Showing papers in "Medicinski arhiv in 2004"

[Classification of drugs using the ATC system (Anatomic, Therapeutic, Chemical Classification) and the latest changes].

Abstract: World Health Organization (WHO) established ATC system of drug classification All drugs are grouped in five levels (anatomical main group, therapeutic subgroup, pharmacological subgroup, chemical subgroup and chemical substance) Alterations in ATC classification are made only by experts in WHO centre in Oslo, Norway Changes are made in assigned new international generic names (INN), in ATC levels likes in changes of Defined Daily Doses (DDD) once a year Changes are made following current scientific articles and international pharmacopeas, as well as the guideline

Transdermal drug delivery systems

Abstract: Transdermal drug delivery systems are pharmaceutical preparations, intended to be applied to the unbroken skin in order to deliver the active ingredient(s) to the systemic circulation after passing through the skin barrier. Transdermal patches are formulated in different ways, but normally they consist of release liner, adhesive layer and backing layer. Active ingredient(s) can be incorporated in reservoir, matrix, adhesive, membrane-matrix and microreservoir. The releasing rate of active substances from patches is controlled by membrane, matrix and adhesive. Only several transdermal systems are available on the market today, because for the penetration of most substances skin represents a strong barrier. With transdermal systems it is possible to obtain a controllable and sustained plasma levels, to minimaze the risk of undesirable side effects and to avoid the hepatic first- pass metabolism. These devices are easy to apply and also to remove from the skin. Of a great pharmaceutical interest are also socalled cosmetic patches. They are applied with aim of cleaning and protecting the skin.

Sensitivity of the neuroimaging techniques in ischemic stroke.

Abstract: The aim of this study was to investigate and compare the sensitivity and effectiveness of neuroimaging techniques in 190 patients with acute ischemic stroke. The first computed tomography (CT) scan for all patients was performed within the first 12 hours of the stroke symptoms onset. For each patient, between the third and fifth day of the hospitalization, at least one more neuroimaging procedure (CT and/or magnetic resonance imaging--MRI, and/or diffusion weighted imaging--DWI) was done. The CT scan in the first 12 hours of the stroke onset was positive in 32% of the patients; the highest number of the positive findings was in the patients with total anterior circulation infarct (52%). After 48 hours of the stroke onset second CT was positive in 85% (75/89), MRI in 93.5% (115/123), and DWI in 98.8% (79/80) patients. MRI was significantly more sensitive than CT in detection of ischemic lesion (88% vs. 72%, P=0.01), particularly in the patients with lacunar infarcts (75% vs. 50%, P=0.005). In detection of ischemic stroke 48 hours of the stroke onset the slightly higher number of strokes were detected on DWI in comparison with MRI (98.6% vs. 88.7%). According to our results, within the first 12 hours after the stroke onset, CT is reliable only for detection of considerable number of cortical ischemic strokes of the anterior cerebral circulation. After 48 hours from the stroke onset CT, MRI and DWI show high sensitivity in the detection of ischemic lesion of all clinical stroke subtypes. MRI is more sensitive in comparison with CT in detection of ischemic lesion, while DWI does not show dominance in comparison with MRI in identification of ischemic stroke after 48 hours of the symptoms onset.

Basiliximab, mechanism of action and pharmacological properties.

Abstract: Basiliximab is a chimeric anti-intcrleukin-2 receptor monoclonal antibody. Basiliximab is a glycoprotein produced by recombinant technology. It is used to prevent white blood cells from acute renal transplantation rejection. It specifically binds to and blocks the alpha chain of interleukin-2 receptors (IL-2R alpha), also known as CD25 antigen, on the surface of activated T-lymphocytes. Due to its monoclonal nature it provides safer and more predictable therapeutic, that is, immunosuppressive response of the polyclonal antibodies. The most common adverse effects in adult patients are constipation, infections, pain, nausea, peripheral oedema, hypertension, anaemia, headache, hyperkalacmia, hypercholesterolemia, increase in serum creatinine, and hypophosphataemia.

A study of gabapentin in the treatment of tonic-clonic seizures of alcohol withdrawal syndrome.

