Antioxidant Enzymes Activity in Patients with Peripheral Vascular Disease, with and without Presence of Diabetes Mellitus

The study evaluated antioxidant status in patients with peripheral vascular disease (PVD), with and without concomitant diabetes mellitus (DM). 211 participants were divided into standardized 4 groups: patients with PVD and DM (PVD+DM+), patients with PVD without DM (PVD+DM-), patients without PVD with DM (PVD-DM+) and patients without PVD and DM (PVD-DM-). The diagnosis of PVD was established by Doppler sonography analysis, including determination of the ankle brachial index (ABI), partial pressures along the leg, and CW Doppler sonography at typical locations. Antioxidant status has been evaluated through the colorimetrically assessed serum activity of key antioxidant enzymes: superoxide dismutase (SOD), catalase, and glutathione peroxidase (GLPX) as well as through total antioxidant status (TAS) determination. In PVD+DM- group, as well as PVD-DM+ group, a significantly lower activity of the GLPX, catalase and TAS was found, whereas activity of SOD was significantly higher. There was no statistically significant difference between PVD+DM+ and PVD-DM+ group. Likewise, there was no statistically significant difference between PVD+DM- and PVD -DM-group. This study has shown that there is statistically significant difference in activity of antioxidant enzymes between diabetic and non-diabetic patients, irrespectively of PVD presence. Furthermore, PVD present alone does not alter key antioxidant enzymes activity in comparison with healthy subjects

Pouzdanost urodinamske obrade u potvrdi stresne inkontinencije mokraće u odnosu na Bonney test

According to the International Continence Society, stress (static) urinary incontinence is defined as any involuntary loss of urine on effort or physical exertion, due to which intravesical pressure overcomes urethral pressure, with no detrusor activity. Urodynamic testing accurately assesses the function of the bladder and urethra. The urodynamic assessment includes three tests: cystometry, uroflowmetry and profilometry (determination of urethral pressure profile). Prior to urodynamic assessment, it is mandatory to rule out urinary tract infection since it is an invasive test. Urethral profilometry is a technique that measures pressure in the urethra and bladder at rest, during stressful actions, and during the act of miction. Its main purpose is to evaluate the sphincter mechanism. During the examination, a special catheter is used, which is being slowly pulled out from the bladder neck throughout the urethra, with continuous recording of intraurethral pressure. In addition to measuring urethral pressures, stress urinary incontinence is also very successfully proven by the cough test and Bonney test. If, on forced cough, the urine escapes uncontrollably, and continence is restored by finger lifting the neck of the bladder, the diagnosis of static incontinence is confirmed. At our urogynecologic clinic, urodynamic examination is being routinely performed. In the present study, we included patients previously treated for urinary stress incontinence and compared their results of urodynamic assessment to the results of Bonney test. Of the 43 subjects in whom stress incontinence was proven with Bonney test, we recorded an appropriate profilometry result in 13 cases.Stresna (statička) inkontinencija mokraće definira se prema ICS-u kao neželjeno otjecanje mokraće kroz uretru istodobno s porastom intraabdominalnog tlaka zbog kojeg intravezikalni tlak nadvlada tlak u uretri, uz odsutnu aktivnost detruzora. Urodinamskom obradom precizno se procjenjuje funkcija mokraćnog mjehura i mokraćne cijevi. U urodinamsku obadu ubrajajmo tri metode: cistometriju, mikciometriju (uroflow) i profilometriju (određivanje profila uretralnog tlaka). Prije urodinamske obrade moramo uvijek isključiti infekciju mokraćnih kanala, jer se radi o invazivnoj pretrazi. Profilometrija uretre je tehnika kojom mjerimo tlak u uretri kod mokraćnog mjehura u mirovanju, tijekom stresnih radnja i samog akta mokrenja. Osnovna joj je namjena ispitivanje sfinkterskoga mehanizma. Pri pregledu rabi se specijalni kateter koji se malom brzinom povlači od vrata mjehura prema distalno uz kontinuirano bilježenje intrauretralnoga tlaka. Uz mjerenje tlakova uretre stresna inkontinencija mokraće se vrlo uspješno dokazuje i testom kašlja, odnosno Bonney testom. Ako kod forsiranog kašlja mokraća nekontrolirano otječe, a podizanjem vrata mokraćnog mjehura prstima ispitanica uspijeva zadržati mokraću u mjehuru, radi se o statičkoj inkontinenciji. U OB “Dr Josip Benčević’’ pri uroginekološkoj ambulanti radi se urodinamsko ispitivanje. U ovo istraživanje uključili smo samo ispitanice s liječenom stresnom inkontinencijom mokraće te smo usporedili njihove rezultate na urodinamskoj obradi u odnosu na rezultate Bonney testa. Od 43 ispitanice kojima smo stresnu inkontinenciju dokazali Bonney testom u 13 slučajeva zabilježili smo uredan nalaz profilometrije

