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    ΠŸΠ Π˜ΠœΠ•ΠΠ НА ЀИНАНБИБКАВА ΠΠΠΠ›Π˜Π—Π Π’Πž ΠžΠ¦Π•ΠΠšΠ НА ΠšΠ Π•Π”Π˜Π’ΠΠΠ’Π Π‘ΠŸΠžΠ‘ΠžΠ‘ΠΠžΠ‘Π’ НА ΠšΠžΠœΠŸΠΠΠ˜Π˜Π’Π•

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    ΠŸΡ€ΠΎΡ†Π΅Π½ΠΊΠ°Ρ‚Π° Π½Π° ΠΊΡ€Π΅Π΄ΠΈΡ‚Π½Π°Ρ‚Π° способност Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΠΈΡ‚Π΅ Π΅ Π΅Π΄Π΅Π½ ΠΎΠ΄ Π½Π°Ρ˜Π²Π°ΠΆΠ½ΠΈΡ‚Π΅ процСси ΠΎΠ΄ ΠΊΠΎΠΈ зависи ΠΊΠ²Π°Π»ΠΈΡ‚Π΅Ρ‚ΠΎΡ‚ Π½Π° ΠΏΠΎΠ±Π°Ρ€ΡƒΠ²Π°ΡšΠ°Ρ‚Π°, односно ΠΊΠ²Π°Π»ΠΈΡ‚Π΅Ρ‚ΠΎΡ‚ Π½Π° ΠΊΡ€Π΅Π΄ΠΈΡ‚Π½ΠΎΡ‚ΠΎ ΠΏΠΎΡ€Ρ‚Ρ„ΠΎΠ»ΠΈΠΎ ΠΈ Π°ΠΊΡ‚ΠΈΠ²Π°Ρ‚Π° Π½Π° Π΅Π΄Π½Π° Π±Π°Π½ΠΊΠ°. Π‘ΠΈΡ‚Π΅ Ρ„Π°ΠΊΡ‚ΠΎΡ€ΠΈ ΠΊΠΎΠΈ Π²Π»ΠΈΡ˜Π°Π°Ρ‚ Π²Ρ€Π· Ρ€ΠΈΠ·ΠΈΡ†ΠΈΡ‚Π΅ со ΠΊΠΎΠΈ сС соочуваат Π±Π°Π½ΠΊΠΈΡ‚Π΅ Π²ΠΎ Π½ΠΈΠ²Π½ΠΎΡ‚ΠΎ Ρ€Π°Π±ΠΎΡ‚Π΅ΡšΠ΅, ΠΎΠ΄ ΠΊΠΎΠΈ Π½Π°Ρ˜Π·Π½Π°Ρ‡Π°Π΅Π½ Π΅ ΠΊΡ€Π΅Π΄ΠΈΡ‚Π½ΠΈΠΎΡ‚ Ρ€ΠΈΠ·ΠΈΠΊ, сС ΠΏΡ€Π΅Π΄ΠΌΠ΅Ρ‚ Π½Π° ΠΈΡΠΏΠΈΡ‚ΡƒΠ²Π°ΡšΠ΅ Π²ΠΎ процСсот Π½Π° финансиската Π°Π½Π°Π»ΠΈΠ·Π°, односно Π°Π½Π°Π»ΠΈΠ·Π°Ρ‚Π° Π½Π° ΠΊΡ€Π΅Π΄ΠΈΡ‚Π½Π°Ρ‚Π° способност Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΠΈΡ‚Π΅. ΠŸΡ€ΠΎΡ†Π΅ΡΠΎΡ‚ Π½Π° финансиска Π°Π½Π°Π»ΠΈΠ·Π° ΠΎΠΏΡ„Π°ΡœΠ° Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° Ρ€Π°Π±ΠΎΡ‚Π΅ΡšΠ΅Ρ‚ΠΎ Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΡ˜Π°Ρ‚Π° Π²ΠΎ ΠΌΠΈΠ½Π°Ρ‚ΠΎΡ‚ΠΎ ΠΈ ΡΠ΅Π³Π°ΡˆΠ½ΠΎΡΡ‚Π°, со Ρ†Π΅Π» Π·Π° ΡˆΡ‚ΠΎ ΠΏΠΎΡƒΡΠΏΠ΅ΡˆΠ½ΠΎ ΠΏΡ€Π΅Π΄Π²ΠΈΠ΄ΡƒΠ²Π°ΡšΠ΅ Π½Π° Π½Π΅Ρ˜Π·ΠΈΠ½Π°Ρ‚Π° ΠΈΠ΄Π½Π° Π΄Π΅Π»ΠΎΠ²Π½Π° активност. ΠŸΡ€Π΅Π΄ΠΌΠ΅Ρ‚ Π½Π° ΠΈΡΡ‚Ρ€Π°ΠΆΡƒΠ²Π°ΡšΠ΅ Π²ΠΎ овој Ρ‚Ρ€ΡƒΠ΄ прСтставува ΡƒΡ‚Π²Ρ€Π΄ΡƒΠ²Π°ΡšΠ΅ ΠΈ Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° ΠΏΠΎΠ»ΠΈΡ‚ΠΈΠΊΠΈΡ‚Π΅ ΠΈ ΠΏΡ€ΠΎΡ†Π΅Π΄ΡƒΡ€ΠΈΡ‚Π΅ ΠΊΠΎΠΈ Π³ΠΈ користат Π±Π°Π½ΠΊΠΈΡ‚Π΅ Π²ΠΎ ΠΏΡ€ΠΎΡ†Π΅Π½ΠΊΠ°Ρ‚Π° Π½Π° ΠΊΡ€Π΅Π΄ΠΈΡ‚Π½Π°Ρ‚Π° способност Π½Π° ΠΎΠ΄Π΄Π΅Π»Π½ΠΈΡ‚Π΅ ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΠΈ, ΠΏΠΎΠΊΠΎΠ½ΠΊΡ€Π΅Ρ‚Π½ΠΎ Π΄Π° сС ΡƒΡ‚Π²Ρ€Π΄ΠΈ ΠΊΠΎΠΈ ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΠΈ ѝ сС ΠΏΠΎΡ‚Ρ€Π΅Π±Π½ΠΈ Π½Π° Π±Π°Π½ΠΊΠ°Ρ‚Π° Π²ΠΎ процСсот Π½Π° Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° финансискитС ΠΈΠ·Π²Π΅ΡˆΡ‚Π°ΠΈ ΠΈ Π½Π° кој Π½Π°Ρ‡ΠΈΠ½ (ΠΏΡ€Π΅ΠΊΡƒ ΠΏΡ€ΠΈΠΌΠ΅Π½Π° Π½Π° ΠΊΠΎΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈ ΠΈ Ρ‚Π΅Ρ…Π½ΠΈΠΊΠΈ) иститС Π³ΠΈ Ρ‚ΠΎΠ»ΠΊΡƒΠ²Π°, Π·Π° Π΄Π° Π³ΠΎ ΠΎΡ†Π΅Π½ΠΈ ΠΊΡ€Π΅Π΄ΠΈΡ‚Π½ΠΈΠΎΡ‚ Π±ΠΎΠ½ΠΈΡ‚Π΅Ρ‚ Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΡ˜Π°Ρ‚Π° ΠΈ Π½Π΅Ρ˜Π·ΠΈΠ½Π°Ρ‚Π° способност Π·Π° Π·Π°Π΄ΠΎΠ»ΠΆΡƒΠ²Π°ΡšΠ΅

