Background/Aim. Tuberculosis in the second decade of the 21st century is an infectious disease with the highest mortality rate. In addition, in developed countries, pneumonia is the major couse of morbidity and mortality in adults. The aim of our study was to point out the differences and similarities between symptoms, laboratory parameters and clinical indicators in patients with pulmonary tuberculosis (PTB) and patients with pneumonia in the general population and in people belonging to the high risk groups for developing tuberculosis. Methods. This prospective study included patients with PTB (n = 70) and pneumonia (n = 75) treated at the Pulmonology Department of Clinical Hospital Center in Kosovska Mitrovica. Results. PTB was more frequent in men, 30-39 years of age (OR; 6:08), mainly from rural areas (p = 0.001), and with lower levels of education (p = 0.031). Pneumonia was more frequent in women older than 60 years of age (p = 0.0012). Night sweats (p = 0.001) and weight loss (p = 0.062) were significantly more frequent in patients with PTB, while chest pain (p = 0.001) and high temperature (p = 0.036) were more common in patients with pneumonia. X-ray changes in patients with PTB were located in the upper fields (p = 0.001), or appeared to be bilateral (p = 0.004). The strongest predictor associated with an increased risk of night sweats was diagnosed PTB (OR = 30.0). The chest pain was a predictor of pneumonia, unilateral changes (OR = 4.65) in the lower lung fields (OR = 0.08). Conclusion. Night sweats, weight loss and chest X-ray abnormalities in upper fields were significant indicators of PTB. Chest pain, fever and chest X-ray abnormalities in lower fields were significant indicators of pneumonia.
Uloge endotelina u kardiovaskularnoj fiziologiji i patofiziologiji od njegovog otkrića do danas su neosporne. U srcu endotelini su značajni za procese razvoja, rasta i remodelovanja kao i za kontrolu kontraktilnosti i ritmičnosti. Srčane endotelne ćelije u endokardu i miokardnim kapilarima predstavljaju glavni izvor endotelina, a kardiomiociti su njihova primarna meta. Endotelin-1 je jedna od najpotentnijih poznatih supstanci sa pozitivnim inotropnim efektom, stoga endotelini imaju ključnu ulogu u srčanoj endotelno-miokardnoj interakciji. Endotelini su familija peptida od 21 amino kiseline koju čine endotelin-1, endotelin-2 i endotelin-3. Ostvaruju svoje efekte aktivacijom endotelinskih receptora, ETA i ETB, koji pripadaju familiji receptora vezanih za G proteine. ETA i ETB receptori su gusto distribuirani na kardiomiocitima, ćelijama provodnog sistema srca, koronarno vaskularnim i endokardno endotelnim ćelijama. U fiziološkim uslovima mesto sinteze endotelina su endotelne ćelije ali u patofiziološkim uslovima i veliki broj neendotelnih ćelija u srcu. Endotelin-1 ima pozitivno hronotropno i inotropno dejstvo. Administracija ET-1 uzrokuje koronarnu vazokonstrikciju, dovodi do ishemije miokarda i letalne ventrikularne aritmije. U akutnom infarktu miokarda ET-1 povećava miokardnu nekrozu i aritmije ali ima povoljan efekat na oporavak srca nakon infarkta u početnoj fazi remodelovanja srca. ET-1 preokreće acidozom indukovan negativan inotropan i luzitropan efekat, bez povećanja intracelularnog kalcijuma. Endotelin može da se suprotstavi aritmogenim efektima kateholamina. Tako, male koncentracije endotelina imaju protektivni efekat na srce. Osnovne indikacije za primenu antagonista endotelina jesu srčana insuficijencija, plućna hipertenzija i rezistentna arterijska hipertenzija. Dobro i pažljivo dizajnirane kliničke studije su potrebne za verifikaciju terapeutskih potencijala novih klasa lekova u kardiovaskularnoj medicini.Ključne reči: srčane performanse, endotelin, endotelinski receptori ET A i ET B UVODEndotelne ćelije u srcu sintetišu i oslobađaju različ-ite auto-i parakrine medijatore koji direktno utiču na srčani rast, metabolizam, kontraktilnost i ritmičnost. Sinteza, sekrecija i aktivnost endotelnih medijatora je srodna, povezana i interaktivna. Neke od ovih supstanci moduliraju efekat drugih endotelnih supstanci na istu ciljnu ćeliju, a efekti mogu biti međusobno aditivni, sinergetski ili inhibitorni. Oni čak mogu rezultirati novim efektima, koji nisu viđeni kod samih medijatora ali su određeni sredinom u kojoj se interakcije dešavaju. U fiziološkim uslovima u odraslom srcu, srčane endotelne ćelije proizvode azot oksid (NO) putem enzimske aktivnosti konstitutivne azot oksid sintaze (NOS), endotelin (ET) nakon konverzije pre-proET do pro-ET i u ET putem endotelin konvertujućeg enzima (ECE), eikosanoide i protaciklin (PGI2) i transformišu angiotenzin I (ANG I) u aktivni ANG II. U srcu se sintetišu i medijatori poput fibroblastičnog faktora rasta (bFGF), vaskularnog endotelnog faktora rasta (VEGF), neuregulina i...
