Ima li spol djeteta utjecaj na poslijeoperacijsku bol i odgovor na stres?

Surgical procedure causes multisystem stress response reactions. The aim of this study was to assess whether gender has an impact on the level of neuroendocrine response to surgical stress and intensity of postoperative pain in children undergoing inguinal hernia repair surgery, as well as satisfaction of their parents with preoperative and postoperative care. The study included 60 children aged 3-6 years, all of them the only child in the family. All children included in the study were categorized as American Society of Anesthesiologists PS Class I, and divided into two groups: group 1 composed of 30 boys and group 2 composed of 30 girls. After oral premedication with midazolam, general anesthesia with endotracheal intubation was performed in all patients. Ketorolac, 1 mg.kg-1, was administered for postoperative analgesia. Serum cortisol was measured in all children preoperatively and postoperatively. The quality of postoperative analgesia was evaluated by Wong-Baker (FACES) scale, along with parental satisfaction. Male children who were the only child in the family had stronger neuroendocrine response to surgical stress and stronger intensity of postoperative pain. The parents of the girls expressed greater satisfaction with preoperative and postoperative care.Kirurški zahvat uzrokuje multisistemsku reakciju organizma u odgovoru na stres. Cilj ovog istraživanja je bio procijeniti ima li spol djeteta i ponašanje roditelja utjecaj na razinu neuroendokrinog odgovora bolesnika na kirurški stres i intenzitet poslijeoperacijske boli u djece koja su podvrgnuta operaciji preponske kile. Studija je uključivala 60 djece u dobi od 3 do 6 godina, od kojih su svi bili jedino dijete u obitelji. Sva djeca uključena u studiju kategorizirana su kao klasa I. Američkog društva anesteziologa i podijeljena u dvije skupine: prvu skupinu od 30 dječaka i drugu skupinu od 30 djevojčica. Nakon oralne premedikacije midazolamom kod svih bolesnika je provedena opća endotrahealna anestezija. Ketorolak u dozi od 1 mg.kg-1 je primijenjen za poslijeoperacijsku analgeziju. Kortizol u serumu mjeren je prijeoperacijski i poslijeoperacijski. Kod sve djece provedena je procjena kvalitete poslijeoperacijske analgezije pomoću Wong-Bakerove ljestvice (FACES) i zadovoljstva roditelja. Muška djeca koja su bila jedino dijete u obitelji imala su jači neuroendokrini odgovor na kirurški stres i jači intenzitet poslijeoperacijske boli. Roditelji djevojčica bili su zadovoljniji prijeoperacijskim i poslijeoperacijskim tretmanom njihove djece

Age and assay related changes of laboratory thyroid function tests in the reference female population

Background: Laboratory thyroid function tests play a central role in the diagnosis of thyroid disorders. The aim of our cross-sectional study was to determine reference values for thyroid tests in a rigorously selected group of Montenegrin females, investigate the impact of possible age-related changes and the influence of the interassay bias between three frequently used immunoassays. Methods: Female subjects were randomly selected, aged between 20 and 69 and 946 of them met the selection criteria. TSH, fT3, fT4, thyroid peroxidase and thyroglobulin antibodies were measured. Eighty samples were further analyzed on two other immunochemistry platforms. Results: Median TSH progressively increased with age, there was no difference in fT3, while fT4 was significantly higher in the two oldest groups compared to the others. When using the age-related 97.5 percentile of TSH the percentage of reclassification was highest in the 20-29 years of age group (5.2%, p lt 0.05). In the oldest band, 7.7% had TSH values above cohort-specific and below the age-related upper reference limit. Bland-Altman bias plots revealed the highest interassay absolute mean difference between compared TSH assays of 24.5% and for fT4 assays of 13.8%. Conclusions: The correlation coefficients between fT3 assays from different manufacturers were low. Serum TSH and fT4 concentrations increased with age and the implementation of age-specific TSH reference intervals would be of interest. The bias between the three commercial immunoassays indicated that the standardization of thyroid function tests is a task of great importance

Bioavailable testosterone is independently associated with Fatty Liver Index in postmenopausal women

