AKTIVNOST SUPEROKSID DISMUTAZE I LIPIDNI PROFIL U SERUMU PACIJENATA S HEMODIJALIZOM

Objectives/Aim: Hemodialysis (HD) is associated with a number of biochemical abnormalities including dyslipidemia and oxidative stress. The aim of this study was to evaluate the relationship between serum superoxide dismutase (SOD) activity and lipid profi le in HD patients with different duration of HD treatment. Material and Methods: This cross-sectional study included 100 HD patients that were divided into two subgroups based on the duration of HD therapy: patients on HD for more than three months but less than fi ve years (HD <5 years; n=48) and patients on HD for fi ve years or more (HD ≥5 years; n=52). Control group (n=50) consisted of age- and gender-matched, apparently healthy individuals without subjective and objective indicators of any renal disease. Blood samples were obtained for determination of SOD, total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Serum SOD concentration was determined by ELISA method using a commercial kit. Results: Serum concentration of SOD was increased in HD patients when compared to healthy controls. SOD concentration was signifi cantly higher in HD <5 year group compared with control group [12.29 (10.85-14.15) vs.11.04 (9.42 -12.99) U/mL; p<0.05]; however, there was no signifi cant difference in SOD concentration between HD≥5 year group [12.97 (10.27-14.56) U/mL] and healthy control subjects. In addition, there was no significant difference in serum SOD concentration between HD patients with different duration of dialysis therapy. The levels of TC, LDL and HDL were significantly decreased in both groups of HD patients as compared with control subjects (p<0.0005); however, serum TG levels did not differ significantly between the study groups. According to the ROC analysis, serum levels of TC, LDL and HDL had higher sensitivity than serum SOD concentration in differentiating HD patients from healthy subjects. Conclusions: According to our results, it is concluded that increased serum SOD concentration together with alterations in the lipid profi le enhances the risk of atherosclerosis and favors higher incidence of cardiovascular complications in HD patients.Uvod/cilj: Hemodijaliza (HD) je povezana s brojnim biokemijskim abnormalnostima uključujući dislipidemiju i oksidativni stres. Cilj istraživanja bio je ispitati aktivnost i utvrditi povezanost enzima superoksid dismutaze (SOD) s parametrima lipidnog profi la kod bolesnika na HD. Metode: Presječnom studijom obuhvaćeno je 100 HD bolesnika koji su podijeljeni u dvije skupine: bolesnici koji su bili liječeni pomoću HD više od tri mjeseca, ali manje od pet godina (HD <5 godina, n=48) i bolesnici koji su bili liječeni pomoću HD pet godina i više (HD ≥5 godina, n=52). Kontrolnu skupinu (n=50) činile su po dobi i spolu odgovarajuće zdrave osobe bez subjektivnih i objektivnih pokazatelja bubrežne bolesti. Uzorci krvi služili su za određivanje koncentracija SOD, ukupnog kolesterola, triglicerida (TG), lipoproteina male gustoće (LDL) i lipoproteina velike gustoće (HDL). Serumska koncentracija SOD određena je metodom ELISA upotrebom komercijalnog kita. Rezultati: Serumska koncentracija SOD bila veća kod HD bolesnika u usporedbi sa zdravim kontrolnim osobama. Koncentracija SOD u skupini bolesnika na HD <5 godina bila je značajno veća u odnosu na kontrolnu skupinu ispitanika [12,29 (10,85-14,15 prema 11,04 (9,42-12,99) U/mL (p<0,05)], ali nije utvrđena značajna razlika u koncentraciji SOD između skupina bolesnika na HD ≥5 godina [12,97 (10,27-14,56) U/mL] i zdravih ispitanika kontrolne skupine. Uz to, nije bilo značajne razlike u serumskoj koncentraciji SOD između HD bolesnika koji su bili liječeni pomoću HD <5 godina i ≥5 godina. Utvrđeno je značajno smanjenje koncentracija TC, LDL i HDL u objema skupinama HD bolesnika u odnosu na kontrolnu skupinu (p<0,0005), ali razine serumskih TG nisu se značajno razlikovale između promatranih skupina. Rezultati dobiveni ROC analizom pokazali su da su serumske razine TC, LDL i HDL u odnosu na serumsku koncentraciju SOD osjetljivije u razlikovanju HD bolesnika i zdravih osoba. Zaključak: Na osnovi naših rezultata može se zaključiti da povišena serumska koncentracija SOD, zajedno s promjenama lipidnog profi la, povećava rizik od ateroskleroze i kardiovaskularnih komplikacija kod HD bolesnika