Abstract: In this study for thirty (30) patients with alcohol withdrawal syndrome, the response to anticolvusant gabapentin was assessed Thirty (30) patients with median age of 570 years and median body weight of 791 kg were treated with gabapentin 3 x 300 mg daily for up 30 days The preliminary findings of this study suggest that gabapentin is very effective against tonic-clonic seizures in alcohol withdrawal syndrome Gabapentin was safe and well tolerated For twenty (20) patients no side effect were observed

Serum angiotensin converting enzyme in patients with psoriasis.

Abstract: Serum angiotensin-converting enzyme (ACE) was measured in 60 patients with psoriasis and in 16 healthy individuals. According to clinical forms ofpsoriasis, the patients were further divided into three groups: psoriasis with solitary lesions (n=20), psoriasis with multiple disseminated lesions (n=20) and erythrodermic psoriasis (n=20). The serum ACE activity was determined before and after therapy, by the spectrophotometric method using hippuryl-l-histidyl-l-leucine as a substrate. Before therapy, serum ACE activity was significantly increased in patients with psoriasis (47.20 +/- 2.06 U/L) in comparison to healthy individuals (28.33 +/- 1.32 U/L). The greatest increase in serum ACE activity was observed in patients with multiple disseminated lesions (78%), followed by those with solitary psoriatic lesions (76%) and erythrodermic psoriasis (31%). After therapy, serum ACE activity was significantly decreased in all clinical forms of the disease. In conclusion, the determination of serum ACE activity may be helpful in the diagnosis of psoriasis and one of the discriminators to assess the effects of used therapy.

Effects of iron therapy on motor and mental development of infants and small children suffering from iron deficiency anaemia

Abstract: UNLABELLED The aim of this paper is to establish the effect of iron therapy on mental and motor development in children suffering from iron deficiency anaemia by Bayley Scales of Infant Development (BSID). PATIENTS AND METHODS In prospective study were enroled 90 anemic children with Hb 110 g/l, all of them 6-24 months of age. RESULTS Indexes of mental development (MDI) before and 3 months after iron therapy for group of patients with severe and mild form of anemia (Hb 0.05) before and after three months after iron therapy. Before iron therapy there was statisticaly significant difference (p < 0.001) between group with Hb < 95 g/l and group with Hb 95-110 g/l, and also statisticaly significant difference (p < 0.001) between anemic groups and control group. Indexes of psychomotor development (PDI) before and three months after iron therapy were similar to results MDI. CONCLUSION level of Hb < or = 95 g/l had great importance for results BSID test in infants and small chilren up to age of two years.

The number of malignant neoplasm in Sarajevo region during the period 1998-2002.

Abstract: UNLABELLED Due to the specific war and post-war situation in Bosnia and Herzegovina it is possible to notice some differences in the number, type, advancement, biological course, treatment and its outcome. The actual situation which appeared in connection to depleted uranium has additionally raised questions about its influence on human health and about eventual increase in the number of malignant diseases in Bosnia and Herzegovina. In public, we often see that there are claims about enormous increase in the incidence of cancer. In order to achieve a realistic picture of actual condition and to avoid panic and ignorant attitude, correct and constant data of malignant tumors are necessary. THE AIM OF THE STUDY To collect and analyze data on population with malignant tumors in the region of Sarajevo city, which represents a symbol of difficult times in our country in the recent past. MATERIAL AND METHODS We have collected and analysed data on, population with malignant tumors which included persons with permanent residence in Sarajevo Canton during 5-year period, from 01.01.1998, until 31.12.2002. Results were compared to regional and world indicators, and were observed in the light of specific local situation. RESULTS During period of 5 years (1998-2002) 7733 new cases of malignant tumors were registered in Sarajevo Canton; 3940 among men and 3809 among women. Mostly registered tumors were: lung cancer, amelanotic skin tumors, breast cancer, colorectal cancer, cervical and uterine cancer, urinary bladder cancer, prostate cancer and cancer of larynx. CONCLUSIONS Number of all malignant tumors in the region of Sarajevo Canton correlates to those in South European countries and the one estimated by GLOBCAN 2000. High number was registered in 1998, possibly due to normalization of the health services (diagnostics and treatment of malignant tumors), which didn't exist during the war and early post-war period. After 2000, there is a gradual increase in the number of people with malignant tumors. The most common tumors are lung and breast cancer. Significant differences to estimation and data registrated in other South European counties is high number of laryngeal cancer, urinary bladder cancer, bone and cartilage sarcoma, brain tumors and malignant lymphomas among both genders. Cervical cancer is extremely high up on the list, which correlates with data in developing countries. The incidence of smoking in Bosnia and Herzegovina is extremely high, almost complete, which can influence not only the appearance of lung cancer but also laryngeal and urinary bladder cancer. It is hard to say whether the war and post-war stress, irregular and insufficient nutrition during and after the siege of the city or some other factor have influenced their appearance among exposed population and differences in the observed incidence.

