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

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

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

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

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

SPOLNE RAZLIKE U RAZINI GLUKOZE U KRVI KOD ŠTAKORA NAKON VJEŽBE FORSIRANOG PLIVANJA

The aim of this study was to investigate possible differences in blood glucose levels between male and female rats immediately after acute bout of forced swimming exercise. Adult male Wistar rats (weight 300- 350 g) were divided into two groups by gender: males (n =8) and females (n =8). All the rats were given standard rat chow and tap water ad libitum and were housed at 25±3o C on a 12-hour dark/light cycle. Both groups of rats were exposed to forced swimming stress daily, for 6 days. Duration of each swimming session progressively increased from 5 minutes on the first day to 30 minutes on sixth day, allowing adaptation to swimming conditions. The rats were forced to swim in plastic tanks (90 cm wide, 120 cm deep) containing tap water (temperature ca. 25 degrees C). The depth of water was 40 cm. Seventh day we performed acute bout of 40 minutes swimming exercise. Animals were fasted 12 hours before start of last swimming sessions to obtain fasting blood glucose levels. Preexercise blood samples were taken immediately before last swimming session (7th day) and postexercise samples immediately after the last swimming session from rat\u27s tail vein. Glucose levels in blood were determined using Optium Xceed™ Diabetes Monitoring System (Abbot). Before last swimming session male rats had slightly lower glucose levels in comparation with female rats, but this difference was not statistically significant (3.77vs4.64 mmol/l). Acute bout of forced swimming exercise raised blood glucose level and established values in postexercise period were significantly higher in both study group in comparation to values before exercise. Male rats had greater postexercise glucose blood levels (11.85 mmol/l) in comparation with female rats (6.26 mmol/l). Our findings document the existence of gender impact on the glucose postexercise concentrations confirming the differences in the energy substrates utilization and glucose metabolism regulation during and after exercise.Cilj ove studije bio je istražiti moguće razlike razine glukoze u krvi izmeðu muških i ženskih štakora odmah nakon akutnog opterećenja vježbom forsiranog plivanja.: Odraslih muški štakori soja Wistar (prosječne mase 300-350 g) su bili podijeljeni u dvije skupine po spolu: muški (n= 8) i ženski (n = 8). Svi štakori su dobili standardnu, komercijalnu hranu za štakore i vodu iz slavine ad libitum, a bili su smješteni na 25 ± 3 ° C na 12- satnom tamno / svijetlo ciklusu. Obje skupine štakora bila su izložene vježbama forsiranog plivanja,dnevno u trajanju od 6 dana. Trajanje svake sesije plivanja postupno se povećavalo sa 5 minuta prvog dana do 30 minuta šestog dana , čime se postigla prilagodba životinja na uslove plivanja. Sedmi dan smo izveli akutno opterećenje 40 minutnog forsiranog plivanja. Štakori su plivali u plastičnim spremnicima (90 cm širine, 120 cm dubine) koji su sadržavali vodu iz slavine (temperature približno 25 stupnjeva C). Dubina vode iznosila je 40 cm. Životinjama nismo davali hranu 12 sati prije početka posljednje sesije plivanja kako bi dobili razine glukoze u krvi natašte. Uzorci krvi za odreðivaje glukoze uzeti su neposredno prije posljednje sesije plivanja (7.dan) i neposredno nakon posljednje sesije plivanja iz repne vene štakora. Razine glukoze u krvi utvrðene su pomoću Optium ™ Xceed Dijabetes sustava praćenja (Abbot) . U uzetim uzorcima krvi neposredno prije posljedenje sesije plivanja utvrðene su nešto niže razine glukoze kod muških u usporedbi s ženskim štakorima, ali ta razlika nije bila statistički značajna (3.77vs4.64 mmol /l). Akutno opterećenje vježbom forsiranog plivanja podiglo je razinu glukoze u krvi i srednje vrijednosti u uzorku uzetom neposredno nakon posljednje sesije plivanja bile su značajno više u obje skupine u usporedbi s vrijednostima prije vježbanja. Muški štakori imali su značajno veću razinu glukoze u krvi (11,85mmol / L) u usporedbi sa ženskim štakorima (6,26 mmol / L). Naši rezultati ukazuju na uticaj spola na razinu glukoze nakon fizičkog opterećenja potvrðujući spolne razlike u iskorištavanju energetskog supstrata i i regulaciji metabolizma glukoze u toku i nakon vježbanja

Nitric oxide as a potential biomarker in inflammatory bowel disease

The aim of this study was to investigate changes in serum nitric oxide (NO) concentration in inflammatory bowel diseases (IBD) patients and its use as potential biomarker in differential diagnosis of ulcerative colitis (UC) and Crohn's disease (CD) and in disease activity assessment. In 60 patients of both genders - 30 with ulcerative colitis and 30 with Crohn's disease - and 30 controls serum nitric oxide concentration was determined by measuring nitrite concentration, a stable metabolic product of NO with oxygen. Conversion of nitrates (NO3-) to nitrites (NO2-) was done with elementary zinc. The nitrite concentration was determined by classic colorimetrical Griess reaction. Median serum NO concentration was statistically different (p=0,0005) between UC patients (15.25 µmol/L; 13.47 - 19.88 µmol/L), CD patients (14.54 µmol/L; 13.03 -16.32 µmol/L) and healthy controls (13.29 µmol/L; 12.40 - 13.92 µmol/L). When active UC and CD patients were compared with inactive UC and CD patients respectively a significant difference in serum NO level was found (p=0.0005). With a cut-off level of 17.39 µmol/L NO had a sensitivity of 100% and a specificity of 100% in discriminating between active and inactive UC patients. With cut-off value of 14.01 µmol/L serum NO level had a sensitivity of 88% and a specificity of 69% in distinguishing between patients with active CD and inactive CD. Serum NO concentration is a minimally invasive and rapid tool for discriminating between active and inactive IBD patients and could be used as useful biomarker in monitoring of disease activity in IBD patients

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