Medicinski Glasnik最新文献

Aim: To examine dietary iodine intake and urinary iodine concentration in young adults, as well as the relationship between iodine concentration in urine and muscle mass and speed of muscle reaction.

Methods: Seventy euthyroid participants between the ages of 18 and 24 participated, 35 (50%) male and 35 (50%) female. The participants were young adults who live, study and work in the region of Osijek, Osijek-Baranja County, Croatia. Exclusion criteria were diagnosed thyroid disease and iodine metabolism disorder. Spot urine samples were analysed, dietary iodine intake was assessed, muscle mass and reaction speed were measured.

Results: The median concentration of iodine in urine was 120.77 μg/L, and the estimated iodine intake was 624.66 μg. The median muscle mass was 32.55%, and the median speed of muscle reaction 274.5 ms. A significant, negative and weak correlation between iodine concentration in urine and speed of muscle reaction was observed (Rho = -0.289). Other associations of urine iodine concentration and muscle mass percentage, muscle tissue and reaction speed were not significant Conclusion: The estimated dietary iodine intake was higher than the reference values of the World Health Organization. The urinary iodine concentration was within the reference values. Urinary iodine concentration was not related to muscle mass. Urinary iodine concentration in urine was significantly, negatively and weakly related to reaction speed.

Aim To investigate the relationship between postoperative serum thyroglobulin level ​​and outcome of therapy with I-131 of follicular thyroid cancer. Methods A total of 106 patients with follicular thyroid cancer who were being treated and monitored at the Clinic for Nuclear Medicine at Clinical Center of the University of Sarajevo were included. The inclusion criteria were: surgery of total thyroidectomy, histopathological diagnosis of follicular thyroid cancer, and applied therapy with radioactive iodine. Exclusion criteria were patients with incomplete data, who were not treated with radioidine treatment, or had a different histopathological diagnosis. Postoperative serum thyroglobulin levels were correlated with results of whole body scintigraphies after 12 months (first diagnostic scintigraphy) and whole body scintigraphies after 24 months (second diagnostic scintigraphy). Results The higher frequency of recurrent disease in patients with elevated level of thyroglobulin was found compared to patients with lower postoperative thyroglobulin level. Elevated level ​​of postoperative thyroglobulin correlated with positive scintigraphy findings, i.e., with the occurrence of recurrence and/or metastases in patients with follicular cancer. The cut-off level of postoperative thyroglobulin for recurrence and/or metastasis, i.e. for failure of ablative therapy with I-131, was >12.6 ng/mL. Conclusion  Our study showed that level of postoperative thyroglobulin is an important prognostic factor for the outcome of radiodine therapy of follicular thyroid cancer and should be taken into account in deciding on therapy in this type of cancer in everyday practice Keywords: prognosis, radioiodine, thyroid neoplasm, recurrence.

A caesarean section (CS) is an obstetric surgical intervention and mode of delivery which aims to finish the pregnancy surgically. CS are one of the most important surgical interventions in modern obstetrics and have lead to a significant reduction of fetal and maternal mortality. However, it is important to take into consideration that CS can have risks and lead to unwanted short-term and long-term consequences. One of the main questions of modern obstetric is the ideal CS rate, including ways to reduce an undesirably high CS rate. The ideal CS rate ranging between 10 to 20% according to various research, but some countries have reached rates exceeding 50%, while in other, less developed countries, the issue of accessibility for CS still exists and consequently leads to a high mortality rate. Significant inequality exists in CS accessibility between developed and less developed areas of countries, and countries themselves. In some cases it is even desirable to increase CS rates in order to reduce negative patient outcome.

Aim: This study aimed to reveal the prevalence of the insulin resistance (IR) identified by triglyceride glucose index (TyG index) among students of University of Sarajevo. The impact of visceral fat level and waist to hip ratio measures on TyG value in students has been investigated.

Patients and methods: Study included 160 apparently healthy students, both genders, aged from 19-27 years. Two groups were formed: Group1, TyG <4,49 and Group 2, TyG³4,49. A short interview, questionnaire, anthropometric measures, visceral fat level (VFL), blood pressure and biochemical parameters were applied. The statistical level of significance was P<0,05.

Results: Forty-five students (28, 1%) were insulin resistant. There was a significant difference in TyG value (P<0,001), [group 1- 4,19 (3,93-4,34 vs. group 2 - 4,59 (4,55-4,74)]. Fasting blood glucose (FBG) and lipid parameters-total cholesterol, triglycerides and very low-density lipoprotein cholesterol (TC, TG and VLDL-C) were significantly higher in group TyG ³4,49 compared to TyG <4,49 group, with exception of HDL-C of LDL-C (P>0.05). Stepwise linear regression analysis showed significant impact of waist to hip ratio on TyG value (P=0,001).

