Evaluation of quality of life in patients treated for colorectal cancer at the University Hospital Trnava

Introduction: The aim of the study was to evaluate quality of life (QoL) in patients with colorectal cancer (CRC) during complex treatment using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR29 questionnaires and to implement routine QoL assessment into our practice. Methods: 30 patients diagnosed with CRC at the Department of Surgery, Faculty Hospital Trnava, Slovakia were included in the study between May 2014 and April 2015. QoL was assessed using EORTC QLQ-C30 and QLQ-CR29 questionnaires before surgery and 1 month after surgery. Data are presented as means, and a paired t-test and independent t-test were used for statistical analysis. Results: A significant correlation between the type of treatment and QoL was identified in the cohort. A trend to lower QoL was observed in patients with completed neoadjuvant chemoradiotherapy (CRT) and after surgery with stoma formation. The QoL was also affected by the age and gender of the patients. Conclusion: QoL assessment provides important outcomes reflecting the consequences of particular therapeutic modality in patients with CRC. The worse effect of neoadjuvant CRT and stoma formation was shown in our study in comparison to radical resection with adjuvant chemotherapy

Malondialdehyde as an independent predictor of body mass index in adolescent girls

Background: Given the fact that the studies that examined oxidative stress in relation to obesity that included late adolescents are scarce and show inconclusive results we aimed to investigate a wide spectrum of nitro-oxidative stress biomarkers i.e., malondialdehyde (MDA), xanthine oxidase (XO), xanthine oxidoreductase (XOD), xanthine dehydrogenase (XDH), advanced oxidation protein products (AOPP) and nitric oxide products (NOx), as well as an antioxidative enzyme, i.e., catalase (CAT) in relation with obesity in the cohort of adolescent girls ages between 16 and 19 years old. Methods: A total of 59 teenage girls were included in this cross-sectional study. Binary logistic regression analysis was performed to examine possible associations between biochemical and nitro-oxidative stress markers and body mass index (BMI). Results: There were not significant differences between oxidative stress markers between normal weight and overweight/obese girls (i.e., AOPP, XOD, XO, XDH) and CAT, except for MDA (p<0.001) and NOx (p=0.010) concentrations which were significantly higher in overweight/obese adolescent girls. Positive associations were evident between BMI and high sensitivity C-reactive protein (hsCRP) (OR=2.495), BMI and uric acid (OR=1.024) and BMI and MDA (OR=1.062). Multivariable binary regression analysis demonstrated significant independent associations of BMI and hsCRP (OR=2.150) and BMI and MDA (OR=1.105). Even 76.3% of the variation in BMI could be explained with this Model. Conclusions: Inflammation (as measured with hsCRP) and oxidative stress (as determined with MDA) independently correlated with BMI in teenage girls

Treatment with Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors (PCSK9i): Current Evidence for Expanding the Paradigm?

Background: Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) are low-density lipoprotein cholesterol (LDL-C)-lowering drugs that play a critical role in lipoprotein clearance and metabolism. PCSK9i are used in patients with familial hypercholesterolemia and for the secondary prevention of acute cardiovascular events in patients with atherosclerotic cardiovascular disease (CVD). Methods: We focused on the literature from 2015, the year of approval of the PCSK9 monoclonal antibodies, to the present on the use of PCSK9i not only in the lipid field but also by evaluating their effects on metabolic factors. Results: PCSK9 inhibits cholesterol efflux from macrophages and contributes to the formation of macrophage foam cells. PCSK9 has the ability to bind to Toll-like receptors, thus mediating the inflammatory response and binding to scavenger receptor B/cluster of differentiation 36. PCSK9i lower the entire spectrum of apolipoprotein B-100 containing lipoproteins (LDL, very LDLs, intermediate-density lipoproteins, and lipoprotein[a]) in high CVD-risk patients. Moreover, PCSK9 inhibitors are neutral on risk for new-onset diabetes mellitus and might have a beneficial impact on the development of nonalcoholic fatty liver disease by improving lipid and inflammatory biomarker profiles, steatosis biomarkers such as the triglyceride-glucose index, and hepatic steatosis index, although there are no comprehensive studies with long-term follow-up studies. Conclusion: The discovery of PCSK9i has opened a new era in therapeutic management in patients with hypercholesterolemia and high cardiovascular risk. Increasingly, there has been mounting scientific and clinical evidence supporting the safety and tolerability of PCSK9i

Post-Hypoglycemic hyperglycemia are highly relevant markers for stratification of glycemic variability and partial remission status of pediatric patients with new-onset type 1 diabetes.