The relationship between circulating carcinoembryonic antigen (CEA) levels and parameters of primary tumor and metastases in breast cancer patients.

Abstract: AIM The Carcinoembryonic antigen (CEA) is used as a tumor marker for breast cancer (BC). In order to better define clinical usefulness of CEA in breast cancer patients (BCP) we determined its baseline pre-treatment levels and correlated them with main parameters of primary tumor and metastases. PATIENTS AND METHODS The main experimental group consisted of 47 female patients with histologically confirmed diagnosis of BC. The obtained results have been compared with those of two control groups: clinically healthy women, and patients with other types and locations of cancer. In both cancer groups the parameters of primary tumor (size, grade) and metastases (time interval to metastases, location, size) have been determined. Circulating levels of CEA were measured by the means of immunoradiometric assay. Results were processed by means of t-test, two way analysis of variance in F-test, and logistic general linear model with calculations of Pearson's correlation coefficient. RESULTS Baseline levels of CEA in BCP were significantly higher than in healthy women (p < 0.0001), and in patients with other types and locations of cancer (p < 0.007). There also was significant difference (p < 0.001) between serum CEA in other cancer patients and healthy women. Baseline CEA levels were in significant positive correlation with the size of primary tumor both in all BCP (p < 0.03) and in hyperCEA BCP (p < 0.002), while in other cancer patients such a correlation did not exist. There was no correlation between CEA and degree of differentiation of primary tumor either in BCP or in other cancer patients. The average circulating levels of CEA in metastatic BCP were significantly higher (p < 0.03) in comparison to non-metastatic patients, while in other cancer patients such a difference did not show up. There was significant correlation (p < 0.0001) between circulating CEA and the size of metastases in all BCP and in subgroup of hyperCEA BCP, while in other cancer patients it was not a case. There was no correlation between serum CEA and other two metastatic parameters either in BCP or in other cancer patients. CONCLUSIONS CEA does not have high tumor specificity for BC since its baseline levels may be elevated in other types of cancer. Circulating levels of CEA in BCP are directly dependable on the size of both primary and metastatic tumor. CEA is a tumor antigen of less differentiated cancer cells. Circulating CEA is a good prognostic marker for patients with metastatic BC.

Micronuclei occurrence in population exposed to depleted uranium and control human group in correlation with sex, age and smoking habit.

Abstract: Observation of micronuclei presents reliable method for evaluation of genotoxicity effects on chromosomal level. One of genotoxins evidenced in the environment as impact of the last conflict in Bosnia and Herzegovina is depleted uranium. This research included an evaluation of genctic load in lymphocytes of individuals from population exposed to depleted uranium and the control group in correlation with sex, age and smoking habit. Results have shown increased micronuclei formation within exposed population and their statistically significant correlation with ages.

Atopic dermatitis and Staphylococcus aureus.

Abstract: Atopic dermatitis is chronic, pruritic inflammatory skin disorder strongly influenced by environmental factors. Staplylococcus aurcus is the common pathogen and colonize the normal skin but it is not number of normal skin flora. Damaged protective skin function by atopic dermatitis, the disturbance of quantity and quality of lipids of stratum corneum are some of the reasons for increasing degree of skin colonisation with staphylococcus aureus. We had presented frequency of the isolation staphylococcus aureus from eczematous atopic skin, from the nose and throat of atopic patients and also from clinically unaffected atopic skin in the group of 30 children compared with 15 healthy children without positive atopic family history. Staphylococcus aureus had been significantly more isolated by all earlier mentioned places in atopic group of children. There is a direct correlation between intensity and also extensity of atopic dermatitis and frequency of the isolation of staphylococcus aureus from mentioned places. The role of staphylococcus aureus in pathogenesis of atopic dermatitis was discussed.