Hrvatske smjernice za farmakološko liječenje šećerne bolesti tipa 2 [Croatian guidelines for the pharmacotherapy of type 2 diabetes]

Introduction: The Croatian Association for Diabetes and Metabolic Disorders of the Croatian Medical Association has issued in 2011 the first national guidelines for the nutrition, education, self-control, and pharmacotherapy of diabetes type 2. According to the increased number of available medicines and new evidence related to the effectiveness and safety of medicines already involved in the therapy there was a need for update of the existing guidelines for the pharmacotherapy of type 2 diabetes in the Republic of Croatia. Participants: as co-authors of the Guidelines there are listed all members of the Croatian Association for Diabetes and Metabolic Diseases, as well as other representatives of professional societies within the Croatian Medical Association, who have contributed with comments and suggestions to the development of the Guidelines. Evidence: These guidelines are evidence-based, according to the GRADE system (eng. Grading of Recommendations, Assessment, Development and Evaluation), which describes the level of evidence and strength of recommendations. Conclusions: An individual patient approach based on physiological principles in blood glucose control is essential for diabetes' patients management. Glycemic targets and selection of the pharmacological agents should be tailored to the patient, taking into account the age, duration of disease, life expectancy, risk of hypoglyce- mia, comorbidities, developed vascular and other complications as well as other factors. Because of all this, is of national interest to have a practical, rational and applicable guidelines for the pharmacotherapy of type 2 diabetes

CROATIAN GUIDELINES FOR THE PHARMACOTHERAPY OF TYPE 2 DIABETES

Uvod: Hrvatsko društvo za dijabetes i bolesti metabolizma Hrvatskoga liječničkog zbora izradilo je 2011. godine prve nacionalne smjernice o prehrani, edukaciji i samokontroli te farmakološkom liječenju šećerne bolesti tipa 2. Sukladno povećanom broju dostupnih lijekova te novim spoznajama o učinkovitosti i sigurnosti primjene već uključenih lijekova, pokazala se potreba za obnovom postojećih smjernica za farmakološko liječenje šećerne bolesti tipa 2 u Republici ­Hrvatskoj. Sudionici: Kao koautori Smjernica navedeni su svi članovi Hrvatskog društva za dijabetes i bolesti metabolizma Hrvatskoga liječničkog zbora, kao i ostalih uključenih stručnih društava, koji su svojim komentarima i prijedlozima pridonijeli izradi Smjernica. Dokazi: Ove su Smjernice utemeljene na dokazima, prema sustavu GRADE (engl. Grading of Recommendations, Assessment, Development and Evaluation) koji uz razinu dokaza opisuje i snagu preporuke. Zaključci: Individualan pristup temeljen na fiziološkim principima regulacije glikemije nuždan je u liječenju osoba sa šećernom bolesti. Ciljeve liječenja i odabir medikamentne terapije treba prilagoditi oboljeloj osobi, uzimajući u obzir životnu dob, trajanje bolesti, očekivano trajanje života, rizik od hipoglikemije, komorbiditete, razvijene vaskularne i ostale komplikacije, kao i ostale čimbenike. Zbog svega navedenoga od nacionalnog je interesa imati praktične, racionalne i provedive smjernice za farmakološko liječenje šećerne bolesti tipa 2.Introduction: The Croatian Association for Diabetes and Metabolic Disorders of the Croatian Medical Association has issued in 2011 the first national guidelines for the nutrition, education, self-control, and pharmacotherapy of ­diabetes type 2. According to the increased number of available medicines and new evidence related to the effectiveness and safety of medicines already involved in the therapy there was a need for update of the existing guidelines for the ­pharmacotherapy of type 2 diabetes in the Republic of Croatia. Participants: as co-authors of the Guidelines there are listed all members of the Croatian Association for Diabetes and Metabolic Diseases, as well as other representatives of professional societies within the Croatian Medical Association, who have contributed with comments and suggestions to the development of the Guidelines. Evidence: These guidelines are evidence-based, according to the GRADE system (eng. Grading of Recommendations, Assessment, Development and Evaluation), which describes the level of evidence and strength of recommendations. Conclusions: An individual patient approach based on physiological principles in blood glucose control is essential for diabetes’ patients management. Glycemic targets and selection of the pharmacological agents should be tailored to the patient, taking into account the age, duration of disease, life expectancy, risk of hypoglycemia, comorbidities, developed vascular and other complications as well as other factors. Because of all this, is of national interest to have a practical, rational and applicable guidelines for the pharmacotherapy of type 2 diabetes