Introduction. Endocardial endothelium is formed from a single layer of closely related cells with complex interrelationships and extensive overlap at the junctional edges. Morphological characteristics of blood-heart barrier. Endocardium is composed of three layers: endocardial endothelium, subendothelial loose connective tissue and subendocardium. The fibrous component of the subendothelium consists of small amount of collagen and elastic fibers. Several cell types are present in subendocardium: telocytes, fibroblasts and nerve endings. Intercellular bonds between the endocardial endothelial cells. Endocardial endothelial cells are attached to one another via sets of binding proteins forming solid, adherent and communicating connections. Communicating connections form transmembrane channels between the neighboring cells, while solid and adherent connections form pericellular structures like stitches. The maintenance of the presumed transendocardial electrochemical potential difference provides a high gradient for certain ions as well as a selective boundary barrier, basal lamina, preventing ionic leakage. The negatively charged glycocalyx also modulates endothelial permeability. Electrophysiological characteristics of heart-blood barrier. Electrophysiological studies have shown the existence of a large number of membrane ion channels in the endocardial endothelial cells: inward rectifying K + channels, Ca 2+ dependent K + channels, voltage-dependent Clchannels, volume-activated Clchannels, stretch-activated cation channels and one carrier mediated transport mechanism-Na + K + adenosine triphosphatase. Conclusion. Numerous diseases of the cardiovascular system may be a consequence, but also the cause of the endocardial endothelium dysfunction. Selective damage to the endocardial endothelium and subendocardium is found in arrhythmia, atrial fibrillation, ischemia/reperfusion injury and heart failure. Typical lesions of endocardial and microvascular endothelium have also been described in sepsis, myocardial infarction, inflammation and thrombosis. The result of endothelial dysfunction is the weakening of the endothelial barrier regulation and electrolyte imbalance of the subendocardial interstitium.
Introduction/Objective. Vitamin D not only plays a role in calcium and phosphorus metabolism, but also has antiproliferative, prodifferentiation, anti-inflammatory and immunomodulatory effects. The aim of this study was to investigate the association between vitamin D deficiency in individuals with autoimmune Hashimoto's thyroiditis. Methods. A total of 156 patients were enrolled and divided into two groups. First group included 108 patients with 25(OH) D insufficiency, and second included 48 individuals with normal 25 (OH) D levels. All participants underwent a detailed clinical examination, laboratory tests for thyroid function (T3, fT4, TSH, thyroid antibodies (TPO-Ab, and TG -Ab)), as well as ultrasound scanning (thyroid volume and Doppler characteristics). Results. The patients with vitamin D insufficiency (n = 108 (69.2%)) were predominantly female and had a higher BMI than the patients with normal vitamin D levels. The group with vitamin D insufficiency had statistically significantly higher TSH levels. The prevalence of positive thyroid antibodies was higher in the vitamin D insufficiency group, while thyroid volume, ATS, and ATI resistance index, as well as the prevalence of positive CD signals, were significantly higher in the vitamin D insufficiency group. 44 of the 156 subjects were diagnosed with thyroiditis (28.2%). The mean serum level of 25 (OH) D was statistically notably lower in patients with thyroiditis [20.23 ? 8.10 ng / mL)] than in the group without thyroiditis [(25.44 ? 8.38 ng/mL)], p < 0.001. Conclusion. There was an association between vitamin D insufficiency and hypothyroidism in subjects with Hashimoto's thyroiditis.
SUMMARYOne of the best-studied responses of cognitive evoked potentials is a so-called "P300", the late positive wave complex that occurs about 300-500 ms after the stimulus. It is obtained when the subject's attention is focused on a signal that is rare, especially if the signal has a motivational or emotional meaning. In the study of P300 potential, we followed the variations of potential amplitude and latency, so the objective was to examine whether there is a difference in Fz and Cz amplitudes of auditory induced cognitive evoked P300 potential depending on the performance of oddball tasks, both in male and female subjects. The study included 60 subjects (30 female respondents and 30 male respondents). P300 potential is induced by the auditory "oddball" paradigm with 80% of non-target and 20% of target stimuli that are presented to the patient through headphones. The target tones are high tones of 2000 Hz. The standard, 1000 Hz tones the respondent should ignore but when he hears the target tones the respondent should press the button on the special handle. The value of Fz and Cz amplitudes both in male and female subjects obtained in the classical "oddball" paradigm when the subject reacted to the signal by pressing the key with the dominant (right) arm were statistically significantly lower (p>0,05) than the values of Fz and Cz amplitudes obtained when the key was pressed by the non-dominant hand. Based on this experiment it can be concluded that both in male and female subjects the performance of oddball tasks does not affect the amplitude of P300 cognitive evoked potentials.
