TYPE OF CELL SEPARATOR, FENWAL AMICUS VS FRESENIUS COM TEC, MAY INFLUENCE THE CORPUSCULAR ELEMENTS VALUE OF THE DONOR`S BLOOD

ntroduction: During the plateletpheresis procedure the number of thrombocytes in the donor’s blood significantly decreases, and the levels of the hematocrit (HCT), hemoglobin (Hgb), and leukocyte (WBC) diminish as well. Influence of the cell separator is one of the factors that affects the levels of HCT, Hgb and WBC. In this study, the goal was to determine the value difference o f HCT, Hgb, WBC, and platelets after the platelet pheresis process between performance on Fenwal AMICUS and on Fresenius Com Tec. Donors and methods: The criteria for participation: male in the age range of 25-45. We have formed two groups: for both groups - 180 separations were performed on 60 participants were the values of hematocrits, concentration of hemoglobin and number of leukocytes were established before and after separation using the double-needle continuous flow cell separation (DN- CFCS) on two different devices, Fenwal AMICUS device and the Fresenius Com Tec. device. To confirm the statistical differences we have used Student t-test for independent or dependent samples, as well as Mann-Whitney U test as non-parametric alternative. To compare differences between the values of four parameters (P1-P2) from two groups (using two devices - Fenwal AMICUS and Fresenius Com Tec) The possibility of errors were accepted for Į<0.05, and the difference between groups as statistical relevant were accepted for p<0.05. Results Statistically significant lower values were noted for all researche d parameters after separation on both devices. The statistically significant average values for Hct, Hgb and WBC obtained between two devices, were less than 0.05 (p=0.05). For the platelets (Plt) there was no statistical significant difference (p>0.05 - Į=0.05), between average level obtained using either Fenwal AMICUS or Frazenius Com Tec. Conclusion: The type of cell separator had the influence on the decrease value of the observed parameters

LIVER TRANSPLANTATION AND ALLERGY: TRANSPLANT-ACQUIRED FOOD ALLERGY

Transplant-acquired food allergy is a well known phenomenon especially linked to liver transplants. Risk factors lie both in transplant recipient and transplant donor - age of recipient and the maturity of immune regulatory mechanisms, family history of atopy in recipient, young age of the donor and atopic history in donor. The exact mechanism has not yet been established and there are many different explanations of this pathophysiologic process. Transplanted liver is a large and well perfused organ, rich in pluripotent hematopoietic stem cells and donor\u27s IgE antibodies that can alter immunological response in the host. Some studies suggest that post-transplant immunosuppression with tacrolimus is linked to an increased occurrence of IgE-mediated sensitization and manifestation of allergic disease. Research in the field of transplant-acquired food allergy is not important only for transplant patients and physicians involved but also for understanding the mechanism of food allergy development in general population and potentially reducing this global health concerning issue

LIVER TRANSPLANTATION AND ALLERGY: TRANSPLANT-ACQUIRED FOOD ALLERGY

Transplant-acquired food allergy is a well known phenomenon especially linked to liver transplants. Risk factors lie both in transplant recipient and transplant donor - age of recipient and the maturity of immune regulatory mechanisms, family history of atopy in recipient, young age of the donor and atopic history in donor. The exact mechanism has not yet been established and there are many different explanations of this pathophysiologic process. Transplanted liver is a large and well perfused organ, rich in pluripotent hematopoietic stem cells and donor\u27s IgE antibodies that can alter immunological response in the host. Some studies suggest that post-transplant immunosuppression with tacrolimus is linked to an increased occurrence of IgE-mediated sensitization and manifestation of allergic disease. Research in the field of transplant-acquired food allergy is not important only for transplant patients and physicians involved but also for understanding the mechanism of food allergy development in general population and potentially reducing this global health concerning issue

