RELATIONSHIP BETWEEN OBESITY AND QUALITY OF GLYCEMIC CONTROL IN POSTMENOPAUSAL WOMEN WITH TYPE 2 DIABETES

The aim of this paper was to study the relationship between the category of obesity and type of obesity with the quality of glucoregulation in postmenopausal women with type 2 diabetes (T2DM). Glycemic control was assessed according to ADA recommendations (2008). Subsequently, all the patients were divided into two groups - I group including 10 patients with T2DM and satisfactory glycemic control (HbA1c7%). All the patients were diagnosed with T2DM at least one year prior to examination and duration of postmenopausal period was at least one year. All the subjects used medical nutrition therapy and oral antidiabetics. Glycemic control was evaluated with fasting plasma glucose and HbA1c, category of obesity was assessed with body mass index (BMI) and type of obesity was evaluated with waist circumference and waist-to-hip ratio. It was shown that age of patients, duration of T2DM and duration of postmenopausal period did not influence the quality of glycemic control. Category of obesity and type of obesity did not show important correlation with glycemic control parameters. The waist circumference relationship with glycemic control parameters was found to be the best, and that was particularly expressed through moderate correlation with fasting plasma glucose

EFFECT OF ACUTE RENAL FAILURE ON KIDNEY AMIDINOTRANSFERASE ACTIVITY

L-Arginine-:glycine amidinotransferase (EC 2.1.4.1) catalyzes the transfer of an amidino group from arginine to glycine to form guanidinoacetate, precursor in creatine synthesis. The kidneys are major site of the creatine synthesis and primary target organs for mercury toxicity. In evaluation of molecular mechanisms of mercury chloride intoxication relating to creatine metabolism we have investigated the enzyme activity in kidney tissue after mercury chloride administration. Acute renal failure was induced by i.p administration of mercury chloride in a dose of 3 mg/kg to male Spraque Dawley rats weighing about 200 g. The results of our study indicate an acute renal failure 24 hours after mercury chloride administration. Urea and creatinine levels in blood plasma were significantly elevated compared to control group (p<0.001). Amidinotransferase activity in kidney tissue was depressed, while, in plasma of intoxicated rats activity of enzyme was increased (p<0.001). The obtained results indicate that mercury chloride has strong nephrotoxic effect. Depressed amidinotransferase activity and decreased production of guanidinoacetate, initial product in creatine synthesis, may be implicated in neurotoxicity, cardiotoxicity and muscle damage in mercury intoxication, because creatine and its phosphorylated form creatine phosphate play an important role in the energy metabolism

THE ROLE OF THE VIRUS RESPIRATORY INFECTIONS IN THE PATHOGENESIS OF THE ASTHMATIC EXARCEBATIONS

The virus infections of the respiratory pathways represent an important cause of the emergence of the symptoms of the puffing (wheezing) in the lungs of the patients of all age groups. In the patients suffering from asthma the virus respiratory infections are the main causes of asthmatic exarcebations. In 80 to 85 % of the school children and in 50 % of the adult asthmatics, the exarcebations are caused by the respiratory virus infection while the most frequent cause is the rhinovirus. It is believed that in the pathogenesis of the virus-induced asthmatic exarcebations the following mechanisms are involved: the damage of the epithelium, the inflammation increase in the respiratory pathways, the disturbance of the small respiratory pathways' geometry, the disturbance of the nerve controlling mechanisms and the disturbance of the IgE synthesis regulation

HYPOLIPEMIC THERAPY AND LOW SERUM CHOLESTEROL CONCENTRATION

Low concentration of plasma lipoproteins (hypolipoproteinemia) presents decreasing concentrations of all or particular lipids components. Classification of hypolipoproteinemia (hypoLP) divides them into: primary (hereditary) and secondary. Primary hipoLP are rare diseases and their main characteristic is disorder of apolipoproteins synthesis, which leads to low serum cholesterol concentration. Secondary hipoLP are presented in many diseases. They have diagnostic, prognostic significance and present good therapeutic marker. However, modern therapeutic approaches for aggressive lipid lowering pointed out many questions about physiological limits for cholesterol lowering. These approaches, also, open many questions about consequences of low serum concentration of total cholesterol and triglicerides

