Kvantificiranje mikrovaskularnih promjena u kroničnih bubrežnih bolesnika

Introduction. Ocular microvascular changes can be related to kidney deterioration in chronic kidney disease (CKD). We aimed to identify the association between retino-choroidal parameters and kidney deterioration in diabetics and non-diabetics. Methods. The study group consisted of CKD patients (cross-sectional study) with arterial hypertension with different stages of CKD. Complete eye examination was completed with optical coherence tomography angiography (OCTA) scans of the macular region. According to the value of glomerular filtration rate (GFR) and albuminuria, patients were divided into groups: low GFR (60ml/min) and CKD patients without albuminuria and CKD with micro or macroalbuminuria. Results. One hundred and six eyes of 106 chronic kidney disease patients were evaluated. The mean retinal thickness in GFR 60 ml/min group was 274,36±10,77 μ. OCTA showed lower deep vascular density (DVD ) in CKD with albuminuria versus CKD without albuminuria group (p < 0.001). Albuminuria was inversely related to choroidal and retinal thickness measures of superficial (SVD) and DVD . Conclusions. CKD is associated with retinal diluting and decreasing kidney function with reduction of retinal and choroidal vascular density.Uvod. Korioretinalne mikrovaskualrne promjene mogu biti povezane s bubrežnim oštećenjem u kroničnoj bubrežnoj bolesti (KBB). Rad istažuje udruženost korioretinalnih parametara i bubrežnog oštećenja u hipertoničara, dijabetičara i nedijabetičara s KBB. Metode. Presječna studija KBB pacijenata s arterijskom hipertenzijom različitog stupnja oštećenja funkcije u KBB. Skeniranje makularne regije na očima je izvedeno pomoću optičke koherentne tomografije angiografije (OCTA). Pacijenti su podijeljeni na grupe prema stopi glomerularne filtracije na GFR60ml/min, kao i na KBB pacijenti s albuminurijom i KBB pacijenti bez albuminurije. Rezultati. Evaluirano je 106 očiju KBB pacijenata. Srednja vrijednost retinalnog zadebljanja u grupi s GFR <60ml/min je 275,73±9,65 mikrona (μ), dok je u grupi s GFR>60ml/min 274,36±10,77μ. Pomoću OCTA skena prikazana je značajno niža duboka vaskularna gustoća (DVD ) retine u grupi KBB s albuminurijom u odnosu na grupu KBB bez albuminurije (p<0.001). Albuminurija je bila u negativnom odnosu s mjerama debljine koroida i retine, kao i indeksima površne vaskularne gustoće (SVD) i DVD -a. Zaključak. KBB je povezan s retinalnim zadebljanjima, a opadajuća funkcija bubrega s progresivnom redukcijom korioretinalnom vaskularnom gustoćom

Distribution of oxygen consumption by graded loads during ergonometric testing

Cardiopulmonary exercise monitoring is a valuable method not only for the evaluation of medical health, but also for the assessment of patients with cardiac or pulmonary dysfunction. Spiroergometry provides additional criteria for the assessment of cardiopulmonary efficiency compared to simple ergometry. Maximal oxygen consumption (VO2max) is the most critical variable during spiroergometry. Most submaximal exercise measures provide the heart rate (HR) response to predetermined workloads in equations or nomograms used to predict VO2max. According to previous studies, the heart rate is divided into five fields. In this paper, we are doing a new redistribution of heart rates-to-workloads into seven fields, corresponding to the ergo bar. In other words, an answer is given based on the initial anthropological values of the subjects, when and in which field there will be a mismatch between the lung capacity of the subjects and the power required for that field

