Design of windows of rolling stock for the passenger transport

The aim of the master thesis is the research the design and selection of the optimal glass for driver's cabin windows and passenger compartments, as well as their installation in the rail vehicle. The new windows should be designed and implemented in the "Avenio" trams. Choosing a new glass requires it to withstand normal operating loads, including environmental conditions, following EN 15152 and EN 50125-1 standard. In addition to selecting glass, it is necessary to choose the appropriate adhesive for mounting the window in the vehicle structure. In accordance with the Din 6701 standard, an analysis of the type and characteristics of the adhesive was described. The subject is to research and analyze the window load, as well as the thermal and acoustic characteristics of windows. Furthermore, the installation of windows in the vehicle structure and the design of windows for EMU (electric multiple units) were described

Neuobičajen klinički tijek neurosarkoidoze s razvojem hidrocefalusa

Approximately 5% to 15% of patients with systemic sarcoidosis develop neurological complications. However, the actual prevalence of subclinical disease may be higher. Symptoms are not specific, and may resemble those of other neurological diseases. Hydrocephalus occurs in 6% of patients with neurosarcoidosis. Acute hydrocephalus is extremely rare and when it occurs, it is usually difficult to diagnose, thus leading to possible complications. We present a patient who developed acute hydrocephalus due to neurosarcoidosis, for which he had to be operated on; soon after the operation, cranial infection developed that required definitive drainage system and ventriculoperitoneal shunt had to be implanted. In further complicated clinical course, after four years on corticosteroid therapy (corticosteroid dependent sarcoidosis), he had to be urgently operated on because of significant ventricular catheter adhesions, but several days after the operation he died in coma because of progressive brain edema not responding to treatment. As hydrocephalus due to neurosarcoidosis has high morbidity and mortality, early diagnosis and proper treatment are of utmost importance.Oko 5% do 15% bolesnika sa sistemskom sarkoidozom razviju neurološke komplikacije. Međutim, stvarna učestalost subkliničke bolesti može biti veća. Simptomi nisu specifični, a mogu sličiti onima drugih neuroloških bolesti. Hidrocefalus se pojavljuje u 6% bolesnika s neurosarkoidozom. Akutni hidrocefalus je iznimno rijedak, a kada se pojavi obično se teško dijagnosticira, što dovodi do mogućih komplikacija. Prikazujemo bolesnika u kojega se razvio akutni hidrocefalus zbog neurosarkoidoze, zato je morao biti operiran, no ubrzo nakon operacije kranijuma razvija se infekcija koja zahtijeva definitivnu kanalizaciju, ugradnju ventrikularnog šanta. U daljnjem kompliciranom kliničkom tijeku, nakon četiri godine kortikosteroidne terapije (o kortikosteroidima ovisna sarkoidoza), morao je biti hitno operiran zbog značajnih priraslica na ventrikularnom kateteru, ali je nekoliko dana nakon operacije umro u komi zbog progresivnog edema mozga koji nije reagirao na liječenje. Kako hidrocefalus kod neurosarkoidoze ima visok pobol i smrtnost, rano otkrivanje i odgovarajuće liječenje osobito su važni

The usefulness of MMP-9, TIMP-1 and MMP-9/TIMP-1 ratio for diagnosis and assessment of COPD severity

