Vrednosti osnovnih hematoloških parametara u perifernoj krvi radnika izloženih uticaju para žive

In the present study was assessed the influence of occupational exposure to mercury vapours on the basic haematological parameters (erythrocyte, leukocyte and platelet count, haemoglobin concentration, haematocrit, MCV, MCH and MCHC). Studies were carried out on 138 workers involved in the production of chlorine using the mercuric electrolysis method (divided into three groups: permanently, periodically and earlier exposed to mercury vapours), as well as on 38 healthy workers. The shift time - weighted averages for mercury was determined in the workplace air before research; mean value was significantly over maximum tolerated dose. The mercury content in the blood and urine of exposed workers was determined by atomic absorption spectrophotometry. In all three groups 95th percentile values of mercury in blood and urine are significantly over MTD. Peripheral blood cell parameters were determined using an automatic cell counter. In the group exposed to mercury vapours, was found a statistically significant increase of erythrocyte count with a concomitant decrease in MCV. The mean values of haemoglobin concentration, MCHC and platelet count were higher in the group of workers exposed to mercury vapours, but the difference was not statistically significant. There were no significant differences in haematocrit, MCH and leukocytes between the studied groups. Our results indicate that long-term and permanent exposure to mercury vapours induces changes in the important haematological parameters of the peripheral blood.U radu je ispitivan uticaj izloženosti parama žive iz radne sredine na osnovne hematološke parametre (broj eritrocita, leukocita i trombocita, koncentraciju hemoglobina, hematokrit, MCV, MCH i MCHC). U studiju je uključeno 138 radnika koji rade u proizvodnji hlora procesom elektrolize (podeljeni su u tri grupe: stalno izloženi, povremeno izloženi i ranije izloženi uticajima para žive), kao 38 zdravih radnika. Pre studije su određene koncentracije žive u vazduhu radne sredine; srednje vrednosti su bile znatno iznad maksimalne doze tolerancije (MTD). Koncentracije žive u krvi i urinu radnika koji su izloženi živi određena je atomskom apsorpcionom spektrometrijom. U sve tri grupe je vrednost 95-tog percentila bila znatno iznad MTD. Hematološki parametri su određeni uz pomoć automatskog brojača. U grupi koja je stalno izložena parama žive, dobijeno je značajno poveć anje srednje vrednosti broja eritrocita, kao i značajno smanjenje vrednosti MCV. Srednje vrednosti koncentracije hemoglobina, MCHC i broja trombocita u grupi radnika koji su stalno izloženi uticaju žive bile su viće nego u kontrolnoj grupi, ali ta razlika nije statistički značajna. Između posmatranih grupa nije bilo značajne razlike u vrednostima hematokrita, MCH i broja leukocita. Dobijeni rezultati pokazuju da dugotrajna i stalna izloženost parama žive može da dovede do promena u vrednostima važnih hematoloških parametara