CORRELATION OF CLINICAL AND ENDOSCOPIC INDICES IN IBD PATIENTS IN UNIVERSITY CLINICAL HOSPITAL MOSTAR

Background: To explore correlation between clinical and endoscopic indices in inflammatory bowel disease (IBD) patients. Subjects and methods: There were 112 patients with inflammatory bowel disease. All patients with diagnosed IBD was established a degree of clinical and endoscopic disease activity. CDAI (Crohn\u27s disease activity index) was used as clinical and SESCD (Simplified Endoscopic Crohn Disease Index) as endoscopic index for Crohn\u27s disease. For ulcerative colitis Truelov & Witts index was used as clinical and Baron as endoscopic activity index. Correlation of clinical and endoscopic indices were compared in Crohn disease (CD) and ulcerative colitis (UC). Patients were analyzed by clinical entities - CD and UC, according to sex, age, parameters of anemia, duration of disease and education. Results: In the total of 112 IBD patients there were 69 patients diagnosed as ulcerative colitis (61.6%) and 43 as Crohn\u27s disease (38.4%). There were 58 (51.8%) women and 54 (48.2%) men. Comparison between endoscopic and clinical indices in CD and UC demonstrated no significant differences in ilnness activity. Endoscopic and clinical disease activity was associated with a higher inflammatory parameters (CRP and leucocytes, L) and lower parameters of hemoglobin (Hb) and MCV. Conclusion: Our research has established a good correlation between clinical and endoscopic index of disease activity in the CB and UC in inflammation. Clinical indices can be used for monitoring inflammation

Psychosocial and clinical characteristics of depressive patients with the diagnosis of metabolic syndrome

There is a growing quantity of data showing that mental illnesses affect the somatic health. Depression is a complex disease, connected with the disturbances of sleep-cycle, appetite, body weight and level of physical activity, all of which may represent the risk factors for the development of metabolic disturbances. In the depressive patients, there is a number of various physiological mechanisms and psychosocial factors which may influence the development of metabolic syndrome (MS), such as sex, age, smoking, stress levels, nutrition and level of physical activity. It is considered that chronic stress causes depression and the resulting bad life habits may lead to MS and finally KVB. Aim of this study was to investigate the psychosocial and clinical features of depressive patients with the diagnosis of MS. The cross-reference study has been done at the sample of 80 patients diagnosed with MS. Among the diagnostic instruments applied, we have used the structured socio-demographic questionnaire, MINI questionnaire, Hamilton Rating Scale for Depression (HAMD-17) and Clinical Global Impression (CGI). The diagnosis of metabolic syndrome had been established following the NCEP ATP criteria. Among the depressive patients, there were 38.8% who fulfilled the criteria for establishing the diagnosis of MS. There was a greater incidence of suicide among the depressive patients with the diagnosis of MS. The diagnose was more frequently established in depressive women, while an increased intake of carbohydrates represented a significant feature of both depression and MS. Further research is needed to explain the observed gender differences and to determine if the interventions aimed to treating the depression can also contribute to accepting the healthy life habits and as a consequence, indirectly reduce the incidence of MS

Razlike u kvaliteti života ovisnika o heroinu liječenih u metadonskom programu i ovisnika liječenih u programu terapijske zajednice

