Antioxidative and anti-inflamatory effectiveness of flavonoids in retinoic acid induced osteoporosis in rat

Osteoporoza je bolest kostura karakterizirana smanjenjem koštane mineralne gustoće (BMD) i poremećajem mikroarhitekture koštanog tkiva. Rizik za osteoporozu može biti genetski ili stečeni. Stečenom riziku pridonose brojni lijekovi, uključujući 13-cis retinoičnu kiselinu (13cRA). U ovome radu dokazano je da 13cRA u dozi od 80 mg kg-1 tijekom 14 dana uspješno uzrokuje osteoporotske promjene u štakora putem mehanizama povećanog oksidativnog stresa (OS) i stvaranja reaktivnih radikala, smanjenja aktivnosti osteoblasta i povećanja aktivnosti osteoklasta, smanjenja razine estrogena i pojavnosti upalnih citokina koji aktiviraju osteoklaste i uzrokuju apoptozu osteoblasta, smanjenja aktivnosti receptora vitamina D, smanjenja apsorpcije Ca2+ u crijevima i povećanja izlučivanja Ca bubrezima i učincima na paratireoidni hormon. Kroz model osteoporoze prouzročen 13cRA (RMO) u ovom istraživanju prikazana su protuoksidativnna, protuupalna, fitoestrogenska i regenerativna svojstva flavonoida (krizina, proantocijanida, naringenina, ikarina i kvercetina ) na osteoblaste i inhibiciju osteoklasta, što je pokazano odnosima između biljega OS, biokemijskim biljezima koštanog preokreta, mjerenjima koštane mase i geometrijskih odrednica bedrenih kosti, mjerenjima proupalnih citokina i histopatoloških oštećenja kosti. Učinci flavonoida uspoređeni su kroz navedene odrednice sa alendronatom, danas lijekom izbora u liječenju osteoporoze, a prikazana je i procjena oštećenja DNA kod RMO štakora nakon obrade flavonoidima i alendronatom. Dobiveni rezultati pokazuju mogućnost novog farmakoterapijskog pristupa u terapiji osteoporotičnih promjena u kojem laka dostupnost, ekonomska isplativost i nedostatak toksičnosti mogu biti prednost u primjeni flavonoida u odnosu na alendronat. Nadalje ovo istraživanje pridonosi boljem razumijevanju odnosa između prehrane i zdravlja te razvoja koncepta funkcionalne hrane s temeljnim ciljem postizanja boljeg zdravstvenog statusa, spriječavanja i liječenja bolesti.Osteoporosis is a skeletal disease characterized by decreased bone mineral density (BMD) and bone microarchitecture disorder. The risk of osteoporosis can be genetic or acquired. Numerous medications including 13-cis retinoic acid (13cRA) contribute to the acquired risk. In this PhD thesis it has been proved that 13cRA at a dose of 80 mg kg-1 during 14 days successfully causes osteoporotic changes in the rats through the mechanisms of increased oxidative stress (OS) and the formation of reactive radicals, reduced activity of osteoblasts and increased osteoclast activity, decreased estrogen levels and the appearance of inflammatory cytokines which activate osteoclasts and cause osteoblasts apoptosis, reduction in vitamin D receptor activity, decreased absorption of Ca2+ in the intestine, increase the Ca secretion by kidneys and the effects on the parathyroid hormone. Through the model of osteoporosis caused by 13cRA (RMO) in this study are shown antioxidative, anti-inflammatory, phytoestrogenic and regenerative features of flavonoids (chrysin, proanthocyanidins, naringenin, icariin and quercetin) on osteoblasts and osteoclasts inhibition, which has been shown by the relationships between markers of OS, biochemical markers of bone turnover, measurements of bone mass and geometric determinants of thigh bones, measurements of proinflammatory cytokines and histopathological bone damage. The effects of flavonoids are compared through these features with alendronate, nowadays the medication of choice to treat osteoporosis, and the evaluation of DNA damage at RMO rats after the treatment with flavonoids and alendronate is presented. The results show the possibility of a new pharmacological approach for the treatment of osteoporotic changes, where easy accessibility, cost-effectiveness and lack of toxicity may be an advantage in the application of flavonoids with respect to alendronate. Furthermore, this study contributes to a better understanding of the relationship between diet and health and development of the concept of functional foods with the fundamental aim of achieving better health status, prevention and treatment of disease