In vitro/in silico ispitivanje lekovite supstance i tableta telmisartana

Telmisartan acts as antagonist of angiotensin II type-1 (AT1) receptor and is indicated in the treatment of essential hypertension. In order to rationalize the pharmacokinetic characteristics, pharmacological activity, as well as the optimal method of administration of this drug, knowledge of its physico-chemical properties is needed. The assessment of the drug physico-chemical parameters on the basis of its chemical structure at different pH values, which are characteristic for physiological conditions, enables the prediction of its behaviour in the body before the drug is synthesized. Such assessment of its physico-chemical parameters during the preformulation phase is important for the development of a safe, efficient and stable dosage form. Based on the calculated pKa values, this paper is focused on the prediction of distribution of the ionized and nonionized drug species in the pH gradient of 1 to 8 and the calculation of physico-chemical parameters such as telmisartan lipophilicity (log P) and intrinsic solubility (log S0). On the basis of the calculated physicochemical parameters, the pH-dependent solubility and lipophilicity curves of this medicinal substance have been constructed. The assessment of intrinsic dissolution rate and dissolution rate of telmisartan from tablets was used to investigate the influence of medium pH values applied on the model substance behavior. The results obtained from predicting the physico-chemical properties and from experimental evaluation of the model substance intrinsic dissolution rate and telmisartan dissolution rate from tablets, indicate the importance of physico-chemical characterization of the active substance during the preformulation investigation for predicting the drug behaviour in the body (absorption, bioavailability, tissue penetration, elimination). .Telmisartan deluje kao antagonista angiotenzinskog II tipa-1 (AT1) receptora i indikovan je u terapiji esencijalne hipertenzije. Da bi se razjasnile farmakokinetičke osobine, farmakološka aktivnost, kao i optimalni način primene ove lekovite supstance, potrebno je poznavanje njenih fizičko-hemijskih osobina. Određivanje fizičko-hemijskih parametara lekovite supstance na osnovu hemijske strukture pri različitim pH vrednostima koje su karakteristične za fiziološke uslove omogućava predviđanje njenog ponašanja u organizmu pre nego što se lekovita supstanca sintetiše. Određivanje fizičko-hemijskih parametara u toku preformulacionih ispitivanja značajno je za razvijanje bezbednog, efikasnog i stabilnog farmaceutskog oblika. U ovom radu je, na osnovu izračunatih pKa vrednosti, izvršeno predviđanje raspodele jonizovanih i nejonizivanog oblika lekovite supstance u pH gradijentu od 1 do 8 i izračunavanje fizičko-hemijskih parametara telmisartana kao što su lipofilnost (log P) i osnovna rastvorljivost (log S0). Na osnovu izračunatih fizičko-hemijskih parametara konstruisane su krive pH-zavisne rastvorljivosti i lipofilnosti ove lekovite supstance. Određivanjem osnovnih brzina rastvaranja i brzina rastvaranja telmisartana iz tableta ispitan je uticaj pH vrednosti primenjenog medijuma na ponašanje model supstance. Rezultati dobijeni predviđanjem fizičko-hemijskih osobina, kao i eksperimentalnim određivanjem osnovne brzine rastvaranja model supstance i brzine rastvaranja telmisartana iz tableta ukazuju na značaj fizičko-hemijske karakterizacije aktivne supstance tokom preformulacionih ispitivanja za predviđanje njenog ponašanja u organizmu (resorpcije, biološke raspoloživosti, penetracije u tkiva, eliminacije)

Određivanje holesterola u membrani eritrocita

Quantification of cholesterol in biological membranes is an important step toward understanding of metabolism of intracellular cholesterol, composition of cell membrane and plasma lipid profile. The aim of our study was to optimize the method for determination of cholesterol in erythrocyte membrane and then to use this method in the determination of cholesterol concentration in erythrocyte membrane in the studied group of blood samples. Cholesterol in erythrocyte membrane was determined in dry lipid extract of erythrocyte membrane by the enzymatic manual CHOD-PAP method. Cholesterol in erythrocyte membrane and plasma lipid parameters (total cholesterol HDL-cholesterol, LDL-cholesterol and triglycerides) were determined in blood samples of 58 females, obtained by routine health control. Lipid parameters were determined by standard biochemical methods. We examined the relationship between cholesterol in erythrocyte membrane and other plasma lipid parameters as well as other atherogenic risk factors (BMI, blood pressure). Optimization of the method for determination of cholesterol in erythrocyte membrane was based on the observation that primary cholesterol standards prepared by dissolving crystal cholesterol cannot be used due to the interference of the dissolved dry extract in organic solvents with the enzymatic reagent. Commercial standard solutions of cholesterol were used for calibration because they contain detergents for solubilisation of the dry extract in enzymatic reagent. The obtained mean value for cholesterol in erythrocyte membrane, as mmol/L erythrocyte is 4.44 ± 1.019; median 4.65 5-th percentile is 2.70, and 95-th percentile is 6.26. In the examined female group we tested cholesterol concentration in erythrocyte membrane according to age. Two groups were formed (females below and above 50 years) using nonparametric t-test no statistically significant difference was found between these two age groups (p>0.05), while plasma lipid parameters of total cholesterol, triglycerides and LDL-cholesterol were different in the examined groups (p lt 0.05). By Spearmen nonparametric correlation method we found no statistically significant correlation between cholesterol in erythrocyte membrane and other atherogenic risk factors.Određivanje membranskog holesterola je važan stepen u utvrđivanju povezanosti intracelularnog metabolizma holesterola, sastava ćelijske membrane i plazmatskog lipidnog profila. Prvi cilj ovog rada je bio optimizacija metode za određivanje membranskog holesterola što je podrazumevalo izbor standarda i primenu enzimskog testa. Holesterol u membrani eritrocita određivan je ručno u suvom lipidnom ekstraktu membrane, enzimskom CHOD-PAP metodom firme Randox. Optimizirana metoda je primenjena za određivanje koncentracija holesterola u membrani eritrocita kod 58 žena kojima je krv uzeta na rutinskom sistematskom pregledu. U ispitivanim uzorcima određen je i serumski lipidni profil standardnim biohemijskim metodama. Ispitivane žene su podeljene u dve starosne grupe: na mlađe od 50 godina i na starije od 50 godina. Ispitan je i stepen povezanosti između membranskog holesterola sa jedne strane i plazmatskih lipida i drugih faktora rizika za aterosklerozu (starosti, BMI, sistolni i dijastolni pritisak) sa druge strane. Optimizacijom metode za određivanje membranskog holesterola došlo se do zaključka da se ne mogu koristiti primarni standardni rastvori holesterola dobijeni rastvaranjem kristalnog holesterola u organskom rastvaraču zbog slabe rastvorljivosti suvog ekstrakta u enzimskom reagensu i uticaja pojedinih rastvarača na bojenu reakciju. Za kalibraciju treba koristiti komercijalne standardne rastvore holesterola jer sadrže deterdžente koji omogućavaju rastvorljivost suvog ekstrakta. U ispitivanoj populaciji dobijena srednja vrednosti za holesterol u membrani eritrocita (izražene kao mmol/L eritrocita) iznosi 4,44 ± 1,019, mediana 4,65, 5-ti procenat iznosi 2,70, a 95-ti procenat je 6,26. Poređenjem ispitivanih parametara između dve starosne grupe za holesterol u eritrocitnoj membrani nije bilo značajne razlike (p>0,05) dok je za ukupan holesterol, LDL-holesterol i trigliceride ova razlika bila statistički značajna (p lt 0,05). Primenom Spearmanove neparametarske korelacije nije nađena statistički značajna korelacija između membranskog holesterola i drugih faktora rizika za aterosklerozu