Colonic lipoma intussusception: a case report.

Abstract: Lipomas are the most common mesenchymal benign tumor of the colon. They are usually asymptomatic but may cause bleeding, obstruction, intussusception, or abdominal pain. The diagnosis can be made by colonoscopy, barium enema examination, and by computed tomography (CT). We have reported a case of large submucosal lipoma of the ascending colon with intestinal obstruction. At laparotomy there was an intussusception descending colon, and subtotal colectomy was performed.

[Nitric oxide--a potential modulator of left ventricular diastolic function in hemodialysis patients treated with erythropoietin].

Abstract: UNLABELLED Left ventricular hypertrophy (LVH) is commonly present in hemodialysis patients (HD pts) and is considered as an independent risk factor for high mortality. Many studies have confirmed sound connection between anemia and LVH in this patients. OBJECTIVE To analyse dystolic function of LVH in uraemic pts during the 6 months human recombinant erythropoectin (rHu-Epo) treatment of anemia, with emphasis on the role of nitric oxide (NO), whose role in regulation of LV diastolic distensibility has been hinted in some recent studies. PATIENTS AND METHODS The study included 20 HD pts, aged 39.6 +/- 5.3 yrs, with the same condition of HD treatment, signs of anemia and echocardiographically verified LVH. Pulse Doppler echocardiography confirmed LV diastolic function as a ratio of early to late diastolic mitral flow velocity (E/A). Nitrate concentration was determined by colorimetric method using Greiss reagent. Renal anemia was treated with rHuEpo. RESULTS Six months rHuEpo treatment of anemia in HD pts with LVH caused significant reduction of LV mass index (p = 0.008). However, we observed unfavourable fall in LV diastolic function (E/A = 0.83, p = 0.007). In the same time, it was found that the serum NO level was higher for 11.8% in HD pts with LVH as compared with the pts with normal LV mass. Also, the significant positive correlation was found between the level of NO and LV mass index before (p = 0.004) and after rHuEpo therapy (p = 0.03), as well as a significant positive correlation between NO and E/A in the same conditions (p = 0.002) and p = 0.049). Level of NO negatively correlates with blood hemoglobin level, but without statistical significance. CONCLUSIONS Correction of anemia with rHuEpo leads to the significant partial regression of LVH. Reduction of diastolic function of LV, observed after diminished LV mass index, could be related to the significant fall of NO level and damaged response of LV to NO. The results of the study strongy suggest that NO can present an important determinant of LV diastolic function in uraemic pts.

Angiographic imaging of supernumerary kidney arteries by nonselective angiography

Abstract: In this paper was examined the occurrence frequently more of one kidney artery of the aortic origin The examinations were performed on the 213 angiograms of the kidney artery by the method of the unselective renal angiography per Seldinger, in both sexes, of the various life ages On the analyzed angiograms was the presence of these arteries in 2582% of cases They were more often at the right side in 4909%, than on the left side in 3636%, while their both side presence was found in 1455% Although are these arteries more frequently in male persons, a though the sex cannot be statistically significant the parameter for the determination the frequency of their occurrence In the relation to the backbone column the level of the exit of this arteries from the aorta is the greatest number of cases between the trunk of the first and third loins vertebra (L1-L3) and all were directed according to the medial edge of the corresponding kidney According the place of the entrance in the kidney can be differed three types of these arteries: the artery, and upper and low polar artery On the analyzed angiograms most often were found the hilar and lower polar artery, while the upper polar artery was present in only seven cases of the total number of the analyzed angiograms We consider that the recognition of the supernumerary arteries of the kidney there is both anatomically and the significance in the surgical and radiological practice and their best identification achieves by the application of the angiographic radiology methods

Hemothorax caused by bleeding inside extralobar pulmonary sequestration in a patient on anticoagulation therapy

Abstract: Extralobar pulmonary squestration is a rare anomaly of abnormal pulmonary tissue without any communication to the bronchial tree and that receives blood supply from anomalous systemic arteries. We presented a case of massive hemothorax caused by bleeding inside extralobar pulmonary sequestration in an 34-year young man on anti-coagulation therapy because of built-in mechanic aortic valve. Surgical treatment was decortication and sequestrectomy after ligature of the aberrant vessels. We reviewed the literature on this topic and did not found any report about similar case.

Comparative parameters of myelotoxicity in patients treated with simultaneous chemotherapy and radiotherapy or only radiotherapy

Abstract: Background The Modern oncological treatment usually consists of the different kind of the therapies. Improvement of survival and local control of disease could be possible with combined treatments: surgery, radiotherapy, chemotherapy, etc. However if these treatments are given concomitantly one can expect higher toxicity. Aim Comparation of parameters of miclotoxicity: red blood cell count, white blood cell count, platelets and hemoglobin in patients with advanced cervical carcinoma treated with concomitant chemo-radiotherapy versus radiotherapy alone. Patients and methods From 1997-1999, we performed prospective, by randomised, study, and 80 patients were divided in two groups: Group A--40 patients treated with concomitant chemo-radiotherapy versus, Group B--40 patients treated with radiotherapy alone. Red blood cell count, white blood cell count, platelets and hemoglobin were evaluated before enrollement, during the theraphy, after 3 and 6 months, according to CTC toxicity criteria. Results We perform statistical analysis using H2 test, and we found no significant difference in mild nad severe toxicity in red blood cell count, white blood cell count, platelets and hemoglobin among groups.

Reduced left ventricular diastolic function in asymptomatic patients with non-insulin-dependent diabetes mellitus.

Abstract: AIMS: This prospective study was performed to assess the provalence of diastolic dysfunction of the lelt ventricle (LV) in patients with noninsulin-dependent diabetes mellitus (NIDDM), and the effect of patients' age and the duration of diabetes in the appearance of this dysfunction. METHODS AND RESULTS: We studied 103 patients with NIDDM (group I) and 103 subjects without diabetes (group 2). SF and EF were lower in patients with NIDDM as compared with the control group (32.7+/-5.5%, vs. 34.2+/-5.2%, p=0.04 and 61+/-8.7% vs. 64.4+/-8.1, p<0.01, respectively). The EA ratio <1 is found in 71 (68.9%) patients with NIDDM, and in 36 (34.9%) subjects of the control group (p<0.01). The age of patients had significant correlation with E/A ratio of transmitral Doppler flow (r = -0.38, p<0.01). The duration of diabetes had significant correlation with EF (r = -0.26, p<0.01) and with E/A ratio (r= -0.295, p<0.01). Body mass index and waist/hip ratio did not have significant correlation with EF and with E/A ratio. CONCLUSIONS: In asymptomatic NDDM patients there was a more frequent reduction of systolic and diastolic function of the LV, as compared with healthy subjects. The presence of diastolic dysfunction of the LV in NDDM patients is dependent on the age of the patients and duration of diabetes.

[Complications in the posterior eye segment after Nd-YAG laser capsulotomy]

Abstract: After the Nd-YAG laser posterior capsulotomy can be develop complications on the posterior eye segment. Aims of the research is showed the frequency of the complications which developed during six months, and to analyze the influence of total laser energy on them. Number complications is raised on the time. Rupture of the anterior hyaloid face in 7.5% of the cases, rupture retina in 4.1%, rupture macule in 2.5%, retinal detachment in 2.5%, cystoid macular edema in 4.1%, macular fibrose in 10.8%, changes in the corpus vitrei in 10.8% of the eyes. The influence total laser energy on the complications is statistically significant, and the collerative connections are positive and strong.

Value of bone scintigraphy for detection and ageing of vertebral fractures in patients with severe osteoporosis and correlation between bone scintigraphy and mineral bone density.

Abstract: Osteoporosis is the most common of the metabolic bone diseases, and is an important cause of morbidity in the elderly. Bone scintigraphy is used to detect skeletal lesions at the earliest possible time, to monitor the course of the skeletal discase and to evaluate the metabolic activity of skeletal lesions. The aim of this study was to determine, by using the bone scan age of vertebral fractures in patients with severe osteoporosis, and make correlation between bone scintigraphy and mineral bone density. Material and methods 30 female patients were studied with bone scintigraphy after BMD.BMD was measurred with DEXA Hologic QDR 4500 Elite System. Correlation between T-score and uptake of radiofarmaceutical (Tc-99mMDP) was 0.849, and it was high. Intensity of uptake of Tc-99m MDP scintigraphy is an accurate method for the detection and ageing of fractures in osteoporotic patients.