The Single Economic Entity Doctrine in EU Competition Law

The Single Economic Entity Doctrine in EU Competition Law Focused on applying single economic entity doctrine in relation to merger control of State Owned Enterprises Abstract This thesis focuses on the issues surrounding single economic entity doctrine in relation to State Owned Enterprises (SOEs), in particular on the effects of Article 22 of the Preamble of Council Regulation (EC) No 139/2004 of 20 January 2004 on the control of concentrations between undertakings (EUMR), and the Commission Consolidated Jurisdictional Notice under Council Regulation (EC) No 139/2004 on the control of concentrations between undertakings. Together these documents set the standards for merger control practice concerning SOEs. They are centred around the principle of applying the single economic entity doctrine when identifying the turnover of SOEs and when determining the jurisdiction of the Commission. The thesis possesses two major goals. The primary goal of the thesis is to elucidate the criteria used for the determination of a single economic unit (single economic entity) with independent decision-making power in the public sector. To this end, in chapter 3, the author has synthetized a list of the relevant criteria used for the determination of an economic entity, based on the criteria used by the Commission that have...Doktrína jedné hospodářské jednotky v soutěžním právu EU Se zaměřením na aplikaci jedné hospodářské jednotky na kontrolu koncentrací veřejných podniků Abstrakt Tato práce se zabývá aplikací doktríny jedné hospodářské jednotky na veřejné podniky (neboli SOEs - State Owned Enterprises), konkrétně důsledky odstavce 22 preambule Nařízení Rady (ES) č. 139/2004 ze dne 29. 1. 2004 o kontrole spojování podniků (EUMR), společně s Konsolidovaným sdělením Komise k otázkám příslušnosti podle nařízení Rady (ES) č. 139/2004 o kontrole spojování podniků. Tyto dokumenty stanovují jakožto pravidlo k výpočtu obratu a určení jurisdikce doktrínu jedné hospodářské jednotky s nezávislou rozhodovací pravomocí. Tato práce si klade za primární cíl sestavit z rozhodovací praxe kritéria, dle kterých je možné takovouto hospodářskou jednotku s nezávislou rozhodovací pravomocí detekovat. Tato kritéria vycházejí z rozhodovací praxe Komise, jejíž dlouhodobý vývoj autor studoval v kapitolách 3 a 4 práce. Autor sestavil pomocí syntézy poznatků z prostudovaných rozhodnutí přehled relevantních kritérií, jejichž výčet uvádí v závěru kapitoly 3. V kapitole 4 pak autor zkoumá, zdali je přistupováno nediskriminačně k veřejným podnikům ze třetích zemí. Tato kapitola je založená na analýze rozhodovací praxe týkající se veřejných podniků z Číny a...Department of European LawKatedra evropského právaPrávnická fakultaFaculty of La

Ihtiofauna slivnog područja reke Krivaje

Terenski dio ihtioloških istraživanja rijeke Krivaje i njenih pritoka obavljen je u periodu oktobar-novembar 2010. godine na području opština Olovo, Vareš i Zavidovići za potrebe izrade Ribarske osnove za područje Zeničko-dobojskog kantona. Izlov ribe je obavljen elektroagregatima marke “Honda”: „FEG 15.000“ snage 15 kW i „OHV 5.5“ snage 3,0 kW. Elektro-ribolov je izvršen na 18.870 m vodotokova, odnosno na 591.140 m2 ukupne vodene površine. Prikupljeni uzorci ribe obrađeni su na terenu i vraćeni u njihovo prirodno stanište, dok je manji broj reprezentativnih primjeraka fiksiran u 4%-tnom formaldehidu i dopremljen u laboratorije Centra za akvakulturu i ribarstvo Poljoprivredno-prehrambenog fakulteta Sarajevo na dalju analizu. Sistematska determinacija riba je vršena po Vukoviću i Ivanoviću (1971) i Sofradžiji (2009). Najveću brojnost u mješovitoj populaciji riba u rijeci Krivaji imale su jedinke iz porodice Cyprinidae sa procentualnim učešćem od 93,92%. Ostale evidentirane vrste iz porodica Thymalidae, Cottidae, Salmonidae i Cobitidae bile su zastupljene od 0,33-2,64%. Najveću brojnost iz pritoka rijeke Krivaje imale su vrste iz porodice Cyprinidae sa procentualnim učešćem od 54,93%. Nižu brojnost u istraživanim pritokama rijeke Krivaje imale su vrste iz porodice Salmonidae 31,54% i Thymallidae sa 9,34%. Najnižu brojnost imale su vrste iz porodice Cottidae sa 4,53%. Na osnovu dobivenih podataka o kvantitativno-kvalitativnom sastavu ihtiofaune sliva rijeke Krivaje, generalno se može zaključiti da ovo istraživano područje ima zadovoljavajuće ekološke uslove za život mnogih vrsta riba

