Our results suggest that neuroinflammation plays a principal role in perinatal hypoxic-ischemic brain damage and we postulate that oxidative stress and upregulation of VEGF might be important contributing factors in the pathogenesis of hypoxic-ischemic brain injury, particularly in preterm neonates.

Ferritin concentration, as a parameter of iron status that is commonly used in the diagnosis of iron deficiency anaemia (IDA), often has limited values if the iron deficiency is accompanied by inflammatory disease. This study evaluated the value of reticulocyte haemoglobin content (CHr) and soluble transferrin receptor-ferritin index (sTfR/F) in the diagnosis of IDA and differential diagnosis of IDA and anaemia of chronic disease. The study included 66 nonanaemic individuals as controls, 86 patients with IDA divided into noninflammatory and inflammatory subgroups, and 32 patients with anaemia of chronic disease. Blood count, iron, transferrin saturation, total iron binding capacity, ferritin, C-reactive protein, sTfR and CHr were determined. Receiver operator characteristic curve analysis showed very high discriminating power for CHr, soluble transferrin receptor (sTfR) and sTfR/F in the diagnosis of IDA. In patients with anaemia of chronic disease these parameters showed no significant difference from the control. CHr and sTfR enabled recognition of iron deficiency and were not affected by acute phase reaction. They are sensitive markers of body iron status with additional value to conventional tests for the detection of iron deficiency.

Objective: Interleukin 6 (IL6) has the ability to influence each level of the hypothalamo-pituitaryadrenocortical (HPA) axis. The aim of the study was to test whether IL6 concentration correlates with the adrenal cortex response to ACTH in healthy humans. We postulated that higher basal IL6 concentration would be associated with the higher cortisol response to the stimulation. Design and methods: Basal IL6 concentration was measured and a low dose (1 mg) ACTH test was performed to assess cortisol response. Twenty-seven apparently healthy subjects (11 male, 16 female, mean age 31.1 years, age range 22-47 years) were included in the study. Results: Data are presented as meanGS.E.M. Basal IL6 level was 0.84G0.10 pg/ml. Basal cortisol was 351.9G18.3 nmol/l. Maximal cortisol during synacthen test was 653.0G20.6 nmol/l. Maximal cortisol increment was 301.1G20.0 nmol/l. IL6 concentration was not correlated with basal or maximal cortisol concentration, but correlated significantly with cortisol increment (rZ0.63, 95% confidence interval) 0.42-0.83). Conclusions: In our study, we found that higher basal IL6 concentration is associated with the higher cortisol response to ACTH stimulation. Based on previous research and our data, IL6, even in low concentrations and under physiologic conditions, modulates adrenal cortex responsivity to ACTH. Therefore, it seems that immune modulation of HPA axis is also present under physiologic and not only pathologic conditions. European Journal of Endocrinology 159 649-652