Širina distribucije eritrocita i trombocitni indeksi kao inflamatorni parametri kod pacijenata sa šećernom bolesti tipa 2 i disfunkcijom bubrega

Aim: To assess Red blood cell Distribution Width (RDW) and platelet indices values in patients with type 2 diabetes mellitus (T2DM) and to verify its association with kidney dysfunction (KD). Patients and Methods: A cross-sectional study included 149 T2DM subjects divided into two groups with (T2DM – KD; n=52) and without (T2DM-nKD; n=97) presence of kidney dysfunction and 30 healthy subjects. White Blood Cells (WBC) count, C-reactive protein (CRP), fibrinogen, RDW, platelet indices, urea, and creatinine, were measured in all participants. Kidney function was evaluated by the estimated glomerular filtration rate (eGFR) calculated using the simplified Modification of Diet in Renal Disease (MDRD) formula. Results: T2DM-KD subjects showed statistically significantly higher values of the parameters RDW (p<0.01), Mean Platelet Volume - MPV (p<0.01), Platelet Distribution Width-PDW (p<0.01), Platelecrit-PCT (p<0.01), and Platelet Mass Index-PMI (p<0.01) compared to T2DM-nKD subjects, and statistically significantly lower values of the WBC count in T2DM-KD subjects compared to subjects suffering from T2DM without kidney dysfunction (p<0.01). ROC curve analysis revealed that RDW (sensitivity of 80.8%, specificity of 78.3%), MPV (sensitivity of 75%, specificity of 78.4 %), and PDW (sensitivity of 80.8%, specificity of 83.5%) could be used as markers in distinguishing between T2DM subjects with and without kidney dysfunction. Conclusion: This study confirms the reliability of the RDW,MPV, and PDW as simple, low cost and useful markers in distinguishing between T2DM subjects with and without kidney dysfunction.Cilj: Evalvirati vrijednosti širine raspona veličine eritrocita (RDW) i trombocitnih indeksa kod pacijenata sa šećernom bolesti tipa 2 (T2DM) i potvrditi njihovu povezanost s disfunkcijom bubrega (KD). Pacijenti i metode: Presječna studija uključila je 149 pacijenata sa šećernom bolesti tipa 2 podijeljenih u dvije grupe – pacijente s bubrežnom disfunkcijom (T2DM-KD; n = 52) i bez nje (T2DM-nKD; n = 97), te 30 zdravih ispitanika. Broj leukocita (WBC), C-reaktivni protein (CRP), fibrinogen, RDW, indeksi trombocita, urea i kreatinin izmjereni su kod svih participanata. Kao mjera funkcije bubrega korištena je procijenjena brzina glomerularne filtracije (eGFR) izračunata korištenjem formule MDRD (Modification pf Diet in Renal Disease). Rezultati: Pacijenti s T2DM-KD pokazali su statistički značajno veće vrijednosti parametara RDW (p < 0,01), srednji volumen trombocita - MPV (p < 0,01), širinu distribucije volumena trombocita - PDW (p < 0,01), trombokrit - PCT (p < 0,01) i indeks mase trombocita - PMI (p < 0,01) te statistički značajno niže vrijednosti WBC u odnosu na pacijente koji boluju od T2DM bez bubrežne disfunkcije (p < 0,01). Analiza ROC krivulje otkrila je da se RDW (granični nivo 53,5, senzitivnost 80,8 %, specifičnost 78,3 %), MPV (granični nivo 11,55, senzitivnost 75 %, specifičnost 78,4 %) i PDW (granični nivo 15,65, senzitivnost 80,8 %, specifičnost 83,5 %) mogu koristiti kao markeri u razlikovanju pacijenata sa šećernom bolesti tipa 2, onih s bubrežnom disfunkcijom i onih bez nje. Zaključak: Ova studija potvrđuje pouzdanost RDW, MPV i PDW kao jednostavnih, jeftinih i korisnih markera u razlikovanju pacijenata sa šećernom bolesti tipa 2, s bubrežnom disfunkcijom i bez bubrežne disfunkcije