Conclusion: The prevalence of IR measured by TyG in university students was 28,1%. The impact of waist to hip ratio on value of TyG index points on possible application of both parameters in visceral obesity and insulin resistance assessment in apparently healthy individuals.

Objective: This study aims to analyze the effects of Pulmonary Rehabilitation (PR) and short-wave Diathermy (SWD) on the Blood Urea Nitrogen (BUN)/Albumin ratio, Pneumonia Severity Index (PSI), IL-8 levels, and length of stay (LOS) in hospitalized pneumonia patients.

Material and method: This is a randomized experimental study with a pre-post control group structure. The study included 24 pneumonia patients who were treated at Dr. Saiful Anwar General Hospital and Lawang General Hospital between 2022 and 2023. For 5 days, subjects were separated into three groups: control, intervention (PR only), and intervention (PR and SWD). The data were examined by comparing the deltas of each group. PSI and CURB-65 were used to calculate severity indices and blood samples were obtained before and after the intervention to determine the BUN/Albumin ratio and IL-8 levels.

Results: There was a significant decrease in the BUN/Albumin ratio after the intervention (p=0.03). IL-8 levels and LOS showed a decreasing trend, although not statistically significant (p=0.208; p=0.249). There was a substantial correlation between PSI and IL-8 and the BUN/Albumin ratio (p=0.015; p=0.002; p=0.001).

Conclusion: This study highlights reduced IL-8 levels, the BUN/Albumin ratio, and a shorter LOS in pneumonia patients receiving PR and SWD therapy for 5 days. This study reinforces the evidence that PR and SWD can serve as adjunctive therapies for patients with pneumonia.

Aim To systematically review the efficacy and safety of fixed-dose combination (FDC) antihypertensive agents in chronic kidney disease (CKD). Methods This systematic review included studies from January 2014 to December 2023 that evaluated FDC antihypertensives in CKD. We searched The PubMed, Embase, and the Cochrane Library databases were searched. Inclusion criteria encompassed studies written in English and published in peer-reviewed journals. Exclusion criterias among others were review articles, editorials, letters, and conference abstracts. Results Six studies met inclusion criteria from 1156 identified publications. Analyzed studies were  included randomized trials (4), cohort studies (1), and retrospective analyses (1). FDCs improved medication adherence, blood pressure control, and renal outcomes. Significant blood pressure  puni naziv skraćenice (BP) reductions were noted with FDCs compared with free combinations. FDCs of renin-angiotensin system inhibitors and thiazide diuretics showed improved adherence, reduced major adverse cardiovascular events, and better renal function preservation. Some combinations losartan hidrochlortiazid demonstrated a more significant reduction of proteinuria and urinary protein-to-creatinine ratio (UPCR), indicating potential renoprotective effects. Conclusion While using FDC antihypertensives has shown promising results in improving patient outcomes in CKD, further large-scale, long-term randomized trials are urgently needed to confirm these findings and optimize treatment strategies. Keywords:  cardiovascular diseases, hypertension management, medication adherence, proteinuria, renoprotection  .

Aim To assess whether colorectal carcinoma (CRC) survivors 5 years post-fluoropyrimidine (5-fluorouracil and capecitabine) chemotherapy (ChemT) have increased presence of subclinical coronary artery disease (CAD), lower iron and altered blood cell composition. Methods This prospective, 2 year, single-center study used invasive coronary angiography to detect the presence of CAD among ChemT (N=45) and control group patients (age, gender-matched, cancer-naïve (N=45). Full blood count and iron levels were compared between two groups. Results Coronary angiography in 90 patients (mean age 65±7 years; 60% male) identified significantly higher presence of CAD in CRC ChemT patient group compared to control: 80% vs. 55 % (p=0.013). CRC ChemT patients had lower red blood cell count (4.45± 0.56 vs. 4.68± 0.50 x109/L; p=0.044), platelet count (214.18±50.99 vs. 251.00 ±156.40 x109/L; p=0.002) and white blood cell count (5.50 ±1.62 vs. 7.67±1.72 x109/L; p=0.000). Mean corpuscular hemoglobin concentration was higher in CRC ChemT patients (342.11 g/L ±15.74 vs. 336.42 g/L ±10.29: p=0.046), and iron deficiency was more prevalent (ChemT20.40 µmol/L ±3.891vs. control 23.37 µmol/L ±4.10: p=0.001). Conclusion Our study shows that among CRC survivors who underwent 5-FU and capecitabine therapy there is a significantly higher prevalence of CAD accompanied by long-term impairment in blood erythropoiesis. Keywords: coronary artery disease, coronary angiography, erythropoiesis.