Antioxidative and anti-inflamatory effectiveness of flavonoids in retinoic acid induced osteoporosis in rat

Osteoporoza je bolest kostura karakterizirana smanjenjem koštane mineralne gustoće (BMD) i poremećajem mikroarhitekture koštanog tkiva. Rizik za osteoporozu može biti genetski ili stečeni. Stečenom riziku pridonose brojni lijekovi, uključujući 13-cis retinoičnu kiselinu (13cRA). U ovome radu dokazano je da 13cRA u dozi od 80 mg kg-1 tijekom 14 dana uspješno uzrokuje osteoporotske promjene u štakora putem mehanizama povećanog oksidativnog stresa (OS) i stvaranja reaktivnih radikala, smanjenja aktivnosti osteoblasta i povećanja aktivnosti osteoklasta, smanjenja razine estrogena i pojavnosti upalnih citokina koji aktiviraju osteoklaste i uzrokuju apoptozu osteoblasta, smanjenja aktivnosti receptora vitamina D, smanjenja apsorpcije Ca2+ u crijevima i povećanja izlučivanja Ca bubrezima i učincima na paratireoidni hormon. Kroz model osteoporoze prouzročen 13cRA (RMO) u ovom istraživanju prikazana su protuoksidativnna, protuupalna, fitoestrogenska i regenerativna svojstva flavonoida (krizina, proantocijanida, naringenina, ikarina i kvercetina ) na osteoblaste i inhibiciju osteoklasta, što je pokazano odnosima između biljega OS, biokemijskim biljezima koštanog preokreta, mjerenjima koštane mase i geometrijskih odrednica bedrenih kosti, mjerenjima proupalnih citokina i histopatoloških oštećenja kosti. Učinci flavonoida uspoređeni su kroz navedene odrednice sa alendronatom, danas lijekom izbora u liječenju osteoporoze, a prikazana je i procjena oštećenja DNA kod RMO štakora nakon obrade flavonoidima i alendronatom. Dobiveni rezultati pokazuju mogućnost novog farmakoterapijskog pristupa u terapiji osteoporotičnih promjena u kojem laka dostupnost, ekonomska isplativost i nedostatak toksičnosti mogu biti prednost u primjeni flavonoida u odnosu na alendronat. Nadalje ovo istraživanje pridonosi boljem razumijevanju odnosa između prehrane i zdravlja te razvoja koncepta funkcionalne hrane s temeljnim ciljem postizanja boljeg zdravstvenog statusa, spriječavanja i liječenja bolesti.Osteoporosis is a skeletal disease characterized by decreased bone mineral density (BMD) and bone microarchitecture disorder. The risk of osteoporosis can be genetic or acquired. Numerous medications including 13-cis retinoic acid (13cRA) contribute to the acquired risk. In this PhD thesis it has been proved that 13cRA at a dose of 80 mg kg-1 during 14 days successfully causes osteoporotic changes in the rats through the mechanisms of increased oxidative stress (OS) and the formation of reactive radicals, reduced activity of osteoblasts and increased osteoclast activity, decreased estrogen levels and the appearance of inflammatory cytokines which activate osteoclasts and cause osteoblasts apoptosis, reduction in vitamin D receptor activity, decreased absorption of Ca2+ in the intestine, increase the Ca secretion by kidneys and the effects on the parathyroid hormone. Through the model of osteoporosis caused by 13cRA (RMO) in this study are shown antioxidative, anti-inflammatory, phytoestrogenic and regenerative features of flavonoids (chrysin, proanthocyanidins, naringenin, icariin and quercetin) on osteoblasts and osteoclasts inhibition, which has been shown by the relationships between markers of OS, biochemical markers of bone turnover, measurements of bone mass and geometric determinants of thigh bones, measurements of proinflammatory cytokines and histopathological bone damage. The effects of flavonoids are compared through these features with alendronate, nowadays the medication of choice to treat osteoporosis, and the evaluation of DNA damage at RMO rats after the treatment with flavonoids and alendronate is presented. The results show the possibility of a new pharmacological approach for the treatment of osteoporotic changes, where easy accessibility, cost-effectiveness and lack of toxicity may be an advantage in the application of flavonoids with respect to alendronate. Furthermore, this study contributes to a better understanding of the relationship between diet and health and development of the concept of functional foods with the fundamental aim of achieving better health status, prevention and treatment of disease