Cardiovascular risk factors in 7-13 years old children from Vojvodina (Serbia)

Background: Atherosclerosis is a chronic inflammatory disease which starts early in life and depends on many factors, an important one being dyslipoproteinemia. According to several studies, atherosclerotic plaques or their precursors could be seen in children younger than 10 years. During later life, interaction with a sedentary way of life, as well as unhealthy nutrition, smoking, alcohol consumption, obesity and family history of cardiovascular disease cause the burden of atherosclerotic disease. Methods: Study included 624 children (316 boys, 308 girls), aged from 7-13 years. We analysed socio-demographic data (BMI, blood pressure, cardiovascular family history, smoking status), as well as lipid status with lipoprotein little a-Lp(a), and apolipoproteins: Apo AI, Apo B-100 for all children. This enabled us to calculate new atherogenic indices Tg/HDL-c, lipid tetrad index (LTI) and lipid pentad index (LPI). Cardiovascular risk for later life was estimated by using modified Risk Score for Young Individuals (RS), which divided the subjects according to the score level: low, medium and higher risk. Results: The older children (13 y) had better lipid status than the younger children, i.e. significantly lower total cholesterol, LDL-C, triglycerides and non-HDL-C concentration and significantly higher HDL-C concentration than the younger children and this was in accordance with the RS level. Children with a positive family history of CV disease had significantly higher Lp(a) concentration and blood pressure. LPI was significantly higher in children with a higher RS. Conclusions: The results of our work could be used for cardiovascular risk assessment in apparently healthy children to provide preventive measures which could control the change able risk factors

