METABOLIC SYNDROME AND PSYCHOLOGICAL SYMPTOMS IN PATHOLOGICAL PREGNANCY

Base: There are numerous studies that indicate the co-morbidity of a metabolic syndrome and mental disorders. Metabolic syndrome and mental disorders in pregnant women are rarely investigated, especially in pathological pregnancy. Goal: To determine a relationship between predisposed factors in pregnancy and the occurrence of metabolic syndrome as well as to determine the occurrence of psychological symptoms and disorders in pregnant women. Subjects and methods: The tested sample consisted of 162 pregnant women (80 with normal and 82 with pathological pregnancy). For the examination, 3 questionnaires were used: clinical, laboratory, ultrasound and radiological scanning. Metabolic syndrome was diagnosed according to WHO criteria, and psychological symptoms by using the SCL 90-R questionnaire. Results: Metabolic syndrome was confirmed in 19 (23.2%) women with pathological pregnancy. These women had a greater prevalence of psychological symptoms (p<0.001). Conclusion: Women with pathological pregnancy who are diagnosed with metabolic syndrome showed significantly more psychological symptoms

ASSOCIATION BETWEEN DURATION OF DIALYSIS AND HELICOBACTER PYLORI INFECTION IN DIALYSIS PATIENTS AT THE UNIVERSITY CLINICAL HOSPITAL MOSTAR

Introduction: Association of Helicobacter pylori (HP) infection with the length of dialysis in dialysis patients is contradictory. This study was conducted in order to determine the association between the duration of dialysis and the HP infection status in the dialysis patients. Furthemore, biochemical parameters were monitored in two subject groups that were included in this study. Subjects and methods: The study included 51 patients on chronic hemodialysis program who had gastrointestinal symptoms. The subjects were divided in two groups per the length of dialysis treatment. In this study we analyzed age, gender, the time period since the onset of the chronic hemodialysis program, body mass index, biochemical parameters, and whether the patients have arterial hypertension and/or diabetes. The presence of HP antigen was determined in the stool samples with use of he UlcoGnost AG test plate. Results: The incidence of HP infection in hemodialysis patients, with some of the gastrointestinal symptoms, was 25.5%. Patients on hemodialysis for less than 24 months had lower incidence of HP infection than those on hemodialysis program for more than 24 months. HP positive and HP negative subjects were also compared by gender, age, biochemical parameters and body mass index. There was no statistical significant difference between the groups in any of those characteristics. When comparing the HP status of the subjects with the presence of arterial hypertension and diabetes, no statistically significant difference was found between the groups. Conclusion: This study showed negative correlation between HP infection and the length of hemodialysis program. Analysis of age, gender, body mass index, biochemical parameters, presence of arterial hypertension and/or diabetes showed no statistically significant difference was found between the hemodialysis patients who were HP positive and those who were HP negative. Additional studies are needed to elucidate the correlation mechanism between the HP infection and the duration of dialysis, in order to examine how long the dialysis time period is the most susceptible to HP infection, and then to improve the prognosis of patients with renal disease

ASSOCIATION BETWEEN DURATION OF DIALYSIS AND HELICOBACTER PYLORI INFECTION IN DIALYSIS PATIENTS AT THE UNIVERSITY CLINICAL HOSPITAL MOSTAR