INFLUENCE OF BASIC VARIABLES ON MICRONUCLEI FREQUENCY AND CHROMOSOMAL ABERRATIONS IN GENERAL POPULATION OF FB&H

The aim of this study was to determine the values of micronuclei (MN) and structural chromosomal aberrations (CA) in peripheral blood lymphocytes from 200 healthy participants of both genders from general population of FB&H, as well as to explore the influence of gender and age on MN and CA frequencies. Standard protocols for MN test, cultivation and micronuclei analysis from peripheral blood binuclear lymphocytes have been applied. MN values ranged from 0 to 8 MN per 1000 binuclear cells. The results suggest that gender and age influence MN frequency, with pronounced effect on 2 MN frequencies. Females on average have higher values of all observed variables of MN test than men. We have also found significant effect of gender – females had increased number of CAs – chromatid type; and of the age in both genders. Frequency distribution of CTAs and CSAs between male and female groups showed predominance of CTAs over CSAs, independently of gender. The results of this study will be incorporated into reference data base for comparative research in future

PERIPHERAL 8-ISO-PGF2α AS A BIOMARKER IN BOSNIAN PATIENTS WITH ALZHEIMER’S DISEASE AND VASCULAR DEMENTIA

Background: Cerebrospinal levels of isoprostanes (IsoPs) have been established as biomarkers of oxidative stress in Alzheimer’s disease (AD) and vascular dementia (VD). The value of peripheral levels in the diagnostics of these diseases is less conclusive. The aim of this study was to determine serum 8-iso-prostaglandin-F2alpha (8-iso-PGF2α) levels in Bosnian AD and VD patients and to establish whether there is an association between 8-iso-PGF2α serum concentration and cognitive impairment (CI) in patients with dementia. Subjects and methods: Serum levels of 8-iso-PGF2α were measured by enzyme immunoassay method in AD (n=30) and VD patients (n=30) and control subjects (CG, n=30). The AD and VD group were further stratified according to the level of CI. Results: The serum 8-iso-PGF2α levels were significantly higher in the AD (74.00 pg/mL) and VD groups (38.00 pg/mL) compared to the CG (17.50 pg/mL). A significant difference in serum 8-iso-PGF2α levels between patients with moderate and severe CI was not established in either AD or VD. Conclusion: Serum 8-iso-PGF2α proved to be a good biomarker in AD and VD, however it cannot be recommended for the differentiation of moderate and severe CI

Effect of atorvastatin on systolic and diastolic function in patients with heart failure with reduced ejection fraction (HFrEF)

Aim To investigate the benefit of high-dose lipophilic statin therapy on cardiac remodelling, function and progression of heart failure (HF) in patients with ischemic heart disease. Methods A total of 80 patients with ischemic HF diagnosis were followed during 6 months, and they were divided in two groups. First group (n=40) was treated by high-dose lipophilic statin therapy (atorvastatin 40 mg) and conventional therapy for HF, while the second group (n=40) had no atorvastatin in the therapy. Results In the beginning of study, from all of the observed parameters, only the ratio of flow rates in early and late diastole (E/A ratio) differed between the test groups (p=0.007). After six months, a statistically significant increase in left ventricular end-diastolic diameter (LVIDD) in patients who had not been treated with atorvastatin was found. In the patients treated with atorvastatin, there was a significant reduction in basal right ventricle diameter in diastole and systole (p<0.001 and p<0.001, respectively), and in tricuspid annular plane systolic excursion (TAPSE) (p<0.001); there was a reduction in LVIDD (p<0.001), and an increase of ejection fraction of the left ventricle according to Teicholtz and Simpson (p<0.001 and p<0.001, respectively). Also, there was an increase of deceleration time of early diastolic velocity (DTE) (p<0.05) and a decrease of isovolumic relaxation time (IVRT) (p<0.001). Conclusion The reduction in the right and left ventricle diameters was noted after the six-month atorvastatin therapy. Atorvastatin in the therapy resulted in increased EFLV and better systolic function and should be a part of a therapeutic modality of HF