Dislipidemija u dijabetes melitusu tip 2

Type 2 diabetes mellitus is a chronic high-prevalence metabolic disease, which is characterized by hyperglycaemia, but also with lipid and protein metabolism disorders. Patients with type 2 diabetes have a high risk for cardiovascular disease (CVD) development and dyslipidemia is considered as a key marker of this increased risk. Hypertriglyceridemia, reduced high density lipoprotein cholesterol (HDL-c) concentrations, and a shift in low-density lipoprotein particles (LDL) distribution toward the small, triglycerides-rich particles, are the most important changes in the lipid profile in diabetes.Type 2 diabetes is a metabolic disorder associated with low grade inflammation and oxidative stress, so in this condition high density lipoprotein particles (HDL) also undergo structural and functional changes and, as a consequence, lose their atheroprotective role. Dyslipidemia treatment in type 2 diabetes patients younger than 40 and without any other risk factor for CVD development starts with changes in a lifestyle, but in patients older than 40 years, first line medications are statins.Glycemic and lipid control in type 2 diabetes patients significantly reduces CVD risk.Dijabetes melitus tip 2 je hronično oboljenje sa visokom prevalencom, koje se karakteriše hiperglikemijom, ali i poremećajima u metabolizmu lipida i proteina. Pacijenti sa tipom 2 dijabetesa imaju visok rizik za razvoj kardiovaskularnih bolesti (KVB) i upravo se dislipidemija smatra ključnim uzročnikom ovog povećanog rizika. Hipertrigliceridemija, snižena koncentracija holesterola u lipoproteinskim česticama visoke gustine (HDL-h) i promena u raspodeli lipoproteinskih čestica niske gustine (LDL) u smeru većeg udela malih čestica, bogatih trigliceridima, predstavljaju najvažnije promene lipidnog profila koje se odnose na dislipidemiju u dijabetesu. Kako je dijabetes stanje kontinuirane blage inflamacije niskog stepena i stalne produkcije slobodnih radikala, HDL lipoproteinske čestice takođe podležu strukturnim i funkcionalnim promenama, usled čega gube svoje ateroprotektivne osobine. Terapija dislipidemije kod pacijenata mlađih od 40 godina bez prisutnih drugih faktora rizika za razvoj KVB počinje promenom životnog stila, a kod pacijenata starijih od 40 godina lekovi izbora u terapiji su statini. Glikemijska i lipidna kontrola kod pacijenata sa tipom 2 dijabetesa značajno umanjuje rizik od nastanka KVB