AimsTo evaluate whether parameters of post-hypoglycemic hyperglycemia (PHH) correlated with glucose homeostasis during the first year after type 1 diabetes onset and helped to distinguish pediatric patients undergoing partial remission or not.MethodsIn the GLUREDIA (GLUcagon Response to hypoglycemia in children and adolescents with new-onset type 1 DIAbetes) study, longitudinal values of clinical parameters, continuous glucose monitoring metrics and residual β-cell secretion from children with new-onset type 1 diabetes were analyzed during the first year after disease onset. PHH parameters were calculated using an in-house algorithm. Correlations between PHH parameters (i.e., PHH frequency, PHH duration, PHH area under the curve [PHHAUC]) and glycemic homeostasis markers were studied using adjusted mixed-effects models.ResultsPHH parameters were strong markers to differentiate remitters from non-remitters with PHH/Hyperglycemia duration ratio being the most sensitive (ratioConclusionPHH parameters are new minimal-invasive markers to discriminate remitters from non-remitters and evaluate glycemic homeostasis during the first year of type 1 diabetes. PHH parameters may also allow patient-targeted therapeutic management of hypoglycemic episodes

Natural and natural-like polyphenol compounds: in vitro antioxidant activity and potential for therapeutic application

Introduction Phenols are a large family of natural and synthetic compounds with known antioxidant activity. The aim of this study was to preform an in vitro screening of natural and natural-like phenol monomers and their C2-symetric dimers (hydroxylated biphenyls) in order to identify those representatives which pharmacophores have the strongest antioxidant and the lowest prooxidant activity. Material and methods Antioxidative properties of 36 compounds (monomers and their C2-symmetric dimers) were evaluated in vitro. Different (red/ox) assays were used to measure their total oxidative potential (TOP), their total antioxidative capacity (TAC), the pro-oxidative-antioxidant balance (PAB) and total SH-group content (SHG) in a biologically relevant environment. The Pro-oxidative Score, Antioxidative Score and the Oxy Score were also calculated. Trolox, a water soluble analogue of α- tocopherol was used as a positive control. Results In an assay consisting of pooled human serum 6 of the 36 compounds indicated significant antioxidant activity (compounds 6, 7, 12, 13, 26, and 27) whereas 4 indicated extremely weak antioxidant activity (compounds 2, 29, 30, and 31). Within the 36 compounds comprising of zingerone, dehydrozingerone, aurone, chalcone, magnolol derivatives, in both monomeric and dimeric forms, the 2 compounds that indicated the highest antioxidant activity were dehydrozingerone derivatives (compounds 6 and 12). Trolox’s activity was found between the strong and weak antioxidant compounds analysed in our study. Conclusions In this study selected dehydrozingerones were identified as good candidates for in-depth testing of their biological behaviour and for possible precursors for the synthesis of novel polyphenolic molecules with potential therapeutic applications

Are liver function biomarkers independently associated with Framingham risk score in women?

Introduction/Objective Given the contradictory results regarding the association of liver function biomarkers [e.g., alanine-aminotransferase (ALT), gamma-glutamyl transferase (GGT) and total biliru-bin)] and the risk of cardiovascular disease (CVD), we aimed to explore the relationship between these biomarkers and Framingham risk score (FRS), an established tool used in the prediction of 10-year CVD risk in the cohort of women.Methods A total of 278 women participated in this cross-sectional study. Anthropometric, biochemical parameters, and blood pressure were obtained.Results There was a significant increase in ALT and GGT activity, as well as a decrease in total bilirubin level in the high-risk FRS group compared to moderate-, and low-risk FRS (p for trend = 0.025, p < 0.001, p < 0.001, respectively). Multivariate logistic regression analysis showed that body mass index, triglycer-ides, creatinine, and high sensitivity C-reactive protein levels were the independent predictors of FRS in women [odds ratio (OR) = 1.234, p = 0.001; OR = 2.856, p = 0.001; OR = 1.090, p = 0.002, and OR = 1.295, p = 0.045, respectively]. In contrast, total bilirubin, ALT and GGT lost their independent predictions for high CVD risk.Увод/Циљ С обзиром на контрадикторне резултате који се односе на повезаност биомаркера функције јетре [аланин-аминотрансферазе (АЛТ), гама-глутамил трансферазе (ГГТ) и укупног билирубина)] и ризика за појаву кардиоваску-ларних болести, циљ студије је био да се испита повезаност између ових биомаркера и Фрамингхамског скора за ризик (ФСР), алгоритма за процену 10-годишњег ризика за појаву кардиоваскуларних болести у кохорти женске популације. Методе У овој студији пресека учествовало је укупно 278 жена. Мерени су антропометријски, биохемијски параметри и крвни притисак. Резултати Уочен је статистички значајан пораст активности АЛТ и ГГТ, као и пад вредности укупног билирубина у групи са високим статусом ФСР, у поређењу са средњим и ниским ФСР (p = 0,025, p < 0,001, p < 0,001, редом). Мултиваријантна логистичка регресиона анализа показала је да су индекс телесне масе, вредности триглицерида, креатинина и висо-коосетљивог c-реактивног протеина независни предиктори ФСР код жена (OR = 1,234, p = 0,001; OR = 2,856, p = 0,001; OR = 1,090, p = 0,002 и OR = 1,295, p = 0,045, редом). С друге стране, укупни билирубин, АЛТ и ГГТ су изгубили независну предикцију за високи ризик за појаву кардиоваскуларних болести