The effects of pentadecapeptide BPC 157 in stress urinary incontinence models in female rats

Pozadina: Na osnovi prethodno ustanovljenih promotivnih učinaka stabilnog želučanog pentadekapeptida BPC 157 (PL 14736) na tkivno specifične procese cijeljenja, npr. skeletnih poprečno-prugastih te glatkih mišića gastrointestinalnog trakta, napose sfinktera, kao i živčanog tkiva, u ovom je radu istraživan njegov učinak na oporavak urodinamskog parametra LPP (eng. leak point pressure) u štakorskim modelima stresne urinarne inkontinencije (SUI) s transabdominalnom uretrolizom (TU) i protrahiranom vaginalnom dilatacijom (VD), uz praćenje histoloških promjena na uretrama eksperimentalnih životinja. ----- Materijali/Metode: Tretman s pentadekapeptidom BPC157 provođen je u trajanju od 7 dana i kod zdravih i kod operiranih životinja (TU ili VD), i to (i) intraperitonealno, 10 µg/kg ili 10 ng/kg, (prva doza 30 minuta nakon operacije, posljednja 24 sata prije mjerenja LPP-a i žrtvovanja), ili (ii) peroralno, 10 µg/kg otopljen u vodi za piće (0.16 µg/mL, 12 mL po štakoru po danu). Kontrolne životinje primale su ekvivolumno (5 mL/kg) intraperitonealno čistu fiziološku otopinu, odnosno, peroralno, standardnu vodu za piće. Vezikouretralni segmenti preuzeti su za imunohistokemijsku analizu. ----- Rezultati: Svi režimi terapije s BPC 157 spriječile su pad u vrijednostima LPP-a nakon TU i VD. Dodatno, pojedine skupine s mikrogramskim dozama (peroralno i intraperitonealno kod TU, te intraperitonealno kod VD) dosižu vrijednosti LPP-uočene kod zdravih životinja. U zdravih životinja, terapija s BPC 157 nije alterirala vrijednosti LPP-a. Imunohistokemijske analize uretri životinja tretiranih s BPC 157 pokazale su, u odnosu na kontrole, veću pozitivnost za dezmin (prikaz udjela poprečno-prugastih mišićnih vlakana), glatkomišićni aktin te za CD34 (marker angiogeneze), kao i sačuvan omjer ukupnog mišićnog i vezivnog tkiva (bojanje Mallory trikrom metodom). ----- Zaključci: Pentadekapeptid BPC 157 primijenjen peoralno ili intra-peritonealno ima terpijske učinke na SUI, funkcionalno i histološki korigirajući inače dertimentalan tijek nakon TU i VD. Demonstrirani učinci mogu predstavljati osnov za buduće strategije terapijsko-prevencijskog pristupa SUI.Background: Since an originally anti-ulcer stable gastric penta-decapeptide BPC 157 (PL 14736) was shown to promote healing of injured striated muscle and also smooth muscle in the gastrointestinal tract, we explored its therapeutic potentials for leak point pressure (LPP) recovery in rat stress urinary incontinence (SUI) after transabdominal urethrolysis (TU) and prolonged vaginal dilatation (VD), along with urethral histology assessment. ----- Materials/Methods: During a 7-day period, TU-rats and VD-rats (or healthy rats) received BPC 157, either (i) intraperitoneally, 10 µg/kg or 10 ng/kg, once daily (first administration 30 min after surgery, last 24 h before LPP-testing and sacrifice), or (ii) per-orally, 10 µg/kg in drinking water (0.16 µg/mL, 12 mL/rat/day). Controls received only drinking water or an equal volume of saline (5 mL/kg, intraperitoneally). Vesicourethral segments were harvested for immunohistochemical evaluation. ---- Results: All BPC 157 regimens counteracted decrease of LPP values in TU-rats and VD-rats. Additionally, BPC 157-TU rats (µg-intraperitoneally or per-orally) and BPC 157-VD rats (µg intraperitoneally) reached LPP values originally noted in healthy rats. Conversely, in healthy rats, BPC 157 did not alter LPP. Immunohistochemical studies revealed higher desmin (delineates striated organization of skeletal muscle), smooth muscle actin, and CD34 (angiogenic marker) positivity within the urethral wall in BPC 157-treated rats vs. controls, as well as overall preserved muscle/connective tissue ratio assessed with Mallory’s trichrome staining. ----- Conclusions: Pentadecapeptide BPC 157, applied parenterally or per-orally, appears to ameliorate the SUI in rat models, improving the otherwise detrimental course of healing after VD and TU, which may be analogous to human injury. These beneficial effects may possibly be selectively used in future strategies for treatment of SUI