L’APPLICAZIONE DELE REGOLE DI HACP SUL’ALEVAMENTO INTENSIVO DI SELVAGINA DI PENA

Utjecaj primjene HACCP sustava na podizanje kvalitete proizvodnje i postizanje visoke zdravstvene ispravnosti proizvoda istražen je u intenzivnom uzgoju pernate divljači tijekom dva proizvodna ciklusa (2005/06). Putem HACCP sustava predstavljen je koncept analize rizika, odnosno mogućnosti pravovremenog reagiranja na svim prepoznatim kritičnim kontrolnim točkama (CCP), sa svrhom uhodavanja sustavnog pristupa u identifikaciji, procjeni i kontroli određenih opasnosti u pojedinim fazama proizvodnje. Prema provedenim analizama rizika (opasnosti) glavno težište HACCP-a u intenzivnom uzgoju pernate divljači stavlja se na rezultate laboratorijskih pretraga, odnosno mikrobiološku ispravnost svih faza uzgojnog procesa. Posebna pozornost posvećena je bakterijama iz roda Salmonella jer upravo one predstavljaju najveću opasnost za kontaminaciju sirovina, opreme i gotovih proizvoda, a samim time i za zdravlje čovjeka kao krajnjeg korisnika. Standardima HACCP-a obuhvaćene su i sve propisane profilaktičke mjere (imunosna zaštita matičnog jata i podmlatka) kao i uvođenje pravila higijensko-zdravstvene zaštite prema standardnom sanitacijskom operativnom postupku (SSOP). Primjena HACCP-a u intenzivnom uzgoju pernate divljači omogućila je i dodatnu kontrolu proizvodnih objekata, te svih dobnih kategorija životinja koje borave u njima. Dobiveni rezultati potvrđuju uspješnost uvođenja sustava kontrole kritičnih točaka proizvodnje u intenzivni uzgoj pernate divljači.Introduction of the HACCP system and its effects on the up-grading of production quality and achievement of high health safety of products have been investigated in the intensive breeding of wild game birds during two production cycles (2005/06). The concept of hazard analysis, presented by the HACCP system, makes possible timely reaction to all known critical control points (CCP), for the purpose of gradual introduction of systemic approach to identification, evaluation and control of certain hazards in individual production phases. According to the performed hazard analyses, the principal emphasis of HACCP in intensive breeding of game birds was put on results of laboratory tests, microbiological safety respectively, in all the phases of breeding process. Special attention was paid to bacteria of the genus Salmonella, since they represent the highest risk for contamination of raw material, equipment and final products, and consequently, for human health. The HACCP standards cover all the required prophylactic measures (immune protection of breeding stock and chickens), as well as the introduction of principles of hygienic quality and health protection according to standard sanitary operating procedure (SSOP). The implementation of HACCP in intensive breeding of game birds has also enabled an additional control of production facilities and of all age categories of birds housed there. The obtained results have confirmed the efficiency of introduction of the system of critical control points in the intensive production of game birds.Der Einfluss der Anwendung von HACCP-System auf die Verbesserung der Produktionsqualität und das Erreichen einer hohen gesundheitlichen Produktrichtigkeit wurde in intensiver Zucht des Federwilds während zwei Produktionszyklen untersucht (2005/06). Durch das HACCP System ist das Konzept der Risikoanalyse dargestellt, bzw. die Möglichkeit des rechtzeitigen Reagierens auf allen erkannten kritischen Kontrollpunkten (CCP), zwecks Einführung einer systematischen Auseinandersetzung bei der Identifikation, Schätzung und Kontrolle bestimmter Gefahren in einzelnen Produktionsstufen. Nach durchgeführten Risikoanalysen (Gefahren) wird der Hauptschwerpunkt des HACCP Systems in intensiver Zucht des Federwilds auf Resultate von Laboruntersuchungen, bzw. auf mikrobiologische Richtigkeit aller Phasen des Zuchtprozesses, gesetzt. Besondere Aufmerksamkeit wurde den Bakterien der Salmonellenart gewiedmet, weil gerade sie die größte Gefahr für Kontaminierung von Rohstoffen, Ausrüstung und Fertigprodukten, und somit für die Gesundheit der Menschen als Endverbraucher, darstellen. Die HACCP Standarde enthalten alle vorgeschriebenen prophylaktischen Maßnahmen (Immunschutz des Mutterschwarms und der Nachkommenschaft) sowie die Einführung der Regeln des hygienisch-gesundheitlichen Schutzes nach dem standardgemäßen sanitarischen operativen Verfahren (SSOP). Die Anwendung von HACCP in intensiver Zucht des Federwilds ermöglichte auch die zusätzliche Kontrolle der Produktionsobjekte, sowie aller Alterskategorien der Tiere, die in ihnen leben. Die erzielten Resultate bestätigen die Wirksamkeit der Einführung des Systems der Kontrolle von kritischen Produktionspunkten in die intensive Zucht des Federwilds.In questo studio è stato verificato l’influsso dell’applicazione delle regole di HACCP sul miglioramento della qualità della produzine e sull’ottenimento dell’alta validità sanitaria dei prodotti durante i due periodi della produzione (2005/2006) in allevamento intensivo della selvaginna di penna. Tramite HACCP è presentato un concetto dell’analisi di rischio, cioè la possibilità di reazione a tempo oportuno su tutti i punti di controllo critici (CCP), allo scopo di inserire l’accesso sistematico nell’identificazione, nella valutazione e nel controllo dei rischi allegati ad alcune fasi della produzione. Secondo le verifiche ottenute, HACCP mette l’accento dell’allevamento intensivo sui risultati delle analisi laboratorie, cioè sulla validità microbiologica di tutte le fasi della produzione. La più grande attenzione è data alle batterie del genere Salmonella, perche loro rapresentano il pericolo più grande per la contaminazione delle materie prime, dell’equipaggio, dei prodotti finali, e, sopratutto, per la salute degli uomini come consumatori ultimi. Le regole del HACCP includono tutte le misure adottate (imunizzazione dei stormi), l’introduzione delle regole igienico-sanitarie secondo il processo operativo sanitario standardizzato. L’applicazione del HACCP sull’allevamento intensivo di selvaggina di penna ha ammesso il controllo aggiuntivo dei complessi per la produzione, includendo gli animali che vivono in questi complessi. I risultati ottenuti confermano il successo dell’introduzione del sistema di controllo dei punti critici della produzione nell’allevamento della selvaggina di penna

A Multimarker Approach for the Prediction of Coronary Artery Disease: Cost-Effectiveness Analysis