Antioxidative and anti-inflamatory effectiveness of flavonoids in retinoic acid induced osteoporosis in rat

Osteoporoza je bolest kostura karakterizirana smanjenjem koštane mineralne gustoće (BMD) i poremećajem mikroarhitekture koštanog tkiva. Rizik za osteoporozu može biti genetski ili stečeni. Stečenom riziku pridonose brojni lijekovi, uključujući 13-cis retinoičnu kiselinu (13cRA). U ovome radu dokazano je da 13cRA u dozi od 80 mg kg-1 tijekom 14 dana uspješno uzrokuje osteoporotske promjene u štakora putem mehanizama povećanog oksidativnog stresa (OS) i stvaranja reaktivnih radikala, smanjenja aktivnosti osteoblasta i povećanja aktivnosti osteoklasta, smanjenja razine estrogena i pojavnosti upalnih citokina koji aktiviraju osteoklaste i uzrokuju apoptozu osteoblasta, smanjenja aktivnosti receptora vitamina D, smanjenja apsorpcije Ca2+ u crijevima i povećanja izlučivanja Ca bubrezima i učincima na paratireoidni hormon. Kroz model osteoporoze prouzročen 13cRA (RMO) u ovom istraživanju prikazana su protuoksidativnna, protuupalna, fitoestrogenska i regenerativna svojstva flavonoida (krizina, proantocijanida, naringenina, ikarina i kvercetina ) na osteoblaste i inhibiciju osteoklasta, što je pokazano odnosima između biljega OS, biokemijskim biljezima koštanog preokreta, mjerenjima koštane mase i geometrijskih odrednica bedrenih kosti, mjerenjima proupalnih citokina i histopatoloških oštećenja kosti. Učinci flavonoida uspoređeni su kroz navedene odrednice sa alendronatom, danas lijekom izbora u liječenju osteoporoze, a prikazana je i procjena oštećenja DNA kod RMO štakora nakon obrade flavonoidima i alendronatom. Dobiveni rezultati pokazuju mogućnost novog farmakoterapijskog pristupa u terapiji osteoporotičnih promjena u kojem laka dostupnost, ekonomska isplativost i nedostatak toksičnosti mogu biti prednost u primjeni flavonoida u odnosu na alendronat. Nadalje ovo istraživanje pridonosi boljem razumijevanju odnosa između prehrane i zdravlja te razvoja koncepta funkcionalne hrane s temeljnim ciljem postizanja boljeg zdravstvenog statusa, spriječavanja i liječenja bolesti.Osteoporosis is a skeletal disease characterized by decreased bone mineral density (BMD) and bone microarchitecture disorder. The risk of osteoporosis can be genetic or acquired. Numerous medications including 13-cis retinoic acid (13cRA) contribute to the acquired risk. In this PhD thesis it has been proved that 13cRA at a dose of 80 mg kg-1 during 14 days successfully causes osteoporotic changes in the rats through the mechanisms of increased oxidative stress (OS) and the formation of reactive radicals, reduced activity of osteoblasts and increased osteoclast activity, decreased estrogen levels and the appearance of inflammatory cytokines which activate osteoclasts and cause osteoblasts apoptosis, reduction in vitamin D receptor activity, decreased absorption of Ca2+ in the intestine, increase the Ca secretion by kidneys and the effects on the parathyroid hormone. Through the model of osteoporosis caused by 13cRA (RMO) in this study are shown antioxidative, anti-inflammatory, phytoestrogenic and regenerative features of flavonoids (chrysin, proanthocyanidins, naringenin, icariin and quercetin) on osteoblasts and osteoclasts inhibition, which has been shown by the relationships between markers of OS, biochemical markers of bone turnover, measurements of bone mass and geometric determinants of thigh bones, measurements of proinflammatory cytokines and histopathological bone damage. The effects of flavonoids are compared through these features with alendronate, nowadays the medication of choice to treat osteoporosis, and the evaluation of DNA damage at RMO rats after the treatment with flavonoids and alendronate is presented. The results show the possibility of a new pharmacological approach for the treatment of osteoporotic changes, where easy accessibility, cost-effectiveness and lack of toxicity may be an advantage in the application of flavonoids with respect to alendronate. Furthermore, this study contributes to a better understanding of the relationship between diet and health and development of the concept of functional foods with the fundamental aim of achieving better health status, prevention and treatment of disease