Učinci pentadekapeptida BPC 157 na modelima stresne inkontinencije kod ženki štakora [The effects of pentadecapeptide BPC 157 in stress urinary incontinence models in female rats]

Background: Since an originally anti-ulcer stable gastric penta-decapeptide BPC 157 (PL 14736) was shown to promote healing of injured striated muscle and also smooth muscle in the gastrointestinal tract, we explored its therapeutic potentials for leak point pressure (LPP) recovery in rat stress urinary incontinence (SUI) after transabdominal urethrolysis (TU) and prolonged vaginal dilatation (VD), along with urethral histology assessment. ----- Materials/Methods: During a 7-day period, TU-rats and VD-rats (or healthy rats) received BPC 157, either (i) intraperitoneally, 10 µg/kg or 10 ng/kg, once daily (first administration 30 min after surgery, last 24 h before LPP-testing and sacrifice), or (ii) per-orally, 10 µg/kg in drinking water (0.16 µg/mL, 12 mL/rat/day). Controls received only drinking water or an equal volume of saline (5 mL/kg, intraperitoneally). Vesicourethral segments were harvested for immunohistochemical evaluation. ---- Results: All BPC 157 regimens counteracted decrease of LPP values in TU-rats and VD-rats. Additionally, BPC 157-TU rats (µg-intraperitoneally or per-orally) and BPC 157-VD rats (µg intraperitoneally) reached LPP values originally noted in healthy rats. Conversely, in healthy rats, BPC 157 did not alter LPP. Immunohistochemical studies revealed higher desmin (delineates striated organization of skeletal muscle), smooth muscle actin, and CD34 (angiogenic marker) positivity within the urethral wall in BPC 157-treated rats vs. controls, as well as overall preserved muscle/connective tissue ratio assessed with Mallory’s trichrome staining. ----- Conclusions: Pentadecapeptide BPC 157, applied parenterally or per-orally, appears to ameliorate the SUI in rat models, improving the otherwise detrimental course of healing after VD and TU, which may be analogous to human injury. These beneficial effects may possibly be selectively used in future strategies for treatment of SUI

The effects of pentadecapeptide BPC 157 in stress urinary incontinence models in female rats