Cardiovascular risk estimated by UKPDS risk engine algorithm in diabetes

Since there is a high prevalence of type 2 diabetes mellitus (DM2), as well as CVD in Montenegro, we aimed to estimate CVD risk by United Kingdom Prospective Diabetes Study (UKPDS) risk engine algorithm in individuals with DM2. Furthermore, we aimed to explore whether non-traditional biomarker such as high sensitivity C-reactive protein (hsCRP) is superior for CVD risk prediction over old traditional risk factors. A total of 180 participants with DM2 (of them 50% females) were included in the current cross-sectional study. Biochemical and anthropometric parameters, and blood pressure were obtained. More males than females were classified at high UKPDS risk category (p<0.001). Also, about one third of diabetic patients (29.4%) were classified into the high-risk category. In multivariate regression analysis, triglycerides [Odds ratio (OR) =1.703, p=0.001] and creatinine concentration (OR=1.040, p<0.001) were independent predictors of CVD risk, whereas hsCRP was not correlated with CVD risk. HsCRP is not superior for CVD risk prediction by UKPDS risk engine algorithm over high triglyceride and creatinine levels in diabetic population, which suggests that the old traditional markers must not be underestimated when examining CVD risk in population with diabetes

The Association between Coagulation and Atrial Fibrillation

The existing literature highlights the presence of numerous coagulation factors and markers. Elevated levels of coagulation factors are associated with both existing and newly diagnosed cases of atrial fibrillation (AF). However, this article summarizes the role of coagulation in the pathogenesis of AF, which includes fibrinogen and fibrin, prothrombin, thrombomodulin, soluble urokinase plasminogen activator receptor, von Willebrand factor, P-selectin, D-dimer, plasminogen activator inhibitor-1, and platelet activation. Coagulation irregularities play a significant role in the pathogenesis of AF

Retinol-binding protein 4 in obese and obese-diabetic postmenopausal women in Montenegro

Introduction: Menopause is associated with an increase in visceral fat and obesity and is the leading risk factor for insulin resistance (IR) and type 2 diabetes mellitus (T2DM). Recent evidence suggests that retinol-binding protein 4 (RBP4) is not an independent determinant of IR and its role in human glucose metabolism is not well clarified. We examined RBP4 and its association with IR, cardiometabolic and kidney parameters in obese postmenopausal women with and without T2DM. Methods: Basic anthropometric, biochemical parameters, and blood pressure (BP) were determined in 50 obese diabetic and 50 obese non-diabetic sedentary postmenopausal women, and compared with 50 healthy normal weight controls. Results: Higher levels of RBP4 were observed in obese individuals, as compared with normal weight group (p=0.033). However, we did not find significant difference between obese non-diabetic and obese-diabetic individuals (p=0.583). Serum RBP4 did not correlate with anthropometric measurements or any indicator of glucose metabolism in diabetic group, whereas RBP4 correlated with creatinine (r=0.416, p=0.003), eGFR (r= -0.304, p=0.032) and triglycerides (r=0.484, p<0.001). In obese non-diabetic group, correlations were observed with fasting glucose (r=0.346, p=0.014), insulin (r=0.292, p=0.038), HOMA-IR (r=0.329 p=0.020), HbA1c (r=0.326, p=0.021), creatinine (r=0.399, p=0.004), eGFR (r= -0.389, p=0.005), HDL-c (r= -0.316, p=0.025), triglycerides (r=0.461, p<0.001), and systolic BP (r=0.286, p=0.044). In multiple regression analysis, triglycerides (Beta=0.302, p<0.001) and eGFR (Beta= -0.188, p=0.015) were independent predictors of RBP4. Conclusions: Serum RBP4 is not increased in obese type 2 diabetic postmenopausal women, but is associated with triglycerides and eGFR independently of diabetes

Cystatin C in healthy middle-aged adults: A relationship with anthropometric and cardiometabolic parameters

Introduction: Data suggesting that cystatin C levels are linked to obesity, apart from renal pathology, are conflicting. The aim of the study was to explore the potential association between serum cystatin C levels, anthropometric, and cardiometabolic parameters in healthy middle-aged adults. Methods: A total of 132 participants (mean age 56.2 ± 6.73 years, 69% females) were included in this cross-sectional study. Anthropometric and biochemical parameters, as well as blood pressure, were obtained. Results: Obese participants displayed higher cystatin C levels than normal-weight participants (p < 0.001). Multiple linear regression analysis revealed that waist circumference (WC) (Beta = 0.376, p < 0.001) and estimated glomerular filtration rate (Beta = -0.484, p < 0.001) were independently associated with cystatin C levels (R2 = 0.447; p < 0.001). Conclusions: Cystatin C is associated with abdominal obesity independent of renal function. Its relationship with changes in other target organs  should be determined