Optimalna analgezija za kirurgiju dojke ubrzala je oporavak u dnevnoj kirurgiji

Aesthetic breast surgery is the most common body surgery at Bagatin Polyclinic. During 2020 and 2021, altogether 274 cosmetic surgeries were performed on the breasts. This included breast augmentation, breast augmentation and lifting operations, in a ratio of 2 to 1.According to statistics from the American Association of Plastic Surgeons (ASPS), in 2020 breast augmentation with implants was ranked fifth of all cosmetic surgeries performedand the second largest body surgery immediately after liposuction, with 193,073 procedures done. In addition to these procedures, breast augmentation (87,051) and breast reduction (33,574) procedures were also popular. Due to the increased interestin these procedures and their high daily percentage of operating programs, adequate analgesia and recovery of patients, who undergo these cosmetic breast corrections, areimportant. Today, it is no longer enough for an operation to go well and the patients to have good results. It is also important that the procedure itself, from induction of anesthesia to early and late recovery, allows for a quick return to daily activities and work.Estetska kirurgija dojke najčešći je operativni zahvat na tijelu u Poliklinici Bagatin. Prema statistici američkog udruženja plastičnih kirurga ( ASPS-u) 2020. povećanje grudi implantatima je bilo na 5-om mjestu svih estetskih operativnih zahvata i na 2-om mjestu operacija na tijelu odmah iza liposukcije i iznosio je 193,073. Uz navedene zahvate popularni su zahvati podizanje grudi (87,051) i smanjenja (redukcije) grudi (33,574). Zbog velike popularnosti ovih zahvata i velikog udjela istih u svakodnevnom operativnom programu bitna je adekvatna analgezija i oporavak pacijentica koje idu na estetske operacije korekcije grudi. Ovaj segment je bitan jer danas više nije dovoljno samo da operacija prođe dobro i da pacijenti imaju dobar rezultat nego je bitan i sam postupak od uvođenja u anesteziju do ranog i kasnog oporavka i brzog povratka svakodnevnim aktivnostima i poslu

Utjecaj lokalne infiltracijske analgezije na poslijeoperacijsku bol u pacijenata s abdominoplastikom