Background/Aim. While the mechanisms responsible for the beneficial effects of aerobic exercise training on cardiovascular function are well known, detraining effects on myocardial parameters has not been adequately elucidated. Therefore, the study aimed to determine the occurrence and speed of cardiac adaptation reversibility after the cessation of aerobic exercise, and also to reveal gender differences in achieved effects of training/detraining. Methods. Female and male Wistar albino rats were divided into following groups: control, trained and two detrained groups. Hearts were perfused according to Langendorff technique and cardiodynamic parameters: maximum and minimum rate of pressure development in the left ventricle (dp/dt max, dp/dt min), systolic and diastolic left ventricular pressure (SLVP, DLVP), heart rate (HR) and coronary flow were determined. Results.Training significantly reduced values of dp/dt max, dp/dt min and SLVP in males and females and coronary flow in males. Detraining caused reversion of those changes, which was gender specific. In females, levels of SLVP were higher after 4 weeks of detraining than training and 2 weeks of detraining. Values of SLVP were lower in both detraining periods compared to training in males. While males had higher coronary flow after 2 weeks of detraining, it was reduced in the 4 th week of detraining in females. Conclusion:Present study by using a model of the isolated rat heart confirmed existence of traininginduced changes in cardiac function. Cessation of training was followed by the loss of those adaptations, faster in males than females. Apstrakt Uvod/Cilj. Dok su mehanizmi odgovorni za blagotvorno dejstvo aerobnog treninga na funkciju kardiovaskularnog sistema dobro poznati, efekti detreninga na parametre srčane funkcije nisu dovoljno razjašnjeni. Studija je imala za cilj da utvrdi pojavu i brzinu reverzibilnosti srčane adaptacije nakon prestanka aerobnog treninga, kao i da otkrije postojanje razlike među polovima prilikom treninga/detreninga. Metode. Wistar albino pacovi (ženke i mužjaci) su svrstani u sledeće grupe: kontrolna, trening i dve detrening grupe.Izolovana srca su perfundovana po Langendorff tehnici pri čemu su praćeni sledeći kardiodinamski parametri: maksimalna i minimalna stopa razvoja pritiska u levoj komori (dp/dt max, dp/dt min), sistolni i dijastolni pritisak u levoj komori (SLVP, DLVP), frekvenca srca (HR) i koronarni protok. Rezultati. Trening je značajno smanjio vrednosti dp/dt max, dp/dt min i SLVP kod mužjaka i ženki kao i koronarni protok kod mužjaka. Detrening je doveo do polno zavisnog vraćanja vrednosti postignutih tokom treninga. Kod ženki, nivo SLVP je bio viši nakon 4 nedelje detreninga nego u treningu i 2 nedelje detreninga. Vrednosti SLVP su bile niže u oba perioda detreninga u poređenju sa treningom kod mužjaka. Mužjaci su imali veće vrednosti koronarnog protoka nakon 2 nedelje detreninga dok se koronarni protok smanjio u 4 nedelji detreninga kod ženki. Zaključak. Ovim istraživanjem smo na modelu izolovanog srca pacova po...
SUMMARYDisturbances of thyroid function are often accompanied by cognitive and affective disorders. Assessment of cognitive status in the patients with subclinical hypothyroidism represents a possibility for early diagnostics of cognitive impairment and timely introduction of necessary pharmacotherapy treatment. The aim of this study was to quantify whether there are P3 event related potential (ERP) deviations as electrophysiological markers of cognitive activity in patients with subclinical hypothyroidism. P300 potentials were examined in thirty patients with subclinical hypothyroidism and in 30 healthy subjects of the control group. P300 was recorded using the classic auditory oddball paradigm, with 20% of target and 80% of non-target stimuli. The results analysis showed a significantly longer latency P300 and reduced amplitude P300 in subjects with subclinical hypothyroidism compared to euthyroid subjects. There is also a statistically significant negative correlation between the results of a mini mental state examination and the P300 latency at Fz electrode (r= -0.47, p <0.01) and Cz electrode (r= -0.43, p =0.017). P300 ERP is important in the evaluation of patients with subclinical hypothyroidism, due to the sensitivity in the detection cognitive disorders.
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