Background: Inflammation, oxidative stress and an imbalance between proteases and protease inhibitors are recognized pathophysiological features of chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate serum levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in patients with COPD and to assess their relationship with lung function, symptom severity scores and recent acute exacerbations. Methods: In this observational cohort study, serum levels of MMP-9 and TIMP-1 and the MMP-9/TIMP-1 ratio in the peripheral blood of COPD patients with stable disease and healthy controls were determined, and their association with lung function (postbronchodilator spirometry, body plethysmography, single breath diffusion capacity for carbon monoxide), symptom severity scores (mMRC and CAT) and exacerbation history were assessed. Results: COPD patients (n = 98) had significantly higher levels of serum MMP-9 and TIMP-1 and a higher MMP-9/TIMP-1 ratio than healthy controls (n = 47) (p ≤ 0.001). The areas under the receiver operating characteristic curve for MMP-9, TIMP-1 and the MMP-9/TIMP-1 ratio for COPD diagnosis were 0.974, 0.961 and 0.910, respectively (all p < 0.05). MMP-9 and the MMP-9/TIMP-1 ratio were both negatively correlated with FVC, FEV1, FEV1/FVC, VC, and IC (all p < 0.05). For MMP-9, a positive correlation was found with RV/TLC% (p = 0.005), and a positive correlation was found for the MMP-9/TIMP-1 ratio with RV% and RV/TLC% (p = 0.013 and 0.002, respectively). Patients with COPD GOLD 3 and 4 presented greater MMP-9 levels and a greater MMP-9/TIMP-1 ratio compared to GOLD 1 and 2 patients (p ≤ 0.001). No correlation between diffusion capacity for carbon monoxide and number of acute exacerbations in the previous year was found. Conclusions: COPD patients have elevated serum levels of MMP-9 and TIMP-1 and MMP-9/TIMP-1 ratio. COPD patients have an imbalance between MMP-9 and TIMP-1 in favor of a pro-proteolytic environment, which overall indicates the importance of the MMP-9/TIMP-1 ratio as a potential biomarker for COPD diagnosis and severity

Significance of LDL and HDL subclasses characterization in the assessment of risk for colorectal cancer development

Introduction: Dyslipidaemia contributes to the occurrence of colorectal cancer (CRC). We hypothesized that qualitative changes of lipoproteins are associated with the risk for CRC development. This study analyses low-density lipoprotein (LDL) and high-density lipoprotein (HDL) diameters, as well as distribution of LDL and HDL subclasses in patients with CRC, with an aim to determine whether advanced lipid testing might be useful in predicting the risk for the onset of this malignancy. Materials and methods: This case-control study included 84 patients with newly diagnosed CRC and 92 controls. Gradient gel electrophoresis was applied for separation of lipoprotein subclasses and for LDL and HDL diameters determination. Lipid parameters were measured using routine enzymatic methods. Results: Total cholesterol, HDL and LDL-cholesterol were significantly lower in CRC patients compared to controls (4.47 mmol/L vs. 5.63 mmol/L; 0.99 mmol/L vs. 1.27 mmol/L; 2.90 mmol/L vs. 3.66 mmol/L; P lt 0.001, respectively). Patients had significantly smaller LDL (25.14 nm vs. 26.92 nm; P lt 0.001) and HDL diameters (8.76 nm vs. 10.17 nm; P lt 0.001) and greater proportion of small, dense LDL particles (54.0% vs. 52.9%; P = 0.044) than controls. Decreased LDL and HDL diameters were independent predictors of CRC (OR = 0.5, P = 0.001 and OR = 0.5, P = 0.008, respectively), and alongside with age and HDL-cholesterol concentrations formed the optimal cost-effective model, providing adequate discriminative abilities for CRC (AUC = 0.89) and correct patients classification (81%). Conclusions: Patients with CRC have decreased LDL and HDL diameters and increased proportion of smaller particles. LDL and HDL diameters determination could be useful in assessing the risk for CRC development

Association among resistin, adenylate cyclase-associated protein 1 and high-density lipoprotein cholesterol in patients with colorectal cancer: a multi-marker approach, as a hallmark of innovative predictive, preventive, and personalized medicine

Background: Elevated concentrations of resistin have been reported in colorectal cancer (CRC), but its interactions with adenylate cyclase-associated protein 1 (CAP-1) are largely unexplored. We investigated resistin plasma concentration, peripheral blood mononuclear cells (PBMCs) resistin messenger ribonucleic acid (mRNA), and CAP-1 mRNA levels in CRC patients, as well as the impact of resistin gene polymorphism rs1862513 on the examined markers. We also explored associations of resistin with high-density lipoprotein cholesterol (HDL-C) and predictive potential of our parameters for CRC. Methods: Eighty-six patients with CRC and 75 healthy adults were included. Commercial ELISA kit was used for obtaining resistin’s concentrations, while polymerase chain reaction (PCR) method was applied for evaluation of resistin and CAP-1 mRNA levels and rs1862513 polymorphism. Results: Plasma resistin and CAP-1 mRNA levels were higher in CRC patients (p < 0.001 and p < 0.05, respectively), while resistin mRNA levels were lower (p < 0.001). Negative association existed among plasma resistin and HDL-C concentrations (ρ = − 0.280; p < 0.05). A model including age, body-mass index, HDL-C, low-density lipoprotein cholesterol (LDL-C), and plasma resistin concentrations as independent predictors of CRC showed very good diagnostic accuracy (AUC = 0.898). We found no associations of rs1862513 with the examined markers. Conclusions: Our study demonstrated increased plasma resistin and CAP-1 mRNA levels, implying their possible interaction in CRC. The association among plasma resistin and HDL-C might indicate that HDL-C is involved in alterations of resistin’s secretion process. As a hallmark of personalized medicine, multi-marker approach in determination of resistin-related parameters might be useful for prediction and prevention of CRC development