Education of medical informatics at Medical Faculty of Sarajevo.

Abstract: The medical informatics as the separate medical discipline very quickly gets developed, both in Bosnia and Herzegovina. In our country, the medical informatics is a separate subject for the last ten years, regarding to the Medical curriculum at the biomedical faculties in Bosnia and Herzegovina is in accordance with the project of the education related to Bologna declaration and the project EURO MEDICINA. Last year the Chair of the Medical Informatics of the Medical Faculty in Sarajevo celebrates ten years of its existence. The research was performed using the separate questionnaire patterns data carriers with the defined characteristics for the quality assessment of the performed course. The total attitude of the assessed students speaks about dominantly expressed satisfaction with the majority of the parameters that are important for assessment of the quality and the tuition contents which were evaluated during the questionnaire. The education in the field of the medical informatics is based at the concept which is used in the developed countries of the world, and according the recommendations of the working groups of the European and world association of the medical informatics. The theoretical and practical teaching and training performance in the wholeness is performed by use of the computer equipment, and the final knowledge check of the students also is performed using the Data Base Management System MSAccess specifically designed to cover full teaching and training material by using questions set in the data base which encircled nearly 1500 questions combinations. In this paper author presents ten years of experience of medical informatics education at biomedical faculties in Bosnia and Herzegovina.

Trends in diet and nutritional status in elementary school children in the Tuzla Canton

Abstract: The inverted papilloma is relatively rare urothelial benign tumor. In 1980 was described only 108 cases of this benign proliferative lesions of bladder. Papillary fronds project into the fibrovascular stroma of the bladder rather than into the bladder lumen. The lesion is usually covered by a thin layer of normal urothelium. In Our case, tumor was found during the open adenomectomy, although patient was examined by ultrasound, before surgical treatment. One year after surgical treatment, control cystoscopic examine shows no recidive benign lesion.

Medical informatics in Bosnia and Herzegovina.

Abstract: The ductus cysticus is variable in the length, position and the site where it enters the ductus hepaticus communis--the cystohepatic junction. The investigations were carried out on 100 livers (50 anatomical preparations and 50 patients) adults of both sexes, randomized trial. Main methods of the research were: anatomical macrodissection and analysis of the clinical radiograms. The ductus cysticus were present as: flat--down course in 70%, flat--horizontal course in 2%, flat--ascendant course in 4%, curved in the shape "J" in 10%, curved in the shape "S" in 12% and curved in the shape "U" in 2%. The cystohepatic junction shows variations in topographic zones.

Laparoscopic repair of perforated duodenal ulcer.

Abstract: Laparoscopic closure of an acutely perforated duodenal ulcer is an alternative procedure to open surgery. With proper training and experience this procedure might overtake laparotomy and simple closure thereby reducing the post operative morbidity in terms of reduced wound pain, short hospital stay, likely reduced wound sepsis and hernia occurrence and post operative chest complications. We report a 63-year old man with acute perforation of duodenal ulcer who were submitted to an emergency laparoscopic repair, first time done on the Department of Surgery, Univerisity Clinical Center of Tuzla.

Importance of immunoglobulins and nutrition in infections in neonates

Abstract: The purpose of the study was an estimation of the immunoglobulin serum and the way of nutrition of a new-born child at the beginning of bacterial infections during the first month of life. 120 new-born children (infantiles) of both sexes was prospectively studied, who were born in the Gynecology-obstetrician clinic in Tuzla, in the period from March-May 2000 year. On the base of mothers SES during the pregnancy, new-born children were separated in two groups. Group A was formed of 60 new-born children (32 female and 28 male), mothers had good SES during the pregnancy, and concentration of serum immunoglobulin G (IgG) examined from cords blood, from 10.02 to 17.58 g/L (X 14.48 g/L +/- 1.87). Group B was formed of 60 new-born children (27 female and 33 male), with bad mothers SES and with concentration of IgG from 6.80 to 13.01 g/L (X 10.62 g/L +/- 1.49). Immunoglobulins M and immunoglobulins A were negative in both groups of children. During the first month of life it was studied the way of nutrition and health condition of each new-born child. New-born children with bad mothers SES during the pregnancy, with low values of IgG and who were on the artificial food (nutrition), were showing with the significant difference (p < 0.001) in bacterial infections, comparing with the group who had good IgG. The new-born children with natural nutrition, despite the lower concentration of IgG, were protected from severe bacterial infections.