Aim of the study was comparing the quality of life of addicts treated in frame of methadone substitution programs and addicts undergoing the rehabilitation on the frame of therapeutic community. We have done a crossover study in the Center for Prevention and Out-patient Treatment in Mostar. We have included 60 subjects in our study. All of them were heroin addicts, referred to the Center for Prevention and Out-patient Treatment in Mostar, who satisfied the DSM-IV criteria for the addiction disease. The subjects have been divided in three groups: 1) group of just-admitted patients (N=20), 2) group of patients who had spent six months in methadone program (N=20) and 3) group of patient who had spent six months in the therapeutic community program (N=20). In this study, we have gathered data for social-demographic variables such as age, education, marital and professional status and variables related to the addiction, such as duration of addiction, manner of drug administration, alcohol use and presence of HCV, HBV or HIV viral infections. For the estimation of quality of life, we have used the “Quality of life index”, to measure the perception of the important areas of life, such as health and functioning in the fields of social, economic, psychological and spiritual domains. A majority of subjects from this sample had achieved the secondary school education and were of similar age, unmarried, mostly unemployed and only a smaller number of them were living alone, out of their primary families. The groups tested have not significantly differed considering those living conditions which reflect the quality of life. The results of addiction variables had showed that a majority of subjects administered the drug intravenously, there were no significant differences concerning the duration of addiction and the most of the subjects had drunk no alcohol. We have not detected any cases of HIV infection, while a significant number of subjects had been infected with hepatitis B virus. This study revealed significant differences in quality of life between the groups tested. The groups of subjects who had undergone the methadone program and the group of those treated in the frame of therapeutic community showed significantly higher scores on quality of life scales compared to the group of just-admitted patients, while there were no such differences between the group of subjects who had undergone the methadone program and the group of those treated in the frame of therapeutic community. The data obtained indicate that the methadone treatment is similarly effective concerning the quality of subjects’ life as the treatment in the frame of therapeutic communityCilj istraživanja bio je usporediti kvalitetu života ovisnika liječenih u supstitucijskom metadonskom programu i ovisnika na rehabilitaciji u terapijskoj zajednici. Provedeno je presječno istraživanje u Centru za prevenciju i izvanbolničko liječenje ovisnosti u Mostaru. U istraživanje je uključeno 60 ispitanika. Svi su ovisnici o heroinu koji su se javili u Centar za prevenciju i izvanbolničko liječenje ovisnosti u Mostaru, a koji zadovoljavaju DSM-IV kriterije za dijagnozu ovisnosti. Ispitanici su podijeljeni u tri skupine: 1) skupinu tek primljenih pacijenata (N=20), 2) skupinu pacijenata koji su proveli 6 mjeseci u metadonskom programu (N=20) i3) skupinu pacijenta koji su proveli 6 mjeseci u programu terapijske zajednice (N=20). U istraživanju su prikupljane socidemografske varijable kao što su dob, edukacija, bračni i radni status, te varijable vezane za ovisnost kao što su dužina ovisničkog staža, način uzimanja droge, uporaba alkohola te prisutnosti infekcije virusima HCV, HBV i HIV. Za procjenu kvalitete života koristio “Quality of life index” kojim se mjerila percepcija važnih životnih područja kao što su zdravlje i funkcioniranje, socijalno i ekonomsko, psihološko i spiritualno, te obiteljsko područje. Većina ispitanika u uzorku je bila srednjoškolski obrazovana, podjednake dobi, neoženjeni, najveći dio je bio bez posla, a samo mali broj je živio sam van primarne obitelji. Ispitivane skupine se nisu značajno razlikovale prema uvjetima življenja koji su pokazatelji kvalitete života. Rezultati istraživanja ovisničkih varijabli pokazuju da je većina ispitanika drogu uzimala intravenskim putem, nije bilo razlika u trajanju ovisničkog staža među skupinama, te ih većina nije pila alkohol. Nije nađen nijedan slučaj infekcije HIV-om, a veći broj ispitanika u uzorku su bili zaraženi virusom hepatitisa C, dok je vrlo mali broj ispitanika bio zaražen virusom hepatitisa B. U ovom istraživanju su nađene značajne razlike u kvaliteti života među ispitivanim skupinama. Skupine ispitanika liječenih u metadonskom programu i u programu terapijske zajednice pokazale su značajno veće rezultate na skalama kvalitete života u odnosu na skupinu tek primljenih pacijenata, a između skupine ispitanika koji su bili u metadonskom programu liječenja i skupine u terapijskoj zajednici nije bilo takvih razlika. Dobiveni podaci ukazuju na činjenicu da je liječenje metadonom podjednako djelotvorno kao i boravak u terapijskoj zajednici po utjecaju na promjene u kvaliteti života ispitanika