AimTo evaluate the clinical course and outcomes of oligoarticular juvenile idiopathic arthritis(JIA) patients from 2003 to 2021, identifying factors linked to severe disease and complications. Methods We analyzed 208 oligoarticular JIA patients followed at Cerrahpaşa Medical School, using medical records. Continuous variables were compared with the Mann-Whitney U test, and logistic regression was applied to identify predictors of severe disease and damage. Results Among 208 patients (68.75% female), the average treatment duration was 45 months. The knee was the most affected joint (82.6%), followed by the ankle (50.4%). The initial mean Juvenil Arthritis Disease Activity Score (JADAS) score was 18, decreasing to 3 at the last visit. Juvenile Arthritis Damage Index (JADI) score averaged 0.64. Limited range of motion was observed in 34.13% patients. Uveitis was the most common extra-articular complication (14.9%), with higher biologic use in these patients (p<0.001). Disease severity correlated with initial and final JADAS (p<0.001) and JADI (p<0.001). Regression analysis linked elbow involvement (p=0.000) and adalimumab use (p=0.001) to disease sequelae. MEFV gene mutations were found in 10.9% of patients. Based on Wallace criteria, 85% were in remission with medication, 6.25% had inactive disease, and 8.6% achieved drug-free remission. Conclusion: Oligoarticular JIA generally has a mild course and good prognosis. However, elbow involvement and biologic use are associated with more severe disease and sequelae. Uveitis is the most common extra-articular complication. Keywords: arthritis, biologics, damage, oligoarticular JIA.

Aim to investigate the potential of SG followed by injection of MSCs in type 2 diabetic rats with obesity in improving IR. Methods This study used a pre and post-control group design with 24 rats divided into three groups: Control (C), SG, and SG + MSCs (SG+M). On day 10, the level of vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), triglyceride (TG), pancreatic beta cells, and homeostasis model assessment of IR (HOMA-IR) was evaluated using qRT-PCR, ELISA, and immunohistochemistry. Results A significant decrease of TNF-α (1.179 pg/mL), CRP(209 pg/mL), and TG levels (82,83  15,02pg/mL) in all treatment groups on day 10, in which SG + M group showed optimum inhibition was found (p < 0.05). This result was in line with the optimum increase of VEGF (8,1500 ± 2,47397) and pancreatic beta cell(10,1783±0,47) in SG + M group (p < 0.05). Moreover, our study also revealed the optimum decrease of HOMA-IR in SG+M group on day 10 (49,8233 ± 1,07303). Conclusion A combination of SG and MSCs can optimally improve insulin resistance by inhibiting TNF-α, CRP, and TG level and upregulating VEGF and pancreatic beta cell in an obese T2DM rat model.

Aim: This study aimed to evaluate antibiotic resistance, biofilm formation, and the presence of virulence-associated genes in Staphylococcus haemolyticus isolates.

Methods: Clinical specimens were obtained from patients in Mosul city. Antibiotic susceptibility was determined using the Kirby–Bauer disk diffusion method against fourteen antibiotics Biofilm production was assessed by both the tube adherence method and the microtiter plate assay. Polymerase chain reaction (PCR) was employed to detect selected resistance and virulence genes.

Results: The isolates exhibited high resistance rates to ampicillin (94.7%) and cloxacillin (94.7%). These antibiotics were tested separately to compare β-lactamase-labile (ampicillin) and β-lactamase-stable (cloxacillin) penicillins. All isolates were uniformly susceptible to vancomycin. Nitrofurantoin was not included in the final interpretation due to its limited clinical relevance in non-urinary tract infections, especially considering that S. haemolyticus is not a typical uropathogen. Variable resistance patterns were observed with other antibiotics. All isolates demonstrated biofilm production. PCR analysis revealed the presence of the SH gene in 100% of isolates. The mecA gene, conferring methicillin resistance, was detected in 88.88% of isolates; tetK (tetracycline resistance) in 83.33%; and ermC (erythromycin resistance) in 26.31%. Among the virulence factors, hla and fnbB were found in 100% and 73.68% of isolates, respectively.

Conclusion: The study highlights the alarming antibiotic resistance, strong biofilm-forming ability, and high prevalence of virulence and resistance genes in S. haemolyticus, reinforcing concerns over the global spread of multidrug-resistant organisms.