Tuesday, 22 June 2021

HNS and St Catherine Specialty Hospital Invite Christian Eriksen to Zagreb for Genetic Testing

June 22, 2021 - After collapsing on the pitch during the Euro 2020 game between Denmark and Finland, HNS and St Catherine Specialty Hospital want to help Danish footballer Christian Eriksen. 

St Catherine Specialty Hospital Management Board president and Croatian Football Federation health commission president Dragan Primorac sent a letter to the Danish Football Federation president Jesper Moller and Secretary-General Jakob Jensen, urging them to have their national team member Christian Eriksen (29) perform a comprehensive genetic test in Croatia to determine the possible genetic basis of cardiac arrest, reports Index.hr.

The Denmark national team player shocked the world when he collapsed on the pitch in the 43rd minute of the match between Finland and Denmark on June 12. The doctors revived him on the pitch for ten minutes. Eriksen was transferred to the hospital, from where he later contacted his teammates, and they then decided to continue the match. He was then fitted with an ICD, a device that can restore normal heart function.

It is known that the Croatian Football Federation and the St Catherine Special Hospital, in cooperation with the American corporation Invitae, launched a project in June 2019 to prevent sudden cardiac death, which with a complete cardiac examination (12-channel electrocardiogram, heart ultrasound, ergometry, and 24-Holter) includes the most comprehensive analysis described in the literature genes associated with conditions that can lead to sudden cardiac death in athletes.

Eriksen's genetic testing would be conducted as part of the project "Development of a Comprehensive Model for the Prevention of Sudden Heart Death: Analysis of 294 Genes and Related Mutations Associated with Conditions That Can Lead to Athlete's Sudden Heart Death."

If, after genetic testing, the occurrence of a mutation in one of the genes associated with conditions that can lead to the sudden cardiac death of an athlete is determined, it will be necessary to test his children as well. Eriksen, meanwhile, is fitted with an implantable cardioverter-defibrillator (ICD) that can successfully detect the occurrence of arrhythmias in the future and restore a normal heart rhythm and save a person's life.

The first results related to the role of specific genetic markers as possible predictors of sudden cardiac death in athletes were conducted by scientists from the USA, Canada, Croatia, and Germany, led by Dr. Primorec, and recently published in the scientific journal Frontiers in Medicine.

The results of a study involving three generations of families of athletes who died of sudden cardiac death have been published, and the study has analyzed the largest number of genes associated so far with several inherited cardiac conditions leading to sudden cardiac death 294 genes.

Among the analyzed genes are those that lead to various disorders of the electrical activity of the heart, including hereditary disorders of cardiac ion channels, such as prolonged QT interval syndrome, Brugada syndrome, but also genes whose changes lead to structural changes in the heart, such as cardiomyopathies (most often hypertrophic cardiomyopathy), and several other conditions.

HNS President Davor Suker introduced FIFA leader Gianni Infantino and UEFA president Alexander Ceferin to the published, as it is now called, "Croatian model for the prevention of sudden cardiac death in athletes," which includes the analysis of the largest number of genes associated with sudden cardiac death, especially in players from risk groups. 

During the start of the project in June 2019, a member of the project team and one of the most prominent German cardiologists, prof. Dr. Johannes Brachmann stated that the latest scientific findings suggest that classical cardiac examination is not sufficient in the early detection of conditions that can lead to sudden cardiac death in athletes and that genetic screening in predisposed athletes plays a key role.

It was then particularly emphasized that extremely intense physical activity can increase the risk of sudden cardiac death in predisposed athletes. Following the Guidelines (Positions) of the Croatian Society for Human Genetics of the Croatian Medical Association, all persons identified through screening as persons at higher risk will be provided with information as part of genetic counseling during risk identification and after additional tests. This will be the basis for optimal treatment and, if necessary, exclusion from sports of high-risk athletes to reduce the incidence of sudden cardiac death.

Since the beginning of the project "Development of a comprehensive model for the prevention of sudden cardiac death: Analysis of 294 genes and associated mutations associated with conditions that can lead to sudden cardiac death of athletes", on two occasions, the Croatian Football Federation sent a letter to all First, Second and Third HNL clubs, First and Second HNLŽ clubs, and First and Second HNML clubs, urging all players from defined risk groups (athletes with a personal or family history of cardiovascular disease, athletes with a specific cardiovascular result after a clinical examination, athletes with previous episodes of weakness or excessive fatigue that are not in line with exertion, athletes with dizziness or unexplained loss of consciousness and chest pain, etc.) after standard cardiac treatments, and underwent genetic testing as part of the project.

At the end of the letter,  Dr. Primorac congratulated Denmark on advancing to the round of 16.

"It was tough for all of us to watch the recent scenes of Eriksen after he collapsed in the first half of the 2020 European Championship match between Denmark and Finland. The most important thing now is that he is well and that the medical team has done everything to stabilize his condition. However, the New England Journal of Medicine, one of the leading scientific journals, points out that in about 40% of cases of sudden cardiac death, the cause remains unknown. Therefore, I believe that genetics and other OMICS disciplines will play a key role in better understanding the mechanism occurrence and the prevention of these tragic events.

In our comprehensive model of sudden cardiac death prevention, in addition to standard cardiac tests, we placed special emphasis on the analysis of 294 genes associated with conditions that lead to sudden cardiac death. Therefore, as part of the project, we want to help colleagues from the Danish Football Association in searching for the real cause of cardiac arrest that happened to Eriksen, to optimize his treatment, but also to determine the possible existence of mutations associated with conditions that can lead to sudden cardiac death," concluded Dragan Primorac.

