12 research outputs found

    Poikilocytotic forms caused by hyperthermia and heat stroke- experimental study on Wistar rats

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    Background: The aim of the study was to find out what happens to erythrocytes and their forms during life and after death as a result of high water temperature.Methods: Heat stress was used on a rat model.to investigate the effects of different temperature intensities (37°C and 44°C) and exposure time (20 min and until the time of death) on erythrocyte morphology. Total of 23 Wistar rats were divided into two groups: 37°C as control group and 44°C as trial groups. The trial groups were classified into antemortem the exposure time of 20 min and postmortem groups exposure time until fatal outcome. The anaesthetised rats were exposed to preheated water using the water bath. May-Grünwald-Giemsa colouring technique was applied on blood samples taken from the abdominal aorta. Results: Exposure of Wistar rats to water temperature in groups KG37 and G44 led to a significant changes in core temperature. In the control group, the thermoregulatory mechanism established normothermia, and in G44 hyperthermia was detected during 20 minutes of exposure. The frequency of heat stroke in group G44 was 43.8%. Target cells and anulocytes were predominant in antemortem group at 44°C, while anulocytes and spherocytes in postmortem groups 44°C, respectively. Dacryocytes with spherocytes were significantly higher in postmortem group 44°C than in antemortem group 44°C (p=0.002, p=0.017, respectively).Conclusions: Poikilocytosis is associated with the exposure length and temperature intensity. Following a fatal outcome dacryocytes with spherocytes at 44°C were significantly more than in corresponding antemortem groups

    Correlation of serum lipid profile and glycemic control parameters in patients with type 2 diabetes mellitus

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    Introduction: Diabetes mellitus type 2 has become a global health-care problem of modern society due to a pronounced increase of prevalence to pandemic proportions and vascular complications. At present, glycated hemoglobin (HbA1c) is widely accepted as a measure of glycemic control in established diabetes. The aim of this study was to analyze the lipid profile in serum of patients with diabetes mellitus type 2, and its relationship with HbA1c levels. Methods: The observational cross-sectional study included 60 diabetic patients, 30 men, and 30 women, age 32–94 years. Patients were assigned into two groups based on HbA1c values; Group 1: HbA1c ≤ 7% (good glycemic control) and Group 2: HbA1c > 7% (poor glycemic control). We analyzed the concentration of glucose, HbA1c, and lipid profile including total cholesterol levels, triglycerides (TAG), low-density lipoproteins (LDL), and high-density lipoproteins (HDL). Results: Significantly lower values of glucose concentration, TAG and the ratio TAG/HDLc were obtained in the group of patients with good glycemic control. (p 0.005) Our study revealed a significant positive correlation between HbA1c and triglyceride level (r = 0.375; p = 0.003) and HbA1c and ratio triglyceride/HDLc (r = 0.335; p = 0.009). Conclusion: HbA1c can also be used as a predictor of dyslipidemia in type 2 diabetics in addition to as a glycemic control parameter

    Increased mean platelet volume is associated with acute myocardial infarction in patients with diabetes mellitus type 2

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    Background: The correlation between diabetes mellitus and acute myocardial infarction is greater every day. The mean platelet volume (MPV), which is the determinant of platelet function, is an independent risk factor for the cardiovascular disease. The aim of the study was to investigate the effect of each disease (hypothyroidism, hypertension, myocardial infarction) individually and combined on MPV in diabetic patients.Methods: The cross-sectional study included 102 patients who suffer from diabetes mellitus type 2 (DMT2), of both sexes (46 females, 56 males), with the average age of 58.91 (SD=12.93). All the patients were treated at the Primary Health Centre in Zenica from May to July 2017. All patients had diabetes mellitus and the disease had lasted for 10 years in both sexes.Results: Mean platelet volume was significantly higher in patients with myocardial infarction than in those without myocardial infarction. Age, sex, HbA1c, BMI, lipids and platelet count did not show any significance in either group of patients. Regression analysis showed that the prevalence of myocardial infarction had the highest predictive significance for MPV values, (predictor importance 0.49; coefficient 1.275, p<0.001).Conclusions: Mean platelet volume was significantly higher in patients with diabetes mellitus and myocardial infarction than in DM patients without myocardial infarction. Regression analysis showed correlation with acute myocardial infarction in patients with DMT2, but not with other chronic illnesses. The highest platelet volume indices were observed in patients with myocardial infarction. MPV can be used as a specific indicator in diabetic patients with myocardial infarction.  

    Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

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    BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

    Correlation between diabetic nephropathy and diabetic retinopathy as a long term complications of diabetes mellitus

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    Background/aim: Diabetes mellitus is a metabolic disorder of multiple etiologies characterized by a lack of insulin, with a consequent disordered metabolism of glucose, fats, and proteins. A number of complications, such as diabetic nephropathy and retinopathy, may develop as a result of long-term diabetes. The aim of this study aimed to determine the correlation between diabetic nephropathy and diabetic retinopathy as long-term complications of diabetes mellitus

    Multiorgan morphological changes caused by hyperthermia: Case study on experimental model