Introduction: Association of Helicobacter pylori (HP) infection with the length of dialysis in dialysis patients is contradictory. This study was conducted in order to determine the association between the duration of dialysis and the HP infection status in the dialysis patients. Furthemore, biochemical parameters were monitored in two subject groups that were included in this study. Subjects and methods: The study included 51 patients on chronic hemodialysis program who had gastrointestinal symptoms. The subjects were divided in two groups per the length of dialysis treatment. In this study we analyzed age, gender, the time period since the onset of the chronic hemodialysis program, body mass index, biochemical parameters, and whether the patients have arterial hypertension and/or diabetes. The presence of HP antigen was determined in the stool samples with use of he UlcoGnost AG test plate. Results: The incidence of HP infection in hemodialysis patients, with some of the gastrointestinal symptoms, was 25.5%. Patients on hemodialysis for less than 24 months had lower incidence of HP infection than those on hemodialysis program for more than 24 months. HP positive and HP negative subjects were also compared by gender, age, biochemical parameters and body mass index. There was no statistical significant difference between the groups in any of those characteristics. When comparing the HP status of the subjects with the presence of arterial hypertension and diabetes, no statistically significant difference was found between the groups. Conclusion: This study showed negative correlation between HP infection and the length of hemodialysis program. Analysis of age, gender, body mass index, biochemical parameters, presence of arterial hypertension and/or diabetes showed no statistically significant difference was found between the hemodialysis patients who were HP positive and those who were HP negative. Additional studies are needed to elucidate the correlation mechanism between the HP infection and the duration of dialysis, in order to examine how long the dialysis time period is the most susceptible to HP infection, and then to improve the prognosis of patients with renal disease

Biopsy quantitative patohistology and seral values of prostate specific antigen-alpha (1) antichymotrypsine complex in prediction of adverse pathology findings after radical prostatectomy

In this prospective study we examined the utility of parameters obtained on prostate needle biopsy and prostate specific antigen-alpha(1)-antichymotripsine complex (PSA-ACT) to predict adverse pathologic findings after radical prostatectomy. 45 consecutive patients assigned for radical prostatectomy due to clinically localized prostate cancer were included in the study. Prostate biopsy parameters such as number of positive cores, the greatest percentage of tumor in the positive cores, Gleason score, perineural invasion, unilaterality or bilaterality of the tumor were recorded. PSA-ACT was determined using sandwich immunoassay chemiluminiscent method (Bayer, Tarrytown, New York). We analyzed relationship of preoperative PSA, PSA-ACT and quantitative biopsy parameters with final pathology after prostatectomy. Adverse findings were considered when extracapsular extension of cancer (pT3) was noted. Postoperatively, 29 (64.4 %) patients were diagnosed with pT2 disease and 16 (35.6 %) with pT3 disease. There was a significant difference in localized vs. locally advanced disease in number of positive biopsy cores (p<0.001), greatest percentage of tumor in the core (p=0.008), localization of the tumor (p=0.003) and perineural invasion (p=0.004). Logistic regression was used to develop a model on the multivariate level. It included number of positive cores and PSA-ACT and was significant on our cohort with the reliability of 82.22%. The combination of PSA-ACT and a large scale of biopsy parameters could be used in prediction of adverse pathologic findings after radical prostatectomy. Clinical decisions and patients counselling could be influenced by these predictors but further confirmation on a larger population is necessary

Psychosocial and clinical characteristics of depressive patients with the diagnosis of metabolic syndrome

There is a growing quantity of data showing that mental illnesses affect the somatic health. Depression is a complex disease, connected with the disturbances of sleep-cycle, appetite, body weight and level of physical activity, all of which may represent the risk factors for the development of metabolic disturbances. In the depressive patients, there is a number of various physiological mechanisms and psychosocial factors which may influence the development of metabolic syndrome (MS), such as sex, age, smoking, stress levels, nutrition and level of physical activity. It is considered that chronic stress causes depression and the resulting bad life habits may lead to MS and finally KVB. Aim of this study was to investigate the psychosocial and clinical features of depressive patients with the diagnosis of MS. The cross-reference study has been done at the sample of 80 patients diagnosed with MS. Among the diagnostic instruments applied, we have used the structured socio-demographic questionnaire, MINI questionnaire, Hamilton Rating Scale for Depression (HAMD-17) and Clinical Global Impression (CGI). The diagnosis of metabolic syndrome had been established following the NCEP ATP criteria. Among the depressive patients, there were 38.8% who fulfilled the criteria for establishing the diagnosis of MS. There was a greater incidence of suicide among the depressive patients with the diagnosis of MS. The diagnose was more frequently established in depressive women, while an increased intake of carbohydrates represented a significant feature of both depression and MS. Further research is needed to explain the observed gender differences and to determine if the interventions aimed to treating the depression can also contribute to accepting the healthy life habits and as a consequence, indirectly reduce the incidence of MS