GENDER-RELATED DIFFERENCES IN INFLAMMATORY AND LIPID PARAMETERS IN PATIENTS WITH DIABETES MELLITUS TYPE 2

Diabetes mellitus type 2 (DM type 2) is one of the most common health problems worldwide. Diabetics have increased risk for development of wide spectrum of atherosclerotic complications, at the basis of which are inflammation and diabetic dyslipidemia. Increasing of relative risk for coronary artery disease development is higher in females with DM type 2.The aim of this study was determination of characteristic inflammatory and lipid disorders in type 2 diabetics and their association with patient gender.The study involved 35 patients with DM type 2 and stable angina pectoris. Besides anamnesis, all patients underwent clinical examinations (measure of blood pressure, body height and weight and calculation of body mass index). Inflammatory markers (sedimentation in I and II hour-SE I and SE II, C reactive protein - CRP, fibrinogen concentration and leukocyte count) as well as lipid parameters (total cholesterol, LDL and HDL cholesterol concentration and triglycerides) were determined in all the patients.Total cholesterol and triglycerides concentrations were higher in females with DM type 2 compared to males (p<0,05). There were not significant gender differences in HDL and LDL cholesterol concentration. All inflammatory markers (SE I and SE II, CRP, fibrinogen concentration and leukocyte count) were higher in females with DM type 2 and CAD compared to men (p<0,05). In males, there was a strong positive correlation between SE I and SE II with total LDL (p<0,05) and HDL cholesterol concentrations (p<0,01). Concentration of CRP was only significantly connected with triglycerides concentration (p<0,05). There was a strong association between leukocyte count and increased triglycerides (p<0,05) and low HDL cholesterol concentration (p<0,01). In females, there was only a strong positive correlation between SE II (p<0,01) and CRP concentration (p<0,05) and triglycerides.Women with DM type 2 and clinically manifest CAD (stable angina pectoris) are at higher risk for development the cardiovascular complications as they have more prominent lipid and inflammatory disorders than men

SMOKING HABITS OF NIS PRESCHOOL CHILDREN'S PARENTS

The greatest threat for the public health in Serbia is definitively smoking. 1,3 billion of people in the world are smokers and 4,9 million of death at the global level are direct consequences of smoking. If this smoking rhythm continues until 2020. the number of deaths caused by smoking will have been doubled. There are 4000 identified substances in the tobacco smoke, 50 of which have been proven to be carcinogenic. Nowdays, 14000 to 15000 young people in the developed countries and 68000-84000 in the underdeveloped contries begin to smoke. 700 millions of children, the half of the whole children population, are exposed to the passive smoking.The prevalence of smoking in Serbia, although reduced by 6,9% compared to 2000 is still very high and makes 33,6% of the whole population (38,1% of men and 29,9% of women).The aim of this study was to investigate the smoking habits of preschool children's parents, motivated by the fact that the children of that age are highly sensitive and susceptible to the toxic influence of tobacco smoke, but also to check the necessity for an aggressive public health programme implementation in the aimed populations.This research, as a cross-sectional stady, is carried out among preschool children's parents, children being 4 to 6 years old that attend nursery schools in Nis.The prevalence of smoking in preschool children's parents is extremely high, and makes 46% (45,1% of men and 46,9% of women). Having taken into consideration the parental role in upbringing and education of children, as well as the influence of passive smoking, the main conclusion is that the children's health is seriously endangered. Education, making new and maintaining already existing programmes and legal obligations considering smoking are significant steps for reducing smoking and promoting health

Improvements in long standing cardiac pathologies by individualized homeopathic remedies: A case series