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Saturday, 21 December 2019

St. Catherine Hospital Scientists Confirm Long-Term Benefits of Stem Cells Therapy

Croatian scientists from the St. Catherine Specialty Hospital published an extremely important scientific paper in the Genes scientific journal, showing that the injection of the stromal and the mesenchymal stem cells into the knee joint shows long-term effects when measured 24 months after application.

The paper, which you can read here (full text of the paper is available if the reading of highly technical and scientific papers is your thing) is called "A 24-Month Follow-up Study of the Effect of Intra-Articular Injection of Autologous Microfragmented Tissue on Proteoglycan Synthesis in Patients with Knee Osteoarthritis”. It's a multicentric project, with the goal to confirm the effect of micro-fragmented fat tissue (stromal vascular fraction from microfragmented lipoaspirate, so-called SVF) intra-articular injection 24 months after application, in the patients suffering from osteoarthritis (OA). The project head and the corresponding author of the paper was professor Dragan Primorac, M.D.,Ph.D., and the other authors are St. Catherine's drs. Igor Borić, Damir Hudetz, Eduard Rod, Željko Jeleč, Andrea Skelin, Mihovil Plečko, Trpimir Vrdoljak and their partners from other Croatian scientific institutions drs Ozren Polašek, Irena Trbojević-Akmačić and Gordan Lauc.

The results of this study suggest that the mesenchymal stromal and the mesenchymal stem cells separated from the microfragmented fat tissue lead to the increase of the key molecules of cartilage (the so-called glycosaminoglycans (GAGs) two years after the application within the joint. Although the level of GAGs for 24 months after the application were somewhat lower than when measured 12 months after the application, in over 50% of the subjects (52 per cent) they were higher than before the treatment. The glycosaminoglycans (GAG) content in cartilage was measured by means of delayed gadolinium (Gd)-enhanced magnetic resonance imaging of cartilage (dGEMRIC), while the clinical outcome on observed level of GAG using standard orthopaedic physical examination.

Lucija Zenić and Denis Polančec from the Srebrnjak Children's Hospital helped the team in using the methods of immunophenotyping and flow cytometry to determine the types and the content of the SVF, determining the dominant populations of cells. At the same time, while examining the clinical results of the treatment of the knee with the autologous micro-fragmented fat tissue it was determined that 85 per cent of the patients report the significant improvement, as confirmed by the standard orthopaedic tests, such as Knee Injury and Osteoarthritis Score (KOOS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), as well as pain intensity measurement - VAS scale.

Simultaneously, the team at St. Catherine's hospital wanted to report that Springer the publisher of the leading scientific magazine Nature published a chapter on "The Future of Cartilage Repair” in the book entitled "Personalized medicine in Healthcare Systems", in which the physicians from St. Catherine Hospital participated as authors. They've argued that the production of the bioactive molecules increases the improvement of a number of measurable parameters in patients, and because of that specific effect they would like the "Mesenchymal Stem Cells" to be renamed the "Medicinal SIgnaling Cells". The new findings in the modern regenerative medicine and the available methods of therapy, performed at the St. Catherine's Specialty Hospital give new hope to the patient, provide the newest breakthroughs in the treatment of this disease, but also position the Croatian health system powerfully worldwide.

Osteoarthritis is one of the most common health problems in the world with the increasingly ageing population, and some estimated say that currently, over 600 million people suffer from it. The treatment has been based on relieving the symptoms and implanting the endoprosthesis when it was determined that the cartilage can not be salvaged.

Prof. Dragan Primorac, M.D.,Ph.D., said that the results published in the Genes and the results published earlier will be changing some existing paradigms, and show the way towards a better understanding of the biology and the treatment of the osteoarthritis with autologous mesenchymal stromal and stem cells present within the microfragmented fat tissue. In osteoarthritis and in numerous other diseases, the future of medicine will be based on the integration of the principles of personalized and regenerative medicine into the clinical practice. I am happy that the Croatian experts once more proved their global excellence, and I'm especially happy that the results of our research have a great impact on the treatment of the patients suffering from osteoarthritis. It is clear that our results have an extraordinary significance in the development of the new diagnostic, therapeutic and prognostic algorithms related to osteoarthritis.

Tuesday, 16 October 2018

Croatia's St Catherine Specialty Hospital, OneOme Partner to Increase Pharmacogenetic Testing Access in Europe

October 15, 2018 - Talking medical care to a new level in Croatia and  Europe, OneOme, co-founded with Mayo Clinic, and St Catherine Specialty Hospital in Zagreb, announce a partnership to increase access to pharmacogenetic testing across Europe. 

Monday, 30 October 2017

Most Complex Orthopaedic Surgery Performed at St. Catherine Special Hospital

One of the most complex orthopaedic surgery interventions in the lower extremities of a child suffering from brittle bone disease (osteogenesis imperfecta) was performed in St. Catherine Special Hospital.

Thursday, 5 October 2017

St. Catherine Hospital in Croatia Awarded Prestigious Global Healthcare Accreditation

During the plenary session at 10th World Medical Tourism & Healthcare Congress in Los Angeles, St. Catherine Hospital in Croatia, along with Cleveland Clinic in the USA, was awarded one of the world’s most prestigious accreditation.