Kašnjenje zbog bolesnika, zdravstvenog sustava i ukupno kašnjenje u dijagnosticiranju i liječenju tuberkuloze u populaciji Srbije

Currently, topical are studies that examine diff erent reasons for delay of tuberculosis (TB) diagnosis and its impact on disease prognosis. The aim was to examine three time periods associated with treatment delay: patient related, health system related and total delay. This retrospective-prospective study included 100 consecutive patients hospitalized at Department of Pulmonology, Clinical Center of Serbia, in the period from March to December 2015. Study results showed median patient delay to be 92.5 days. Total delay was aff ected by patient related delay. Median healthcare delay was 18.5 days. Patients that reported excessive alcohol consumption were more likely to have prolonged time to seek medical help. Years of alcohol consumption yielded moderate positive correlation with patient related delay (r=0.362, p0.05). Clinical characteristics such as patient TB category and chest radiograph abnormalities were not associated with prolonged patient related delay (p>0.05). Study results point to the importance of health education and/or health intervention in the population group at a high risk of TB.Trenutno su veoma aktualne studije koje istražuju razloge za kašnjenje dijagnosticiranja tuberkuloze (TB) te njihov utjecaj na prognozu bolesti. Cilj je bio ispitati tri razdoblja povezana s kašnjenjem dijagnoze: bolesnikovo, zdravstvenog sustava i ukupno kašnjenje. Ovo retrospektivno-prospektivno istraživanje uključilo je 100 uzastopnih bolesnika s dijagnozom TB i hospitaliziranih u Klinici za pulmologiju Kliničkog centra Srbije između ožujka i prosinca 2015. Studija je pokazala medijan vremena kašnjenja bolesnika od 92,5 dana, što je utjecalo i na ukupno vrijeme kašnjenja. Medijan vremena kašnjenja zdravstvenog sustava bio 18,5 dana. Kod bolesnika koji su prekomjerno konzumirali alkohol bilo je vjerojatnije da će imati produženo vrijeme do traženja liječničke pomoći. Godine konzumiranja alkohola bile su u pozitivnoj i umjerenoj korelaciji s vremenom kašnjenja bolesnika (r=0,362, p0,05). Kategorija bolesnika s TB i nenormalnosti radiograma nisu bile povezane s vremenom kašnjenja bolesnika (p>0,05). Sve ovo ukazuje na važnost zdravstvenog odgoja i/ili zdravstvene intervencije kod stanovništva s visokim rizikom od TB

Postponed diagnosis of alpha-1 antitrypsin deficiency

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Alcohol use and clinical manifestations of tuberculosis

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Patient, Healthcare System and Total Delay in Tuberculosis Diagnosis and Treatment among Serbian Population

Currently, topical are studies that examine diff erent reasons for delay of tuberculosis (TB) diagnosis and its impact on disease prognosis. The aim was to examine three time periods associated with treatment delay: patient related, health system related and total delay. This retrospective-prospective study included 100 consecutive patients hospitalized at Department of Pulmonology, Clinical Center of Serbia, in the period from March to December 2015. Study results showed median patient delay to be 92.5 days. Total delay was aff ected by patient related delay. Median healthcare delay was 18.5 days. Patients that reported excessive alcohol consumption were more likely to have prolonged time to seek medical help. Years of alcohol consumption yielded moderate positive correlation with patient related delay (r=0.362, p0.05). Clinical characteristics such as patient TB category and chest radiograph abnormalities were not associated with prolonged patient related delay (p>0.05). Study results point to the importance of health education and/or health intervention in the population group at a high risk of TB