ANXIETY, DEPRESSION AND PERSONALITY TYPES IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: COMPARISONS WITH PEPTIC ULCER AND THE GENERAL POPULATION

Background: To explore corellation of anxiety, depression ant type of personality in inflammatory bowel disease (IBD) and compare with peptic ulcer (PU). Subjects and methods: In this study, prevalence of anxiety, depression and type of personality was investigated in 362 cases divided into three groups: 112 of IBD patients, 122 of peptic ulcer patients and 128 of control group who didn\u27t have any gastrointestinal or psychic complaints. IBD and peptic ulcer diagnosis were established by standard diagnostic procedures (anamnesis, clinical manifestations, laboratory, endoscopy and biopsy in IBD and upper endoscopy in peptic ulcer). Anxiety and depression were established by Hamilton anxiety rating scale (HAM-A) and Hamilton rating test for depression (HAM-D). Type of A/B personality was established by Bortner scale and D type of personality by Denollet scale (DS14). Results: Anxiety was found in 47 (41.9%) and depression in 44 (38.3%) of a total of 112 IBD cases. In group with peptic ulcer anxiety was found in 40 (32.8%) and depression aalso in 40 (32.8%) of total 122 cases. In control group anxiety was diagnosed in 21 (16.4%) and depression in 20 (15.6%) of total 128 cases. Anxiety and depresson were significantly higher in both groups than in control group but anxiety and depression were significantly higher in IBD group than peptic ulcer group. D type of personality was statistically significant in peptic ulcer group. Conclusion: Anxiety and depression in IBD and peptic ulcer cases have a greater prevalence compared to the normal population and surprisingly are higher in IBD than peptic ulcer group. D type of personality is associated with peptic ulcer

CORRELATION BETWEEN BIOCHEMICAL AND HISTOPATHOLOGICAL PARAMETERS IN PATIENTS WITH CHRONIC HEPATITIS C TREATED WITH PEGYLATED INTERFERON AND RIBAVIRIN

Aim: The main goal of this study was to compare the biochemical and histopathological findings in patients with sustained virological response (SVR) before and two years after the therapy with pegylated interferon α-2a and ribavirin in chronic hepatitis C. Subjects and methods: The study was conducted at the Department of Internal Medicine and the Clinic for Infectious Diseases of the Clinical Hospital Mostar. The study included 48 patients whose treatment for chronic hepatitis C with pegylated interferon α-2a and ribavirin was finished two years prior to the achieved SVR at the end of the treatment. The main criterion for inclusion was a negative result of HCV RNA, determined by the RealTime HCV assay. After taking a history, physical examination, laboratory tests: AST, ALT, GGT, a liver biopsy were performed with the help of the ultrasound. The assessment of necroinflamatory score was determined by histologic activity index (HAI) score, and the stage of fibrosis according to Knodell\u27s numerical score. Results: The values of AST and ALT levels were statistically significantly decreased after the successful treatment (p<0.001), as well as the value of HAI score (p=0.001) and the stage of fibrosis (p=0.010), in contrast to GGT (p=0.054). For the components of HAI score like focal necrosis (0.001) and portal inflammation (0.042) the result showed that they were significantly higher before the therapy, which was not true for the piecemeal (p=0.054) and confluated necrosis (p=0.078). The improvement of HAI score after therapy was found in 36 patients (75.0%), and 27 patients (56.2%) showed an improvement in the degree of fibrosis with the most common improvement of 1 degree (85.7%). One third of patients (31.3%) had the same result in the degree of fibrosis before and after the therapy. Before the treatment, a positive correlation was observed between ALT (p=0.039) and AST (p=0.04) with HAI, AST and the stage of fibrosis (p=0.04). In contrast, after the treatment the only correlation was observed between AST and the stage of fibrosis (p=0.042). Conclusion: Virological and biochemical responses in patients with SVR may not reflect the histopathological effects of the treatment and therefore these patients should be monitored for the possible development of the liver cirrhosis and hepatocellular carcinoma