Pozadina: Na osnovi prethodno ustanovljenih promotivnih učinaka stabilnog želučanog pentadekapeptida BPC 157 (PL 14736) na tkivno specifične procese cijeljenja, npr. skeletnih poprečno-prugastih te glatkih mišića gastrointestinalnog trakta, napose sfinktera, kao i živčanog tkiva, u ovom je radu istraživan njegov učinak na oporavak urodinamskog parametra LPP (eng. leak point pressure) u štakorskim modelima stresne urinarne inkontinencije (SUI) s transabdominalnom uretrolizom (TU) i protrahiranom vaginalnom dilatacijom (VD), uz praćenje histoloških promjena na uretrama eksperimentalnih životinja. ----- Materijali/Metode: Tretman s pentadekapeptidom BPC157 provođen je u trajanju od 7 dana i kod zdravih i kod operiranih životinja (TU ili VD), i to (i) intraperitonealno, 10 µg/kg ili 10 ng/kg, (prva doza 30 minuta nakon operacije, posljednja 24 sata prije mjerenja LPP-a i žrtvovanja), ili (ii) peroralno, 10 µg/kg otopljen u vodi za piće (0.16 µg/mL, 12 mL po štakoru po danu). Kontrolne životinje primale su ekvivolumno (5 mL/kg) intraperitonealno čistu fiziološku otopinu, odnosno, peroralno, standardnu vodu za piće. Vezikouretralni segmenti preuzeti su za imunohistokemijsku analizu. ----- Rezultati: Svi režimi terapije s BPC 157 spriječile su pad u vrijednostima LPP-a nakon TU i VD. Dodatno, pojedine skupine s mikrogramskim dozama (peroralno i intraperitonealno kod TU, te intraperitonealno kod VD) dosižu vrijednosti LPP-uočene kod zdravih životinja. U zdravih životinja, terapija s BPC 157 nije alterirala vrijednosti LPP-a. Imunohistokemijske analize uretri životinja tretiranih s BPC 157 pokazale su, u odnosu na kontrole, veću pozitivnost za dezmin (prikaz udjela poprečno-prugastih mišićnih vlakana), glatkomišićni aktin te za CD34 (marker angiogeneze), kao i sačuvan omjer ukupnog mišićnog i vezivnog tkiva (bojanje Mallory trikrom metodom). ----- Zaključci: Pentadekapeptid BPC 157 primijenjen peoralno ili intra-peritonealno ima terpijske učinke na SUI, funkcionalno i histološki korigirajući inače dertimentalan tijek nakon TU i VD. Demonstrirani učinci mogu predstavljati osnov za buduće strategije terapijsko-prevencijskog pristupa SUI.Background: Since an originally anti-ulcer stable gastric penta-decapeptide BPC 157 (PL 14736) was shown to promote healing of injured striated muscle and also smooth muscle in the gastrointestinal tract, we explored its therapeutic potentials for leak point pressure (LPP) recovery in rat stress urinary incontinence (SUI) after transabdominal urethrolysis (TU) and prolonged vaginal dilatation (VD), along with urethral histology assessment. ----- Materials/Methods: During a 7-day period, TU-rats and VD-rats (or healthy rats) received BPC 157, either (i) intraperitoneally, 10 µg/kg or 10 ng/kg, once daily (first administration 30 min after surgery, last 24 h before LPP-testing and sacrifice), or (ii) per-orally, 10 µg/kg in drinking water (0.16 µg/mL, 12 mL/rat/day). Controls received only drinking water or an equal volume of saline (5 mL/kg, intraperitoneally). Vesicourethral segments were harvested for immunohistochemical evaluation. ---- Results: All BPC 157 regimens counteracted decrease of LPP values in TU-rats and VD-rats. Additionally, BPC 157-TU rats (µg-intraperitoneally or per-orally) and BPC 157-VD rats (µg intraperitoneally) reached LPP values originally noted in healthy rats. Conversely, in healthy rats, BPC 157 did not alter LPP. Immunohistochemical studies revealed higher desmin (delineates striated organization of skeletal muscle), smooth muscle actin, and CD34 (angiogenic marker) positivity within the urethral wall in BPC 157-treated rats vs. controls, as well as overall preserved muscle/connective tissue ratio assessed with Mallory’s trichrome staining. ----- Conclusions: Pentadecapeptide BPC 157, applied parenterally or per-orally, appears to ameliorate the SUI in rat models, improving the otherwise detrimental course of healing after VD and TU, which may be analogous to human injury. These beneficial effects may possibly be selectively used in future strategies for treatment of SUI

Web application for solving the restricted container relocation problem on the container terminal stacking area

U radu su objašnjene moderne tehnologije razvoja web aplikacija na primjeru Web aplikacije Container Relocate za rješavanje ograničenog problema premještanja kontejnera na slagalištu kontejnerskog terminala. Predstavljena je React knjižnica kao moderna knjižnica za razvoj jednostraničnih web aplikacija. Navedene su prednosti i mane knjižnice te je opisan postupak razvoja klijentskog dijela Container Relocate aplikacije. Detaljno je opisana Redux knjižnica što uključuje njene komponente i koncepte. Navedene su sve optimizacije koje omogućava prebacivanje aplikacije na centralizirano Redux stanje. Opisan je postupak animiranja pomoću Framer Motion knjižnice te su opisani svi potrebni izračuni prilikom animiranja. Također objašnjeno je kako je animirana simulacija rješenja zadanog problema. Naposljetku je opisano kreiranje baze podataka, kreiranje poslužiteljskog dijela, spajanje baze podataka s poslužiteljskim dijelom te spajanje klijentskog dijela s poslužiteljskim dijelom.This thesis contains explanation of modern web development technologies based on the example web application Container Relocate which is used to solve the restricted container relocation problem. The React library is presented as a modern library for the development of single page web application. All the positives and negatives of the library are mentioned. The process of developing client side for the Container Relocate application is documented. The thesis also contains introduction to the Redux library. Explained are all of its components and concepts. The optimizations which are made possible by using Redux library have been mentioned as well as their implementation details. The animating process using Framer Motion library has been described. All required mathematical calculations are also included. Playing the solution simulation for the given problem has been described. Finally, the creation of graph database, backend application, connecting of backend and the databse and connecting of frontend and backend was de