Širina distribucije eritrocita i trombocitni indeksi kao inflamatorni parametri kod pacijenata sa šećernom bolesti tipa 2 i disfunkcijom bubrega

Aim: To assess Red blood cell Distribution Width (RDW) and platelet indices values in patients with type 2 diabetes mellitus (T2DM) and to verify its association with kidney dysfunction (KD). Patients and Methods: A cross-sectional study included 149 T2DM subjects divided into two groups with (T2DM – KD; n=52) and without (T2DM-nKD; n=97) presence of kidney dysfunction and 30 healthy subjects. White Blood Cells (WBC) count, C-reactive protein (CRP), fibrinogen, RDW, platelet indices, urea, and creatinine, were measured in all participants. Kidney function was evaluated by the estimated glomerular filtration rate (eGFR) calculated using the simplified Modification of Diet in Renal Disease (MDRD) formula. Results: T2DM-KD subjects showed statistically significantly higher values of the parameters RDW (p<0.01), Mean Platelet Volume - MPV (p<0.01), Platelet Distribution Width-PDW (p<0.01), Platelecrit-PCT (p<0.01), and Platelet Mass Index-PMI (p<0.01) compared to T2DM-nKD subjects, and statistically significantly lower values of the WBC count in T2DM-KD subjects compared to subjects suffering from T2DM without kidney dysfunction (p<0.01). ROC curve analysis revealed that RDW (sensitivity of 80.8%, specificity of 78.3%), MPV (sensitivity of 75%, specificity of 78.4 %), and PDW (sensitivity of 80.8%, specificity of 83.5%) could be used as markers in distinguishing between T2DM subjects with and without kidney dysfunction. Conclusion: This study confirms the reliability of the RDW,MPV, and PDW as simple, low cost and useful markers in distinguishing between T2DM subjects with and without kidney dysfunction.Cilj: Evalvirati vrijednosti širine raspona veličine eritrocita (RDW) i trombocitnih indeksa kod pacijenata sa šećernom bolesti tipa 2 (T2DM) i potvrditi njihovu povezanost s disfunkcijom bubrega (KD). Pacijenti i metode: Presječna studija uključila je 149 pacijenata sa šećernom bolesti tipa 2 podijeljenih u dvije grupe – pacijente s bubrežnom disfunkcijom (T2DM-KD; n = 52) i bez nje (T2DM-nKD; n = 97), te 30 zdravih ispitanika. Broj leukocita (WBC), C-reaktivni protein (CRP), fibrinogen, RDW, indeksi trombocita, urea i kreatinin izmjereni su kod svih participanata. Kao mjera funkcije bubrega korištena je procijenjena brzina glomerularne filtracije (eGFR) izračunata korištenjem formule MDRD (Modification pf Diet in Renal Disease). Rezultati: Pacijenti s T2DM-KD pokazali su statistički značajno veće vrijednosti parametara RDW (p < 0,01), srednji volumen trombocita - MPV (p < 0,01), širinu distribucije volumena trombocita - PDW (p < 0,01), trombokrit - PCT (p < 0,01) i indeks mase trombocita - PMI (p < 0,01) te statistički značajno niže vrijednosti WBC u odnosu na pacijente koji boluju od T2DM bez bubrežne disfunkcije (p < 0,01). Analiza ROC krivulje otkrila je da se RDW (granični nivo 53,5, senzitivnost 80,8 %, specifičnost 78,3 %), MPV (granični nivo 11,55, senzitivnost 75 %, specifičnost 78,4 %) i PDW (granični nivo 15,65, senzitivnost 80,8 %, specifičnost 83,5 %) mogu koristiti kao markeri u razlikovanju pacijenata sa šećernom bolesti tipa 2, onih s bubrežnom disfunkcijom i onih bez nje. Zaključak: Ova studija potvrđuje pouzdanost RDW, MPV i PDW kao jednostavnih, jeftinih i korisnih markera u razlikovanju pacijenata sa šećernom bolesti tipa 2, s bubrežnom disfunkcijom i bez bubrežne disfunkcije