    Π•Π²Π°Π»ΡƒΠ°Ρ†ΠΈΡ˜Π° Π½Π° (1,3)--d-Π³Π»ΠΈΠΊΠ°Π½ СсСј Π²ΠΎ дијагноза Π½Π° ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΈ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ со Аspergillus

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    Invasive fungal infections caused by Aspergillus are a significant problem in immunocompromised and critically ill patients and associated with increased morbidity and mortality. Early diagnosis of invasive aspergillosis is still a big clinical and diagnostic challenge. Conventional methods are not sensitive enough, and therefore, there is a need for rapid, more sensitive methods for early diagnosis of invasive fungal infections with Aspergillus. The aim of this study was to evaluate the diagnostic performance, sensitivity and specificity of serological panfungal (1,3)-b-D-glucan marker compared to conventional method for diagnosis of invasive fungal infections with Aspergillus. Material and methods: Specimens of 125 patients divided into 4 groups (group I - immune deficiency, group II - prolonged ICU stay, group III - chronic aspergillosis, group IV - cystic fibrosis), classified according to clinical diagnosis and EORTC/MSG criteria, were analyzed at the Institute of Microbiology and Parasitology, with conventional and serological methods, during a period of two years. Results: A total of 71 isolates of Aspergillus were confirmed in this study. Four isolates were recovered from bloodculture of patients with primary immune deficiency. With BAL culture, Aspergillus was detected in the group of chronic aspergillosis (63.33%), followed by the groups of cystic fibrosis (56.67%), primary immune deficiency (51.43%), and the group with prolonged ICU stay (43.33%). Sensitivity and specificity of BAL culture were: 64.29% and 100%, 59.09% and 100%, 54.55% and 12.5%, 100% and 54.17%, in I, II, III and IV group, respectively. In 79.1% (53/67) from positive BAL cultures in all groups, A. fumigatus was confirmed, of which, 32.1% (17/53) in group III, followed by group I – 26.42% (14/53) and group IV – 26.42% (14/53), and 15.1% (8/53) in group II. Other species confirmed in BAL were A. flavus 16.42% (11/67) and A.terreus 4.48% (3/67). Sensitivity and specificity of the serological panfungal (1,3)-b-D-glucan (BDG) marker were: 64.71% and 85.71%, 50% and 87.5%, 36.36% and 50%, in groups I, II and III, respectively. No positive findings of the panfungal (1,3)-b-D-glucan (BDG) marker were found in the group with cystic fibrosis. Conclusion: The results obtained in this study have demonstrated that a positive (1,3)-b-D-glucan assay highlights the value of this test as a diagnostic adjunct in the serodiagnosis of invasive fungal infections with Aspergillus, and along with the results from conventional mycological investigation, helped in reaching a timely antifungal treatment with a favorable clinical outcome. Β Π˜Π½Π²Π°Π·ΠΈΠ²Π½ΠΈΡ‚Π΅ Ρ„ΡƒΠ½Π³Π°Π»Π½ΠΈ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ со Aspergillus прСтставуваат сСриозСн ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌ кај ΠΈΠΌΡƒΠ½ΠΎΠΊΠΎΠΌΠΏΡ€ΠΎΠΌΠΈΡ‚ΠΈΡ€Π°Π½ΠΈΡ‚Π΅ Π»ΠΈΡ†Π° ΠΈ ΠΊΡ€ΠΈΡ‚ΠΈΡ‡Π½ΠΎ Π±ΠΎΠ»Π½ΠΈΡ‚Π΅ Π»ΠΈΡ†Π°, ΠΈ сС асоцирани со Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½ ΠΌΠΎΡ€Π±ΠΈΠ΄ΠΈΡ‚Π΅Ρ‚ ΠΈ ΠΌΠΎΡ€Ρ‚Π°Π»ΠΈΡ‚Π΅Ρ‚. Π Π°Π½Π° дијагноза Π½Π° ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½Π°Ρ‚Π° аспСргилоза Π΅ сѐ ΡƒΡˆΡ‚Π΅ Π³ΠΎΠ»Π΅ΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡ‡ΠΊΠΈ ΠΈ Π΄ΠΈΡ˜Π°Π³Π½ΠΎΡΡ‚ΠΈΡ‡ΠΊΠΈ ΠΏΡ€Π΅Π΄ΠΈΠ·Π²ΠΈΠΊ. ΠšΠΎΠ½Π²Π΅Π½Ρ†ΠΈΠΎΠ½Π°Π»Π½ΠΈΡ‚Π΅ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈ Π½Π΅ сС Π΄ΠΎΠ²ΠΎΠ»Π½ΠΎ сСнзитивни, ΠΈ Π·Π°Ρ€Π°Π΄ΠΈ Ρ‚ΠΎΠ°, сС Π½Π°ΠΌΠ΅Ρ‚Π½ΡƒΠ²Π° ΠΏΠΎΡ‚Ρ€Π΅Π±Π° Π·Π° Π±Ρ€Π·ΠΈ ΠΈ посСнзитивни ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈ Π·Π° Ρ€Π°Π½Π° дијагноза Π½Π° ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΈ Ρ„ΡƒΠ½Π³Π°Π»Π½ΠΈ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ со Aspergillus. Π¦Π΅Π»Ρ‚Π° Π½Π° ΠΎΠ²Π°Π° ΡΡ‚ΡƒΠ΄ΠΈΡ˜Π° бСшС Π΄Π° сС Π΅Π²Π°Π»ΡƒΠΈΡ€Π° Π΄ΠΈΡ˜Π°Π³Π½ΠΎΡΡ‚ΠΈΡ‡ΠΊΠΈΠΎΡ‚ пСрформанс, сСнзитивноста ΠΈ спСцифичноста Π½Π° ΡΠ΅Ρ€ΠΎΠ»ΠΎΡˆΠΊΠΈΠΎΡ‚ ΠΏΠ°Π½Ρ„ΡƒΠ½Π³Π°Π»Π΅Π½ ΠΌΠ°Ρ€ΠΊΠ΅Ρ€ (1,3)-b-D-Π³Π»ΠΈΠΊΠ°Π½ спорСдСно со ΠΊΠΎΠ½Π²Π΅Π½Ρ†ΠΈΠΎΠ½Π°Π»Π½ΠΈΠΎΡ‚ ΠΌΠ΅Ρ‚ΠΎΠ΄ Π·Π° дијагноза Π½Π° ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΈΡ‚Π΅ Ρ„ΡƒΠ½Π³Π°Π»Π½ΠΈ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ со Aspergillus. ΠœΠ°Ρ‚Π΅Ρ€ΠΈΡ˜Π°Π» ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈ: ΠŸΡ€ΠΈΠΌΠ΅Ρ€ΠΎΡ†ΠΈ ΠΎΠ΄ 125 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈ, ΠΏΠΎΠ΄Π΅Π»Π΅Π½ΠΈ Π²ΠΎ 4 Π³Ρ€ΡƒΠΏΠΈ (Π³Ρ€ΡƒΠΏΠ° I - ΠΈΠΌΡƒΠ½ Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚, Π³Ρ€ΡƒΠΏΠ° II - ΠΏΡ€ΠΎΠ»ΠΎΠ½Π³ΠΈΡ€Π°Π½ ΠΏΡ€Π΅ΡΡ‚ΠΎΡ˜ Π²ΠΎ Π•Π˜Π›, Π³Ρ€ΡƒΠΏΠ° III - Ρ…Ρ€ΠΎΠ½ΠΈΡ‡Π½Π° аспСргилоза, Π³Ρ€ΡƒΠΏΠ° IV - цистична Ρ„ΠΈΠ±Ρ€ΠΎΠ·Π°), ΠΈ класифицирани спорСд ΠΊΠ»ΠΈΠ½ΠΈΡ‡ΠΊΠ°Ρ‚Π° дијагноза ΠΈ EORTC/MSG ΠΊΡ€ΠΈΡ‚Π΅Ρ€ΠΈΡƒΠΌΠΈΡ‚Π΅, Π±Π΅Π° Π°Π½Π°Π»ΠΈΠ·ΠΈΡ€Π°Π½ΠΈ Π½Π° Π˜Π½ΡΡ‚ΠΈΡ‚ΡƒΡ‚ΠΎΡ‚ Π·Π° ΠΌΠΈΠΊΡ€ΠΎΠ±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡ˜Π° ΠΈ ΠΏΠ°Ρ€Π°Π·ΠΈΡ‚ΠΎΠ»ΠΎΠ³ΠΈΡ˜Π°, со ΠΊΠΎΠ½Π²Π΅Π½Ρ†ΠΈΠΎΠ½Π°Π»Π½ΠΈ ΠΈ ΡΠ΅Ρ€ΠΎΠ»ΠΎΡˆΠΊΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈ, Π²ΠΎ Ρ‚Π΅ΠΊ Π½Π° Π΄Π²Π΅-годишСн ΠΏΠ΅Ρ€ΠΈΠΎΠ΄. Π Π΅Π·ΡƒΠ»Ρ‚Π°Ρ‚ΠΈ: Π’ΠΊΡƒΠΏΠ½ΠΎ 71 ΠΈΠ·ΠΎΠ»Π°Ρ‚ Π½Π° Aspergillus Π±Π΅Π° ΠΏΠΎΡ‚Π²Ρ€Π΄Π΅Π½ΠΈ Π²ΠΎ ΠΎΠ²Π°Π° ΡΡ‚ΡƒΠ΄ΠΈΡ˜Π°. Π§Π΅Ρ‚ΠΈΡ€ΠΈ ΠΈΠ·ΠΎΠ»Π°Ρ‚ΠΈ Π±Π΅Π° Π΄ΠΎΠΊΠ°ΠΆΠ°Π½ΠΈ Π²ΠΎ Ρ…Π΅ΠΌΠΎΠΊΡƒΠ»Ρ‚ΡƒΡ€Π°, кај ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈ со ΠΏΡ€ΠΈΠΌΠ°Ρ€Π΅Π½ ΠΈΠΌΡƒΠ½ Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚. Π‘ΠΎ ΠΊΡƒΠ»Ρ‚ΡƒΡ€Π° Π½Π° БАЛ, Aspergillus Π½Π°Ρ˜Ρ‡Π΅ΡΡ‚ΠΎ бСшС Π΄Π΅Ρ‚Π΅ΠΊΡ‚ΠΈΡ€Π°Π½ Π²ΠΎ Π³Ρ€ΡƒΠΏΠ°Ρ‚Π° Π½Π° Ρ…Ρ€ΠΎΠ½ΠΈΡ‡Π½Π° аспСргилоза (63,33%), ΠΏΠΎ ΡˆΡ‚ΠΎ слСдуваа Π³Ρ€ΡƒΠΏΠΈΡ‚Π΅ со цистична Ρ„ΠΈΠ±Ρ€ΠΎΠ·Π° (56,67%), ΠΏΡ€ΠΈΠΌΠ°Ρ€Π΅Π½ ΠΈΠΌΡƒΠ½ Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ (51,43%), ΠΈ Π³Ρ€ΡƒΠΏΠ°Ρ‚Π° Π»ΠΈΡ†Π° со ΠΏΡ€ΠΎΠ»ΠΎΠ½Π³ΠΈΡ€Π°Π½ ΠΏΡ€Π΅ΡΡ‚ΠΎΡ˜ Π²ΠΎ Π΅Π΄ΠΈΠ½ΠΈΡ†ΠΈΡ‚Π΅ Π·Π° ΠΈΠ½Ρ‚Π΅Π½Π·ΠΈΠ²Π½ΠΎ Π»Π΅ΠΊΡƒΠ²Π°ΡšΠ΅ (43,33%). БСнзитивноста ΠΈ спСцифичноста Π½Π° ΠΊΡƒΠ»Ρ‚ΡƒΡ€ΠΈΡ‚Π΅ Π½Π° БАЛ Π±Π΅Π°: 64,29% ΠΈ 100%, 59,09% ΠΈ 100%, 54,55% ΠΈ 12,5%, 100% ΠΈ 54,17%, Π²ΠΎ I, II, III ΠΈ IV Π³Ρ€ΡƒΠΏΠ°, соодвСтно. Π’ΠΎ 79,1% (53/67) ΠΎΠ΄ ΠΏΠΎΠ·ΠΈΡ‚ΠΈΠ²Π½ΠΈΡ‚Π΅ ΠΊΡƒΠ»Ρ‚ΡƒΡ€ΠΈ Π½Π° БАЛ Π²ΠΎ ситС Π³Ρ€ΡƒΠΏΠΈ, бСшС Π΄ΠΎΠΊΠ°ΠΆΠ°Π½ A.fumigatus, ΠΎΠ΄ ΠΊΠΎΠΈ, 32,1% (17/53) ΠΎΠ΄ Π³Ρ€ΡƒΠΏΠ° III, ΠΏΠΎΡ‚ΠΎΠ° 26,42 % (14/53) ΠΎΠ΄ Π³Ρ€ΡƒΠΏΠ° I ΠΈ 26,42% (14/53) ΠΎΠ΄ Π³Ρ€ΡƒΠΏΠ° IV, ΠΊΠ°ΠΊΠΎ ΠΈ 15,1% (8/53) ΠΎΠ΄ Π³Ρ€ΡƒΠΏΠ° II. Π”Ρ€ΡƒΠ³ΠΈ спСциСси ΠΏΠΎΡ‚Π²Ρ€Π΄Π΅Π½ΠΈ Π²ΠΎ БАЛ Π±Π΅Π° A.flavus 16,42% (11/67) ΠΈ A.terreus 4,48% (3/67). БСнзитивноста ΠΈ спСцифичноста Π½Π° ΡΠ΅Ρ€ΠΎΠ»ΠΎΡˆΠΊΠΈΠΎΡ‚ ΠΏΠ°Π½Ρ„ΡƒΠ½Π³Π°Π»Π΅Π½ (1,3)-b-D-Π³Π»ΠΈΠΊΠ°Π½ (BDG) ΠΌΠ°Ρ€ΠΊΠ΅Ρ€ Π±Π΅Π°: 64,71% ΠΈ 85,71%, 50% ΠΈ 87,5%, 36,36% ΠΈ 50%, Π²ΠΎ Π³Ρ€ΡƒΠΏΠΈΡ‚Π΅ I, II ΠΈ III, соодвСтно. НС Π±Π΅Π° Π΄Π΅Ρ‚Π΅ΠΊΡ‚ΠΈΡ€Π°Π½ΠΈ ΠΏΠΎΠ·ΠΈΡ‚ΠΈΠ²Π½ΠΈ Π½Π°ΠΎΠ΄ΠΈ ΠΎΠ΄ ΠΏΠ°Π½Ρ„ΡƒΠ½Π³Π°Π»Π½ΠΈΠΎΡ‚ (1,3)-b-D-Π³Π»ΠΈΠΊΠ°Π½ (BDG) ΠΌΠ°Ρ€ΠΊΠ΅Ρ€ Π²ΠΎ Π³Ρ€ΡƒΠΏΠ°Ρ‚Π° со цистична Ρ„ΠΈΠ±Ρ€ΠΎΠ·Π°. Π—Π°ΠΊΠ»ΡƒΡ‡ΠΎΠΊ: Π Π΅Π·ΡƒΠ»Ρ‚Π°Ρ‚ΠΈΡ‚Π΅ ΠΎΠ΄ ΠΎΠ²Π°Π° ΡΡ‚ΡƒΠ΄ΠΈΡ˜Π° ΠΏΠΎΠΊΠ°ΠΆΠ°Π° Π΄Π΅ΠΊΠ° ΠΏΠΎΠ·ΠΈΡ‚ΠΈΠ²Π΅Π½ Π½Π°ΠΎΠ΄ Π½Π° (1,3)-b-D-Π³Π»ΠΈΠΊΠ°Π½ ја истакнува врСдноста Π½Π° овој тСст ΠΊΠ°ΠΊΠΎ Π΄ΠΈΡ˜Π°Π³Π½ΠΎΡΡ‚ΠΈΡ‡ΠΊΠΎ Π½Π°Π΄ΠΎΠΏΠΎΠ»Π½ΡƒΠ²Π°ΡšΠ΅ Π²ΠΎ ΡΠ΅Ρ€ΠΎΠ΄ΠΈΡ˜Π°Π³Π½ΠΎΠ·Π°Ρ‚Π° Π½Π° ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΈΡ‚Π΅ Ρ„ΡƒΠ½Π³Π°Π»Π½ΠΈ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ со Aspergillus, ΠΈ Π·Π°Π΅Π΄Π½ΠΎ со Ρ€Π΅Π·ΡƒΠ»Ρ‚Π°Ρ‚ΠΈΡ‚Π΅ ΠΎΠ΄ ΠΊΠΎΠ½Π²Π΅Π½Ρ†ΠΈΠΎΠ½Π°Π»Π½ΠΈΡ‚Π΅ миколошки ΠΈΡΠΏΠΈΡ‚ΡƒΠ²Π°ΡšΠ°, ΠΏΠΎΠΌΠ°Π³Π°Π°Ρ‚ Π²ΠΎ Π½Π°Π²Ρ€Π΅ΠΌΠ΅Π½Π° ΠΏΡ€ΠΈΠΌΠ΅Π½Π° Π½Π° Π°Π½Ρ‚ΠΈΡ„ΡƒΠ½Π³Π°Π»Π½Π° Ρ‚Π΅Ρ€Π°ΠΏΠΈΡ˜Π°, ΠΈ ΠΏΠΎΡΡ‚ΠΈΠ³Π½ΡƒΠ²Π°ΡšΠ΅ ΠΏΠΎΠ²ΠΎΠ»Π΅Π½ ΠΊΠ»ΠΈΠ½ΠΈΡ‡ΠΊΠΈ исход.