Introduction: Previous studies have examined the correlation between hyperandrogenemia and non-alcoholic fatty liver disease (NAFLD) in women and showed contradictory results. Therefore, we aimed to evaluate the relationship between testosterone level and Fatty Liver Index (FLI), as a surrogate marker for NAFLD, in a cohort of postmenopausal women. Material and methods: A total of 150 postmenopausal women were included in this cross-sectional study. Anthropometric and biochemical parameters, as well as blood pressure, were obtained. Non-alcoholic fatty liver disease is assessed by FLI, an algorithm based on body mass index, waist circumference, triglycerides and gamma-glutamyl transferase, as a simple and accurate predictor of hepatic steatosis. Women were divided into three groups (FLI lt 30, n = 80; 30 = FLI lt 60, n = 44; FLI = 60, n = 26). Homeostasis model assessment of insulin resistance (HOMA-IR) as a surrogate marker of insulin resistance was calculated. Results: Multiple linear regression analysis revealed that the best model consisted of 4 parameters (e.g., bioavailable testosterone (beta = 0.288, p = 0.001), log HOMA-IR (beta = 0.227, p = 0.005), log high-sensitivity C-reactive protein (beta = 0.322, p lt 0.001), and retinol-binding protein 4 (beta = 0.226, p lt 0.001)). Adjusted R-2 for the best model was 0.550, which means that as much as 55.0% of variation in FLI could be explained with this model. Conclusions: Bioavailable testosterone is independently associated with FLI in postmenopausal women

Prooxidant-antioxidant balance, hsTnI and hsCRP: mortality prediction in haemodialysis patients, two-year follow-up

Oxidative stress and inflammation are highly intertwined pathophysiological processes. We analyzed the markers of these processes and high-sensitive troponin I (hsTnI) for mortality prediction in patients on haemodialysis. This study enrolled a total of 62 patients on regular haemodialysis. The patients were monitored for two years, and the observed outcomes were all-cause and cardiovascular mortality. Blood samples were taken before one dialysis session for analysis of the baseline concentrations of prooxidant-antioxidant balance (PAB), total antioxidant status (TAS), total oxidative status (TOS), hsTnI, hsCRP and resistin. The overall all-cause mortality was 37.1% and CVD mortality 16.1%. By univariate and multivariate logistic regression, our findings suggest that good predictors of all-cause mortality include hsCRP and PAB (p lt .05) and of CVD mortality hsCRP (p lt .05) and hsTnI (p lt .001). To evaluate the relationship between the combined parameter measurements and all-cause/CVD mortality risk, patients were divided into three groups according to their PAB, hsCRP and hsTnI concentrations. The cutoffs for hsCRP and hsTnI and the median for PAB were used. Kaplan-Meier survival curves pointed out that the highest mortality risk of all-cause mortality was in the group with hsCRP levels above the cutoff and PAB levels above the median (p lt .001). The highest risk of CVD mortality was found in the group with hsCRP and hsTnI levels above the cutoff levels (p =.001). Our data suggest that hsCRP and PAB are very good predictors of all-cause mortality. For CVD complications and mortality prediction in HD patients, the most sensitive parameters appear to be hsTnI and hsCRP

High uric acid and low superoxide dismutase as possible predictors of all-cause and cardiovascular mortality in hemodialysis patients

We investigated the role of serum uric acid (sUA) and superoxide dismutase (SOD) as predictive factors for mortality in hemodialysis (HD) patients. SOD, butyrylcholinesterase, and malondialdehyde were estimated spectrophotometrically and the other parameters by standard procedures. High-sensitive C-reactive protein was assayed by a sandwich ELISA method. sUA among survivors (112.1 +/- A 13.82 mu mol/L) was significantly lower than in deceased (160.8 +/- A 16.81 mu mol/L, p lt 0.001), while SOD was higher in survivors (31.8 +/- A 6.61 kU/L) than among deceased (20.2 +/- A 3.03, p lt 0.05). Kaplan-Meier survival curves showed the greatest mortality risk in the highest tertile of basal sUA concentration (a parts per thousand yen127.11 mu mol/L, p lt 0.001), and for SOD in the lowest tertile (a parts per thousand currency sign23.83 kU/L, p lt 0.05). Our results suggest that high sUA and low SOD may predict all-cause and cardiovascular mortality in HD patients