KORONAROGRAFIJA KAO ELEKTIVNA METODAOTKRIVANJA BOLESTI KORONARNIH ARTERIJA

Uvod: koronografija je elektivna metoda pretrage u kardioloških pacijenata koja se sve više primjenjuje u dijagnostici. Cilj rada: utvrditi je li koronarografija elektivna (izborna) metoda pretrage kod kardioloških pacijenata. Drugi cilj je utvrditi koju populaciju i u kojoj dobi najviše zahvaća koronarna bolest. Materijali i metode: Istraživanje je provedeno pregledom medicinske dokumentacije. Ispitivani uzorak tvorio se za vremenski period od 01.01.2018. do 30.06.2018. Ispitivana skupina čini 577 pacijenata koji su podvrgnuti koronarografiji, s tim da je jedna skupina dilatirani pacijenti. Svi podaci su obrađeni programom Microsoft Office 2007 tabelarno i grafički. Rezultati: Rezultati istraživanja pokazuju da je 75 % ispitanika imalo koronarografiju. Više je muškaraca imalo koronarografju, njih 70 %, a također i dilataciju, njih 80 %, u odnosu na žene. Dob od 62-71 godine (39 %) bila je najzastupljenija kod koronarografije, a isti rezultati su i kod dilatacije. Najveći broj mjesta implatancije stenta ili dilatacije je bio na prednjoj silaznoj grani (LAD), njih 44 %, potom slijedi desna koronarna arterija (RCA), njih 39 %, znatno manje je bilo na cirkumfleksnoj arteriji (CX), njih 15 %, a najmanje na glavnom stablu (LM), 2 %. Zaključci: Koronarografija je elektivna (izborna) metoda pretrage kod kardioloških pacijenata. Kod dilatacije je bilo znatno više muškaraca, njih 80 % u odnosu na 20 % žena. Dob od 62-71 godine (39 %) bila je najzastupljenija kod koronarografije, a isti rezultati su i kod dilatacije

Impact of positive surgical margins after radical prostatectomy on disease progression and adjuvant treatment in pathologically localized prostate cancer

The aim of our study was to evaluate the impact of margin positivity in clinically and pathologically localized prostate cancer (pT2) after radical prostatectomy on biochemical recurrence and time to adjuvant treatment. We analyzed data from 371 patients who underwent radical prostatectomy. At the mean follow up of 36 (25-54) months, impact of margin positivity in pT2 patients on prostate specific antigen (PSA) recurrence and time to introduction of adjuvant treatment was noted. Out of 371 radical prostatectomies there were 277 (74.6%) pT2 and 94 (25.4%) pT3 (locally advanced) prostate cancers. Mean age was 67.6 years, mean Gleason score 6.78, mean preoperative PSA 11.45 ng/mL. Out of 277 pT2 pts., 233 (84%) had negative (SM-) and 44 (16%) positive surgical margins (SM+). Only 3% of SM- pts. had biochemical relapse (BCR). Among pT2 patients with SM+, 18 (41%) had BCR while 26 were free of recurrence at 3 years follow up. Positive surgical margins had an adverse impact on biochemical progression free survival (3% SM- vs. 41% SM+; p<0,001). No difference was found in age, preoperative PSA, Gleason score or follow up between BCR-SM+ and BCR+SM+ patients. Mean time to PSA recurrence in surgical margin positive pT2 patients was 15.7 months. Surgical margin status pT2 disease has an impact on biochemical progression but only 41% of margine positive patients show biochemical recurrence at 3 yr follow up. Not all SM+ patients need to receive treatment after radical prostatectomy. Longer follow up should be awaited to see the impact on overall survival in this group of patients

Impact of positive surgical margins after radical prostatectomy on disease progression and adjuvant treatment in pathologically localized prostate cancer