    De facto states

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    De facto states are also known as β€œunrecognized states”, β€œpartially recognized states”, and states with limited recognition... They are the target of research, proving facts, debates, and analyses, about the applicability of international rules and segmenting which states can enter the group of de facto states, and which do not.For many, the Montevideo Convention is applicable here, to see the rights and obligations of states. But is there a list of these countries today? Many mention Kosovo, Northern Cyprus, Abkhazia, and South Ossetia, Palestine, Transnistria, Nagorno-Karabakh, Donetsk People’s Republic, and Luhansk People’s Republic... What is the status of these countries and why do they not yet have international recognition

    Gastrointestinal Colonization with Vancomycin-Resistant Enterococci in Hospitalized and Outpatients

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    BACKGROUND: The incidence of infection and intestinal colonization with vancomycin resistant enterococci (VRE) is increasing in many countries in the last decade. Concerning the difficult antimicrobial treatment of infections caused by VRE, decreasing the incidence and prevalence of these infections is an important factor in VRE-induced morbidity and mortality control.AIM: To determine the prevalence of gastrointestinal colonization with vancomycin resistant enterococci in hospitalized and outpatients, and to determine the genetic base of the vancomycin resistance in VRE isolates.MATERIAL AND METHODS: Seven hundred and eighty stool specimens were investigated for the gastrointestinal carriage of vancomycin-resistant enterococci (VRE). Susceptibility to vancomycin was tested in all isolates by disk-diffusion test and E-test (AB Biodisk, Sweden). Determined vancomycin resistant enterococci were than tested for detection of vanA, vanB and vanC genes by PCR.RESULTS: Vancomycin resistant strains of enterococci were isolated from 46 (16.1 %) of the 285 hospitalized patients and 5 (7.7 %) of the 65 patients living in the community (p < 0.05). The most of the highly resistant enterococci strains to vancomycin (95.2 %), were identified as E. faecium. Minimal inhibitory concentrations (MICs) to vancomycin in all 39 vanA genotypes of E. faecium and two vanA genotypes of E. fecalis were > 256 mg/ml. Three vanB genotypes of E. faecium and one vanB genotype of E. faecalis had MICs of 32 mg/ml. All six vanC genotypes of E. gallinarum had MICs of 8 mg/ml. All vanA genotypes of VRE were highly resistant to vancomycin, with MICs above 256 mg/ml. Three vanB genotypes of VR E. faecium and one VR E. fecalis were resistant, with MICs 32 mg/ml. vanC genotypes of VR E. gallinarum were intermediate resistant to vancomycin with MICs of 8 mg/ml.CONCLUSIONS: The prevalence of vancomycin resistant enterococci in Republic of Macedonia was 2-fold higher in hospitalized than in outpatients. VanA genotype was dominant in isolates of E. faecium and it was highly associated with the MIC values above the 256 mg/ml. Since most of the enterococcal infections are endogenous, there is a need for screening the colonization of patientÒ€ℒs intestinal flora with VRE at the hospital entry. Identification and genotyping of faecal enterococci, together with their susceptibility testing to vancomycin, could be useful marker for the infection control

    ΠšΠΎΠ½Ρ†Π΅ΠΏΡ‚ΠΎΡ‚ Π½Π° ΠΎΠ΄Ρ€ΠΆΠ»ΠΈΠ² Ρ€Π°Π·Π²ΠΎΡ˜ Π½ΠΈΠ· ΠΏΡ€ΠΈΠ·ΠΌΠ°Ρ‚Π° Π½Π° ΠΏΡ€Π°Π²ΠΎΡ‚ΠΎ ΠΈ ΠΏΠΎΠ»ΠΈΡ‚ΠΈΠΊΠΈΡ‚Π΅/The concept of sustainable development through the prism of law and policies