Effect of erythropoietin on gonadotropic hormones and sexual function in patients on hemodialysis

Abstract: INTRODUCTION Correction of anemia in haemodialysed patients by recombinant human erythropoetin (R-Hu Epo) has been reported to improve sexual functions and hormonal disturbances. The purpose of this study was to evaluate how levels of sexual hormones and sexual function differ before and during a 12 month R-Hu Epo therapy. MATERIALS AND METHODS Thirty six male patients, mean age 47.5 +/- 12.78 and thirty six female patients, mean age 53.0 +/- 10.14, were included in this study. All patients were dialyzed 3 times per week with haemodialysis mean duration of 4.56 +/- 3.84 years. In order to evaluate sexual activities, the questionnaire was presented to all patients. The levels of prolactin, testosterone, FSH, LH were measured at the beginning of the study and every forth month during the study. RESULTS During twelve month therapy with Epo, serum hemoglobin significantly increased from 96.0 +/- 13.3 g/dl to 104.0 +/- 17.2 g/dl (p < 0.005), and hematocrit value rose from 0.284 +/- 0.046% to 0.308 +/- 0.052% (p < 0.05). Prolactin was not significantly decreased: at the beginning of the study was 540.3 +/- 302.2 and at the end 537.4 +/- 297.1 microIU/ml. Testosterone concentrations were in normal range in male patients (18.26 +/- 8.61 microIU/ml). There was significant difference in value of LH in female patients which increased from 57.68 +/- 62.58 to 73.79 +/- 68.52 IU/L. Improvement of sexual function was remarkable in female patients. In male patients sexual desire, frequency of sexual intercourse was strengthen after R-Hu epo therapy. CONCLUSION Better sexual functions in our patients after treatment with R-Hu Epo did not correlate with hormonal disturbances except changes of LH that increased at the end of the therapy.

[Anxiety and depression in deaf and hard-of-hearing adults].

Abstract: The main purpose of this study was to determine the differences between the anxiety and depression degree in individuals with severe hearing impairments and deaf people in relation to sex and marital status. The sample consisted of 54 subjects, 35 males and 19 females, aged from 18-61 years, with hearing loss greater than 60 dB. We used "SCL-90-R" (Symptom Checklist-90-Revised), to assess the level of anxiety and depression. For the examination of marital stress we used "Stockholm Marital Stress Scale". The results showed that deaf and hard-of-hearing individuals demonstrated certain anxiety and depression levels which correlated significantly with marital status, marital stress, and communication problems. The married deaf subjects showed higher anxiety degree than single one. We determined the statistically significant differences for the anxiety level (p < .03861), age (p < .0006), and communication problems (p < .033) between the married and single deaf people. The females exhibited higher anxiety and depression levels than males, but these differences were not statistically significant. For the prevention of psychological problems in deaf and hard-of-hearing individuals it is necessary to pay attention to their communication problems which are a condition for adequate society integration.

Genotoxicity evaluation of paracetamol applying Allium test

Abstract: Paracetamol genotoxic potential was evaluated among different concentrations, applying Allium test on Allium cepa. Total number of roots, number of dark roots, the length of the longest root, the average root, and the shortest root were determined. Statistically significant differences among total number of roots (p > 0.05) was observed at concentrations of 50 microg/ml and 100 microg/ml, and highly statistically significant differences at concentrations of 5 microg/ml and 25 microg/ml, while at the highest concentration (400 microg/ml) was observed statistically significant higher number of roots in comparation to all other concentrations of paracetamol and control group. The results of research suggest the concentrations of 5 microg/ml, 25 microg/ml and 400 microg/ml for further evaluation of paracetamol mutagenic potential.

[Retinal and pineal melatonin--from a circadian signal to therapeutic use].