The aim of this study was the influence of local infiltrating analgesia with levobupivacaine on acute postoperative pain in patients that underwent abdominoplasty in day surgery. Local infiltration anesthesia is an injection of local anesthetic solution in painful areas. General anesthesia and tumescent fluid solution were performed in all patients. The study included 55 patients within age range from 20 to 72 years old. Study was conducted from January 2016 to February 2019. Postoperative pain after abdominoplasty was evaluated. LIA were performed before closure of abdominal wall after resection of skin and subcutaneous fat in lower part of abdominal wall. Infiltration was performed after plication of rectus abdominis muscles with single shot of 40 ml 0.25 % Bupivacaine. Postoperative pain was reduced in the abdominal wall and in the wound area around umbilicus and in lower abdomen scar after waking from general anesthesia. Occurrence of acute postoperative was noticed in all participants. 85% of patients required an additional dose of analgesics and only in 3% of patients was required during the first postoperative day discharged during 48 hours. The research has shown that the appearance of acute postoperative pain did not lead to prolonged stay in the facility for day surgery.Cilj istraživanja je utjecaj lokalne infiltracijske analgezije s levobupivakainom na akutnu postoperacijsku bol u pacijenata podvrgnutih abdominoplastici u dnevnoj kirurgiji. Lokalna infiltracijska anestezija je injiciranje lokalnog anestetika u bolna područja na kojima operiramo. Opća anestezija učinjena je uz infiltraciju trbušnog potkožnog zida s tumescentnom otopinom. U studiju je uključeno 55 pacijenta u dobi od 20 do 72 godine. Studija se provodila od siječnja 2016. do veljače 2019. godine s evaluacijom poslijeoperacijske boli kod abdominoplastike. LIA se koristila prije zatvaranja trbušne stjenke nakon resekcije kožno-potkožnog tkiva u području donjeg dijela trbušne stjenke sa 40 ml 0,5 % Bupivakaina. Poslijeoperacijska bol u trbušnom zidu i u rani oko pupka i u području donjeg vodoravnog reza bila je manja. Dodatne analgetike poslije kirurškog zahvata dobilo je 85% pacijenata dok prvi poslijeoperacijski dan samo 3% pacijenata koji su otpušteni iz Poliklinike tijekom 48 sati. Istraživanje pokazuje da poslijeoperacijska bol poslije abdominoplastike neće produljiti boravak u poliklinici

Oblikovanje nosa strukturalnim graftovima

Cilj rada je pokazati kako strukturalni graftovi u nosu osiguravaju estetski i funkcijski zadovoljavajući rezultat kod naših bolesnika. Strukturalni graftovi podrazumijevaju “spreader” graftove, graftove za elongaciju nosne pregrade i alarne graftove. Kandidati za strukturalnu rinoplastiku su bolesnici s asimetrijom lica, izražene devijacije nosa, spušteni vršak, deformiteti i malformacije usnice i nosa, bolesnici s debelom kožom vrška, kao i bolesnici starije životne dobi. U svim zahvatima je korišten otvoreni pristup na nos koji osigurava najbolju vidljivost struktura nosa i na taj način osigurava mogućnost preciznijeg kirurškog mijenjanja i rekonstrukcije nosa sa strukturalnim graftovima. Strukturalni graftovi osiguravaju se iz hrskavice nosne pregrade ili, ako ona nije dostupna, koštanim graftovima iz iste, čime se osigurava stabilna struktura nosa. Kao rezultat se vidi osigurana stabilnost centralnog i prednjeg segmenta nosa, uz estetski i funkcijski zadovoljavajući rezultat. Strukturalna rinoplastika osigurava trajan i estetski adekvatan rezultat kod svakog bolesnika

Anesthesia in Plastic Surgery: Intersurgical I-gel Placement in a Prone Position

Anesthesia is a specialization which in past history has branched off of surgery. It needs to be very creative in its delivery, in order to accommodate the many operating positions, needed by the surgeon. The patient positions must also be safe and adequate for proper ventilation, throughout the operative procedure. There are times when multiple positions must be used, turning the patient over, even several times. Careful planning and team discussions prior to an operation are absolutely necessary, to form anesthetic and operative plans. The aim of the supraglottic airway device (Intersurgical i-gel) prone position induction method is to describe, detail and present its safe efficacy for certain planned operative procedures. Patient fasting preparation is a must, nil by mouth for 8 h. This method and sequence alleviates the use of muscle relaxants for patient rotation. This increases patient safety by keeping muscle tone normal, reduced drug use, minimizing rotation of the patient, and reduces possible injury of patient and among staff involved in rotating. Some may say induction in the prone position may be unsafe due to aspiration risks, but knowing anatomy and gravitational physics, in the event of any secretions projected, they will project forwards onto the operating table (through the gastric port of the i-gel), not into the tracheal area. This similar technique and principle are seen and used for the recovery position, to aid in free drainage of fluid from within the oral cavity. The method is used for a variety of operations worldwide and introduced in 2018 at Poliklinika Bagatin (PB). Approximately, 80 prone position inductions or 10% of all general anesthesias are performed every year at PB. More than 240 anesthesized patients in the prone position with an i-gel have used this method, since it was introduced. All have been with excellent results, minimal risk and appropriate ventilation of patients. I-gel placement in prone position was successful everytime. This method is advantageous to avoid multiple rotations of patients and avoid the use of muscle relaxants, otherwise used, with classic endotracheal intubation methods. The exact process will be discussed in more detail and described within the chapter

Fan-Shaped Application of Local Abdominal Wall Analgesia in Abdominoplasty Patients: Does the Technique Lead to Better Recovery?