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    ΠŸΡ€ΠΎΠ΅ΠΊΡ‚ΠΎΡ‚ β€žΠšΠΎΠ½Ρ†Π΅ΠΏΡ‚ΠΎΡ‚ Π½Π° ΠΎΠ΄Ρ€ΠΆΠ»ΠΈΠ² Ρ€Π°Π·Π²ΠΎΡ˜ Π½ΠΈΠ· ΠΏΡ€ΠΈΠ·ΠΌΠ°Ρ‚Π° Π½Π° ΠΏΡ€Π°Π²ΠΎΡ‚ΠΎ ΠΈ ΠΏΠΎΠ»ΠΈΡ‚ΠΈΠΊΠΈΡ‚Π΅β€œ прСтставува ΠΌΠ΅Ρ“ΡƒΠ½Π°Ρ€ΠΎΠ΄Π΅Π½ Π½Π°ΡƒΡ‡Π½ΠΎ-истраТувачки ΠΏΡ€ΠΎΠ΅ΠΊΡ‚ ΠΏΡ€Π΅Π΄Π²ΠΎΠ΄Π΅Π½ΠΎ ΠΎΠ΄ Π¦Π΅Π½Ρ‚Π°Ρ€ΠΎΡ‚ Π·Π° Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° ΠΏΡ€Π°Π²ΠΎ ΠΈ ΠΏΠΎΠ»ΠΈΡ‚ΠΈΠΊΠΈ ΠΏΡ€ΠΈ ΠŸΡ€Π°Π²Π½ΠΈΠΎΡ‚ Ρ„Π°ΠΊΡƒΠ»Ρ‚Π΅Ρ‚, Π£Π“Π” - Π¨Ρ‚ΠΈΠΏ, Π²ΠΎ соработка со Π£Π½ΠΈΠ²Π΅Ρ€Π·ΠΈΡ‚Π΅Ρ‚ΠΎΡ‚ ΠœΠΈΡˆΠΊΠΎΠ»Ρ† Π²ΠΎ Π£Π½Π³Π°Ρ€ΠΈΡ˜Π°. Π˜Π΄Π΅Ρ˜Π°Ρ‚Π° Π½Π° ΠΏΡ€ΠΎΠ΅ΠΊΡ‚ΠΎΡ‚ Π΅ Π΄Π° сС Ρ„ΠΎΡ€ΠΌΠΈΡ€Π° истраТувачки Ρ‚ΠΈΠΌ Π²ΠΎ Ρ€Π°ΠΌΠΊΠΈΡ‚Π΅ Π½Π° ΠŸΡ€Π°Π²Π΅Π½ Ρ„Π°ΠΊΡƒΠ»Ρ‚Π΅Ρ‚ ΠΊΠΎΡ˜ΡˆΡ‚ΠΎ ќС Ρ€Π°Π±ΠΎΡ‚ΠΈ Π½Π° Ρ‚Π΅ΠΌΠ°Ρ‚ΠΈΠΊΠ°Ρ‚Π° ΠΏΠΎΠ²Ρ€Π·Π°Π½Π° со ΠΊΠΎΠ½Ρ†Π΅ΠΏΡ‚ΠΎΡ‚ Π½Π° ΠΎΠ΄Ρ€ΠΆΠ»ΠΈΠ² Ρ€Π°Π·Π²ΠΎΡ˜ Π²ΠΈΠ΄Π΅Π½ Π½ΠΈΠ· ΠΏΡ€ΠΈΠ·ΠΌΠ°Ρ‚Π° Π½Π° ΠΏΡ€Π°Π²ΠΎΡ‚ΠΎ ΠΈ ΠΏΠΎΠ»ΠΈΡ‚ΠΈΠΊΠΈΡ‚Π΅ ΠΊΠ°ΠΊΠΎ Π²ΠΎ МакСдонија, Ρ‚Π°ΠΊΠ° ΠΈ Π½Π° Ρ€Π΅Π³ΠΈΠΎΠ½Π°Π»Π½ΠΎ/Свропско ΠΈ Π½Π° ΠΌΠ΅Ρ“ΡƒΠ½Π°Ρ€Π΄Π½ΠΎ Π½ΠΈΠ²ΠΎ. ОсвСн Ρ„ΠΎΡ€ΠΌΠΈΡ€Π°ΡšΠ΅ Π½Π° Ρ‚ΠΈΠΌ Π½Π° истраТувачи, ΠΊΠΎΡ˜ΡˆΡ‚ΠΎ Π΅ Π΅Π΄Π½Π° ΠΎΠ΄ Π³Π»Π°Π²Π½ΠΈΡ‚Π΅ Ρ†Π΅Π»ΠΈ, ΠΏΡ€ΠΎΠ΅ΠΊΡ‚ΠΎΡ‚ исто Ρ‚Π°ΠΊΠ° ΠΈΠΌΠ° Π·Π° Ρ†Π΅Π» Π΄Π° Ρ€Π΅Π³Ρ€ΡƒΡ‚ΠΈΡ€Π° студСнти ΠΎΠ΄ Ρ€Π°Π·Π»ΠΈΡ‡Π½ΠΈ Π³ΠΎΠ΄ΠΈΠ½ΠΈ ΠΊΠΎΠΈΡˆΡ‚ΠΎ Π±ΠΈ Ρ€Π°Π±ΠΎΡ‚Π΅Π»Π΅ Π½Π° Ρ‚Π΅ΠΌΠ°Ρ‚ΠΈΠΊΠΈ ΠΏΠΎΠ²Ρ€Π·Π°Π½ΠΈ со ΠΎΠ΄Ρ€ΠΆΠ»ΠΈΠ²ΠΈΠΎΡ‚ Ρ€Π°Π·Π²ΠΎΡ˜ Π²ΠΎ соработка ΠΈ ΠΏΠΎΠ΄ мСнторство Π½Π° Ρ‡Π»Π΅Π½ΠΎΠ²ΠΈΡ‚Π΅ Π½Π° истраТувачкиот Ρ‚ΠΈΠΌ. На овој Π½Π°Ρ‡ΠΈΠ½ ќС сС оствари Π΅Π΄Π½Π° ΠΎΠ΄ дСлСкусСТнитС Ρ†Π΅Π»ΠΈ Π½Π° ΠΏΡ€ΠΎΠ΅ΠΊΡ‚ΠΎΡ‚, Π° Ρ‚ΠΎΠ° Π΅ подигањС Π½Π° свСста кај ΠΌΠ»Π°Π΄Π°Ρ‚Π° ΠΏΠΎΠΏΡƒΠ»Π°Ρ†ΠΈΡ˜Π° Π·Π° ΠΊΠΎΠ½Ρ†Π΅ΠΏΡ‚ΠΎΡ‚ Π½Π° ΠΎΠ΄Ρ€ΠΆΠ»ΠΈΠ² Ρ€Π°Π·Π²ΠΎΡ˜ ΠΈ ΠΎΠ±Π΅Π·Π±Π΅Π΄ΡƒΠ²Π°ΡšΠ΅ Π½Π° одрТливост Π·Π° ΠΊΠΎΠ½Ρ†Π΅ΠΏΡ‚ΠΎΡ‚ Π½Π° ΠΎΠ΄Ρ€ΠΆΠ»ΠΈΠ² Ρ€Π°Π·Π²ΠΎΡ˜ ΠΏΡ€Π΅ΠΊΡƒ ΠΏΡ€Π΅Π½Π΅ΡΡƒΠ²Π°ΡšΠ΅ Π½Π° знаСњС ΠΈ интСрСс Π·Π° истиот

    Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): a prospective, multinational study