Relationship between depression and quality of life after myocardial infarction

Aim To examine the prevalence of depression in patients after acute myocardial infarction (AMI), as well as the relationship between the depression and quality of life. Methods The survey was conducted via sociodemographic questionnaire, Beck Depression Inventory (BDI), and Short Form 36 Health Survey questionnaire (SF-36). The result of SF-36 is expressed in subscales that make up the health status profile, i.e. physical functioning, physical role, emotional role, social functioning, mental health, vitality, pain and general health. Results The study included 120 patients, of which 70 males and 50 females aged between 41 and 88 years (mean 64.73±11.218). All patients were hospitalized at the Clinical Centre of the University of Sarajevo, Clinic for Cardiovascular Disease and Rheumatism, due to complications caused by AMI. After AMI 59 (49.17%) patients had depression. Depression was negatively associated with physical functioning, physical role, emotional role, social functioning, mental health, vitality, pain and general health. Physical functioning (r= -0.701; p<0.01) and physical role (r = -0.538; p<0.01) had the highest correlation with depression. Conclusion The evaluation of depressive symptoms after AMI is imperative, because the appearance of symptoms could have an effect on the patient's quality of life

Can neutrophil-to-lymphocyte ratio and proatherogenic risk factors improve the accuracy of pneumonia severity index in the prediction of community acquired pneumonia outcome in healthy individuals?

Aim To investigate influence of neutrophil-to-lymphocyte ratio (NLR) and proatherogenic risk factors to improve the accuracy of pneumonia severity index (PSI) in the prediction of community acquired pneumonia (CAP) outcome in healthy individuals. Methods A retrospective observational cross-sectional study conducted at the Clinic for Pulmonary Diseases and Tuberculosis “Podhrastovi”, University Clinical Centre Sarajevo, included 83 patients with the diagnosis of CAP during the period March 2019-March 2021. Once diagnosed with CAP, PSI score was calculated and according to its value the need for hospital treatment was identified. Patients were divided in two groups: low risk of CAP (PSI 90). Results The overall average hospital stay was 22.76±10.154 days. In the patients diagnosed with CAP, a positive correlation was established between the following parameters PSI score and age (r=0.670; p<0.01), C-reactive protein-CRP (rho=0.287; p<0.01), leukocytes (rho=0.406; p<0.01), NLR (rho=0.313; p<0.01) and platelet to lymphocyte ratio (PLR) (0.296; p<0.05). CRP, leukocytes, NLR and PLR were statistically significantly higher in patients with high risk of CAP compared to patients with low risk of CAP. Diastolic blood pressure, lymphocytes, eosinophils were significantly lower in patients with high risk of CAP (p<0.05;) compared to patients with low risk of CAP (p<0.01). The optimal cut-off value of NLR for CAP patients was 3.089 with an estimated area under curve (AUC) of 0.664. Conclusion Proatherogenic parameters such as age, systolic blood pressure and leukocytes in combination with neutrophil-lymphocyte count ratio could improve accuracy of the pneumonia severity index in community acquired pneumonia outcome

The serum triglyceride to high-density lipoprotein (HDL) ratio in patients with acute coronary syndrome with and without renal dysfunction

Aim To assess triglyceride – to high-density lipoprotein cholesterol (TG/HDL)-C ratio in patients with acute coronary syndrome (ACS) and to verify its association with renal dysfunction. Methods A cross sectional study included 85 ACS patients divided in two groups with (ACS – RD) and without (ACS-nRD) presence of renal dysfunction, and 35 healthy subjects. Blood pressure, blood glucose, C-reactive protein, urea, creatinine, eGFR and serum lipids levels (total cholesterol, triglycerides, LDL-C, HDL-C) was measured in all participants. Based on the values of the measured lipid fractions TG/HDLc ratio was calculated. Results Patients in ACS group had significantly lower HDL-C level (p<0.0005) but significantly higher TG level (p=0.046) and TG/HDL-C ratio (p<0.0005) than controls. There was a significant increase (p<0.0005) in TG/HDL-C ratio in ACS-RD group compared to ACS-nRD group. The ACS-RD group had significantly higher level of TG (p=0.001), serum urea (p=0.02) and creatinine (p<0.0005) compared to the ACS-nRD group. With a cut-off level of 1.135 TG/HDL-C ratio had a sensitivity of 77.6% and a specificity of 62.9% in distinguishing between ACS patients and healthy subjects. With cut-off value of 1.905 TG/HDL-C ratio had a sensitivity of 75.9% and a specificity of 78.6% in distinguishing between ACS patients with and without renal dysfunction. Conclusion This study confirms the reliability of the TG/HDL-C ratio as a simple, low cost and useful marker in distinguishing between patients with ACS and healthy subjects and ACS patients with and without renal dysfunction

Parameters in predicting the risk of a prolonged hospital stay in patients with acute exacerbation of chronic obstructive pulmonary disease: a single-centre experience

