja. Imajući u vidu da su mjerenja na terenu urađena samo godinu dana nakon izgradnje šumske ceste, nameće se zaključak da niska kvaliteta gradnje i nepridržavanje tehničkih propisia rezultira ubrzanim propadanje ceste.