We present three cases of cardiac arrest at different stages of pathology. Acute myocardial infarction and resulting heart failure is emerging as the leading cause of mortality. In the long run, acute episodes and cardiac remodelling can cause considerable damage and result in heart failure. In these cases, individualized homeopathic therapy was instituted along with the conventional medicines and the results were encouraging. The changes in the laboratory diagnostic parameters (single-photon emission computed tomography, electrocardiograph, echocardiography and ejection fraction as the case may be) are demonstrated over time. The key result seen in all three cases was the preservation of general well-being while the haemodynamic states also improved. While the three cases provide evidence of positive outcomes for homeopathic therapy, more extensive studies are required in a hospital setting to establish the real extent to which this therapy may be employed

THE EFFECTS OF VERAPAMIL ON SODIUM AND POTASSIUM SERUM CONCENTRATION AND HE COLORING MORPHOLOGICAL CHANGES IN EXPERIMENTAL GENTAMICIN NEPHROTOXICITY

The effects of verapamil on glomerular changes and tubular system in rats were analyzed in gentamicin nephrotoxicity. Epithel desquamation of proximal tubules and degenerative changes in glomerular was detected in animals treated by gentamicin (100 mg/kg body mass/24h). In animals, treated by gentamicin, the decreasing of sodium and potassium appeared in comparison to the control group. The combination of verapamil and gentamicin resulted in lower kidney damage than gentamicin itself, so the level of sodium concentration in serum and potassium concentration was higher in the third experimental group. Nephron morphological changes were lower by simultaneous treatment of gentamicin and verapamil. Consequently, the obtaind results support hypothesis that verapamil is a protective factor in gentamicin nephrotoxicity

Indicators of stress hematopoiesis in the blood predict COVID-19 progression in patients over 65 years old

ABSTRACTObjectives Advanced age is a well-established risk factor for severe coronavirus disease 2019 (COVID-19). Exacerbated inflammation affects multiple organs, among which hematopoiesis responds by increased output of various cells. We aimed to determine the association between COVID-19 progression and large immature cell (LIC) counts, changes in erythrocyte and platelet distribution widths (RDW, PDW) with reference to patients’ age.Methods A total of 755 patients with complete blood cell (CBC) analysis in the first 24 h of hospitalization were enrolled. Patients were divided into two groups: under and above 65 years of age.Results The LIC counts were different in both groups (p < 0.003). However, only the senior patients had markedly different values of RDW and PDW (p < 0.001). The receiver operating characteristic (ROC) curve analysis provided increased LIC (AUC = 0.600), RDW (AUC = 0.609), PDW (AUC = 0.556), and platelet to LIC ratio (AUC = 0.634) as significant in discriminating outcome in the older group. Importantly, these results were not repeated in the younger patients. In the elderly, the progression was predicted with LIC cut-off at ≥ 0.305 × 109/L (OR = 3.166) and RDW over 12.15% (OR = 2.081).Discussion Aging is characterized by a decline in immunological competence with a compromised control of inflammation leading to a proinflammatory state. This background together with the actions of pathogens may lead to emergency myelopoiesis.Conclusion Our results point to the important differences between age groups regarding CBC-related parameters of stress hematopoiesis during severe infection. Higher LIC, RDW and PDW levels were reliable in the early identification of COVID-19 progression only in the elderly

CLINICAL OPINION: BRUGADA SYNDROME AND SICK SYNUS SYNDROME — CASE WHICH WE MEET IN OUR PRACTICE

In our work we describe the case of a patient with a Brugada syndrome. It is a rare syndrome which carries a potential risk of sudden cardiac death which occurs usually at an early age. Unfortunately it is most frequently the first clinical manifestation of this genetic disease. Sometimes, as in our patient it could co-exist with other cardiovascular abnormalities which give us an opportunity to establish the right diagnosis and apply adequate preventive measures. It is of paramount importance to explore the possibility of the existence of this syndrome in the patient’s family members. The first diagnostic procedure is an ECG which is an inexpensive and readily available diagnostic tool