Aim To identify clinical and laboratory parameters on admission and/or during a hospital stay that would predict prolonged hospital stay in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A retrospective cross-sectional study was conducted at the Clinic for Pulmonary Diseases and Tuberculosis, Clinical Centre University of Sarajevo for the period 2019-2021 accounting patients admitted due to AECOPD. The need for hospitalization was evaluated according to the current GOLD criteria and certain clinical parameters. Spirometry testing and laboratory analysis were performed for all patients on the day of admission and on the 10th day of hospital stay. Linear regression was used to show the relationship between multiple independent predictor variables and LOS. Results A total of 50 patients were evaluated during their hospital stay due to AECOPD. Median of LOS was 22.02±1.06, with 90% hospital survival rate. Due to AECOPD the median of LOS in the intensive care unit (ICU) was 4±0.68 days with pH<7.35 in 34% of hospitalized patients. According to spirometry classification on the day of admission, 56% of patients were assigned to group 3 and 16% to group 4 with significant improvement identified on spirometry findings on discharge. Platelets on the day of admission were the only statistically significant positive predictors of the length of hospital stay. Conclusion Identifying chronic obstructive pulmonary disease patients at risk of frequent exacerbations and appropriate disease management could reduce the disease burden

ELEVATED SERUM C-REACTIVE PROTEIN LEVEL IS NOT ASSOCIATED WITH SERUM NITRIC OXIDE IN PATIENTS WITH POSTTRAUMATIC STRESS DISORDER

Background: The aim of the present study was to evaluate serum nitric oxide (NO) and C reactive protein (CRP) concentration in veterans with and without PTSD. Furthermore, we aimed to assess whether there is a correlation between serum NO and CRP concentrations in tested groups. Subjects and methods: Cross-sectional study included 90 male individuals, with and without experience of direct war combat, divided into three equal groups (n=30): group 1- included war veterans with PTSD, group 2 - included war veterans without PTSD, and control group - 30 apparently healthy volunteers, without experience of direct war combat. The diagnosis of PTSD was assessed according to the guidelines in the 10th revision of the International Classification of Diseases (ICD-10). High-sensitivity CRP was determined by immunonephelometry. The serum NO level was determined by classic colorimetrical Griess reaction. Results: Serum CRP concentration in veterans with (3.54±1.19 mg/L) and without PTSD (3.24±2.04 mg/L), was significantly higher (p<0.05) compared to control group (1.26±1.06 mg/L). Serum NO concentration in veterans with (7.64±4.43 μmol/L) and without PTSD (7.12±2.60 μmol/L) was significantly lower (p<0.05) compared to control group (11.26±7.01 μmol/L). Statistically significant correlation between serum NO and CRP concentration was determined in veterans without PTSD (r=-0.473; p<0.01). No correlation was observed between serum NO and CRP concentration in veterans with PTSD (r=0.118; p=0.534) and in control group (r=-0.067; p=0.727). Conclusion: The present study has showed significant increase of serum CRP and significant decrease of serum NO concentrations in veterans with and without PTSD. Furthermore, statistically significant negative correlation between serum NO and CRP concentration was determined only in veterans without PTSD. Obtained results indicate that the complex mechanism of the pathogenesis of PTSD requires further research

Endometrijalni karcinom povezan s porastom CA 15_3 i CA 125 u bolesnice s karcinomom dojke liječene tamoksifenom

U radu je prezentiran slučaj endometrijalnog karcinoma kod pacijentice s rakom dojke tretiranim tamoksifenom. Bolest se manifestovala povišenim vrijednostima tumorskih markera CA 125 i CA 15_3, bez drugih znakova. Urađene su dodatne dijagnostičke analize koje su pokazale da se radi o de novo nastalom endometrijalnomkarcinomu, a ne o metastatskoj promjeni karcinoma dojke. Pacijentica je podvrgnuta operativnom zahvatu i radioterapiji. Nakon toga, vrijednosti tumorskih markera bile su u referentnim vrijednostima

Serum malondialdehyde (MDA) level as a potential biomarker of cancer progression for patients with bladder cancer

Introduction. Bladder cancer is the most common malignancy involving the urinary system. Recent research tends to emphasize the role of oxidative stress products in the carcinogenesis of bladder cancer. The level of oxidative stress can be measured by assessing the MDA levels. This study aimed to evaluate serum MDA levels in patients with bladder cancer, as well as to determine its potential role as a biomarker in the diagnosis of the disease and progression risk considerations