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SummaryAn adequate assessment of the measurement uncertainty in a laboratory medicine is one of the most important factors for a reliable interpretation of the results. A large number of standards and guidelines indicate the need for a proper assessment of the uncertainty of measurement re sults in routine laboratory practice. The available docu ments ge nerally recommend participation in the proficiency schemes/ external quality control, as well as the internal quality control, in order to primarily verify the quality performance of the method. Although all documents meet the re quirements of the International Standard, ISO 15189, the standard itself does not clearly define the method by which the measurement results need to be assessed and there is no harmonization in practice regarding to this. Also, the uncertainty of measurement results is the data relating to the measured result itself, but all factors that influence the interpretation of the measured value, which is ultimately used for diagnosis and monitoring of the patient's treat ment, should be taken into account. So in laboratory medicine, an appropriate assessment of the uncertainty of the measurement results should have the ultimate goal of reducing diagnostic uncertainty. However, good profes sional laboratory practice and understanding analytical aspects of the test for each individual laboratory is ne ces sary to adequately define the uncertainty of measurement results for specific laboratory tests, which helps to imple ment good clinical practice. Also, setting diagnoses in medicine is a decision with a certain degree of uncertainty, rather than statistically and mathematically calculated conclusion.Keywords: ISO 15189, laboratory medicine, measurement uncertainty Kratak sadr`ajAdekvatna procena nesigurnosti rezultata merenja u biohemijskoj laboratoriji je jedan od najzna~ajnijih faktora za pouzdanu interpretaciju rezultata. Veliki broj standarda i vodi~a ukazuju na neophodnost pravilne procene nesigurnosti rezultata merenja u rutinskoj laboratorijskoj praksi. Dostupni dokumenti uglavnom preporu~uju u~e{}e u {e -mama osposobljenosti/spolja{njoj kontroli kvaliteta, kao i svakodnevno merenje unutra{njih kontrola kvaliteta, kako bi se primarno proverilo izvo|enje metode. Mada svi dokumenti zadovoljavaju zahteve internacionalnog standarda ISO 15189, sam standard ne defini{e jasno metodu kojom treba procenjivati nesigurnost rezultata merenja i ne postoji harmonizacija u praksi. Tako|e, nesigurnost rezultata merenja je podatak koji se odnosi na sam izmereni rezultat, ali treba uzeti u obzir sve faktore koji uti~u i na interpretaciju izmerene vrednosti, koja se u krajnjem koristi za dijagnozu i pra}enje le~enja pacijenta. Tako da u laboratorijskoj medicini odgovaraju}a procena nesigurnosti rezultata merenja treba da ima za krajnji cilj smanjenje dijagnosti~ke ne sigurnosti. Ipak, dobra profesionalna laboratorijska praksa i razumevanje analiti~kih aspekata testa za svaku poje dina~nu laboratoriju je neophodno da bi se adekvatno definisala procena nesig...

Sedentary lifestyle is highly associated with increased risk of cardiovascular disease, obesity, and type 2 diabetes. It is known that regular physical activity has positive effects on health; however several studies have shown that acute and strenuous exercise can induce oxidative stress and lead to DNA damage. As magnesium is essential in maintaining DNA integrity, the aim of this study was to determine whether four-week-long magnesium supplementation in students with sedentary lifestyle and rugby players could prevent or diminish impairment of DNA. By using the comet assay, our study demonstrated that the number of peripheral blood lymphocytes (PBL) with basal endogenous DNA damage is significantly higher in rugby players compared to students with sedentary lifestyle. On the other hand, magnesium supplementation significantly decreased the number of cells with high DNA damage, in the presence of exogenous H2O2, in PBL from both students and rugby players, and markedly reduced the number of cells with medium DNA damage in rugby players compared to corresponding control nonsupplemented group. Accordingly, the results of our study suggest that four-week-long magnesium supplementation has marked effects in protecting the DNA from oxidative damage in both rugby players and in young men with sedentary lifestyle. Clinical trial is registered at ANZCTR Trial Id: ACTRN12615001237572.

Our results emphasize that HSA-derived structural indices of proximal femoral structure may be an important index of greater fragility in patients with alcoholic cirrhosis.

SUMMARYSystemic markers of inflammation are considered reliable predictors of future coronary events in patients with acute myocardial infarction (AMI). The aim of this study was to evaluate the prognostic relevance of serial C-reactive protein (CRP) measurements in patients with ST-elevation AMI (STEMI) on one-year outcome. In 31 patients with STEMI, serial measurements of CRP were obtained, and for each patient, the following values were determined: (i) values at admission, up to 12 hours after symptom onset, (ii) maximal values obtained 24-72 hours after symptom onset (early acute values), and (iii) late acute values (96-120 hours after symptom onset). The combined endpoint was any new cardiovascular event, including death.Early and late acute CRP levels were the only parameters found to be significantly higher in patients with an adverse outcome than in patients with a good outcome. A significantly higher rate of endpoint events was found in patients with elevated early (Hazard ratio [HR] 5.54, 95%CI 2.05-25.40; P = 0.007) and late acute CRP (HR 9.01, 95% CI 1.66-19.56; P = 0.005). Multiple logistic regression analysis identified only early acute CRP as an independent predictor of an unfavorable outcome (Odds ratio 8.00, 95%CI 1.15-55.60; P = 0.04), after adjustment for established risk factors.CRP level measured 24-72 hours after symptom onset is an independent predictor of one-year outcome in patients with STEMI. Values obtained later in the setting of STEMI do not add further prognostic information. CRP at admission is not related to long-term prognosis. (Int Heart J 2006; 47: 833-842)