Objectives: Coronary artery disease (CAD), as the leading cause of death, poses a huge economic burden on health-care systems. We used a multi-marker approach to explore discriminative abilities of several lipid, inflammatory, and oxidative stress/antioxidative defense markers as CAD predictors. We assessed their cost-effectiveness compared with the Framingham risk score (FRS). Methods: Using a decision model, we evaluated the costs, accuracy, and cost-effectiveness of each model. The FRS was used as the baseline model. Other models were formed with the consecutive addition of selected markers: apolipoprotein A-I (apoA-I), apolipoprotein B (apoB), apolipoprotein (a) [apo(a)] isoform, lipoprotein (a), high-sensitivity C-reactive protein, malondialdehyde, superoxide dismutase (SOD), sulfhydryl, and superoxide anion (O-2-). A best-case model was formed from a combination of diagnostic markers to yield the best patient stratification algorithm. All models were assessed by their predictive probabilities using receiver operating characteristic curves. To accomplish our goals, we recruited 188 CAD patients (verified by coronary angiography) and 197 asymptomatic CAD-free subjects for comparison. The analysis was performed from a third-party payer perspective. Results: Only two strategies had outstanding discriminative abilities: the best-case model (FRS, SOD, and O-2-) and FRS plus SOD with area under the curve (AUC) values of 0.924 and 0.906, respectively. The cost-effectiveness ratio varied between 593 per AUC for the baseline model to 2425 per AUC for FRS plus apo(a) isoform. Strategies involving oxidative stress/antioxidative defense markers were more cost-effective than strategies involving lipid or inflammatory markers. All results were robust. Conclusion: Our results support the feasibility of a multimarker approach for CAD screening. The introduction of oxidative stress/antioxidative defense markers in the clinical laboratory would be convenient and cost-effective

Lipidni status u dece sa hipotireoidizmom: uticaj bolesti i supstitucione terapije levotiroksinom

Hypothyroidism is associated with dislipidaemia and an increased risk of atherosclerosis. The aim of this study was to examine the effect of disease and long-term levothyroxine replacement therapy on serum lipids in hypothyroid children. We measured concentrations of total cholesterol, HDL-cholesterol LDL-cholesterol, triglycerides and thyroid-stimulating hormone in serum samples of 58 children with hypothyroidism (before and after therapy) and in 100 healthy controls. LDL-C and TC values were most markedly affected by the hypothyroid state. The values in the patients were on the average of 100% (LDL-C) and 54% (TC) higher than in the healthy controls. This finding is accordance with the known fact that LDL clearance is slower in hypothyroidism. TG concentrations were slightly higher (p lt 0.05) and HDL-C lower (p lt 0.02), but only in some age groups of patients. The effect of long-term L-T4 replacement on LDL-C and TC was quantitatively most pronounced. The values obtained in patients after therapy were markedly lower than before therapy and did not differ significantly from the values found in the corresponding age groups of healthy children. Significantly lower concentrations of HDL-C and TG after L-T4 administration were found only in children aged from 10 to 15 years. When we compared the lipid-lowering effect of L-T4 replacement therapy in normometabolic versus hypometabolic patients, we obtained a significantly greater effect on TC and LDL-C values in the normometabolic than in hypometabolic group (p lt 0.01). TC and LDL-C concentrations obtained in the L-T4 treated patients correlated well with the corresponding TSH levels (r = 0.770 and 0.725, respectively).Hipotireoidizam je povezan sa dislipidemijom i povećanim rizikom od ateroskleroze. Cilj ovog rada je bio da se ispita uticaj bolesti i dugoročne supstitucione terapije levotiroksinom (L-T4) na lipidni status dece sa hipotireoidizmom. Određene su koncentracije ukupnog holesterola (TC) HDL-holesterola (HDL-C), LDL-holesterola (LDL-C), triglicerida (TG) i tireostimulirajućeg hormona (TSH) u uzorcima seruma sakupljenim od 58 dece sa hipotireoidizmom (pre i posle terapije) i 100 zdrave dece. Hipotireoidizam je najviše uticao na vrednosti LDL-C i TC: kod pacijenata su nađene prosečno 100% (LDL-C), odnosno 54% (TC) više koncentracije nego u kontrolnoj grupi. Ovo se slaže sa poznatom činjenicom da je katabolizam LDL čestica u hipotireoidizmu usporen. Vrednosti TG su bile nešto više (p lt 0,05), a HDL-C niže (p lt 0,02), ali samo u nekim starosnim grupama pacijenata. Dugoročna supstituciona terapija imala je najizrazitiji uticaj na nivoe LDL-C i TC: vrednosti dobijene kod pacijenata posle terapije bile su znatno niže nego pre terapije i nisu se značajno razlikovale od koncentracija dobijenih kod zdrave dece odgovarajuće starosti. Značajno niže vrednosti HDL-C i TG posle davanja L-T4 dobijene su jedino kod dece uzrasta od 10 do 15 godina. Sniženje vrednosti TC i LDL-C pod uticajem L-T4 bilo je izraženije kod normometaboličnih nego kod hipometaboličnih pacijenata (p lt 0,01). Kod pacijenata pod terapijom L-T4 dobijena je dobra korelacija između nivoa TC, odnosno LDL-C pacijenata sa koncentracijom TSH (r = 0,770 i 0,725, respektivno)