Abstract: Melatonin, the major product of the pincal gland, is also synthesized in the retina of several vertebrate species. Retinal melatonin levels show a marked daily variation, with high levels at night and low levels during the light period. Melatonin rhythm generating system includes photodetector, circadian clock and melatonin synthesis machinery and they are located in pincal organ and retina. In both, light regulates daily variations in melatonin secretion by controlling the activity of arylalkylamine N-acetyltransferase (AANAT). In mammals, circadian system is comprised of three major components: the eyes, the hypothalamic suprachiasmatic nucleus (SCN) and the pincal gland. The SCN harbours the endogenous oscillator that is entrained every day to the ambient lighting conditions via retinal input. Among the many circadian rhythms in the body that are driven by SCN output, the synthesis of melatonin in the pincal gland functions as a hormonal message encoding for the duration of darkness. Dissemination of this circadian information relies on the activation of melatonin receptors, which are most prominently expressed in the SCN, and the hypophysical pars tuberalis (PT), but also in many other tissues. Melatonin is essential for rhythmic signaling in the PT. Here, melatonin acts in concert with adenosine to elicit rhythms in clock gene expression. By sensitizing adenylyl cyclase, melatonin opens a temporally-restricted gate and thus lowers the threshold for adenosine to induce cAMP-sensitive genes. This interaction, which regulates gene expression and pituitary output (by endocrine-endocrine interaction) represents general mechanism by which the master clock in the brain synchronizes clock cells in peripheral tissues that require unique phasing of output signals.

[Trends in cardiovascular diseases in Bosnia-Herzegovina and some European countries].

Abstract: In the last twenty years, the European office of WHO with its expert groups designated CVD as a problem of top priority in European health policy. The documents of WHO related to CVD, and their directives to member countries, are illustrated in this paper. The authors emphasize that according to available data, CVDs are cause of 40% of total mortality among the European population above the age of 75. In Bosnia and Herzegovina, CVDs are the leading cause of mortality in the last few years. The difference in incidence and prevalence of CVD among European countries is emphasized in the paper. According to the available data of WHO, the greatest incidence and prevalence of these diseases is in East European and Central European countries and the lowest in Mediterranean countries, with the exception of Bosnia and Herzegovina. The evaluation of the present state of frequency of CVD in Europe and the projection of their trends in some countries until 2020 is given in the paper. An alternative projection of the trends of CVD in Bosnia and Herzegovina, including a variant of application of organized preventive programs, is presented in the paper. Illustrative examples of the effects of preventive programs in some European countries, and possibilities of their application in Bosnia and Herzegovina are presented in this paper. Cost analysis of the application of preventive programs and their effects on the reduction of number of people affected by CVD in the short period until 2010 and 2020 is also elaborated in this paper.

Presentation of variations in the anterior part of the circle of Willis as a result of MRI-angiography method.

Abstract: As it is well known the beginning, the course and the result of the cerebral-vasculare disease depends on, among other stuff, the possibility of establishment of the brain collateral circulation The Willis's artery circle based on brain is the most important anastomoses between the blood circulation of the both, carotid and basilar artery However, in almost half of the cases of the examined circle of Willis, certain deviations from the normal anatomy configuration have been identified that immensely facilitate occurance of vascular diseases, because it makes difficult establishment of collateral blood circulation In this particular study, 150 MRI patient's angiographics had been analyzed that were processed at the Radiology Institute of the Clinic Center of the University of Sarajevo The morphologic variations of the circle of Willis were analyzed on these angiographics and those were patients who did not have any signs of cerebral-vasculare diseases We have tried to determine which variations are the most commonly occuring in the front segment of the circle of Willis with two target groups (older -- above 60 years old and younger- up to 34 years old) and including both genders The method of the MR angiography in two projections enabled good visualisation of all components of the circle of Willis and based on their analysis we have achieved the following results The complete front configuration of the circle of Willis had been found with all patients in 76,7% of the cases We noted slightly higher percentage of the anterior configuration with younger category of patients compared to older patients, and with males compared to females Out of the variations that damage the anterior segment of the circle of Willis, the first one, according to the frequency of occuring, is the variation of the type of hypoplasia or aplasia of Al segment of the anterior cerebral artery, and then the variation marked as duplication or multiplication of the anterior communicating artery