CORRELATION BETWEEN BIOCHEMICAL AND HISTOPATHOLOGICAL PARAMETERS IN PATIENTS WITH CHRONIC HEPATITIS C TREATED WITH PEGYLATED INTERFERON AND RIBAVIRIN

Aim: The main goal of this study was to compare the biochemical and histopathological findings in patients with sustained virological response (SVR) before and two years after the therapy with pegylated interferon α-2a and ribavirin in chronic hepatitis C. Subjects and methods: The study was conducted at the Department of Internal Medicine and the Clinic for Infectious Diseases of the Clinical Hospital Mostar. The study included 48 patients whose treatment for chronic hepatitis C with pegylated interferon α-2a and ribavirin was finished two years prior to the achieved SVR at the end of the treatment. The main criterion for inclusion was a negative result of HCV RNA, determined by the RealTime HCV assay. After taking a history, physical examination, laboratory tests: AST, ALT, GGT, a liver biopsy were performed with the help of the ultrasound. The assessment of necroinflamatory score was determined by histologic activity index (HAI) score, and the stage of fibrosis according to Knodell\u27s numerical score. Results: The values of AST and ALT levels were statistically significantly decreased after the successful treatment (p<0.001), as well as the value of HAI score (p=0.001) and the stage of fibrosis (p=0.010), in contrast to GGT (p=0.054). For the components of HAI score like focal necrosis (0.001) and portal inflammation (0.042) the result showed that they were significantly higher before the therapy, which was not true for the piecemeal (p=0.054) and confluated necrosis (p=0.078). The improvement of HAI score after therapy was found in 36 patients (75.0%), and 27 patients (56.2%) showed an improvement in the degree of fibrosis with the most common improvement of 1 degree (85.7%). One third of patients (31.3%) had the same result in the degree of fibrosis before and after the therapy. Before the treatment, a positive correlation was observed between ALT (p=0.039) and AST (p=0.04) with HAI, AST and the stage of fibrosis (p=0.04). In contrast, after the treatment the only correlation was observed between AST and the stage of fibrosis (p=0.042). Conclusion: Virological and biochemical responses in patients with SVR may not reflect the histopathological effects of the treatment and therefore these patients should be monitored for the possible development of the liver cirrhosis and hepatocellular carcinoma

TUMOR MARKER CA 125 IN THE DIAGNOSIS OF ACTIVE PULMONARY TUBERCULOSIS – A STUDY OF ADULTS IN MOSTAR, B&H

Background: Tumor marker CA 125 is found in normal mesothelial lung cells and normal bronchial epithelial cells. If destruction of these cells occurs due to inflammation or tumour, CA 125 will be released, and increased in the serum. Subjects and Methods: From November 2008 to May 2009 a study analysing CA 125 levels in serum samples from patients who are hospitalized at the Pulmology Department of University Hospital Mostar. Standard laboratory tests, X-ray, sputum examination to BK, and tumour marker CA 125 were performed in all patients. Patients were divided into 5 groups. Comparing clinical and laboratory findings of patients and statistical processing of collected data, conclusions were drown about the role of tumor markers Ca 125 in the diagnosis of pulmonary tuberculosis. Results: This analysis is performed on 220 patients, forty with pulmonary tuberculosis. Of the total number of patients included, there is 60% of the negative findings of tumor marker Ca 125 which is statistically significant (P<0.05). Further analysis of Ca 125 shows that there is 75% of positive findings in active pulmonary tuberculosis, which is a statistically significant difference (P=0.002). Within the group of patients with lung carcinoma, half of the patients showed positive finding of tumor marker CA 125. Statistical analysis showed that sensitivity of CA 125 was 75%, specificity was (68%) and positive predictive value was 12% in patients with active tuberculosis. Conclusions: The result of this study showed that the increase in serum tumor marker CA 125 is present in active pulmonary tuberculosis as well as in patients with lung cancer