Plastic surgery can be considered an art form, molding and shaping areas of the body to provide enhancement and visual improvements. During this process, anesthesia is a key role player, for both local and general aspects. Proper combinations of local and general anesthesia can provide not only great pain relief and the ability to perform the artwork of plastic surgery, but can also lead to better and faster postoperative recovery of patients. Take a moment to imagine doing our skills without anesthesia, not only would it be barbaric, but also unethical. The method of using fan-shaped anesthesia application will be explored as a technique to improve patient recovery. This, instead of the classic straightforward areal injection application, seems to provide improved anesthetic distribution, penetrates layers better, and offers a swifter and more efficient way of blocking pain receptors. Choosing an appropriate anesthetic from the various ones available today is very important for pain control and postoperative recovery, as well as combining it with other drugs to increase its duration of action. This medley of drug combinations provides patient satisfaction and enhanced recovery

VASER Liposuction - How to Get Natural Results with Ultrasound Assisted Liposuction?

Ultrasound assisted liposuction technology is a selective technique to emulsify fatty tissue and improve the removal of fat. This technique can be used on many areas of the body such as: chin neck, back, buttocks, abdomen, legs, arms. Fatty areas, as well as, skin and cellulite can be molded in a process known as ultrasound cavitation. Results can produce significant skin contraction and smoothing of areas. Using this method reduces the need for surgical intervention and requires less energy to achieve similar results. This method is also good for treatment of fibrous scar tissue, producing less bruising and blood loss. The advantages of the VASER ultrasound prepared liposuction in comparison to the mechanical liposuction method are better with fat extraction, less blood loss, and smoother results. While the disadvantages of VASER ultrasound method are possible thermal injuries, the need for larger incisions for protective ports, increased incidence of seromas, slightly increased cost and longer preparation and operative times. However further presentation will show the benefits of this newer generation of liposuction method. Also, various probes for better fat extraction and specific treatment areas will be discussed

Antioxidative and Anti-Inflammatory Activities of Chrysin and Naringenin in a Drug-Induced Bone Loss Model in Rats

Oxidative stress (OS) mediators, together with the inflammatory processes, are considered as threatening factors for bone health. The aim of this study was to investigate effects of flavonoids naringenin and chrysin on OS, inflammation, and bone degradation in retinoic acid (13cRA)-induced secondary osteoporosis (OP) in rats. We analysed changes in body and uterine weight, biochemical bone parameters (bone mineral density (BMD), bone mineral content (BMC), markers of bone turnover), bone geometry parameters, bone histology, OS parameters, biochemical and haematological parameters, and levels of inflammatory cytokines. Osteoporotic rats had reduced bone Ca and P levels, BMD, BMC, and expression of markers of bone turnover, and increased values of serum enzymes alkaline phosphatase (ALP) and lactate dehydrogenase (LDH). Malondialdehyde (MDA) production in liver, kidney, and ovary was increased, while the glutathione (GSH) content and activities of antioxidant enzymes were reduced and accompanied with the enhanced release of inflammatory mediators TNF-α, IL-1β, IL-6, and RANTES chemokine (regulated on activation normal T cell expressed and secreted) in serum. Treatment with chrysin or naringenin improved bone quality, reduced bone resorption, and bone mineral deposition, although with a lower efficacy compared with alendronate. However, flavonoids exhibited more pronounced antioxidative, anti-inflammatory and phytoestrogenic activities, indicating their great potential in attenuating bone loss and prevention of OP