The aim of our study was to evaluate the impact of margin positivity in clinically and pathologically localized prostate cancer (pT2) after radical prostatectomy on biochemical recurrence and time to adjuvant treatment. We analyzed data from 371 patients who underwent radical prostatectomy. At the mean follow up of 36 (25-54) months, impact of margin positivity in pT2 patients on prostate specific antigen (PSA) recurrence and time to introduction of adjuvant treatment was noted. Out of 371 radical prostatectomies there were 277 (74.6%) pT2 and 94 (25.4%) pT3 (locally advanced) prostate cancers. Mean age was 67.6 years, mean Gleason score 6.78, mean preoperative PSA 11.45 ng/mL. Out of 277 pT2 pts., 233 (84%) had negative (SM-) and 44 (16%) positive surgical margins (SM+). Only 3% of SM- pts. had biochemical relapse (BCR). Among pT2 patients with SM+, 18 (41%) had BCR while 26 were free of recurrence at 3 years follow up. Positive surgical margins had an adverse impact on biochemical progression free survival (3% SM- vs. 41% SM+; p<0,001). No difference was found in age, preoperative PSA, Gleason score or follow up between BCR-SM+ and BCR+SM+ patients. Mean time to PSA recurrence in surgical margin positive pT2 patients was 15.7 months. Surgical margin status pT2 disease has an impact on biochemical progression but only 41% of margine positive patients show biochemical recurrence at 3 yr follow up. Not all SM+ patients need to receive treatment after radical prostatectomy. Longer follow up should be awaited to see the impact on overall survival in this group of patients

Impact of Hemoglobin Concentration on Plasma B-type Natriuretic Peptid Level and Left Ventricle Echocardiographics Characteristics in Chronic Kidney Disease Patients

Anemia is common in patients with chronic kidney disease (CKD) and contributes to cardiovascular alterations. Recent findings suggest that B-type natriuretic peptide (BNP) is a sensitive biomarker for left ventricular dysfunction, but relationship between hemoglobin and BNP in CKD patients is unclear. Hemoglobin, plasma BNP and serum creatinine levels were measured in 49 patients with CKD (without heart failure), divided in two groups according to the hemoglobin status (cut-off point 110 g/L). All patients underwent echocardiography in order to assess left ventricular (LV) morphology and function. The results showed that in the group of patients with hemoglobin levels under 110 g/L BNP levels were significantly elevated (p<0.001), as well as left ventricular mass index (p<0.001). Systolic and diastolic LV function were significantly better in patients with hemoglobin levels above 110 g/L (p<0.001). Hemoglobin levels were inversely related to BNP values (r=–0.451, p<0.001). Significantly negative correlation between BNP level and creatinine clearance (p=0.009), and significantly positive correlation between BNP level and left ventricular mass index (LVMI) were established. A similar but positive relationship was observed between hemoglobin levels and creatinine clearance (p<0.01). We established statistically significant negative correlation between hemoglobin levels and LVMI (r=–0.564, p<0.001). In conclusion, BNP and hemoglobin levels depend on the renal function. Anemia may contribute to elevated BNP levels in CKD patients, and may represent an important confounder of the relationship between BNP and cardiac alteration in these patients

The Role of Endothelin-1 and Nitric Oxide in the Pathogenesis of Hypertension in Diabetic Patients

The pathogenesis of renal hypertension has not yet been fully clarified. As the potential role of endothelin-1 (ET-1) and nitric oxide (NO) has been postulated, their concentrations were determined in plasma and urine of diabetic patients. The study included 30 diabetic patients (both IDDM and NIDDM) with initial or advanced diabetic nephropathy (decreased endogenous creatinine clearance, proteinuria) and 20 healthy control subjects. The correlation with blood pressure and other renal function parameters was monitored and compared with the control group. Also, the effect of ACE inhibitors (ACEI) on ET-1 and NO patterns was monitored in correlation with arterial hypertension. In diabetic patients that did not receive ACEI therapy, the increase in plasma ET-1 was associated with both systolic and diastolic blood pressure elevation, whereas in those administered ACEI the increase in plasma ET-1 was associated with a systolic blood pressure decline. In addition, the increase in plasma NO was accompanied by a statistically significant decline of both systolic and diastolic blood pressure in diabetic patients receiving ACEI