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    Morphologic changes in organs vary from nonspecific to specific ones, depending on causes of sudden death, e.i whether it is an acute, subacute or chronic event. The aim of this pilot study was to observe the appearance and occurrence of morphological characteristics on organs that were exposed to long-term effects of hyperthermia. A sample of 7 rats was exposed to a water temperature of 41 °C, which is defined in the literature as “heat stroke temperature”, both sexes, weighing 250 to 300 g were used. Tissue samples, obtained by dissection of rats, were fixed in 10% buffered neutral formalin, at room temperature, then incorporated into paraffin blocks, cut at 4-5 microns, mounted and stained with standard hematoxylin-eosin (HE) method. In order to prove/exclude lipid and glycogen accumulation in hepatocytes we did additional histochemical staining, using Sudan black and Periodic Acid Shiff (PAS) method, respectively. We obtained samples from kidney, liver, pancreas, spleen, lung and brain. Analyzing tissue samples of different organs obtained from seven Wistar rats, we gained insight into morphological changes caused by induced hyperthermia. All sampled organs showed congestion and some degree of oedema. The most prominent changes were observed in liver and lung samples. Tissue samples of the lung of all seven rats showed signs of acute bronchitis and bronchiolitis, together with signs of initial bronchopneumonia. We also noticed signs of focal acute emphysema as well as focal accumulations of foamy macrophages. Our study suggests that changes in the vascular bed occur soon after hyperthermia and while some organs are more tolerant to heat stroke than others, most organs show similar changes consisting of capillary dilation, congestion and interstitial extravasation, observed after 30 minutes at a temperature of 40.5 °C, with the most significant changes observed in liver and lung samples

    Cellular network of damage caused by exposure to high ambient temperature in Wistar rats: The role of Hsp70

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    Objectives: As a universal cytoprotective protein, Hsp70 is used to monitor the effects of environmental temperature changes, increasing the survival rate of cells exposed to stress, as well as the role of protein in cardiovascular disease, body decay and cell aging. Our research aims to to examine whether changes in serum protein 70 (Hsp70) values due to exposure to water temperature (41 °C and 44 °C) may indicate a mechanism of cardiomyocyte damage due to hyperthermia. Methods: A total of 40 adult albino Wistar rats, of known gender and body weight from 250 g to 300 g were used as material in this research. Rats were housed in polypropylene cages with optimum environmental conditions. Depending on the temperature of the water (WT) to which they were exposed, rats were randomized into the following groups.WT 37 °C (n = 8); WT 41 °C, antemortem (n = 8), WT 41 °C, postmortem (n = 8); WT 44 °C, antemortem (n = 8), WT 44 °C, postmortem (n = 8). Blood samples for determination of Hsp70 were taken before and after the expiration of the given duration of the experiment of 20 min or death. The Hsp70 level was determined by Enzyme-Linked Immunosorbent Assay (ELISA) Results: Hsp70 basal values in serum were significantly different, p = 0.004 pg/ml, and in the groups depending on the duration of exposure to Hsp70, p = 0.002. Serum Hsp70 values after being exposed to water temperature were significantly different according to the group, p = 0.009. Significant lower Hsp70 levels were found in the control group according to G41 p = 0.006 and G44, p = 0.002. Insignificant differences in Hsp70 level were found among theseG41 and G44, p > 0.005. The concentration of Hsp70 in rat serum and ≥ 31.36 ng/ml indicates exposure to temperatures higher than 37 °C (sensitivity 85.71%, specificity 83.33%, PPV 96%, and NPV 55%, p = 0.002). Conclusions: Altered concentration of serum Hsp70 may show exposition to the elevated water temperature

    Impact of Temperature on Morphological Characteristics of Erythrocytes and Heart Weight: Experimental Study on Wistar Rats

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    The aim was to find what happens to heart weight and forms of erythrocytes antemortemly and postmortemly as a result of exposure to high water temperature. Total of 40 adult Wistar rats is divided into three groups, depending on water temperature exposure of 37°C (KG, n = 8), 41°C (G41, n = 16), and 44°C (G44, n = 16). Depending on the length of time of exposure to water, temperatures of 41 and 44°C are further divided into G41-AM, G41-PM, G44-AM, and G44-PM. The anesthetized rats were exposed to preheated water using the water bath. May-Grünwald-Giemsa coloring technique was applied to blood samples. Light microscopy was performed to detect poikilocytes. Heart weight was measured after dissection with a scale. A statistically significant difference in heart weight was found in the experimental groups (p = 0.024). The lowest value was observed in KG37 and was 0.99 ± 0.11 g, and the highest values were found in rats of the G41-PM group, with a mean value of 1.26 ± 0.26 g. There is a statistically significant difference between the experimental groups in forms of poikilocytes

    Heat-related biomarkers: Focus on the correlation of troponin I and 70 kDa heat shock protein

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    Heat-related biomarkers: Focus on the correlation of troponin I and 70 kDa heat shock protein Abstract Introduction: There is intensive research related to the forensic importance of biomarkers that would be the standard for postmortem damage to cardiomyocytes and the mechanism of the resulting damage. The aim of the research was to examinate the forensic-medical significance of serum levels of biomarkers as detectors of terminal hyperthermic damage to the myocardium. Material and Method: 40 laboratory animals were divided into groups: the first group was the control (n = 8) exposed to a physiological temperature of 37 °C, the second group was divided into two subgroups: antemortem (n = 8) and postmortem (n = 8), which included a exposure temperature of 41 °C and the third group was divided into two subgroups: antemortem (n = 8) and postmortem (n = 8), which included a exposure temperature of 44 °C. The concentration of cardiac TnI and Hsp70 was resoluted in serum by immunochemical enzyme-labeled immunoabsorption method. Results: A positive correlation was found between the temperature measured at the time of death and the serum values of cTnI (p = 0.02), in G41, and Hsp70 values did not significantly correlate with the core temperature in this group, p > 0.005. A positive correlation was significant between the concentration of Hsp 70 and the body temperature of rats in the group of rats with a fatal outcome was determined, p = 0.03. Conclusion: Changes in the concentration of cTnI and Hsp70 in rat serum may indicate hyperthermic damage to the myocardium in the Wistar rat model of heat stroke
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