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    ΠŸΡ€ΠΈΠΌΠ΅Π½Π° Π½Π° финансиската Π°Π½Π°Π»ΠΈΠ·Π° Π²ΠΎ ΠΎΡ†Π΅Π½ΠΊΠ° Π½Π° ΠΊΡ€Π΅Π΄ΠΈΡ‚Π½Π°Ρ‚Π° способност Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΠΈΡ‚Π΅

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    ΠŸΡ€ΠΎΡ†Π΅Π½ΠΊΠ°Ρ‚Π° Π½Π° ΠΊΡ€Π΅Π΄ΠΈΡ‚Π½Π°Ρ‚Π° способност Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΠΈΡ‚Π΅ Π΅ Π΅Π΄Π΅Π½ ΠΎΠ΄ Π½Π°Ρ˜Π²Π°ΠΆΠ½ΠΈΡ‚Π΅ процСси ΠΎΠ΄ ΠΊΠΎΠΈ зависи ΠΊΠ²Π°Π»ΠΈΡ‚Π΅Ρ‚ΠΎΡ‚ Π½Π° ΠΏΠΎΠ±Π°Ρ€ΡƒΠ²Π°ΡšΠ°Ρ‚Π°, односно ΠΊΠ²Π°Π»ΠΈΡ‚Π΅Ρ‚ΠΎΡ‚ Π½Π° ΠΊΡ€Π΅Π΄ΠΈΡ‚Π½ΠΎΡ‚ΠΎ ΠΏΠΎΡ€Ρ‚Ρ„ΠΎΠ»ΠΈΠΎ ΠΈ Π°ΠΊΡ‚ΠΈΠ²Π°Ρ‚Π° Π½Π° Π΅Π΄Π½Π° Π±Π°Π½ΠΊΠ°. Π‘ΠΈΡ‚Π΅ Ρ„Π°ΠΊΡ‚ΠΎΡ€ΠΈ ΠΊΠΎΠΈ Π²Π»ΠΈΡ˜Π°Π°Ρ‚ Π²Ρ€Π· Ρ€ΠΈΠ·ΠΈΡ†ΠΈΡ‚Π΅ со ΠΊΠΎΠΈ сС соочуваат Π±Π°Π½ΠΊΠΈΡ‚Π΅ Π²ΠΎ Π½ΠΈΠ²Π½ΠΎΡ‚ΠΎ Ρ€Π°Π±ΠΎΡ‚Π΅ΡšΠ΅, ΠΎΠ΄ ΠΊΠΎΠΈ Π½Π°Ρ˜Π·Π½Π°Ρ‡Π°Π΅Π½ Π΅ ΠΊΡ€Π΅Π΄ΠΈΡ‚Π½ΠΈΠΎΡ‚ Ρ€ΠΈΠ·ΠΈΠΊ, сС ΠΏΡ€Π΅Π΄ΠΌΠ΅Ρ‚ Π½Π° ΠΈΡΠΏΠΈΡ‚ΡƒΠ²Π°ΡšΠ΅ Π²ΠΎ процСсот Π½Π° финансиската Π°Π½Π°Π»ΠΈΠ·Π°, односно Π°Π½Π°Π»ΠΈΠ·Π°Ρ‚Π° Π½Π° ΠΊΡ€Π΅Π΄ΠΈΡ‚Π½Π°Ρ‚Π° способност Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΠΈΡ‚Π΅. ΠŸΡ€ΠΎΡ†Π΅ΡΠΎΡ‚ Π½Π° финансиска Π°Π½Π°Π»ΠΈΠ·Π° ΠΎΠΏΡ„Π°ΡœΠ° Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° Ρ€Π°Π±ΠΎΡ‚Π΅ΡšΠ΅Ρ‚ΠΎ Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΡ˜Π°Ρ‚Π° Π²ΠΎ ΠΌΠΈΠ½Π°Ρ‚ΠΎΡ‚ΠΎ ΠΈ ΡΠ΅Π³Π°ΡˆΠ½ΠΎΡΡ‚Π°, со Ρ†Π΅Π» Π·Π° ΡˆΡ‚ΠΎ ΠΏΠΎΡƒΡΠΏΠ΅ΡˆΠ½ΠΎ ΠΏΡ€Π΅Π΄Π²ΠΈΠ΄ΡƒΠ²Π°ΡšΠ΅ Π½Π° Π½Π΅Ρ˜Π·ΠΈΠ½Π°Ρ‚Π° ΠΈΠ΄Π½Π° Π΄Π΅Π»ΠΎΠ²Π½Π° активност. ΠŸΡ€Π΅Π΄ΠΌΠ΅Ρ‚ Π½Π° ΠΈΡΡ‚Ρ€Π°ΠΆΡƒΠ²Π°ΡšΠ΅ Π²ΠΎ овој Ρ‚Ρ€ΡƒΠ΄ прСтставува ΡƒΡ‚Π²Ρ€Π΄ΡƒΠ²Π°ΡšΠ΅ ΠΈ Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° ΠΏΠΎΠ»ΠΈΡ‚ΠΈΠΊΠΈΡ‚Π΅ ΠΈ ΠΏΡ€ΠΎΡ†Π΅Π΄ΡƒΡ€ΠΈΡ‚Π΅ ΠΊΠΎΠΈ Π³ΠΈ користат Π±Π°Π½ΠΊΠΈΡ‚Π΅ Π²ΠΎ ΠΏΡ€ΠΎΡ†Π΅Π½ΠΊΠ°Ρ‚Π° Π½Π° ΠΊΡ€Π΅Π΄ΠΈΡ‚Π½Π°Ρ‚Π° способност Π½Π° ΠΎΠ΄Π΄Π΅Π»Π½ΠΈΡ‚Π΅ ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΠΈ, ΠΏΠΎΠΊΠΎΠ½ΠΊΡ€Π΅Ρ‚Π½ΠΎ Π΄Π° сС ΡƒΡ‚Π²Ρ€Π΄ΠΈ ΠΊΠΎΠΈ ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΠΈ ΠΈ сС ΠΏΠΎΡ‚Ρ€Π΅Π±Π½ΠΈ Π½Π° Π±Π°Π½ΠΊΠ°Ρ‚Π° Π²ΠΎ процСсот Π½Π° Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° финансискитС ΠΈΠ·Π²Π΅ΡˆΡ‚Π°ΠΈ ΠΈ Π½Π° кој Π½Π°Ρ‡ΠΈΠ½ (ΠΏΡ€Π΅ΠΊΡƒ ΠΏΡ€ΠΈΠΌΠ΅Π½Π° Π½Π° ΠΊΠΎΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈ ΠΈ Ρ‚Π΅Ρ…Π½ΠΈΠΊΠΈ) иститС Π³ΠΈ Ρ‚ΠΎΠ»ΠΊΡƒΠ²Π°, Π·Π° Π΄Π° Π³ΠΎ ΠΎΡ†Π΅Π½ΠΈ ΠΊΡ€Π΅Π΄ΠΈΡ‚Π½ΠΈΠΎΡ‚ Π±ΠΎΠ½ΠΈΡ‚Π΅Ρ‚ Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΡ˜Π°Ρ‚Π° ΠΈ Π½Π΅Ρ˜Π·ΠΈΠ½Π°Ρ‚Π° способност Π·Π° Π·Π°Π΄ΠΎΠ»ΠΆΡƒΠ²Π°ΡšΠ΅. ΠšΠ»ΡƒΡ‡Π½ΠΈ Π·Π±ΠΎΡ€ΠΎΠ²ΠΈ: финансиска Π°Π½Π°Π»ΠΈΠ·Π°, финансиски ΠΈΠ·Π²Π΅ΡˆΡ‚Π°ΠΈ, ΠΊΡ€Π΅Π΄ΠΈΡ‚Π½Π° способност, ΠΊΠΎΠΌΠΏΠ°Π½ΠΈ