Pulmonary function, oxidative stress and inflammatory markers in severe COPD exacerbation

Background: Oxidative stress and inflammation play an important role in the pathogenesis of chronic: obstructive pulmonary disease (COPD). Objective: Pulmonary function, oxidative stress parameters and inflammatory markers were measured in 74 patients with severe COPD exacerbation and 41 healthy subjects. In patients all parameters were assessed at two time points: Firstly, one day after admission and secondly, after 7-10 days when they were clinically stable enough to be discharged. Patients were divided in two groups according the presence of ischemic heart disease (IHD): IHD positive (IHD+) patients and IHD negative (IHD-) patients. Methods and Results: During hospitalisation O(2)(center dot-), malondialdehyde (MDA), advanced oxidation protein products (AOPP) and total oxidant status (TOS) increased and were higher at discharge compared with admission and the control group. Superoxide dismutase (SOD) activity was significantly lower in COPD patients at both time points compared with the control group. Total antioxidant status (TAS) was significantly lower and the prooxidant-antioxidant balance (PAB) was higher at both time points in COPD patients compared with the control group. High sensitive C-reactive protein (hsCRP) and also the neutrophil count were significantly higher at admission compared with discharge. Paraoxonase 1 (PON1) enzymatic activities in COPD patients did not differ compared with the control group. IHD+ COPD patients had significantly lower PON1 activity but higher PAB levels and hsCRP concentrations, compared with IHD- COPD patients. Conclusion: The oxidant/antioxidant imbalance was significantly pronounced in patients with COPD exacerbation for at least 24 hours following their admission and when they were clinically stable enough to be discharged. Increased oxidative stress, elevated systemic inflammation and decreased antioxidant defence were common in end-stage disease and particularly COPD patients with ischemic heart disease

Lack of association between low HDL-cholesterol and elevated circulating cellular adhesion molecules in normolipidemic CAD patients and healthy subjects

High plasma HDL-cholesterol (HDL-c) is a well-established protective factor in coronary artery disease (CAD). One of its potential protective mechanisms is the inhibition of the cytokine-induced upregulation of expression of cellular adhesion molecules (CAMs). High sCAM levels were found to be associated with low HDL-c in some studies performed mostly in hyperlipidemic subjects, but this association has not yet been investigated in CAD patients. In addition, conflicting results were obtained from in vitro studies that explored the proposed HDL effect on cytokine-induced CAM expression. The aim of the present case-control study was to investigate whether low HDL-c values are associated with CAM overexpression in normolipidemic CAD patients and healthy individuals, matched according to age and gender. Plasma HDL-c, sICAM-1, sVCAM-1, and sE-selectin were measured in 37 normolipidemic patients with angiographically verified coronary artery disease and in 52 healthy normolipidemic subjects. The sCAM values obtained in the subjects (patients or controls) with low HDL-c levels ( lt 1.03 mmol/L) were compared with the values in the subjects with high HDL-c (>= 1.03 mmol/L). No significant difference was found between sICAM-1, sVCAM-1, and E-selectin values obtained in subjects with low and high HDL-c, either among the patients or the healthy controls. In conclusion, low HDL-c levels are not associated with CAM overexpression in normolipidemic CAD patients and healthy subjects