    Correlation of serum leptin with anthropometric parameters and abdominal fat depots determined by ultrasonography in overweight and obese women

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    Leptin is an adipocytokine that has an important role in energy homeostasis and therefore in the pathophysiology of obesity. Leptin levels are influenced by many factors such as gender, race, energy intake, fat mass, etc. The aim of our study is to investigate the relationship of circulating leptin levels to anthropometric parameters and to the subcutaneous and visceral fat tissue determined by ultrasonography in healthy overweight and obese women. The study included 50 healthy women, with body mass index (BMI) above 25 kg/m2. Measurements of anthropometric parameters were performed with a standardized technique. The subcutaneous and visceral fat tissue was measured with ultrasound 1 cm above the umbilicus. Leptin was determined by radioimmunoassay. The serum leptin levels presented a positive correlation between the levels of leptin and BMI (r-0.73, p < 0.05) waist circumference (r-0.73, p < 0.05) hip circumference (r-0.74, p < 0.05), thigh circumference (r-0.56, p < 0.05) and abdominal subcutaneous fat tissue (r- 0.46, p < 0.05). There was no correlation between leptin and visceral fat tissue, waist to hip and waist to thigh ratio. The results of our study confirmed the correlation between leptin and BMI. The correlation between leptin and all measured circumferences cannot be attributed to a particular fat depot, but rather reflect the correlation between this adipocytokine and the total body fat. The subcutaneous fat depot determined by ultrasound showed a correlation with leptin, while this kind of connection was not established for the visceral fat tissue. Key words: Leptin, abdominal subcutaneous fat, abdominal visceral fat

    Insulin, insulin resistance and anthropometric parameters in overweight and obese women

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    Insulin resistance together with obesity, hypertension and dyslipidemia is part of the cluster that represents the metabolic syndrome. The impaired insulin sensitivity has been reported to be linked with obesity; however the importance of the fat distribution has also been emphasized in the development of this disorder. The aim of our study was to determine to association of serum insulin and insulin resistance assessed by HOMA with anthropometric parameters in obese and overweight women. Also the correlation of insulin and insulin resistance (HOMA-IR) with the subcutaneous and visceral abdominal fat was evaluated. The study included 41 overweight and obese women, aged 20- 60 years. The anthropometric parameters like body mass index (BMI), waist, hip and thigh circumference were measured with standard methods. Abdominal subcutaneous fat tissue (SFT) and visceral fat tissue (VFT) were determined by ultrasonography. Insulin values were measured with radioimmunoassay and the insulin resistance was assessed by the HOMA2 method. The results of our study showed strong correlation of insulin and HOMA-IR with BMI (r 0.36, p<0.01). The median and mean values of these parameters were much higher in subjects with obesity grade 2 and 3. The insulin concentrations and HOMA-IR also showed good correlation with waist and hip circumference and with the subcutaneous fat tissue (p<0.05). The results of our study point to the fact that in addition to the total body fat accumulation, the role of the subcutaneous fat tissue in the development of insulin resistance in overweight and obese Macedonian women should not be underestimated. Key words: insulin resistance, subcutaneous fat, visceral fa

    Hand tracing vs digital methods of cephalometric analysis

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    Introduction Cephalometric radiography is an essential tool to orthodontists for studying growth and development of the facial skeleton, diagnosis, treatment planning, and evaluating pre- and post-treatment changes. Manual cephalometric analysis has been performed by tracing radiographic landmarks on acetate overlays and measuring linear and angular values. Rapid technological advances have made it possible to perform cephalometric tracing using computers where the landmarks are usually digitized first. MatΠ΅rials and method We reviewed several studies in which comparison was made between manual analysis and using computer software programs for cephalometric analysis. Digital films are transferred to conventional films using a printer. Printed films are hand-tracked and measured by one observer. Digital films are analyzed twice using computer software programs by the same observer, using basic and advanced features. Results From the reviewed scientific papers it is registered that the basic and the advanced feature procedures took significantly less time than the total time needed for the hand-tracing procedure. The basic procedure independent of the software took significantly less time than the advanced procedure. Small discrepancies were also found between hand-tracing and computerized measurements, but the differences are minimal and clinically acceptable. Conclusion Computerized technique can be regarded equally reliable to hand-tracing as far as cephalometric measurements are concerned. Time-saving characteristics of computerized tracing makes this method preferable to hand tracing for cephalometric analysis of radiographs used in diagnosis, treatment planning, and the evaluation of treatment outcome. Keywords: Cephalometric analysis; Cephalometric radiography; Comparison studies Digital methods; Hand-tracing
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